Over the last few eventful years in public health, we have learned that when we partner with communities, listen to their needs and amplify their voices, the progress we make is not only more substantial — it’s meaningful.
We know this approach works based on the results of our COVID-19 vaccine strategy. At the start of the crisis, the data spoke volumes: Death rates among African Americans were 15.99 per 100,000, compared to 3.79 per 100,000 among White residents. That disparity was alarming, but not surprising given the health disparities and barriers to access that existed in vulnerable communities for decades prior to the pandemic.
The incoming data told us we urgently needed to close the gap and reach communities where COVID-19 was inflicting the most devastation. By meeting people where they were through active and strategic partnerships with community groups, organizations, elected officials and health providers, we were able to build trust and get health information out in a way that mattered.
We partnered with organizations and coalitions that knocked on doors, ran phone banks and helped us identify barriers, answer questions and organize events in trusted locations. In addition to enrolling traditional vaccine providers, shots have been administered at more than 12,000 pop-up clinics at churches, community and senior centers, and in the workplace.
These intentional efforts have led to one of the highest vaccine equity scores in the nation, with Louisiana scoring a 937 out of 1,000 on the scale graded by the U.S. Department of Health and Human Services. For context, the national average in March was 543 out of 1,000. We have scored above 900 since the score was released in spring 2021.
Meaningful community engagement has also been key to supporting the launch of the 988 suicide and crisis lifeline. We’ve learned that those most vulnerable to suicide and mental health crisis belong to marginalized communities. This month, we are holding listening sessions with residents representative of marginalized communities to better understand what would improve the likelihood that those vulnerable would make a life-saving call. It is critical that those who are more likely to need support are aware of 988 and see it as a resource that is built to serve everyone.
Over the last two years, the Louisiana Department of Health has partnered with unconventional sites throughout Louisiana to address two of the most prevalent chronic diseases that result in poor health outcomes: high blood pressure and diabetes. Through community partnerships, we conducted blood pressure tests and screenings as well as diabetes prevention classes in convenient, familiar locations like athletic events, barber shops, churches, festivals, gyms and libraries. This approach — rooted in community engagement and focused on removing barriers to health resources — works because communities know their needs best.
Key partners in both the fight against COVID-19 and the ongoing work to improve health outcomes in Louisiana are our hospitals. But to ensure our hospitals could continue to care for our communities, including our most vulnerable residents, we knew we needed to revisit the way we reimburse them for services. As we examined our payment system, we also knew we needed to work collaboratively with our hospital partners and gather valuable feedback. The new payment system is now geared toward paying hospitals based on how Medicaid members utilize services in a way that incentivizes comprehensive care.
Additionally, for the first time, LDH invested in directed payments to psychiatric, long-term acute care and rehabilitation hospitals. This investment in post-acute hospital care prioritizes specialty care for those with mental illness and the elderly. Ultimately, the reforms — which wouldn’t have been possible without the leadership of Gov. John Bel Edwards and the support of the Legislature — preserve about $1.7 billion in hospital funding while adding approximately $925 million in funding to these systems.
As we close out 2022, I am more optimistic about what we can do together thanks to the many partnerships we have deepened this year. We have much more work to do, especially given the setbacks the COVID-19 pandemic dealt us. But I know we can overcome those challenges because of what we’ve learned together, and set a new course to realize a healthier Louisiana, together, in 2023.
Courtney N. Phillips is secretary of the Louisiana Department of Health.