This week saw the Institute of Medicine of Chicago host its biennial State of Health of Chicago event and panel discussion. [Health News Illinois]

The panel, moderated by Health News Illinois, took a deep dive into a wide range of health issues facing the city, including addressing health disparities, improving public trust in health and the potential impact of federal changes to the Medicaid and Supplemental Nutrition Assistance Program.

Panelists included:

• Dr. Arti Barnes, Chief Medical Officer, Illinois Dept. of Public Health
• Dr. Kimberley Darey, CEO and President, Edward – Elmhurst Hospital, Endeavor Health System
• Ollie Idowu, President and CEO, Illinois Primary Health Care Association
• Dr. Olusimbo Ige, Commissioner of the City of Chicago Department of Public Health
• Dr. Ian Jasenof, Chief Medical Officer, Mile Square Center, University of Illinois Health Center
• Dr. Doriane Miller, Director, Center for Community Health & Vitality, University of Chicago Medical Center
• Sana Syal, Senior Director of Programs and Strategic Impact Leader, Greater Chicago Food Depository
• Dr. Lauren Smith, Chief Medical Officer, Cook County Health

Edited excerpts below:

HNI: What do you see as some of the pressing health issues facing the communities you serve?

Sana Syal: Some of the most pressing health concerns for me, I care less about my own health and seeing my doctor if I'm worried about putting food on the table for my kids. And so health-related social needs for me are the most pressing health-related concern, and cross-sector partnerships between healthcare and community-based organizations are critical to help us ensure that people are getting the care that they need in the order that they prioritize for themselves.

Dr. Lauren Smith: We have a 180-year history of providing care to Cook County residents, regardless of their ability to pay. So obviously for us, the hot burning topic is the one behind the (Affordable Care Act) and the impact that it might have. So you know, Cook County, prior to the Affordable Care Act, almost 50 percent of our patients were uninsured. And we did see that drop over these last five to 10 years, down to 20 percent. And we've already started to see an uptick towards the end of 2025. Last year, we spent about $280 million dollars in charity care. We estimate that 100 million more will be added on top of that in 2026. Then obviously, as other changes that will kick off in 2027, that impact and that ripple effect will really have a huge impact on the ability for us to continue to do as much charity care as we do. We do believe in the city, we provide the largest percentage of charity care in Chicagoland. And so for us, that's kind of the biggest thing. Then the other pressing topic, I would say, is probably the shortages in the workforce. So, nursing positions are getting more and more challenging to recruit. It is definitely a new day from recruiting docs 20 years ago to what we're seeing today, as well as nurses.

Ollie Idowu: We have a math problem. So everyone here knows what happened with HR1, or (the One, Big, Beautiful Bill Act), whatever you want to call it, it's impossible to expect that you can cut a trillion dollars from the system and not have to worry about sustainability. So the biggest issue facing my health centers today is sustainability. The safety net is really looking at what it means to be sustainable. All those fights we had 10, 15, 20 years ago, about access, about social determinants of health, about health-related social needs, about health equity, we're not even having those conversations. First of all, we can't even say some of those words. But honestly speaking, we have a math problem, and that's where we are. I mean, I'm looking at health centers that traditionally are underfunded year over year. One thing that's kept us alive with 340B, and now we're looking at churn because of what's going to happen with redeterminations, with work requirements. We have shortages in the workforce. