Health Watch: Life Cut Short for City's Minorities

By: Natalie PardoRick Chappell was unusually tired when he took a shower that morning in the summer of 1983. "I felt miserable and listless. My throat was dry, my hands were clammy." His son took him to the VA Chicago Health Care System, at 333 E. Huron St. on Chicago’s near North Side. One more day, the doctors told Chappell, and he would have lapsed into a diabetic coma.

Chappell began taking time-release insulin, but the drug gave him headaches and the "sweats" if he didn’t eat every 41/2 hours. He lost 25 pounds within a month. After six months on the medication, Chappell started a new regimen: He cut down on sweets and starches, and loaded up on vegetables.

Today, the 60-year-old Chappell begins each day at 5:30 a.m. with a four-mile walk around his West Pullman neighborhood on Chicago’s far South Side. He maintains his 212-pound, 6-foot-5-inch physique through exercise, proper eating and herbal supplements.

"My lifestyle had to change," said Chappell, who counts four diabetics in his family. "It was do or die. I love the Lord, but I’m not in a hurry to meet him. The bottom line is do something."

Chicagoans are living longer and more are surviving serious illness, thanks to better eating habits, more exercise, and new and improved medicines. In 1997, the last year for which statistics are available, the city’s overall mortality rate reached its lowest level in 18 years, with 605 deaths per 100,000 people, according to data from the Chicago Department of Public Health.

But like so many other aspects of urban life, staying healthy in Chicago may depend on who you are and where you live, an analysis by The Chicago Reporter shows. The ultimate measure of health—life expectancy—reveals a city sharply divided by race, economic status and neighborhood.

While the average Chicagoan lives 71.5 years, the racial gap is enormous: White women live to be nearly 80; black men die at 60. The differences by neighborhood are equally startling. The mostly white, middle-class residents on the city’s Northwest Side can expect to live 75 to 80 years. For the mostly poor African Americans on the South Side, the life expectancy is around 60 years.

"It is clear in the world that health status disparities are greatest where the socio-economic inequalities are greatest," said Dr. Linda Rae Murray, medical director at the Woodlawn Adult Health Center, a Cook County clinic at 6337 S. Woodlawn Ave. "We’re not just talking about income. In our country it’s class and race. Middle-class blacks have the same rate of high blood pressure as poor whites."

In 1997, mortality rates for black males were nearly twice the citywide average and more than 2 1/2 times the rate for white Chicagoans.

Chappell describes himself as an anomaly: a black man who has taken charge of his own health.

Chappell sees the difference on Saturdays, when his six-mile walk takes him across Western Avenue, where whites are in-line skating, jogging and walking.

"In the white community, they are more conscious," he said. "You start to exercise and you start to feel better. It’s a passion. Black people don’t like to step out of our comfort zone."

Since his brush with death, Chappell has become a messenger of health. On Sunday mornings, he co-hosts a 30-minute call-in radio show on health with Soundrea Hickman, founder of the Association for Improving and Maintaining Black Health, a non-profit organization at 9320 S. Cottage Grove Ave. The program, on WBEE-AM, targets a black audience but gets few calls, he said.

"I became shocked that health was not part of the African American community," said Hickman, who started a healthy eating project in 1996 after four friends in their 40s died of cancer or heart disease.

"When I looked at the data in 1984, white and black health were on an equal plane," she said. "But as the years move on, white Americans became more concerned about eating healthy and exercising while black Americans didn’t. And a gap began that is moving farther apart."

Deadly Rates
Statistics back up Hickman’s observations. The gap between black and white mortality almost doubled between 1980 and 1997, the Reporter’s analysis shows. For white Chicagoans, death rates in 1997 stood at 468 per 100,000 people, down from 681 per 100,000 in 1980.

Latino rates have risen to the level of white mortality, reaching 463 per 100,000 in 1997. And while African American death rates have fallen, they remain alarmingly high: from 884 in 1980 to 858 in 1997. Black men died at a rate consistently above 1,100 per 100,000 over the 18-year period; the rate for black women is now near twice that of white women.

African Americans suffer the highest rates of mortality from a variety of serious illnesses, such as heart disease, cancer and AIDS. But they also are more likely to die of external causes, such as homicide, and from illnesses that can be controlled, such as asthma.

"Health status is more than just medical care, it’s not just the absence of disease," Murray said. "How is it possible to have a healthy community if you’re afraid to let your 16-year-old go to a Friday night dance because he might come back dead? How can you have a healthy community when you know the mortality rate for asthma is the third highest in the country?"

Five-year-old George Geangelo Hudson Jr. was one of asthma’s young victims. Born with the disease, "his chest would jump when he cried," said his mother, Edna Hudson, 36. "If I rubbed his head, his breathing would calm down. He was bonded to me."

