The Medical College of Wisconsin has long been in the business of producing a pipeline of doctors prepared to respond to patients’ health needs.
But with research showing a significant link between social factors seemingly unrelated to clinical care and health outcomes, MCW is seeking to address social determinants of health and establish a presence in Milwaukee neighborhoods where health disparities are most acute.
MCW leaders are working on a development in Milwaukee’s central city that would aggregate its community-facing programs in one location. Leaders are calling it the Center for Flourishing Lives.
“Responding to the community is important, but there is a growing understanding that health disparities and overall wellbeing are more linked to social and economic factors than they are to the environment, genetics or even clinical care,” said Dr. John Raymond, president and chief executive officer of MCW. “We, as an institution, have focused largely on clinical care, but we believe that if we can employ our talent and resources to addressing some of the root causes of health disparities, we could have a larger impact.”
While conversations around tackling health disparities have been ongoing for several years, plans for the new development – which could be new construction or the renovation of an existing facility – are still in the early stages.
Zip codes currently being considered for the building are 53206 and 53205 on Milwaukee’s north side, 53233 near downtown, and portions of 53203, 53202 and 53212.
Persistent health disparities across Milwaukee-area zip codes are well documented. Milwaukee ranked second-to-last among the state’s 72 counties for its health outcomes in the latest Wisconsin County Health Rankings, compiled by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. Its neighbor to the north, Ozaukee County, was first.
Residents of the central city see higher rates of certain types of cancer and other chronic illnesses than their suburban counterparts, namely obesity and hypertension, Raymond said.
MCW’s new initiative is a response to recommendations from its Cancer Center advisory board that the school work to address cancer disparities in predominantly black zip codes, paired with the urgency prompted by the civil unrest in Milwaukee’s Sherman Park neighborhood in 2016.
“We had a series of internal conversations about what MCW could do better,” Raymond said. “First, we started focusing on our employees who lived in or near Sherman Park. Then, we brought in some community leaders to advise what we could do more effectively.”
All of those conversations led to the consensus that MCW needs to increase its visibility, approachability and presence in the central city.
The new initiative will enhance all components of the school’s mission, said Gregory Wesley, an MCW senior vice president who is helping spearhead the initiative.
“We have a strong clinical mission, but we have an equally strong education mission and research mission,” Wesley said. “And our community engagement mission … is the fourth pillar of MCW. This initiative gives us the ability to strengthen the education function, research function, as well as the clinical function by putting us closer to some of the greater needs in our community.”
Until now, the institution has worked on social determinants of health in silos – through its Advancing a Healthier Wisconsin Endowment and Institute for Health & Equity, or an individual faculty member’s research, for example – but MCW leaders see the potential in aggregating those efforts. Those two departments, along with MCW’s Center for AIDS Intervention Research, could be among the departments housed in the new facility, along with a space to recruit for clinical trials and house service learning opportunities for medical students.
When the new space is operational, Raymond envisions hiring employees to serve as community and academic navigators who will “connect people from the community to MCW faculty and students, and vice versa.”
Leaders are also mulling the idea of collaborating with other organizations within the building.
“We also want to consider some community interactive space – a space to co-locate with partners who are working on social determinants of health in those zip codes,” Raymond said. “They could be large not-for-profits or small not-for-profits.”
Initially, leaders expected to have decided on the site and scope of the project by May, and to take those plans to the board by June. But Raymond said that timeline didn’t allow for enough community input.
“What we heard from the community was that we were moving too quickly and that we weren’t giving people time to give us advice and to help us shape the impact of the project, so we have slowed down,” he said.
He expects to bring a proposal to the board this calendar year, possibly as late as December.
MCW is working with Milwaukee real estate developer Kevin Newell’s Royal Capital Group LLC on the community engagement and site selection process. Royal Capital Group is involved with several noteworthy developments in the city, including a 90-unit apartment complex near the new Milwaukee Bucks arena and a 181-unit residential development in Milwaukee’s Brewers Hill neighborhood.
MCW leaders hope the effort will help jumpstart more investment in the neighborhood that’s chosen.
“We hope we’ll be able to attract a grocery store from a national chain, retail, and affordable housing across the full spectrum, not just low-income housing,” Raymond said. “We also want to be mindful that we don’t create a situation that results in gentrification, because that won’t help solve Milwaukee’s health disparities.”
Still, leaders don’t see the Center for Flourishing Lives as a panacea for Milwaukee’s deep-seated disparities. Moving the needle on those issues requires collaboration across organizations and sectors, Raymond said.
“We know we’re not the first, we’re not the only and we’re not the most important entity to make a commitment to central city Milwaukee,” he said. “We need to work in partnership with the entities that are already there. We want to make sure that we’re not saying we’re the ultimate solution.”
Establishing a presence in the central city could enhance the school’s ability to produce more urban primary care physicians, which was identified as an unmet need in Milwaukee in a recent Wisconsin Policy Forum report. According to that report, the City of Milwaukee has been identified by the federal Department of Health and Human Services as a Health Professional Shortage Area for primary care physicians, and an estimated additional 57 physicians are needed in Milwaukee’s central city to address the shortage.
Placing students who are in the school’s urban and community health pathway in the central city would allow those students to “be inspired by role models who are already serving in the community,” Raymond said.
