The authors of the study are: Samantha Crowley, MD, MPH; Sarah D. Hohl, MPH, PhD; Hazel Behling; John Eich; Gary D. Gilmore, MPH, PhD, MCHES; Jonathan Temte, MD, PhD

Read the study here. 

Taking action to prevent or minimize the impending surge in hospitalizations and deaths is the responsibility of all Wisconsinites. We can all do our part to slow the spread of Omicron by collectively taking several simple actions. These include:

• Getting vaccinated for COVID-19, including a booster dose as soon as you are eligible.
• Wearing a well-fitting mask in indoor spaces when others are present who do not live with you.
• Celebrating safely over the holidays by keeping gatherings small, getting tested before visiting others, and staying home if you test positive or have any symptoms.

Further information regarding the Wisconsin Department of Health Services (DHS) recommendations to reduce the spread of COVID-19 is outlined below. All Wisconsinites should follow these actions to protect themselves, and those most vulnerable in our communities, against COVID-19. We all have a critical role to play in stopping the spread of COVID-19. For more information about how to stay protected and stop the spread of COVID-19, call 211, or contact your local health department.

Get vaccinated against COVID-19. Vaccination remains essential to protecting your health and slowing the spread of COVID-19. While cases of the Omicron variant are growing, the overwhelming majority of COVID-19 infections in Wisconsin are still being caused by the Delta variant. The authorized COVID-19 vaccines remain highly effective at preventing severe disease and death from DPH Memo Page 2 of 2 Delta. Evidence also suggests that fully boosted people are protected against serious illness and hospitalization from Omicron. Everyone ages five and older is eligible to get vaccinated against COVID-19. Boosters are also available for everyone ages 16 and older. If you need help finding a vaccine, visit:

• COVID-19: Find a Vaccine Appointment (Wisconsin Department of Health Services)
• Vaccines.gov – Find COVID-19 Vaccines
• Covid-19 Vaccination Special Event directory provided by 211 Wisconsin

Wear a mask. Mask wearing is advised for everyone ages two and older at indoor gatherings, regardless of vaccination status. Given high rates of COVID-19 transmission currently occurring in all 72 counties, and given the emerging evidence that the Omicron variant is more contagious than the Delta variant, DHS advises that everyone should wear a well-fitting mask in all public indoor settings. Masks continue to be an effective strategy to prevent COVID-19 infection.

Get tested for COVID-19. Anyone with signs or symptoms of COVID-19 should get tested, regardless of their vaccination status. If you are exposed to COVID-19, get tested five to seven days after exposure. If you are experiencing COVID-19 symptoms, stay home while you are waiting for your results. Trusted testing partners include health care providers, local health departments, and community testing sites. At home COVID-19 tests can also be used before gathering with family and friends. DHS currently provides free at-home collection kits, a type of at-home test, for all Wisconsinites.

DHS also recommends that everyone continue to complete the appropriate quarantine or isolation guidance after being exposed to, or diagnosed with COVID-19. Due to the large numbers of cases, not everyone who has COVID-19 or is exposed will get a call from public health. Individuals can assist public health efforts by informing their close contacts who were exposed to COVID-19.

Special considerations for holiday gatherings. To prevent the spread of disease, gatherings outside of your immediate household should remain small. It is important for individuals to know whether they have an active COVID-19 infection before gathering. Consider getting tested before spending time with others outside of your household. Gatherings should also occur in well ventilated spaces and are always safer outdoors.

People who are immunocompromised should wear a mask, and take additional precautions like getting tested for COVID-19 before a gathering. Everyone should wear a well-fitting mask if you are celebrating with someone who has a weakened immune system, is at an increased risk of severe disease, or is unvaccinated. Getting tested for COVID-19 before gathering with groups from different households, including if you are traveling, can reduce the risk of spreading COVID-19 to friends and family.

Please, click here for the DHS Media briefing held on 12/20.

Thank you for all you do in public health and for the Wisconsin Public Health Council to recognize our workforce.

