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Chicago tries to close life expectancy gap

Chicago tries to close life expectancy gap

Axios24-02-2025

A new city campaign aims to close the whopping 11-year life expectancy gap between Black Chicagoans and their non-Black peers.
The big picture: As the city enters an era where its racial makeup is nearly 30% white, 30% Black and 30% Latino, Axios is starting a yearlong series examining racial equity in the city across several metrics from opportunities and perks to health disparities and disadvantages.
Backstory: The life expectancy gap wasn't always this big. In 2010, the disparity between Black and non-Black Chicagoans was 8.4 years.
In 2020, Black life expectancy in Chicago fell below 70 for the first time in decades, driven largely by COVID deaths.
During the pandemic in 2021, the gap peaked at 12.7 years before settling at 11.4 in 2022.
Across all races the average life expectancy is 77 years.
Driving the news: The "Healthy Chicago 2025 Strategic Plan" focuses on the root causes of health inequity including economics, housing and access to health care while zeroing in on the primary drivers of Black mortality, like chronic disease and opioid overdose, and the neighborhoods with the highest rates.
Zoom in: Chicago Department of Public Health is concentrating on these neighborhoods with a life expectancy much lower than the city's 77-year average.
What they're saying:"Preventing premature mortality from chronic diseases (namely heart disease), violence, and opioid overdose offer the most room for progress in reducing the racial life expectancy gap," CDPH commissioner Olusimbo Ige tells Axios.
"Reversing these trends will require consistent, long-term commitment to increase access and uptake of health protective behaviors and resources. We have already seen significant reductions in opioid overdose and violence, and we want to build on these successes."
The cost: While the report doesn't quote a specific cost of the program, it cites the use of hundreds of millions in funds for health-related projects including sports programs, alternative policing, homelessness services, prison re-entry programs and more.
Between the lines: Even before the pandemic, life expectancy in some largely Black neighborhoods was falling, in part, due to opioid deaths. Declines from 2010 to 2019 included:
Englewood: 3.3 years.
East Garfield Park 3.23 years.
Yes, but: COVID accelerated the drop further, seeing life expectancy declines from 2019 to 2020 of 5.84 years in West Garfield Park and 4.2 years in North Lawndale.
The intrigue: While Black communities saw an overall 4.6-year life expectancy drop from 2019 to 2020, Latinos saw the biggest decline of 6.3 years.
Most Black Chicagoans who died of COVID were people 70 years old and older, but at least 50% of Latino COVID deaths were in people aged 40-69, which CDPH attributes largely to a high representation among essential workers.
Here is how CDPH is trying to address the disparity by cause of death:
Chronic disease: Strategies include tobacco prevention and cessation programs through community partnerships.
Using the PlayStreets initiative to increase youth and adult physical activity.
Increasing healthy food access and navigation.
Increasing health literacy and promoting risk reduction resources.
Violence prevention: Strategies include "a proactive 2025 summer violence prevention plan."
Investing in community greenspace by cleaning vacant lots and promoting tree plantings.
Hospital-based violence interventions.
Opioid overdose reductions: Strategies include expanding access to treatment and recovery services and making overdose reversing drug Naloxone more available.
Surprising stat: In 2020, the opioid-related overdose death rate among Black males aged 45-64 years was six times higher than the rate among White males of the same age group.
Infectious disease: Strategies include modernizing public health surveillance systems and approaches to enhance rapid response.
Identifying highest-risk community areas.
Tailoring vaccine messaging for communities of color.
Promoting the uptake of the HIV services.
Infant and maternal health: Strategies include hyperlocal outreach to promote safe sleep practices.
Understanding barriers to prenatal care and creating a media campaign for improvement.
Modernizing the Women, Infants, and Children (WIC) program.
Mental health: Strategies include improving the city's Mental Health Equity Network and Crisis Assistance Response and Engagement program.
Developing "a housing to recovery continuum of care" for unhoused people and those with behavioral health conditions.
Federal effect: Ige acknowledges that Trump administration policies restricting funding for for equity-based work could affect federal support for the plan, but says, CDPH "intends to deploy programs and resources to serve the needs of Chicagoans with a priority on the people and places most impacted by adverse health outcomes."
What's next: CDPH says it should have updated life expectancy numbers this spring.

