2019 Community Health Needs Assessment And 2020 – 2022 .
2019 Community Health Needs Assessment and2020 – 2022 Community Health Implementation Plan
Where we’ve been.Where we are today.And what’s next
Table of ContentsLetter from Rush leaders2Where we’ve been: A progress report4Where we are today: The 2019 Rush University Medical Centerand Rush Oak Park Hospital Community Health Needs Assessment10Neighborhood profilesAustin16East Garfield Park18Forest Park20Humboldt Park22Lower West Side24Near West Side26North Lawndale28Oak Park30River Forest32South Lawndale34West Garfield Park36West Town38What’s next: The 2020–2022 Community HealthImplementation Plan (CHIP)40Appendix 1: IRS Form 990, Schedule H Compliance44Appendix 2: Existing health care facilities and resourceswithin the community45Appendix 3: 2020–2022 CHIP at a glance47Appendix 4: CHNA and CHIP collaborators49
Where you live makes a lot ofdifference to your health.A baby born today near Rush Oak Park Hospital is likely to liveto be 82 years old. In Aurora near Rush Copley Medical Center,life expectancy is 81 years. But in West Garfield Park, near RushUniversity Medical Center, life expectancy is just 70 years.These disparities reinforce the fact that where you live, workand play can influence how long you live.Aurora81WestOak Park Garfield Park8270Race, racism andhealth equityLoop82Research has shown that the impact ofrace on health stems largely from differencesin access to resources and opportunitiesthat can hurt or enhance health. Additionally,researchers have found that racial andethnic discrimination can negatively affecthealth across lifetimes and generations.— The Robert Wood Johnson FoundationWhile violence is often blamed for the disparities in life expectancy,more than half of the early deaths in under-resourced communitiesare actually caused by common conditions like heart disease,cancer, stroke and diabetes. Morbidity and mortality from theseand other health conditions are more prevalent in people livingin neighborhoods afflicted by poverty, racism, and lack of accessto health care, educational opportunities and good jobs.All of these factors create major obstacles to health equity.According to the World Health Organization, health equity isachieved when everyone has a fair opportunity to attain theirfull health potential and no one is prevented from achieving thatpotential. Where there is more equitable access to education,jobs, resources and health care, life expectancy gaps are smaller.A hospital’s mission is to help heal people — and that’s why RushUniversity System for Health is working to address the socialinequities that contribute to poor health. Health equity is a2Rush CHNA/CHIP 2019–2022The goals and strategies you’ll readabout in the following pages show howRush University Medical Center andRush Oak Park Hospital are workingtoward health equity.In many of the West Side neighborhoodsnear Rush University Medical Center,structural racism is one of the biggestbarriers to health equity.Structural racism means the laws, policiesand unofficial practices that give advantagesto white people and disadvantage peopleof color in our society.Structural racism takes many forms.Banks’ refusal to approve mortgage loansfor homes in black neighborhoods — apolicy known as “redlining” — preventedpeople who live there from having thesame chance at home ownership as
systemwide strategy for achieving Rush’s mission: to improve thehealth of the individuals and diverse communities we servethrough the integration of outstanding patient care, education,research and community partnerships.people in white neighborhoods. Studentsof color have less access to top-ratedChicago public schools: A 2018 analysis bythe nonprofit Kids First Chicago showedthat highly ranked schools enroll 45% ofthe district’s black students, 72% of Latinxstudents and 91% of white students (despitethe fact that the district is 90% nonwhite).Because inequities are so deeply rooted in our social systemsand structures, a team approach is required. We are coordinatingour efforts and resources with other health systems, communityresidents, nonprofit organizations, government agencies andfaith communities. Rush hospitals are partnering with theseorganizations to have a greater collective impact in ourcommunities. In the pages that follow, you’ll read about theinequities that exist in our communities and how we areaddressing them. Instead of simply treating the illnesses thatare a result of these inequities, Rush is working to createhealthier communities.K. Ranga Rama Krishnan, MDCEO, Rush University System for HealthMichael J. DandorphPresident, Rush University System for HealthAnd these are just two examples. Peopleof color feel the effects of structuralracism everywhere, from employmentto wealth accumulation, from criminaljustice to health care. Ultimately, thisaffects their health and overall well-being.It also affects where people choose to live:Chicago’s black population has declinedfor seven straight years, according to theU.S. Census Bureau.Sherine