Creating a Healthier Northshore

More than 50 of the Northshore’s leaders in healthcare, government and nonprofit sectors are partnering in a new venture to improve health and well-being in St. Tammany and Washington parishes.

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Illustration DONOUGH O’MALLEY

With high rates of obesity, smoking and vaping, coupled with some of the highest mortality rates from chronic illness like cancer and heart disease, Louisiana has notoriously ranked near the bottom of most of the nation’s health outcome measures for decades.

Concerned that an already precarious population may have skipped check-ups and recommended screenings, thereby allowing illnesses to go undiagnosed and untreated in the last year due to the COVID-19 pandemic, St. Tammany Health System and Ochsner Health partnered last fall with more than 50 of the Northshore’s leaders in the healthcare, community, civic and government sectors to form an advisory body focused on improving the overall health of residents in St. Tammany, our state’s healthiest parish, and neighboring Washington, the state’s least healthy parish, according to the Louisiana Department of Health.

St. Tammany and Washington have higher rates of cancer incidence than the rest of the state, according to the Louisiana Tumor Registry. Lung cancer is the leading cause of cancer-related death in both parishes, accounting for more than breast, prostate and colorectal cancer deaths combined. Washington Parish has the highest prostate cancer mortality in the state, particularly among its African American male population.

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“Healthier Northshore was born out of necessity,” said Joan Coffman, president & CEO of St. Tammany Health System in Covington and co-chair of Healthier Northshore’s executive committee. “Our mortality rates from chronic illnesses like cancer and heart disease are some of the highest in the country. COVID-19 highlighted our vulnerability, and we were one of the hardest hit states according to death statistics. We realized we weren’t going to change our collective health status alone; it would take a group effort from all points of view to really impact change.”

Coffman said the idea for Healthier Northshore was sparked by Ochsner’s 40 by 30 initiative, which aims to lift Louisiana’s health ranking to No. 40 by 2030.

“I give Joan the credit for being the creator of the idea, but it really comes out of the fact that we see Louisiana consistently in the bottom of population health measures,” said Tim Riddell, M.D., medical director of Ochsner Health’s Northshore Region. “We know that the effort to raise the overall level of health, not healthcare, but health across specifically St. Tammany and Washington parishes is really going take a multi-organizational approach from public organizations, governmental entities, healthcare entities, and community service organizations all working together to improve that overall health. So, the idea of Healthier Northshore is to serve as an avenue for bringing that collaboration together.”

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For decades, American health professionals have fought to improve health measures through a variety of clinical means, Coffman said, but medical experts now agree that social determinants like health behaviors and socio-economic factors, are responsible for 80% of health outcomes versus clinical care at 20%.

Riddell said the healthcare industry has been focused on working together to improve health outcomes for the region and the state, including large investments in workforce development with local universities and colleges, the development of a center for health equity and health disparities, and working with medical schools to increase the number of primary care doctors and psychiatrists that work in the community.

“While there are certainly ZIP codes on the Northshore that have higher, better health outcomes and higher access to both resources and health care, there are large pockets of our population on the Northshore that don’t enjoy that same benefit,” said Susan Bonnett Bourgeois, president and CEO of the Northshore Community Foundation, which works to unite human and financial resources to enhance the quality of life in St. Helena, Tangipahoa, Washington, and St. Tammany. “Washington Parish has large pockets of rural populations, some with poverty issues. It’s a really good example of how there are impediments to people just being able to access the care that is there. Even in St Tammany, there are some ZIP codes that drive healthier outcomes and some ZIP codes that don’t. There’s a huge conversation about the social determinants of health. One of the biggest determinants is access to transportation and access to care.”

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Organizers say the two parishes have such varied health disparities due to socioeconomic factors and racial and ethnic biases. Healthier Northshore aims to educate residents on the value of preventive care, promote early detection and connect residents to available community resources for treatment.

“We see there is a variability between the two parishes in the availability of those resources. There’s a lot of different reasons why those disparities exist. The goals are really developed around overcoming the barriers,” Riddell said. “The first one is educating people about prevention — healthier diets, active lifestyles, smoking cessation — which is a huge piece. But then … how do you bring the resources that will help people be successful there? The second one is in early detection, and that really is around access to screening. Maybe that’s easy access to a mammogram, blood pressure monitoring and blood work for diabetes. Then the last is sort of taking all of that and creating a goal for resources.”

“The initiative is about pulling together individuals, organizations, and the, sometimes, disparate perspectives and resources into an effort that can be more integrated and collaborative to address the physical and mental health outcomes of the population on the Northshore,” Bourgeois said. “It is not just healthcare related, but it’s all related. It is about poverty. It is about quality of life. It is certainly about education. It is about access to healthy food.”

The all-volunteer endeavor kicked off in September 2020 with a socially distanced meeting to share the idea with business, government, and non-profit leaders across the Northshore. Attendees were invited to join the advisory board and help craft three goals: prevention through teaching the benefits of good nutrition, regular physical activity, quitting and abstaining from nicotine consumption via vaping, smoking, and chewing tobacco, and good mental health; early detection of illness through biometric and cancer health screenings; and serving as a central point of information to connect people with primary care, specialty services, and social support resources. Efforts are underway to develop a communications strategy to raise awareness, direct residents to information and create free public events to educate, screen, and connect people to resources.

