Promoting Health and Health Equity in Urban Wisconsin

Lots that once held broken glass and weeds blossom with gardens and hoop houses. A notorious drug den now houses a nonprofit neighborhood center called the Walnut Way Conservation Corporation.

It’s here that third- and fourth-year medical students enrolled in the University of Wisconsin School of Medicine and Public Health’s Training in Urban Medicine and Public Health (TRIUMPH) Program are undergoing their own transformations. The neighborhood is their classroom, and their efforts target broad public health goals: promote health equity; reduce infant mortality and gun violence; increase nutrition and exercise; increase immunization rates; and prepare for careers as community engaged physicians.

TRIUMPH is the urban counterpart to the Wisconsin Academy for Rural Medicine (WARM). Both programs place medical students in medically underserved communities outside of Madison to address health challenges. For fourth-year medical student Chrissy Ripp, TRIUMPH means working in a predominantly Latino neighborhood on Milwaukee’s south side, where obesity rates and lack of exercise are issues of concern for schoolchildren.

Presenting her project at Walnut Way recently to UW-Madison Chancellor Rebecca Blank, PhD, Ripp said that by reaching out to neighborhood groups and other organizations, such as the Wisconsin Bike Fed, they were able to launch a two-week summer bike camp to teach school-age children and families safe ways to use bicycles for transportation. Other TRIUMPH students presented a range of projects they are conducting in partnership with community organizations. Ripp said the experience was unlike any previous part of her medical education. Her fellow students agreed that what they were learning in TRIUMPH could not happen in a classroom.

Blank asked students about their projects and how this experience would affect how they approach their careers.

It’s a question that the medical community is watching closely. TRIUMPH partners, such as Aurora Health Care in Milwaukee, are contributing to the efforts and watching the effects of projects that aim to address the root causes of health problems.

“This is the future of medicine,” says Andrew Anderson, MD, executive vice president and chief medical officer at Aurora Health Care, the home of the UW School of Medicine and Public Health’s Milwaukee Academic Campus. “The future of health care is in promoting health and not just treating diseases.”

The City of Milwaukee Health Department — a national leader as an academic health department with multiple long-standing partnerships with UW-Madison and other academic institutions — works with TRIUMPH students to help build healthy communities.

“Graduates come out of TRIUMPH knowing not just about medicine, but about health,” said Geof Swain, MD, MPH, professor in the UW School of Medicine and Public Health Department of Family Medicine and Community Health and chief medical officer of the Milwaukee Heath Department.

Cynthia Haq, MD, a professor in the same UW School of Medicine and Public Health department — who founded and directs TRIUMPH — says the program has enrolled more than 100 students and has more than 60 graduates. All graduates have entered residencies serving urban, medically underserved populations and they have been more likely than other medical students to choose primary care careers and to train and practice in Wisconsin. Several are already practicing in Milwaukee after completing postgraduate training, and others are planning to return.

At Walnut Way, staff, medical professionals and trainees work under the principle that “Caring Neighbors Make Good Communities.” The number of caring neighbors that have emerged is striking — TRIUMPH has worked with more than 26 Milwaukee community partners, including schools, and public health and neighborhood organizations. The program also draws support directly from neighborhood activists and those who live where the students work.

Haq says one of the program’s strengths is that the students are embedded within local organizations, get to know local residents outside of clinical settings, learn to appreciate the resilience and challenges faced by the people they serve, and cultivate skills to become effective community engaged physician partners.

One example of a neighbor who teaches TRIUMPH students is Andre Lee Ellis, who came to Walnut Way for Blank’s visit. Ellis founded an organization called “We Got This” that puts youth to work in Milwaukee’s gardens and neighborhoods. He says he founded his organization on the fly to intervene for a young man who was in trouble with the police. Law enforcement told him that the young man could perform community service rather than be charged if an official organization agreed to take responsibility for his supervision. Ellis shares that he invented “We Got This” on the spot. Steve Harvey recently featured Ellis’ work on his national daytime talk show.

s national daytime talk show. Examples like this, and the way TRIUMPH interacts with community members and builds on their positive work, is “the epitome of the Wisconsin Idea,” according to TRIUMPH Program Manager Melissa Lemke.