Gabriel, MDPresident, Rush UniversityUndoing those effects means working toreform systems that are hundreds of yearsold. It means providing resources andopportunities that will help close the gapsin education, housing, employment, income,health care and other areas. And it meansworking to heal our communities in waysthat go far beyond just providing health care.Barry C. FinnPresident and CEO, Rush Copley Medical CenterWhen everyone has more opportunitiesto be healthier, everyone in ourcommunity benefits.Omar B. Lateef, DOCEO, Rush University Medical CenterDavid Ansell, MD, MPHSenior Vice President for Community Health Equity,Rush University Medical CenterAssociate Provost for Community Affairs, Rush UniversityBruce M. ElegantPresident and CEO, Rush Oak Park HospitalSusan CrownBoard chair, Rush University System for Health andRush University Medical CenterGary McCulloughBoard chair, Rush Oak Park HospitalBruce DienstBoard chair, Rush Copley Medical CenterLetter From Rush Leaders3
Where we’ve been: A progress reportCollaborating more with other health systems was oneof the biggest changes spurred by Rush’s partnershipwith the Alliance for Health Equity (AHE) in creatingour last Community Health Needs Assessment (CHNA):Health inequities are so deeply rooted in longstandingconditions that one organization alone cannot addressthem, so we’re working in partnership with others.Based on the data we analyzed and the communityfeedback we received, we’ve also made a number ofother changes in how we do things at Rush UniversityMedical Center and Rush Oak Park Hospital. We formed West Side United (WSU) with fiveother health systems and the Illinois MedicalDistrict, plus community residents, educationproviders, the faith community, business, governmentand other organizations. By addressing inequalityin health care, education, economic vitality and thephysical environment, our goal is to reduce the lifeexpectancy gap between the Chicago Loop andthe West Side by 50% by 2030.4Rush CHNA/CHIP 2019–2022 We adopted an Anchor Mission Strategythat guides how we use our economic power toimprove health in the communities served byRush University Medical Center and Rush OakPark Hospital. With thousands of employees andmillions of dollars spent on goods and servicesevery year, every dollar we spend — on payroll,medical supplies, construction, catering, donationsand more — is an opportunity to support thecommunity. Our Anchor Mission Strategy workmeans that we do the following:– Hire locally and develop talent– Use local labor for capital projects– Buy and source locally– Invest locally and create financial stabilityfor employees– Volunteer and support community-building
We helped form the West Side Anchor Committeeunder the umbrella of WSU, with representativesfrom six West Side health care institutions andthe Illinois Medical District, that together employmore than 43,000 people and spend 2.8 billion onsupplies and services each year. Each is adoptingits own anchor mission strategy. Rush University Medical Center is a partnerin the Chicago HEAL Initiative (HEAL) begunby U.S. Sen. Dick Durbin, bringing together 10Chicago hospitals to reduce gun violence, heal thephysical and mental trauma of violence and createeconomic opportunities in our neighborhoods. We heard from community residents that we need tobe out in the community more, so we’ve added morestaff to our Office of Community Engagementand Department of Social Work and CommunityHealth, enabling us to serve more people. We also heard that many people, particularlyimmigrants, sometimes fear seeking health care,so we created a policy to protect people whoneed care but lack legal permission to be in theUnited States. We’ve also submitted commentson proposed changes to the federal Public ChargeRule that would affect our community members’ability to get access to health care and healthy food. We committed to training all Rush leaders incultural competence (the ability to provide care topatients with diverse values, beliefs and behaviors)and implicit bias (unconscious associations thatcan lead us to evaluate someone negatively on thebasis of characteristics such as race, gender, abilityor sexual orientation). We know that Rush has to think about howgovernment policy shapes health care, so wesupported the Tobacco 21 legislation thatincreases the legal age for buying tobaccoproducts in Illinois from 18 to 21. Gov. J.B.Pritzker signed this bill into law in April 2019.In addition to these changes, our 2016 CHNA gaverise to the following goals and strategies that madeup our 2017–2019 Community Health ImplementationPlan (CHIP). Some of these strategies requiredintensive planning, so they didn’t begin producingresults immediately, but all of them eventually wentinto effect between fiscal years 2017 and 2019. Here’s alook at the impact of that work.Where We’ve Been: A Progress Report5