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New paper sheds light on experience of Black prisoners in infamous Stateville prison malaria experiments
New paper sheds light on experience of Black prisoners in infamous Stateville prison malaria experiments

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New paper sheds light on experience of Black prisoners in infamous Stateville prison malaria experiments

Much has been said and written over the years about controversial malaria research conducted on inmates at Illinois' Stateville Penitentiary starting in the 1940s. But at least one part of that story has been largely ignored until now: the role of Black prisoners in that research, which helped lead to the modern practice of using genetic testing to understand how individual patients will react to certain medications, according to the authors of a newly published paper out of the University of Utah. 'We want to highlight the stories of Black prisoners that participated in this prison research in the 1950s onward and give them their due,' said Hannah Allen, a medical ethicist and assistant professor of philosophy at the University of Texas Rio Grande Valley, and first author of the paper, which was published as an opinion piece Wednesday in the Journal of the American Medical Association. 'They haven't been properly acknowledged in the past, and their participation in these studies was really foundational in launching the field of pharmacogenetics and, later on, precision medicine,' said Allen, who recently completed her doctorate at the University of Utah. Starting in the 1940s, researchers infected inmates at the Joliet-area prison with malaria to test the effectiveness of drugs to treat the illness as part of a U.S. military-funded effort to protect American troops overseas, according to the paper. A University of Chicago doctor was the principal investigator. The inmates consented to being part of the studies and were paid for their participation. At first, the research was greeted with enthusiasm. In 1945, Life magazine ran a spread about it, featuring a photo of a Stateville inmate with cups containing malaria-carrying mosquitoes pressed against his bare chest. The first line of the story reads, 'In three U.S. penitentiaries men who have been imprisoned as enemies of society are now helping science fight another enemy of society.' But as the years passed, attitudes began to shift. Questions arose about whether inmates could truly, freely consent to participate in medical experiments or whether they felt coerced into them because of their often dire circumstances. At the Nuremberg trials, defense attorneys for Nazi doctors introduced text and images from the Life article about Stateville prison, though an Illinois physician argued at the trials that the prisoners in Stateville consented to being part of medical research whereas Nazi prisoners did not, according to the JAMA paper. In the mid-1970s, news broke about a study at Tuskegee, in which Black men with syphilis went untreated for years — news that raised awareness of ethical problems in medical research. News outlets also began publishing more stories about prison research, according to the JAMA article. The Chicago Tribune published an article in 1973, in which an inmate participating in the Stateville malaria research said: 'I've been coerced into the project — for the money. Being here has nothing to do with 'doing good for mankind' … I didn't want to keep taking money from my family.' The experiments at Stateville came to a halt in the 1970s. A number of protections and regulations are now in place when it comes to research involving prisoners. Since the 1970s, the Stateville research has often been discussed and analyzed but little attention has been paid to its Black participants, said James Tabery, a medical ethicist and philosophy professor at the University of Utah who led the new research, which was funded by the federal National Institutes of Health. For a time, Black prisoners were excluded from the studies because of a myth that Black people were immune to malaria, Tabery said. Later on, once scientists had pinpointed the drug primaquine as an effective medication for malaria, they turned their attention to the question of why 5% to 10% of Black men experienced a violent reaction to the drug, according to the paper. Ultimately, the scientists were successful, finding that the adverse reaction was related to a specific genetic deficiency. 'There are people all over Chicago today that are getting tested, that clinicians are recommending they get a genetic test before they get prescribed a drug because they want to make sure that their patient isn't going to have an adverse reaction to the drug,' Tabery said. 'It's really sort of powerful and interesting that you can trace that approach to doing good clinical medicine right back to this particular moment and place and population.' 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History Shows the Danger of Trump's Health Policies
History Shows the Danger of Trump's Health Policies

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Scientists made decisions and worked together—no matter what country they came from—by focusing on disease and vaccination, not international tensions. The Soviet-initiated program was lead by Donald A. Henderson, a U.S. epidemiologist, who worked alongside the Russians until the last case of smallpox occurred in Somalia on October 26, 1977. During the 20th century, smallpox was responsible for an estimated 300 to 500 million deaths. Smallpox was officially declared eradicated by the WHO in October 1980, and is today still the only human disease to achieve this distinction. Less than a year after the declaration of smallpox eradication, the emergence of another pandemic, the HIV/AIDS crisis, reinforced the importance of science-first cooperation over politically-driven decision making. In June 1981, the first cases of a new unknown disease were reported in the CDC's Morbidity and Mortality Weekly Report. 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What to know about the new ‘Nimbus' COVID variant
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