Louisiana’s rural health disparities deserve a longer look

Legislative task forces are often the product of proposed legislation that runs out of steam. Seeing that their bill has no chance of advancing, a lawmaker will often propose a study resolution to convene a panel to examine the issue they’re confronting. Some task forces are pointless and politically reckless, while others result in substantive ideas that lead to effective laws.

One that falls squarely into the latter category is the Task Force on Health Disparities in Rural Areas, which convened for its final meeting Thursday – unless legislators decide to extend its life past the “sundown” date in the resolution responsible for its creation. That’s actually one of the recommendations its members will make – to renew the resolution Rep. Dustin Miller, D-Opelousas, authored a year ago.

Some 1.2 million state residents – almost a fourth of the total – live in rural areas. The majority of them are Black, elderly and poor. Miller’s resolution seeks to improve health outcomes for this portion of the population.

One of the task force’s suggestions to the legislature will be to create an advisory commission to reduce poverty in Louisiana. Its chair, Karen Wyble of Ochsner Lafayette General Medical Center, noted a 15.5% rate of deep poverty in Louisiana  – households with income 50% below the $27,750 poverty threshold (for a family of four) – is behind many of the health concerns task force members have identified.   

People of color by far comprise the largest share of those in deep poverty, and Wyble said the legislature will be asked to make them a priority. She highlighted a mortality rate for Black infants in Louisiana that is three to four times higher than the rate for white infants.

The task force is also calling on lawmakers to increase allocations to smoking cessation efforts in Louisiana, which lags behind the southern states average spent per person. 

Other recommendations from the task force target the lack of health care workers, not just in rural areas but throughout the state. Nearly three-quarters of people in Louisiana live in areas with a shortage of health care professionals. That includes portions of New Orleans where access to caregivers is limited.

One specific shortage the task force noted in Thursday meetings involved registered nurses. Louisiana is the only state that requires nurses to train for one year in a hospital setting before they are allowed to practice home health medicine. 

Members also discussed Louisiana’s low numbers of community health workers, professionals who work in the public sector as liaisons between health systems and state officials. Their work has been critical in the state’s response to the coronavirus and other public health concerns. 

The only training ground for community health workers in Louisiana is LSU’s medical school in New Orleans, and the task force is suggesting that more schools be allowed to set up programs.

The task force also sees a need for medical professionals to be educated on health disparities. Wyble said there isn’t a full understanding among some industry workers as to where the shortcomings exist – or how to address them.

The task force has only scratched the surface when it comes to Louisiana’s deficiencies in rural health care. With more time, its members could work with lawmakers and state officials to identify actual solutions.  

For those in desperate need of better care, time is critical.