EDITORIAL: Being Prepared

Author: Dr. Rebekah Gee, secretary of the Louisiana Department of Health

Recently, the attorney general and others have made statements and have published letters that suggest my agency was premature in alerting nursing home residents and others of the possible impact on their health care and lives should the legislature not properly fund health care services.

To that false allegation, I would ask, “when do you fill your car up with gas … when the tank starts to get low, or do you keep on driving it until it’s empty and it stalls?” Responsibility is not intentionally driving your car until it runs out of gas. Instead, we keep an eye on the indicator and take action before it is too late. Being prepared is being responsible, not only when driving a car, but in all situations.

It was this sole reason that we made the most difficult decision to send letters to nursing home residents and others alerting them there was a strong possibility that the funds necessary to pay for their care would be eliminated. It was important to us to give vulnerable Medicaid recipients enough early warning so they could be prepared.

Going back to the running on empty example … the tank became half-full when the Legislature refused to address the known budget shortfall in 2017 and during this year’s special session. Then, when the House approved a budget that cut health care by more than $1.8 billion a few weeks ago, the tank had run dry.

Although there were some promises that health care funds would be restored during a special session, history of inaction during past sessions left us with little confidence. Those letters were written to give full transparency to those who are at risk for a life and health upheaval, and we have been busy since they were mailed.

We have had numerous meetings with providers, advocates and families to keep them fully informed. We have researched every Medicaid rule and how it affects individual situations to see if there are alternative solutions, and my team has visited every nursing home in the state to meet with patients, families and nursing home staff.

I have also visited several nursing homes and have seen first-hand the heartbreak and anguish on the faces of those whose lives are at risk, and my staff and I have told them the hard truths. As another special session is set to begin, I hope and pray our elected leaders have the courage to take the actions to fully fund not only vital health care services but all of the services that the people of Louisiana rely upon to live their lives to the fullest. 

When a disease outbreak hits, who you gonna call? Disease Detectives

Author: Theresa Sokol, epidemiology manager

When a case of an infectious disease such as measles is confirmed in Louisiana, the epidemiologists in the Louisiana Department of Health’s Infectious Disease Epidemiology Program act as disease detectives to track the causes and consequences of these diseases.

The Program studies the spread of infectious diseases in the community and carries out or coordinates programs that prevent the spread of communicable diseases. With incidents such as the measles case in a traveler from the United Kingdom that was discovered in New Orleans in April 2018, an epidemiological investigation is done.

Don’t wait, vaccinate!

Author: Stacy Hall, Louisiana Department of Health Immunization Program Director

Despite many years of progress, Louisiana’s infant vaccination rates have declined slightly for each of the past three years, and now, over 30 percent of young children in Louisiana are not up-to-date on vaccines that prevent serious diseases.

Freeing Louisiana of racial and ethnic disparities in health

Author: Rudy Macklin, director, Bureau of Minority Health Access

The Bureau of Minority Health Access’s vision is a Louisiana free of racial and ethnic disparities in health and healthcare. Minority Health Month is just one of several programs produced by the Bureau that shines light on that goal.

Since deciding to take part in the federal Department of Health and Human Service’s Office of Minority Health’s program in 1998, the Bureau has awarded mini-grants to deserving healthcare associations, churches, federally qualified health centers, historically black colleges and universities (HBCU), Hispanic groups, Native Americans and Asian Pacific Islanders to carry out minority health activities in their areas.

Many of our programs in Louisiana would never come to light without our community partners to assist with formulating policy, implementing new programs and promoting healthy living in the areas they serve.

Minority Health Month in 1998 was and still is designed to:

•         promote healthy lifestyles;
•         provide crucial information to allow individuals to practice disease prevention;
•         showcase the resources for and providers of grassroots health care and information;
•         highlight the resolution of the disparate health conditions between Louisiana's minority and non-minority populations; and
•         gain additional support for the ongoing efforts to improve minority health year-round.

Health disparities are differences in the overall rate of disease incidence, prevalence, morbidity, mortality or survival rates between different groups. Disparities result not only in a lower overall quality of life among those impacted but of their families and communities as well.

Racial and ethnic differences in health perceptions and health behaviors are often unconventional when compared to modern medicine and can hinder the process of healing and promotion. This is especially the case when health care providers have not received training in cultural competence. The lack of knowledge about the cultural beliefs and health behaviors of a patient can be detrimental to the provision of care.

Although ethnic and cultural beliefs have a powerful influence on the health of minority populations, it is widely observed that socioeconomic status has a greater impact on health than does race and ethnicity.

Due to the overwhelming representation of minorities living below the poverty line in Louisiana, the socioeconomic factor becomes especially relevant to minority health. Level of income tends to dictate where groups live, and therefore what services are available to them. Geographic isolation from health care services is a great disadvantage to many minority populations.

The Impact of Poverty

Poor nutrition, inaccessibility to health care providers, and inability to pay for services are all factors which result from poverty and lead to poor health status. Poverty and poor health are also detrimental to education attainment, as accessibility and ability to afford are impacted by income levels, and poor health affects one's functioning in an academic environment.

For minorities in Louisiana, this means higher rates of diabetes, hypertension and being overweight or obese.

Since 2012, the push to eliminate health disparities has taken an entirely new narrative by minority health advocates. The big push today is about achieving health equity. It is said, “One must reduce health disparities in order to achieve health equity.” Health equity is the attainment of the highest level of health for all people. Health equity means efforts to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives.

As for me personally, true equity lies in understanding not what is legal, but what is just. With new, bold leadership in Governor John Bel Edwards and a dynamic Secretary of Health in Dr. Rebekah Gee, I truly believe now we can get there.

For more information on Minority Health Access, click here.

Medicaid Expansion created new jobs, boosted economy by $3.5 billion

Author: Dr. Rebekah Gee, Secretary, Louisiana Department of Health

When this administration took office, Gov. John Bel Edwards took the immediate step to sign an executive order to make Medicaid coverage available to low-income, working adults. The goal was to ensure that more people had coverage for primary and preventive health care, hospitalizations, mental health care services and substance abuse treatment. The goal was to take the first and most important step to make our residents healthier. It was the right thing to do.