On Oct. 15 Chicago Ideas Week hosted a conversation on what is called the “death gap,” a 16-year divergence in life expectancy for Chicagoans living in the Loop compared to those living on the city’s West Side, assessed in a 2015 Virginia Commonwealth study.
West Side United is a public-private collaborative anchored by 23 health institutions and community partners with a stated goal of shrinking this gap 50 percent by the year 2030. Here is what we know so far.
1. Average life expectancy on the West Side mirrors the national average in the 1950s.
David Ansell, senior vice president for community health equity at Rush University Medical Center, likened the CTA to a time machine: “seven stops, seven decades.”
“We need to make equity a strategy at Rush, equity meaning that these gaps are unjust, they’re built into the conditions in which people live: poverty, racism, lack of educational opportunities,” he said.
2. Opportunity, not health care alone, is the biggest driver of these divergent outcomes.
When Cook County Health started screening patients at community- based health centers for social determinants of health, they found high rates of food insecurity and unstable living environments among adult health care recipients.
John Shannon, CEO of Cook County Health & Hospitals System, talked about the need to move beyond what he called resurrection medicine. “We send you out into the same circumstances that drove how you got sick in the first place.”
He added that the “health care that an individual or community receives contributes about 10 percent to the health status of that individual or community,” with the rest stemming from environmental or social factors.
For instance, the geography of life expectancy differences across the city directly correlate to heat maps of average income change from 1970-2010, according to Shannon.
3. Gun violence is not the largest factor or community concern.
Conversations about life and death on the South and West Sides of Chicago frequently devolve into sensationalism around gun violence. In fact, the two leading causes of death among adults on the West Side are cancer and heart disease, according to Ansell, both at rates which indicate deeper truths about structural violence and racial inequity.
In 2017, the collaborative that would become West Side United hosted a listening tour across West Side communities after an initial meeting for community feedback. After speaking with around 500 residents in 21 locations, the priorities which emerged were much more expansive than prevailing ideas about violence in the city.
Residents’ top concerns were (starting with most important) jobs; investment in local businesses and entrepreneurs; youth engagement, including partnerships in education and youth enrichment; and mental health resources.
4. Communities on the West Side are already organizing around these issues.
Fanny Diego Alvarez, project manager of Sustainable Community Schools for Chicago Public Schools and former community organizer, was nominated to West Side United’s planning committee through the listening tour.
She pointed out that the community health worker model has a long history of approaching resident health holistically, inclusive of some of the public health social determinants that the institutional members of West Side United are just now beginning to address.
She also talked about the parallels between the community school strategy of engaging children as whole students and West Side United’s strategies in addressing social determinants of patient health.
Each of these solutions were fought for and pioneered first on the community level, before West Side United stepped into the role of partner and amplifier.
5. Economic vitality is a central component of West Side United’s approach.
Capital has been systematically removed from these neighborhoods since the 1970s. Ansell estimated the capital gap on the West Side, the figure that would need to be invested to bring the median income up to middle- class levels, at $70 billion.
Ayesha Jaco, senior program director at West Side United, said that most of the economic opportunities migrants pursued when coming from the Jim Crow South no longer exist, and that this changed situation has a direct impact on life expectancy.
West Side United has adopted a strategy focused on economic revitalization that includes impact investing, small business support and development, local hiring and procurement and building career pipelines with multiple points of entry. Demand has far outstripped availability for the career opportunities that have been created at member institutions in West Side United’s first year.
One of West Side United’s more ambitious goals is building enough partnerships to offer 20,000 summer jobs and internships for West Side youth which can put them on educational and career paths.
This report was produced by City Bureau, a Chicago-based civic journalism lab. Learn more and get involved at www.citybureau.org.