Ann & Robert H. Lurie Children’s Hospital of Chicago conducted a community health needs assessment (CHNA) in 2019 to better understand the health of children and adolescents in Chicago, and to guide Lurie Children’s continuing efforts to improve the health and well-being of youth, consistent with our longstanding mission.
The overarching goal of our community health strategy is to improve the health and well-being of children and adolescents and advance health equity for youth and their families – consideration of family context is a cross-cutting emphasis in our assessment and implementation strategy.
To maximize the potential for hospitals in Chicago and Cook County to work together on shared priorities, Lurie Children’s participated in the development of the Alliance for Health Equity’s Collaborative CHNA. This effort, led by the Illinois Public Health Institute, involved 37 hospitals, six local health departments, and nearly 100 community-based organizations. Lurie Children’s extracted key findings from the Collaborative CHNA specifically related to children and adolescents age 0-19 years in Chicago for our CHNA. Lurie Children’s supplemented this by conducting, reviewing and analyzing additional primary and secondary data for Chicago youth.
Lurie Children’s CHNA combined the Collaborative CHNA, public health data, community input, existing research, existing plans, and other existing assessments to document the health status of communities within Chicago and to highlight health inequities and disparities that are negatively impacting child and adolescent health. The CHNA also provided insight into community-based assets and resources that should be supported and leveraged during the implementation of health improvement strategies.
Significant health inequities persist in Chicago for youth and affect all priority health areas. The most pervasive health inequities in Chicago are related to race.
Social determinants of health, including poverty, education, employment, housing/homelessness and food insecurity substantially contribute to the health status of youth in Chicago, and disproportionally affect youth in neighborhoods with low/very low opportunity.
In Chicago, infant mortality rates per 1,000 births ranged from 3.4 for whites to 12.7 for blacks/African Americans.
Because of state policy advances in the Medicaid program, only 4 percent of youth in Chicago are uninsured. This progress is significant, but challenges related to access to care, including proximity and quality remain.
The prevalence and exacerbation of chronic health conditions, including asthma, complex chronic conditions and obesity, are highly affected by social determinants of health.
Approximately 15-20 percent of youth have a serious mental or behavioral health condition and as many as 50 percent do not receive the mental health care they need. There has been progress in the recognition of the longstanding effects of trauma and childhood adversity on long-term health. Recent policy changes in Illinois are helping to move towards more integrated physical and behavioral health services. However, mental and behavioral health services are the top concern for many individuals in low/very low opportunity neighborhoods, driven largely by quality concerns, inadequate reimbursement, stigma and workforce shortages.
Unintentional injuries are the leading cause of death and a major cause of emergency department visits among children and adolescents, and infants and adolescents are the age groups with the highest unintentional injury death rates.
Although violence occurs in all communities, it disproportionately affects low-income communities of color and especially black/African American boys and young men. In 2017, young black males were 13.7 times more likely to die from a firearm-related homicide than non-black males in Chicago.
Significant interconnectedness exists between all the above highlighted key findings. Implementation strategies that reach “upstream” to focus on prevention and underlying causes of health outcomes should be prioritized.
Community health priorities
Through a collaborative assessment process, we identified the following community health priorities:
Addressing social and structural determinants or influencers of health and improving access to care and community resources
Addressing risk factors, prevention, and management of chronic health conditions
Improving mental and behavioral health
Preventing unintentional and violence-related injuries and mortality