Kandace Power Graves discusses the city's health with City Health Department Director Sheila Webb.
Q: What is the biggest health concern or challenge for New Orleans in the coming year?
A: The No. 1 health problem facing the people of New Orleans is cardiovascular disease. It's still the No. 1 killer of all Americans -- and in our state as well as Orleans Parish. What contributes to cardiovascular disease is people who are overweight, people who do not exercise, people who smoke, and people who have dietary habits whereby they're consuming large quantities of fat in their diets. Inactivity, smoking, obesity are those things that are going to contribute the cardiovascular disease.
Q: What segment of the population is most at risk?
A: Like the (other) major big killers of Americans, African Americans are disproportionately affected by cardiovascular disease in that we are experiencing a higher incidence and higher rates of mortality.
Q: Is it a matter of money or access to health care or education?
A: If you look at it as a pie in its entirety, about 20 percent of what happens to a person happens as a result of heredity, with 20 percent environmental influences, and 10 percent what kind of medical care they have. The other 50 percent of the pie is related to lifestyle choices: if we choose to smoke, if we choose not to exercise, if we choose to eat diets high in fat.
Q: How does the city go about reaching these people?
A: There are a number of different ways we attempt to reach people to inform them and educate them about what is acceptable in terms of dietary requirements, exercising, etc. When people go to their personal physicians -- of course not all of us have them -- through the public Health Department, the clinics we operate, the Office of Public Health at the state level, information is provided in school sites as well as work sites. There's a lot of information as far as the media ... the Internet and Public Broadcast System and through personal inquiry and personal experience. Some people are much more aware because they have access to information. The first line of information is where you live and what diet you're served in your home, your schools, and later work sites. Even though we do know there are all these different venues where information comes forward in a number of ways, we know that everybody does not have access to all those vehicles. Access is a major issue, and that goes in terms of access to information, health care. ... If we look at the state of Louisiana, we're the poorest state in the nation, we have the largest number of people who live below the poverty level, we have a large number who are uninsured. That speaks to the issue of health care and who can go the doctor. We have a significant problem here in Louisiana. We know that when we look at New Orleans' large metro area, in many instances, our statistics are going to be even more significant.
Q: What are other health concerns?
A: Cancer is another concern, diabetes, HIV/AIDS. Violence is another major concern in terms of public health problems. Then you're going to have those diseases that come under that cardiovascular umbrella, such as stroke and other heart problems.
Q: What do people need to be doing that they aren't doing?
A: We don't want to make it sound like it's simplistic, that if you exercise and eat right everything will be OK. The Centers for Disease Control says a large percentage of what happens to our health, we contribute to it. We do know that we have a lot of people that (find) it difficult ... to do what we're supposed to do to maintain a good level of health. Just maintaining a good, nutritious diet -- the better it is, the more it costs. There is a correlation between many of these outcomes and economics. ... We are a poor state. We have large numbers of people who are uninsured. We have these social and economic determinants of health. It's a very complex picture for many individuals, and it's something we all struggle with. ... There's not an easy and simple solution.