Brekke brings decades of confronting health care barriers to state Health Equity Council

LA CROSSE, Wis. (WKBT) — Sandy Brekke was mystified when, as a spitfire young nurse volunteering at the St. Clare Health Mission in La Crosse, patient outcomes fell short of her expectations.

“When I first started at the mission, I remember being really puzzled that people who went to the clinic had poorer outcomes” than people who were able to afford hospital care, she recalled during an interview.
The doctors and nurses who volunteered at the free clinic were the same ones providing care at hospitals and their clinics, and the level of care was the same, said Brekke, a critical care nurse herself.
Wiser and three decades older now — not that she’s over the hill, as she still can entertain her three adult children and select audiences with her lively dance routine to Michael Jackson’s “Thriller” — Brekke will apply her St. Clare experience as a member of the new Wisconsin Health Equity Council  last week.
“I can bring the perspective of being on the ground,” said Brekke, whose 27 years of involvement at the mission included being its director for nearly 15 years, until she gave up that role in January.
“The longer I was there, the more I understood that health happens out in the community,” she said. “If somebody is homeless and without shelter, they don’t worry about high blood pressure, but where they are going to stay. I worked with inequities and barriers to health care.”
Brekke, a senior consultant in the Office of Population Health at Gundersen Health System, is diminutive in stature but a large figure as an activist for the homeless, disadvantaged and people trying to recover from drug addiction, among other initiatives.
That background will serve her and the Health Equity Council well, said Katie Berkedal, program director at the La Crosse Community Foundation who has worked with Brekke not only at the foundation but also on a variety of causes, including the Alliance to Heal.

“Sandy will bring a well-needed push toward action,” Berkedal said.
“For a long time, people experiencing health inequity have suffered,” with little understanding of their plight, Berkedal said in an interview. “People who treat them only recently have developed … a more heightened knowledge.”
That created a gap between that knowledge and how to apply it to the inequity, a gap that activists such as Brekke can fill to change circumstances of people mired in the unequal conditions, Berkedal said.

Gov. Tony Evers established the council with an executive order  on March 19, 2019. The council was nearing reality when the novel coronavirus derailed it, along with most other things known to man — and woman — early this year.
The council’s charge is to create a comprehensive plan by 2030 to address factors that perpetuate health disparities to achieve equitable health outcomes for all Wisconsinites, Evers said in announcing the council’s 33 members last week.
Council members, who met virtually for the first time Wednesday, come from all walks of life, noted Brekke, who finds praise such as Berkedal’s embarrassing. Most members are not involved in health care, said Brekke, who said that provides the benefit of a broad range of experiences.
Although hospitals provide services when people are sick, she said, ensuring health in everyday life is the key to overall health equality.
That requires addressing factors that affect health, including socioeconomic status; race; access to education, transportation, water and adequate food, as well as geography and other components, Brekke said.
Geography includes balancing conditions not only between urban and rural communities but also those in adjoining neighborhoods, she said.

“Neighborhoods can be only blocks apart, but residents have decades of difference in life expectancy,” said Brekke, who said health inequity has existed for decades but generally remained under the radar.
“I think it just wasn’t talked about,” she said. “Now, with electronic health records, data is much easier to access, and that definitely makes it easier.”
COVID-19 also has brought inequities to the forefront, she said.
The federal Centers for Disease Control and Prevention agrees with that assessment, saying, “Long-standing systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19.” https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html
“To achieve health equity, barriers must be removed so that everyone has a fair opportunity to be as healthy as possible,” according to the CDC.
It’s almost as if the CDC had Brekke in mind with that assessment, with her decades of striving to remove such barriers.
“We’re already seeing the health disparities” with COVID-19, she said, adding, “now that we can see and understand those disparities, it’s perfect timing” for the council to push forward.