After the devastation of Hurricane Katrina in 2005 and a statewide rejection of the benefits of the federal Affordable Care Act, the availability and accessibility of healthcare for low-income residents was dangerously limited. The hurricane completely destroyed the city’s main public hospital, affectionately known as Big Charity, and a system of distributed clinics took its place. People were uncertain about where to receive their healthcare and/or simply chose not to use the benefits afforded them. Understanding the reasons for non-use was the big question; providing opportunities for investing in one’s health and well-being was the big challenge.
As part of the City Accelerator program, the City, in cooperation with the non-profit 504HealthNet, created the campaign “Stand Up And Get Care,” designed to listen and respond to the city’s low-income residents. Emphasizing the element of inclusion, New Orleans staged a “Design Day” and heavily recruited low-income people from all across the city to participate. Most importantly, they didn’t just seek opinions, but sought open collaboration through exercises and problem-solving sessions wherein participants were tasked with improving healthcare access for everyone in the city.
Based on feedback and results from “Design Day,” New Orleans worked with the Behavioural Insights Team to encourage the continuing use of primary health services through A/B testing of text messages. Since technology alone is not enough for lasting results, the City launched a Health Ambassador program which followed a “train the trainer” model for people to encourage their neighbors to use primary healthcare services with a robust toolkit. The feedback received was then used directly by the City Hall Department’s health literacy committee to improve the department’s website and health education materials.