David Ansell and Chicago's Death Gap

October 25, 2018


I looked at the faded print of The School of Athens hanging on the wall. Considered the perfection of artistic ideals of the Italian Renaissance, it seemed for a moment that the great minds of the ancient world pictured in Raphael’s masterpiece stood silent, ready to listen. Seemingly unaware of the print that hung above him, physician, professor, and author David Ansell looked forward, smiling, and talked passionately about a tapestry of a different medium - Chicago’s west-side. 


With family dying in the Holocaust and finding himself impacted as a child by the Civil Rights movement after his family moved to the United States, Ansell has always known the importance of knowing what is going on in our neighborhoods. After spending seventeen years at Cook County Hospital, which television drama E.R. was based, he found himself at Mount Sinai Hospital. Ansell said it was a realization for him that where you live in America determines who lives and who dies. Ansell described moving from Cook County to Mount Sinai as “one street, two worlds.”


Ansell has been at Rush University Medical Center since 2005. In 2015, the same year Ansell became Senior Vice President for System Integration/Community Health, Virginia Commonwealth University released a report that indicated life expectancy rates in four different American cities. The numbers in Chicago were staggering. Residents in the Loop had a life expectancy that matched some of the highest in the world at 85. A short fifteen-minute train ride to West Garfield Park, however, had a life expectancy of 69. 


It only takes seven stops on the Blue Line to get from the Loop to West Garfield Park. The last time 69 was the national average life expectancy for Americans was in 1950. “Do you know why the life expectancy is so low?” Ansell asks all of us around the table. There is a brief silence before someone speaks up and says what is already on many of our minds, “Gun violence.”


Nodding quietly, Ansell agrees that violence is a problem. Violence is not the number one cause of death on the west side, though. Ansell tells us that the major causes of death are strokes, cancer, heart disease, infant mortality. He almost slows down for a moment, making sure we all understand, “The major cause of death is health inequality.”


Ansell does not speak like a prophet or community activist. He is a physician at heart, and he views inequality as he does any other disease that is impacting his patients. Yet, how can one inoculate and vaccinate against structural racism, economic exploitation, and discrimination that, according to Ansell, can result in a thirty-five-year difference in life expectancy for residents of wealthy and poor neighborhoods? Ansell talks about the importance of knowing what to repair, having the courage to disrupt the system, leverage to dismantle, and then the patience to recreate something new.


Someone at the table spoke up and was quick to point out the importance of placing people of color in power and even how it was important for Ansell to mentor someone for the future. Ansell agrees and mentions that some of the questions at Rush have included conversations around how policies and procedures reflected this, including who is serving on the board. Ansell does not take time to defend himself. There was no mention about Rush’s Chief Medical officer Omar Lateef, who Ansell had taken under his wing. Instead, Ansell used the moment to talk about how important it was during conversations and meetings at the hospital to “talk about racism.” Ansell speaks about the need for personal reflection, which resulted in his ability to not only talk more honestly about racism but to mention the reasons why it has taken him so long to talk about racism. 


Rush’s goals for the west-side are ambitious. It includes closing the death gap by 2030, not by gentrification, but by creating career paths at the hospital for residents on the west-side. Rush increased minimum wages after polling their employees to see what an hourly wage had to be to keep employees from having to dip into retirement accounts to pay for unforeseen emergencies. There is a focus to build wealth locally by creating supply chains on the west side for goods and services. Ansell shared a conversation that took place around laundry services for the hospital. Instead of outsourcing, Rush created a laundry service that paid higher wages to the employees. Ansell said, ultimately, they decided that it was an investment in the community.


The personal benefits of empowering the west side are obvious to Ansell. An inclusive body at Rush means multiple voices for better decisions. Ansell points out that the alternative also costs. “If we don’t focus on the community," he says, "and the death gap remains then we are leaving human potential behind.’


Ansell is aware of his position and the opportunity it gives him to make significant change within the community. He notes the importance of each person’s voice, though, and the dangers of remaining silent. “Why would people want to talk about racism and systematic inequity if I am in a seat of power?” Ansell empathizes with the desire to remain silent, “I am benefiting from the system remaining the same and so are the people who employ me.” Then he begins to talk about his relatives that died in the Holocaust. The Jews in Poland did not always have the best relationship with other Polish citizens, but they lived together for nearly a thousand years. Then, the Nazi ideology destroyed the community in less than a decade. As a child, Ansell would wonder why others in Poland remained silent.


Ansell’s voice changes, as if he is about to give a patient a bad prognosis, “The reason we need more voices is because we are losing and losing tremendously.” Ansell shows that this is the time to speak up and hold conversations because silence is permitting an inequality that for those, seven stops away, could very well be a death sentence.


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