Analyze

Place-making practices refer to the ways in which people create and define physical spaces as meaningful and significant through their everyday activities and social interactions.[1] In Ethnography, the study of these practices is often referred to as ‘ethnography as place-making,’ which involves the exploration of the cultural meanings and practices that shape the physical and social environments in which people live. This can include examining how people create and maintain social boundaries, how they express their identities and values through the built environment,[2] and how they negotiate power and control over the spaces they inhabit.

This place in Gröpelingen is made a place through the interaction of the people tending to the urban gardening project. 

1. Pink 2008, 178ff. 

2. See: urbanization 

3. Pink 2008, 190. 

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“Since asthma surveillance data were not available at the census tract level for most of Louisiana, we estimated asthma burden using the inpatient discharge data available through LDH.”  (4)

“Case counts are not provided for CTs with a 2018 population of less than 800 to safeguard privacy.” (4)

“To minimize the need for suppression, inpatient discharge data was aggregated for the three most recent years available (2017–2019) and average annual crude rates were calculated for cases where asthma (ICD-10 code J45) was the primary diagnosis, as well as where asthma was any diagnosis.” (4)

“Spearman’s Rank Correlation was utilized to analyze the correlation between various social and environmental vulnerability factors, COVID-19 incidence, and the measures of asthma risk by CT.” (4)

“This was performed by first ranking the values in each dataset using RANK.AVG function in MS Excel 2016, followed by applying the PEARSON function to compare two datasets. Significance was set at alpha less than 0.05 (α < 0.05), with degrees of freedom (df) equal to two less than the total number of data points represented in both datasets” (4)

The research team works for the Section of Environmental Epidemiology and Toxicology, Office of Public Health, Louisiana Department of Health in Baton Rouge. Team members included Arundhati Bakshi; Shanon Soileau; Collete Stewart; Kate Friedman; Collete Maser; Alexis Williams; Kathleen Aubin; and Alicia Van Doren. 

“Currently, much of the environmental focus of the pandemic remains on PM2.5 levels; however, we noted that higher levels of ozone was consistently associated with higher incidence rates of COVID-19, and it was the only environmental factor that appeared to have an additive effect over SVI on COVID-19 incidence (Fig 1).” (11)

“Specifically, our data show a moderately strong positive correlation between SVI due to minority status/language barrier and three health data variables: asthma hospitalization; estimated asthma prevalence; and cumulative COVID-19 incidence at 3 months (Table 2). Interestingly, SVI measures were either negatively or not significantly correlated COVID-19 incidence at the 9-and 12-month time points, indicating that social vulnerability factors may have played a greater role in COVID-19 spread early in the pandemic, but may have been of diminishing importance as the pandemic wore on (Fig 1 and Table 2).” (9)

Bakshi A, Van Doren A, Maser C, Aubin K, Stewart C, Soileau S, et al. (2022) Identifying Louisiana communities at the crossroads of environmental and social vulnerability, COVID-19, and asthma. PLoS ONE 17(2): e0264336. https:// doi.org/10.1371/journal.pone.0264336. 

This document uses data resources from the Center for Disease Control/Agency for Toxic Substances and Disease Registry (CDC/ATSDR), the Environmental Protection Agency (EPA), and the Louisiana Department of Health (LDH).

These data resources include the Social Vulnerability Index (2018 - CDC/ATSDR), the NATA Respiratory Hazard Index (EPA 2014), PM2.5level (average annual concentration in ug/m3, EPA 2016), ozone level (summer seasonal average of daily maximum 8-hour concentration in air in parts per billion, EPA 2016), indoor mold concerns reported to IEQES program (average annual number of calls, LDH 2017-2019), cumulative COVID-19 incidence rate at 3-, 6-, 9- and 12-month increments (LDH March 2020 - March 2021), asthma hospitalization (average annual crude rate, where asthma was a primary diagnosis among hospitalization cases, LDH 2017-2019), and estimated asthma prevalence (average annual crude rate, where asthma was any diagnosis among hospitalization cases, LDH 2017-2019).

Ochsner Health is a 501(c)3 not-for-profit organization and one of the US’s largest non-university academic medical centers.  It encompasses 46 hospitals and more than 370 health and urgent care centers. There are more than 38,000 team members and over 4,700 physicians employed or affiliated with Oschner. 

Ochsner. N.d. “About Ochsner.” https://www.ochsner.org/about-ochsner. Accessed March 1, 2024. 

Xavier University of Louisiana -  Oschner and Xavier’s partnership has been centered around establishing a joint College of Medicine, to “create a strong physician pipeline that addresses longstanding inequities within the nation’s health care system and builds the health care workforce of the future” (Xavier University 2023). Xavier and Oschner have partnered since the early 1980s, when Oschner began offering clinical training sites for Xavier pharmacy students. Today, Ochsner and Xavier have established a master data sharing and use agreement that provides Xavier faculty with access to Oschner Health’s electronic medical record data. The program has hired four data scientists to provide data analytic services to Xavier faculty. They have also worked together to launch Oschner’s health equity data and quality improvement strategy. Advocacy emerging from this partnership has focused on the expansion of services covered by Medicaid to include tobacco cessation, as well as increasing access to evidence-based maternal health technology. 

