City-health care partnerships to improve community health

Dr. Fuentes Big River Economic and Agricultural Development Association

City-health care partnerships to improve community health

Our Lady of the Lake Regional Medical Center - Louisiana
Baton Rouge faces some of the highest obesity and chronic disease rates in the country. A hospital-mayoral partnership led to city-wide effort to improve community health.


  • In the last ten years, diabetes has increased 37 percent in Louisiana. One in two children is obese.
  • The Mayor’s Healthy City Initiative, started in 2008, directed city efforts to identify and promote collaborative solutions to improve community health. Our Lady of the Lake Regional Medical Center serves as a founding member and key supporter of the Mayor’s Healthy City Initiative.
  • Our Lady of the Lake has taken an active role in supporting legislative and policy efforts that promote healthy eating and physical exercise. 
  • City-led efforts and the success of programs like the Red Stick Mobile Market, which receive support from OLOL community benefit, were recognized in 2014 for the Robert Wood Johnson Culture of Health Prize.
  • Hospital Type Private, nonprofit, teaching hospital
  • Hospital Size: Large (800 beds)
  • Geographic area: Metro
  • System/Network: Franciscan Missionaries of Our Lady Health System—a network of hospitals, clinics, physicians, and elderly housing
  • Network coverage: Southern Louisiana (covers an 11-parish region)  
  • Caucasian: 47%
  • African American: 45%
  • Asian: 4%
  • Hispanic: 4% 
  • Community health needs assessment region: East Baton Rouge Parish
  • Population: 445,2271
Health indicators
  • Adult obesity: 33%
  • Limited access to healthy food: 11%
  • Children in poverty: 28%
  • Unemployment: 6%
  • Food insecurity: 17%

The 2008 recession left a deep impact on the Louisiana economy that continues to be felt in East Baton Rouge Parish where Our Lady of the Lake Regional Medical Center is located. From 2009 until 2013, over 20 percent of East Baton Rouge residents lived in poverty. In the past several years, southern Louisiana has begun to experience an economic upturn that in the last year has seen the number of children living in poverty dropping by 15 percent. Still, the region lags behind the rest of the country by most social, health, and economic metrics. 

The effects of a lingering recession have contributed to higher-than-average rates of food insecurity, obesity, and chronic disease rates in East Baton Rouge. Louisiana, where one in two children are obese, is 50 percent above the national rate of diabetes. These rates continue to climb and in the last ten years, the prevalence of diabetes has increased 37 percent. 

In response to rising rates of obesity and diet-related health conditions, East Baton Rouge Mayor, Melvin L. “Kip” Holden, launched The Mayor’s Healthy City Initiative in 2008. The Mayor’s Healthy City Initiative (MHCI) is made up of three advisory boards that identify and promote collective and collaborative solutions to improve community health. Our Lady of the Lake has been a supporter and member of the MHCI task force since its inception.

In 2014, Baton Rouge was named a Robert Wood Johnson Foundation Culture of Health Prize Finalist in recognition of the work of the Mayor’s Healthy City Initiative. It is the MHCI, which counts over 75 multi-sector partners as members and collaborators, that has spurred and directed much of the food work happening across the region and in community benefit across the city’s five acute care hospitals.     

Community health needs assessment: Priorities and process

  • Food and diet-related disease priorities: 
    • 2015 CHNA - Obesity 
  • Participation from food-based organizations in community health needs assessment (CHNA) process:
    • Big River Economic and Agricultural Development Association, Louisiana Center for Health Equity, Greater Baton Rouge Food Bank, Slow Food Baton Rouge, Louisiana State University Ag Center
  • How/why did food issues emerge as a priority?
    • High prevalence of obesity, particularly among children and adolescents, was a key factor. Strong involvement in CHNA process from food-based organizations, including Big River Economic and Agricultural Development Association (BREADA) and food banks, helped obesity emerge as one of four priority areas for the region.
  • Key community indicators:
    • In 2011, 36,002 cases (11.1% of the population) of diabetes were diagnosed in East Baton Rouge.
    • In 2012, 4% of East Baton Rouge residents had experienced a heart attack.
    • Obesity in East Baton Rouge has increased from 30% to 33% in the last three years. 

Full assessment: Health Baton Rouge 2015 Community Health Need Assessment 

Assessing health needs — and how to meet them

Community health needs assessment process

Our Lady of the Lake Regional Medical Center has an in-house Community Advocacy Team, headed by Coletta Barrett, Vice President of Mission for Our Lady of the Lake and Monique Marino, Director of Community Impact. The team consists of a dedicated part-time nurse, a full-time coordinator, and five PRN nurses who provide support, such as health screenings, at the OLOL mobile health unit and community health fairs. 

The community benefit work of the hospital is only one of the many hats the Community Advocacy Team wears. Barrett and her team also lead a community benefit workgroup represented by approximately 20 hospital staff and administration including physicians, foundation, and ethics personnel. This workgroup provides input for the regional, collaborative CHNA the hospital participates in.

Our Lady of the Lake Regional Medical Center, along with five regional acute care hospitals, have participated in a collaborative CHNA process since 2011. In 2011-2012, the Mayor’s Healthy City Initiative facilitated a CHNA process that aligned regional hospitals’ priorities, but each hospital wrote a unique CHNA. In 2015-2016, the Mayor’s Healthy City Initiative again led a collaborative CHNA that produced a single assessment as well as a single implementation plan for all participating hospitals. During this last CHNA process, community-based organizations, including several food organizations such as Big River Economic and Agricultural Development Association (BREADA), Slow Food Baton Rouge, and Greater Baton Rouge Food Bank, provided written edits and feedback on draft assessments.

During the CHNA process, Louisiana State Public Health officials proved key to bringing food to the forefront of discussions. “During board meetings [they would] … educate board members about food insecurity, food policy, breastfeeding impacts on obesity,” said Barrett. In addition to food-related expertise, the Louisiana Public Health Department offered qualitative data, such as anecdotal and qualitative data gathered from Women, Infants and Children (WIC) Program customers, that helped further shape the background data for the CHNA.

Red Stick Mobile Farmers Market
Red Stick Mobile Farmers Market, which serves 61,000 residents in low food access communities.


Investing in solutions

Implementation strategy

Given the highly collaborative nature of the CHNA and the joint implementation approach of East Baton Rouge’s hospitals, Our Lady of the Lake Regional Medical Center does not approach its community benefit work alone. The regional implementation plan lists strategic objectives, action steps, resources committed by each institution, and which organizations are involved. For any given goal and its corresponding strategy, three to five hospitals commit resources and support. 

For the 2015-2016 CHNA, obesity emerged as one of four community health priorities. The goal for the Healthy Baton Rouge CHNA is to “increase the number of children and adults with a healthy weight.” To accomplish this goal, the implementation plan lists four principal strategies:

  • Reduce childhood obesity through health education;
  • Increase access to fresh and healthy foods;
  • Increase access to physical activity;
  • Promote health in all policies.

An important distinction that Barrett underscores is the strategic focus on healthy eating rather than food access. “Because the priorities codified in the CHNA are healthy eating rather than food access, the framework for implementation is more narrowly focused on healthy eating … OLOL focuses their dollars on partners that can address this priority area,” she explains. Funding, then, is directed largely at organizations that focus on healthy food, such as farmer’s markets, rather than a food bank, which primarily focus on food insecurity. 

This distinction is an important reminder of how the precise focus, and even wording, of implementation plan strategies can have big impacts on how hospitals direct funding and resources.

End Notes

1. This population refers to the region covered by the 2015 Healthy Baton Rouge Community Health Needs Assessment, a regional collaborative health assessment.

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