![]() ![]() 10 This book advances the idea that structural violence is a root cause of low life expectancy in marginalized communities - structural because it is designed into our laws, policies, procedures, structures, and norms and a form of violence because people are harmed and die early as a result. Potential solutions were laid out in a book on neighborhood racial life expectancy gaps, “The Death Gap: How Inequality Kills,” written by one of the authors of this article (David A. As a health system and a national leader in health care quality and safety, this CHNA report forced us to ask: What more could we do to address the social and structural determinants of health inside and outside our doors? The Rush CHNA report named structural racism, economic deprivation, and other social and structural determinants of health as among the root causes of the poor life expectancy outcomes in the West Side neighborhoods. There is a 14-year life expectancy gap between the Chicago Loop in the downtown commercial area (median household income, $107,246) and the East Garfield Park neighborhood (median household income, $22,818) - just two stops on the Chicago Transit Authority Blue Line from Rush. To illustrate the stark gap between the largely white downtown and the West Side neighborhoods, we depicted the life expectancy along the tracks of the elevated transportation system known as the Chicago “L” ( Figure 1). 9 These low life expectancy communities were largely racially segregated neighborhoods of concentrated poverty, with substandard housing, food deserts, unsafe streets, and poor educational outcomes. An analysis of the major causes of premature mortality in these neighborhoods identified that common chronic diseases such as cardiometabolic disease and cancer were responsible for a significant proportion of premature deaths. The Rush CHNA identified eight (ultimately 10) Chicago West Side neighborhoods, geographically close to the medical center and comprising more than 500,000 individuals within Rush’s primary service area. 7, 8 The requirement, under the Affordable Care Act, that Rush and other not-for-profit hospitals conduct triennial community health needs assessments ( CHNA) helped surface these startling health gaps to Rush leaders. In fact, Chicago has the largest racial mortality gaps among the 30 largest U.S. The context for the decision to launch this new equity strategy was the long-standing racial health and life expectancy gaps in Chicago. We discuss: (1) Rush’s launching of a health care equity strategy (2) the creation of the Rush health equity framework, including expansion into the community via the creation of West Side United (WSU) - a regional racial health equity collaborative aligned with the City of Chicago’s Healthy Chicago 2025 public health plan 6 and (3) the adaptation of the health equity strategy in response to the Covid-19 pandemic and the implications for the future. ![]() We explain why Rush University Medical Center (RUMC), a Chicago-based academic health system, initiated a health equity strategy in 2016 to address racial health inequities. The confluence of the disproportionate Covid-19 case and mortality rates in people of color and the murder of George Floyd and the subsequent civil unrest have once again thrust the issue of racial health inequities to the fore. EIN: 52-2359517.Despite more than a century of literature documenting racial and ethnic health inequities, 1 - 5 few health systems have made the achievement of health equity a central pillar of their strategy. ![]() The Leapfrog Group is a registered 501(c)(3). #RUSH HOSPITAL PROFESSIONAL#Never disregard, avoid or delay in obtaining medical advice from a doctor or other health care professional because of material on this site, as the site is not intended to be a substitute for professional medical advice. Neither Leapfrog nor its affiliates are responsible for any damages or costs that may be incurred with respect to use of this site. Individuals are solely responsible for any and all decisions with respect to their medical treatment. The information viewed on this site is not intended to be the only or primary means for evaluating health care facility quality nor is it intended to be relied upon as advice or a recommendation or an endorsement about which facility to use or the quality of the medical treatment that a patient will receive from a hospital, ambulatory surgery center, or other health care provider. © The Leapfrog Group - All rights reserved.īy viewing this website you are agreeing to our TERMS OF USE. ![]()
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