Click here for the resolution

Absent this type of self-assessment, public health measures will fall short and exclude the most vulnerable. A visible, recent example of this is the failure to track racial demographic data at the start of the COVID-19 pandemic. Though not explicitly stated, the working theory underlying this massive misstep is that race is irrelevant, or at least of minimal relevance to quelling the pandemic. This is despite widespread evidence pre-COVID-19 that racial inequalities are intertwined with inequities in food, education, housing, work, mental health support, and numerous other examples. These same inequalities have been exacerbated during the pandemic with additional disparities in morbidity and mortality. Had government agencies questioned the assumption that mitigating the pandemic could be achieved without explicit attention to race, this misstep may have been avoided. This is just one example of how unacknowledged theories, in this case on the salience of race to the COVID-19 pandemic, nonetheless directed practice.

Even now, the assumed irrelevance of race continues to inform pandemic responses in ways that exacerbate existing inequities. For example, Ruqaiijah Yearby and Seema Mohapatra have illuminated how emergency response has been rooted in structural discrimination through upstream “unfair laws and policies” impacting workers in the home health care and meat-processing industries. Yearby and Mohapatra identify laws—designation of essential workers, limitations in CARES Act protections, invocation of the Defense Production Act—that have been enacted in ways that harm low-paid workers, especially women of color and immigrants, in the absence of other efforts (e.g., paid sick leave, childcare for essential workers) to address racial and other inequities impacting these workers.

These examples illustrate that our search for practical law and policy solutions must start with critical and open curiosity about the theories we consciously (and unconsciously) adopt. Only then is there a strong basis to implement reforms based on well-reasoned and empirically grounded criteria that will not simply reproduce a social system that makes minor improvements at the margins but maintains a deeply racialized structure. It is in this light that I propose two theoretical starting points that can inform good practice.

The first starting point is to recognize that race is a social institution not a “natural” category. That is, racial categories do not delineate objective, inevitable, or essential distinctions between human beings. It might seem odd to label this as “theory” because it is a position that is now so widely accepted. But identifying it as a theoretical starting point forces us to begin with a fundamental question: as a social institution, what is the work that race is doing?

A recent New York study, for instance, concluded Black people were not “inherently more susceptible to having poor COVID-19 outcomes” and even had lower mortality rates than white people “if Black patients make it to the hospital.” The authors “inferred that the higher mortality noted in Black populations could largely be attributed to higher out-of-hospital deaths” which in turn “could certainly be explained by the lower neighborhood SES [socioeconomic status] noted in Black communities.” This study indicates that the work that race is doing within communities is to function as a “plus” or “minus” factor for who will ultimately get through the hospital door and even live. It would be a mistake to conclude that race is reducible to SES. At minimum because SES in our society is color-coded and racial disparities do not simply disappear up the SES ladder. Instead, treating race as its own impactful social institution will cause us to start asking the right questions. That is, it will immediately raise questions about race’s relationship with other social and political institutions—even when those other institutions seem race neutral on the surface.

Second, intersectionality theory generally calls attention to the fact that individuals often experience multiple forms of oppression that are not reducible to just one aspect of one’s identity (e.g., race or gender). Kimberly Crenshaw provides an analogy to

traffic in an intersection, coming and going in all four directions. Discrimination, like traffic through an intersection, may flow in one direction, and it may flow in another. If an accident happens in an intersection, it can be caused by cars traveling from any number of directions and, sometimes, from all of them.

Crenshaw later explained that intersectionality theory captures how one’s location at an intersection: uniquely shapes individuals’ experiences, has been marginalized by an inability of others to identify and articulate these experiences, and has been obscured by our cultural construction of these individuals. Importantly, intersectionality theory points not just to individuals’ personal definitions of their identity, but to how that identity is socially construed and, in turn, interacts with other institutions.

Intersectionality theory reminds us not to approach public health solutions with overly simplistic categories that reduce inequities to race or gender or class or rurality or LGBTQ status or veteran status. Such models fail to recognize how these factors interact to create unique obstacles that hinder the ability of individuals and communities to truly be healthy.

