In Louisville, Health Equity is Everyone’s Work

In Louisville, we have set a bold vision: a healthy Louisville where everyone and every community thrives. At the Louisville Metro Department of Public Health & Wellness (LMPHW), we are setting out to achieve health equity and improve the health and well-being of each of our residents and visitors. Health equity means that everyone has a fair and just opportunity to be healthy and reach their full human potential. A person’s identities, whatever they may be, should not predict how long or how well one will live.

Getting to the Root of the Problem The Louisville Metro Department of Public Health & Wellness established the Center for Health Equity—the first of its kind in the nation—to promote awareness, dialogue, and action to create more equitable communities. Our 2017 Louisville Health Equity Report (HER) presented a timeline documenting the city’s historical context of shaping disparities in different communities across Jefferson County, particularly for people of color. To begin to create more equitable communities we re-organized the Department into 6 Root Cause Teams (RCT) to better tackle the root causes of health and health equity.

Resources like the City Health Dashboard that offer more focused and granular data, have really helped us shed a light on the distribution of health inequities and their relationship to policies and practices.  For example, the map below shows the regional values of the Dashboard’s housing with potential lead risk measure and the number of blood tests where lead levels were ≥5µg/dL in Louisville. The same neighborhoods in west and downtown Louisville where lead risk is high are the same neighborhoods where children are testing positive for high levels of lead.*  A recent analysis of Louisville’s blood lead testing data, however, suggests our population is under-tested leading us to infer that the number of children with elevated blood lead levels is potentially higher.

Taking Data Further Data and maps alone cannot create the significant changes we need; equity requires action. Action for equity means we must work together at multiple levels to create long-term solutions. So, how is LMPHW using data to put equity into greater practice? LMPHW Childhood Lead Poisoning Prevention Program staff and the Environmental Equity RCT are implementing several strategies to increase testing, including:

• Increased prevention efforts in the highest risk areas of Louisville Metro, which are predominantly in Black communities where children represent nearly 60% of all elevated blood level cases in Louisville.

• Encourage increased blood lead screening for children and pregnant women by working closely with our laboratory and community physicians.

• Create a strong network of community, government, non-profit and private business partners to advocate for ending childhood lead poisoning through coalition building.

• Work closely with Lead Safe Louisville to provide occupants, renters, and home-owners with knowledge of lead hazards and how to respond when it comes to lead exposure in their homes.

• Strengthen local enforcement of chipping and peeling paint housing codes.

Our strategies are multi-dimensional. They engage actors from across the community and invite them to participate in decision-making and take ownership of their health. Long-lasting health equity is everybody’s work! I am proud of what we do and the way we do it and am confident that we’ll reach our bold vision of a healthy Louisville for EVERYONE.

To learn more about our Health Equity Report and evidence-based best practices visit healthequityreport.com.

*Caution is important when examining metric comparison maps; just because two metrics are lower or higher in the same neighborhood does not mean that one causes the other.

T Benicio Gonzales, MSW, PMP, is the Interim Director for the Louisville Center for Health Equity.