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Ochsner Health is a 501(c)3 not-for-profit organization and one of the US’s largest non-university academic medical centers.  It encompasses 46 hospitals and more than 370 health and urgent care centers. There are more than 38,000 team members and over 4,700 physicians employed or affiliated with Oschner. 

Ochsner. N.d. “About Ochsner.” https://www.ochsner.org/about-ochsner. Accessed March 1, 2024. 

Xavier University of Louisiana -  Oschner and Xavier’s partnership has been centered around establishing a joint College of Medicine, to “create a strong physician pipeline that addresses longstanding inequities within the nation’s health care system and builds the health care workforce of the future” (Xavier University 2023). Xavier and Oschner have partnered since the early 1980s, when Oschner began offering clinical training sites for Xavier pharmacy students. Today, Ochsner and Xavier have established a master data sharing and use agreement that provides Xavier faculty with access to Oschner Health’s electronic medical record data. The program has hired four data scientists to provide data analytic services to Xavier faculty. They have also worked together to launch Oschner’s health equity data and quality improvement strategy. Advocacy emerging from this partnership has focused on the expansion of services covered by Medicaid to include tobacco cessation, as well as increasing access to evidence-based maternal health technology. 

“Xavier University of Louisiana and Ochsner Health Partner to Create College of Medicine and Pursue Health, Educational Equity - Xavier University of Louisiana.” n.d. Accessed February 27, 2024. https://www.xula.edu/news/2023/01/xavier-university-of-louisiana-and-ochsner-health-partner-to-create-college-of-medicine-and-pursue-health-educational-equity.html.

Ochsner. 2023. “Ochsner Health-Community Benefit Report.” https://issuu.com/ochsnerweb/docs/communitybenefitreport_8x10.5_final. 

Chevron - Oschner’s partnership with Chevron is centered around a smoking cessation and education program that was launched in 2021. In 2023, Chevron opted to continue the partnership for a third consecutive year through a $50,000 donation. The program is offered in the following parishes: Jefferson, St. Tammany, East Baton Rouge, West Baton Rouge, Ascension, St. Charles, Terrebonne, and Lafourche.  In a press release for Oschner, cigarette smoking was described as “the leading cause of preventable deaths and diseases in the nation” (Oschner 2023). The release refers to America’s Health Rankings data that indicates smoking as one of the top 20 factors shaping poor health in Louisiana. This program is part of Oschner’s broader Healthy State initiative. Chevron funding also supports initiatives to encourage low-dose CT scans (to detect and diagnose lung cancer), teach high school students about the risks of smoking, and teach people to recognize and treat the stressors that lead to smoking.

Oschner. 2023. “Ochsner Health and Chevron Partner for a Third Consecutive Year to Offer Smoking Cessation and Education Program.” n.d. Online Newsroom. Accessed February 28, 2024. https://news.ochsner.org/news-releases/ochsner-health-and-chevron-partner-for-a-third-consecutive-year-to-offer-smoking-cessation-and-education-program.

 The Healthy State by 2030 initiative emerged in 2020. The goal of the initiative is to improve access to healthcare in Louisiana through community engagement and by partnering with organizations across different sectors (healthcare, business, religion, education, government, and education). The program also includes a focus on collecting, analyzing, and sharing health data. The program’s priorities are to reduce smoking cessation (with 214,000 fewer residents smoking by 2030); improve access to care for cancer and other chronic conditions like diabetes and high blood pressure through screenings (aiming for 100,000 fewer residents with chronic conditions by 2030); reduce obesity rates (with 182,000 “more physically active adults” by 2030); reduce rates of food insecurity (helping 72,000 more households gain access to healthy food); improve per-capita income levels (by $4,838); and improve access to high-speed internet (with 86,000 more homes having access). 

 This initiative is focused on improving health by improving “the conditions in which we are born, live, and work,” in the words of Dr. Eboni Price-Haywood, the medical director of the Healthy State 2030 Initiative and the Oschner Xavier Institute for Health Equity and Research. However, the projects that have been highlighted under this initiative seem to largely consist of expanding Oschners’ service delivery footprint. Ochsner’s expansion has been welcomed by communities that have long struggled to access care, but this form of intervention is limited in addressing broader structural drivers of health. 

One of the largest investments of Health States has revolved around the opening of five new health centers (in Baton Rouge, Lafayette, Monroe, and Shreveport). The health centers are framed as addressing health equity because they are “strategically located in areas of the state with high instances of chronic conditions, low birth weights, infant mortality, and early adult mortality” (Mcelfresh np, 2022). In addition to healthcare services, the centers offer resources for smoking cessation, diabetes management, and “social issues” that include transportation and food insecurity. Each center has an advisory council that includes patients, elected officials, businesspeople, and community members. 

