LCHE produces its own weekly radio show, Today's Health Topics, hosted by Ms. Alma Stewart-Allen. The show features various interrelated health topics relevant to Louisiana.
LCHE's initiatives have also been covered by regional and local news outlets like BR Proud and the Louisiana Illuminator. Notable articles include the following:
#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.
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.
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.
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.
Because of my work on the Bhopal disaster, I follow worst case scenario potential in many places -- and the corridor between New Orleans and Baton Rouge has long been on my radar. Worst case scenarios involve the catastrophic release of dangerous chemicals into the atmosphere and create "vulnerability zones" -- what many people call kill zones -- around an industrial facility. A 2014 report from the Environmental Justice and Health Alliance documents how these zones are hotspots of environmental injustice in the United States.
See this 2001 Greenpeace map. When Greenpeace made this map, there was a push (by organizations like the Competitive Enterprise Institute) to pull worst case scenario information off the Internet because of its potential use by terrorists. Greenpeace pushed back in campaigns for "chemical security," arguing that the best way to reduce risk is to reduce the production, handling and use of dangerous chemicals -- laying ground for today's movement for a "just transition." See just transition work in Lousiana by the another gulf is possible campaign .
Worst case scenarios came back into US national attention after the fertilizer plant explosion in West, Texas in 2014, prompting the Center for Effective Government's report, Kids in Danger Zones (showing that Houston and Port Arthus in Texas and Baton Rouge in Louisiana are the most high-risk metro areas in the United States). See the Louisana Fact Sheet from the report (listing the highest risk facility in New Orleans as a wastewater treatment plant.). Note that the maps in the Center for Effective Government's report are no longer interactive -- pointing to a challenge the QA project is addressing: what we've termed "archiving for the anthropocene." We need to figure out what archiving for the anthropocene should look like, how to build and sustain it, and how to put it to good use.
Worst case scenarios have come back into controversy recently with Trump's EPA's saying that focus on worst case climate scenarios are unrealistic. Louisiana looks pretty bad.... see Propublica’s “Losing Ground.”
The extreme weather that comes with climate change of course exacerbates worst case scenario risks. See this on floods and chemical plant safety across the United States. See this on the 2016 "thousand year" flood in Louisiana. See this moderate recognition of the problem.
As a participant in the NOLA Anthropocene Campus, I have gained insights on how communities, stewards, and managers of ecosystems in New Orleans have rolled out forms of interspecies care vis-à-vis ongoing environmental changes, coastal erosion, climate catastrophes and their deeply present and current effects (i.e., the 2010 BP oil disaster). Whilst much analytical lens has been given to geospatial changes in the study of the Anthropocene, here, I focus on how relations to non-human beings, also threatened by the changing tides of NOLA’s waterscapes, can enrich our understanding of such global transformations.
After disasters like Katrina, urban floodwaters harbored many hidden perils in the form of microbes that cause disease. Pathogenic bacterial exposure occurred when wastewater treatment plants and underground sewage got flooded, thus affecting the microbial landscape of New Orleans and increasing the potential of public health risks throughout Southern Louisiana. But one need not wait for a disaster event like Katrina to face these perils. Quotidian activities like decades of human waste and sewage pollution have contaminated public beaches now filled with lurking microbes. Even street puddle waters, such as those found on Bourbon Street, contain unsanitary bacteria level from years of close human exploitation of horses and inadequate drainage in 100-year old thoroughfares. More recently, microbial ecologies have also changed in the Gulf of Mexico due to the harnessing of energy resources like petroleum. Lush habitats for countless species are more and more in danger sounding the bells of extinction for the imperiled southern wild.
Human-alteration has severely damaged the wetland marshes and swamps that would have protected New Orleans from drowning in the water surge that Hurricane Katrina brought from the Gulf of Mexico. The latter is something that lifelong residents (i.e., indigenous coastal groups) of the Mississippi River Mouth have been pointing to for a long time. Over the past century, the river delta’s “natural” infrastructure has been altered by the leveeing of the Mississippi River. Consequently, much of the silt and sediments that would generally run south and deposit in the river mouth to refeed the delta get siphoned off earlier upstream by various irrigation systems.
