Community Health Improvement Plan 2011-2015 - West Allis-West Milwaukee
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West Allis-West Milwaukee
Community Health
Improvement Plan
2011-2015
V: 09192011Introduction
This document marks the third comprehensive Community Health Improvement Plan (CHIP) for
the West Allis and West Milwaukee communities providing a blueprint for community action
through the year 2015. The process framework used for the development of the West Allis-
West Milwaukee Community Health Improvement Plan 2015 was MAPP (Mobilizing Action
through Planning and Partnerships), available through NACCHO (National Association of County
and City Health Officials). MAPP is a community driven strategic planning process designed to
improve community health. This interactive process, facilitated by public health leaders, helped
the community prioritize public health issues and identify resources to address them. For more
information regarding the MAPP process, see the MAPP website:
http://www.naccho.org/topics/infrastructure/MAPP/index.cfm.
The West Allis-West Milwaukee Community Health Assessment was completed in 2010. This
document was a thorough report of community health, assets, challenges, barriers, and
resources. Each of the four assessments: Local Public Health System Assessment, Community
Themes and Strengths Assessment, Forces of Change Assessment, and Community Health
Status Assessment gathered data to thoroughly analyze the community’s health.
A Community Health Improvement Planning Team was convened in 2011 to provide oversight
for the development of the 2015 West Allis-West Milwaukee Community Health Improvement
Plan. Team members consisted of:
Terry Brandenburg, MPH, CPH – West Allis Health Department
Melissa Hanson, RN – West Allis Health Department
Shawne Johnson, RN, MPH – West Allis Health Department
Sally Nusslock, RN – West Allis Health Department
Mary Sue Oppermann, RN, MPH – West Allis Health Department
Geyla Savic – West Allis Health Department
The process of developing the West Allis-West Milwaukee Community Health Improvement
Plan 2015 began with the formation of a Steering Committee consisting of a broad array of
community stakeholders. This committee met to review and analyze the findings of the
Community Health Assessment 2010, review the accomplishments of the Community Health
Improvement Plan 2010, receive an overview of the Public Health Preparedness Program for
the Milwaukee/Waukesha County Consortium, design the structure of CHIP 2015, develop a list
of top health priorities for the community, and set in motion a process for workgroups to create
achievable, measurable objectives for the community to complete by the year 2015.The Steering Committee recommended nine health priorities critical to improving the community’s health: • Access to Care • Alcohol and Other Drug Use • Emotional Well Being • Health Communications • Healthy Homes • Healthy Lifestyle • Obesity • Safety and Injury • Unhealthy Aggressive Behaviors Workgroups were formed around each of the nine priorities determined by the Steering Committee. Facilitators guided each workgroup to develop SMART (specific, measurable, achievable, relevant, and time-framed) objectives and determine appropriate agencies willing to take responsibility for measuring progress and achieving completion. In addition, each workgroup was provided with current state and/or federal objectives related to their assigned priority. The workgroups were asked to consider these and incorporate them when formulating new objectives for the community. The Steering Committee subsequently finalized and approved the 2015 West Allis-West Milwaukee Community Health Improvement Plan.
Acknowledgements Steering Committee Steve Bane ................................................................ Assistant Fire Chief, City of West Allis Jeannette Bell................................................................... President, West Allis Rotary Club Terry Brandenburg................................................ Health Commissioner, City of West Allis Dan Devine.....................................................................................Mayor, City of West Allis Kim Eagan ..........................................................Administrator, Village of West Milwaukee MaryCay Freiberg ....................................................... Member, West Allis Board of Health Mickey Gabbert .....................Manager Chemical Dependency, Rogers Memorial Hospital Ron Hayward ............................................................President, Village of West Milwaukee Mike Jungbluth ..................................................................... Police Chief, City of West Allis Rick Kellar ............................................................... CEO, Aurora West Allis Medical Center Joe Kempen ............................Member Hospital Board, Aurora West Allis Medical Center Susan Lockman................................................................. Pastor, United Methodist Church Lydia Lopez ..........................................................................................................Promotora Joanie Luedke ................................................President, West Allis Chamber of Commerce Kathy Schneider .................................................................. Greater Milwaukee Free Clinic Mary Steinbrenner..............................Marketing Director, Meadowmere, Mitchell Manor John Stibal ............................................................. Dept of Development, City of West Allis Kurt Wachholtz ..................... Superintendent, West Allis-West Milwaukee School District Marty Weigel ........................................................................... Alderman, City of West Allis Access to Care Yvonne Duemke ................................................................... West Allis Health Department Kitty Dufek-Maier ................................................................. West Allis Health Department Melissa Hanson* ................................................................... West Allis Health Department Shawne Johnson* ................................................................. West Allis Health Department Lydia Lopez ..........................................................................................................Promotora Kim Melcher.....................................................................Aurora West Allis Medical Center Kathy Schneider .................................................................. Greater Milwaukee Free Clinic Alcohol and Other Drug Use Steve Bane .................................................................................West Allis Fire Department Steve Beyer ............................................................................ West Allis Police Department Mickey Gabbert .......................................................................... Rogers Memorial Hospital Shawne Johnson ................................................................... West Allis Health Department
