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‘Urban Health’ documents data collection – and action in numerous communities

Studies about why people in some neighborhoods are healthier than residents of other neighborhoods are nothing unusual. What's more unusual is application of those studies to solving those problems on the ground—and any analysis of how that research can be extrapolated to improve health in all neighborhoods.

Photo: Elias Carmona

'Urban Health' provides detailed accounts of six projects that resulted from the Sinai Urban Health Institute study, launched in 2001.

“Lots of people study disparities, write articles, get promoted, and then just to go on to the next topic. We didn’t want to be like that,” says Steven Whitman, founder and director of the Sinai Urban Health Institute at Sinai Health System, which includes Mount Sinai Hospital and Schwab Rehabilitation Hospital. SUHI launched such a study a decade ago in six of Chicago’s 77 communities. “We wanted to fix things, not just report on bad conditions.”

That study and its aftermath have been fleshed out into a book, “Urban Health: Combating Disparities With Local Data” (Oxford University Press, 2010), co-edited by Whitman, Ami M. Shah and Maureen R. Benjamins. It documents how SUHI and its partners have applied their data in Norwood Park, Humboldt Park, West Town, North Lawndale, Little Village and Roseland—and inspired others throughout Chicago to do the same.

Unveiled during a book signing ceremony on Jan. 20 at the Humboldt Park Diabetes Empowerment Center, 2753 W Division St.—itself a major outgrowth of SUHI’s work—“Urban Health” was inspired partly because journal articles don’t allow for the space to tell the full range of stories, and because journal editors aren’t interested in certain story angles.

Photo: Elias Carmona

Juana Ballesteros, executive director of the Greater Humboldt Park Community of Wellness, has been among those putting the research of Sinai Urban Health Institute into action.

Whitman says that was notably true of the importance SUHI placed on working closely with community activists to document their own neighborhood conditions. “The journals were not interested. It was not appropriate [subject matter],” he says. “We thought it was one of the most important things we did.”

And looking forward, “We want to repeat the survey 10 years later,” Whitman says. “We thought putting a lot of this is in one place would be an attractive document for funders interested in supporting us.”

“Urban Health” is divided into four sections: background and history, data gathering in the six communities SUHI chose and four others where community groups picked up the ball and ran with it, descriptions of six projects undertaken as a result of the data, and what it all portends for the future.

Illustrating What is Possible
The six projects described have combated smoking in North Lawndale, childhood obesity in Humboldt Park and West Rogers Park, diabetes in the Puerto Rican community, and asthma in both Humboldt Park and in black and Latino communities more generally.

Photo: Elias Carmona

Several dozen people attended a book signing for 'Urban Health' on Jan. 20 at the Greater Humboldt Park Diabetes Empowerment Center, which the research efforts chronicled in 'Urban Health' helped to make possible.

“It contains six case studies about how SUHI, the city and its communities were able to move from the data to programs of improvement,” Whitman says. “That’s the meat of the book. … It’s an illustration of what is possible.”

To help engage people in improving their health, SUHI has taken a relentlessly local approach in the six communities, Whitman says. “It’s one thing to say, ‘20 percent of adults smoke,’ ” he says. “It’s another thing to say, ’20 percent of adults in your community smoke.’ ”

The Humboldt Park Diabetes Task Force that resulted in that community spent six months putting together a plan that has led to two National Institutes of Health grants and the construction of the Diabetes Empowerment Center, which provides treatment, information and classes.

The center also serves as a hub for Block-by-Block intensive anti-diabetes efforts that have arisen, first in Humboldt Park and more recently in North Lawndale, which began with a journal article on the SUHI diabetes findings, Whitman says.

Photo: Elias Carmona

Jose Lopez, executive director of the Puerto Rican Cultural Center, listens to one of the speakers during the event.

Since receiving the NIH money, caseworkers have literally gone door-to-door searching for people who have or are at-risk of developing diabetes, and tried to get them into treatment or preventative measures.

“We said we didn’t want to just bring more bad news to the communities,” he says. “We wanted to plan to do something. We didn’t want to write a paper or have a press conference and say, ‘Bad news.’ ”

“We’re excited to be able to do two projects, with the same concepts, in different communities,” Whitman adds, referring to the block-by-block data gathering efforts. “It will yield fascinating results.”

Whitman also finds it exciting that groups not directly affiliated with SUHI have used its data to gain their own grants. “Many projects have gotten money with data from the survey,” he says. “That’s not a complaint. That’s a proud statement that people have recognized the richness of the data.”

Photo: Elias Carmona

Jaime Delgado of SUHI and Daisy Rodriguez of Norweigan American Hospital share hellos and ideas during the book signing event.

Among other communities that have done similar work, inspired by SUHI’s approach, are Chinatown, the Vietnamese community in Uptown, Cambodians in Albany Park, the Indian-Pakistani community along Devon Avenue, and the Jewish community in West Rogers Park.

“There’s a lot of balls in the air, and a lot of exciting things going on,” Whitman says. “All of these efforts are being led by the community. It’s not like the hospital is coming in and saying, ‘Will you sign on the dotted line?’ … It’s ideal that the community brings in the professionals, not the other way around.”

What Can We Learn?
The findings of SUHI and other groups also have raised new questions that merit further study, Whitman says. For example, the smoking-related piece found that 40 percent of adults in North Lawndale are regular smokers, levels not seen in the U.S. as a whole in 35 years, yet in Little Village, a/k/a South Lawndale, only 15 percent of adults smoke regularly.

“Why do two adjacent communities have such totally different [results]?” Whitman says. “We hope we’ll be able to show people the findings and put programs in place. Why do some groups get screened a lot for cancer and other groups hardly at all? We’re trying to understand what the differences are, how they work, and what we can do to make things better.”

Photo: Elias Carmona

Community members joined agency staff and public officials at the book signing.

As SUHI and its partners move forward with further studies and on-the-ground efforts, Whitman says they will continue to seek broad community input. “The notion of collectivity is an important one for us,” he says. “We are fully aware of all the huge contributions made by all the people involved in these efforts.”

Among those contributions are restaurants that have changed their menus to include diabetes-friendly offerings. Whitman mentions cafes near his house, along the Paseo Boricua on Division Street, which have added salads, and fresh fruits and vegetables—places where he’s observed high school students eating chips and Coke for breakfast. He also picks up signs of change in conversations he overhears.

“It’s common for people to comment on unhealthy eating,” Whitman says. “These are the tiniest of signs that consciousness is changing. The key is the behavioral change. They can become active participants in shaping their own health.”

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