Letter to the Editor: LWV report looks at persistence of Health inequities

Life expectancy data tells us that there are health inequities in Evanston. The average life expectancy in Evanston is 82 years, but depending on where you live, it ranges from 86 years in northeast Evanston to only 75.5 in west Evanston. The difference persists despite a strong health care infrastructure in our city.

Evanston has two major hospitals that provide comprehensive medical care and a city-based Health and Human Services Department (HHS). We have one of only four certified municipal health departments in Illinois. The important role of the health department was demonstrated by the significant role they played in responding to the COVID-19 pandemic. 

Health equality in Evanston is strengthened because of services provided by the Erie Family Health Center and the school-based health center at ETHS.

• The Erie Family Health Center is a Federally Qualified Health Center (FQHC) which provides medical, dental and behavioral health care to underserved residents. It plays a major role by providing access regardless of income, insurance, or citizenship. Without the Erie Family Health Center, comprehensive patient care would remain an unmet need for most of the population it serves.
• The health center at ETHS eliminates barriers to quality health care for all ETHS students. The clinic has remained open and provided health care services throughout the pandemic. These two organizations receive funding from a variety of sources including Federal and State funding and insurance when patients have coverage.

With many resources available in Evanston, access to medical care is broadly available, but actually obtaining care can be restricted by financial barriers.

In the most recent community health assessment by the Evanston Health Department, 94% of residents reported that they had health insurance. However, not all insurance has adequate coverage.  The Affordable Health Care Act expanded Medicaid coverage, but some physicians do not accept it, and some policies require co-payments that are unaffordable. 

And while medical care is widely available in Evanston, mental health care is not. Lack of adequate mental health care is not unique to Evanston. News sources from around the country warn of a mental health crisis. Mental health has been affected by the pandemic, but there were significant unmet mental health needs before COVID-19.

Many mental health care providers do not accept Medicaid, and coverage provided by traditional insurance is often inadequate. Providers, large and small, are having difficulty hiring and retaining mental health professionals. There is competition with all health care organizations in the Chicago area, and the supply of mental health workers is not adequate to meet the demand. This is a gap in service for the entire community, but it especially affects underserved populations.

 Although access to medical services is available through one of the many health care resources in Evanston, health inequity continues to impact lives. Beyond access to these resources, inequity results from unequal social determinants of health including income, employment, housing, nutrition, education, clean air and water, and trust in the system. Evanstonians in different neighborhoods face sharp differences in these qualities of life and therefore in their life expectancy and their overall health.