“Xavier University of Louisiana and Ochsner Health Partner to Create College of Medicine and Pursue Health, Educational Equity - Xavier University of Louisiana.” n.d. Accessed February 27, 2024. https://www.xula.edu/news/2023/01/xavier-university-of-louisiana-and-ochsner-health-partner-to-create-college-of-medicine-and-pursue-health-educational-equity.html.

Ochsner. 2023. “Ochsner Health-Community Benefit Report.” https://issuu.com/ochsnerweb/docs/communitybenefitreport_8x10.5_final. 

Chevron - Oschner’s partnership with Chevron is centered around a smoking cessation and education program that was launched in 2021. In 2023, Chevron opted to continue the partnership for a third consecutive year through a $50,000 donation. The program is offered in the following parishes: Jefferson, St. Tammany, East Baton Rouge, West Baton Rouge, Ascension, St. Charles, Terrebonne, and Lafourche.  In a press release for Oschner, cigarette smoking was described as “the leading cause of preventable deaths and diseases in the nation” (Oschner 2023). The release refers to America’s Health Rankings data that indicates smoking as one of the top 20 factors shaping poor health in Louisiana. This program is part of Oschner’s broader Healthy State initiative. Chevron funding also supports initiatives to encourage low-dose CT scans (to detect and diagnose lung cancer), teach high school students about the risks of smoking, and teach people to recognize and treat the stressors that lead to smoking.

Oschner. 2023. “Ochsner Health and Chevron Partner for a Third Consecutive Year to Offer Smoking Cessation and Education Program.” n.d. Online Newsroom. Accessed February 28, 2024. https://news.ochsner.org/news-releases/ochsner-health-and-chevron-partner-for-a-third-consecutive-year-to-offer-smoking-cessation-and-education-program.

 The Healthy State by 2030 initiative emerged in 2020. The goal of the initiative is to improve access to healthcare in Louisiana through community engagement and by partnering with organizations across different sectors (healthcare, business, religion, education, government, and education). The program also includes a focus on collecting, analyzing, and sharing health data. The program’s priorities are to reduce smoking cessation (with 214,000 fewer residents smoking by 2030); improve access to care for cancer and other chronic conditions like diabetes and high blood pressure through screenings (aiming for 100,000 fewer residents with chronic conditions by 2030); reduce obesity rates (with 182,000 “more physically active adults” by 2030); reduce rates of food insecurity (helping 72,000 more households gain access to healthy food); improve per-capita income levels (by $4,838); and improve access to high-speed internet (with 86,000 more homes having access). 

 This initiative is focused on improving health by improving “the conditions in which we are born, live, and work,” in the words of Dr. Eboni Price-Haywood, the medical director of the Healthy State 2030 Initiative and the Oschner Xavier Institute for Health Equity and Research. However, the projects that have been highlighted under this initiative seem to largely consist of expanding Oschners’ service delivery footprint. Ochsner’s expansion has been welcomed by communities that have long struggled to access care, but this form of intervention is limited in addressing broader structural drivers of health. 

One of the largest investments of Health States has revolved around the opening of five new health centers (in Baton Rouge, Lafayette, Monroe, and Shreveport). The health centers are framed as addressing health equity because they are “strategically located in areas of the state with high instances of chronic conditions, low birth weights, infant mortality, and early adult mortality” (Mcelfresh np, 2022). In addition to healthcare services, the centers offer resources for smoking cessation, diabetes management, and “social issues” that include transportation and food insecurity. Each center has an advisory council that includes patients, elected officials, businesspeople, and community members. 

In 2023, Oschner’s executive leadership announced their commitment to the Global Health Network (GHEN) Zero Health Gaps Pledge.  This initiative falls under the UN Sustainable Development Goals and has been described as a part of Healthy State.  

Ochsner Health. N.d. "Healthy State." https://www.ochsner.org/healthystate. 

Oschner Health. N.d. “Ochsner Health Pledges Zero Health Gaps for World Health Day.” Accessed February 28, 2024. https://www.newswise.com/articles/ochsner-health-pledges-zero-health-gaps-for-world-health-day.

McElfresh, Amanda. 2022. “Ochsner’s Healthy State 2030 Uses Community-First Approach to Improve Life for Louisianans.” NOLA.Com. August 7, 2022. https://www.nola.com/sponsored/cox_business/ochsner-s-healthy-state-2030-uses-community-first-approach-to-improve-life-for-louisianans/article_cfb1a366-1345-11ed-bfdf-33daaec76946.html.

Louisiana Clinical Data Research Network (LACDRN) is a collaborative project between the Louisiana Public Health Institute (LPHI), Pennington Biomedical Research Center, Tulane University, and Ochsner Health System. The network provides warehouses of clinical data available to clinical and health systems researchers: “representing a state and region that has unique health challenges related to disparities, natural disasters, high prevalence of chronic diseases, and some rare conditions, LACDRN is an important resource for clinical and health system research that will advance evidence-based diagnosis, treatment, disease management, and healthcare delivery” (Kurshid et al. 2014, 612).

Khurshid, Anjum, Elizabeth Nauman, Tom Carton, and Ron Horswell. 2014. “Louisiana Clinical Data Research Network: Establishing an Infrastructure for Efficient Conduct of Clinical Research.” Journal of the American Medical Informatics Association : JAMIA 21 (4): 612–14. https://doi.org/10.1136/amiajnl-2014-002740.