HJBR Jul/Aug 2023

HEALTHCARE JOURNAL OF BATON ROUGE I  JUL / AUG 2023 43 For weekly eNews updates and to read the journal online, visit HealthcareJournalBR.com with Opelousas General Health System, we are advancing the fight against cancer.” LAReps Participate in Listening Session withWhite House Office of National AIDS Policy More than 80 public health professionals and community members from New Orleans and sur- rounding parishes, Baton Rouge, and the State of Louisiana gathered with members of the White House Office of National AIDS Policy to share plans, challenges, and successes in their work to end the HIV epidemic. Staff with the New Orleans Health Department and its Ryan White Services and Resources division presented details of the recently launched HIV Care program in a listening session with the White House Office of National AIDS Policy Director Harold Phillips and staff members; the session was held at the University Medical Center. The new HIV Care program, Centralized Link- age, provides for people living with HIV to call or text 504-884-3307 seven days a week to access free or low-cost HIV primary care appointments and support services, regardless of whether they have insurance. “The Centralized Linkage pro- gram is another strong example that we are using all tools available to provide our citizens the best HIV care and support,” said Vatsana Chanthala, director of Ryan White Services and Resources. “We are grateful for the support of the White House, federal partners, and local stakeholders for the funding and collaboration that allows us to provide these services.” The Centralized Linkage program, one of the components of the Bounce to Zero campaign to end the HIV epidemic, went live earlier this year; the program features a call or text option staffed by service coordinators who connect persons with HIV with a comprehensive suite of resources to manage an HIV diagnosis including primary care appointments and assistance with transportation, medication, housing, and insurance. A Centralized Linkage Coordinator works with individuals to connect them to HIV care pro- viders. The phone line is available to both cli- ents and providers. The “Bounce to Zero” cam- paign is the local implementation of the national effort of Ending the HIV Epidemic by reducing the number of new HIV infections in the U.S. by 95% by 2030. It is coordinated by Ryan White Ser- vices and Resources of the New Orleans Health Department. The New Orleans metro area has the highest number of HIV cases in Louisiana and was identi- fied as one of 57 priority jurisdictions in the fed- eral effort of ending the HIV epidemic in the U.S. by 2030. According to the Louisiana Department of Health, there are 8,642 persons living with HIV in the New Orleans metro area, which rep- resents 38% of the State’s HIV cases. The eight parishes benefiting from the Bounce to Zero campaign have the highest cases of persons liv- ing with HIV in Louisiana. Nationwide, approxi- mately 1.2 million people are living with HIV. An estimated 38,000 Americans are newly diagnosed each year. While the overall number of new inflec- tions has dropped by 73% between 1984 and 2019, progress to further reduce those numbers has stalled. Without intervention, nearly 400,000 more Americans will be newly diagnosed over 10 years, despite the availability of tools to prevent transmissions. Study Finds Eight Factors Put Black Adults at Greater Risk of Early Death Black adults who live in the United States have a 59% higher risk of premature death than White adults. A new study from Tulane University published in Lancet Public Health has found that this gap can be entirely explained by disparities in eight areas of life critical to health and well-being: employ- ment, income, food security, education level, access to healthcare, quality health insurance, home ownership, and marital status. These eight factors are called social determi- nants of health, conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Using data from the National Health and Nutrition Examination Survey, a CDC survey used to determine disease prevalence and risks across the country, Tulane researchers modeled the impact of each factor on a person’s life expec- tancy. When all unfavorable social determinants were accounted for, the 59% mortality disparity was reduced to zero. “It totally disappeared,” said Josh Bundy, lead author and epidemiologist at Tulane’s School of Public Health and Tropical Medicine. “There’s no difference between Black and White premature mortality rates after accounting for these social determinants.” While the mortality gap has been largely pinned on socioeconomic factors such as education level, income, and employment status in recent years, researchers have acknowledged that these fac- tors only explained most of the gap, Bundy said. “This is the first time that anyone completely explained the differences,” Bundy said. “We didn’t expect that, and we were excited about that finding because it suggests social determi- nants should be the primary targets for eliminat- ing health disparities.” Socioeconomic factors were still found to play a major role, accounting for approximately 50% of the Black-White difference in mortality in the study. However, the other nearly 50% of the dif- ference was explained by marital status, food security, and whether someone has public or pri- vate health insurance — softer indicators that can speak to a person’s social support network, sta- bility, or job quality. Unfavorable social determinants of health were more common among Black adults and were found to carry enormous risk. Having just one unfavorable social determinant of health was found to double a person’s chances of an early death. With six or more, a person has eight times higher risk of premature mortality. Jiang He, the corresponding author and Joseph S. Copes Chair of Epidemiology at the School of Public Health and Tropical Medicine, said these results “demonstrated that race-based health disparities are social, not biological, constructs.” Bundy agreed, adding that the findings explain how “structural racism and discrimination lead to worse social risk factors, which may lead to pre- mature death.” “So how do we eliminate the structural differ- ences between races?” Bundy said. “And regard- less of race, if you have six or more of these fac- tors, you’re at a really high risk. How do we address these issues for everyone?” As a concept, social determinants of health is a relatively new framework being emphasized by CDC’s Healthy People 2030 initiative.