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 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.

Ochsner is using a digital platform developed by Unite US to expand and improve community health throughout Louisiana, in partnership with CVS Health and Humana. The platform is used by insurance companies’ care managers and provider teams to coordinate social services for patients. The Louisiana Unite US more than doubled following the outbreak of COVID-19 (Unite US, 2020).

Unite US. “CVS Health, Humana, Ochsner Health, and Unite Us Join Forces.” 2020. Uniteus.Com. November 18, 2020. https://uniteus.com/press/unite-louisiana-healthcare/.

As a tax-exempt hospital, Ochsner produces publicly accessible community health assessments as a requirement of the Patient Protection and Affordable Care Act (PPACA). As a statewide network, Ochsner has conducted health assessments for Shreveport, Lafayette, Monroe, New Orleans, Kenner, Baton Rouge, St. Mary, St. Anne, Northshore, Houma, Kaplan, Crowley, and Breaux Bridge, as well as Bay St. Louis in Mississippi. 

Ochsner’s proprietary Diversity, Equity and Inclusion (DE&I) Dashboard launched in 2022. The dashboard does not appear to be public however and there is very little available information about this tool. Ochsner's 2022-2023 impact report describes the tool as follows:  “In 2022, Ochsner’s proprietary Diversity, Equity and Inclusion (DE&I) Dashboard launched, informing delivery model innovations and enabling clinicians to identify populations with gaps in care and outcomes. The dashboard includes patient experience and care metrics, with data sortable by sociodemographic groups like race, location, and insurance type. Through the dashboard, we could see that 36% of Ochsner Health Network patients with hypertension are Black or African American, and of those, 80% have their hypertension controlled. In comparison, 86% of white patients with hypertension have it controlled. This data was in turn used to inform strategies to close gaps in care and improve outcomes”  (Ochsner 2022-2023 Impact Report, n.p.). 

Ochsner Health Network. “2022 – 2023 Impact Report, Accelerating Value-Based Care.” Accessed March 2nd 2024.  https://www.ochsner.org/impact-report/. 

Ochsner’s  Enterprise Data Warehouse (EDW) stores clinical data collected over more than 20 years, includes data captured through EPIC/Clarity and claims data.

According to Philip M. Oravetz, MD, MPH, MBA, chief population health officer at Ochsner Health, Oschner is in the process of developing an electronic health record that includes demographic and SDOH data collected at the point of care, and then integrated into artificial intelligence (AI) and predictive modeling (Caffrey and Klein 2022). 

Caffrey, Mary, and Hayden Klein. 2022. “How Ochsner, Xavier Are Working Together to Make Louisiana a Healthy State,” December 2022, 10 (December). https://www.ajmc.com/view/how-ochsner-xavier-are-working-together-to-make-louisiana-a-healthy-state.

Oschner was founded on January 2, 1942, in New Orleans by Alton Oschner, an American surgeon and medical researcher. Before founding Oschner, he worked at Tulane University and organized a surgical teaching program at New Orleans Charity Hospital. Oschner Medical Center, formerly known as the Oschner Clinic, was the first to document the connection between cancer and cigarette use. This work mobilized Oschner to expose the hazards of tobacco and pioneer the war against smoking. 

Blum, Alan. 1999. “Alton Ochsner, MD, 1896-1981 Anti-Smoking Pioneer.” The Ochsner Journal 1 (3): 102–5.

Ochsner’s mission statement is to “We Serve, Heal, Lead, Educate and Innovate” (Ochsner n.d.).

Their vision is to inspire “Healthier Lives and Stronger Communities” (Ochsner n.d.)

Ochsner. N.d. “Mission, Vision, Values.” https://www.ochsner.org/values. 

The LDEQ’s organizational predecessor was founded as the Stream Control Commission (SCC) in 1940. 

The death of a young man in Iberville Parish later spurred the formation of the Department of Environmental Quality. In 1978, 19-year-old Kirtley Jackson died from hydrogen sulfide fumes from an unlicensed hazardous waste pit. In 1983, the Louisiana Environmental Quality Act authorized the established of LDEQ. 

In 1988, environmental scientist Paul Templet was appointed to head the LDEQ by Gov. Buddy Roemer. At the time, the first annual National Toxics Release Inventory had just been released and Louisiana was listed as one of the worst offenders. Templet and Roemer worked with the Legislature to pass a law “requiring that toxic pollution statewide be cut in half over a decade, a goal Louisiana industry met and exceeded” (Russell 2019). Templet developed a plan to create environmental scorecards tied to tax incentives and other incentives. Under Templet, LDEQ took action to protect human health from pollution. For instance, LDEQ fined and revoked a permit from Marine Shale Processors, a company using dangerous industrial waste in an area of St. Mary Parish with a cluster of rare pediatric cancers. Templet describes his work in LDEQ in “Defending the Public Domain: Pollution, Subsidies and Poverty” (2001). In this paper, Templet includes data showing how investment and jobs in Louisiana increased as pollution declined (contrary to common industry warnings). 