Tammy Molter* .................................................................................. Community Coalition Duncan Shrout ..........................................................................................................IMPACT Emotional Well Being Steve Bane .................................................................................West Allis Fire Department Janet Gatlin ................................................................................ Rogers Memorial Hospital Beth Heflin* ......................................................West Allis-West Milwaukee School District David Henderson......................................................................................................InHealth Shawne Johnson ................................................................... West Allis Health Department Rod Nelson ............................................................................ West Allis Police Department Mary Sue Oppermann........................................................... West Allis Health Department Jodi Pahlavan .............................................................................. Rogers Memorial Hospital Marsha Wojciechowski ........................................................ West Allis Health Department Health Communications Terry Brandenburg*.............................................................. West Allis Health Department Melissa Hanson ..................................................................... West Allis Health Department Sally Nusslock........................................................................ West Allis Health Department Healthy Homes and Neighborhoods Mary Ann Curtis .................................................................... West Allis Health Department Dan Devine.....................................................................................Mayor, City of West Allis Chad Evenson......................................................................... West Allis Police Department Mary Koller*.......................................................................... West Allis Health Department John Stibal ..............................................................West Allis Department of Development Laura Temke.......................................................................... West Allis Health Department Marty Weigel ........................................................................... Alderman, City of West Allis Healthy Lifestyles Terese Beauchamp*.........................................................Aurora West Allis Medical Center Diane Brandt ...................................................................West Allis Chamber of Commerce Mike Jungbluth ..................................................................... Police Chief, City of West Allis Joe Kempen ............................Member Hospital Board, Aurora West Allis Medical Center Dan Ledvorowski........................................................................West Allis Fire Department Shelly Zajdel .......................................................................... West Allis Health Department
Obesity Jeanne Clark .....................................................................Aurora West Allis Medical Center Cheryl Davies*....................................................................... West Allis Health Department Mary Koller............................................................................ West Allis Health Department Dan Koralewski...................................................................... West Allis Health Department Steve Kosnar ..............................................................................................................Sodexo Shelly Strasser ...................................West Allis-West Milwaukee Recreation Department Jennifer Vaclav* .................................................................... West Allis Health Department Safety and Injury MaryCay Freiberg *..................................................................... West Allis Board of Health Linda Huske ......................................................................... Public Works, City of West Allis Dan Machowski..........................................................................West Allis Fire Department Marilyn Matter...................................................................... West Allis Health Department Mary Sue Oppermann........................................................... West Allis Health Department Brian Saftig ............................................................................. West Allis Police Department Mary Steinbrenner.............................................................. Meadowmere, Mitchell Manor Unhealthy Aggressive Behaviors Robert Fletcher* .................................................................... West Allis Police Department Beth Heflin ........................................................West Allis-West Milwaukee School District Karen Fuerstenau-Zigman.................................West Allis-West Milwaukee School District * Denotes facilitator
Table of Contents
PAGE
NUMBER
Access to Care................................................................................. 1
Alcohol and Other Drug Use............................................................ 4
Emotional Well Being...................................................................... 9
Health Communications................................................................ 14
Healthy Homes and Neighborhoods.............................................. 16
Healthy Lifestyles.......................................................................... 25
Obesity ......................................................................................... 32
Safety and Injury........................................................................... 39
Unhealthy Aggressive Behaviors ................................................... 43ACCESS TO CARE
Access to Care
Background
Access to health services means the timely use of personal health services to achieve the best
health outcomes. This requires three distinct steps:
• Gaining entry into the health care system
• Accessing a health care location where needed services are provided
• Finding a health care provider with whom the patient can communicate and trust1
Currently, access to health care services in the United States is regarded as unreliable; many
people do not receive the appropriate and timely care they need. Furthermore, it is anticipated
there will be an added burden placed on the already strained U.S. health care system when a
projected influx of patients in 2014, will lead to approximately 32 million Americans having
health insurance for the first time.1
Access to health care services can be better understood when broken down into four
components: Coverage, Services, Timeliness and Workforce.
1. Coverage – Adequate coverage helps people to get the health care they need and avoid
the burden of large medical bills.
2. Services – Improving health care services depends in part on ensuring that people have
a usual and ongoing source of care. People with a usual source of care have better
health outcomes and fewer disparities and costs
3. Timeliness – Timeliness is the health care system's ability to provide health care quickly
after a need is recognized. Actual and perceived difficulties or delays in getting care
when patients are ill or injured reflect significant barriers to care.
4. Workforce – The number of practicing primary care physicians can dramatically affect
the general public’s health status.2
In order to access cost effective, quality health care in a timely manner from the appropriate
medical provider, it is extremely important for health care consumers to learn to advocate for
their own health care needs.1 One primary way for a health care consumer to get high-quality
health care is to be an engaged, responsible member of his own health care team and to find,
use, and share information wisely on decisions made regarding his health care.2 A person’s
ability to access adequate and safe healthcare services impacts his overall physical, social and
mental health status, his quality of life and life expectancy.
Resources
1) Access to Health Services. Healthy People 2020. U.S. Department of health and Human
Services. http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=1
Page 1ACCESS TO CARE
2) Agency for Healthcare Research and Quality. Quick Tips When Talking with Your Doctor.
U.S. Department of Health and Human Services.
http://www.ahrq.gov/consumer/quicktips/doctalk.htm
Assessment Data and Objectives
Objective 1: By December 31, 2012, build a network of community partners to designate a
frontline information and referral source for medical, dental and mental health needs in order
to provide up-to-date, appropriate options for accessing health care services.
Baseline: No network in place
Goal: Network in place
This objective will be tracked by the creation of a network of community partners brought
together to develop culturally competent media outreach strategies to increase consumer
awareness of a frontline information and referral source for access to health care services
options.
Strategies/Activities Responsibility How is progress evaluated?
