
The Louisiana Public Health Institute (LPHI) is a non-profit organization created in 1997 to improve the health and well-being of Louisiana residents with a focus on racial justice and health equity. LPHI provides financial resources, expertise, tools and programming for the organization’s partners which include more than 500 different entities ranging from government agencies to community-based health centers to foundations and academic institutions.
Taslim van Hattum is the chief program officer at LPHI. She previously served as the director of the family health portfolio at LPHI, and the director of behavioral health, where she oversaw programs focused on increasing access to quality primary care, reproductive health and behavioral health services in the greater New Orleans area, across Louisiana and the Gulf Coast. Verite spoke with van Hattum about LPHI’s role in Louisiana’s health care system.
Verite: Tell me about the Louisiana Public Health Institute.
Taslim van Hattum: Louisiana Public Health Institute is a statewide entity that seeks to bolster communities across Louisiana’s public health. We are complementary to state and local health departments. Folks in Louisiana will know us for a few different things. They’ll know us, for example, through our tobacco-free living, tobacco cessation commercials that they might see on Hulu when they’re watching shows throughout the day. They might know us as the data housing infrastructure system that provides alerts for when they bring their children to the ER at 11:30 at night. Their primary care provider will get an alert so that they can follow up the next day and say, “Hey, are you okay? Can we bring you in for a follow-up?” That care coordination system is housed through our health information exchange. So the best way to understand it (LPHI) is we serve communities across Louisiana within a variety of different ways, providing partnership and collaboration, funding, and then public health programs to build towards a healthier Louisiana. This might include large scale health systems from your Ochsners to your LCMCs to working with Black pastors and churches on menthol free Sundays. It means working with community level doulas and it means working with the Louisiana Primary Care Association to bring their providers together. A lot of the work that we love doing is working with different folks in the community to bring them together in order to help solve complex problems and move us forward around large scale systems change. And for us, that looks like making sure that we’re building the capacity of community leaders while also making sure that we’re leveraging the statewide capacities of larger health systems partners.
Verite: Why is LPHI needed?
Taslim van Hattum: We work in deep partnership with state and local health departments, but we are different from your local health department or your state health department in that a lot of our work supports innovative programming that state health departments are not set up to do with the same level of potentially community engagement, flexibility, and responsiveness. So while a health department might want a certain group of healthcare providers to increase a service, they don’t necessarily have the partnerships or the know-how to do deep technical assistance with those partners. And so we come in and do a lot of the strategic training and technical assistance and capacity building with partners to further increase public health overall. I think what really sets us apart is our ability to ground in what we believe as the social determinants of health as critical to healthcare. Many health departments, some of their work sits in the social determinants, but some of it sits purely in healthcare, right, or health. And we are able to think very expansively and understand all of the social determinants of health and how those play into the larger public health picture over time.
Verite: Please explain the phrase “social determinants of health.”
Taslim van Hattum: The social determinants of health, in the most basic sense, are the conditions and environments where people are born, live, work, play, and pray. They’re the social conditions and environments within which an individual’s health is impacted. What the social determinants of health really help us to understand is where you live, work, play, pray, and in many cases, also the way in which we understand historical inequities and racial justice or racial oppression, deeply impacts the way in which an individual’s health is shaped. So what we know from the social determinants is that only about 30 percent of our individual health is determined by our individual behaviors and about 70 percent of our health is really determined by where we live, whether the systems around us support us. So, it’s about economic stability, education, it’s access, it’s the quality issues, it’s the built environment. In addition to that, it’s the community context, right, the social context. What do you have in place to make sure that you are supported to go to the gym, that folks around you are also healthy, that everything within your community has been set up to ensure that health and wellness versus blaming you for your individual behavior, stigmatizing mental health, deeply sort of shaming us around the ways in which we show up physically and mentally, and then healthcare access? So I would say that there’s this deep desire on all of our parts to be healthy. We want our children to be healthy. We want to feel good. We want to have enough time in our days and enough economic parity to make all these decisions that we know are good, but we are simultaneously engaged in or not supported by all of the systems around us to best optimize that.
Verite: Why are health fairs important?
Taslim van Hattum: I think when you think about health fairs, it’s fabulous that folks will go to a health fair and get screened. For me, the next step is that those healthcare systems think about how they can engage in that next mutually reinforcing step for folks to be further engaged in care. It’s phenomenal to screen people for high blood pressure and think about the ways, particularly because Black and Latinx folks are underscreened. But the next most important part of the conversation is what are we doing to connect anybody that screens positive to care and make sure that they’re engaged in a positive and mutually reinforcing relationship with the health system after that initial engagement. They know they’re unhealthy, they know they want to go to the health fair, they know they want to get their BP checked. How do we make sure once you have that information,that it translates to action and support? Another reason health fairs are important is because we continue to see that folks are disengaged in care because of fear of payment. And when we can provide resources for folks to get their first foot in the door to accessing care because they are not scared of what a copay is at a visit or the fear of payment, that is a first engagement in order to build a trusting relationship and rapport with a health system.