HJBR Jul/Aug 2021

26 JUL / AUG 2021  I  HEALTHCARE JOURNAL OF BATON ROUGE   Healthcare Briefs hypertension, while also serving as a vehicle for a new focus on reducing Louisiana’s low-risk first- time cesarean delivery rate. Smoking Cessation Trust Offers Free Cessation Products, Services to EligibleMinority Smokers In recognition of April being designated National Minority Health Month (NMHM), the Smoking Cessation Trust (SCT) is offering free cessation products and services to eligible smok- ers across all racial/ethnic groups in Louisiana to help them quit their addiction to nicotine. According to the Truth Initiative, Black people smoke at a similar rate compared to white peo- ple, with 16.7% smoking every day or some days, but they are more likely to die from a tobacco- related disease than white people. One of the leading causes is menthol cigarettes, which are easier to smoke and harder to quit. Today, nearly 90% of all African American smokers use men- thol cigarettes (including 70.5% of African Ameri- can middle schoolers), and more than 39,000 Afri- can Americans die from tobacco-related cancers each year. Experts believe that racial differences in smoking habits, socioeconomic factors, and the metabolism of tobacco carcinogens may all play a role. Researcher Geoffrey Fong, a professor of psy- chology and public health and health systems at the University of Waterloo in Canada, found that banning menthol cigarettes in the U.S. would lead an additional 923,000 smokers to quit, including 230,000 African American smokers. “The reason for these disparities is due, in part, to the targeted inundation of polished and per- sistent marketing to minority groups,” said Mike Rogers, CEO, Smoking Cessation Trust Manage- ment Services, Inc. “There are up to 10 times more tobacco ads in Black neighborhoods than in other neighborhoods. And while these tactics are particularly unfair to Black smokers, deceptive tobacco marketing, overall, is unfair to all smok- ers and should be more strictly monitored, so that smokers are given a fighting chance to success- fully quit.” Cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including more than 41,000 deaths resulting from secondhand smoke exposure. Smoking Louisiana Department of Health Reports Sustained Improvements in ReducingMaternal Morbidity The Louisiana Department of Health is report- ing additional progress in reducing severe mater- nal morbidity among birthing persons who expe- rience hemorrhage and severe hypertension in facilities that are part of the Louisiana Perinatal Quality Collaborative (LaPQC). The LaPQC’s final report on reducing maternal morbidity shows that severe maternal morbidity among hemorrhage was reduced by nearly 35% and severe mater- nal morbidity among hypertension was reduced by almost 12%. The Reducing Maternal Morbidity Initiative was designed to reduce the occurrence of two recognized contributors to maternal morbidity and mortality, preventable hypertension and/or hemorrhage, while also reducing disparities in outcomes. This data shows that Louisiana has made sig- nificant progress toward ensuring safe, equita- ble and dignified births for all birthing persons in Louisiana. The final report covers work that began in 2018 with the launch of the Louisiana Department of Health’s Louisiana Perinatal Qual- ity Collaborative, which is authorized under the Louisiana Commission on Perinatal Care and Pre- vention of Infant Mortality. The LaPQC has been working with 42 birthing facilities, including hos- pitals, using quality improvement science to cre- ate sustainable change that improves maternal outcomes. The report shows that the goal of a 20% reduc- tion in severe maternal morbidity among hemor- rhage was surpassed, with an actual reduction of almost 35%. However, though severe maternal morbidity among hypertension was also reduced by almost 12%, the goal of a 20% reduction was not reached. The differences between outcomes in severe maternal morbidity among hemorrhage and hypertension may be due to Louisiana’s lon- ger history of engaging quality improvement work to reduce outcomes related to hemorrhage. Improvement work related to hypertension began over two years after work related to hemorrhage, so processes that reduce severe maternal mor- bidity among hemorrhage are more engrained in birthing facilities. “What is evident through the Reducing Maternal Morbidity Initiative is that intentional, consistent and sustained improvement in pro- cesses have led to better recognition and response to hemorrhage and hypertension,” said Veronica Gillispie-Bell, MD, the medical director of the LaPQC. “This progress is encour- aging, especially given the challenges of the pan- demic, though we clearly have more work to do in reducing racial disparities. We appreciate the hard work and continued commitment of our hos- pitals to making Louisiana a safer, healthier place for all birthing persons.” Black-white disparity remains Additionally, the report shows that there were overall decreases in disparity for severe mater- nal morbidity related to both hemorrhage and to hypertension. However, severe maternal morbid- ity Black-white disparity still exists. While non-His- panic Black birthing persons are still more likely to experience severe maternal morbidity among hemorrhage, this measure decreased among non-Hispanic Black birthing persons by almost 50% in comparison to a 16% decrease among non-Hispanic white birthing persons. And while there was an improvement in reduc- ing severe maternal morbidity related to hyper- tension among non-Hispanic white birthing per- sons, there was a slight increase (approximately 8%) for non-Hispanic Black birthing persons. “We have much more work ahead of us to make health disparities a thing of the past, but these results are encouraging,” Gillispie-Bell said. Louisiana has become a model in the coun- try for working to improve maternal outcomes, linking public health data to drive very specific transformational change. Since August 2018, the LaPQC has grown to 42 birthing facilities, meaning that nine out of every 10 births in Lou- isiana occurred in a LaPQC participating facility by the end of the Reducing Maternal Morbidity Initiatives. Structured, continuous quality improvement work in birthing facilities is an important and necessary component to ensure that Louisiana birthing persons experience safe, equitable, and dignified birth. Programs like the LaPQC are successful in supporting these changes. The work continues, and in January 2021, the LaPQC launched the Safe Births Initiative that continues improvement work related to hemorrhage and