Tying theory back to practice, here are examples of where intersectional work is being pursued:

• An examination of the traumatic experiences of GBQ boys and young men of color advocating that we “no longer view the racial, gender and sexual identities of these young men as separate and unrelated aspects of their existence;”
• An assessment of how an intersectional framework can address mental health disparities in Latino/a groups;
• The creation of breastfeeding campaigns that account for historically rooted stereotypes of Black women as bad mothers and their continued impacts;
• A call to tackle the link between climate change and gender-based violence, including intersections with rurality, forced migration, and discrimination against indigenous communities;
• A state-formulated equity framework addressing COVID-19 response and recovery stating that an intersectional perspective must center equity in planning and response efforts; and
• A Black Emotional and Mental Health Collective (BEAM) that provides tools and trainings on “Social Justice Informed Mental Health Literacy,” which recognizes the relevance of factors like “HIV/AIDS, transphobia, homophobia, racism, misogynoir” and ableism.

In conclusion, I have used the term “theory” to refer to the norms, assumptions, and values that are built into practice, which can be overt and consciously thought out, or, covert and invisible even to those who advocate for their implementation. In the quest to develop practical strategies to address systemic racism, it is of critical importance that we recognize that: (1) our practices are always informed by theory (whether good or bad); (2) if we are not self-conscious about the theories we have internalized, we will unquestionably exacerbate inequalities or at minimum ensure their continued existence; and (3) self-reflective theory is the necessary starting point of good practice.

I have highlighted two theoretical grounds that will help inform good practice: viewing race as a social (not natural) institution and using an intersectional lens. Both raise important questions for public health interventions, including: What is the work that is race doing? What communities are being targeted for assistance? What active efforts are being made to uncover intra-group differences?  How are the experiences of marginalized community members being incorporated? How is that knowledge treated? Asking these types of questions is how theory drives change in the right direction.

This post written by April Shaw, Staff Attorney, Network for Public Health Law – Northern Region Office. The Network for Public Health Law provides information and technical assistance on issues related to public health.

The legal information and assistance provided in this document do not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state. Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF. 

Gov. Evers Announces Wisconsin PFAS Action Council Releases PFAS Action Plan

Action Plan includes 25 action items for addressing emerging chemicals

MADISON —Gov. Evers today announced the release of a statewide PFAS Action Plan developed by nearly 20 state agencies to address growing public health and environmental concerns regarding PFAS (per- and polyfluoroalkyl substances) in Wisconsin. The plan includes 25 action items centered around three guiding principles: environmental justice, health equity, and pollution prevention.

Wisconsin’s PFAS Action Plan was developed at the direction of Gov. Evers, who in 2019 issued Executive Order #40, requesting that the Department of Natural Resources (DNR) lead a PFAS coordinating council, charged with creating a plan of action to address the environmental and public health risks posed by PFAS contamination. The Wisconsin PFAS Action Council (WisPAC) was created to fulfill this order, comprising representatives from nearly 20 state agencies and the University of Wisconsin System.

Wisconsin is now one of less than a dozen states in the nation to have developed a plan to address the use of and contamination caused by PFAS.

“I am proud of the efforts from our state agencies and the contributions by the public to connect the dots and develop this comprehensive blueprint for our state to address these forever chemicals,” Gov. Evers said. “I look forward to evaluating the plan and the dozens of recommendations provided to find how we can best move our state forward in addressing PFAS for the health of our families, communities, and wildlife.”

PFAS are a group of over 5,000 human-made chemicals that were invented in the 1930s. They were introduced into industrial manufacturing and commercial use in the 1940s, with peak production occurring between 1970 and 2000. PFAS are primarily found in temperature-resistant and water- and oil-repellent products, including nonstick cookware, food packaging, waterproof clothing, stain-resistant fabrics, and certain types of firefighting foam.

