To the healthcare workers and the community activists working on the West Side, the fact that COVID-19 took a harsher toll on Black and Hispanic communities wasn’t a surprise. The healthcare disparities have been documented for years, and the pandemic has only made them worse.
The disparities are particularly evident in Chicago, which has a 10-year gap in life expectancy between Black Chicagoans and non-Black Chicagoans. Suburbs with majority-Black populations also have lower life expectancies, through the differences aren’t quite as stark and not all suburbs fit the pattern. Area healthcare providers have been trying to tackle those issues, and they all agreed that any effort to improve life expectancy gaps and other health disparities, must invest in the communities and empower residents – even if they take different approaches to tackling it.
Lena Hatchett, director of community and university partnerships at the Maywood-based Loyola University Chicago Stritch School of Medicine, said that one major difference between the city and the suburbs is that there is less access to transportation. The West Side is served by three CTA lines, Oak Park has two and Forest Park has one, but Maywood and other communities further out have buses and the more expensive Metra commuter trains.
Maywood is served by multiple Pace buses that feed into the CTA Blue Line, but the service gets more sparse and less frequent further out.
David Ansell, the senior vice president for health equity at Rush University Medical Center, said that, since the start of the pandemic, Chicago’s gap continued to increase to 10 years. More alarmingly, Ansell said, the average age of Black Chicagoans slid below 70 years for the first time.
“The COVID hit, and we knew that it would plant its roots in pre-existing fault lines, social fault lines as identified prior to the pandemic, who got to live and who got to die early,” he said. “A lot of people were shocked at the disparate Black and Latinx death rates, but it’s consistent with what we’ve seen with other pandemics and epidemics.”
Ansell added that some of those deaths weren’t caused by the virus itself. The already higher rates of heart disease, hypertension, infant mortality and homicide increased during the pandemic.
“The good news is that we think that, with the pandemic hopefully under some measure of control – and the pandemic is not over, there are still 300 people dying daily in United States — maybe life expectancy will bounce back, but we still have a lot of work to do,” he said.
Hatchett offered similar sentiments, saying that disparities “all worsened during COVID, because they are all problems they were ignoring before COVID.”
Rush is one of the founding members of West Side United, a coalition of mostly West Side-based Chicago health systems, which was formed because the founders determined that closing the life expectancy gap and other health disparities was impossible without addressing non-medical factors that affect the quality of life in the community. Since 2017, WSU member hospitals steered procurement toward West Side businesses, set up job pipelines in area high schools and issued grants to local businesses and nonprofits.
Rukiya Curvey Johnson, a member of the WSU executive leadership council and Rush’s vice president of community health equity and engagement, said that workforce development was particularly important.
“As the saying goes, health is wealth,” Johnson said. “A lot of time, your ability to access higher wages and jobs that come with health insurance is one of the ways people can improve health.”
WSU members have also hired West Siders as community health workers in order to share health information with city residents and do “social determinates health screening.”
“They ask [patients] about their access to food, do they have a place to live, are they concerned about paying rent, and we can refer them to various services, help them apply for SNAP benefits,” Johnson said. “We also make referrals, help them connect to other primary care [providers].”
She also said that the history of medical experimentation on African Americans, such as the Tuskegee Experiment syphilis study, as well as doctors not taking Black patients’ concerns seriously, made many patients mistrustful of medical professionals. Building that trust, often from scratch, is an ongoing process.
Rush is also part of the Garfield Park Rite to Wellness, a collaborative between West Side churches, healthcare providers and community organizations that tries to figure out the best way to improve health and wellness. Ansell said that it’s trying to do its part to reverse decades of disinvestment with the Sankofa Wellness Village project, which would be made up of three buildings along Madison Street – “The K” business incubator at Kostner Avenue; a 60,000-square-foot Sankofa Wellness Village center with a clinic, fitness center and credit union at Kildare Avenue, and a grocery store at 3835 W. Madison St., where an Aldi grocery store was shuttered in October 2021. He said that the project would cost around $60 million, and Rite to Wellness is applying for the $10 million Chicago Prize, a community grant from the Pritzker Traubert Foundation. The project is currently one of the six finalists, and the winners are expected to be announced sometime in December.
