By DR. ALEXANDER BILLIOUX | Assistant Secretary, LDH Office of Public Health
At the beginning of every year, many of us make resolutions for the year to come, and most of those relate to goals to improve our health. With Louisiana Department of Health Secretary Dr. Rebekah Gee declaring 2019 the “year of public health,” the Office of Public Health is no different. We are setting some big goals to improve Louisiana’s health, and big goals are needed because the state faces big health challenges.
The United Health Foundation’s America’s Health Rankings often ranks Louisiana among the least healthy states in the country. However, a closer inspection of this year’s results reveals a more complicated picture of the state’s health. Medicaid expansion continues to drive down the state’s rate of uninsured individuals, and perhaps as a result, the number of Louisianans with dedicated healthcare providers has increased. Similarly, access to care likely had some impact on improvements we achieved in the rates of cancer deaths, childhood immunizations and suicides last year.
So then why does Louisiana continue to be ranked low with all these improvements? The answer reminds us that achieving and maintaining good health requires more than healthcare. Indeed, though we performed well on many direct measures of healthcare and public health services, we continue to have some of the nation’s worst rates of infant mortality; infectious diseases like HIV, hepatitis C and syphilis; and chronic illnesses like obesity, heart disease and diabetes. These illnesses drive the high levels of preventable hospitalizations and early deaths that continue to challenge us.
Understanding what is driving those conditions is critical to shaping our response, and the America’s Health Rankings report sheds some light there as well. We know that social, behavioral and environmental factors have a three to six times greater impact on health than access to healthcare. So Louisiana’s high rates of disconnected youth, violent crime and un/under-employment, along with low rates of high school graduation and median income, not only mean life is harder for many in our state, but that these factors are also robbing us of health and life.
The Year of Public Health
Rising to these meet these health challenges and truly “moving the needle” on the state’s health will require more than simply doubling down. Improving the health of all Louisianans requires nothing less than a shift to a culture of health statewide. The Office of Public Health can and will lead that shift, but we cannot do this alone.
We need to expand our reach into communities and create new allies among businesses, schools and community organizations and leaders. We need to communicate the value of focusing on health, both to improve our neighbors’ lives, as well as to stop health care costs from consuming all other resources across the state. If you care about building new schools and paying teachers to train our future workforce, or building new roads to get your products to stores and consumers, or being able to invest more in helping our communities prosper, you need to care about improving health.
To lead this culture shift, the Office of Public Health plans to innovate, partner and lead the state to a future of better health.
We are innovating by applying new strategies to tackle some of our biggest health challenges, like launching our house call-based syphilis treatment program for pregnant women and their partners. Or by establishing the nation’s first statewide hepatitis C elimination program by combining a game-changing drug purchasing arrangement, giving the state unrestricted access to treatment with a public health-led effort to screen, link into care and cure those living with hepatitis C in the Medicaid and corrections populations over the next five years.
We are partnering with health systems and providers across the state by sharing local health data and helping set targets for care improvement; as in our Perinatal Quality Collaborative focused on reducing Louisiana’s high levels of maternal mortality in partnership with 31 birthing facilities across the state. Or by participating in the Secretary’s Taking Aim at Cancer in Louisiana initiative, bringing together health systems, researchers, insurers and advocates to reduce the state’s high rates of breast and colon cancer, especially among people of color.
And, we will lead by engaging businesses, schools and local governments across the state to establish policies and programs addressing the social determinants of health, such as by helping establish more smoke-free zones and by launching a new health-related social needs navigation pilot program in St. Landry Parish.
I am grateful to be able to join you all in this incredibly important work. Together, we will take on these challenges and improve the health of our state. As President John F. Kennedy observed: “… that challenge is one that we are willing to accept, one we are unwilling to postpone and one which we intend to win.”