HJNO Jan/Feb 2023

HEALTHCARE JOURNAL OF NEW ORLEANS I  JAN / FEB 2023 23 Initiative 2: Improve Prevention, Early Detection, and Treatment of Chronic Diseases Chronic diseases are among the leading causes of death and disability in Louisiana and the leading driver of healthcare costs. Many of these serious illnesses — including colorec- tal cancer, high blood pressure, and diabe- tes — are preventable and treatable. This makes prevention, early detection, and treat- ment both achievable and critical to improv- ing health, reducing disparities, and reducing healthcare costs for individuals and families. According to County Health Rankings, health can be attributed to four main factors: 40% socioeconomic factors, 30% health be- haviors, 20% clinical care, and 10% physical environment. Health risk behaviors like poor diet, physical inactivity, and tobacco use, as well as social determinants of health inequi- ties like access to healthcare, education, and income contribute to the high prevalence of chronic disease in Louisiana. Louisiana has the fifth-highest cancer mor- tality rate and the fourth highest colorectal cancer mortality rate in the United States. Colorectal cancer (CRC) is one of the most preventable and survivable cancers when di- agnosed early along with healthy lifestyle modifications and routine screening. Na- tionally, 1 in 3 adults between the ages of 50 and 75 are not up to date on recommended screening for colorectal cancer. Screening rates in Louisiana are 73% statewide and 39% for individuals enrolled in Medicaid. Although CRC incidence and mortality rates are higher than national averages for all Louisianans, a number of racial, socioeconom- ic, and geographic disparities exist in screen- ing, incidence, and mortality rates in our state. Black Louisianans are more likely to be diag- nosed with CRC compared to white Louisian- ans, and more likely to die from the disease. Nationally, rural residents experience a great- er cancer burden for tobacco-related cancers and cancers that can be prevented by screen- ing, such as CRC. Compared to the rest of the country, Loui- siana has higher prevalence rates of diabetes, high blood pressure, and cardiovascular dis- eases, ranking 40th or lower out of 50 states for all three chronic conditions. 14.1% of adults in our state have diabetes, compared to the national rate of 10.6%; 39.7% of adults have high blood pressure, compared to the nation- al rate of 32.5%; and 10.5% have a cardiovas- cular disease, compared to the national rate of 8.1%. Louisiana residents with lower socio- economic status are more likely to have high blood pressure, high blood cholesterol, dia- betes, and heart disease, which puts them at an increased risk for a stroke or heart attack. Black Louisianans are more likely than white Louisianans to be diagnosed with both hyper- tension and diabetes. Louisiana also has higher rates of obesi- ty, smoking, and tobacco use — some of the leading causes of preventable disease and death in the United States. Louisiana has the third highest rate of childhood obesity in the country, affecting 22% of Louisiana’s children. According to the CDC, obesity places children at risk for health issues such as Type 2 diabe- tes, asthma, high blood pressure, anxiety, de- pression, low self-esteem, and more as they become adults. Approximately 18% of Loui- sianans smoke cigarettes, and rates are high- est among those with the lowest incomes. Na- tionally, adults enrolled in Medicaid are more likely to be current smokers, placing them at increased risk for smoking- related diseases. Asthma is another chronic condition with real impact. 9.7% of adults in Louisiana were living with asthma in 2021, according to the CDC. Individuals enrolled in Medicaid experi- ence a high burden of asthma with racially dis- parate rates of emergency department and hospital utilization. Asthma is also one of the leading causes of school absenteeism among children, according to the CDC. Genetic, en- vironmental, and occupational factors have been linked to developing asthma, but asth- ma can be controlled by taking medication and avoiding asthma triggers. This initiative will utilize multiple approach- es and engage different partners to promote the prevention, detection, management, and treatment of several chronic diseases, and im- prove the health and well-being of individu- als in our state. LDH will partner with Medic- aid MCOs, community partners, and clinicians to bolster screening campaigns for colorectal cancer, cardiovascular disease, diabetes, and asthma. Strengthening community-clinical Commitment 1 / Initiative 1 / Goal 1 Commitment 1 / Initiative 1 / Goal 2 Commitment 1 / Initiative 2 / Goal 1