The president of Marine Shale Processors ultimately spent $400,000 on ads against Roemer in the 1991 gubernatorial primary. Roemer ended up in third place behind Edwin Edwards and white supremacist David Duke.

Dr. Paul Templet Interview. 1988. Louisiana: The State We’re In.  PBS Digital Collection. http://ladigitalmedia.org/video_v2/asset-detail/LSWI-1116-05_Templet. 

Russell, Gordon. 2019. “How an Environmental Regulator Became Known for Protecting Industry.” ProPublica. December 19, 2019. https://www.propublica.org/article/how-an-environmental-regulator-became-known-for-protecting-industry.

Kaare Johnson Talks. 2023. “Dr. Paul Templet, Former Head of La DEQ Joins Kaare To Discuss Lack of Enforcement And More!” Streamed on Sep 11, 2023. https://www.youtube.com/watch?v=e-8jJtKRI2w. 

Templet, Paul H. 2001. “Defending the Public Domain: Pollution, Subsidies and Poverty.” SSRN Scholarly Paper. Rochester, NY. https://doi.org/10.2139/ssrn.333280.

The department is divided into the following entities:

The Office of the Secretary

The Office of Management and Finance

The Office of Environmental Services

The Office of Environmental Compliance

The Office of Environmental Assessment

Regional Offices in Baton Rouge, Harahan, Bayou Lafourche, Lafayette, Lake Charles, Alexandria, Monroe, and Shreveport. 

Aurelia Skipwith Giacometto was just appointed by the Landry administration as DEQ Secretary. She formerly served in the U.S. Fish and Wildlife Service (2020-2021) under the Trump administration. Prior to these positions, she worked as an executive for Mosanto Co. and has played an active role in pushing back on environmental justice efforts and climate science (e.g. contributing to leading the Steamboat Institute, a nonprofit against climate change science). She is also part of the advisory board of Collossal BioSciences, a company specializing in genetic engineering that is attempting to resurrect the woolly mammoth (O’Donoghue 2023). Giacometto’s predecessor, Chuck Carr Brown, was a former Exxon employee.

O’Donoghue, Julie, Louisiana Illuminator November 15, and 2023. 2023. “Jeff Landry Picks Former Trump Official, First Black Woman for Environmental Post.” Louisiana Illuminator (blog). November 15, 2023. https://lailluminator.com/2023/11/15/landry-environment/.

A survey of DEQ employees conducted by the Louisiana Legislative Auditor Office in 2006 revealed the department’s challenges with poor communication and knowledge infrastructure. Employees noted in the survey a need for better mechanisms through which to share information within LDEQ (“about who does what and other issues”) and better training for new employees. 

Louisiana Legislative Auditor. 2006. “Louisiana Department of Environmental Quality.”

https://app2.lla.state.la.us/publicreports.nsf/0/bbc259a7e7a73cfa8625713b002c8e7b/$file/00001572.pdf?openelement&.7773098.

"In response to growing public pressure, state legislators created the Stream Control Commission (SCC) in 1940. It advocated cooperation as a way to retain industries and protect their payrolls, and it relied in part on industrial expertise to set pollution thresholds. Touting its early accomplishments, the SCC claimed its policy resulted in an “almost 100% correction of that [pollution] from oil refineries.”13 Thus on the eve of the wartime industrial build up, the state admitted that refiners had created pollution but claimed that the SCC was an effective response and had pollution under control.” (Colten 2012, 96)

 "By the early 1950s the SCC suggested that pollution was only noticeable during low-river stages and that “little remains to complain about regarding the effluent coming from this [Baton Rouge Esso] plant.” Such positions accommodated industry’s continuing reliance on the river as a waste disposal sink.14” (Colten 2012, 96-97)

“Escalating pollution problems, however, exposed the inadequacies of the system and prompted a series of water-quality investigations. Federal studies in the 1950s asserted that pollution was a pressing problem, but the prevailing view among state officials was that pollution was a limited, localized issue; their permitting and enforcement actions, which did little to impede uncontrolled discharges to the river, reflected this perception. The state’s lackluster response continued into the 1960s. Following an industrial spill that contaminated public water supplies in 1960, the state created a warning system that placed the burden on water-supply operators to close their intakes and imposed no penalties or new requirements on industries responsible for spills.15” (Colten 2012, 97)