In 2023, Oschner’s executive leadership announced their commitment to the Global Health Network (GHEN) Zero Health Gaps Pledge.  This initiative falls under the UN Sustainable Development Goals and has been described as a part of Healthy State.  

Ochsner Health. N.d. "Healthy State." https://www.ochsner.org/healthystate. 

Oschner Health. N.d. “Ochsner Health Pledges Zero Health Gaps for World Health Day.” Accessed February 28, 2024. https://www.newswise.com/articles/ochsner-health-pledges-zero-health-gaps-for-world-health-day.

McElfresh, Amanda. 2022. “Ochsner’s Healthy State 2030 Uses Community-First Approach to Improve Life for Louisianans.” NOLA.Com. August 7, 2022. https://www.nola.com/sponsored/cox_business/ochsner-s-healthy-state-2030-uses-community-first-approach-to-improve-life-for-louisianans/article_cfb1a366-1345-11ed-bfdf-33daaec76946.html.

Louisiana Clinical Data Research Network (LACDRN) is a collaborative project between the Louisiana Public Health Institute (LPHI), Pennington Biomedical Research Center, Tulane University, and Ochsner Health System. The network provides warehouses of clinical data available to clinical and health systems researchers: “representing a state and region that has unique health challenges related to disparities, natural disasters, high prevalence of chronic diseases, and some rare conditions, LACDRN is an important resource for clinical and health system research that will advance evidence-based diagnosis, treatment, disease management, and healthcare delivery” (Kurshid et al. 2014, 612).

Khurshid, Anjum, Elizabeth Nauman, Tom Carton, and Ron Horswell. 2014. “Louisiana Clinical Data Research Network: Establishing an Infrastructure for Efficient Conduct of Clinical Research.” Journal of the American Medical Informatics Association : JAMIA 21 (4): 612–14. https://doi.org/10.1136/amiajnl-2014-002740.

Ochsner is using a digital platform developed by Unite US to expand and improve community health throughout Louisiana, in partnership with CVS Health and Humana. The platform is used by insurance companies’ care managers and provider teams to coordinate social services for patients. The Louisiana Unite US more than doubled following the outbreak of COVID-19 (Unite US, 2020).

Unite US. “CVS Health, Humana, Ochsner Health, and Unite Us Join Forces.” 2020. Uniteus.Com. November 18, 2020. https://uniteus.com/press/unite-louisiana-healthcare/.

As a tax-exempt hospital, Ochsner produces publicly accessible community health assessments as a requirement of the Patient Protection and Affordable Care Act (PPACA). As a statewide network, Ochsner has conducted health assessments for Shreveport, Lafayette, Monroe, New Orleans, Kenner, Baton Rouge, St. Mary, St. Anne, Northshore, Houma, Kaplan, Crowley, and Breaux Bridge, as well as Bay St. Louis in Mississippi. 

Ochsner’s proprietary Diversity, Equity and Inclusion (DE&I) Dashboard launched in 2022. The dashboard does not appear to be public however and there is very little available information about this tool. Ochsner's 2022-2023 impact report describes the tool as follows:  “In 2022, Ochsner’s proprietary Diversity, Equity and Inclusion (DE&I) Dashboard launched, informing delivery model innovations and enabling clinicians to identify populations with gaps in care and outcomes. The dashboard includes patient experience and care metrics, with data sortable by sociodemographic groups like race, location, and insurance type. Through the dashboard, we could see that 36% of Ochsner Health Network patients with hypertension are Black or African American, and of those, 80% have their hypertension controlled. In comparison, 86% of white patients with hypertension have it controlled. This data was in turn used to inform strategies to close gaps in care and improve outcomes”  (Ochsner 2022-2023 Impact Report, n.p.). 

Ochsner Health Network. “2022 – 2023 Impact Report, Accelerating Value-Based Care.” Accessed March 2nd 2024.  https://www.ochsner.org/impact-report/. 

Ochsner’s  Enterprise Data Warehouse (EDW) stores clinical data collected over more than 20 years, includes data captured through EPIC/Clarity and claims data.

According to Philip M. Oravetz, MD, MPH, MBA, chief population health officer at Ochsner Health, Oschner is in the process of developing an electronic health record that includes demographic and SDOH data collected at the point of care, and then integrated into artificial intelligence (AI) and predictive modeling (Caffrey and Klein 2022). 

