Transcript of podcast with Charlotte Parent, director of health for the New Orleans Health Department
Interview conducted by Lindsey Wahowiak, senior editor for The Nation’s Health newspaper.
Listen to this interview as a recording on our podcast page.
What was the New Orleans Health Department like when you got there nine years ago?
So, the New Orleans Health Department was primarily focused on providing direct safety net services to the community, which included the running of health clinics, providing lab testing and immunizations and those sort of things, and, you know, running those throughout the City of New Orleans to make sure that those who were in need had access to health services.
Great. And then that was pre-hurricane Katrina. Is that correct?
Correct.
After the hurricane, what changes, if anything, did we see in the Health Department?
So, initially after the hurricane the Health Department came back and tried to reestablish those safety net services. Because there really weren't a whole lot of services yet in place.
But what also was happening at the same time is other health care systems and services within the city were starting to transform themselves into community-based clinics. And so, the need for those safety net services for the city weren't as great post-Katrina. And as those other clinics came into being, the health department took a look at itself and decided, where could we best serve the citizens and decided to transform ourselves from doing those direct services that we provided into looking at more population health activities, which included work around childhood obesity, violence prevention, emergency preparedness — those things that would serve the entire community and let the people who were running health clinics and doing it well, provide those services to all citizens.
So, it sounds to me like you and the rest of the Health Department team were really looking at social determinants of health, the things that were affecting neighborhoods and communities to move forward. So, like what were some of the specific social determinants that you looked at and are trying to address?
So, the health department tied itself into what we've adopted and what we're continuing to work on: health in all policies issues.
Particularly, you know, as New Orleans was rebuilding, how could health insert itself into the areas that were rebuilding? So, as parks were being developed how can we ensure that health is being looked at? The increase in bike lanes. The increase of parks and green spaces. You know, all those things that promote health going forward.
In particular, you know, we began a lot of zonal work and neighborhood work. So, through like our Healthy Start program, which focused on the entire city after Katrina, we started to move towards looking at specific neighborhoods and what were the barriers and the assets that were in those neighborhoods that we could build upon to increase the livability in those neighborhoods and then tying those city departments to help us move that work forward, whether or not that was working with Parks and Parkways, or Safety and Permits about lighting or removing blighted houses. All of those were pieces and parts of how do you create healthy and safe neighborhoods.
Can you give a few examples of specific neighborhoods and the things you worked on in them?
Sure. So, one in particular is a neighborhood called Holly Grove here in the city, which became an area called the Best Babies Zone.
We worked our Healthy Start program along with Babies Zone in that area and looked at things like blighted houses and one particular house, which had been used in the neighborhood as a, you know, a space where people would hang out, drugs and those sort of issues were being dealt there and we worked with the city’s Office of Property Development to get the house demolished. It was abandoned and that was a big issue not only before Katrina, but after Katrina. A lot of houses that were, you know, were just not in shape that people could live in. And so we did that particularly in that neighborhood. And what that tended to do for that neighborhood, was show that we were in it to try to help that work and the neighborhood was already engaged, became even more engaged to do different things in that neighborhood to move it forward.
Can you give an example of another neighborhood that you did different things in because it had different needs?
Sure. I guess one of our more recent activities was in the lower Ninth Ward, the City was rebuilding a community center called the Sanchez Center that was there before the storm.
And one of those fantastic things that has happened since Katrina, it's allowed us to look at things that were in place before and re-envision what that should look like going forward. How could we build it better?
And in the lower Ninth Ward, you know, an area that was extremely devastated by the storm, this community center was coming onboard and primarily the community centers had focused on the New Orleans Recreation Department putting in services for families to get that moving. But this site in particular also had built next to it or part of the building was an area that was dedicated toward health and wellness. And so the health department was given the opportunity to help fill that side of the building. And what we did was create a space that goes from prenatal parenting families all the way up to our elderly. So, there's a parenting center, a WIC center, Healthy Start, there's also a primary care center on that site, as well as a senior center.
So, when people come into that building, not only are they getting the opportunity to use first class facilities for activities and kids and teens can work there. But on the other side, they can receive health care as well as resources for parenting, as well as resources for senior citizens.
