Inside a warehouse on the West Side, there are freezers of whitefish and chicken drumsticks, boxes of fruit and plump carrots, and aisles of bread, beans and pasta.
Daisy Gabriel combs through a list of names of low-income seniors who have picked from a menu which healthy foods they want this month. She fills bright green bags full of milk, eggs and cheddar cheese. They’ll go along with boxes of dry food, sometimes adding a birthday card or a Christmas gift inside.
“We’ve had people be like, this was the only thing that I have under my tree,” Gabriel said. “I know what that is.”
Gabriel manages the home delivery program at the nonprofit Beyond Hunger, delivering fresh food to mostly seniors who live in Austin and in neighboring suburban Oak Park and River Forest. Most are homebound and live alone. In Austin, residents have some of the least access to fresh fruits and vegetables in the entire city, public health data shows.
The COVID-19 pandemic in 2020 illuminated inequities like this that were invisible to so many people even though health disparities raged long before the virus tore through the city, particularly on the South and West sides.
Five years later, public health officials and community leaders are working to make sure the trust they built and the lessons they learned during the pandemic to help people become healthier aren’t lost — with fewer resources and a federal government that has targeted Chicago for everything from gun violence to immigration.
During the pandemic, Beyond Hunger expanded the home delivery program into Austin and added an extra delivery of fresh produce every month to help stretch groceries a bit more for their clients.
Gabriel grew up with four siblings and a single mom. Her family received food assistance when she was a kid. She remembers having to pick approved cereals at the store. She still needed food aid during college and again when she lost a previous job during the pandemic.
“People are really scared right now,” Gabriel said. “Knowing that we can still offer this service, and clients know even if we have to purchase the eggs, and it’s going to cost us $4 a unit, we’re going to make sure you’re getting the items that you depend on and look forward to each month.”
And with that, employees and a volunteer load up the food onto a small bus and head to a senior apartment building in Oak Park, where about 40 clients await their deliveries.
How health inequities have changed
Whether a person has access to healthy meals, a job and stable housing all contribute to their physical and mental health, and ultimately how long they can expect to live. In Chicago, it’s vastly unequal depending on where you live and what you look like. There’s a 25-year life expectancy gap between the Loop and West Garfield Park, public health data shows.
In fact, researchers in 2019 found that Chicago had the largest life expectancy gap across neighborhoods of any big city in America.
Since the pandemic, in some cases the gap has swelled.
The gap grew to around 16 years between Black and Asian Chicagoans, and to around 12 years between Black and Latino Chicagoans, according to the most recent public health data from 2022. There was a small decrease to 11 years between Black and white Chicagoans, though this gap is still wider than it was in 2010.
Dr. Simbo Ige, who became Chicago’s public health commissioner in 2023, said she isn’t surprised. Depending on where you live there’s still less access to medical care, pharmacies and food despite a pandemic, she said.
“The challenge here is the failure of societal attention for those who are most impacted,” Ige said. “There is a zero-sum mindset, like if we try and put additional resources and some support in communities that are more impacted, everybody else feels like it is taking something away from them.”
She said she’s “cautiously optimistic” data from 2023 will be better because some factors that drive life expectancy have improved, such as fewer people dying from opioid overdoses.
As Ige looks to help Chicagoans live longer, there are lessons learned during the pandemic that could carry on. A key one is maintaining the trust built with leaders at community organizations who felt empowered to take an equal seat at the table alongside government leaders and major institutions.
What started as a massive effort to vaccinate neighborhoods hardest hit by COVID-19 turned into a longer term effort to pour other resources into these areas. The city was divided into six health equity zones and invested more than $25 million with the help of federal dollars into programs based on what residents said they needed to improve their health. The goal: to reduce the life expectancy gap in Chicago.
Researchers who evaluated the program found that it helped build the city’s “health equity muscle,” according to a draft of their report. For example, more than 600 partnerships were built or strengthened between leaders at the city and community organizations.
But these relationships are delicate, stresses one of the program evaluators, Tiffany Ford, an assistant professor at University of Illinois Chicago.
“As much work as it takes to build up, it can sort of just as easily crumble if we don’t continue to nurture the relationships and the shared power and the work together,” Ford said.
But it’s hard to do this work without funding, said another evaluator, UIC Professor Benjamin Shaw. The health equity zones were covered with federal dollars that have run out, Ige said.
She acknowledged the fight ahead — tackling inequities with a drastically reduced budget and potentially more cuts on the way from the Trump administration.
Cook County invests in housing for people experiencing homelessness
The same financial worries are playing out at Cook County, which started a medical respite center during the pandemic for people who are experiencing homelessness.
The center operates out of a former hotel in Oak Park that the county helped a nonprofit buy. It aims to help patients who no longer need to be hospitalized but otherwise would be on the street if they were discharged. These patients might have cancer or lost a part of their foot to diabetes and need time to heal and manage their conditions, said Dr. Keiki Hinami, who helped start the center.
“The look in patients’ faces when they are shown a hotel room where they will be staying is very emotional, and it goes both ways,” Hinami said. “Some people burst out laughing. Others break down and cry. But regardless, it is always a very emotionally charged experience at the very beginning for them to see that where they are going after their hospitalization is not congregate shelter. It’s not back on the Red Line.”
The median length of stay is about six months.
The county has served about 350 patients at the center. Most are Black. There are 19 beds and there can be a wait list, especially during the winter when a lot of unhoused patients come to the hospital with frostbite.
Herbert Barnes, 56, has lived at center for about seven months. He has a wound on his ankle he said is the size of a slice of bread that is stubborn to heal. He said he fell off of someone’s porch. The pain was so intense, he said, he couldn’t keep a job. He wound up living on the L train and said his leg kept getting infected.
Barnes remembers when he first arrived at the center. He was exhausted and said he slept most of the day.
“When you (are) out there, you can’t rest,” Barnes said of not having a home. “To be here is like a relief.”
He’s made friends with others who live at the center. Nurses and counselors are there for him when he needs not just medical care, but someone to talk to, Barnes said.
Now he feels that he can make it. The county tries to help link patients to stable housing once it’s time to leave. But it’s a struggle with a lack of supply, Hinami said.
A 2022 report found that during the center’s first year, they helped patients avoid unnecessary nursing home stays and improved their access to medical care.
“I think medical respite is needed as long as homelessness exists, or until we’ve lost our capacity to be moved by the suffering of other people,” Hinami said.
The program costs about $2 million a year to operate and is currently funded with federal pandemic relief dollars that will expire. The county is looking for other ways to cover the cost, a spokeswoman for the county health system said.
“I’m waiting for them like they’re family”
The bus full of food from Beyond Hunger arrives at the Oak Park senior apartment building. Employees and volunteers start to unload the boxes and bags of food onto carts.
Gabriel takes a cart up to Margaret Burbridge’s apartment. Even though she picked the items off a menu, Burbridge is excited to see what’s inside. In her kitchen she opens up a box and pulls out fresh collards, bananas and carrots.
“I look forward to it,” Burbridge said. “I’m waiting for them like they’re family coming to bring me a present.”
Her favorite item on the menu? Chicken drumsticks, and she looks forward to a huge ham around Christmas.
Burbridge is on a fixed income and said it’s helpful not to have to make an extra trip to the store to buy items like milk, butter and eggs, especially since eggs have become so much more expensive.
“It definitely stretches my food further,” Burbridge said, adding that she shares food with other residents in her building.
Survey results from last year show Beyond Hunger’s home food delivery program appears to be helping seniors become healthier. Over half of the clients surveyed said they ate more fruits and vegetables, managed diabetes and blood pressure better, and felt more connected to their community.