While some actors see it as a futile effort, there have been many proposals to restore the Mississippi River Delta. For instance, the aerial planting of mangrove seeds has even been recommended to help protect the struggling marshes and Louisiana’s coastal region. Tierra Resources, a wetland’s restoration company, proposed that bombing Lousiana’s coast with mangrove seeds could save it. Mangrove root systems are especially useful in providing structures to trap sediments and provide habitats for countless species. Additionally, mangroves have been touted as highly efficient species in carbon sequestration, thus taking carbon dioxide out of the biosphere.
Species diffusion into new environments has been of great concern for the different lifeways these soggy localities sustain, whether human or non-human. Many so-called “invasive species” have been identified throughout the river delta by researchers at the Center for Bioenvironmental Research hosted by Tulane and Xavier University. Such species have disrupted local ecological relations and practices and have had profound economic effects. Some plants have even entirely blocked waterways in the swamps and estuaries where salt and freshwater mix.
Louisiana’s humid subtropical climate, and the diverse ecosystems therein, also warrant attention in that they can incubate some of the world’s deadliest parasites and other microbes. Of particular concern would be some of today's Neglected Tropical Diseases (i.e., Chagas, Cysticercosis, Dengue fever, Leishmaniasis, Schistosomiasis, Trachoma, Toxocariasis, and West Nile virus) often perceived as only affecting tropical regions of Latin America and revealing the enduring legacies of colonial health disparities.
How and when are seemingly quotidian events and upsets understood as not isolated but rather as produced in conjunction with other anthropocenics worldwide? What roles will interspecies relations and forms of care play as we cope with further anthropocenic agitation?
NOLA’s oldest tree, McDonogh Oak in City Park, 800 years old: https://www.youtube.com/watch?v=DK9YoGpng_c&t=0s
Other trees in New Orleans: https://www.atlasobscura.com/things-to-do/new-orleans-louisiana/trees
My interests center around soil--its preservation, regeneration, and remediation. Living farther up North on the Mississippi in Saint Louis has changed my thinking around the relationships between soil, water, and contamination. Saint Louis and New Orleans are linked not just through their shared river and its attendant water management issues, but through patterns of extraction and contamination. New Orleans may also provide some clues (and potential solutions) to my community's changing relationship with water as we confront climate change. My work as an artist explores our relationship with landscape through tours of contaminated sites and remediative interventions in the landscape, so I approach New Orleans with questions about contaminated environments and water management through landscape design, gardening, and education.
I situate my research at the crossroads of history, philosophy, sociology and anthropology of science. In the past, I have focused on epigenetics, environmental research, empirical bioethics and environmental justice, within and outside the academia, as you can read here, or here. Now I am focusing on antibiotic resistance, and I use it as a lens to interpret the contradictions of the last century derived by industrial production, environmental degradation and biomedical cultures.
What interests me is the (at that time) new epistemic discourse that since the Forties has been produced to explain morphological changes of organisms produce when they experience new environmental conditions or perturbations. Through an important experiment at the base of the so-called concept of genetic assimilation, Conrad H. Waddington showed that a thermic shock can produce changes in wings’ veins of fruit flies, changes that can eventually be inherited across generations, without the environmental trigger that caused them.
This focus on production and (genetic) storage of biological differences elicited by the environment is nowadays coupled with the knowledge produced through microbiome research that explains the phenotypic patterns that recur across generations.
