If you’re living in a house where your wastewater runs into your yard, that means you’re at
a higher risk for diseases like cholera, e. Coli, for diarrhea.
These are diseases we typically associate with developing country settings, and not
with the wealthiest country in the world.
So the waste just comes out of your house and into your backyard. And are you worried
about your kids and your grandmas playing in it?
B: Yes I am.
Concordia is a place where infants die at 3 times the rate the healthiest county in
a rich state like Maryland. It’s a place where nearly half of the children live in
poverty.
Nearly half the population is obese. ¼ of the people never finished high school. There
aren't a lot of job opportunities, and unemployment is higher than the national average.
We know a lack of education and poverty drives down health outcomes, and for this and other
reasons, Concordia has become one of the sickest counties in America.
So we wanted to go down to Concordia and really understand why do places like this in central
Louisiana, why are they always at the bottom of these health rankings? Why are they struggling
so much with their health?
What I did hear again and again was that people really felt forgotten and left behind by Washington.
They felt like their needs weren’t being addressed, that their problems weren’t being
looked at by anyone.
We can’t get any help from anyone. I went to State rep, I went to the health department.
Went to the Congressman. No help.
There were no biological reasons why people here were less healthy than in any other counties,
but there were clear political failures that made them sick.
If you compare Concordia to the U. S. overall, the people there are doing worse on pretty
much any health measure or health indicator you can think of.
The people in Concordia have gone through long periods without clean drinking water,
and they had to have water tanks shipped in by the National Guard, and go to these water
tanks every day so their kids wouldn’t be sickened by what was coming out of the tap.
Barbara and her neighbors, they've gone to the mayor of Ferriday, and they've gone to
the mayors of neighboring towns. They’ve asked local lawmakers for help, they asked
the health department for help getting their sewage system fixed, and they say no one will
help them. They keep hearing that local health officials don't have the money, they don't
have the budgets to fix the problem.
You don’t typically think people are living without the basic fundamental requirements
for healthy living with the wealthiest country on the planet.
Over the last three years between 2008 and 2016 Louisiana had this Republican governor
Bobby Jindal. Jindal really believed that in order to grow the economy in Louisiana
he had to cut down on government. So he slashed about 30,000 jobs in the state's work force.
He dismantled and privatized the charity hospital system, which was set up to care for the poor.
He nearly halved the staff at the Department of Children & Family Services.
He refused the funding Obamacare gave to states to expand Medicaid which would give more people
health insurance.
Governors are hurting and they don't want a Medicaid expansion that they're seeing in
these House and Senate bills. They really need more funding, especially Louisiana.
Jindal’s successor, John Bel Edwards, on the second day in office, signed an executive
order that would expand Medicaid finally and give more people health insurance.
More than 300,000 people have signed up in Louisiana. So if Obamacare is repealed, all
these people who just got health insurance are gonna be in limbo again.
In Louisiana, I met the medical director for central Louisiana. He oversees public health
for Concordia and some of the other counties with really poor health outcomes.
So much funding for public health comes from federal sources that if there's really a change
in direction and a desire to ratchet back federal participation, it will affect maternal
and child care, reproductive health, nutrition...
When you look at state health rankings, they are like this for Louisiana. And if you were
in the ICU you would say was a flat line. I mean you would say the patient is dead.
In his ten years on the job, his staff has been whittled down almost in half. And that
meant firing the health providers who see patients who can't afford health care.
To fill in the gap, Holcombe stepped outside of his role as medical director, and he's
now seeing up to 100 patients a month.
This is an enormously difficult problem. Because the black / white disparities of this are
enormous. And for HIV aids, it's also like the prison population. 3/4 of the people are
African American in a state that has 33% percent African Americans.
One of the really startling things about Concordia and these other counties with very poor health
outcomes is that they're all dotted along the Mississippi River and on the other side
you have these grand antebellum plantation homes just a short drive from Concordia.
I think a lot of the political attention has been focused on places like West Virginia,
PA, OH, the rust belt, where people are seeing their economic prospects dry up and they’ve
been really affected by trade and changes in technology and globalization.
But in that conversation, communities like Concordia have been completely lost. These
are the places that have been arguably struggling for a much longer time, with more complicated,
systemic difficult problems. And they didn’t get a shred of attention in this election
campaign.
Well, you see large residual African American populations that have more or less been left
behind. So they've been left behind economically, they’ve been left behind educationally.
They have low socioeconomic status and that's your triangle that determines health. So you
have lots of people in little triangles, little incomes, little education, and low social
status.
We did see a state government that dismantled the safety net, put in policies that benefitted
the rich and hurt the poor, and we’re looking at a republican federal government that his
campaign now promises to do something very similar.
If Donald Trump and the republican party make good on their promises, we might see more
communities that have their own version of what happened in Concordia, when it comes
to public health.