Parish Health Rankings 2014: Time For Reflection

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Dr. David J. Holcombe
Dr. David J. Holcombe

Every spring, the Robert Wood Johnson Foundation, in collaboration with the University of Wisconsin’s Population health Institute, publishes the “County Health Rankings”.  The results provide a snapshot of health in the state and the opportunity to devote time, energy and money to areas of particular concern.

 

The results are divided into “Health Outcomes”, based on length and quality of life, and “Health Factors” (also called “health determinants”), based on a complex group of measures of health behaviors, clinical care indicators, social and economic factors and environmental factors, which influence health outcomes.  For the specific measures and how these values are weighted, consult the www.countyhealthrankings.org site.

 

So how does Cenla do when our eight parishes are compared to each other and to all 64 parishes of Louisiana?  As in past years, the picture is mixed.  As far as health outcomes are concerned, LaSalle (10/64) and Vernon (14/64) fall in the top third of Louisiana parishes, Winn (22/64), Rapides (32/64) and Grant (33/64) land in the middle third, and Avoyelles (45/64), Concordia (55/64) and Catahoula (61/64)  fall in the bottom third.  These groupings have changed little since 2010, with almost no trends except a modest improvement in Vernon (from 35/64 to 29/64) and a slight worsening in Vernon (from 2/64 to 14/64).  Those Louisiana parishes with poorer outcomes form a cluster adjacent to Caddo-Bossier and another that extends down the Mississippi River (on both sides, including parishes in Mississippi and Arkansas).

 

Since “Health Factors” (or determinants) result in “Health Outcomes”, there is always a more or less direct correlation between the two.  Once again, our Cenla parishes fall in three groups:  Rapides (18/64), LaSalle (19/64) and Vernon (21/64) fall in the top third of Louisiana parishes, Grant (34/64) and Winn (40/64), are in the middle third, and Avoyelles (52/64), Concordia (53/64) and Catahoula (57/64) appear in the bottom third.  There does appear to be some improvements in heath factors from 2010 to 2014 in Vernon (from 44/64 to 24/64) and a modest deterioration in Catahoula (from 53/64 to 60/64).

 

Compared to other OPH regions, Cenla has the same lack of homogeneity among parishes.  There are healthier parishes and less healthy parishes.  Statewide, St. Tammany Parish came in 1/64 for both outcomes and factors.  Without taking anything away from that accomplishment, it should be remembered that, as a state, Louisiana ranked 48/50 states in its overall rank in America’s Health Ranking 2013 (www.americashealthranking.org).  In that national ranking, we are 44/50 for outcomes and 49/50 for “determinants” (factors).  Although the two ranking systems do not use identical measures, 16 are same.

 

Tackling health issues proves to be a daunting task, and Louisiana’s Department of Health and Hospitals has a host of programs to help improve our national rankings (and target areas of specific need within the state).  The depth and complexity of the issues, often compounded by serious racial disparities, requires a concerted effort by individuals and government.  It has been repeatedly shown that health can be a byproduct of three measures:  income, educational level and social status.  When any of these variables increases, health outcomes improve as well.   Poverty, low educational levels and low social status remain enemies to health, not just in Cenla, but everywhere in Louisiana, the United States and the world.  Working together as individuals and organizations, we can not only improve our rankings within the state, but also relative to other states and countries.