“A major fish kill during the winter of 1963–1964 created a nationally significant event that served as the tipping point for a policy shift. Endrin, an agricultural chemical used in sugarcane fields in south Louisiana, was responsible for an estimated 5 million fish deaths that winter. Louisiana officials were unable to pinpoint the source and requested assistance from the U.S. Public Health Service. The federal investigation pointed toward an Endrin manufacturer far upriver in Memphis, Tennessee, not lower-river sugar planters or grinding mills. Occurring shortly after the publication of Rachel Carson’s Silent Spring (1962), this event captured public attention. Congress conducted hearings on the calamity, and the Public Health Service convened a public conference on interstate pollution of the lower Mississippi. This event transformed public and government opinions about the scale of pollution and recast lower–Mississippi River pollution as a regional problem that could harm people, not just fish.16” (Colten 2012, 97)

“Industrial pollution came under even more intense scrutiny in 1974 when a national exposé reported that the New Orleans water supply contained cancer-causing organic chemicals and that the city’s residents had a history of above-average cancer rates. The exposé sparked a debate among Louisiana officials and garnered considerable national attention as it cast the Mississippi River as a waterway sacrificed for industrial gain.” (Colten 2012, 97)

“By the 1990s the Baton Rouge–New Orleans industrial corridor stood out as one of the most prominent zones of chemical plant explosions. In addition to the threat from a deadly chlorine leak when a barge sank during Hurricane Betsy in 1965, major explosions at the Shell refinery at Norco (in 1979 and 1988) and at the Exxon (former Standard) refinery at Baton Rouge (in 1989) caused fatalities and inflicted damage on neighboring communities.7” (Colten 2012, 94)

Craig E. Colten. 2012. "An Incomplete Solution: Oil and Water in Louisiana." Journal of American History, Volume 99, Issue 1, June 2012, Pages 91–99, https://doi.org/10.1093/jahist/jas023.

In the years following Gov. Buddy Roemer and Paul Templet’s leadership of the DEQ, “Louisiana has not seen a governor make environmental protection a priority” (Russell 2019). Templet was replaced with Kai Midboe, an attorney who had formerly represented the gas and oil industry. The environmental scorecard program ended. In 2008, Bobby Jindal became governor and cut 300 positions from the department. 

Between 2008 and 2018, Louisiana reduced environmental protection program funding by 35% and reduced its staffing by 30% (Environmental Integrity Project 2019). A 2021 legislative audit of LDEQ found that “DEQ faces challenges related to low staffing levels, high workloads, frequent turnover of staff, and ineffective data systems that make it more difficult to perform its regulatory work. For example, DEQ’s positions dedicated to air quality regulation decreased 14.6%, from 247 in fiscal year 2010 to 211 in 2019.” (Louisiana Legislative Auditor 2021).

Today, LDEQ explicitly avoids use of the term “Cancer Alley,” according to the department spokesperson Greg Langley: “ ‘That term implies that there is a large geographic area that has higher cancer incidence than the state average. We have not seen higher cancer incidence over large areas of the industrial corridor between Baton Rouge and New Orleans.’ ”—this, despite the data from the EPA showing that almost every census tract in the area is ranked in the top 5% nationally for cancer risk as a result of toxic air pollution (LaRose 2024).  

 “The Thin Green Line.” Environmental Integrity Project. December 5, 2019.

Russel, Gordon. 2019. “How an Environmental Regulator Became Known for Protecting Industry.” ProPublica. December 19, 2019. https://www.propublica.org/article/how-an-environmental-regulator-became-known-for-protecting-industry.

Kaare Johnson Talks. 2023. “Dr. Paul Templet, Former Head of La DEQ Joins Kaare To Discuss Lack of Enforcement And More!” Streamed on Sep 11, 2023. https://www.youtube.com/watch?v=e-8jJtKRI2w. 

Templet, Paul H. 2001. “Defending the Public Domain: Pollution, Subsidies and Poverty.” SSRN Scholarly Paper. Rochester, NY. https://doi.org/10.2139/ssrn.333280.

LaRose, Greg, Louisiana Illuminator February 1, and 2024. 2024. “DEQ Remains in Denial over ‘Cancer Alley’ Industry Correlations.” Louisiana Illuminator (blog). February 1, 2024. https://lailluminator.com/2024/02/01/cancer-alley-3/. 

Louisiana Legislative Auditor. 2021. “Monitoring and Enforcement of Air Quality. Louisiana Department of Environmental Quality.” https://app2.lla.state.la.us/publicreports.nsf/0/bbc259a7e7a73cfa8625713b002c8e7b/$file/00001572.pdf?openelement&.7773098.