But being asthmatic didn’t stop George. The family was trained by doctors and armed with inhalers, medicine and a nebulizer, a machine that dispenses asthma medication. George took "two puffs and kept on running," often jogging with his father, Hudson said.

He was a normal kid, and at 40 pounds, strong and energetic, his mother said. "But because he had asthma I was a watchdog over him. He would always put an inhaler in his pocket. He knew how to treat himself," she said.

On Nov. 25, George woke up wheezing, and Hudson decided not to send him to kindergarten at Ella Flagg Young Elementary School, at 1434 N. Parkside Ave. in Austin. By the afternoon, George’s breathing worsened. Hudson put him on the nebulizer and called 911 at about 3:30 p.m., she said.

Fifteen minutes later, Chicago firefighters arrived at the Hudson home at 1119 N. Massasoit Ave. on the West Side. Two paramedics entered. Before Hudson could say anything, she said the paramedics turned off the nebulizer and grabbed George, who began crying for his mother.

"Please don’t let them take me. If you do, I’m going to die," his mother said George called to her as the paramedics carried him out.

When Hudson got to the truck, George was laying flat on his back, and the paramedics were pounding on his chest, she said. "I know that he’s dead. … My baby is dead," she recalled saying. "The paramedics shouted, "We’re breathing for him," she said.

Doctors at West Suburban Hospital Medical Center in Oak Park were able to maintain George’s heartbeat and transferred him to Children’s Memorial Hospital in Lincoln Park on the city’s North Side, where he lay in a coma for four days. He was pronounced dead on Nov. 29.

"When they put George in the ambulance without me, George died," Hudson said. "That’s why his heart stopped because with an asthmatic, the thing is that you never upset them. They’re already scared. As young as he was, he was petrified to know that I’m not there."

On March 29, she and her husband filed a lawsuit against the city and the Chicago Fire Department, charging negligence in the death of their son. "Somebody’s got to give me some answers," said George Hudson Sr., 52.

"Some days are really hard," Edna Hudson said. "Sometimes I can’t cope because it’s too hard."

In 1980, 52 Chicagoans—32 blacks and 20 whites—died of asthma; by 1997, asthma deaths had climbed to 134: 87 blacks, 27 whites, 16 Latinos and four others.

"No one should ever die of asthma, but some still die," said Steven Whitman, director of epidemiology for the city health department. "Access to medical care is at issue."

"There’s medication out there to better manage your asthma, to identify your risk and be able to reduce it. It all boils down to education and access," said Caroline Jackson, a respiratory therapist and program director at the Community Asthma Project at Bethany Hospital, 3435 W. Van Buren St. in East Garfield Park.

Vertical Disease
Coping with stress, or failing to, creates myriad health problems for African American women, whose mortality rates are rising for such illnesses as breast cancer, lung cancer and stroke.

Disease prevention is "such a hard sell," said Hickman, who is black. "We assume that my hair is done, my makeup is done, my outfit matches my shoes, I got up this morning, I walked out the door, therefore I’m healthy.

"I call that vertical disease," she said. "We don’t understand that our lifestyle causes us to be disease in motion. We just don’t have a heart attack. That heart attack has been cooking inside the body for years."

That’s what doctors told Vertis Burns-Sims, a 300-pound diabetic. On several occasions last year, intense chest pains sent the 40-year-old African American woman to the hospital, and she began taking nitroglycerin pills.

The South Shore resident ate a lot of sugar and fatty foods. "I just ate until I got tired, and that was a lot of food," she said. "Sometimes if I’m very upset, I stuff myself to numb the pain."

But after hearing Hickman speak at a health seminar about a year ago, Burns-Sims got serious. Now she takes an aspirin daily to guard against a heart attack and stroke, and keeps lots of fruits and vegetables at home. "I haven’t lost a lot of weight, but I feel 100 percent better. I can think better and focus better," said Burns-Sims, adding she has lost 15 pounds.

Three times a week, she walks about 11/2 miles, but rarely sees other women power walking. "This is not the best neighborhood to walk in."

One-on-one counseling sessions with Hickman, she said, helped her realize that "I can’t sit around and wait for other people to spoon-feed me or to tell me this-that-and-the-other. I have to be proactive about my health and my life."

Susan Denise Lee certainly isn’t waiting around. In 1990, when she was 35, Lee learned she had high blood pressure. Five family members suffer from the disease, but Lee was surprised because she "didn’t feel it.

"Black people don’t listen," she said. "Some black people feel that if you don’t acknowledge it, then they don’t have to deal with it."

She immediately went on medication, started exercising and changed her eating habits. "I didn’t want to drop dead or have a stroke," she said recently, while riding a stationary bike at the Hyde Park Women’s Workout World, 5201 S. Harper Ave.

