The residents of Louisiana and Mississippi have the worst health in the United States, according to the United Health Foundation’s America’s Health Rankings.
The states tied for 49th place in health indicators in 2012.
They also rank at the top — Mississippi first and Louisiana second — of Poverty USA’s national list for poverty.
Two programs in Louisiana are targeting poor health profiles: Healthy Communities in West Carroll Parish and HealthyBR in East Baton Rouge Parish. Those parishes, located in nearly opposite ends of the state, may seem completely different. West Carroll Parish is rural, for instance, while East Baton Rouge Parish is urban.
Both parishes, however, exceed the national overall poverty rate of 14 percent. Both have adult obesity rates of 32 percent and a comparable prevalence of diabetes — 11 percent of East Baton Rouge residents and 13 percent in West Carroll.
In East Baton Rouge Parish, the Mayor’s Healthy City Initiative is taking a three-part approach to become healthier: HealthyBR, MedBR and the Healthy Innovation Center for Research. Several initiatives fall under HealthyBR, including Fresh Beginnings, a three-year project that strives to increase healthy food access and promote health and fitness education.
Fresh Beginnings grant coordinator Lyndsi Lambert said the project faces a complex combination of problems. Many Baton Rouge citizens are obese, have heart disease and diabetes, and are uninsured. In North and Old South Baton Rouge, where obesity and disease rates are highest in the parish, a number of residents rely on public transportation and have limited access to healthy foods because there are few nearby grocery stores that stock fresh produce.
On top of that, there is a lack of positive health messages in Baton Rouge, Lambert said, citing an abundance of billboards advertising junk and fast foods in North Baton Rouge. Because there are no policies in Louisiana restricting such ads, one of Fresh Beginnings’ goals is to advocate better health choices to children, she said. Obesity and diabetes can be prevented in children, whereas adults facing those conditions must restructure their lifestyle, Lambert said.
In Louisiana, where eating is part of culture — “we like seafood on seafood,” Lambert noted — and poor diets are found statewide across all socioeconomic strata, people’s food traditions present additional hurdles. A related problem, she said, is that America is a “convenience culture” in which people often eat out.
“If we just start cooking more at home, we can lose weight,” Lambert said. “Not that losing weight is the goal, but being healthier so we [don’t] have to rely on insulin for the rest of our lives.”
Lambert said this is not a “missionary-style situation” and that people in these areas already want to make changes to improve their health. But that is hard to do, she said, if all the dinner options at the corner store “come out of a box.”
East Baton Rouge Parish has seven “food deserts” — low-income pockets more than a mile away from the nearest grocery store. This challenge is being tackled by the Food Access Policy Commission, which launched in February as part of Fresh Beginnings.
About 23 percent of the parish is food desert, according to Stephanie Broyles, commission member and assistant professor at Pennington Biomedical Research Center. The commission is studying the best ways to develop a business structure that can support more food options in areas of low access.
Broyles said while access to healthy foods does not automatically mean eating healthy, people cannot be expected to make healthy choices without access.
“Once that barrier is removed, then they bear a much larger responsibility for their health and how they respond to messages about the importance of making healthy decisions,” she said.
Broyles said most of the research on food deserts has been done in urban areas, and little is known about the problem in rural areas. In West Carroll Parish, the Healthy Communities program is plowing that uncharted territory.
Located in Louisiana’s northeastern corner, West Carroll Parish ranks 33rd out of Louisiana’s 64 parishes for health. Just three years ago, however, it ranked ninth.
That decline is one reason West Carroll Parish was selected as the pilot location for Healthy Communities, an initiative that officially launched in October to improve health in rural Louisiana. It is a joint effort of Pennington Biomedical Research Center and the agricultural centers at LSU and Southern University.
Gina Eubanks, Southern University Ag Center vice chancellor for extension and LSU AgCenter associate vice chancellor, said Healthy Communities’ goal is to enhance residents’ health from every angle — eating habits, exercise, healthcare, recreational facilities and food access.
Southern and LSU extension agents in the parish will focus on demonstrating the importance of being healthy. One objective is making people more aware of health services in the parish. Because rural areas generally have fewer or more limited health services than cities, it is important to get people’s feedback and ensure they suit their needs, Eubanks said.
Educating and engaging residents is also crucial. “Health is very personal,” Eubanks said, meaning people need to both understand how making better lifestyle choices will benefit them and be equipped with practical knowledge.
Healthy Communities may be a “three to six year ordeal where it’s truly going to take chipping away … to see what makes a difference,” said LSU AgCenter extension agent and Healthy Communities coordinator Monica Stewart. Eating healthy is not an option for many residents, a quarter of whom live in poverty. With only one gym and one park in the entire parish, there just is not much to do, so many residents lead a sedentary lifestyle, Stewart said.
The parish’s poverty, slow-paced way of life and eating-centered traditions, such as dinner on the grounds at church, form a lifestyle that harbors poor health but that residents are nevertheless reluctant to part with.
The problem is compounded by a lack of new people and ideas. Stewart said most residents have either never left the parish, or they leave and never come back.
“Your reality of what your surroundings are and what you were taught — eating habits, values, character traits, all that — it’s just what you know,” Stewart said. “Unless you have opportunities or have the ability to get beyond that, that’s just how you think.”
However, residents recognize they are unhealthy, according to Stewart. She said diabetes and heart attacks have become so commonplace that just about everyone knows someone suffering from bad health. While the dynamics are not the same in other places, health problems like those in West Carroll Parish are everywhere, and people’s stories can motivate universally.
Stewart believes hearing about someone who was obese and died of a heart attack at age 45 reminds people that it can happen to anyone, anywhere.
“Your reality of what your surroundings are and what you were taught — eating habits, values, character traits, all that — it’s just what you know. Unless you have opportunities or have the ability to get beyond that, that’s just how you think.”
Cans of food that have been donated to the food pantry during the holiday season.
