Residents on the South Side of Chicago have a life expectancy that is 30 years shorter than that of North Side residents, according to a study by NYU Langone Health. Factors such as socioeconomic status, access to healthcare and racial segregation have created and further exacerbated health disparities there. It’s a stunning health equity gap, but Chicago is far from the only place grappling with this sort of crisis. Large metropolitan areas, small industrial cities, rural America, commuter suburbs and college towns are all facing similar imbalances.
Given that every factor is interconnected with another, finding ways to improve health by meeting the unique needs of individual communities can feel like an overwhelming endeavor, especially when institutions attempt to do so on their own. When nonprofits, government agencies and other groups work separately, efforts are uncoordinated and often ineffective. But two healthcare organizations are finding that when they collaborate with community entities, they can create innovative, widespread and long-lasting solutions to pervasive population and community health problems.
Advocate Trinity Hospital Chicago
Part of Illinois’ Advocate Health Care system, Advocate Trinity Hospital has been providing care to residents in southeast Chicago for over 120 years. Advocate Trinity treats more than 90,000 patients annually, offering access to 300 physicians across 50 specialties, including advanced heart attack care, primary stroke care and oncology. Many of the hospital’s Medicare patients are from areas with high deprivation levels. In fact, in Advocate Trinity’s primary service area, the percentage of families living below the federal poverty level is 22.85%, which is higher than both Illinois (10.79%) and Cook County (13.83%) percentages. The percentage of families living below the FPL in Advocate Trinity’s secondary service area is 31.84%, nearly three times the state percentage.
Although Advocate Trinity has been recognized as one of the best regional hospitals, the glaring life expectancy imbalance in Chicago—rooted in the hospital’s own service area—has fueled leaders to take a much broader, yet targeted, approach to closing that gap. “We have the data to show that the status quo isn’t working, and that data alone would be enough to drive many hospitals to leave a market like ours,” says Michelle Y. Blakely, PhD, FACHE, president, Advocate Trinity Hospital, who was born and raised on Chicago’s South Side. “But we said ‘no’. We are doubling down and disrupting the idea that closing the gap is too difficult.”
Using $300 million of a total $1 billion commitment, Advocate plans to replace the aging Trinity hospital with a new 23-acre, state-of-the-art facility. Advocate Health Care leaders say they hope to break ground on the new 52-bed hospital by the end of 2025 and open by 2029. Equally as important, however, is that the remaining $725 million of this unprecedented investment will fund Advocate’s ultimate goal: improving wellness for South Side Chicago residents.
“The new hospital is a significant part of this project,” says Dia Nichols, FACHE, president, Advocate Health Care. “But it’s about so much more. We are committed to expanding health and wellness on the South Side of Chicago with the help and input of community partners. Engaging them is the best way to shift the paradigm when it comes to improving the health of a community.”
Advocate aims to help change the trajectory of healthcare delivery in its community by focusing on the following tactics.
Getting community input. To ensure that the new wellness project would effectively meet the community’s needs, the hospital first held dozens of listening sessions at local churches, civic centers and libraries. Hundreds of residents—including clergy, political allies and community leaders—participated in these meetings.
“We asked people about how they access care and how we could improve that access,” says Blakely. “We wanted the community to help us design a model that fits their lives and could serve them well.” These conversations and the themes that emerged from them became the basis for Advocate’s new, ambulatory-forward outpatient care model.
Growing the outpatient footprint. On Chicago’s South Side, 84% of residents who are hospitalized have two or more chronic conditions, according to Advocate Health Care. Furthermore, the rate of diabetes-related deaths is four times higher for South Side residents than it is on Chicago’s North Side. Thus, preventive care and wellness are serious targets. To address the enormous task of improving health, Advocate is creating 10 neighborhood care sites over the next three years to expand access to primary and specialty care, diagnostics and chronic disease management support.
The input gathered at the community listening sessions spurred leadership to place these clinical access points where people naturally gravitate, such as churches and community centers. The clinics are being staffed by certified Advocate medical assistants who use leading-edge telemedicine to evaluate adult patients and children aged 2 years and older. Patients then receive on-site care for minor illnesses like flu and strep throat or, when appropriate, referral to an urgent care facility or hospital for more emergent or higher-level care needs. Ultimately, these local clinics will offer convenient hours daily and also act as bridges to social services.
“The success of these clinics depends on collaboration with community organizations,” says Blakely. “By sharing the data about health in our community and hosting the listening sessions, we were able to fully engage local organizations that are eager to help facilitate touchpoints and introduce our services to residents.”
Expanding food pharmacies. Limited access to affordable and healthy food options impacts food security and can lead to an increase in diabetes, high blood pressure and other chronic conditions. Unfortunately, many South Side neighborhoods are known as “food deserts,” which means that at least 33% of the population lives more than half a mile from a supermarket or large grocery store.
Addressing the challenges of nutrition is one way Advocate “gets upstream and catches people before they become patients,” says Nichols. To that end, Advocate providers can write prescriptions for food that residents take to a local food pharmacy that is operated by Advocate, with support from organizations like the Greater Food Depository. Twice per month, the food pharmacy dispenses nutritious foods and pantry staples and provides recipes for healthy preparation.
What makes this program unique is that Advocate sources some of its pharmacy food from a 60-acre farm in northern Illinois that is aligned with Advocate Health Care. “The hospital’s medical staff collaborates with farmers to decide what to plant so that the output reflects evidence-based nutritional guidelines,” says Nichols. “Through this program, we come full circle within our system where the food we grow is the medicine we provide.”
Developing the workforce. Along with the new hospital site and community wellness programs, Advocate will spend $25 million on workforce development as Advocate Health Care seeks to hire more than 1,000 new employees to support the new South Side care model in the coming years. By creating jobs and stimulating economic growth, Advocate hopes that this community investment will serve as a catalyst for further investment and revitalization in the area.