After a long day working as a secretary at the Cook County Public Defender’s Office, she puts in a two-hour workout on the treadmill, stationary bike and weight training—four times a week, she said.

Since June, her weight has dropped from 197 to 166 pounds, she said, and last October, the 44-year-old Hyde Parker walked the 26.2-mile Chicago Marathon in about seven hours.

Iris Gettings, a manager and partner at the club, said many of her mainly black clientele are getting their first real physical activity in years.

"Scare tactics don’t work. Image is still important. But [a woman] cares less about getting into that dress and more about ‘I want to feel better,’" she said.

"Black women don’t necessarily feel that you have to be thin to be attractive," added Jacqueline Walcott-McQuigg, research director of the University of Illinois at Chicago’s National Center of Excellence in Women’s Health, a research and advocacy group.

"They tend to accept the larger body weight than what’s recommended by the health charts. In our culture, African American men don’t have the same kinds of concerns about dating women who might be a little bit heavier than Caucasian men do."

Women’s Workout World offers fitness seminars with breast cancer awareness sessions and diabetes screenings. But the emphasis is on exercise and its direct connection to better health.

"Sometimes exercise feels like work," said Alice J. Dan, director of the National Center. "We must shift the perception: that exercise makes you feel better."

Erasing Fears
"Be encouraged and praise him," said the Rev. Jeremiah Wright Jr., senior pastor of Trinity United Church of Christ, 400 W. 95th St, during Palm Sunday services last month. "When the praises go up, the blessings come down."

No one understands this better than two worshippers sitting in the second row—Lucille Graham and Louise Monegain. Both are breast cancer survivors.

"It’s God, it’s you and your doctor," Monegain said. "It’s a partnership. … I have complete faith in God."

They are members of the Can-Cer-Vive Ministry, a church support group established in 1994 for cancer patients and their caregivers to educate the community about early detection and prevention of cancer.

Monegain, a 57-year-old retiree who lives in the South Deering neighborhood, was diagnosed in 1994 during a routine medical examination.

Graham discovered lumps in her breast in 1983. She had 55 lymph nodes, and 45 were cancerous. The doctor gave her six to eight months to live, she said. Sixteen years later, the 62-year-old artist and church elder is managing the group’s support hot line from her Washington Heights home.

"I follow them all the way. I’m very upbeat, but as soon as I hang up the phone, I cry," she said. Graham must use a walker to get down the church aisle, underwent triple bypass surgery, and lost her teeth to chemotherapy. "You’d need two whole pages to tell all my health problems," she laughed.

Dr. Rhonda Y. Gans, a family practitioner at Rush Homan Square Health Center, 3333 W. Arthington St., said when it comes to breast cancer, "there’s a taboo about examining ourselves, touching ourselves. That’s nasty, icky.

"A lot of black women do a lot and have no time to read McCall’s and Woman’s Day [magazines] that says to do breast exams."

Graham agrees, and laments that her support group’s monthly meetings never draw more than 25 of the church’s 10,000 members. "People are very secretive and reluctant to talk about it," she said. "Denial is hereditary."

Health Advocates
The pages inside the bright blue folders are labeled "Depresión Y Ansiedad," "Cancer del Seno," "Diabetes Y Asma," "Prevención del VIH/SIDA"—all major health issues for Mexican-Americans in Little Village on Chicago’s Southwest Side. Eleven residents came to Health Advocacy Project at Little Village, 3047 W. Cermak Road, to attend the second session of a 13-week program to become health advocates.

Training neighbors to help neighbors is the key to health education for Latinos, said Francisco Ramos, executive director of the center, which takes a holistic approach to health by addressing a broad range of medical and other issues, including child care and nutrition.

HIV/AIDS is a major priority. "We have a migration where men come [to the U.S.] first," Ramos said. "While they are here alone, they have [sexual relations] with others. It may be years before the family comes here, and by that time the men have another family. This is high-risk behavior for AIDS.

"In the Latino community, religion, education and health—the mother takes care of that. So the male tends to not be connected to the health system. It’s only when it hurts so bad that he says ‘I have to go to the emergency room.’"

The health workers deliver information door to door to new immigrants who "don’t know how to speak English and where to go for the doctor," said Juana Gonzalez, a center coordinator. The program recruits health advocates by posting fliers in churches and making phone calls.

Eleven women attended a March 26 session on depression and anxiety, conducted in Spanish by Dr. Rogelio Rodriguez, a clinical psychologist at the VA Chicago Health Care System, at 820 S. Damen Ave. The women will then canvass the neighborhood and assess the needs of the families they meet.

But while Latino death rates are rising for maladies such as cancer, stroke and cardiovascular diseases, many people believe they will jeopardize their immigrant status if they go to the doctor. "We have an invisible population," Ramos said. "There’s a psychological fear: You access public services and [immigration officials] are going to get you."

