In July 2001, the University of Wisconsin Medical School established the Wisconsin Public Health and Health Policy Institute (WPHI). The mission of the Institute is to stimulate, create, and communicate useful public health and health policy research and analysis. The Institute brings together faculty, staff, and students interested in applying their skills and experience to answer practical public health and health policy questions. Ultimately, the Institute is part of the Medical School’s overall commitment to producing research and researchers that are relevant to a rapidly evolving public health and health care delivery system.

BACKGROUND

Both the public health and health care delivery systems have been undergoing transformation. Public health agencies have traditionally focused on communicable and infectious disease control, providing clinical services to the poor and uninsured. Today’s leading health problems including chronic disease, aging, tobacco use, depression, obesity, and violence require a broad-based community approach. Public health agencies have embraced a three-pronged role defined by the Institute of Medicineassessment, assurance, and policy development. The “public health system” now includes partners in the public, private, non-profit, and voluntary sectors, representing medical care, housing, education, and other social services. This paradigm is embodied in Wisconsin’s recently completed state health plan, Healthiest Wisconsin 2001: A Partnership to Improve the Health of the Public.

The health care delivery system has also undergone significant transition, from fee-for-service medicine toward managed care, from indemnity insurance to risk-based or pre-paid contracts. Although we have recently seen some retreat from this trend, the overall landscape of organized delivery systems remains. Along with traditional concerns of cost and access, the industry has expanded its focus on outcomes and quality, evidence-based clinical care and data-driven service delivery. This has brought health care providers into the realm of population-based health data, particularly as health plans seek collaborative strategies to improve the health of their enrolled members.

Almost a decade ago, the UW Medical School established the Wisconsin Network for Health Policy Research. Directed by Dr. David Kindig, the Network brought together the health policy research and practice communities, engaging practitioners and policy-makers through frequent seminars, Issue Briefs, and a biannual conference. In 1997, Dr. Patrick Remington joined the faculty, bringing over 15 years of public health experience at the U.S. Centers for Disease Control and Wisconsin Division of Public Health. His research addresses the assessment function of public health, monitoring trends in population health and assessing disparities in health status.

THE MODEL

In July 2001, the Medical School consolidated these applied research activities into a single Institute, part of the Department of Population Health Sciences (formerly the Department of Preventive Medicine). The Institute engages UW faculty, staff, and students to address current practice-relevant questions and serves as a bridge to public health and health policy practitioners in the state. Research is translated into practice through several venues: an active advisory board, frequent issue briefs and technical reports, and periodic conferences and educational programs.

Through an active research and education program, the Institute promotes the use of evidence to inform public health and health care policy and program decisions.

The research agenda is user-driven. Researchers and intended users work in partnership to understand and disseminate the evidence, and promote its use in policy and program development, implementation and evaluation. Customers include decision-makers in public health, health care, and other community health systems.

The Institute is structured to enhance communication and interaction between researchers and users. The users of research are varied, including legislators, state and local officials, agency leaders, health care executives, local providers and purchasers. These users are represented on the Institute’s Executive Board and Advisory Committee.

INSTITUTE OBJECTIVES

• Conduct applied research on problems of importance to government, business, providers and the public;
• Collaborate with researchers and users of research and build bridges between the academic community and public and private policy makers;
• Provide outreach continuing education to practitioners and opportunities for applied learning for graduate and medical students;
• Maintain high standards of relevance, rigor and objectivity.

PROGRAMS, PRODUCTS, & SERVICES

Applied Research
The Institute’s research program addresses the major public health goals of improving health status and reducing health disparities. It is guided by input from a diverse external advisory group. The board helps set priorities, oversees Institute activities and serves as a forum of exchange among diverse stakeholders.

The Institute also draws on the expertise and interests of graduate students, medical students, residents, medical students, residents, or medical fellows in the Population Health Program. The students apply their skills to real-world issues and, in turn, have an opportunity to publish results as a master’s thesis, in the Wisconsin Medical Journal, or in a national publication.

Dr. Remington leads the Institute's public health research, focusing on assessment. This includes public health surveillance, identifying health priorities and needs, analyzing the causes of health problems in communities, monitoring disease trends, and evaluating public health program outcomes. Dr. Kindig leads the Institute’s health policy and health services research agenda. This research focuses on health care financing, cost, quality, outcomes, and access.

Outreach and Education

The Outreach function connects the consumers of health information, data and policy with those who generate it. These activities include the following:

• Weekly Seminars. Monday afternoon seminars, co-sponsored with the Population Health Sciences Program are open to the public and bring nationally recognized experts and researchers onto campus to discuss their work. The Institute will web cast these seminars, so that audiences beyond the Madison area can have access to this information.

• Biannual Conference. This conference focuses on Wisconsin public health, health policy and research issues.

• Print and Electronic Publications. A monthly Issue Brief and electronic newsletter (E-News) communicates events, research topics of interest, and research citations. The Check Ups are periodic publications of more in-depth research on the determinants of health in Wisconsin counties and communities.

• Public Health Education and Training. The Institute is planning to offer a year-long training program in applied public health practice. Targeted to public health practitioners, this program will be modeled after successful summer training institutes offered in other states. Participants will represent health department and community-based organizations. The sessions will teach participants assessment, data analysis, and policy skills for practical application in program planning, implementation and evaluation.

• Web Site and Electronic Resources. The Institute web site includes an interactive health data library of Wisconsinspecific data, news updates, downloadable files of Institute publications, and audio web-casting of Institute-sponsored seminars.

AFFILIATED PROGRAMS

Center for Health Policy and Program Evaluation (CHPPE)
Dr. Paul Moberg serves as both director of CHPPE and Associate Director for Evaluation in the Institute. CHPPE focuses on community-based programs, in substance abuse prevention, intervention and treatment, maternal and child health, tobacco control, child and adolescent health promotion, and geriatric service delivery.

UWCCC Cancer Control Program
The Institute shares staff and leadership with the UW Comprehensive Cancer Center in pursuing cancer epidemiology and surveillance research. The program is currently evaluating the state’s tobacco control program and is conducting research on the regional variation of breast cancer in Wisconsin.

Center for Urban Population Health
The CUPH conducts collaborative research, professional education, evaluation and planning, and health promotion, focusing on improving clinical and community practice with Wisconsin’s urban populations. This partnership includes UW Medical School, the UW Milwaukee and Aurora Health Care

CONCLUSION

Healthiest Wisconsin 2010 describes a new vision of public health, with a modern understanding of the broad determinants of “health” and an emphasis on building collaborative partnerships. The Wisconsin Public Health and Health Policy Institute embraces this approach, and looks forward to working together in a partnership to improve the health of the public in Wisconsin.