In a thought-provoking twist, with microbiome research, the focus shifts from production and inheritance of biological differences to production and inheritance of biological similarities. Microbiome research shows that some phenotypic patterns are allowed by ecological communities of microorganisms composing all animals. Bacteria allow the development and functioning of our bodies within an epistemic framework that is now key to understand biology. The network of vessels composing mammals’ stomach is formed through cellular differentiation and expression of genes coordinated by bacteria. The same is true for our immune system that is coordinated by gut bacteria. Food, which is an important aspect of our lives also impacts on this microecology and mediates between our biological functions and functioning of means of production whose parts dedicated to food production have immense importance for our biology and our internal and external ecologies. Antibiotic resistance is one of the crossroads where culture, biology, history and the Anthropocene meet. Indeed, Antibiotic resistance shows that means of production of our societies have an even more widespread, deep and allegedly unexpected impact on the biology of animals and plants. The microorganism can indeed adapt to resist the selective toxicity of antibiotics. Moreover, bacteria can transfer their genetic code horizontally, by touch, so that we can acquire antibiotic resistance by eating food that functions as a vector, by hosting lice on our heads and many other contacts. Bacteria that are resistant to antibiotics that have been used as growth factors in animal husbandry and to prevent diseases in livestock and aquaculture, spread in natural ecosystems and can be found in wild species. Rivers and estuarine waters are places hosting antibiotic resistance.
Searching on PubMed (the search engine for biomedical literature) titles of articles containing the terms ‘antimicrobial’ and ‘Louisiana’ I retrieved just one twelve-years-old article. No results with terms such as 'Mississippi' or 'New Orleans'. The authors collected and analysed Oysters from both waters of Louisiana Gulf and in restaurants and food retailers in Baton Rouge. In most of the samples gathered, scientists recognised the presence of bacteria (Vibrio parahaemolyticus and Vibrio vulnificus) resistant to specific antimicrobials. Food production is indeed the first factor in terms of the quantity of antibiotics used. This use and related antibiotic resistance impact all the living beings present in a specific area, and can easily travel around the globe through many channels. As Littman & Viens have highlighted, a sustainable future is a future without antibiotics as “there may be no truly sustainable way of using antibiotics in the long-run, as microorganisms have shown to be almost infinitely adaptable since the first introduction of antibiotics” (Littman & Viens 2015). But in the meanwhile, we need to use them and antibiotic resistance is a phenomenon that can be better studied through environmental research, by analysing wild species and emissions nearby livestock, for instance.
The study that I retrieved focuses on Oysters. But what about antibiotic resistance conveyed through food that is consumed by the most?
What about exposures of communities that are living in highly polluted areas?
And what is the additive value on antibiotic resistance for individuals who experience the presence of industrial pollutants and that live in areas where cancer epidemics are registered?
In this respect, there is a strategy to cope with the issue of antibiotic resistance promoted by the Center for Disease Control and Prevention. The document doesn’t mention any action to monitor and regulate the production and usage of antibiotics in livestock. Nevertheless, the CDC wants to scrutinise, through genome sequencing, “Listeria, Salmonella, Campylobacter, and E. coli and uploads sequence data into PulseNet for nationwide monitoring of outbreaks and trends.” Moreover, the document reports that “In Fiscal Year 2019, Louisiana will begin simultaneously monitoring these isolates for resistance genes. When outbreaks are detected, local CDC-supported epidemiologists investigate the cases to stop spread.”
The questions that I would like to ask (to local ppl, activists, researchers, practitioners..) are:
What could be the epidemiologic characteristics (socioeconomic status, gender, residence..) of the populations more vulnerable to antibiotic resistance?
What is the additive role of antibiotic resistance for people living in highly polluted areas?
What is the impact of antibiotic resistance for people and patients living in areas where cancer incidence is high?
And on the long run I am interested in imagining possible strategies to not only living with the problem but also to tackle the problem itself, which means to develop strategies to answer the questions:
Why antibiotic resistance, which is known since a century, it’s a problem on the rise?
What is the role and interest of capitalism, in terms of profit-making of corporations, knowledge production and environmental degradation, in not being able to resolve antibiotic resistance?
What can be strategies of local communities to tackle the problem and to promote environmental justice in terms of alliances with ecologists, doctors, epidemiologists and other activists?