Chicago-based Rush University Medical Center's CEO and senior leadership shared their framework for addressing large health inequities in the hospital's West Side Chicago community and worked to promote equity in healthcare, according to a report in the New England Journal of Medicine.
The report's authors include Rush President and CEO Omar Lateef, DO; retired CEO Larry Goodman, MD; David Ansell, MD, senior vice president for community health equity; and Darlene Oliver-Hightower, vice president of community health equity and engagement.
To address health equity, Rush developed the following five pillars of equity framework:
1. Name and eliminate racism.
Rush said it was comfortable in naming poverty and racism as a root cause of healthcare inequity.
"If structural racism, economic deprivation, and neighborhood conditions were afflictions at the root cause of health inequities, we had an obligation as an academic health system to name these as the first step in identifying ways to address these inequities," the report said.
2. Adopt an anchor mission.
Rush launched an "anchor mission" to hire, purchase, invest and volunteer locally. Rush is focusing on hiring locally and developing talent, utilizing local labor for contracts and projects, buying and sourcing locally, investing locally and ensuring retirement readiness, and volunteering locally.
3. Create wealth-building opportunities for employees.
Internal listening sessions determined that many employees experienced extreme financial distress and were not saving for retirement. There were few internal pathways for career growth. Many of Rush's employees lived in the low-income neighborhoods that Rush was trying to elevate. Rush initiated a pension reform program to significantly increase retirement savings, raised entry hourly wages to $15 per hour, launched healthcare career pathways for incumbent employees, and offered financial wellness and credit training.
4. Eliminate healthcare inequities.
Rush established the Health Equity Governance Committee to report on performance projects that address racial, ethnic, gender and age inequities. Rush began screening patients for social determinants of health, including food, transportation, access to primary care and more. The health system launched a home visiting program for homebound patients who live with chronic illness and for postpartum mothers who live in communities with low life expectancy.
5. Address the social and structural determinants of health.
Rush partnered with other hospitals in Chicago so they could collectively make a greater impact. Consisting of Rush and five other hospitals, West Side United is able to invest millions back into the community and hire West Side employees. The partnership will work toward cutting Chicago's 14-year life expectancy gap between wealthy and low-income communities by 50 percent by 2030.
To read an in-depth report on Rush's health equity framework, click here.