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Women and Children Last 

As long as the state's women and children remain in this crisis, the entire population will continue to suffer.

In the past few weeks, three national studies have pointed out to Louisiana residents what many already know: this state's population is arguably the unhealthiest in the country. Yet, in Baton Rouge these days, most discussions of Louisiana's public health revolve around which programs to trim, cut or eliminate.

Earlier this month, the Annie E. Casey Foundation released its annual "Kids Count" statistics measuring indicators of a healthy start to life, and again Louisiana ranked among the bottom 10 states. The numbers compiled by the national nonprofit indicate Louisiana has shown some improvements in prenatal care, as well as reductions of teen births and pregnancies of undereducated women. But we still have far to go.

The United Health Foundation recently rated Louisiana dead last in the overall health of its citizens for 2001. The foundation likewise gave Louisiana its lowest numbers ever regarding support for public health care. The foundation's report also showed increases in cases of cancer and infectious diseases. This study, too, cited at least some level of improved prenatal care in Louisiana.

Studies by the National Women's Law Center, a Washington, D.C.-based advocacy group, focused particularly on women's health. This report, released in December, ranked Louisiana 51st in the nation (dropping from its No. 50 spot last year) in overall women's health measures. It spotlights Louisiana's failure to adequately address wellness and prevention, and to make health services and coverage available to low-income women.

Such numbers are even more compelling when compared to the lists in which Louisiana ranks at the top. These include: infant mortality, new AIDS cases, undereducated parents, and economic insecurity and instability. It's not hard to see a cause-and-effect pattern here.

Meanwhile, at the state Capitol, the Foster Administration is threatening to eviscerate the state Department of Health and Hospitals budget unless the Legislature renews "temporary" sales taxes on food, drugs and utilities. Foster reportedly also wants increased income taxes -- for a total tax bite of $600 million. The "temporary" sales taxes were first levied in 1986, and renewed periodically since then.

Health and Human Services Secretary David Hood has said he expects legislators to renew the temporary taxes, and he believes the department will be funded as usual. But DHH has many public health programs that need more funding than they're getting now if the state wants to pull out of its current rut in health care.

Foremost among these programs are those aimed at reaching women, children and families. Others deal with substance abuse, chronic and infectious diseases and mental health, according to the Office of Public Health's "2001 Louisiana Public Health Report Card."

The public health office, a division of DHH, also has a "wish list" -- recommendations for further improving Louisiana residents' health. Not surprisingly, at the top of the list are proposals for enhancing the health of the state's women and children. Of course, such recommendations will merely look good on paper until legislators get serious about funding them. From the way things appear now, DHH programs will be lucky to hang onto the scant state funding they currently receive.

We all know that times are tough. Nonetheless, health care for all citizens must be considered a top priority. As long as the state's women and children remain in this crisis, the entire population will continue to suffer. Women without access to preventive health programs, health coverage, contraception and education are unlikely to remain healthy, and are more likely to experience illness and, in the case of young women, unplanned pregnancies. Pregnant women without adequate health resources and prenatal care are unlikely to give birth to healthy babies. And children without a healthy beginning are unlikely to thrive to their fullest potential in later life.

Public health officials recognize the overarching importance of women and children's wellness. So do private organizations. Louisiana's only statistical health improvement -- that of prenatal care and unplanned pregnancies -- can be credited to programs funded by public-private partnerships.

These programs are often grassroots projects that bring trained advocates into targeted hot spots with solutions that involve the entire community. Among them in New Orleans are "Plain Talk," aimed at educating urban youths about sexuality, pregnancy, abstinence, contraception and AIDS; "Great Expectations," which educates low-income women about healthy pregnancies and parenthood; "The Sista Project," helping African-American girls and women protect themselves from the HIV virus; "Covering Kids," which attempts to locate and enroll eligible youths into the Louisiana Children's Health Insurance Program; and the statewide "Reality Education About Life" (REAL), a teen anti-pregnancy project.

Such programs have proven to be effective on a small scale, but Louisiana desperately needs large-scale help. Legislators must treat the state's health situation as the crisis it is, one that affects every facet of society from education to economic development. Until legislators recognize that Louisiana can't thrive if its women and children aren't healthy, Louisiana will continue to occupy the bottom tier on every survey that really matters.


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