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SCHOOL OF PUBLIC HEALTH; No Settling' for a Branch Campus

Posted on: Sunday, 23 October 2005, 15:00 CDT

By JERRY RESLER

There should be an immutable bottom line in upcoming discussions between Milwaukee and the University of Wisconsin-Madison's Medical School on the matter of a school of public health.

Milwaukee must not settle for a branch campus of a renamed School of Medicine and Public Health in Madison. Milwaukee's government and business leaders, along with the chancellor of UW-Milwaukee, must insist on a free-standing school at UWM.

The reasons this must be so have not changed a whit since the UW Board of Regents on Oct. 7 instructed the Medical School to engage in discussions with the city and UWM to increase collaboration to deal with Milwaukee's many health care problems, including possibly establishing a branch campus of the new hybrid school at UWM.

Thanks for the thought, but Milwaukee's needs are great enough to have its own school. Madison's arguments to date for siting the state's major public health efforts there simply fall flat. Here's why:

-- While a renamed School of Medicine and Public Health in Madison could tap into a number of assets there, a school of public health in Milwaukee could tap into many first-rate public health resources in this city as well. (And have a better chance at full school accreditation.)

At the top of that list would be the Milwaukee Health Department, the largest in the state and one of the oldest in the nation, established in 1867, with a national reputation for excellence and innovation. The department established a public health lab in 1874 to inspect milk and water for potential sources of disease and has long been among the network of labs selected by the World Health Organization to track influenza.

Milwaukee Health Commissioner Bevan Baker notes that his department won four public health awards, the most given to any health department in the country, at the annual meeting this summer of the National Association of County and City Health Officials. Having an accredited school of public health in the city, which would likely attract tens of millions of federal research dollars, would only complement the Health Department's work.

-- Based on sheer need alone, the argument for a school of public health in Milwaukee is mounting.

The Metropolitan Policy Program at the Brookings Institution recently ranked Milwaukee among the 10 American cities with the highest concentrations of urban poverty. The report said 27% of Milwaukee residents live in neighborhoods of "extreme poverty."

-- The UW Medical School, Aurora Health Care and UWM already have a partnership through the Center for Urban Population Growth, established in 2001 and based at Aurora Sinai Medical Center downtown.

UW medical officials say the public health work done at the center shows that collaboration with UWM is already taking place. Yes, but that also means the center could easily, and quite naturally, be folded into a UWM school of public health.

And a Madison branch campus in Milwaukee?

-- One already exists in the form of a clinical campus of the UW Medical School in Milwaukee based at Aurora Sinai Medical Center.

"Essentially, we provide the urban practice experience for UW students," said Jeff Squire, an Aurora spokesman.

The clinic itself points to the fact that this city is simply the best working laboratory for public health in the state.

(And, by the way, Aurora pays the salaries and benefits for the roughly 50 faculty physicians and 125 residents and fellows at the UW clinical campus here.)

Philip Farrell, dean of the UW Medical School, and Patrick Remington, director of the UW Population Health Institute, don't dispute that Milwaukee has serious health problems. Remington says they would not oppose a school of public health here.

But they question whether simply putting the school in Milwaukee would be the answer. We think, however, that it certainly would be justified based on the fact that at least 20 other large cities in the country have schools of public health independent of medical schools.

Public health experts have repeatedly told us that public health schools should not be in medical schools because the roles are so vastly different. Public health has already been relegated over the years to second fiddle to the field of medicine. About 95% of all health care spending in the United States goes toward medical care and biomedical research, leaving only 5% for public health, according to a 2002 report by the Institute of Medicine of the National Academies.

No, a school independent of UW's Medical School would be the best way to ensure purity of purpose and mission.

Remington makes a compelling practical argument, however: UWM lacks an administrative structure and the resources to create a school of public health. That shouldn't be an excuse but rather more motivation for UWM Chancellor Carlos Santiago and others to get busy.

Some of the more than $600 million in so-called Blue Cross money given to the UW Medical School and the private Medical College of Wisconsin in Wauwatosa for public health initiatives could be used to help establish a school of public health at UWM. Both medical schools already collaborate with UWM.

By all means, Milwaukee collaboration with Madison should continue, if only to make the medical school's graduates there the best they can be. But it's a two-way street. The spirt of collaboration should also dictate that Madison recognize that the need for an independent school of public health is greatest in Milwaukee.

It is simply the best place for such a school.

Copyright 2005, Journal Sentinel Inc. All rights reserved. (Note: This notice does not apply to those news items already copyrighted and received through wire services or other media.)

Source: Milwaukee Journal Sentinel

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