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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).

Facing a pivotal federal investigation into Louisiana’s relationship with petro-chemical companies, the state’s attorney general hired lawyers who were simultaneously representing one of the main corporations at the center of the investigation, documents reveal.

The revelations, contained in documents released under public records requests, have led to allegations of a major conflict of interest and come just weeks after the Environmental Protection Agency [EPA] dropped its civil rights investigation.

Internal emails, contracts and payments, show that the office of the attorney general, Jeff Landry, hired two lawyers to enter closed-door negotiations with the EPA during the 14-month civil rights investigation. But John King and Tim Hardy were also representing the Taiwanese chemicals firm Formosa in separate litigation, challenging a decision to revoke the company’s state air permits. (Moran and Sneath 2023).

In the 1980s, Formosa Plastics Corporation purchased financially struggling petrochemical plants in Delaware, Texas, and Louisiana. The company subsequently shifted its operations to Texas and Louisiana, where a competitive bidding process ensued between the two states, both of which were known for industry-friendly policies (Tubilewicz 2021). As political scientist Tubilewicz (2021, 16) has argued, the politics surrounding Formosa's investments in these states were not purely motivated by profit but were also shaped by the ongoing struggles of sub-state actors such as politicians and NGOs over issues of internationalization and representation in global affairs.

An example of this can be seen in Formosa's attempt to build a rayon fiber plant in Louisiana's St. John Parish in the late 1990s, an area also known as "Cancer Alley." Protests broke out due to concerns about massive tax exemptions, displacement of Black residents, and the plant's location on the historic Whitney Plantation (Tubilewicz 2021, 11). However, the project was eventually abandoned due to declining market demand and delays. In addition, the local St. John Governor was indicted for illegal industrial rezoning of land around the plantation and receiving $200,000 in real estate commission (Tubilewicz 2021, 11).

Byron Good, Ph.D., is a professor of Medical Anthropology at Harvard Medical School. His primary area of research is mental illness and how social perceptions evolves around these issues, in terms of both treatment and social acceptance. Dr. Good has several works on these issues, including several that explore the perspective of bio-medicine in non-western medical knowledge, the cultural meaning of mental illness, and patient narrative during illness. His publications including several papers, books, and edited volumes; he is regarded as a major contributor to the field of psychological anthropology. 

The article primarily asserts that how a patient narrates or describes their medical history is deeply rooted in their native culture. As such, physicians must be aware of how an individual's medical experiences can be altered based on this. In turn, physicians must recognize the importance of story-telling and anecdotes when receiving information directly from patients. Narratives project the patient's experience and events through their perspective, granting professionals a glimpse into their thought processes and action patterns.

The author, Byron J. Good, is a Harvard professor in the department of global health and social medicine. He is the director of the International Mental Health Training Program, and has significant experience with field research that has led to many publications.

The article’s main argument is that the narration of an illness is founded in the emotional connection it has to the sufferers life, the place from which they view the illness which includes individual and cultural aspects. Furthermore any lack of factual accuracy is an indicator of the social and cultural environment in which the illness presents itself and is revealing as to how it will be perceived and treated.

The main argument is supported primarily through interviews with many individuals living in Ankara, through which they describe the first presentation of their seizures and in many cases the steps they tool to attempt a cure. Along with the interviews, statistics of the individuals interviewed and their diagnoses is used to provide a reference point to better understand their stories. Finally the article includes an analysis of narratives in a more general sense that can be applied to the narrative of an illness.