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Initiatives

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#LA40by2030 Campaign 

The 2020 America’s Health Rankings ranks Louisiana 50th in the United States. In response, LCHE has developed the LA40by2030 campaign to improve health outcomes and quality of life for children and families across the state. The goal of the campaign is to improve the state’s national ranking to 40th by the year 2030. LCHE recognizes that improving Louisiana’s health ranking by 2030 will require the participation of government officials, public healthcare professionals, and the general public. LCHE is inviting stakeholders to develop a health equity database and action platform and contribute to achieving #LA40by2030.

Annual Health Summit

LCHE leads an annual health summit with the goal of improving health in Louisiana through the lens of health equity and determinants of health. The summit is designed to engage a diverse array of stakeholders in better understanding rapdily changing conditions of health with the goal of informing policy and building partnerships for community health improvements. This goal of the summit is to inspire action on the state, regional and local levels, and to facilitate progress towards LA40by2030.

The 2023 health summit will focus on population heath, and women and children's health. The summit is also aligned with the Louisiana Department of Health (LDH) state health improvement priorities: behavioral health, chronic disease, community safety, and maternal and child health.

Louisiana Resources and Educational Assessments for Children’s Health (LA REACH)

LA REACH is a pilot program to develop a holistic approach to improving school environments for teachers and students by decreasing instances of student disciplinary actions, violence, alternative school placement, increasing graduation rates, grade point averages, and standardized test scores. The program goals are to address the lack of awareness and resources for mental health, provide trauma-informed training to school personnel, and build stronger home and school relationships. The program strategy is to provide a safe and conducive environment for learning.

Office of Women's Health and Community Health (OHWHCH)

In 2022, LCHE’s organization and activism led to the creation of the first Louisiana office focused on women’s health. The Office of Women’s Health and Community Health (OWHCH) was established under a bill passed by the Louisiana Legislature on June 18, 2022. The office exists to improve women’s health outcomes and act as a coordinating agency and resources center for women’s health data and strategies. 

The Wade Institute for Youth Equity

The Wade Institute for Youth Equity is a year-round program dedicated to pursuing youth equity in key quality indicators, and promoting community safety in communities across Louisiana. For more than a decade, the Louisiana Center for Health Equity has devised and implemented a holistic public health approach to adolescent health. This includes, but is not limited to, youth violence prevention, positive youth development, healthy living including sexual risk avoidance, and mental health wellness. The Institute aims to create a well-rounded and equipped student for positive decision making. 

Louisiana Center for Health Equity: Mission and Vision

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LCHE is dedicated to advancing health equity to improve the overall health and well-being of all Louisianans. Since its founding in 2010, LCHE has worked to eliminate health and healthcare disparities attributed to structural, institutional, or social disadvantages. LCHE educates, advises, and mobilizes in an effort to advance health equity by dismantling health disparities caused by poverty, lack of access to quality healthcare, and unhealthy environmental conditions. In recent years, LCHE’s agenda has centered around supporting the behavioral health needs of youth exposed to trauma and childhood adversity. 

LCHE also provides opportunities for undergraduate and graduate students to participate in experiential learning opportunties through internships and fellowships. Click here to learn more.  

Affiliated Organizations, Collaboration and Critique

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LCHE often collaborates with the following organizations: Louisiana Department of Health, Pennington Biomedical Research Center, Southern University Law Center, Dillard University, and Louisiana State University (LSU), as well as national, state, and community-based organizations, such as the National Collaborative on Health Equity, League of Women Voters, March of Dimes), American Association of University Women (AAUW), National Congress of Black Women, among others. Interdisciplinary collaboration is talked about as an integral component of health equity advocacy. In her Career Pathways interview, founder and director Alma Stewart-Allen has highlighted the importance of bridging gaps between policy, medicine, social science, social services, business, and law. 

LCHE also often works closely with high school and university students, including but not limited to the Louisiana Youth Advisory Council (LYAC). Youth play an integral role in LCHE’s research and advocacy initiatives, through which they acquire the leadership, research and advocacy skills necessary for advancing environmental justice and health equity (see LCHE programs). 

LCHE  acts on behalf of Louisianans who are most impacted by structural inequities. In 2020, ProPublica published an article highlighting the disparities in Covid-related deaths between Black and white patients treated by Oschner Health, the largest nonprofit, academic health system in Louisiana. The journal’s analysis of data from the Centers for Disease Control and Prevention, and the local coroner’s office, found that patients that were Black were more likely to be sent home, and therefore also more likely to die at home. Families reported that Oschner staff pressured them into accepting hospice care. In response, the Louisiana Legislative Black Caucus also called for an investigation of Oschner’s practices. However, the Louisiana Health Department responded by declaring that the complaint was outside their purview. Following this development and seeking more impactful systems-change, LCHE filed a civil rights complaint against Oschner with the Department of Health and Human Services Office of Civil rights. Results of the civil rights investigation are still pending. 

 

Organizational Structure

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LCHE is led by founder and director Ms. Alma Stewart Allen, a registered nurse, former career state civil servant, entrepreneur, and public health policy advocate. For decades, she has testified at legislative hearings, run advocacy campaigns, and emphasized the significance of social and political determinants of health. She led an advocacy campaign to improve access to healthcare coverage, which resulted in Louisiana becoming the first state in the deep south to expand Medicaid under the Affordable Care Act in January 2016. Aiming to improve the state’s health rankings to 40th in the nation by the year 2030 (Louisiana currently ranks 46th), Ms. Stewart Allen continues her advocacy work by developing programs and initiatives aimed at improving health in Louisiana, particularly children’s mental health.

