Search

“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).

Quoted from the front page of the website

"Our Mission ... to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

Our Goal ... to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people."

The membership consists of American natives who would like to receive the benefits of this organization. To be eligible to be a member you must be "an Indian and/or Alaskan Native" evidenced by several factors including being a part of a tribe, living on reservation land, or living in the household of a native. The employees consist of federal healthcare professionals commissioned by the United States Public Health Service and Civil Service federal employees.

Representatives of the Indian Health Service have made numerous congressional testimonies and numerous pieces of legislation have been passes to support the IHS, however, it does not appear that any relate to emergency response or disaster.

The IHS mainly focuses on disaster prevention and preparedness with initiatives such as teaching children about illness prevention, teaching about safe drinking water and food safety, preventing the spread of disease, and preventing injuries. They also have a number of resources available to their members to connect with healthcare professionals. This seems to be a community awareness type approach that prevents the spread of disease by teaching the community. It resembles that of many healthcare systems and does not seem to suggest problems with other approaches.

Legislation including the Indian Healthcare Improvement Act and the Snyder Act are the bases on which the IHS was founded. The passing of the Patient Protection and Affordable Care act by President Obama is the cornerstone of the IHS, however no single event seems to shape the agency's way of approaching health.

The IHS is funded by Congress after being reviewed by The House, Senate, and Congressional committees annually. A budget is formulated by a division within the IHS for approval each year. This means that their way of thinking about disaster and health must be approved by Congress, since they are a Federal agency.

I could not find any data or reports on their website that have been collected to support their approach to healthcare other than the legislation previously mentioned.