St. Bernard Parish
St. Bernard Parish is located five miles east of downtown New Orleans, just southeast of the Lower Ninth Ward neighborhood, and is home to many residents who commute to other parishes for work. In 2000, before Hurricane Katrina and the catastrophic levee failures of 2005, St. Bernard Parish had a population of 67,229. After Hurricane Katrina, the population fell but has since continued to recover. Much of St. Bernard’s population is centered in the communities of Arabi and Chalmette, which is the county seat.
PERCENT OF POPULATION UNDER 65 WITHOUT HEALTH INSURANCE
Health insurance coverage increases an individual’s likelihood of receiving quality medical care.[i] Health insurance is important for preventive care as well as timely treatment of illnesses or injuries.[ii] Those who lack health insurance often do not get timely treatment for chronic illnesses.[iii] When insurance coverage is low, costs to society are often high in the form of emergency room visits and lost worker productivity.[iv] Examining insurance rates for the nonelderly is particularly important, because most adults, age 65 and older, have high rates of health insurance coverage due to Medicare.[v] While health insurance coverage is very important, insurance coverage does not guarantee availability of care nor access to health care services.[vi]
Population under 65 with no health insurance coverage by income to federal poverty threshold ratio, 2016
Notes: Those with incomes under 138 percent of the poverty level may qualify for Medicaid in states such as Louisiana that have accepted ACA’s Medicaid expansion. The income limit for getting a lower cost premium for a health care plan through the Health Care Marketplace is 400 percent the federal poverty level.
Population under 65 with no health insurance coverage, 2016
[i] The Kaiser Family Foundation. (2017). Key facts about the uninsured population. Retrieved from http://kff.org/uninsured/factsheet/key-facts-about-the-uninsured-population/.
[ii] Allen, E. M., Call, K. T., Beebe, T. J., McAlpine, D. D., & Johnson, P. J. (2017). Barriers to care and health care utilization among the publicly insured. Medical Care, 55(3), 207-214. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27579910.
[iii] Beckles, G. L., Engelgau, M. M., Narayan, K. V., Herman, W. H., Aubert, R. E., & Williamson, D. F. (1998). Population-based assessment of the level of care among adults with diabetes in the US. Diabetes Care, 21(9), 1432-1438.
[iv] McBurney, P. G., Simpson, K. N., & Darden, P. M. (2004). Potential cost savings of decreased emergency department visits through increased continuity in a pediatric medical home. Ambulatory Pediatrics, 4(3), 204-208.
[v] Barnett, J. C., & Vornovitsky, M. S. (2016). Health insurance coverage in the United States: 2015. US Government Printing Office. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2016/demo/p60-257.pdf.
[vi] Hall, A. G., Lemak, C. H., Steingraber, H., & Schaffer, S. (2008). Expanding the definition of access: it isn’t just about health insurance. Journal of Health Care for the Poor and Underserved, 19(2), 625-638. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18469432; Allen, E. M., Call, K. T., Beebe, T. J., McAlpine, D. D., & Johnson, P. J. (2017). Barriers to care and health care utilization among the publicly insured. Medical Care, 55(3), 207-214. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27579910 (includes discussion of discrimination as an important barrier to accessing care).
PERCENT OF INDIVIDUALS WHO REPORT FREQUENT MENTAL DISTRESS
The number of people who report that their mental health was not good represents an important indicator of the rate of mental health issues in a parish. This kind of self-reported data is a better indicator of community-wide mental health concerns than data on the (often smaller) number of people who are actively seeking or receiving mental health treatment. Frequent mental distress is when individuals reported ≥14 days in response to the question, “Thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?” [i]
Percent of adults reporting frequent mental distress, 2016
Notes: Frequent Mental Distress is the percentage of adults who reported ≥14 days in response to the question, “Now, thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?”
[i] Robert Wood Johnson Foundation. (2016). County Health Rankings & Roadmaps. Retrieved from http://www.countyhealthrankings.org/explore-health-rankings/what-and-why-we-rank/health-outcomes/morbidity/health-related-quality-of-life/frequent-mental-distress
PERCENT OF VULNERABLE POPULATIONS RECEIVING HIGH-QUALITY CARE
One of the largest groups of vulnerable populations in any parish are the elderly. Most people over 65 years old are enrolled in Medicare. When many Medicare enrollees are treated in hospital settings for conditions that could be treated in an outpatient setting, this suggest that this large vulnerable population may not be receiving high-quality primary health care, or that they are not able to access primary health care at all. It may also suggest hospitals are being overused as a main source of care.[i] Preventable hospital stays are hospitalizations for conditions that could be treated in outpatient settings.
Number of preventable hospital stays per 1,000 Medicare beneficiaries by race/ethnicity, St. Bernard Parish, 2015
Notes: Medicare data classifies race/ethnicity only as black or non-black, then refers to all non-black populations as white. For consistency, this analysis uses this Medicare convention for race/ethnicity. For more information visit: http://archive.dartmouthatlas.org/ downloads/reports/Primary_care_report_090910.pdf. The black estimate for St. Bernard parish is based on a small expected number of cases, so may be unreliable.
Number of preventable hospital stays per 1,000 Medicare beneficiaries, 2015
[i] Robert Wood Johnson Foundation. (2019). Preventable Hospital Stays. County Health Rankings & Roadmaps. Retrieved from http://www.countyhealthrankings.org/explore-health-rankings/measures-data-sources/county-health-rankings-model/health-factors/clinical-care/quality-of-care/preventable-hospital-stays