The Death Gap: How Inequality Kills

 

David Ansell, an MD writes about the important role that inequality plays in health and life expectancy.  His book analyzes Chicago as a case study.  From U of Chicago press,

We hear plenty about the widening income gap between the rich and the poor in America and about the expanding distance separating the haves and the have-nots. But when detailing the many things that the poor have not, we often overlook the most critical—their health. The poor die sooner. Blacks die sooner. And poor urban blacks die sooner than almost all other Americans. In nearly four decades as a doctor at hospitals serving some of the poorest communities in Chicago, David A. Ansell, MD,  has witnessed firsthand the lives behind these devastating statistics. In The Death Gap, he gives a grim survey of these realities, drawn from observations and stories of his patients.

While the contrasts and disparities among Chicago’s communities are particularly stark, the death gap is truly a nationwide epidemic—as Ansell shows, there is a thirty-five-year difference in life expectancy between the healthiest and wealthiest and the poorest and sickest American neighborhoods. If you are poor, where you live in America can dictate when you die. It doesn’t need to be this way; such divisions are not inevitable. Ansell calls out the social and cultural arguments that have been raised as ways of explaining or excusing these gaps, and he lays bare the structural violence—the racism, economic exploitation, and discrimination—that is really to blame. Inequality is a disease, Ansell argues, and we need to treat and eradicate it as we would any major illness. To do so, he outlines a vision that will provide the foundation for a healthier nation—for all.

As the COVID-19 mortality rates in underserved communities proved, inequality is all around us, and often the distance between high and low life expectancy can be a matter of just a few blocks. Updated with a new foreword by Chicago mayor Lori Lightfoot and an afterword by Ansell, The Death Gap speaks to the urgency to face this national health crisis head-on.

Here is Dr. Ansell's 2018 Ted Talk in Chicago:

ABC7 news highlighted the research in this Nov. 20, 2019 segment:

The difference between living downtown compared to some neighborhoods on the South and West Sides can be up to 30 years, according to recent analysis done at New York University School of Medicine. That's the largest gap in the country. 

The City Health Dashboard and the CIA World Factbook reveal Streeterville's life expectancy of 90 is slightly higher than Monaco, the highest for any country in the world. Nine miles south, Englewood's 60-year life expectancy matches the Republic of the Congo, a third world country.

How did we get to this point?

Dr. David Ansell is the Senior Vice President of Community Health Equality at Rush University Medical Center and part of West Side United. He has spent decades taking care of patients at three different hospitals along Ogden Avenue and studying the life expectancy gap in Chicago.

Here is a Q and A with Dr. Ansell published by the AAMC.

Here is a book talk with Dr. Ansell at UVA Medical Center.

Here is an interactive map from the Robert Wood Johnson Foundation.  And here is the 2023 data for Loyola Lakeshore Campus:

The Chicago Health Atlas provides interactive about various measures of wellness by community area.

A similar analysis in the New Left Review by Marco D'Eramo also highlights the gap: