September 19, 2018 – What’s at stake for women’s health? That was the title and driving question of the event I attended on Tuesday. I joined Los Angeles women and girl’s health leaders to learn about changes at the federal landscape, plan out ways to push forward in California, and advance women’s access to care and services in LA County–the largest county in the country. Turns out, there is a lot at stake:

Life expectancy is dropping for the first time in a century. The last time we saw the trendline pointing in this direction was over a century ago (1915-1916), in the midst of World War I and a flu pandemic! The crises fueling today’s declines include obesity-related chronic diseases and opioids.

The Affordable Care Act led to more than four million newly insured people in California. In fact, our state has experienced the biggest drop in the share of uninsured residents. While California has taken important steps to protect some ACA elements through state law (such as preserving coverage of essential health benefits), our residents would be dramatically impacted should the Federal law continue to be threatened.

Infant and maternity mortality rates are unacceptably high in the US. And while racial disparities in these rates persist in California, the state and LA County are addressing the problems head on. California recently approved $8 million in funding to address black perinatal mortality. Following the leadership of black women, LA County has the opportunity to surround pregnant black women with everything they need for a healthy birth (transportation, food, safety, etc.) and change these devastating statistics.

Sexually transmitted infections (STIs) are on the rise in LA. After being nearly eradicated in the early 2000s, syphilis and other STIs have struck back in a big way in LA County. It’s important to note that, at 10 million people and counting, more people live in our county than in 42 individual states. So when diseases spread here, they impact a tremendous number of people. In fact, we have more cases of syphilis than 46 other states. Planned Parenthood is one of the groups trying to turn this tide, through activating teen peer educators, coordinating with consulates, and providing testing and treatment (292,000 tests and counting).

The fastest-growing population of homeless people in LA are older African American women. This became the case about four years ago, and still, very few of the services are tailored to this population. Fortunately, the County understands that housing is a public health issue and forum attendees discussed ways to address the challenge.

Unlocking the Potential of Existing Services

Across the presentations, I heard a common refrain. “The services are there, we just need to get the word out.” Medi-Cal, for examples, covers dental care for all pregnant women, but too few women access that service. This is the greatest strategic communications challenge for the County.

As a strategic counselor, before launching targeted promotion efforts, I would advise service providers to ask themselves one critical question: are they sure that these services are performing as expected/designed? Too often, complex systems fail before the resident even has the opportunity to access the service. At my table, I heard stories about unanswered phone calls, shortages of mental health care providers, and instances of condescension and bias. But if the program or service really does deliver on its promise, then we should build a structure that incentivizes and motivates residents to share their positive experiences with friends, family, and neighbors. This strategy of social notification/word of mouth marketing will have greater credibility and potential impact than, say, billboards and bus shelter ads. Across the many challenges, we must seek strategies for addressing and converting them to opportunities. I’m happy to help advise wherever possible on how communications and social marketing can be part of the solution.

Thank you to forum coordinators Essential Access Health, Community Clinic Association of Los Angeles County, and the Los Angeles County Women’s Health Equity Coalition and forum funders, The California Endowment. I look forward to continuing this critical discussion with the leaders I met at the forum. And if you want to be involved in the work of protecting women and girl’s health in California, please let me know. There’s a role for everyone. We have our work cut out for us, but there is frankly too much at stake to be complacent.