Tulane University

Transforming Health in the Mississippi Delta Region

Health care access

We will transform health in the Mississippi Delta Region by combining data with evidence-based interventions to improve health access, behaviors, and eliminate racial health disparities.

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Mortality among midlife adults is increasing across the country, especially in rural areas, with chronic diseases costing $600 billion over the next decade in Louisiana alone. Rural towns throughout the Mississippi Delta region suffer similar conditions: poor access to high-quality care and prevention, race-based health disparities, an aging population, and health-adverse socioenvironmental factors. Our goal is to reduce chronic disease, eliminate health disparities, and improve life expectancy throughout the Mississippi Delta by simultaneously deploying two classes of evidence-based interventions (mobile/telehealth and community health workers [CHWs]) in three key areas: 1) access to care and prevention, 2) changing health behaviors at individual and community levels, and 3) mitigating adverse socioenvironmental factors. This ‘Bogalusa Health Model’ will use telehealth via mobile technology and CHWs, a versatile, under-utilized class of health professionals, to implement multi-level interventions addressing complex health conditions, and creating a model that can be adapted to low-resource, rural communities world-wide.

Problem Statement

Death rates for people aged 55-64 are increasing across the country, especially in rural and smaller metropolitan areas, with chronic illness estimated to cost Louisiana more than $600B dollars over the next decade. These issues are not Louisiana’s alone—small, rural towns throughout the Mississippi Delta Region suffer under the same conditions: lack of access to health care, dwindling economic opportunities, an aging population, and social and environmental factors influencing decisions affecting residents’ lives. Louisiana and Mississippi routinely rank among the worst economies in the U.S. along with low rankings for education attainment and unemployment. In 2015, 2.9 million people in Louisiana, more than half the state’s population, had at least one chronic disease, with 1.2 million living with two or more. Heart disease, hypertension, and diabetes are all manageable conditions when detected early and treated properly. High poverty, low education attainment, decades of economic disinvestment and the long shadow of segregation have sown the conditions for the current crisis. Many live miles from the nearest hospital or lack transportation to attend well care visits. Others cannot afford coverage or are unaware of affordable options available to them. Still more routinely demonstrate an understandable lack of trust for the health care establishment, one of the most insidious legacies of the Jim Crow era. If we are to make any impact on the issues facing this particular population, the changes will have to come from within the communities themselves.

Solution Overview

A variety of healthcare interventions are effective at reducing racial health disparities and improving health outcomes for our target population: the residents of small, rural towns in the Mississippi Delta Region. Each of these interventions has been deployed individually—often as a result of financial concerns limiting the size and scope of the intervention. Our bold plan is to take what we have learned and, using our long-term partnerships in the community of Bogalusa, demonstrate that we can transform health at the population level by deploying a full suite of proven healthcare interventions simultaneously. We will recruit and train a corps of Community Health Workers [CHWs] to address the social, cultural and environmental factors adversely impacting the population’s health, for example by training barbers to check blood pressure, changing the built environment to combat obesity, and offering nutrition and weight management classes at fellowship halls to prevent diabetes and improve its management. Telehealth and mobile device applications (apps) can remove barriers to both preventive and treatment services. In the short term, we expect to reduce adverse health behaviors at the individual (smoking, poor diet, lack of exercise) and community-wide, systems-level (lack of access to prevention services, lack of health education) in turn reducing emergency room visits, hospital admissions & re-admissions, and eliminating entrenched racial health disparities, ultimately leading to a lower incidence of multiple chronic conditions, in particular heart disease and diabetes, and more healthy years of life in the Mississippi Delta Region and beyond.

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