Coffman said businesses have a vested interest in joining and supporting the initiative because of the potential numerous benefits of reduced healthcare-related costs.

“Preventive care is always less costly than treatment of a chronic illness,” she said. “If more people managed their weight, avoided tobacco, exercised regularly and visited their primary care physician for routine health screenings and care, we’d all experience cost savings in one way or another.”

Rhonda Bagby, vice president, employer group health insurance at Humana — Louisiana and South Mississippi, said the cost of employee benefits, including health insurance premiums, are the second largest expense item behind salaries.

“The role that an individual plays in managing his or her own health cannot be underestimated,” Bagby said. “Many chronic conditions are rooted in lifestyle factors that are within our daily control. By increasing awareness about preventive care, by aiming for early detection and better management of conditions, and by connecting individuals to community resources, we will drive greater efficiency in the healthcare system.”

Kevin M. Gardner, senior vice president at insurance brokerage HUB International’s Metairie office, works with businesses in managing their health insurance programs.

“All businesses today are challenged within the rising cost of health insurance and the challenge of making these benefits affordable,” Gardner said. “Getting control of these cost starts and stops with the health of our population. We have to have affordable services. Our parish has done an amazing job in growing out and improving our healthcare delivery system. But the long-term affordability of these services rest with how our residents take care of themselves and create a better path to sustainable costs.”

An additional benefit of getting the region healthier could be economic growth.

“Economic development plans show that people want to live and work in healthy communities,” Bagby said. “The role that individuals play in being healthy is increasingly important.”

Gardner agreed that improving the region’s overall health grades are important to economic development.

“In order to create an environment that is attractive to live, improve quality of life, attract business, retain employers, attract new residents, it all starts with the health of our population,” he said. “When employers look to relocate, they focus on healthcare cost, education, affordable housing, etc. A community that is not focused on improving the overall quality of their workforce and cost of healthcare with their residents will not be a prime candidate for long-term growth. The health of our population is something we can control, we can impact, and we really have no choice but to do better.”

“The healthier we get our population and the more we get our population paying attention to health outcomes, then that makes for more productive employees,” Bourgeois said. “That, in turn, makes for better prepared students, which ultimately leads to more productive employees when they join the workforce. All of these things build up to healthier people. Healthier people build up to a mentally and physically healthier population, which then improves your workforce. It improves business outcomes. Of course, at the end of the day, it improves bottom lines. But, to me, that’s not the driver. The driver is a healthier population and, therefore, a healthier workforce.”

For now, Healthier Northshore is focused on creating awareness and engagement from all segments — business, government and citizens — as the region continues to face effects of the pandemic.

“COVID exacerbated the challenges that our Northshore community has had,” Bourgeois said. “The timing is important not just because of physical health, but, obviously, behavioral and mental health issues have become even more pronounced in the COVID than before.”

Riddell says he’s been “pleasantly surprised” by the reaction to Healthier Northshore’s formation.

“I’m a primary care physician and have been trying to change minds and convince people of healthy lifestyles and healthy behaviors my entire career. And it’s met with victories and frustration simultaneously,” he said. “It becomes obvious to me that just one person having that conversation with a patient is not going to be effective enough. So, when we started this, I was excited about it, but I was cautiously optimistic. When I saw how many people were initially involved, that optimism grew. And then as I started to see the involvement, as we move forward, it hasn’t waned. (I was concerned that we’d have) a kickoff meeting and a large number of people show up, and you feel like, okay, everybody’s here for the pictures. And then you realize that once the work starts getting done, who’s still around that original, large group of excited, optimistic individuals. They’re still engaged. They’re still involved. And we’re several months into the discussion and are coming up with new initiatives, new ideas, new plans as we move forward.

“When you look at the people who are part of this initiative, they’re such a broad and influential group,” he said. “We’ve got a number of at-large members who are part of our various committees that have been, that have been very engaged and very helpful. And I think it’s going to allow it to get that message out much more aggressively and clearly over the next year.”

“We want all of our residents to have access to information and services that could have a positive impact on their quality of life and that of their loved ones,” Coffman said. “The value of education and preventative care is tremendous, if people know the risks associated with certain behaviors, they have the opportunity to make better decisions. If a health condition is diagnosed in earlier stages of the disease, there are often better options available for treatment and the prognosis is better. Early detection saves lives.”

Riddell said the hope is that Healthier Northshore can serve as a model for the rest of the state.

“One of the things that I hope comes out of this is a model that really expands to other parishes, other regions, and those regions adopt similar activity. The eventual goal is if we just do this in these two parishes, the goal of getting Louisiana further up in those rankings is lives saved and lives improved. I think as we are able to expand this message, you’re going to see over the next year an increased awareness of these opportunities.”

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LEADING THE WAY

Committee Leaders for Healthier Northshore

Executive Committee Chairs
Joan Coffman, St. Tammany Health System and Dr. Tim Riddell, Ochsner Health

Education Committee Chair
Nick Richard, NAMI St. Tammany

Prevention/Early Detection Committee Chair
Rhonda Bagby, Humana

Connect to Resources Committee Chair
Chris Masingill, St. Tammany Corporation

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