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Rush Hospital Wants to Tackle the West Side “Death Gap.” Will It Work?

The huge health system’s goal to reduce massive health disparities in the city is unprecedented. To succeed, it needs to undo decades of racist policies and disinvestment.

Corina Ransburg prepares for a day of cleaning streets as part of Chicago Neighborhood Rebuild pilot program, funded by Rush. She was dismissed earlier this month.   Photo: Sebastian Hidalgo

In the early morning hours of a cold Friday in January, 24-year-old Corina Ransburg is picking up trash along Harrison Avenue on the edge of East Garfield Park. Moving quickly through the drifting snow, she collects beer cans, chip bags, and a black shirt frozen to the gutter. She once found a dead cat. She frequently finds used needles. She and her partner can easily fill 60 garbage bags in one day.

Ransburg grew up in Austin with her aunt and cousin, where she says she saw a man shot and killed when she was just 10 years old. Now a single mother, she lives in West Garfield Park with her two-year-old son, Aiden.

Ransburg says she used to rely on others to help her buy basic necessities like Aiden’s diapers. But since starting this job, she’s had a regular paycheck and a newfound sense of pride.

“I feel like I’m doing the things that I need to do, instead of having to ask somebody else,” says Ransburg. “Now that I came upon Chicago Rebuild it made me want to keep going.”

Ransburg was hired last October by the nonprofit Cara to clean streets on the South and West Sides as part of the Chicago Neighborhood Rebuild pilot program, which provides job training to young people in the three most violent police districts in the city. The initiative expects to generate employment opportunities for 200 young people as well as rehabilitate 50 vacant homes in East and West Garfield Park, Humboldt Park, and Englewood.

Rush University Medical Center’s $1 million investment helped launch the program. It’s part of the health system’s new “anchor strategy,” which it adopted in July 2016, that sets goals for Rush to invest, hire, purchase, and volunteer in the nine West Side neighborhoods that are home to more than 400,000 people.

As part of this strategy, Rush has convened an “anchor committee,” including nine health care institutions (Rush, Rush Oak Park, Mount Sinai, Cook County Health Systems, UI Health, Presence, Loretto, Lurie Children’s, and the Illinois Medical District) to join in its goal to reduce health disparities between Chicago’s West Side and its wealthier neighborhoods. If they were one business, the anchor committee would be the biggest corporation in the state, with 47,800 employees, 6,000 new hires a year, and nearly $3 billion in purchasing ability. Since early last year, this committee has convened with neighborhood residents and community groups to find the best ways for the health care behemoths to invest in the communities that they serve.

All this exemplifies a national movement by nonprofits and public institutions “to think differently about how to use its economic resources and social capital to really benefit not only its long-term wellbeing but that of the community,” says David Zuckerman, a manager for health care engagement at the Democracy Collaborative and organizer of the Healthcare Anchor Network, a group of 30 health systems that are doing this work.

Zuckerman says that hospitals have a lot of “sticky capital,” or “dollars that can’t pick up and leave the way that manufacturing or many corporate employers have left communities.” They are in essence grounded cruise ships, requiring a huge staff, thousands of meals for patients, medical supplies, and linen cleaning services. If hospitals are able to redirect some of their purchasing and hiring to their neighbors, say using a local laundromat instead of shipping soiled bed sheets further away, they could have a large impact on the community, says Zuckerman.

Nationwide, hospitals and health systems have an estimated $780 billion in total annual expenditures, $300 billion in investment portfolios, and $340 billion in purchasing of goods and services. By comparison, Starbucks’ total operating expenses for its worldwide business the last fiscal year were $18.6 billion. If only a small fraction of health systems’ money was redirected toward communities, it could make a big difference in reducing poverty, Zuckerman says.

He points to efforts by universities and health care networks in Philadelphia, Cleveland, Baltimore, and elsewhere that have successfully revived struggling communities. In Cleveland, for example, hospitals formed the Greater University Circle Initiative and helped develop a local cooperative to handle the millions of pounds of soiled sheets and garments that they produce each year. They also run an employer-assisted housing program that provides eligible employees a $10,000 forgivable loan that can be used on the down payment or closing costs of a home. Overall, the initiative has brought 500 new residents to the area and connected 429 residents to jobs and career training at places like the coop, according to a 2016 report.

In Chicago, medical facilities were recently called out for not using their resources to buoy the communities surrounding them. In December, Cook County Commissioner Richard Boykin, whose district includes West Garfield Park and Austin, chastised Cook County Health and Hospitals System for awarding none of its prime contracts and just 2 percent of its subcontracts to African-American-owned companies. African Americans make up 76 percent of CCHHS patients.

Rush’s efforts are still in their early stages, but the health care network has set the goal of directing 4 percent of their addressable spend (products or services that can be supplied by a new vendor) to West Side businesses by the end of June and having 16 percent of new hires come from West Side neighborhoods. It also is starting to give some employees paid time off in order to volunteer with nearby charity organizations.

Additionally, it will use a portion of its investment portfolio to invest in community development. Unlike a donation or a grant, Rush expects to get its money back with a small financial return and a social return in the form of improved housing, jobs, or health on the West Side. According to Zuckerman, this is a first for an academic medical center.

The results haven’t been perfect. Of the 20 people who started working at Cara as part of the Chicago Neighborhood Rebuild pilot program, 11 have either quit or been fired. Eight people are currently working as street cleaners through the program and one was placed at a temporary job at Catholic Charities.

Ransburg herself was dismissed from her position on February 9, a day after she accepted and then declined an offer to participate in a 13-month robotics and electrical manufacturing training program run by Rush.

Mark Toriski, a spokesman for Cara, confirmed Ransburg’s reasons for dismissal adding that she violated “an agreement with an employment partner” and left “on good standing and will be allowed to re-enter Cara through our other portals if she so chooses.” Ransburg, however, says she was never told about other potential opportunities.

Such inflexibility in a program targeting an already challenged population is worrisome, says Darnell Shields, the executive director of Austin Coming Together and a member of the West Side Total Health Collaborative’s planning committee.

“You need to have some kind of flexibility built in to be able to pivot … because every person’s situation is different,” Shields says. “You might say this population struggles with that or this need, but then as you start to drill down and start to work specifically with individuals, the obstacles and the barriers can range and have a lot of variance. It can be childcare, it can be all of these different things. So if [your progam’s] too rigid, you can really set things up for failure.”

While Ransburg has some background in computers and sees herself working in that field, she says she changed her mind on the offer when she realized that it would require her to be in Chicago for the next year. She says she hopes to move to California this summer to be with her fiancé and didn’t want to start a program she couldn’t finish.

“I just wish I had a second chance given to me, since I do have a child to feed and take care of,” Ransburg says. While she’s unsure what she’s going to do for money now, she says she’s looking forward to starting a new life in California away from Chicago’s bad weather and violence. “I know everything is going to be all right.”

This report was supported by a fellowship from the Dart Center for Journalism and Trauma at Columbia Journalism School.

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