Participate in a collaborative process to Access Meeting notes
identify a frontline information and Workgroup, Area
referral source hospital/clinic(s)
Develop protocol among participating Access Protocol, meeting notes
community partners to redirect consumers Workgroup, Area
to this community resource hospital / clinic(s)
Establish a “no wrong door” policy among Access “No wrong door” policy,
participating community partners Workgroup, Area meeting notes
hospital/clinic(s)
Utilize culturally competent media Access to Health Documentation of media
outreach strategies to increase consumer Care Workgroup outreach strategies or tools
awareness regarding a frontline utilized, educational
information and referral source. Example materials
strategies would include fact sheets,
display boards, and a link on City of West
Allis website providing regularly updated
health care services information
Objective 2: By December 31, 2012, survey 75% of the large medical clinics and dental clinics in
West Allis and West Milwaukee to identify clinic policies regarding reduced fees and payment
plans for self pay patients.
Baseline: No survey completed
Goal: 75% of large medical clinics and 75% of dental clinics will be surveyed
This objective will be tracked by a log of the clinics surveyed.
Page 2ACCESS TO CARE
Strategies/Activities Responsibility How is progress evaluated?
Survey clinics regarding their existing WAHD Percent of clinics surveyed
policies
Develop a spreadsheet to record the WAHD Spreadsheet
payment options for each clinic
Review and distribute payment options WAHD Meeting notes documenting
spreadsheet to the Access to Health Care review and distribution
Workgroup
Objective 3: By December 31, 2014, launch a community education campaign on how to
become a responsible health care consumer.
Baseline: No community health care consumer education campaign currently in place
Goal: Community health care consumer education campaign in place
This objective will be tracked through the implementation of a community education campaign
on how to become a responsible health care consumer.
Strategies/Activities Responsibility How is progress evaluated?
Develop a culturally competent teaching Access Development of a teaching
tool for health care providers to use to Workgroup tool on “How to become a
educate the public on their responsibilities responsible health care
as health care consumers consumer”
Identify underserved or at-risk populations Access List of target populations
to offer this teaching tool Workgroup
Provide training to WAHD, Aurora West Access Record of trainings (include
Allis Medical Center and Greater Workgroup date and number of
Milwaukee Free Clinic staff on how to participants), training
coach clients or patients on their health materials
care responsibilities
Explore meeting with WAWM high school Subgroup of Meeting notes
health teachers to discuss the benefit of Access
adding a component on becoming a Workgroup
responsible health care consumer into
their curriculum
Page 3ALCOHOL AND OTHER DRUG USE Alcohol and Other Drug Use Background Alcohol and other drug abuse is defined as any use of a substance that results in negative consequences. This abuse refers to a set of related conditions associated with the consumption of mind and behavior altering substances that have a negative behavioral and health outcome including, but is not limited to, alcohol, prescription substances, and illegal mood-altering substances.1 Social attitudes and political and legal responses to the consumption of alcohol and illicit drugs make substance abuse a very complex public health issue. Studies have shown that substance abuse is a disorder that develops in adolescence and, for some individuals, will develop into a chronic illness that will require lifelong monitoring and care.2 Substance abuse has a major impact on individuals, families, and communities. The effects of substance abuse are cumulative, significantly contributing to costly social, physical, mental, and public health problems such as teenage pregnancy, domestic violence, motor vehicle accidents, physical fights, crime, homicide, and suicide.2 Alcohol Alcohol-related deaths are the fourth leading cause of death in Wisconsin behind heart disease, cancer, and stroke. Although Wisconsin’s drinking culture is not intentionally harmful, rather, most residents drink responsibly, safely, and legally, this culture is, in many ways, tolerant of excessive, dangerous, unhealthy, and illegal drinking. Alcohol-related societal problems include homelessness, child abuse, crime, unemployment, injury, health problems, hospitalization, suicide, fetal abnormalities, and even early death.1 Youth who drink alcohol are at a greater risk to experience difficulties in school, social problems, legal repercussions, physical problems, and alcohol related unintentional injuries. Youth may also place themselves in high-risk social situations leading to unplanned and unprotected sexual activity, physical and sexual assault, homicide, suicide, abuse of other drugs, and/or death from alcohol poisoning due to their altered judgment related to drinking.3 Marijuana Youth marijuana use is associated with a number of risky behaviors. Teens, 12-17 years of age, who smoke marijuana are more than twice as likely to cut class, steal, fight, and destroy property than those who do not smoke marijuana. Marijuana use can also lead to decreased lung functions and impaired memory.4 Prescription Drug Abuse An emerging area of concern is adolescent abuse of prescription drugs. Prescription drug abuse means taking a prescription medication that is not prescribed for you, or taking it for reasons or in dosages other than as prescribed. This abuse has continued to rise over the past five years in the United States. One factor leading to this increase in abuse is the availability of prescription Page 4
ALCOHOL AND OTHER DRUG USE
drugs from many sources including the family medicine cabinet, the Internet, and doctors. In
addition, many adolescents believe that prescription drugs are safer to take than street drugs.2
Resources:
1) Alcohol and Other Drug Use. Wisconsin State Health Plan: Healthiest Wisconsin 2020.
Wisconsin Department of Health Services.
http://www.dhs.wisconsin.gov/hw2020/pdf/alcohol.pdf
2) Substance Abuse. Healthy People 2020.U.S. Department of Health and Human Services.
http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=40
3) Underage Drinking. Centers for Disease Control and Prevention. U.S. Department of
Health and Human Services. http://www.cdc.gov/alcohol/fact-sheets/underage-
drinking.htm
4) Other Drug Consumption. (2008). Wisconsin Epidemiological profile on Alcohol and
Other Drug Abuse. http://www.dhs.wisconsin.gov/stats/pdf/otherdrug2008/pdf
Assessment Data and Objectives
Objective 1: By April 31, 2012, launch a community education campaign for Alcohol Awareness
Month
Baseline: No community education campaign for Alcohol Awareness Month currently in place.
