Now that Wisconsin and many other states have made very significant improvements in access to health insurance (see, for example, this WCCF paper on insurance coverage), health care providers, advocates and policy makers are gradually paying more attention to other factors that affect health. Improving access to insurance and health care services is very important and there is more work to be done in that regard, but that is only one part of what is needed to improve health outcomes.

A recent Wisconsin’s Department of Health Services (DHS) report indicates that there is plenty of work to do on this front, especially for the state’s poorest children. According to the DHS report:

• An estimated 34% of Wisconsin’s children live in low-income families (<200% FPL)
• Low-income children were five times more likely to be in fair or poor health than children above 200% FPL.
• While the overall uninsured rate for children in this study was 4%, 7% of low-income children are uninsured compared to 1% of children above 200% FPL
• 88% of low-income children in comparison to 97% of children above the low-income threshold had continuous health coverage

Other research, from the University of Wisconsin’s Population Health Institute’s County Health Rankings program, also reinforces the correlation between higher rates of poverty and poorer health. The County Health Rankings study reports Census data regarding poverty. In the most recent report, child poverty rates in WI counties ranged from 6 percent to 39 percent, with a state average of 14% of children living below the poverty level.

A recently modified indicator within the County Health Rankings measures income inequality by computing the ratio of household income at the 80th percentile to income at the 20th percentile. Higher ratios reflect a greater division between the top and bottom ends of the income spectrum. The study shows that a larger difference in incomes across communities negatively affects life expectancy. In Wisconsin, the two counties with the highest ratio are Menominee (5.3) and Milwaukee (5.0), both counties with large minority communities. The lowest are Adams and Columbia (3.4).

The data presented by DHS as well as other WI data clearly show that WI needs to be doing more in terms of ensuring that our poorest and most marginalized residents are able to not only have access to health care through insurance, but that other barriers to good health must be addressed as well — including racial disparities and access to quality education, economic and job opportunities, safe neighborhoods and housing,  and local food markets.

We are hopeful that in the coming year the state and healthcare stakeholders and advocates across the Wisconsin will have the opportunity to leverage the new State Innovation Model (SIM) planning grant process to help tackle these important issues.

More information on the latest research on the link between poverty, income and health has been documented in a couple of new Urban Institute/Center on Society briefs:

“How are Income and Wealth Linked to Health and Longevity.” Urban Institute and the Center on Society and Health. April 2015

“Can Income-Related Policies Improve Population Health.” Urban Institute and the Center on Society and Health, April 2015.

Sashi Gregory