PFAS do not break down in the environment and have been discovered at levels of concern in groundwater, surface water and drinking water across Wisconsin. PFAS are known to bioaccumulate in the tissues of fish and wildlife. They also accumulate in the human body and pose a number of risks to human health.

Gov. Evers and WisPAC are grateful for the input offered by individuals, organizations, and advisory groups throughout 2020. Going forward, the PFAS Action Plan will serve as a blueprint for the state in its efforts to tackle environmental and public health concerns posed by PFAS contamination.

To learn more about the work of the Wisconsin PFAS Action Council and read the complete action plan, please visit the DNR website: https://dnr.wisconsin.gov/topic/Contaminants/WisPAC.html.

Working with partners and their communities, public health departments provide expertise, data and population health services as they serve as key leaders in improving the health and well-being of communities. To demonstrate accountability and adopt cultures that promote continuous performance improvement, many health departments strive to achieve national accreditation. Today, the Public Health Accreditation Board (PHAB) is pleased to announce the names of four public health departments that have achieved accreditation or reaccreditation status, after completion of a systematic review process against national standards. These health departments have successfully demonstrated a commitment to a focus on accountability, equity and performance as they work to improve the health of their communities.

PHAB, the nongovernmental, nonprofit organization that administers the national accrediting program, works to improve and protect the health of the public by advancing and transforming the quality and performance of governmental public health departments in the United States and abroad.

“PHAB is incredibly proud of the four health departments awarded accreditation and reaccreditation this November,” said Paul Kuehnert, President and CEO of PHAB. “It is important to shine a light on this important work, especially during such challenging times, as we recognize their achievement in advancing public health practice through continuous quality improvement and using accreditation to transform their communities.”

“We have reached an important milestone for Ross County in our achievement of PHAB accreditation. This achievement moves us closer to our vision of strong partnerships, healthy communities and healthy people,” said Garrett Guillozet, Health Commissioner for the Ross County Health Department in Chillicothe, Ohio. “As we reflect on the hard work it took to get here, we are grateful to our partners and community for their continued commitment to public health and invite them to join us in celebrating this bright spot during a particularly challenging time for all.”

“The Central Michigan District Health Department could not be more proud of being recognized for reaccreditation this week. As one of the early adopters in the country to be nationally accredited, we continue on our performance improvement journey, the importance of which has been highlighted during the pandemic,” said Steve Hall, Health Officer. “I applaud our entire team, our partners and our community for their commitment to safeguarding public health and the environment.”

PHAB, the nonprofit organization that administers the national public health accreditation program, aims to advance and transform public health practice by championing performance improvement, strong infrastructure, and innovation. Launched in 2011 with support from the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, PHAB's accreditation program has become the national standard for public health in the United States.

National reaccreditation was awarded November 13, 2020 to:

• Central Michigan District Health Department, Mount Pleasant, MI
• El Paso County Public Health, Colorado Springs, CO

National initial accreditation was awarded November 13, 2020 to

• Ross County Health District, Chillicothe, OH
• Unified Government Public Health Department, Kansas City, KS

For more information, contact Jessica Solomon Fisher at jfisher@phaboard.org. Learn more about PHAB and accreditation at http://www.phaboard.org. Be in the know: subscribe to PHAB's e-newsletter.

About the Public Health Accreditation Board
The Public Health Accreditation Board (PHAB) was created to serve as the national public health accrediting body and is funded in part by the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation. The development of national public health accreditation has involved, and is supported by, public health leaders and practitioners from the national, state, local, Tribal, and territorial levels.

These funding opportunities span AHW’s four pathways through which we work to advance health in Wisconsin, with funding available to accelerate biomedical research and population health studies, advance innovations in health education and workforce development, and support changes to policies and systems that impact health across the state.

In addition to these funding opportunities, we are also seeking individuals with a broad range of expertise to serve as merit reviewers for each RFA. This is a great opportunity for those not applying to help guide AHW’s funding awards.