Goal: Community education campaign for Alcohol Awareness Month in place
This objective will be tracked through the development of a community education campaign.
Strategies/Activities Responsibility How is progress evaluated?
Distribute an alcohol screening and IMPACT, Availability of alcohol
education tool from IMPACT through a WAHD, screening and education tool
variety of venues – Wellness programs, Community
Chamber of Commerce, etc. Coalition,
City of West Allis,
Chamber of
Commerce,
WAWM Schools
Facilitate Mayoral proclamation for WAHD, Mayoral proclamation
Alcohol Awareness Month Community
Coalition
Develop a display board for display in WAHD, Display board
public settings during Alcohol Awareness Community
Month Coalition
Promote the use of the domino strategy to WAHD, Educational materials
educate the community on drinking Community include domino strategy
responsibly Coalition
Page 5ALCOHOL AND OTHER DRUG USE
Objective 2: By September 30, 2012, maintain or increase current levels of compliance with,
and enforcement of, ordinances and laws related to youth substance abuse as measured by
WAPD and WMPD reports in West Allis and West Milwaukee.
Baseline: In West Allis, from 10-1-09 through 9-30-10, there were 47 tobacco compliance
checks and 139 alcohol compliance checks. In West Milwaukee, from 10-1-09 through 9-30-10,
there were no tobacco or alcohol compliance checks.
In West Allis, from 10-1-09 through 9-30-10, there were 78 tobacco citations issued and 16
alcohol citations issued. In West Milwaukee, from 10-1-09 through 9-30-10, there were no
tobacco citations issued and 16 alcohol citations issued.
Goal: Maintain or increase compliance
This objective will be tracked using alcohol and tobacco compliance checks conducted by the
WAPD and WMPD.
Strategies/Activities Responsibility How is progress evaluated?
Enforce compliance of ordinances and WAPD, WMPD Number of compliance
laws related to youth substance abuse checks completed, number
of citations issued
Review reports of compliance with, and Community Review of enforcement
enforcement of, ordinances and laws Coalition reports
related to youth substance abuse
Objective 3: By December 31, 2013, there will be a 3% reduction in age of onset of using
alcohol prior to age 13 years.
Baseline: 26% in 2009
Goal: 23% in 2013
Objective 4: By December 31, 2013 there will be a 3% reduction of use of alcohol in the past 30
days.
Baseline: 44% in 2009
Goal: 41% in 2013
Objective 5: By December 31, 2013, there will be a 3% increase in students’ perception of risk
or harm from using alcohol.
Baseline: 26% in 2009
Goal: 29% in 2013
Objective 6: By December 31, 2013, there will be a 3% increase in students’ perception of
parents’ disapproval of students’ use of alcohol.
Baseline: 41% in 2009
Goal: 44% in 2013
Page 6ALCOHOL AND OTHER DRUG USE
Objective 7: By December 31, 2013, there will be a 3% reduction in age of onset in using
prescription drugs and non prescription pain killers prior to age 13 years.
Baseline: 5% in 2009
Goal: 2% in 2013
Objective 8: By December 31, 2013, there will be a 3% reduction of use of marijuana in the past
30 days.
Baseline: 5% in 2009
Goal: 2% in 2013
These objectives will be tracked using the Youth Risk Behavior Survey (YRBS) to survey 8th-12th
grade WAWM students.
Strategies/Activities Responsibility How is progress evaluated?
Administer the YRBS to 8th-12th grade WAHD Administration of survey
students every two years in the WAWM
School District
Provide information and enhance skills of Community Report of program delivery
youth grades 6-12 via delivery of Coalition,
comprehensive K-12 ATODA prevention WAWM Schools
program
Provide support for youth to make healthy Community Offering of alcohol and drug
choices through alcohol and drug free Coalition, free events
events Community
Alliance Against
Drugs (CAAD)
Provide information to parents, Community Educational materials
community members and youth about Coalition,
underage alcohol, marijuana, and CAAD
prescription drug and non prescription
pain killers abuse
Objective 9: By December 31, 2013, survey and provide education to 100% of the large medical
clinics in West Allis and West Milwaukee regarding prescription drug use and abuse.
Baseline: No survey has been administered
Goal: Survey completed
Objective 10: By December 31, 2013, survey and provide education to 75% of area dental
clinics in West Allis and West Milwaukee regarding prescription drug use and abuse.
Baseline: No survey has been administered
Goal: Survey completed
These objectives will be tracked through the administration and analysis of the survey and the
provision of educational materials.
Page 7ALCOHOL AND OTHER DRUG USE
Strategies/Activities Responsibility How is progress evaluated?
Survey and provide education to large Rogers Hospital, Distribution of survey,
medical clinics regarding prescription drug WAHD, percent of clinics surveyed,
use and abuse Community educational materials
Coalition
Survey and provide education to area Rogers Hospital, Distribution of survey,
dental clinics regarding prescription drug WAHD, percent of clinics surveyed,
use and abuse Community educational materials
Coalition
Objective 11: By December 31, 2015, annually assess and update alcohol and drug abuse
resources available in West Allis and West Milwaukee listed through IMPACT.
Baseline: Resources not updated regularly
Goal: Updated alcohol and drug abuse resources listed through IMPACT
This objective will be tracked through an annual review and update of area alcohol and drug
abuse resources from IMPACT.
Strategies/Activities Responsibility How is progress evaluated?
