Before Hurricane Katrina struck in August 2005, New Orleans had a largely poor and African American population with one of the nation's highest uninsurance rates, and many relied on the Charity Hospital system for care. The aftermath of Katrina devastated the New Orleans health care safety net, entirely changing the city's health care landscape and leaving many without access to care a year after the storm. State and local officials face the challenge of rebuilding and improving the city's health care system by assuring health care coverage for the population and promoting broader access to primary care and community-based health services.