And so, you know, we see that as a model for us going forward in the city as a way to put services all together that the community can access and utilize. And that Sanchez Center, for us, is one of those successes.
So, APHA was in New Orleans for our annual meeting and exposition a couple of years ago. And while we were there, I heard a statistic that one out of every two black men in New Orleans is unemployed or underemployed. How does unemployment factor into the health of neighborhoods?
Well, logically if you have high numbers of one particular demographic that's unemployed, and let's say those numbers are in specific neighborhoods, you don't have any economic development potentially coming in. You don't have means for people to be able to pay for the basic daily needs.
You know, more than likely in some of those neighborhoods you're finding where you're having poor housing, access to schools, access to health care. All of those things sort of play into the sole issue of how you help people to prosper and move forward.
And so, you know, unfortunately for us, the unemployment rate for African-American males as well as the murder rate for them, there are just so many poor statistics that stack up against a particular segment of our population. And you know, through some of the programs throughout the city, and not just in the health department, which works on some violence prevention issues.
But you know, our Pathway to Prosperity Programs work around youth, are all things that we're looking to try to move that number in terms of the number of African-American men who are unemployed.
Also through the Health Department, you know, a big piece of what we do is to help those men, not only the unemployed, but the underemployed, to be better fathers. And so some of the work that we do is around fathering initiatives through our Healthy Star Program and helping to build the self-esteem and respect of dads and the importance of dads in the life of children and really trying to lift them up so that as we work to reduce that unemployment rate, we're also working to create opportunities for them to build character and to become the best parents that they can be.
So, all that sort of feeds into each other for us to move the needle forward here in New Orleans. There's a lot of work to be done but, I think some of the activities are helping to make that happen.
That all sounds amazing. And I think it does go to show how, you know, one social determinant really just sort of domino effects into all the others.
Absolutely.
It sounds like you've done a lot of tremendous, really good work. Is there something that you are most proud of?
You know, I think what I'm most proud of is that the health department really made the effort to change how we looked at health. We didn't just go back to the way that it was.
And again, that's not to say that the way that it was was wrong. An opportunity in a disaster presented itself for us to become more. And we made a decision that while it was hard to look at the reality of where we were, that it was in our best interest to figure out other ways to do things and to move our community forward.
And you know, I think that it's taken a couple of years — taken some years to build trust with the community that we were doing things that were going to move our health forward and our wellness forward. That the health department was looking at more than just whether or not you had the medical care that you need. That we want to look at the entire person and how their community affects them and how does that all fit together and build that trust with the community that we were doing the right thing. You know, I think that's the most important and the proudest thing that we have. Because we were able to transform.
And I guess for me, when all this is said and done, and we're not here anymore, I'll be even more proud that these initiatives are still living on in some way, shape, or form. It doesn't have to be the ones that we created but that people are looking at health through that entire lens and through the social determinants. So, I'm hopeful that that will happen. And I'm proud that we started it.
That's amazing. I love it so much. Before I let you go, what lies ahead for the Health Department?
So, right now in particular, we are working our programs that we put in place to ensure that they stay here. But, we are also focused on health equity.
And that's our latest initiative that we have in place. As an accredited health department you know we've been trying to figure out how do we take our staff forward to understand what equity is and in that everything that they do that this becomes the norm. And on top of that, as we had begun our journey, the city started its journey around equity. And so, you know, we feel like we've sort of picked up the ball and ran with it. And now the City's attached to it too, and is looking at it for the entire city.
So, you know, it wasn't only about how we bring new initiatives. We want to make sure that whatever we're putting forward is touching everyone in the way that will be the most effective for everyone.
For those that need more, we're making sure that we do that. And those who need to, you know, maybe not need as much, we're also touching them too. So, equity is our next stand and hopefully in the next couple of years you'll hear more about New Orleans around health equity, and equity in general.
Editor’s note: Parent ended her term at the New Orleans Health Department July 29. She is now assistant vice president of community affairs and network navigation for LCMC Health, a nonprofit health care system.