View Flyer

July 16 | 1:00 – 2:30 p.m. ET

Overview

WPHA and WALHDAB lobbyists will distribute the attached written testimony in support of the amendment to committee members at tomorrow's hearing. The testimony endorses the amendment while pointing out that more needs to be done to execute a comprehensive approach to this public health concern.

The Overdose Data to Action Community Prevention Grants Program is funded by the Centers for Disease Control and Prevention.  Strengthening and enhancing the capacity of communities is the goal of this funding opportunity. Emphasis will be placed on promoting strategies and activities that build local capacity to prevent morbidity and mortality associated with opioid overdoses. These include strategies that prevent opioid overuse, misuse, use disorder, overdose, and opioid-related harms.

Letters of intent are requested by February 3, 2020.

The application deadline is March 3, 2020.

Anticipated contract start date is May 1, 2020.

Please distribute this announcement widely through your networks.

Virtual Information Sessions

Virtual information sessions regarding submitting a successful application are scheduled for:

January 23, 2020 at 2 p.m.

January 30, 2020 at 10 a.m.

You may send questions to be answered during the sessions to Betsy Swenson.  A frequently asked questions document will be made available following the virtual sessions.

The Wisconsin Department of Health Services (DHS) Overdose Data to Action Program will be announcing a funding opportunity in January 2020. Eligible applicants include: local health departments, tribal health clinics, cities, counties, and community-based non-profit organizations.

The Overdose Data to Action Community Prevention Grants Program is funded by the Centers for Disease Control and Prevention. The goal of this funding opportunity is to strengthen and enhance the capacity of communities. Emphasis will be placed on promoting strategies and activities that build local capacity to prevent morbidity and mortality associated with opioid overdoses.

Proposed multi-sector, community-level strategies must address at least one of the following focus areas: support the ability to collect, analyze, and apply data; enhance linkages to care; support projects that build partnerships with public safety and first responders; and empower individuals to make safer choices.

This is a multi-year funding opportunity. Renewal funding is based on successful performance and the availability of funds to DHS from a federal funding appropriation. It is anticipated the first contract period will run from May 1, 2020 to August 31, 2020. Renewal contract periods for the following two years will be from September to August, with the entire project ending August 31, 2022. We anticipate funding 10-15 projects with $55,000-$85,000 per year (prorated for year one).

Be on the lookout for the request for application in January 2020.

Questions: Betsy Swenson

Register now for PHAB’s next webinar on the topic of “Building Your Accreditation Team.” To be held May 10, 2018, from 3 – 4 p.m. Eastern Time, this PHAB webinar will provide first-hand perspectives that will assist participants to:

• Explore various approaches to organizing the accreditation team effort within a health department,
• Describe strategies that accredited health departments have used to build and develop an accreditation team,
• Discuss effective strategies for engaging and developing accreditation team members; and
• Describe the long-term value provided by a health department accreditation team.

Presenters will include PHAB staff, as well as individuals leading accreditation efforts in two local health departments: Robert Hines, Houston Department of Health and Human Services, Houston, TX; and Brittany Parker, Franklin County Health Department, Frankfurt, KY.

Click here to register.  For questions, please contact Shirley Orr, shirleyaorr@gmail.com.

Webinar ID: 950-852-627: This webinar will be archived on the PHAB website following broadcast.

WEHA consists of environmental public health professionals in the public, private and academic sector throughout the state. Even with the diverse professional background, WEHA share one common thread: to improve the health and well-being of Wisconsin residents by focusing on environmental and public health issues.

The Environmental Health Professional of the Year Award recognizes an individual for their contributions and commitment to environmental and public health.  The recipient of this award will personify our dedication to serve and protect the citizens of Wisconsin from the health risks posed by the environment in which we live.  Peers, management or the community at large can nominate an individual. 

This is an ideal time to recognize a staff member for their outstanding and committed work to the profession of environmental public health.  Take the time to nominate a deserving individual for this distinguished award. Nomination materials can be found at http://www.weha.net/awardsandscholarships.php. The deadline to submit materials is September 1, 2017. 

Fair Exhibitor - Interested in exhibiting at the event? Sign up here. 