Request listing of area alcohol and drug WAHD, Annual list of resources
abuse resources from IMPACT Community
Coalition,
IMPACT
Review and update listing of area alcohol WAHD, Memo detailing review and
and drug abuse resources from IMPACT Community updates if any
Coalition,
IMPACT
Page 8EMOTIONAL WELL BEING
Emotional Well Being
Background
Emotional well-being is not the absence of emotions, but rather, it is the ability to understand
the value of emotions and use them to move forward in life in a positive direction. Everyday
emotional well-being also involves identifying, building upon, and operating from strengths
rather than focusing on fixing problems or weaknesses. The better one is able to master
emotions, the greater the capacity to enjoy life, cope with stress, and focus on important
personal priorities.1
The emotionally well person maintains satisfying relationships with others, feels positive and
enthusiastic about oneself and life, manages one’s feelings and related behaviors, realistically
assesses one's limitations, develops autonomy, and has the ability to cope effectively with
stress.1
Parenting
Improving parenting skills is one way to improve emotional wellbeing. Family functioning and
positive parenting can have positive outcomes on the mental health of children. Parents play a
critical role in their child's development. Providing a safe and loving home and spending time
together – playing, singing, reading, and even just talking – can make a big difference in the life
of a child by providing the foundation for emotional wellbeing.2
Infant mental health
Infant mental health (IMH) is synonymous with social and emotional development in young
children. Social and emotional development involves skills such as self-confidence, curiosity,
motivation, persistence, self-control, and trust – all of which affect future learning, growth, and
success. The development of these traits begins in infancy and within the context of
relationships. Emotional and social milestones include a child's ability to experience, regulate
and express emotions, and form close and secure interpersonal relationships. A child's
capacities to identify their own feelings, experience empathy for another and constructively
manage strong emotions are skills that begin in early childhood and support later learning.3
Mental health screenings
Mental health is fundamental to overall health and productivity. Mental health disorders are
real and disabling conditions. Left untreated, mental illness can result in disability and despair
for families, schools, communities and the workplace. Teenage depression is a common cause
of reduced academic achievements, poor attendance, tense or non-existent social
relationships, and substance abuse. Early recognition and treatment, if needed, can help
prevent mental illness from worsening and improve an individual’s chances for recovery.4
Page 9EMOTIONAL WELL BEING
Screening is a safe, effective way of detecting the earliest stages of mental illnesses. The U.S.
Preventive Service Task Force recommends routine screenings for all adults as well as
adolescents between the ages 12-18 years and recommends having systems in place for follow-
up. Asking two simple questions about mood, "Over the past 2 weeks, have you felt down,
depressed, or hopeless?" and "Over the past 2 weeks, have you felt little interest or pleasure in
doing things?" may be as effective as using more formal instruments.5
Trauma exposure
Research shows that trauma can undermine children’s ability to learn, form relationships, and
function appropriately in the classroom. When there is family violence, home is not the safe
haven it is for most children. Adults who should be relied upon for nurturance may actually be a
source of terror, or they may be victims themselves and unable to provide protection. When
the perpetrator of violence is a caregiver – the person in whom a child has placed great trust,
and upon who the child’s very life depends – the betrayal a child experiences can be
devastating. These adverse childhood experiences (ACE) such as physical abuse and neglect,
exposure to domestic violence, parental substance abuse, mental illness, and parental
incarceration, may lead to future injury, violence, substance abuse, and even chronic disease.6
The Wisconsin Department of Public Instruction recommends schools become more sensitive to
the needs of children who have been traumatized by directly, or vicariously, experiencing
violence, homelessness, or loss (or fear of loss) of loved ones.7 Given that law enforcement is
often the first and primary system involved in intervening at these events, it is uniquely
positioned to collaborate with schools to develop innovative approaches to reduce the impacts
of adverse childhood experiences on children’s short and long term health and well being.
Rapid intervention with students and families may prevent the development of stress related
symptoms which can interfere with optimal functioning.6
Resource:
1) The Six Dimensions of Wellness Model. National Wellness Institute, Inc.
www.nationalwellness.org
2) Learn Some Positive Parenting Tips. Centers for Disease Control and Prevention. U.S.
Department of Health and Human Services. http://www.cdc.gov/Features/Parenting/
3) Early Relationships Matter. Wisconsin Alliance for Infant Mental Health. www.wiimh.org
4) Mental Health. Wisconsin State Health Plan: Healthiest Wisconsin 2020. Wisconsin
Department of Health Services.
http://www.dhs.wisconsin.gov/hw2020/pdf/mentalhealth.pdf
5) Mental Health and Mental Disorders. Healthy People 2020. U.S. Department of Health
and Human Services.
http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=28
6) The Effects of Childhood Stress on Health Across the Lifespan. Centers for Disease
Control and Prevention. U.S. Department of Health and Human Services.
http://www.cdc.gov/ncipc/pub-res/pdf/childhood_stress.pdf
Page 10EMOTIONAL WELL BEING
7) Creating Trauma-Sensitive Schools to Improve Learning: A Response to Intervention
Model. Mental Health. Wisconsin Department of Public Instruction.
http://www.dpi.wi.gov/sspw/mhtrauma.html
Assessment Data and Objectives
Objective 1: By December 31, 2012, create a network of community maternal child health
(MCH) providers offering parenting support and education, identify populations experiencing
barriers to parenting support and education, and promote strategies to improve access.
Baseline: No network of community MCH providers currently in place
Goal: Network of community MCH providers in place
This objective will be tracked by the creation of a network of community providers offering
parenting support and education.
Strategies/Activities Responsibility How is progress evaluated?
