After the All In Chicago 2016 keynote presentation by Mark Humowiecki, the panel discussion shifted focus to address local challenges in Chicago with Dr. David Ansell, MD (Rush University Medical Center), Nicole Collins Bronzan (Robert Wood Johnson Foundation), Judith Haasis (CommunityHealth), Julie Morita, MD (Chicago Department of Public Health), alongside Humowiecki.
Dr. Ansell discussed some findings in the recently updated Community Health Needs Assessment (CHNA) performed by Rush University Medical Center. Every three years, nonprofit hospitals are required by the ACA to define the community health needs of their respective service areas. This process revealed significant variations in the hardships faced by the people who live on Chicago’s West Side. Decades of structural racism and economic deprivation have led to racial segregation and concentrated poverty. For example, median household income ranges from $23,066 in North Lawndale to $113,317 in River Forest. In West Garfield Park, unemployment is 27.4%, while in River Forest, it is 5.4%. The uninsured rate ranges from 34.8% in South Lawndale to 3.7% in River Forest.
These socioeconomic variations lead to complex health impacts. Using a map of the CTA Blue Line as a framing device, Dr. Ansell explained how life expectancy fluctuates drastically within the span of a few miles: from 78.9 years near the Illinois Medical District stop to 68.8 years near the Pulaski stop and back up to more than 81 years in Oak Park near the Harlem stop. Three stops on the Blue Line represent a 12-year life expectancy gap, giving the West Garfield Park neighborhood a life expectancy lower than Iraq. The CHNA process has given Rush an opportunity to examine the unique health needs of the West Side and begin building partnerships to reduce the inequities that drive these complex issues.
One of Rush’s new partnerships is a patient referral program with CommunityHealth to alleviate acute care costs and help establish a medical home for Chicago’s most vulnerable citizens. Throughout 2016, CommunityHealth received 239 patient referrals from our program with Rush. Of those 239 referrals, we saw a total of 72 patients, and none of them have required further ER readmissions since receiving care at our health centers. Through these types of cross-organizational collaborations, we hope to remove further barriers for patients seeking a medical home.
Dr. Morita discussed parallels between Rush’s recent CHNA findings and a community health assessment conducted by the Chicago Department of Public Health (CDPH) in 2015. The results identified 10 priority areas for improvement, including health outcomes, social determinants of health, as well as public health infrastructure elements like partnerships and data. To implement the goals, objectives, and actionable strategies, CDPH created Healthy Chicago 2.0, Chicago’s four-year community health improvement plan. Implementation updates and new data will be posted here as it becomes available.
To continue the conversation on health care delivery reform, our keynote speaker, Mark Humowiecki, has taken time to answer some of the leftover All In audience questions over at this LinkedIn post.