Is The Wisconsin Health Improvement Plan Really an Improvement?

In 2010, the Department of Health Services (DHS) created the Healthiest Wisconsin 2020 plan with the input of over 1,500 people including staff of the Wisconsin Alliance for Women's Health.  The plan set out to create a healthier Wisconsin by addressing health, social, economic, educational, and environmental issues that contribute to health problems in Wisconsin.  This plan differed from previous plan because it not only focused on risk factors for death, but broadened the plan to include factors that contribute to quality of life. 

The newly released Wisconsin Health Improvement Plan (WI-HIPP) supplements the Healthiest Wisconsin 2020 plan with a narrowing of the focus of the DHS to five main factors.  These new priority factors are alcohol, nutrition and physical activity, opioids, suicide, and tobacco.  While we recognize that these are all important factors in keeping Wisconsin healthy, there are some key components missing from this Health “Improvement” Plan - components that matter greatly to the health and wellbeing of Wisconsin women and girls.

The WI-HIPP reverts back to the problem of only focusing on factors that lead to death by failing to include the following relevant health topics:

• Reproductive and Sexual Health
• Injury and Violence- specifically to women and children
• Mental Health-outside of the suicide and opioid context
• Policy initiatives to deal with disparities in general

These are just examples of health concerns left out of the new plan. 

Reproductive and sexual health deals with unintended pregnancies, teen births, sexually transmitted diseases, adolescents, and HIV/AIDS.  While these factors may not all lead to death, the physical, emotional, mental, and social well-being to a persons’ life under these circumstances are monumental.  Issues such as unintended pregnancies can also create bad birth outcomes while perpetuating disparity in Wisconsin.

Excluding injury and violence is another concern.  Specifically, violence against women and children such as sexual assault needs to be a higher priority.  It is estimated that 14% of Wisconsin women over the age of 18 has been raped in their lifetime.  This is an act that disproportionately affects women in Wisconsin, and it is also noted that two-thirds of victims of assaults are under the age of 15, so female children are who is being harmed by this issue not receiving priority status.

Outside of the context of what issues received priority focus, the WI-HIPP purports to explore these issues from the perspective of older adults, racial and ethnic minorities, poor, and the geographically diverse, but says nothing about other underrepresented populations such as women or those of a different sexual orientation or identification. 

While moving towards a more healthy Wisconsin is always a positive goal, we must be careful about how we go about reaching that goal.  Disparity is one of the biggest issues in Wisconsin, and focusing on the same physical factors that have always been a priority will only perpetuate a cycle in which disparity in Wisconsin continues to grow. 

Key missing components from the Emphasis of WI HIPP:

• Within disparities: WI HIPP mentions older adults, racial and ethnic minorities, economic status, and geographic disparities but hey neglect to include sexual identities and orientations, gender identities (specifically women), and educational status.
• Reproductive and Sexual Health and Education
• Injury and Violence- specifically to women and children
• Mental Health- outside of suicide and opioid context
• Oral Health
• Environmental Concerns
• Policies initiatives to reduce things like disparities, poverty, discrimination
• Policies that would improve education