Through a new collaboration, the RUSH BMO Institute for Health Equity is hoping to dramatically reduce the life expectancy gap for West Side residents driven by cardiovascular disease.
Cardiovascular disease is the leading cause of death both nationally and in Chicago. The impact is disproportionately felt on the city’s West Side, where a range of risk factors, including social determinants of heath, are contributing to stark racial disparities in disease death rates.
Life expectancy is now as high as 84 years in parts of Chicago’s Loop but only 66 in East Garfield Park on the West Side. Poverty, chronic stress and current and historical disparities in access to food, neighborhood safety and educational achievement all contribute to this gap.
Through a new collaboration RUSH, with support from Novartis, is aiming to bridge the life expectancy gap in heart and vascular health. Our clinical, team-based outreach approach is designed to overcome social barriers and access to care by the year 2030. The approach is called E3:
Engage: RUSH will engage with its highest-risk cardiovascular patients in West Side communities with a three-pronged, remote monitoring program that targets hypertension, diabetes and elevated cholesterol. Qualifying RUSH patients will be enrolled by their provider into an E3 team, composed of both clinicians and social workers, aimed at overcoming each patient’s individual challenges. Particular attention will be paid to access, adherence, environmental stressors and social resources. By assessing social needs, screening and engaging with patients remotely, RUSH is making care more accessible and more personalized.
Empower: RUSH will offer a program to reduce heart and vascular risk factors that patients can engage with at home. Developed with community and cultural input, the program will be delivered by West Side residents in collaboration with RUSH experts. E3 teams will be made up of a registered nurse, a pharmacist, a social worker and a group of RUSH community health workers. Together, teams will monitor high-risk patients, provide medications and help patients understand how other factors, such as mental health and access to healthy food and other resources, affect their heart and vascular health. Additionally, most of the health workers are community residents themselves and draw from their lived experience to help build trust with patients who may be skeptical of health care.
Evaluate: By leveraging telehealth technology, RUSH will use a remote, cellular home-based monitoring system to help monitor patients’ progress. The approach moves the setting from a clinic- and doctor-centric treatment plan to one that is based in a participant’s home. This allows patients to provide accurate home-based readings without the need of a tablet or complicated phone application, and to avoid the potential barrier of transportation access.
“We want to make sure that everyone at risk of developing cardiovascular disease on Chicago’s West Side is able to get the care they need, regardless of their race, socioeconomic status, gender or neighborhood,” said David Ansell, senior vice president of Community Health Equity at RUSH.
“The E3 initiative allows us to tailor our approach to the specific needs of Chicago’s West Side, while addressing the root causes of the racial life expectancy gap and increasing community and provider engagement. We believe that in order to achieve health equity in CVD, we need a community-focused approach. If successful, we hope this intervention can be disseminated across other Chicago health care providers and communities."