Convene a group of community MCH WAHD Meeting notes
providers to participate in a collaborative
process to assess the availability, cost,
location, and time commitment of
parenting support and parenting
education
Identify underserved and at-risk parents Network of Meeting notes
who need parenting education and/or community MCH
other supportive services providers
Survey underserved and at-risk parents to Network of Survey
determine what barriers exist that prevent community MCH
them from accessing parenting education providers
and other supportive services
Develop strategies to promote access to Network of Meeting notes
parenting education and other supportive community MCH
services providers
Objective 2: By December 31, 2013, launch a community infant mental health education
campaign.
Baseline: No community infant mental health education campaign currently in place
Goal: Community infant mental health education campaign in place
This objective will be tracked through the implementation of a community mental health
campaign.
Page 11EMOTIONAL WELL BEING
Strategies/Activities Responsibility How is progress evaluated?
Send a minimum of two public health WAHD Training materials
providers to trainings at the Infant Mental
Health Institute in Madison, WI
Trained public health providers will train WAHD List of trainings including
child care providers, SAPP staff and early date, number of
education staff on the topic of infant participants, and target
mental health audience
Objective 3: By December 31, 2012, develop and implement mental health screenings for K-12
students in the West Allis-West Milwaukee School District.
Baseline: Document any tools currently available and/or in use
Goal: Review and pilot chosen screening tools selected for use
This objective will be tracked through the use of mental health screenings in the West Allis-
West Milwaukee School District.
Strategies/Activities Responsibility How is progress evaluated?
Review mental health and substance WAWM Schools Email or memo listing tools
abuse screening tools in use in the WAWM in use
Schools
Research mental health and substance WAWM Schools, Mental Health Workgroup
abuse screening tools appropriate for Mental Health notes
school-age children and adolescents Workgroup
Pilot a new mental health screening tool in WAWM Schools Copy of screening tool
one elementary, intermediate and high
school in the WAWM School District
Objective 4: By December 31, 2015, a shared data system to monitor student attendance,
grades and behavior of students exposed to adverse childhood events to mitigate the harmful
effects of such events will be developed and piloted.
Baseline: No formal shared data system in place
Goal: Formal shared data system in place
This objective will be tracked through a shared data system between the WAPD and the
WAWM School District.
Strategies/Activities Responsibility How is progress evaluated?
Develop data-sharing policies and WAWM Schools Policies and procedures
procedures for students exposed to (Mental Health
trauma Specialist), WAPD
Develop child and adolescent intervention WAWM Schools Protocols
protocols for students exposed to trauma (Mental Health
Specialist)
Page 12EMOTIONAL WELL BEING
Develop parent and family intervention WAWM Schools Protocols
protocols, considering both diversion and (Mental Health
restorative practices Specialist)
Educate local civic, educational, and WAWM Schools Promotional materials
parent organizations about adverse (Mental Health
childhood events and garner support for Specialist)
the initiative
Review and refine the Trauma Card that is WAWM Schools Revised Trauma Card
currently distributed on all police calls (Mental Health
responding to family violence Specialist), WAPD
Page 13HEALTH COMMUNICATIONS
Health Communications
Background
Health communications is the study and use of communication strategies to inform and
influence individual and community decisions that affect health. It links the fields of
communication and health and is recognized as having a vital impact on personal and public
health.1
With the increasing complexity of health information and health care settings, most people
need additional information, skills, and supportive relationships to meet their health needs.
Disparities in access to health information, services, and technology can result in lower usage
rates of preventive services, less knowledge of chronic disease management, higher rates of
hospitalization, and poorer reported health status.2
Health literacy refers to the capacity of individuals to obtain, process, understand and share
basic health information and the services that are necessary to make appropriate decisions
about one’s health. Research shows that increasing health literacy can have a positive impact
on an individual’s overall health.3 Improved health literacy is a shared responsibility between
consumers, families, providers and organizations, with increasing responsibility on the health
care system to present health information in formats that are conducive to optimal learning
and that promote better consumer understanding and participation in their health care and
health decisions.3
Both public and private institutions are increasingly using the Internet and other technologies
to streamline the delivery of health information and services. However, for non-Web users,
other communication venues, besides Internet access, are critical to ensure that all health care
consumers are able to access and understand pertinent health information in a timely manner.
These methods include printed materials, media campaigns, community outreach, and
interpersonal communication.2 Understandably, it is helpful to develop and employ a myriad of
communication tactics in order to better accommodate the general public’s varying capabilities,
preferences, and styles of learning.
Resources
1) Health Communication. U.S. Department of Health and Human Services.
http://www.health.gov/communication/resources/Default.asp#overview
2) Health Communication and Health Information Technology. Healthy People 2020. U.S.
Department of Health and Human Services.
http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx ?topicid=18
3) Health Literacy. Wisconsin State Health Plan: Healthiest Wisconsin 2010. Wisconsin
Department of Health Services.
http://www.dhs.wisconsin.gov/hw2020/pdf/healthliteracy.pdf
Page 14HEALTH COMMUNICATIONS
Assessment Data and Objectives
Objective 1: By December 31, 2013 form a community health communications network to
strategize the timely, accurate, and appropriate dissemination of health information to health
professionals, policy makers, and the general public throughout the community.
Baseline: No community health communications network currently in place
Goal: Community health communications network in place
This objective will be tracked through the development of a health communications network.
Strategies/Activities Responsibility How is progress evaluated?
Invite select community partners, both WAHD Attendance log, meeting
traditional and non-traditional, to form a notes
health communications network (HCN)
Research evidenced-based health Health Notes re: research findings
communications interventions that have Communications
been associated with positive health Network (HCN)
outcomes
Identify the populations at greater risk of HCN Meeting notes
low literacy in order to customize health
literacy interventions
Develop/locate and distribute a fact sheet HCN Fact sheet, distribution list
that highlights the association between
low health literacy and poor health
outcomes to members of the local public
health system to expand awareness of the
impact of health literacy on health
outcomes
Design a health communications plan that HCN Completed plan
recommends specific communication
methods, technologies and social
marketing and media strategies for use
with specific target groups.
