Rush initiatives aim to boost health of nearby communities
By Anne Burgeson
Annette Smith has lived on Chicago’s West Side for most of her life, and while the area has fallen on hard times, she’s not giving up on it.
“I love the West Side and I want to be part of the changes,” says Smith, the manager in the Department of Adult Health and Gerontological Nursing in the Rush University College of Nursing. “It used to be a place where everyone was proud of the community. There are many of us who still love the neighborhoods and are proud of their neighborhoods. We want to bring back what it was before gangs and violence.”
Smith is playing a key role in Rush University Medical Center’s efforts to revitalize the West Side. Earlier this year, she became a member of a new committee of Rush employees that is determining where Rush should invest $2 million during the next fiscal year, which begins July 1.
That $2 million is just the beginning of what Rush plans to invest; it has earmarked $6 million total to invest over the next three years through what’s called “impact investing” — that is, investing with the goal of creating positive social change as well as a financial return.
“The investments will be an important step in supporting our communities and partnering with local borrowers in projects that include affordable housing, day care, and commercial businesses,” says Patricia Steeves O'Neil, chief investment officer and treasurer at Rush. “These are not donations or grants. We expect to get our funds back with a return on the investment.”
An anchor and collaborative partner
The committee that Smith belongs to, the Anchor Capital Deployment Group, is part of a much larger effort that Rush University Medical Center and Rush Oak Park Hospital are making in collaboration with several other Chicago area organizations. Rush aims to make an even greater impact on the health of communities nearby while more fully integrating its work with the West Side.
“For generations, Rush has helped restore the health of countless people who live nearby,” says Larry Goodman, MD, CEO of the Rush system and Rush University Medical Center.” That will always be central to our mission, but as we dig deep to identify the health challenges these neighborhoods face, we also better understand that we must address the social and economic forces like poverty and racism to build healthier communities.”
“It is not enough to identify a problem and then do nothing to fix it.”
To help address these challenges, Rush has committed to be an anchor of community health and economic vitality for eight West Side communities, with the goals of increasing life expectancy, improving quality of life and reducing hardship.
Home to about 350,000 individuals, the West Side anchor communities include the following neighborhoods:
- Lower West Side
- West Town
- East Garfield Park
- West Garfield Park
- North Lawndale
- South Lawndale
- Near West Side
Partnering with and listening to the community
At the same time, Rush is engaging other area hospitals, universities, schools and additional organizations to become “anchors for community health” as well. Together, they are creating what is called the West Side Total Health Collaborative. By working as partners, organizations focused on the same issues can make a greater impact than one organization alone.
“We are the largest employer on the West Side of Chicago and one of the largest in the city of Chicago,” says David Ansell, MD, MPH, senior vice president for Community Health Equity at Rush. “We have an opportunity to think about this in a bigger way and make an impact.”
Darlene Hightower, JD, associate vice president for Community Engagement and Practice, says that the West Side Total Health Collaborative needs many organizations’ involvement to make a difference. So far, Rush is partnering with the following organizations in the collaborative or the West Side Anchor Committee (a group of health care organizations supporting West Side health and development):
- The University of Illinois Hospital & Health Sciences System (UI Health)
- Cook County Health and Hospital System
- Presence Health
- Loretto Hospital
- Illinois Medical District
- Ann & Robert H. Lurie Children's Hospital of Chicago
“There are significant issues of education, poverty and jobs that aren’t going to be solved by one organization. You really need all hands on deck to move the needle in this community,” she says.
This spring, Hightower heard directly from community members of the West Side in special listening sessions. These gatherings brought together a total of 320 people from the eight communities, including Rush employees, to discuss what is going well and what their communities need.
“Having attended nearly all of the 21 listening sessions we conducted, I know there is a real spirit of hope among community residents,” Hightower says. “People recognize the problems, but also had potential solutions. There was also laughter and pride about the West Side.”
Viewing life expectancy along the Blue Line
The need for Rush's efforts is evident when you consider life expectancy data by neighborhood, Ansell says.
If you ride the CTA’s Blue Line train west three stops past the Rush campus, people who live in the surrounding neighborhoods have an average life expectancy of less than 69 years, lower than that in Bangladesh. This average starkly compares to an average life expectancy of 85 years if you live where the Blue Line starts in Chicago’s loop.
Ansell attributes these life expectancy gaps to social and structural determinants of health — “neighborhood effects” that create the life expectancy disparities based on where one lives in Chicago.
Research has shown that the structural determinants and conditions in which people are born, grow, live, work and age affect longevity or lifespan. These determinants, which include factors such as socioeconomic status, education, the physical environment, employment, racism and social support networks, as well as access to health care, affect longevity or lifespan. When poverty is concentrated in neighborhoods, life span is stunted.
“The fact is, some of the neighborhoods that surround Rush and Rush Oak Park Hospital have the highest levels of economic hardship and poverty, the lowest life expectancy and some of the worst health outcomes that you could imagine,” Ansell says. “These are communities that have been disinvested in over many, many decades.
“If we really want to make a difference in illness, life expectancy and other problems, we need to take a holistic approach.”
In other words, a broad approach to address education, employment, and infrastructure improvements is what is needed.
“To improve health is a higher ambition that will not be achieved overnight,” Ansell says. “As we take a step back and say, ‘what does it really mean to improve health,’ it’s imperative that we look outside our walls at the conditions and situations in a different way than we have before.”
“Everything we do, including employee hiring practices, career opportunities, where we purchase our supplies or where we invest our funds, ought to be tied together in a continuous effort to improve our community,” Goodman says.
Anchor efforts include hiring, purchasing, volunteering and investing
Along with O’Neil and her team from the Rush Department of Finance, Rush leaders in human resources, capital projects, business diversity and purchasing have been working since last summer on new approaches in order to achieve its anchor goals, according to Tricia Johnson, PhD, executive director of Building Healthy Urban Communities, a Rush program funded by a $5 million grant from BMO Harris Bank. Johnson is also a professor and associate chair of education and research in the Department of Health Systems Management.
Rush has been working steadily for the last year in the following four areas:
- Hiring employees from the local area/Anchor neighborhoods and developing employees through job coaching, career ladders and more
- Buying and sourcing more products from local vendors
- Volunteering locally
- Investing locally (through the impact investing described above)
“We are focused on health and health care, neighborhood and physical environment, jobs and businesses in the community,” Johnson says.
To support this focus, Rush recently made the following significant changes and commitments:
- Rush set a bold goal of reducing economic hardship and improving life expectancy in our under-resourced neighborhood communities.
- Rush’s corporate mission was changed to focus on “improve health” in June, 2016 — a change that required approval by the Rush Board of Trustees.
- Rush’s top goal of its Community Health Improvement Plan is “Reduce Inequities Caused by the Social, Economic and Structural Determinants of Health.” Rush is working towards that goal in a strategic and coordinated way through the Anchor and West Side Total Health Collaborative efforts.
Annette Smith, who got involved in the capital committee after attending a listening session at Rush this spring, is excited to see what the efforts will mean for the community that she values so much.
“I am really proud to be an employee of Rush. I love the fact that Rush is investing time, energy and income to help the neighborhoods surrounding Rush, where many patients and employees come from,” Smith says. “Rush is not trying to come in and take over. Rush is not just talking about it, we’re doing something.”