Tuesday, October 19

‘Time to fix it’: can Chicago address its growing racial gap in life expectancy? | Chicago

CIn widening the life expectancy gap between black Chicagoans and other groups in the city, Mayor Lori Lightfoot last week called systemic racism a “deadly” public health crisis that has taken a “devastating toll on the health and well-being of our residents of color “and pledged to combat inequality in the city.

“We can no longer allow racism to rob our residents of the opportunity to live and lead a full, happy and healthy life” Lightfoot saying.

But while experts applaud Lightfoot for naming the problem, they say more meaningful and sustained action will be needed to truly address the crisis in the city, and some community leaders and experts wonder if she is doing enough.

“We have to address it urgently and with far more resources than have been used up to this point,” said Dr. David Ansell of Rush University Medical Center, a leader in health equity and author of The Death Gap, which examines disparities in life expectancy in Chicago and across the country.

“Health inequities are inherently unjust and because they are unjust, it is urgent to correct them,” Ansell told The Guardian. “We can’t do it fast enough.”

Lightfoot’s comments came immediately after an alarming report by the city’s public health department, which found that the average life expectancy for black Chicagoans is 71.4 years, compared to 80.6 years for other residents; a 9.2-year life expectancy gap, according to the researchers, is due to a higher prevalence of chronic and infectious diseases. higher infant mortality rates, the opioid crisis and gun violence.

In part thanks to the coronavirus pandemic, which disproportionately affected communities of color, the disparity is likely to worsen.

“Many health outcomes among this population are worse compared to other racial groups in Chicago,” according to the report, which was produced by the Health Equity Index Committee, a task force made up of five black women. “Overall life expectancy among blacks is decreasing and the gap between life expectancy for blacks and non-blacks is widening.”

The racial gap in life expectancy is nothing new, nor is it unique to Chicago, as Dr. Selwyn Rogers, founding director of the University of Chicago Center for Trauma Medicine and a leading public health expert, told The Guardian. .

“Racism and discrimination still prevail,” said Rogers. “The long-standing impact of things like the red line and economic divestment on communities of color persists, and we see evidence of that here in Chicago.”

The disparities may seem especially stark in Chicago, one of the most segregated cities in the United States.

While the nine-year difference in the average life expectancy of black and non-black residents here is worrying enough, the inequalities can become even more pronounced when broken down by neighborhood.

For example, according to a paper co-authored by Ansell and published last month in the New England Journal of Medicine, the life expectancy gap among residents of Chicago’s Loop, the city’s main business district with a median household income of nearly $ 110,000, and East Garfield Park on the city’s West Side, whose median household income is about $ 23,000, is a staggering 14 years.

Lightfoot, the city’s first black woman to serve as mayor, is committed to working to address the root causes of inequality in Chicago.

Last year, the City Council launched the Healthy Chicago 2025 initiative, aimed at closing the life expectancy gap that Lightfoot described as “unacceptable” five years from now. Meanwhile, as the Covid-19 crisis raged in the city, officials specifically targeted vulnerable communities with access to tests Y vaccines.

“These are the communities most burdened by Covid,” Chicago Vaccine Chief Tamara Mahal told the Chicago Sun-Times in February, “and this is one way to lower those rates.” And, as Lightfoot promised last week to “address the racist policies that have wreaked havoc in our Black and Latino communities,” he announced that he would allocate $ 9.6 million in Covid relief funds to establish health equity zones, primarily on the southern sides. and West, which will use “hyperlocal strategies” to improve health outcomes.

But some community leaders in Chicago question Lightfoot’s commitment to addressing systemic racism and have He suggested that some of its policies, including the surveillance, education and the environment – things are making things worse.

“The mayor we have in place now says a lot of right things, but she doesn’t operate in a way that seems to listen, respect, value community voices,” said organizer Jitu Brown, a member of the Chicago Health Equity Coalition. who fought to prevent the closure of Mercy Hospital, a safety net. “She is saying one thing, but doing something completely different.”

Brown noted that disinvestment in neighborhoods, the closure of under-resourced schools and classrooms, and other long-standing issues have continued under Lightfoot, calling for real action to address the needs of underserved communities.

“It does exactly what Rahm Emanuel would have done. He does what Daley would have done. So how is she different? “Brown said, referring to Lightfoot’s predecessors.” If they don’t want to interact with the people closest to pain, they don’t want to bring those people closer to power. “

Meanwhile, experts say closing the life expectancy gap will mean taking a much more aggressive and “multi-pronged” approach to fighting racism in health systems and at the policy level.

“Targeted interventions will be needed disease by disease, condition by condition,” said Rogers. “We will need to reinvent the way we address the societal factors that drive health outcomes … An equity perspective will be needed in all of our policies, in law enforcement, law and health.”

“We can’t keep doing the same things we’ve been doing and fix the problem,” added Rogers.

Current efforts have not matched the broad scale of the problem, Ansell said, noting that Chicago suffers approximately “3,500 excess black deaths” a year due to inequalities in the health care system.

“That’s almost a World Trade Tower disaster in Chicago for blacks in Chicago every year since we told it,” Ansell said. “The scale of this is huge.”

Ansell applauded Lightfoot, who wrote the foreword to the reissue of his book, for describing racism for the public health crisis that it is. But, he said, that should be just the beginning.

“You get one point in the world for pointing out the problem and one hundred points for fixing it,” Ansell said. “Time to fix it. We don’t need more data. We don’t need any more reports. We don’t need a rehash of the past. We need to take concrete steps towards the future. Ultimately, it’s about human capital, social capital, and financial capital. We certainly have the means to do it in this country. “


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