Louisiana has a history of ranking dead last nationwide on overall health. A new initiative has set out to change that and recently published its plan on how to do it.
LA40by30 is an initiative by the Louisiana Center for Health Equity, a nonprofit based in Baton Rouge, with the goal to move the state up 10 ranks in the annual America’s Health Rankings, in which it has come in last place for the past two years.
As its first order of business, the group prepared a report outlining some of the biggest health challenges facing the state, zeroing in on childhood trauma, women’s health and poverty. It outlined ambitious plans to combat them, too, some of which are likely to face political headwinds.
Combatting the effects of childhood trauma
The first issue the group is hoping to tackle are adverse childhood experiences (ACEs), such as abuse, neglect or violence experienced by children that can have lifelong effects on their educational achievement, mental health and overall wellbeing.
“Childhood trauma and economic instability often have residual effects that echo into adulthood,” the report states. “Addressing trauma is increasingly understood as an important component of behavioral health service delivery.”
To help children overcome the effects of traumatic experiences, the group calls for more mental health counseling in schools, training in trauma-informed practices for school and health care staff, and increased screening and therapeutic opportunities for children and adolescents.
The group also called for a less punitive approach to students’ disciplinary issues, such as reducing the use of suspension and eliminating vaguely defined infractions like “willful disobedience,” which they say are overused and disproportionately hinder the education of Black students.
“We would like to see an approach that addresses the social, structural and institutional drivers that create the crime in the first place,” the center’s founder and president, Alma Stewart Allen, said. “Focusing more on community safety than law enforcement and incarceration.”
Improving women’s health
Another key factor in Louisiana’s bad health outcomes is the lack of access to healthcare for women, the group states, citing a 2020 March of Dimes report that found that women in the state often had to travel long distances to access obstetric care, along with Louisiana’s high maternal and infant mortality rates.
“If we can improve women’s health and the health outcomes for women, that is one strategy for improving overall health outcomes,” Stewart said. “If women are healthier, the families are going to be healthier.”
The center noted the creation of the state’s Office of Women’s Health and Community Health as a step in the right direction, but also pointed to some barriers to achieving its mission.
“The office’s capacities for carrying out these charges remain limited by a lack of funds and exclusionary language in the law which restricts services to those born ‘biologically female,’” the report states.
The office’s secretary, Dr. Torrie Harris, in a previous interview with The Current acknowledged a lack of funding is one of its main challenges. The office was funded at $925,000 for the current fiscal year.
Stewart encouraged the office to pursue federal funding to make up for the lack of state funding and ensure it can pursue its mission effectively. “Women’s health is a big priority in the [Biden] administration,” Stewart said. “I think Louisiana could get significant additional funding from the federal level.”
Fighting poverty by increasing the minimum wage
Louisiana currently adheres to the federal minimum wage of $7.25, something the report says contributes to the state’s bad health outcomes by keeping much of its population poor.
“Economic stability is vital to health and wellbeing,” the center said in its report, arguing that historic economic exploitation and structural racism have created deep inequality and poverty in the state.
Eating healthy meals, spending time as a family, going to regular medical appointments — many of the basic steps to maintaining a person’s health are impossible for someone earning the federal minimum wage, Stewart argued.
“No one can live on $7.25,” she said. “People need to have an income that allows them to have a decent standard of living.”
While many other states have minimum wage requirements far above the federal level, the signs in Louisiana are not pointing in the direction of change on that front. Several legislative attempts to raise the minimum wage have failed in recent years, including a proposal last year that would have gradually raised the state minimum to $14 by 2028, which would still place it below current state minimum wages in several states in the West and Northeast.
If Louisiana wants to keep its residents local and healthy, Stewart said, state legislators need to “create public policies that allow the population to be able to live in this state and pay their bills.”
Measuring outcomes
To measure the success of any initiatives aimed at improving the state’s health outcomes, the center proposed incorporating the same indicators used by America’s Health Rankings into public health tracking and surveillance systems.
“Clear, measurable, and realistic benchmarks will be necessary to determine if the tactics being used are successful,” the report stated. “We need data that shows where we are starting from and a clear plan to track our progress on an ongoing basis.”
The list consists of 16 indicators, including obesity, cancer deaths, food insecurity and teen suicide rates.
On this matter, the center is taking its own steps by creating a platform it dubbed the Data & Action Health Equity Platform or DAP, which will keep track of the data as well as allow organizations and providers to share information and collaborate on interventions.
After a 6-month pilot, the center is now looking for financial supporters to fund a full version of the platform. “We need resources to bring it to scale,” Stewart said. “It’s really contingent on us raising the funds.”