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Lala Nuss, Climate Resilience and Equity Manager at Honolulu’s Office of Climate Change, Sustainability, and Resilience states that Hawaii lacks the data needed to characterize the links between environmental hazards and structural inequities. Though diabetes, cardiovascular disease, and asthma disproportionately impact Native Hawaiians in ways that could be linked to environmental hazards, these connections haven’t been clearly made. What is clear is that native Hawaiian communities are more likely to live near environmental hazards (Caulfield 2020).

Hawaiian state agencies have also failed more broadly to collect and track accurate data on Native Hawaiians and the programs intended to serve them (despite the passing of Act 155 in 2014 which codified a commitment to policy that eliminates health disparities by identifying and addressing social determinants of health). Native Hawaiians have also lacked input in decision-making around data collection processes and in determining how data is used (Kauahikaua and Pieper-Jordan 2021).

Caulfield, Claire. 2020. “Is There Environmental Racism In Hawaii?” Honolulu Civil Beat. June 15, 2020. https://www.civilbeat.org/2020/06/is-there-environmental-racism-in-hawaii/.

Kauahikaua, Lilinoe and Seanna Pieper-Jordan. 2021. “Improving Hawai‘i’s data policy to better serve Native Hawaiians.” Hawai’i Budget and Policy Center and Papa Ola Lokahi. /https://static1.squarespace.com/static/5ef66d594879125d04f91774/t/60514869451e1d09b75e4317/1615939719621/Data+Justice+Report_Interactive.pdf. 

The Office of Hawaiian Affairs (OHA) have all advocated for more consistent and coordinated data collection on Native Hawaiiains from state agencies, particularly the Department of Health, Department of Labor and Industrial Relations, Department of Human Services, county police departments and the Judiciary (Hofschneider 2021). The Hawaii Budget and Policy Center and Papa Ola Lokahi have similarly urged state agencies to improve data collection and involvement of Native Hawaiians in decision-making--that is collection of data grounded in principles of Indigenous data sovereignty. See more here on data sovereignty 

Joseph Keawe‘aimoku Kaholokula, chairman of the Native Hawaiian Health program at the University of Hawaiian medical school, has prioritized the need to include people who are “part-Hawaiian” so that they aren’t obscured under the “mixed race” category. He also stresses the need for native Hawaiian input into how they are categorized in state data collection. Kaholokula noted that counting people who are at least part-Hawaiian means that the Native Hawaiian community makes up about 22% of the state population — far more than the 10% accounted for by the Department of Health (Hofschneider 2020).  The Hawai’i Budget and Policy Center and Papa Ola Lokahi highlight the fact that over 34% of children under age 18 are part- or full-Native Hawaiian. They emphasize that the children's "importance to Hawai'i’s future gives greater weight and urgency to the issue of collection and use of disaggregated data for public policy and program development” (Kauahikaua and Pieper-Jordan 2021).

Hofschneider, Anita. 2021. “OHA Says Better Data Is Needed To Tackle Problems Facing Native Hawaiians.” Honolulu Civil Beat. January 24, 2021. https://www.civilbeat.org/2021/01/oha-says-better-data-is-needed-to-tackle-problems-facing-native-hawaiians/.

Hofschneider, Anita. 2020. “Why The State Doesn’t Consistently Track Data On Native Hawaiians.” Honolulu Civil Beat. May 30, 2020. https://www.civilbeat.org/2020/05/the-state-doesnt-consistently-track-data-on-native-hawaiians/.

Kauahikaua, Lilinoe and Seanna Pieper-Jordan. 2021. “Improving Hawai‘i’s data policy to better serve Native Hawaiians.” Hawai’i Budget and Policy Center and Papa Ola Lokahi. /https://static1.squarespace.com/static/5ef66d594879125d04f91774/t/60514869451e1d09b75e4317/1615939719621/Data+Justice+Report_Interactive.pdf. 

Data advocacy: The Hawaii Budget and Policy Center was tasked with analyzing state spending on Native Hawaiian-related programs but shifted to data advocacy once the center realized that data on Native Hawaiians was not consistently collected. In 2021, the nonprofit, in collaboration with Papa Ola Lokahi, released a report to urge the state to improve data collection about Native Hawaiians through legislative action. They emphasize the need for greater accountability in state programs funded to help Native Hawaiians (Jung 2021), as well as “data sovereignty,” that is, Native Hawaiian involvement in decision-making (Kauahikaua and Pieper-Jordan 2021).

Mental health support: Environmental advocates have looked at not only physical health impacts, but the “cultural, spiritual and mental health impacts of land-use decisions” (Caulfield 2020). For instance, on the Waianae Coast of West Oahu, community members worked with mental health professionals to confront the mental health burden living in an area that hosts public utilities and is subjected to the negative perceptions attached to those facilities–that is, being seen as a “dumping ground.” Ethnic studies professor Laurel Mei-Singh describes this as a process of material and psychological “dumping” that is tied into forces of militarism, colonialism and racism. All along the coast, there are public utilities that include a municipal landfill, a power plant, a construction waste landfill, and a waste-to-energy burning facility. These facilities emit volatile organic compounds, heavy metals, and carbon monoxide. People living in the area are disproportionately affected by cancer, asthma, and birth defects. However, the mental health toll of living in the area is not well studied, though census data shows that the Waianae Coast has the highest concentration of adults suffering from poor mental health on Oahu. Mei-Singh and mental health professionals hope knowledge of the history of the area can help local people recover and “reclaim their mo‘olelo (story)” (Kauanoe et al. 2021). 

Caulfield, Claire. 2020. “Is There Environmental Racism In Hawaii?” Honolulu Civil Beat. June 15, 2020. https://www.civilbeat.org/2020/06/is-there-environmental-racism-in-hawaii/.

Jung, Yoohyun. 2021. “Report Calls For Better Data About And For Native Hawaiians.” Honolulu Civil Beat. March 6, 2021. https://www.civilbeat.org/2021/03/report-calls-for-better-data-about-and-for-native-hawaiians/.

Kauanoe, Ku’u and Claire Caulfield. 2021. “From ‘Sacred Place’ To ‘Dumping Ground,’ West Oahu Confronts A Legacy Of Landfills.” Honolulu Civil Beat. December 5, 2021. https://www.civilbeat.org/2021/12/from-sacred-place-to-dumping-ground-west-oahu-confronts-a-legacy-of-landfills/. 

Kauahikaua, Lilinoe and Seanna Pieper-Jordan. 2021. “Improving Hawai‘i’s data policy to better serve Native Hawaiians.” Hawai’i Budget and Policy Center and Papa Ola Lokahi. /https://static1.squarespace.com/static/5ef66d594879125d04f91774/t/60514869451e1d09b75e4317/1615939719621/Data+Justice+Report_Interactive.pdf. 

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:

Canicosa, J. C. “‘We All Deserve to Keep Our Children’: Grieving Grandmother Calls Attention to State’s High Infant, Maternal Mortality Rates.” Louisiana Illuminator. April 15, 2021.

Mipro, Rachel. “Louisiana Activists Still Questioning Why Office for Women’s Health Wasn’t Created.” Louisiana Illuminator. October 7, 2021.

#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.

Continuing to expand my capacity to communicate my research and engage with others in addressing shared research and advocacy commitments--particularly in respect to questions around building public health capacities for engaged research and recognition of plural forms of evidence and expertise. Also start to make better use of PECE. Sharing research and advocacy resources--relationships, ideas, words, questions, stories ...

This photo essay offers a visual example of maps that can be created using the California Healthy Places Index. It specifically focus on various health-related indicators in Santa Ana, California.