New Orleans’ system of health care had big problems even before Hurricane Katrina. But the 2005 storm laid bare the city’s gap in access to quality community care. That’s when Dr. Karen DeSalvo began helping the city rebuild better, stronger—and healthier.
When the hurricane hit, DeSalvo was serving as the chief of internal medicine at the Tulane School of Medicine (where she had earned her medical doctorate, as well as a master’s of public health). In the immediate aftermath of the storm, she worked with a group of doctors practicing out of makeshift clinics around the city. Moved by those experiences, she shifted her focus to help New Orleans create an entirely new system for delivering primary care.
DeSalvo was instrumental in developing a network of more than 100 neighborhood-based “medical homes” providing health-care access for uninsured, underinsured and low-income patients. DeSalvo’s success gained the attention of Mayor Mitch Landrieu, who in 2011 tapped her to be his health commissioner, but to play a very different role: taking on the city’s entire approach to public health and re-envisioning it from the ground up. DeSalvo wanted to transform the health department from a reactionary agency focused on clinical care into a comprehensive resource aimed at making New Orleans a healthier place to live. To accomplish that, she knew she needed to engage academics, business leaders and nonprofits. “We can work around issues of equity and access and quality and affordability that really are cross-cutting,” she says, “and really do better on focusing on everyone in the city—not just one population or another.”
The result? Fit NOLA, a sweeping initiative to improve the public’s health and address New Orleans’ chronically high rates of obesity, diabetes and high blood pressure. Launched last year, it brings together more than 100 organizations to encourage active lifestyles and improve access to nutritious foods. It’s no mere get-fit campaign. Fit NOLA represents a radical new paradigm for the health department. DeSalvo’s team is now focused on things like adding new bike lanes, building parks and bringing supermarkets to underserved areas.
The department today is more proactive and more receptive to working with the private sector, says Warner Thomas, the CEO of Ochsner Health System, the largest nonprofit health system in the state, which has supported the efforts with an incentivized wellness program, reduced prices at fitness centers and modifications to food options on its campuses. “I just see a much more collaborative department of public health for the city,” Thomas says. “That’s been a huge change since Karen has taken over leadership.”
Similarly, DeSalvo worked with Edible Schoolyard New Orleans to create a school wellness campaign. That kind of partnership would have been inconceivable in the past, says Executive Director Claudia Barker. “There was never any kind of initiative like this that embraced providers and people that work in schools and community centers,” she says.
DeSalvo initially planned to serve in the health department for only a year. But as she’s watched the agency transform into a powerful new force for improving lives, she has felt compelled to stay on. “I did intend to stay for a year,” she says. “But I underestimated how much I’d enjoy working for the people of New Orleans. It’s a really special honor.”