Milwaukee County is at the forefront of addressing racial inequity. During the COVID-19 pandemic they cross referenced vaccination rates with the CDC’s social vulnerability index and plotted the results using Geographic Information System (GIS) technology. Armed with this powerful insight, the County was able to increase vaccinations in populations that needed them the most and by doing so increased the safety of the entire County. They are now incorporating an equity lens into other areas of public health.
Healthcare IT Today had the opportunity recently to sit down with Zachary Swingen, Lead GIS Coordinator at Milwaukee County Office of Emergency Management. We wanted to learn more about their pioneering work combining health equity and GIS technology.
Racism as a Public Health Crisis
On May 20, 2019, Milwaukee County became the first governing board in the US to pass a resolution declaring racism as a public health crisis. On that day, Milwaukee County Executive, Chris Abele, stated “It is Milwaukee County’s responsibility to address racism, including seeking solutions to reshape the discourse, actively engaging all citizens in racial justice work. Local government needs to take a leadership role and we intend to do so.”
“It needs to be an emergency,” said County Supervisor Supreme, Moore Omokunde. “We need to treat it as if there was an outbreak of measles, an outbreak of mumps, an outbreak of any kind of disease or as much as we take seriously the opioid epidemic in the state of Wisconsin.”
To confront racial inequity, the County made it a priority to collect data on race so they could make more informed decisions – decisions that included addressing racial and social justice. County officials did not shy away from what the data revealed. They confronted the realities and worked on solutions to deal directly with surfaced problems.
Targeting Public Health Efforts Based on Need and Impact
Milwaukee County remained steadfast in their commitment to racial equity throughout the pandemic and their dedication paid off. They were one of the first jurisdictions to realize that the virus disproportionately affected people of color. How did they come to this realization? Because they tracked the race of the people who were being hospitalized and used it as a dimension in their analysis.
When they fed this information into their GIS technology platform, ArcGIS from Esri, the County was able to quickly identify that certain neighborhoods were disproportionately being affected by COVID-19.
“Knowing who was affected allowed us and our partners to target our resources to those communities, tailor messaging communications, and have outreach with faith leaders,” said Swingen. “When you could see the data on a map of neighborhoods, it was clear why we were focusing attention and resources in those areas.”
Milwaukee County used the same approach when COVID-19 vaccines became available.
Getting Vaccines to the Most Vulnerable
Like all county governments, Milwaukee County carefully tracked the uptake of COVID-19 vaccines, but they went a step further. The GIS team took the vaccination data and placed it on a neighborhood map. Then they overlaid the CDC/ATSDR Social Vulnerability Index (CDC/ATSDR SVI) for each neighborhood onto that same map.
The CDC/ATSDR CVI uses 15 US census variables to identify communities that may need support before, during, or after disasters. It blends factors like socioeconomic status, household composition, minority status, housing type, and access to transportation. It is a dataset designed to help emergency planners and public health officials better allocate resources in times of crisis.
By blending the CDC/ASTSR SVI with vaccination rates on their map, Milwaukee County officials were quickly able to see which vulnerable neighborhoods were lagging behind. They recognized that they needed to increase vaccination uptake in those neighborhoods to improve equity and increase the resilience of the entire County.
Using this insight, the County was able to make more vaccines available to those areas and engaged local faith leaders to help address vaccine hesitancy – all a in matter of days.
Foundation for Transparency and Improved County Response
While all this was happening, the County decided to make community vaccination information publicly available so that citizens could have the same perspective as government decision-makers. The response was overwhelmingly positive according to Swingen: “A lot of organizations that are based in and invested in our communities, told us how helpful and easy it was to navigate this data when displayed on an interactive map.”
The County’s plans to build on the foundation of combining racial, socioeconomic, and vulnerability data with GIS technology and apply it to other public health initiatives. One project that Swingen is excited about is plotting heart disease so that the county can strategically deploy defibrillators and encourage more CPR training.
Watch the interview with Zac Swingen to learn more about Milwaukee County’s health equity initiatives.
Learn more about Milwaukee County: https://county.milwaukee.gov/EN
Learn more about Esri: https://esri.com/health
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