Rush University Medical Center and Rush Oak Park HospitalCommunity Health Implementation Plan, 2017–2019GOAL 1 Reduce inequities caused by the social, economic and structural determinants of healthSTRATEGY Improve educational attainmentMEASURES Evaluate and retool existing programs; identifyneighborhoods and schools with the highest need; implementupdated strategy and begin tracking improvementsRESULTS We selected West Side partner schools thatinclude Helen M. Hefferan STEM Elementary School,Robert Nathaniel Dett Elementary School, WashingtonIrving Elementary School, Genevieve Melody STEMElementary School, Josiah Pickard Elementary School,Michele Clark Magnet High School, Instituto HealthSciences Academy, Benito Juarez Community Academyand Richard T. Crane Medical Prep High School. Studentswhose participation is noted below came from theseschools and others on the West Side.STRATEGY Identify, measure and mitigate thesocial determinants of health among those at risk —particularly children, young adults and people withchronic illnessesMEASURE Develop and implement social determinantsof health screening tool with a goal of screening andreferring 25% of eligible patientsRESULTS Developed and implemented tool and establishedeligibility criteria; screened and referred 7,000 peopleTracking improvements is a long-term goal, but we havetracked program reach to date: 1,900 students participatedin enrichment, instruction and work-based learning.334 teachers/school leaders participated in professionaldevelopment sessions. 250 high school studentsparticipated in apprenticeship/internship program. 1,700 students and parents attended events on STEM/healthcare topics. 50 high school students participated inexternship program. 25 students trained as peer educators.1,400 students participated in curriculum about chronicconditions/risk factors screening. 93 students participatedin IT certification and apprenticeship program. 450students participated in workshops on health equity,health careers, college readiness and professionalism.6Rush CHNA/CHIP 2019–2022STRATEGY Participate in regional community healthimprovement collaborativesMEASURES Collect and share health data; annuallycreate a regional approach to improving one or moresocial, economic and structural determinants of healthRESULTS Collected and shared health data withAHE and others; in partnership with AHE, developed 2regional approaches to improve outcomes related to foodinsecurity and housing
GOAL 2 Improve access to mental and behavioral health servicesSTRATEGY Address psychological trauma throughscreening tools and referral programs in school-basedhealth centers and faith-based organizationsMEASURES Develop and pilot school-based andchurch-based screening, wellness and referral networks;roll out church-based screening to at least 5 partnerchurches annually; begin screening 500 students annuallyat Rush’s school-based health centersRESULTS Spiritual Care Training developed andconducted with 5 churches; trained 240 communitymembers in Mental Health First Aid; referred more than700 people to mental health services; screened morethan 2,000 students at school-based health centersSTRATEGY Expand access to other screeningsand servicesMEASURE Train 200 community members in MentalHealth First AidRESULTS 240 people trainedMEASURE Link 100 people to needed mental healthservicesRESULTS More than 700 people referred to servicesWhere We’ve Been: A Progress Report7
GOAL 3 Prevent and reduce chronic conditions and risk factorsSTRATEGY Expand free and subsidized screeningsMEASURE Provide breast cancer screening and followup to at least 300 uninsured womenRESULTS 750 women screened in partnership with theMetropolitan Chicago Breast Cancer Task ForceSTRATEGY Develop and deliver community servicesto help people stop smokingMEASURE Integrate counseling into existing communityservice projects with goal of achieving 10% decrease intobacco use among participantsSTRATEGY Reduce risk factors through assessments,chronic condition management programs and betteraccess to healthy foodMEASURE Donate food daily for distribution to peoplein needRESULTS Rush Food Surplus program provided morethan 60,000 meals from Rush University Medical Centerand Rush Oak Park Hospital to partner institutionsFranciscan Outreach and Oak Park River Forest FoodPantry. Also implemented Top Box program that enabledRush employees and community members to purchasemore than 3,500 boxes of fresh produceMEASURE Create faith-based programs in at least onecommunity of need to help people reduce cardiovascularand diabetes risk factors; expand education and screeningprograms into at least one community of need and holdevents for at least 300 peopleRESULTS Added 7 new church partners across multiplecommunities; screened and provided educational materialsto more than 1,500 people; engaged more than 300 peoplein Walk to Wellness program8Rush CHNA/CHIP 2019–2022RESULTS Began building infrastructure. To date: 11 peopletrained to provide in-person Courage to Quit classes; morethan 100 providers trained to talk to patients about tobacco;developed partnership between Rush, Pro-ChangeBehavior Systems and Illinois Tobacco Quitline; invested 10,000 in training and personnel to help partner housingfor low-income people become a smoke-free community