Institutional and disciplinary position and background

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Elizabeth Hoover is an anthropologist and associate professor of environmental science, policy and management at Berkley, who long claimed to be native (receiving grants and research access under this assumption) but has recently admitted otherwise. She has a PhD in anthropology from Brown University  with a focus on Environmental and critical Medical Anthropology. 

Concepts

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Katsi Cook, Mother’s Milk Project, collecting samples of breast milk: “Katsi has described this work as “barefoot epidemiology,” with Indigenous women developing their own research projects based on community concerns and then collecting their own data.” (90) - 61? – used a private lab to analyze samples because women did not trust the New York State Health Department

“Barefoot epidemiology” is a concept borrowed from China’s “barefoot doctors”—community-level health workers who brought basic care to China’s countryside in the mid-twentieth century. Hipgrave, “Communicable Disease Control.” According to a “workers’ manual” published by the International Labour Organization, barefoot research is often qualitative, and qualitative research is not the standard approach for conducting health studies, which tend to be based on laboratory experiments and clinical findings. See Keith et al., Barefoot Research” (294)

Civic Dislocation: “In many instances Mohawks experienced what Sheila Jasanoff calls “civic dislocation,” which she defines as a mismatch between what governmental institutions were supposed to do for the public, and what they did in reality. In the dislocated state, trust in government vanished and people looked to other institutions . . . for information and advice to restore their security. It was as if the gears of democracy had spun loose, causing citizens, at least temporarily, to disengage from the state” (118) 

“Dennis Wiedman describes these negative sociocultural changes and structures of disempowerment as “chronicities of modernity,” which produce everyday behaviors that limit physical activities while promoting high caloric intake and psychosocial stress” (235)

Third space of sovereignty: “This tension that arises when community members challenge political bodies while simultaneously demanding that they address the issues of the community has been theorized by political scientist Kevin Bruyneel, who describes how for centuries Indigenous political actors have demanded rights and resources from the American settler state while also challenging the imposition of colonial rule on their lives. He calls this resistance a “third space of sovereignty” that resides neither inside nor outside the American political system, but exists on the very boundaries of that system.” (259)

 

Quotes from this text

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“Akwesasne residents’ main criticism of the Mount Sinai study was that at its conclusion, the researchers packed up and left, and community members felt they had not received any useful information.” (76) 

“As scholars of tribal health risk evaluation Stuart Harris and Barbara Harper explain, among most tribal people, individual and collective well-being comes from being part of a healthy community with access to heritage resources and ancestral lands, which allow community members to satisfy the personal responsibilities of participating in traditional activities and providing for their families.” (96)

“By placing “race/ethnicity” on a list of diabetes causes without qualifying why it is there, the CDC neglects the underlying root cause—that race/ethnicity is often associated also with class, education, levels of stress, and access to health care and fresh foods.” (231)

“Chaufan argues that to counter the focus on the medicalized aspects of diabetes, which has led to the individualization and depoliticization of the issue, a political ecology framework needs to be applied to the disease, one that is concerned with the social, economic, and political institutions of the human environments where diabetes is emerging.39 Such a framework would highlight how diabetes rates among Mohawk people are influenced more by changes in the natural environment and home environments than by genetic makeup.” (231 - 232)

“Understanding community conceptions of this intertwined “social and biological history” is important because, as Juliet McMullin notes, examining the intersections of health, identity, family, and the environment helps to “denaturalize biomedical definitions of health and moves us toward including knowledge that is based on a shared history of sovereignty, capitalist encounters, resistance, and integrated innovation.”61 The inclusion of this knowledge can lead to the crafting of interventions that community members see as addressing the root causes of their health conditions and promoting better health.” (249)

Main argument, narrative and effect

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Hoover’s book is an analysis of the material and psychosocial effects of industrial pollution along the St. Lawrence River, which runs through the Mohawk community of Akwesasne. Hoover focuses on resistance to private and state efforts at land enclosures and economic rearrangements.  Hoover shows how legacy of industrialization and pollution (GM and Alocoa, primarily) ruptured Mohawk relationships with the river, and incurred on tribal sovereignty by disturbing the ability to safely farm, garden, raise livestock, gather, and recreate in ways fostered important connections between and amongst people and the land (“ecocultural relationships”). Hoover describes how confusion about risk and exposure is culturally produced and develops the "Three Bodies" analytic framework to show how individual, social and political bodies are entangled in the process of social and biophysical suffering. 

Hoover also highlights how in response to pollution, Mohawk projects of resistance emerged - a newspaper, documentary films, and  community-based health impacts research. Hoover conducts a comparative history of two research projects tracking the effects on industrial-chemical contamination on Akwesasne people and wildlife: the Mount Sinai School of Medicine’s epidemiological study in the 1980s, which failed to engage Akwesasne people in the production of knowledge or share results meaningfully, and the SUNY-Albany School of Public Health Superfund Basic Research Program study (in the 1990s and 200s), which ultimately began incorporating key theoretical and methodological principles of CBPR.