How Chicago’s ZIP code can shape life expectancy

In Chicago, your life expectancy could be closely tied to your zip code. Data shows people on the city's north side tend to live almost 10 years longer than people on the city's south side. Well, a Chicago physician is working to close that gap. Dr. David Ansell's new book, Crossing the Gap, Healing Epidemics and Inequities in a Divided City, dives into how structural racism and poverty shorten lives. So he joins us now to talk about ways that our city could change this. Dr. Good morning. Good morning. Thank you for having me. It's good to have you. So this is a really interesting topic here because, you know, you think of Chicago, you think of a thriving city. It's not that case for all folks. I mean, you said that another hospital doesn't solve the problem. So we're not talking about health care technically. So when you talk about, you know, life expectancy in different parts of the city, what is the solution, do you think? Yes, I wrote a book in 2017 called How Inequalities Kill, and my organization, Rush, I was the chief medical officer. I moved into this role of really thinking about how we might tackle life expectancy gaps. And it became an issue of really going into the neighborhoods and asking people what they wanted and needed. And for example, When we asked in West Garfield Park what people wanted, they said we wanted a basketball court. And they wanted jobs, and they wanted hope for their children, they wanted safe places to exercise. And partnering with the community and following their lead, on the west side of Chicago, we created the Sankofa Wellness Village in West Garfield Park. We opened up a new laundry linen in North Lawndale, the neighborhood that Martin Luther King came to 60 years ago. That at the time when we started homicide rates were the highest in 60 years in Chicago and the life expectancy gap between these neighborhoods was growing 87 in the loop. And at the time, 67 in West Garfield Park, three stops past rush. It wasn't as if Having a top health system like Rush, Northwestern, U of Chicago was going to solve the problem of these gaps that were caused by the social and structural determinants of health. And so we embarked on a process that we're still in the middle of, but not just Rush. Other hospitals in the city have done it as well. Senator Durbin's HEAL initiative just met this morning. Ten hospitals embarking on what could hospitals do above and beyond health and health care. to close the gaps and it's economic investment at the end of the day. It's investing in the lives of young people and their families. And we've now seen the lowest life expectancy gap certainly in the city of Chicago between black and white people in a decade. So this works. It was a time of hopelessness in a way in the city with all the homicides. And now we're at the lowest homicide rate in 60 years and many other things getting better as well. So we know we can do it. We just have to double down on these efforts. And that's what I talk about in crossing the gap. Yeah, and all of those things are such incredible outcomes. I made some notes on that, Sankofa Wellness Village, and you were saying that regardless of a person's immigration status or whether or not they had insurance, they would be treated, offering workforce development, youth and teen programming, drop-in daycare. But I think the big question is, how is all of this paid for? How do we pay for all of this moving forward? Well, it's interesting. There's a lot of philanthropy on the one hand, but actually, You know, if people live healthier, they're going to use services less. I think our payment systems have focused on sick care, right? You come to the hospital, you're sick, and we repair you, and they haven't gotten upstream. And we've demonstrated in program after program that it pays for itself. The Sankofa Village right now is a break-even proposition. That building is going to be owned by the community. Down the road, Fillmore Linen, where we decided that instead of sending our dirty laundry to Wisconsin or Indiana, what if we could start a new business in Chicago and do it there? Rush saves money, and Fillmore Linen is right now breaking even, has first new laundry linen in Chicago in 50 years. We think there's a way to make this economically successful. We're down, I'm down in Bronzeville now with the new Northwestern. They are having more visits than they thought they would have. So it's counterintuitive to think that what's good for these communities is not also good for business. And better health leads to lower health care costs. And I actually wanted to dive a little deeper when you say that better health leads to lower health care costs in the sense that you did these listening tours and you just mentioned someone said, we want a basketball court or we want jobs. Can you get to the root of why that improves a health outcome, having a job, having a basketball court? Because I think at first blush, you're like, how does that possibly help someone's health? What is it actually doing to the human body to make them healthier? Yeah, so let me say what goes wrong. You have to ask yourself why two neighborhoods, not that far apart, have different health outcomes. And so just I tell the story as a doctor, like malaria is caused by a parasite, but the vector for malaria is the mosquito. So no solving for malaria, Thank you. program would not involve addressing the mosquito in this situation, the conditions in the neighborhood actually get under the skin and cause premature disease. So the problem is people are dying at all ages prematurely leading to this life expectancy gap. Let me tell you the story of Noah. I met Noah in the parking lot in West Garfield Park, New Mount Pilgrim Missionary Baptist Church. Noah has seizures since childhood due to congenital condition, but he was working for tips in a car wash and had no health insurance. We navigated him to an entry-level job at Rush through one of our employment programs. This is on a dashboard at Rush. Our corporate dashboard has what percent of people are we hiring locally. And he gets the job at Rush. He gets health insurance. He gets his... He gets himself treated, so when people have jobs, when they have insurance, then they can afford it when they have the money in their pocket to afford healthy food, join a YMCA and such, health improves. So unfortunately, the way we finance healthcare in this country is wait till you get sick and do it. But we think that this is a model not just for Chicago, but for the country. Yeah, I gotta ask as well, the Democrats on Capitol Hill are pushing this idea of Medicare for all. I would assume that you'd be a proponent of that. Yeah, I'm a proponent for universal healthcare. And I'm a proponent with no co-pays and no deductibles. In this country right now, we spend more than any other country by a factor of two or three on health care. We're ranked 38th in the world in life expectancy. But if you look below the age of 65, we're ranked 60th. So you can't look at the system and say it's going well. Health and health care, universal health care makes a difference, but that's not enough. People need wealth. People need the ability to generate enough income to live a healthy life. And in the United States, that's around the median income. It's around $80,000, $85,000 to $100,000. And so we've got to not just health and health care, universal health care, single payer, yes, but that's not going to solve the problem if we don't raise communities economically. And they have to go hand in hand. But it turns out, you know, in this country, in a neighborhood that's poor, that has concentrated disadvantage, oftentimes did not have in their neighborhoods the same kind of access to health care. You know, that's changing. Rush has moved into West Garfield Park. Lurie Children's has moved into Austin. Northwestern has moved into Bronzeville. Mount Sinai has been there all the time and Cook County Health. But we need them both Both together, but a universal healthcare of some sort like Medicare for all would be part of a national solution. Dr. Ansell, thanks for joining us here and to talk about this interesting, incredibly fascinating topic that we're seeing in our own backyard. We appreciate you being here. Thank you. And I write, call it crossing the gap because we haven't crossed yet. But it sounds like it's happening at the. Yeah, we're crossing that gap. And it's the partnership with the communities and following the voice of the community that has led us to do unconventional things that not only save lives. But costs less at the same time. So thank you for having me. Thank you for explaining that so well.