CDC Pilot Community Health Integration in Wisconsin's Public Health System

Wisconsin is one of four states participating in CDC's chronic disease integration demonstration project. Wisconsin's integration efforts build on the knowledge that many chronic conditions share common risk factors (e.g., smoking, poor diet, lack of exercise) to leverage collective efforts to: reduce duplicative activity; increase efficiency; maximize program impact; and improve health outcomes. Unique among the pilot states, Wisconsin's integration efforts include the state's chronic disease programs as well as other related programs such as coordinated school health, maternal and child health, lead, oral health, asthma, minority health, and injury prevention. Division leadership and multiple cross-program workgroups promote adoption of a life-course perspective and facilitate communication, collective thinking, and problem solving about cross cutting issues. Key accomplishments include:

• Formulating a common language for discussing the life-course perspective and strategies to address health issues over the lifespan; • Piloting new ways of working with external partners; • Funding three community coalitions focused on “Healthy Lifestyles” (rather than specific risk factors); • Holding regular meetings to discuss integration and plan for further implementation; and • Establishing monthly meetings of program epidemiologists to create a report addressing the most common risk factors for chronic disease.

Challenges encountered in integration efforts include: time constraints; competing priorities; negotiating participant interests within collaborations; communication; and funding constraints. Future integration-focused activities include developing an Integrated Risk Factor Report; increasing policy and advocacy activities at the state and local level; and establishing a comprehensive approach to partnering.