Distribute the health communications plan HCN Distribution list
to community partners for community-
wide use
Page 15HEALTHY HOMES AND NEIGHBORHOODS Healthy Homes and Neighborhoods Background Healthy neighborhoods begin with a healthy home. A healthy home is designed, built, and maintained to promote health by providing a clean, safe, supportive environment for residents of all ages. Neighborhoods are the places where the everyday practice of life occurs. Essentially, neighborhoods create and form communities. Residents share the same experiences. They suffer or revel in the availability and quality of local housing, schools, jobs, businesses, health care, and human services. They experience the effects of crime that occurs within neighborhood boundaries. Neighborhoods create the background for people’s life stories. They leave lasting impressions on residents about what life is like and what social problems do or do not exist in the community.1 Carbon Monoxide Detectors Carbon monoxide (CO) is an odorless, colorless gas that can cause sudden illness and death. Carbon monoxide detectors trigger an alarm based on an accumulation of carbon monoxide over time. The most common symptoms of CO poisoning are headache, dizziness, chest pain, and confusion.2 A new Wisconsin law went into effect in February 2011 requiring carbon monoxide detectors to be installed in one-story and two-story homes in addition to multi-family dwellings and any public building that is used for sleeping or lodging purposes.3 Childhood Lead Poisoning Elevated lead levels can have serious health effects, especially for children under six years old. The main source of childhood lead poisoning is lead based paint chips and dust from deteriorated paint that is found in older housing units. Although lead based paint was taken off the market for residential use in 1978, any house built prior to 1978 may still have lead paint. However, it is the deterioration of paint that causes a problem. Other sources of lead exposure may include water pipes, toys, imported candies, pottery, and even traditional folk remedies. Lead poisoning is entirely preventable. The key is stopping children from coming into contact with lead and treating children who have been poisoned by lead. Eliminating the source of lead exposure, and therefore preventing lead exposure to children before they are harmed, significantly lowers the number of lead poisoned children. Lead hazards in a child’s environment must be identified and controlled or removed safely.4 Asthma Asthma is a chronic inflammatory disorder of the airways characterized by episodes of reversible breathing problems due to airway narrowing and obstruction. These episodes can range in severity from mild to life threatening. Symptoms of asthma include wheezing, coughing, chest tightness, and shortness of breath.5 Page 16
HEALTHY HOMES AND NEIGHBORHOODS
Asthma is the most common chronic disorder in childhood. It is the third leading cause of
hospitalization among children under 15 years of age and the leading cause of school
absenteeism attributed to chronic conditions.6
Exhaust fumes contain significant levels of small particles, known as fine particulate matter.
These fine particles pose a significant health risk because they can pass through the nose and
throat and lodge themselves in the lungs causing lung damage and premature death. They can
also aggravate conditions such as asthma and bronchitis and are responsible for thousands of
premature deaths every year.
People with existing heart or lung disease, asthma or other respiratory problems are most
sensitive to the health effects of fine particles. Children are more susceptible to this type of air
pollution than healthy adults because their respiratory systems are still developing and they
breathe faster than adults, inhaling more air per pound of body weight. Reducing the exhaust
emissions of buses and cars around areas where children congregate is an important step in
reducing respiratory threats to health.7
Emergency Preparedness
Emergency preparedness is a social responsibility. It is important for individuals and families to
be knowledgeable and ready in order to create a culture of preparedness and be able to
respond efficiently to emergency situations. The more ready individuals and families are, the
better their community will respond and recover.
Households should have an emergency kit with enough supplies (food, water, pet supplies, and
medicines as well as at least one battery-operated radio) to last three days following a natural
disaster, health or man-made emergency, and an emergency plan that has been discussed with
family, friends, and neighbors. Families should be sure vaccinations are up-to-date, including
vaccinations against pneumonia for older family members. Neighbors should be aware of other
neighbors, friends, or relatives who may need help during an emergency and know whom to
notify to assist them.8
Built Environment
The built environment encompasses all buildings, spaces and products that are created, or
modified, by people. It includes homes, schools, workplaces, parks and recreation areas,
greenways, business areas and transportation systems. It extends overhead in the form of
electric transmission lines, underground in the form of waste disposal sites, and across
communities in the form of roads and highways. The built environment also includes land-use
planning and policies that impact the community in which we live.9
Well-planned neighborhoods can encourage people to engage in physical activities that are
healthful. For example, bike paths make it safer for children to bike to school, communities that
are walkable encourage community members to walk rather than drive which not only
increases physical activity but reduces transportation-related pollution. Developing an
infrastructure that increases opportunities for physical activity, healthy eating, and breathing
Page 17HEALTHY HOMES AND NEIGHBORHOODS
clean air, goes a long way in reducing the rates of chronic disease such as obesity, diabetes, and
asthma. To this end, public health and planning strategies focusing on environmental and policy
changes (e.g., active community environment initiatives, urban planning, safety enforcement,
trails and sidewalks) are needed to reach large sections of the community.10
Neighborhoods
Based on the core concept of neighbors helping neighbors, the Neighborhood Watch Program
brings together law enforcement, city officials and residents and ask them to work together to
provide protection for their homes and communities. It utilizes citizen involvement by tapping
in their awareness and familiarity with their own neighborhoods. Residents not only take care
of their own homes and businesses, but also those of their neighbors. By taking an active role in
the protection of their families and possessions, residents are better able to discourage criminal
activity and keep their neighborhoods safe. As a result, they are able to assist police officers
with the protection of their neighborhood by calling the station at the first sign of suspicious
activity.