Ansell said that, whether Rite to Wellness wins or not, it will have to raise millions, and they are determined to reach that goal.
“We all decided to go into the lowest-life expectancy neighborhood on the West Side and do something about it,” he said. “I believe that, over time, it will reduce that death gap. A lot of times, people wring hands [about] what we can do. We have a plan for West Garfield Park. We think this plan can work in other Chicago communities as well.”
Hatchett is a co-founder of Proviso Partners for Health (PP4H), a collaborative similar to Rite to Wellness, except with Proviso Township institutions. Their approach is somewhat different. They organize a system of “hubs” that empower residents to improve their lives. For example, they are addressing fresh food scarcity by teaching Proviso youth urban gardening, offer job training and leadership training for aspiring entrepreneurs to improve economic opportunities, and offer leadership and community-building training for residents who want to make changes in their communities.
The major component of PP4H work, is to address the generational trauma caused by slavery and racism and teach people healthier ways to respond to stress and avoid passing the trauma on to the next generation. For example, Hatchett said, trauma can result in people not knowing how to raise their children in a nurturing and supportive way, and that affects how those children raise their own children. Breaking the cycle can go a long way.
“If you can change a young person, ages 18 to 24, we’re reversing intergenerational poverty, and the impact of systemic racism,” Hatchett said. “They’re going to parent differently, they’re’ going to look at their life differently.”
Johnson said that, given “decades and decades” of disinvestment and structural racism, the changes are bound to take time. The COVID-19 pandemic hasn’t helped. But she said that their work is making an impact, especially when it comes to expanding job opportunities – the key is to keep going.
“You may not see everything right off, but there’s definitely a movement in the right direction to [overcome] some of these systemic barriers,” she said.
What people die from
Black communities in Chicago and the suburbs are less likely to have pharmacies and grocery stores, less likely to have access to clinics and residents are less likely to have health insurance. This means that residents are more likely to rely on an ER for healthcare, and less likely to get regular check-ups, which can exacerbate health issues that go undetected. Transportation is another issue – on the West Side in particular, buses and CTA trains often run less frequently than in other areas, and it’s not unusual for patients to require multiple transfers to reach their local hospitals.
According to the 2021 State of Health for Blacks report prepared by five Black epidemiologists and researchers at the Chicago Department of Public Health (CDPH), the life expectancy gap between Black and non-Black Chicagoans increased from 8.3 years to 9.2 years between 2012 and 2017. Although there were a number of reasons for the increase, the authors cited five driving factors: chronic disease, violent crime, infant mortality, infectious disease and opioid overdoses. The report found that 1 in 7 African Americans, or roughly 14% of Chicago’s Black population, die of causes other than old age, compared to 1 out of 29, or 3.5%, of non-Black Chicagoans. And while it wasn’t a top five cause, the report showed that Black mothers were more than twice as likely to die during childbirth than non-Black mothers.
The report found that the top four causes of death were the same for all Chicagoans – heart disease, cancer, accidents and strokes. But Black residents were significantly more likely to get killed or die of diabetes and kidney diseases.
The data compiled by the Cook County Department of Public Health paints a more complex picture. From 2010 to 2015, Maywood whose populations are 63.3% Black had, life expectancy of 74.6 years, while Bellwood, whose population is 72.7% Black, had a 76.2-year life expectancy, and Broadview, which is 73.3% Black, had a 77.7 life expectancy. By comparison, Forest Park, which is 27.6% Black, had a 77.2-year life expectancy, Oak Park, which is 18.4% Black, had 80.3-year life expectancy, and Berkeley, which is 26.1% Black, has a 77.1-year life expectancy.