For central and northern Louisianans living with sickle cell disease, a doctor’s visit often requires an hours-long drive.
The region’s care options for the disease, a group of inherited blood disorders that primarily affects Black communities, are severely limited, according to Shay Hardison, executive director of the Sickle Cell Anemia Resource Foundation in Alexandria.
The foundation’s clients often must commute to Shreveport, where the region’s only permanent sickle cell clinic is located, Hardison said; one of its doctors makes semi-regular visits to Monroe and Alexandria to see patients who can’t get to the northwest corner of the state.
The dearth of doctors trained to treat the blood disorder is one of several challenges the Health Disparities in Rural Areas Task Force is hoping to tackle. The group, convened by lawmakers in 2022, met this week to begin formulating its agenda for next year’s legislative session.
Other issues include a shortage of mental health and maternal care services, and broadband shortages in rural areas that can limit patients’ access to telemedicine.
As possible solutions, task force members have floated proposals to offer free internet to families living in deep poverty, establish tax incentives for physicians who set up shop in rural areas and implement remote sickle cell patient monitoring programs.
Dr. Karen Wyble, who chairs the taskforce, said the panel hopes to put at least five to six bills before lawmakers next year. (Wyble also serves as the vice president for regional community affairs with Ochsner Lafayette General.)
Louisiana frequently makes headlines over its abysmal health statistics. The state, whose infant mortality crisis is one of the worst in the developed world, ranks 48th nationally for the health of women and children.
The Louisiana Department of Health has said that nearly every parish in the state is short on health care professionals.
According to the House resolution that established the taskforce, 26% of the state’s population lives in a rural community. Generally, rural Americans face higher risks of adverse health outcomes and tend to have more limited access to care than urban areas, the Centers for Disease Control and Prevention has said.
Rural areas often have spotty internet connections or lack such connections entirely, which makes it hard for residents to access telemedicine, a recent study led by researchers at LSU[WJ1] found. Neighborhoods with a high proportion of Black residents also tended to have lower broadband rates and face the same disadvantage, according to the study.
“What we want to bring forward is a proposal for consideration by the legislatures that families (living in deep poverty) would receive free internet in their homes,” Wyble said.
Task force members are exploring other digital programs that could bridge some of the health gaps they hope to address.
Next month, the panel will hear a presentation about a remote monitoring program for sickle cell patients, Wyble said.
Task force member Dr. Vincent Culotta, an OB-GYN and the executive director of the Louisiana State Board of Medical Examiners, is researching an initiative aimed at increasing access to prenatal care in rural areas, Wyble said.
The program would add patients’ maternal histories to the state’s LA Wallet app, which allows residents to digitize their driver’s licenses and Medicaid cards, according to Wyble. That way, patients’ primary care physicians can easily access the information and better serve expecting moms, connecting them with other clinicians as needed, she said.
Culotta on Thursday described rural Louisiana as an “underserved country” when it comes to prenatal care.
“The real issue is poverty and the inability of people to be able to travel for prenatal visits,” he said.
The taskforce is also looking for ways to bring more physicians to rural Louisiana.
To that end, member Jeff Williams, executive vice president of the Louisiana State Medical Society, suggested that the panel consider recommending tax incentives for healthcare providers and first responders who work in rural communities.
Increasing interventions for youth with Adverse Childhood Experiences and expanding kids’ mental healthcare access is another major priority for the taskforce, Wyble said.
“That’s a huge one because we know that these children are in dire need of some mental healthcare,” she said. “We have a serious problem.”
Ecoee Rooney, the immediate past president of the Louisiana State Nurses Association, heads the taskforce’s working group on healthy schools. Youth impacted by abuse and neglect are less likely to have access to mitigating services when they live in rural areas, she said.
Rooney said her group is still fleshing out its specific legislative recommendations.