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March 05, 2023 03:46 PM

Access to transportation fuels disparities in rural Louisiana

Kara Hartnett
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    Ricky Peters
    Kara Hartnett

    During a conversation with Ricky Peters on the side of the road in a small, southern Louisiana town during the final days of open enrollment, an Americana ringtone persistently interrupted the conversation—four times over the course of 30 minutes. On the final ring, Peters leaned to the side in his electric wheelchair, plucked the phone from his front pocket and shouted, “I already have Medicare!”

    Modern Healthcare sought to map the parts of the U.S. with the poorest access to healthcare and highest levels of social vulnerability. With support from the University of Southern California Annenberg School for Communication and Journalism, Modern Healthcare used the Centers for Disease Control and Prevention social vulnerability index, along with Health Resources and Services Administration access scores, to identify areas with common problems but unique circumstances, including Evangeline Parish, Louisiana, the Bronx, New York, and Navajo County, Arizona.

    Mamou, Louisiana, is the self-proclaimed Cajun Music Capital of the World. Every January, locals begin preparing for their largest celebration of the year: Mardi Gras. “Laissez les bons temps rouler"—let the good times roll—is painted on the side of the town’s beloved bar, Fred’s Lounge. Weathered storefront windows along the main road are festooned with purple and gold decorations.

    The rural community, a collection of swamplands and prairies, rice and sugarcane fields, has been federally designated as medically underserved since 1978. Its 3,000 residents are 65% white, 27% Black, 4% Latino and the remainder mostly identify as multiracial.

    There is deep inequality here, forged by centuries of racial violence and a steady population decline since 2000, which has perpetuated cycles of poverty and limited economic opportunities. Many residents live far from grocery stores and lack access to the internet and reliable transportation, said Karen Wyble, vice president of community affairs at Ochsner Lafayette General Medical Center, which is an hour’s drive from Mamou.

    The local economy revolves around Old Highway 13, which runs south toward the Gulf of Mexico. In town, there are no sidewalks. Businesses such as a pharmacy, food market, liquor store and barbecue joint operate drive-thrus, which underscores how reliant residents are on their automobiles.

    On the edge of town in January, a Troy-Bilt lawn mower sat parked outside Savoy Medical Center between a Kia Telluride and an Acura TL. Residents of the nearby senior housing complex pilot wheelchairs over roads and through grassy lots. Ricky Peters is among them.

    Peters was on his way to a convenience store to buy food. “This is my only form of transportation,” he said.

    Peters moved 30 minutes from his native Mamou to Oakdale to build cabinets when he was younger but returned a few years ago after flooding destroyed his home. "A lot of people got sick," he said. “I was lucky.”

    Arthritis in his back and knees already troubled him when an injury from a fall two years ago made him a wheelchair user, he said. Peters can get himself to the primary care doctor, but he can’t drive. He needs rides from his uncle to other providers.

    Dr. Tina Stefanski oversees this area for the Louisiana Health Department, which has sought money from state and federal authorities as well as local employers to fund transportation for residents in a nearby parish. That would benefit people like Peters if it extended to Evangeline Parish, where Mamou is the third most populated town.

    “That's one way where business and government can come together to try to improve, and it's only good for everyone,” Stefanski said.

    More on health inequity
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    Walmart, CareSource partner on health disparities project
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