Knowing that it will take time to feel the impact of the program, Blakely and Nichols believe that frequent communication with residents at every step and incorporating that feedback into operational plans can go a long way toward engaging the community in its own health while also earning trust.
“We are confronting the enormous challenge of improving the health and wellness of the South Side in an area that has been hurting for generations,” says Nichols. “It’s humbling as a leader to be in a position where we can move the needle and create community health in partnership with the very people we serve.”
Good Samaritan Hospital San Jose, Calif.
Like the rest of the Bay Area, San Jose suffers from a severe shortage of affordable housing, escalating rents and a high cost of living. This makes it challenging for low-income people and families to find stable, secure housing.
To help address this, Good Samaritan Hospital—a 474-bed facility in San Jose serving Silicon Valley since 1965—has pledged $1 million to the city’s emergency interim housing project for people living unsheltered along the Guadalupe River. The project broke ground early this year. The donation is part of a larger $3 million contribution from HCA Healthcare, Good Samaritan’s parent company, to address San Jose’s affordable housing needs.
Housing as a Social Determinant of Health
Joining efforts to address the area’s increasing homeless population was a natural fit for Good Samaritan Hospital. A 2025 study by Johns Hopkins Bloomberg School of Public Health confirms the belief that poorer housing conditions are associated with negative physical and mental health outcomes, highlighting the impact of housing quality on population health. Given the connection between housing and health, Good Samaritan CEO Patrick Rohan, FACHE, believes the hospital has an important role to play in addressing San Jose’s affordable housing crisis.
“Part of a healthcare leader’s job is to recognize that we can improve the lives of the communities we serve outside of the four walls of our hospitals,” he says. “To change the landscape, we must take a holistic view of what it means to care for our patients and recognize that treatment extends beyond surgical procedures or medications.”
Long-Term Solutions Through Interim Housing
Good Samaritan’s $1 million contribution is helping fund a new supportive housing community known as The Cherry Avenue Project. Able to house up to 136 people, the project aims to help San Jose achieve its goal to nearly triple its shelter capacity over the next 18 months. Serving the immediate vicinity of the hospital, the project is set up to provide safe, temporary housing for those transitioning out of homelessness. This means that Cherry Avenue is about much more than housing. “It’s a connectivity point for resources that can break unhealthy cycles,” says Rohan. “Although the project addresses the community’s immediate needs, it also sets people up with long-term solutions.”
Underlying Cherry Avenue is the belief that its residents deserve a safe and dignified space. While other partners involved in the project will tackle issues like job training and support services, Good Samaritan is connecting its behavioral health team with intake specialists at Cherry Avenue. The hope is that forging these connections will bring preventive mental healthcare to those who need it and, thus, prevent an escalation of care to inpatient or more acute service settings. Ultimately, the goal is to ensure that no one falls through the cracks, and then to bridge the gap between homelessness and the mental health issues that might lead to it.
Coordinating Multiple Stakeholders
The Cherry Avenue project differs from other interim housing initiatives because of its collaborative approach with local and state government, nonprofit providers and philanthropists. For example, the San Jose City Council acknowledged the urgency of the city’s housing crisis by unanimously authorizing broad powers—which is consistent with the ordinances the city has been operating under for the past several years—to facilitate rapid development, such as suspending land use and zoning requirements and maximizing legal and administrative flexibility.
Between private philanthropic contributions and fee discounts, the city will be able to save $2.4 million in costs for the project. The area’s water resource management agency, Valley Water, hopes to create a protection zone to safeguard the Guadalupe River waterway, where many homeless residents have created encampments. The agency also aims to help people living in those encampments find other shelter during construction at Cherry Avenue and will give them first priority for living at the new site.
“It’s critically important to collaborate and coordinate strategically among the multiple stakeholders working on Cherry Avenue,” says Rohan. “For the project to be built and implemented effectively, priorities and logistics have to be aligned.”
As with Advocate Trinity’s wellness project, Rohan knows that there are no short-term fixes to the complex social issues that impact health and health equity. Sustainability in this space is critical.
“We aren’t just handing over a check and walking away,” he says. “Continued engagement will help us understand if our approach is working. If it is, we replicate it. If it isn’t, we pivot and keep searching for a better solution.”
Ellen Lanser May is a freelance writer based in Naperville, Illinois.
Strategies for Engaging and Integrating Community Perspectives
A 2021 brief from the Center for Health Care Strategies Inc. emphasizes the importance of integrating the perspectives of community members when it comes to designing and implementing new programs. The authors recommend that healthcare organizations use the following strategies to elicit and incorporate input from community members:
Collective Impact: This structured form of collaboration aims to help organizers gain commitment from individuals in different sectors by coalescing around a common agenda to solve a specific social problem.
Community-Based Participatory Research: By involving multiple partners in the research process, leaders can use this collaborative research approach with an end goal of integrating community expertise into policy or social change benefiting the community members.
Consumer Advisory Boards: Healthcare systems can formally convene groups of community members who regularly provide input to help organizations better understand health issues and improve care delivery.
Human-Centered Design: This problem-solving approach can be used to engage the human/patient perspective in all steps of the problem identification and solving process.
Participatory Budgeting: By giving community members a role in community spending decisions, healthcare leaders can use this process to determine how to allocate part of a public budget.
Patient-Centered Outcomes Measures: For enhanced understanding of the patient population, look at measures that are driven by patients’ expressed preferences, needs and values that inform progress toward better health, better care and lower costs.
Results-Based Accountability: This strategy can be used to help communities and organizations move to action. It uses an outcome-based approach to assess how much was accomplished, how well it was accomplished and whether people are better off.