The roots of New Orleans’ segregated hospitals started with a train ride, advocate says

More than one-third of the 14 hospitals in New Orleans received a think tank’s lowest rating for racial inclusivity.

New Orleans, a metropolis with one of the largest Black populations in America, tops the list of U.S. cities where an appreciable number of people of color receive treatment at the same hospital where white people receive care. And a rights activist says that segregation is rooted in the city’s history and the case that made signs like “Whites Only” and “Colored” legal in this nation. 

As theGrio previously reported, the Lown Institute, a nonpartisan healthcare think tank, compiled patient data using Medicare records from 2021 to assess how well hospitals served people of color. The study evaluated more than 3,000 hospitals to determine the level of racial inclusivity of the patient population. 

And the results showed that of all the cities in America, New Orleans has the most segregated hospital markets.

“New Orleans and Louisiana [are] the birthplace of separate but equal,” said Alanah Odoms, the executive director of the ACLU of Louisiana, referring to the U.S. Supreme Court’s decision in Plessy v. Ferguson, which made offering separate and racially segregated accommodations legal in the country. “If we’re the birthplace of separate but equal then most of our institutions are going to reflect that history. In the same way that other institutions have been formed out of that history, the hospital and healthcare system would look the same.”

According to a study by the University of California that was based on 2020 census data, New Orleans is the 23rd most segregated city in the country. 

The Lown Institute analyzed 59 Louisiana hospitals. Fourteen of them were in the New Orleans area. Of those 14, five hospitals had the lowest ranking for racial inclusivity. 

• St. Tammany Parish Hospital in Covington, Louisiana
• Slidell Memorial Hospital in Slidell, Louisiana
• Ochsner Medical Center – North Shore in Slidell, Louisana
• East Jefferson General Hospital in Metairie, Louisiana
• St. Bernard Parish Hospital in Chalmette, Louisiana

All five hospitals are underserving people of color based on the racial demographics of the areas they’re in, according to data from the Lown Institute. For example, 58% of the people living in the service area of St. Bernard are people of color. The percentage of people of color served in the hospital is only 38%.

None of the five hospitals have responded to requests for comment from theGrio.

Dr. Vikas Saini, the president of the Lown Institute who worked on the study, said segregation data often shows what kind of care certain populations get. “We look at all the people that come to the hospital, and we’re able to define the perimeter using travel time. Then we look at the zip codes, income, education and racial status,” Saini said. “After that, you can see who goes to which hospitals in each city.” 

As Saini points out, there are usually hospitals in the area that serve the poor minority community and hospitals that serve the higher-income population, which is typically white. Most of the time, these hospitals aren’t that far away from each other. 

For example, in New Orleans, University Medical Center New Orleans — which was rated by the Lown Insititute as one of the two most racially inclusive hospitals in the city — is a 20-minute drive from East Jefferson General Hospital, one of the five least racially inclusive hospitals.  

“When you’re talking about an issue of segregation, you have to look at the historical origins of the place,” Odoms said. 

East Jefferson is in Metairie, Louisiana, which is in the 70006 zip code. The average household income is $81,000. It’s surrounded by zip code 70002, where the average family income is $92,000, and 70001 and 70003, with average incomes of $81,000 and $89,000, according to census data. All of those areas are predominantly white. 

But it’s not just about income and people with higher earnings receiving exclusive care. On the other side of the Mississippi River, in Chalmette, Louisiana, is St. Bernard Parish Hospital. In the Lown study, that facility is one of the five least racially inclusive. It’s in zip code 70043 where the median income is less than $50,000 a year and 21% of families live in poverty, according to census data. 

The constitutional foundation for racial segregation started in New Orleans after authorities in 1892 arrested Homer Plessy, a Black man accused of violating a railway segregation law. The courts previously ruled that separate rail cars for interstate travel was unconstitutional. A group of Black men who’d formed the Citizens’ Committee to Test the Constitutionality of the Separate Car Law, decided to use that ruling to challenge intrastate railroad travel by having Plessy travel within the state. In the appeal case involving Plessy, the U.S. Supreme Court decided that “separate but equal” was not unconstitutional. 

The role of segregation and poverty in the Black community is well-documented. And the Lown study revealed that segregated hospital markets expose the inequalities in American neighborhoods. 

For example, New Orleans East Hospital is in the 70127 zip code, which is 93% Black and has a median household income of $27,096. Nearby zip codes like 70126 and 70128 have similar racial and income data. 

However, those long-standing ramifications of segregation haven’t stopped the efforts on the ground in New Orleans to improve the hospitals serving Black people. 

Odoms says many Black healthcare providers in the city launched a massive effort to build up New Orleans East Hospital. “They wanted to make sure that it could be a top-notch place for the [minority] community in New Orleans east,” Odoms said. “These were people who put in the work to improve the hospital. That’s what we need everywhere.”

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