Why the local handling of public health is fractured and expensive.

Survey the public health infrastructure in the counties that surround Milwaukee – Waukesha County, Ozaukee County, etc. – and you’ll notice a common thread. Each has a county-level health department to shoulder such responsibilities as food inspections and lead prevention. So why does Milwaukee County instead rely on a balkanized system of a dozen local health departments, many of them carrying out the same functions?

The nonpartisan Public Policy Forum raised this question in 2011 when it convened a meeting with representatives from Milwaukee County’s 19 municipalities to talk about areas, such as emergency dispatch, where the localities could consolidate efforts and thereby save money and resources. Several North Shore communities did just this in the mid-1990s when they formed the North Shore Health Department, which later grew to include Bayside, Brown Deer, Fox Point, Glendale, River Hills, Shorewood and Whitefish Bay. But when PPF brought up the idea of further consolidating the additional 11 health departments located in Milwaukee County, “There was immediate pushback,” says PPF President Rob Henken. And as “it’s not our style to tell municipalities what to do,” he says, the question fell by the wayside.

In general, the joint effort has worked well and spares the individual municipalities the cost and burden of administering their own local offices, according to Ann Christiansen, health officer for the North Shore Health Department, whose job it is to communicate with the seven governments that support it.

“Public health could be consolidated at the county level,” says Henken, but a more serious investigation would be needed. “We’ve never done a deep dive.”

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‘For Your Health?’ appears in the October issue of Milwaukee Magazine.

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