Chicagoans experience stark disparities in health outcomes and life expectancy across neighborhoods. According to a study conducted by NYU using recent census data, the gap in average life expectancy between residents in two Chicago neighborhoods, Streeterville and Englewood, was cited as large as 30 years. These neighborhoods are only nine miles apart.
So why does life expectancy vary so much from zip code to zip code? And what’s being done to solve the problem?
In our first installment of our "Closing the Gap" series, we focus on solutions around closing the life expectancy gap.
Dr. David Ansell of Rush University Medical Center and author of The Death Gap: How Inequality Kills and Ayesha Jaco Executive Director of West Side United sat down with Reset to share what's being done on Chicago’s West Side.
On what Dr. Ansell makes of the 30 year gap
Ansell: Well, it's profound. It's unacceptable, but it's not new. It's longstanding. It's just newly risen to our national consciousness and certainly to the consciousness of the city. And what people don't realize is that diseases are not just a matter of your beliefs, behaviors, and biology, but place: where you live, the conditions you live under, work under, play in, have a profound impact on life itself. And this is very different for poor people in the United States than rich people. And it’s very different regionally.
On the work of West Side United
Jaco: West Side United is a collaborative of six health institutions that have come together to address the life expectancy gap by leveraging resources from the health institutions involved and those that are in surrounding communities across our 10 areas. It began with Rush University really looking at health equity as a central focal point of their mission and redirecting their focus to address the life expectancy gap, which became prominent after their community health needs assessment. And from there, a table was convened for institutions to look internally around how to look at economic vitality as a health factor.
On community driven reform
Jaco: We had 21 listening sessions where we talked to about 300 residents, and it was clear that there's historical mistrust. People are used to seeing big organizations come in, over promise, under deliver. And so what we didn't want this to be was another prescriptive model being rolled down from the top down to communities dictating what the need was. So for us it was critical to create a planning committee in our early stages made up of community stakeholders. 16 residents, 16 local leaders coming together to help inform what we were looking to unpack and how we could build capacity. We heard from the community that we can not build anything without them. Nothing for us without us.
On why it took Dr. Ansell so long to personally name racism as a driving factor
Ansell: Well, I first had to come to terms with it myself. I had to come to terms with actually seeing how structural racism actually works and when it became visible to me, it took me many many years before I could even say the words. I had to do a root cause analysis on myself and say why would someone who was progressive in these neighborhoods doing this work, why did it take me so long to name racism? And I think because I didn't see how my own unearned privilege opened doors for me allowed me to be in rooms.
On economic realities
Ansell: You look at the West Side of Chicago between 1970 and 2010 income has dropped between 20 and say 150 percent relative to 1970. Whereas on the North Side of the city, income has gone up between 20 and 250 percent. Capital investment in white neighborhoods is nine times that of black neighborhoods. Those are structural conditions. We had to have that discussion around the table with the hospitals about this. And so we said this is not just a collaborative, it's a racial health equity framed collaborative.
On the business community’s role
Ansell: We also need the business community. You have to ask yourself: why did capital leave these neighborhoods? And why since 1970? A lot of it has to do with the unspoken attitudes and collective mental maps we have about neighborhoods that make them bad. And it's not the graffiti. It’s not the broken windows and the overflowing garbage that predicts neighborhood decline. It’s people's attitudes about who lives in those neighborhoods and if those people and those neighbors are black or minorities or immigrants, our collective consciousness says those are not neighborhoods we should go in or invest in. Yet people in these neighborhoods love their neighborhoods. We need to follow the lead of the neighborhoods, but we've got to get the business community to move operations into these neighborhoods, like your billing departments or retail. That's going to be critical for this.
This interview has been edited for brevity and clarity. Click the “play” button to hear the entire conversation.