Who should consider exhibiting at this fair? We are looking for a variety of public health focused organizations who have interest in the Diversity Matters mission of a sufficient and diverse public health workforce in Wisconsin.

We are looking for public health/health care organizations who are willing to offer development opportunities to high school and college students through internships, volunteer opportunities or careers. We also strongly encourage public health focused academic programs to consider exhibiting at this fair. 

Fair Promotion

Consider sharing the fair flyer with students, co-workers or other organizations who may be interested in learning more about the upcoming fair.

This event is hosted by  Diversity Matters -  a statewide initiative with the goal of increasing the diversity of Wisconsin’s public health workforce by inspiring African American and Hispanic students in middle school, high school and college to pursue a career in public health. Diversity Matters is funded wholly by the Advancing a Healthier Wisconsin Endowment at the Medical College of Wisconsin.

Questions? Reach out to Ashley at Ashley@badgerbay.co or 920-560-5640.

In June 2015, the Board of Directors of the Public Health Accreditation Board (PHAB) adopted a new Guide to National Public Health Department Initial Accreditation (PHAB Guide). While the overall process for accreditation has not changed, there are several new and revised policies that health departments working toward accreditation need to understand. PHF and PHAB are co-hosting a webinar to address these important changes, most of which went into effect earlier this year on February 1. The webinar will be held on August 17, 2016, from 1-2:30pm ET. Titled "Practical Application of the Updated PHAB Guide," this webinar will help participants learn about what has changed in the accreditation process and how to apply a performance improvement mindset to the accreditation preparation process. Register today.

www.phf.org

October 19, Wisconsin Health News

Wisconsin outperforms the national average in 36 out of 54 measures studied by the University of Wisconsin Population Health Institute in a new report. 

The report compares Wisconsin to the national average and Minnesota, which has similar demographics and comparable size. The state outperformed both on 10 health indicators including adults meeting recommended levels of physical activity, the percent of children without health insurance and overall quality of healthcare.

But Wisconsin had a higher suicide rate, a greater percentage of children in poverty and a higher rate of preventable hospitalizations than its neighbor.

The Institute’s October 2015 Report “Opportunities to Make Wisconsin the Healthiest State” available online (link).

From the funding announcement:

“Through this grant opportunity, county, municipal, or tribal governments will use 2015 County Environmental Health Profile data to identify and address environmental health concerns in their jurisdiction.  Based on identified concerns, grantees will develop and implement local initiatives related to environmental health in their communities.”   We will be awarding up to 8 projects, each up to $10,500. 

Environmental topics covered under this funding opportunity that are especially relevant to tobacco prevention folks include lung cancer, asthma,  low birth weight, and preterm birth, just to name a few.

September 18, Wisconsin Health News

Attorney General Brad Schimel announced a statewide marketing campaign Thursday to raise awareness of the dangers of misusing opioid pain medications and encourage communities to tackle the problem. 

"This is a message of hope and prevention," Schimel said. "We can win this battle and make our state safer and healthier."

The "Dose of Reality" campaign includes TV and radio spots. A new website launched yesterday and contains a  map showing locations of the Department of Justice's drug take back day on Oct. 17. 

Department of Health Services Secretary Kitty Rhoades said opioid painkiller overdoses in the state accounted for 45 percent of the 843 overdose deaths in 2013.

"This is truly a public health crisis, and one that can be eliminated through sharing information about the risks involved in misusing these medications," Rhoades said in the statement. 

The Wisconsin Hospital Association and the Wisconsin Medical Society applauded the effort.

"Wisconsin's hospitals and their emergency departments all too often see the terrible effects of prescription painkiller abuse in our communities, and have been working within their organizations and communities to combat the problem,"  WHA CEO Eric Borgerding said in a statement.

"This epidemic affects people in every demographic throughout our state - all ages, all incomes, all races and all geographies," Dr. Jerry Halverson, society president, said in a statement. "No one can afford to sit on the sidelines if we are to bring this crisis under control."