Community Gardens
With more awareness of the benefits of local foods and organic foods, urban gardens have
become more popular in many cities across the nation. Numerous cities have established
programs to promote urban gardens and have taken steps to establish urban gardens in
communities through community gardens, garden mentors, providing funds and resources, as
well as other methods.
Community gardens are collaborative projects on shared open spaces where participants share
in the maintenance and products of the garden, including healthful and affordable fresh fruits
and vegetables.
Gardens may improve quality of life for people, offering physical and mental health benefits by
providing opportunities to:
• Stimulate social interaction and improve social well-being through strengthening social
connections
• Foster opportunities for intergenerational and cross-cultural connections
• Eat healthy fresh fruits and vegetables.
• Engage in physical activity and skill building
• Beautify vacant lots, public parks, schools and neighborhoods
• Serve as a catalyst for neighborhood and community development
• Preserve green space
12
• Decrease violence and crime
Resources
1) Geography and Public Safety. U.S. Department of Justice.
http://www.nij.gov/maps/gps-bulletin-v2i2.pdf
2) CDC Injury Fact Book. Centers for Disease Control and Prevention. National Center for
Injury Prevention and Control. www.cdc.gov/injury/publications/factbook
Page 18HEALTHY HOMES AND NEIGHBORHOODS
3) Journal Sentinel Online. Law requiring carbon monoxide detectors goes into effect
February 1. http://www.jsonline.com/news/wisconsin/114912554.html
4) Centers for Disease Control and Prevention. U.S. Department of Health and Human
Services. Lead Prevention Tips. http://www.cdc.gov/nceh/lead/tips.htm
5) Respiratory Disease. Healthy People 2020. U.S. Department of Health and Human
Services.
http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=36
6) Asthma & Children Fact Sheet. American Lung Association. www.lungusa.org/lung-
disease/asthma/resources/facts-and-figures/asthma-children-fact-sheet.html
7) National Idle-Reduction Campaign. U.S. Environmental Protection Agency.
http://epa.gov/cleanschoolbus/antiidling.htm
8) Emergency Preparedness, Response, and Recovery. Wisconsin State Health Plan:
Healthiest Wisconsin 2020. Wisconsin Department of Health Services.
http://www.dhs.wisconsin.gov/hw2020/pdf/emergency.pdf
9) NACCHO Exchange. Promoting Effective Local Public Health Practice. Volume 10, Issue 2.
Spring 2011. Preventing Chronic Disease.
http://www.naccho.org/toolbox/tool.cfm?id=2481
10) Physical Activity. Wisconsin State Health Plan: Healthiest Wisconsin 2010. Wisconsin
Department of Health Services.
http://www.dhs.wisconsin.gov/hw2020/pdf/physicalactivity.pdf
11) Neighborhood Watch. City of West Allis Police Department. http://www.ci.west-
allis.wi.us/police/police_crime_prevention/neighborhood_watch.htm
12) Community Gardens. Centers for Disease Control and Prevention. U.S. Department of
Health and Human Services.
www.cdc.gov/healthyplaces/healthtopics/healthyfood/community.htm
Assessment Data and Objectives
Objective 1: By December 31, 2015, launch a community education campaign regarding the
new state law requiring carbon monoxide detectors.
Baseline: No community education campaign in place
Goal: Community education campaign in place
This objective will be tracked through the development of a community education campaign.
Strategies/Activities Responsibility How is progress evaluated?
Utilize social marketing tools (i.e. video, WAFD,WAHD Educational materials
cable, website, Facebook, water bill) to
increase awareness of the new state law
requiring carbon monoxide detectors
Use CDBG block grant funds to purchase WAFD,WAHD Number of detectors
carbon monoxide detectors for low
income community members
Page 19HEALHY HOMES AND NEIGHBORHOODS Develop an educational board to display in WAFD,WAHD Display public settings to promote the use of carbon monoxide detectors Explore partnering with community WAFD,WAHD List of businesses and businesses for access to low cost detectors responses Objective 2: By December 31, 2015, increase by 5% the number of children under six years old in West Allis and West Milwaukee who have had their blood lead level tested. Baseline: 1,673 children under five tested in 2010 Goal: 1,778 children under five years tested in 2015 Objective 3: By December 31, 2015, reduce to less than 1% (from 1.7%) the percent of children under six years old in West Allis and West Milwaukee having elevated blood lead levels. Baseline: 1.7% of children under age five years have elevated blood lead levels Goal: Less than 1% of children under age five years will have elevated blood lead levels These objectives will be tracked through the Stellar database. Strategies/Activities Responsibility How is progress evaluated? Outreach to parents using social marketing WAHD Log of marketing strategies tools to promote lead screening used Outreach to health care providers WAHD Log of outreach to providers regarding the importance of lead screening Expand the use of the XRF machine for WAHD Number of screenings home lead screening Objective 4: By December 31, 2015, strengthen asthma education, prevention, management, control and access to services using American Lung Association of WI (ALA/W) trainings. Baseline: No plan in place for annual trainings Goal: Three ALA/W training programs per year offered to school personnel, daycare staff, and coaches/recreation department staff in West Allis-West Milwaukee through the Community Asthma Network This objective will be tracked by the number of trainings completed annually. Strategies/Activities Responsibility How is progress evaluated? Host three Asthma 101 programs per year Community CAN statistics/pre and post- utilizing trained ALA facilitators to educate Asthma Network tests at each program school, daycare, and coaches/recreation (CAN) dept. staff regarding asthma education, prevention, control, and safety Page 20
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