GOAL 4 Increase access to care and community servicesSTRATEGY Expand access to primary care medicalhomes for people without insurance and for otherswithout medical homesSTRATEGY Implement adverse childhood eventscreenings and referrals at school-based health centersMEASURE Screen 500 students each yearMEASURE Refer at least 150 uninsured people tomedical homes each yearRESULTS Connected more than 850 people withCommunityHealth, which helps enroll people in insurance,and integrated referral process with FranciscanOutreach shelterRESULTS 999 students screenedSTRATEGY Expand access to insuranceMEASURE Develop process for referring and enrollingthe uninsured; set baseline numbers for bothRESULTS Connected more than 850 people withCommunityHealth, and integrated referral process withFranciscan Outreach shelterWhere We’ve Been: A Progress Report9
Where we are today: The 2019 Rush UniversityMedical Center and Rush Oak Park Hospital CHNAWhen we created our 2016 CHNA, we knew it wasjust the first document of an ongoing journey. Healthinequities are the result of decades of injustice, so itwill take a long time to fix them.We’re glad to see that some of the health factorswe’ve been tracking show improvement. For example,data available in 2016 showed unemployment in WestGarfield Park at 27%. It’s down to 19%, although that’sstill significantly higher than the citywide rate of 11%.Similarly, according to 2016 data, 35% of people inSouth Lawndale lacked health insurance, and that’sdown to 29% — but still significantly higher than thecitywide rate of 15%.In other words, health equity gaps remain. So theneeds, goals and strategies you’ll read about in thefollowing pages are nearly the same as the ones weoutlined in our 2016 CHNA and 2017–2019 CHIP, withseveral important adjustments.10Rush CHNA/CHIP 2019–2022For example, citywide public health data — as well asdata from our emergency rooms — shows that moreblack women have pregnancy-related complicationsthan white women, so we’ve added a new CHIP goalto improve the health of these mothers and babies.We’ve also worked to coordinate our efforts acrossAHE, WSU, the West Side Anchor Committee andHEAL to deepen our impact.This CHNA adds Humboldt Park to our list ofcommunities served. It was a gap in our previousWest Side map, but we know that people who livethere come to Rush University Medical Center andRush Oak Park Hospital. We also see some needs inthe communities of Bridgeport, McKinley Park andBerwyn. While we don’t have many programs in thesecommunities, we’re considering whether we shouldexpand our reach to include them.
How we created this reportThis CHNA followed a process similar to the creationof our 2016 CHNA to identify the health needs in thecommunities we serve on the West Side of Chicagoand the western suburbs.Rush University Medical Center and Rush OakPark Hospital worked with the AHE, which bringstogether more than 30 nonprofit and public hospitals,seven local health departments and more than 100community organizations to improve health acrossChicago and Cook County. Each hospital has toconduct its own CHNA, so it made sense to cometogether to align our goals, analyze data and talk withcommunity members: Collaborating with the AHEhelps all member hospitals make sure we’re targetingthe right areas of need and working toward the samegoals, so we can make a real difference.Rush Copley Medical Center worked with KaneHealth Counts and other community partners on itsown CHNA, using data and community input frompeople who live in Kane, Kendall and other countiesin the Rush Copley service area. Its CHNA and CHIPdiffer slightly from what you’ll read here, but the focusWhen you examine the life expectancy map of Chicago, residents who live closest to excellenthealth care at Rush University Medical Center had among the worst health outcomes in thecity. The answer is not just about providing more health care. If we don’t address the socialand structural conditions with the greatest bearing on health outcomes — like poverty,structural racism, poor educational achievement, food insecurity, housing and safety onChicago’s West Side — we will not achieve our mission of improving health.David Ansell, MD, MPHSenior Vice President for Community Health Equity, Rush University Medical CenterAssociate Provost for Community Affairs, Rush UniversityWhere We Are Today: 2019 CHNA11
on health equity — and the strategies for achievingit — is consistent across the entire Rush system.You can read the Rush Copley CHNA and CHIP ssessment-reports/.Health care is an evidence-based profession, so ofcourse this CHNA contains a lot of data about thefactors t
University System for Health is working to address the social . 6 Rush CHNA/CHIP 2019–2022 Rush University Medical Center and Rush Oak Park Hospital Community Health Implementation Plan, 2017–2019 . Washington Irving Elementary School, Genevieve Melody STEM
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