Addressing Health Disparities in Wisconsin Beyond Race/Ethnicity: Socioeconomic Status, Sexual Orientation, Geography, and Disability Status

BACKGROUND: Routine reporting on health disparities is an important component of achieving health equity. Since 2001, the Wisconsin Department of Health Services’ Minority Health Program has published two reports addressing the health status of racial and ethnic populations in the state. Populations that are of low socioeconomic status, LGBT, very rural or inner-city, and living with disabilities also experience barriers that adversely affect health outcomes; however, rarely do state governments include these populations in the identification of health disparities. In order to provide a more comprehensive understanding of health disparities in Wisconsin, the most current Minority Health Report (MHR) includes surveillance and survey data by these four populations as well as by race/ethnicity. 

METHODS: The MHR primarily consists of rates and 95% confidence intervals from more than 30 sources of state and national surveillance and survey data, which were managed using Microsoft SharePoint and Excel. Multiple years of Behavioral Risk Factor Survey (BRFS) and Youth Risk Behavior Survey (YRBS) were aggregated, allowing for stratification by each of the population groups. The MHR is aligned with the objectives of the state health plan, Healthiest Wisconsin 2020, serving as the baseline for tracking the overarching goal of eliminating health disparities by 2020.

RESULTS:  The report highlights many significant health disparities in Wisconsin. For example, compared to Whites, Blacks were more likely to be hospitalized for long-term diabetes-related complications (26 vs. 6 per 10,000); Hispanics, ages 18-64, were more likely to report no health care coverage (35% vs. 13%); and American Indians were more likely to die from alcoholic-liver disease (24 vs. 4 per 100,000). Compared to youth reporting opposite-sex sexual behavior, youth with same-sex sexual behavior were more likely to attempt suicide (28% vs. 7%). People living in rural regions of the state had the highest rates of motor vehicle crash fatalities, while those in Milwaukee had the highest rates of asthma-related hospitalizations. People living with frequent mental distress were more likely to smoke cigarettes than those without (39% vs. 19%).

CONCLUSIONS: We anticipate that this report will: (1) Prioritize health needs and initiatives; (2) identify gaps in data collection; (3) provide a comprehensive view of health disparities in Wisconsin, drawing attention to population needs that may previously have been overlooked by health professionals; and (4) be easily understood and accessible to a broad audience in a ready-to-use format (annotated slide set) that facilitates action.