Top-down and bottom-up approaches to eliminating health disparities in post-Katrina New Orleans

As New Orleans looks into its post-Katrina healthcare landscape, planners have made the choice to permanently close Charity Hospital, one of the last public hospitals in the country. In its place, they imagine a decentralized network of community-care clinics and universal implementation of managed care. Called the "Medical Home" program, this response to the city's healthcare needs is based in part on the model offered by the community-based clinics that functioned during and after Hurricane Katrina.

A similar, but bottom-up approach is modeled by the first full-service family practice clinic to open in New Orleans after the storm, Common Ground Health Clinic. This clinic serves predominantly elderly African-Americans, operates outreach clinics for Latino day laborers, and focuses on the upliftment of all margainalized people in New Orleans. In its first year, CGHC has served over 20,000 people across several clinical sites.

Medical herbalists and community health workers serve an important role within CGHC, because we create a bridge between clinical medicine and public health. We will examine the medical home concept as it relates to the role of social networks in the city's rebuilding, lessons learned by CGHC medical herbalists, and a variety of visions for our city's future.