“I refuse to accept that we have to be last in every health indicator.”1
—Daniel Edney, MD
Soon after he took the reins as Mississippi’s State Health Officer in August 2022, Dr. Daniel Edney placed a large framed poster in the lobby of his agency’s fourth-floor executive office. The poster, with the banner title “Change Can’t Wait: Moving Mississippi Out of Last Place,” features sobering data from the Commonwealth Fund’s 2021 Health System Performance Scores revealing Mississippi’s presence at the very bottom of the graph, broken down by race and ethnicity, as the worst health system in the country.2 “Not only are we 50th, but we are 50th by a mile! If there were a 60th, we’d be 60th!” says Dr. Edney with urgency. In his eyes, the graph tells everything. Mississippi is not only last, but has fallen off the nation’s healthcare cliff. “The entire state population is underwater.” He adds: “Notice the slope of the curve. This graph cannot stand.”3
“Change Can’t Wait” has become Edney’s theme during his term as Mississippi’s State Health Officer. His health deputies repeat the phrase “Change Can’t Wait” in their presentations to the public and in their daily work interactions, embracing their roles as catalysts for change. We can and must do better, he stresses, and no one in healthcare can rest until we have flipped this graph. Mississippi is where it is not because we have to be but because we choose to be. Mississippi health leaders must encourage better health choices not only by our patients but also by our state’s policymakers and healthcare leaders. The jarring slope reflects our state’s poor access to medical care as well as decades-long anemic funding of core public health work at both the county and state levels. Edney asserts, “This is not because we have bad doctors and nurses; it’s because we have a weak system across the board.”3
Things can change in Mississippi. Dr. Edney not only wants to get us off the bottom of the graph but to get our state “off the radar.” This is all about access to healthcare and a focus on preventive health and health equity. “What breaks my heart is that we lead the nation in preventable deaths,” says Edney, who notes that the three leading causes of death in our state (cardiovascular disease, cancer, and accidents) are all preventable with access to physician-led primary care medical homes which provide proper screening and detection, health education, and core prevention.
The “Change Can’t Wait” poster outlines in three steps how to get Mississippi off the bottom: Getting people healthy (health outcomes); Giving everyone a ticket (access to healthcare); and Granting everyone the tools: screening, check-ups, education, and health literacy (healthcare utilization). Edney cites the recent improvements in education in Mississippi, impacted by policymakers’ choices of better investment and increased accountability. “If we did it with education, it can be done with health.” The Health Department’s laudable vaccine equity work during COVID-19 also reversed healthcare outcomes in our state, proving that healthcare disparities can be eliminated or at least mitigated.4,5
As physicians, we must raise awareness and change attitudes in our state: It does not have to be this way. Change can happen and must happen, and change can’t wait. This must be our mission. We must stop accepting these tragic health outcomes as who we are. We must take the steps and make the investment to transform the Commonwealth Fund’s graph. Dr. Edney’s mantra should be that of every Mississippi physician: Change Can’t Wait!
Contact me at drluciuslampton@gmail.com. — Lucius M. Lampton, MD. Editor