Parish Health Rankings 2013: Cenla’s Problematic Profile

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

Each spring, the Robert Wood Johnson Foundation, in collaboration with the University of Wisconsin Population Health Institute, releases the County (Parish) Health Rankings & Roadmaps.  These statistics are intended to stimulate local health and state health departments to focus on those problem areas within their states.  These statistics are separated into “Health Outcomes”, based on mortality and morbidity results (often a year or more late) and “Health Factors”, based on a weighted conglomerate of health behaviors (30%), clinical care (20%), social and economic factors (40%) and physical environment (10%).  Each of the health factors is based on a number of components, too numerous to mention here, but readily available on www.countyhealthrankings.org.

 

Over the years, Central Louisiana’s eight parishes have been divided into four groups relative to one another and the other 64 Louisiana parishes.  As far as “Health Outcomes” are concerned, LaSalle (8/64) and Vernon (14/64) rank in the top quartile, Winn (23/64) and Rapides (31/64) rank in the second quartile, Grant (38/64) and Avoyelles (44/64) fall in the third quartile, and Concordia (59/64) and Catahoula (61/64) rank in the bottom quartile of Louisiana Parishes.

 

Since “Health Outcomes” are largely determined by “Health Factors”, there is a rough correlation between the two.  That being said, none of our eight parishes fall in the top quartile of health factors, while Rapides (17/64), LaSalle (22/64) and Vernon (24/64) rank in the second quartile, Grant (35/64) and Winn (46/64) fall in the third quartile, and Avoyelles (51/64), Concordia (54/64) and Catahoula (60/64) bring up the lowest quartile.

 

Over the past four years (since the 2010 County Health Rankings), there has been little variation in these rankings.  LaSalle and Vernon Parishes consistently top the list of Central Louisiana parishes with the best health outcomes, while Catahoula and Concordia have proven the worst.  Over the last four years, there have been no remarkable trends in health outcomes rankings, except perhaps a decline from 2 to 14/64 for Vernon and an improvement from 35 to 29/64 for Winn parishes, respectively.  When health factors are considered, LaSalle and Rapides top the list as the “healthiest” places to live in our region, while Avoyelles, Catahoula and Concordia consistently appear to be the “unhealthiest”.  Since 90% of this determination is based on personal behaviors, access to care and socio-economic factors, it is easier to understand these rankings.

 

While West Feliciana was 1/64 in its health outcomes and St. Tammany (1/64) topped the list for health factors, these rankings must be taken in context of the Louisiana’s state health ranking of 49/50 (America’s Health Rankings 2012).  Being first among the last (or next to last) may not be much cause for celebration.  Having said that, Louisiana health remains a challenge which can only be met by a concerted effort of public policy and individual commitment. Either alone will rarely achieve the desired goals of improvement in our parish (or state) health statistics.