Taking Charge
Before seeking public office in the early-1970s, U.S. Rep. Danny K. Davis (D-Chicago) was executive director of the non-profit

West Side Health Planning Organization. "If people are unhealthy, they don’t fulfill their purpose for being," Davis said. "If they are not healthy, they can’t fulfill their social roles.

"Education, education, education is the key," said Davis, whose 1977 doctoral dissertation at The Union Institute in Cincinnati focused on the health care needs of black Chicago.

Today, he represents the 7th Congressional District, which stretches from Lake Michigan to west suburban Bellwood, and houses four major medical teaching centers: Rush-Presbyterian-St.Luke’s Medical Center, the University of Illinois at Chicago, Northwestern Memorial Hospital and Loyola University Medical Center.

"And yet these disparities exist because we can’t always get the resources to the people who need them," Davis said. "People live at the poverty level—almost—but don’t qualify for Medicaid or Medicare. So these are the people who fall between the cracks." About 175,000 in Davis’ district live at or below the poverty level, he said.

Poor people without health insurance don’t go to the doctor because they "don’t have the resources to [use] the health care delivery system," added Aida Giachello, director of the Midwest Latino Health Research, Training and Policy Center at the University of Illinois at Chicago.

But some in Congress do not believe more public money should go to health care, said Davis, who campaigned to persuade Congress to add $100 million to the fiscal 1999 federal budget community health centers nationwide. "Not everybody in the city believes they need more clinics. What we have to do is activate people with needs to become engaged. And demonstrate what those needs are."

The government is committed to eliminating racial disparities in health care, said Hannah Rosenthal, regional director of Region V [the Midwest] for the U.S. Department of Health and Human Services. As a result of President Bill Clinton’s Initiative on Race, all federally funded medical research projects must now include data on all ethnic and racial groups, Rosenthal said.

And government health goals must be uniform, even if that means spending more money to help certain racial groups catch up, she said.

"We can no longer let certain pockets in our city of Chicago or in any place experience lower immunization rates, higher rates of cancer, higher rates of death from cancer, diabetes, etc," she said. "We have to say that disparity is unacceptable."

African Americans are reluctant to participate in medical projects, said Eva Smith, an associate professor at the College of Nursing at the University of Illinois at Chicago who is researching breast cancer in the African American community.

Collecting accurate data is crucial to taking the pulse of a community’s health, said Whitman of the city health department.

Whitman’s 20-member staff produces reports for city agencies, hospitals and community groups. "Medical centers look at who walks in their doors," Whitman said. "We help them understand what’s going on in their community."

Health advocates say there’s more to health than doctors and medicine. "It takes nurturing the whole person," said Jacqueline Reed, executive director of the Westside Health Authority, 5437 W. Division St. "It is understanding the socio-economic needs of human beings and that we are more than just scientific matter."

That means more treatment for people with high blood pressure and child immunization, said Murray of the Woodlawn health center. "But it also means having decent schools where our children feel like they have a future, and it means having recreation areas for families."

The government will never reach its goals unless it attacks social injustice, Murray said. "Racism," she said, "has an impact on our inner sense of health."

Change in mortality rates will only come when residents and health providers collaborate, said Margie Schaps, executive director of Health and Medicine Policy Research Group, a non-profit policy center that advocates for the underserved.

"We have to say ‘OK, we’re focusing resources and it’s not working, let’s take another look and evaluate the way we have put our resources into minority communities,’" Schaps said. "Too often, we sit in offices and try to figure that out without asking the people who are affected."

For more information on mortality rates and the health of minorities, visit the following Web sites:

The Chicago Department of Public Health

The Centers for Disease Control and Prevention's National Center of Health Statistics.

National mortality data from the National Vital Statistics System.

The Chicago Health Policy Council.

Health and demographic data from the Center for Health Administration Studies at the University of Chicago.

The University of Illinois' Multicultual Health Clearinghouse and listing of health organizations.

The Illinois Department of Public Health and Illinois vital statistics.

The Illinois Department of Public Health Project for Local Assessment of Needs.

Chicago Public Library's health and medicine listings.

Digital City Chicago Community Health Statistics

The Minority Health Network.

The Healthweb subject list of medical topics.

Michigan State University's minority health resources.

U.S. Department of Health and Human Service's Office of Minority Health Resource Center.

American Public Health Association's public health resources.

The Chicago Asthma Consortium and the Chicago Asthma Surveillance Initiative.

The Midwest Latino Health, Research, Training, and Policy Center.

Contributing: Danielle Gordon, who also helped research and analyze health department data. Rebecca Anderson, Dwayne Ervin, Pamela A. Lewis, Kareem R. Muhammad, Christine Starr and Stephen J. Stanis helped research this article.