In some neighborhoods in the US, life expectancy is lower than in some developing countries. How do poverty, inequality, and the uneven distribution of healthcare resources contribute to this problem? 

Dr. David A. Ansell is a professor of medicine at Rush University Medical Center in Chicago. His books, County: Life, Death, and Politics at Chicago's Public Hospital and The Death Gap: How Inequality Kills examine the aspects of inequality that lead to a decline in life expectancy among marginalized groups. 

He and Greg discuss Dr. Ansell’s experiences working in hospitals in some of Chicago's poorest communities and why the current healthcare systems are leaving vulnerable populations behind.

*unSILOed Podcast is produced by University FM.*

Episode Quotes:

The impact of capital extraction on communities and social cohesion

30:09: So this idea of when you extract capital out of a neighborhood, meaning the Sears leaves, the Western Electric leaves, the Zenith leaves—the big companies leave because white people have left. The bosses now, the ones who run the factories, said, I'm not going to rebuild it here. Why do I want to drive into a black neighborhood? When you take that capital out, it's not disinvestment; it's extraction. And then people are left devoid of work that's meaningful. But look at the South and globalization. Then what happens is what sets in: Grandma gets depressed, but the uncles now are off doing something else, and they don't look in on her. So you begin to erode that social cohesion, and when it erodes to a degree, that is now something that you could measure as concentrated disadvantage.

The destructive role of holding companies in healthcare

44:51: It's not just capitalism; it's the toxic form of capitalism that we have in this country that's allowed our healthcare delivery systems to be overly endowed with profit-making machines—holding companies, not healing companies.

How our ahistorical thinking hinders progress

16:05: One of the challenges that we have in our world is that we're ahistorical. We have this myth of meritocracy. There are ways in which ideology, built into a society, blinds us to the structures and realities of the world that we're in.

Rethinking healthcare in a broken system

33:39: So, I think we need universal healthcare because this idea of cherry-picking that goes on – that's racialized because white people, in general, have better, or people who have been assigned to whiteness have better, insurance – drives the behavior of healthcare delivery. It needs to be eliminated by some form of universal healthcare.

Show Links:

Recommended Resources:

• The Case for Reparations by Ta-Nehisis Coates (The Atlantic)
• Raj Chetty
• Paul Farmer
• Michael Marmot
• Second Bill of Rights

Guest Profile:

• Faculty Profile at Rush University Medical Center

His Work:

• County: Life, Death, and Politics at Chicago's Public Hospital
• The Death Gap: How Inequality Kills