Jane Mooney, a volunteer physician assistant with the Benevolent Specialists Project, attempts to squeeze an extra Moderna COVID-19 vaccine dose out of a vial during a free vaccination clinic on March, 9, 2021, at Life Center in Madison, Wis. The Hmong Institute ran the clinic, which targeted Hmong and Southeast Asian adults 65 and older. Coburn Dukehart / Wisconsin Watch
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More than a century ago, Wisconsin was among the U.S. leaders in making public health a priority, helping Wisconsin minimize deaths during the Spanish flu pandemic — at least compared to most other states. 

But as the COVID-19 pandemic ebbs, data show Wisconsin — roiled by repeated high-level fights over school closings, mask mandates and other control measures — performed below the national average in primary series vaccination rate; 61.6% compared to the national average of 69.5%. Wisconsin’s weekly COVID-19 hospitalization rate per 100,000 as of June 10 was 1.94 — highest in the Midwest.

While public health budgets have shriveled across the country, Wisconsin’s seems to stand out. By one measure, Wisconsin in 2022 ranked 49th among the states in per-capita public health funding — $72 per person per year compared to a national average of $116. 

Department of Health Services spokesperson Jennifer Miller acknowledged that “compared to the rest of the nation, Wisconsin has been significantly underfunding its public health efforts for years.”

She said city and county health departments rarely spend much beyond the $72 in state and federal funding cited by America’s Health Rankings on programs to prevent disease and injuries and change unhealthy behaviors. 

Gov. Tony Evers has proposed an unprecedented level of public health funding, Miller said. But Republicans who run the Legislature have rejected many of Evers’ spending proposals.

Joan Theurer of the advocacy group Wisconsin Public Health Forward told a recent gathering of public health officials that more than half of Wisconsin’s 85 top city or county health officials left between 2020 and 2022. The former Marathon County health officer said one of the organization’s goals is to create support for public health officials as they perform the “delicate balance” of protecting the public and individual rights while managing communicable disease outbreaks.

When it comes to overall health, America’s Health Rankings puts Wisconsin about in the middle of the pack of states, ranking 21st. 

Wisconsin scores well on some measures of well-being, including voter participation, dental care and high-school graduation rates.

But it falls far behind in others, ranking in the bottom five in metrics including excessive drinking and the disparity between white residents and the residents of color with low-birthweight babies. 

Wisconsin, like many states, also faces a fentanyl epidemic. More than 1,300 people in Wisconsin died of fentanyl overdoses in 2022. 

Our new series, Unhealthy Wisconsin, will examine some areas where Wisconsin falls short in well-being. Student-journalists from the University of Wisconsin-Madison under the direction of Wisconsin Watch Managing Editor Dee J. Hall explored some of the most pressing health problems in the state and possible solutions. 

The problem is bigger than individuals choosing a healthier lifestyle. State officials increasingly look to improve so-called social determinants of health to boost Wisconsin’s overall health. They include economic security, better child and dependent care, affordable housing, access to transportation, physical safety, accessible and affordable health care, social connectedness and mental and emotional health. 

In announcing the state’s five-year health plan in February, State Health Officer Paula Tran said there is “growing and consistent evidence that health outcomes are shaped by the conditions around us such as our economic well-being, our sources of healthy food (and) healthy housing.”

Maggie Northrop, state health plan coordinator for the Wisconsin Department of Health Services, said the plan is based largely on listening sessions with local, county and tribal health officials and members of the public.

“We expected that we’d hear more about particular heart conditions or other chronic or mental health conditions,” Northop said. “What Wisconsinites told us was that the environment around them was actually what was driving their health outcomes.”

State officials found health disparities aligned with economic and social disparities. 

“The same populations (were) experiencing the burden of all of the social and economic struggles as well as a lot of different health conditions,” Northrop said. 

In its five-year plan, Wisconsin has sketched out a new approach to public health that calls for systemic changes and broad prevention strategies — along with changes in individual behavior. 

“If we continue to think about each one of the health outcomes in isolation, we just keep moving the problem,” Northrop said. “People are just constantly chasing after the latest substance, the latest toxin, the latest chemical, or the latest pathogen, but we’re not really in the moment for saving lives … we need to figure out what is at the bottom of the suffering.”

In Unhealthy Wisconsin, Wisconsin Watch explores some of those problems, including: 

  • The causes and possible strategies to reduce infant mortality, which befalls Black babies three times as often as white infants;
  • The toll of alcohol in one of America’s drunkest states — and some strategies that can curb excessive drinking;
  • Efforts to reduce and erase state residents’ hundreds of millions in medical debt;
  • How 300,000 Wisconsinites could soon lose access to publicly-subsidized health care and what lawmakers could do to change that; 
  • The promise of telemedicine, which boomed during the pandemic — providing access to health care in rural parts of Wisconsin — but which may face renewed restrictions; 
  • Wisconsin’s high and growing suicide rate among young people and efforts to boost funding to provide needed mental health care;
  • The risks of vaping, which has exploded in popularity despite concerns over its health effects and lack of regulation; 
  • Wisconsin’s mixed record on managing the COVID-19 pandemic and what could have been done better;
  • The Menominee Tribe’s push to prevent rampant diabetes by addressing the economic and social challenges linked to obesity; and 
  • The growing number of Wisconsin lives lost to fentanyl — and the white boxes mounted in public spaces that could save them.

The stories were reported by students in the spring 2023 investigative reporting class. They are Robert Beyer-Bowden, Maggie Degnan, Sarah Eichstadt, Allyson Fergot, Ethan Ferrell, Grace Friedman, Emily Hirsch, Jane Houseal, Tyler Katzenberger, Kelly Holm, Ryan Mares, Erin McGroarty, Anupras Mohapatra, Max Stapleton, Hina Suzuki, Ken Wang, Drake White-Bergey and Katrina Williams. 

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Dee J. Hall, a co-founder of Wisconsin Watch, joined the staff as managing editor in June 2015. She is responsible for daily news operations. She worked at the Wisconsin State Journal for 24 years as an editor and reporter focusing on projects and investigations.

A 1982 graduate of Indiana University’s journalism school, Hall served reporting internships at the weekly Lake County Star in Crown Point, Ind., The Gary (Ind.) Post-Tribune, The Louisville (Ky.) Times and The St. Petersburg (Fla.) Times. Prior to returning to her hometown of Madison in 1990, she was a reporter for eight years at The Arizona Republic newspaper in Phoenix, where she covered city government, schools and the environment. During her 35-year journalism career, Hall has won more than three dozen local, state and national awards for her work, including the 2001 State Journal investigation that uncovered a $4 million-a-year secret campaign machine operated by Wisconsin’s top legislative leaders.