Caffrey, Mary, and Hayden Klein. 2022. “How Ochsner, Xavier Are Working Together to Make Louisiana a Healthy State,” December 2022, 10 (December). https://www.ajmc.com/view/how-ochsner-xavier-are-working-together-to-make-louisiana-a-healthy-state.

Oschner was founded on January 2, 1942, in New Orleans by Alton Oschner, an American surgeon and medical researcher. Before founding Oschner, he worked at Tulane University and organized a surgical teaching program at New Orleans Charity Hospital. Oschner Medical Center, formerly known as the Oschner Clinic, was the first to document the connection between cancer and cigarette use. This work mobilized Oschner to expose the hazards of tobacco and pioneer the war against smoking. 

Blum, Alan. 1999. “Alton Ochsner, MD, 1896-1981 Anti-Smoking Pioneer.” The Ochsner Journal 1 (3): 102–5.

Ochsner’s mission statement is to “We Serve, Heal, Lead, Educate and Innovate” (Ochsner n.d.).

Their vision is to inspire “Healthier Lives and Stronger Communities” (Ochsner n.d.)

Ochsner. N.d. “Mission, Vision, Values.” https://www.ochsner.org/values. 

“The large question this study addresses is the following: How do people make sense of (and cope with) toxic danger? The Martinezes’ story anticipates the complexity of the answer(s): physical and psychological suffering is compounded by doubts, disagreements, suspicions, fears, and endless waiting.” (4)

‘Flammable is a story of people’s confusion, mistakes and/or blindness regarding the toxicity that surrounds them. Flammable is also a story of silent habituation to contamination and of almost complete absence of mass protest against toxic onslaught’ (4)

“Schoolteachers, journalists, and lawyers are also part and parcel of daily life in Flammable. Together, all these actors contribute to what Flammable residents know about their place. They also influence what they ignore, what they want to know, and what they misrecognize. Government officials, company personnel, physicians, teachers, journalists, and lawyers jointly (but hardly cooperatively, given that their opinions don’t count equally) shape locals’ experiences of contamination and risk. This book examines how and why this production of shared knowledge (or lack thereof ) occurs.” (5)

“All in all, confusions, bewilderments, divisions, rumors, frustrations, and hopes are making Flammable residents wait—they wait for more testing, for further and better knowledge, for relocation, and for the “huge” settlement with one of the “powerful companies” that will, in the words of a neighbor, “allow us to move out.” This waiting is, as we will show, one of the ways in which Flammable residents experience submission.” (6) 

“We did our best to learn how to listen, look, and touch with respect and care, knowing with Nancy Scheper-Hughes (1992:28) that “seeing, listening, touching, recording, can be, if done with care and sensitivity, acts of fraternity and sisterhood, acts of solidarity. Above all, they are the work of recognition. Not to look, not to touch, not to record, can be the hostile act, the act of indifference and of turning away.” (14)

‘… the culture of toxic uncertainty is a complex web of meanings and shared understandings’ (108)

Labor of confusion: “During the long period of slowly germinating contamination, the actions of government authorities toward pollution in the neighborhood were less consistent and more contradictory than either the denial or underestimation that has been documented in the existing literature. Those multiple incongruous actions gave shape to what we term, extending the insights of students of ideology and symbolic power (Thompson 1984; Eagleton 1991; Bourdieu 1991), a labor of confusion that has a decisive effect on shared (mis)understandings.” (10)

 Ulrich Beck, social invisibility, lack of “social thinking” about environmental issues (Beck 1992)

Bourdieu, symbolic violence - misrecognition of power structures on part of the oppressed enables domination

Toxic uncertainty: “a way of experiencing toxic suffering that is shaped by what we call, borrowing from Charles Tilly (1996), the interacting “invisible elbows” of external power forces and of everyday routine survival struggles” (6)

Flammable is an account of how people in a particular place make sense of slow, invisible environmental pollution. The people of Flammable live in an Argentinean shantytown located next to petrochemical companies and storage facilities. They have been deeply affected by the rise in unemployment in the 1990s, with most residents subsisting on part-time manual jobs at one of the companies, retirement pensions, state welfare programmes and what else they can find. The area in which these residents live is known and recognized by government experts to be contaminated and unsafe for human habitation–and yet widespread confusion and uncertainty amongst residents and a lack of government actions means that the shantytown continues to exist. Auyero and Swistun explore the multitude of influences that ‘‘shape what people see, what they don’t see, what they know, what they don’t know, and what they would like to know, what they do and what they don’t do’’ (145). They show how residents gradually naturalize their situations, which, combined with the mystification of dominant discourses, contributes to their quiescence in the face of contamination.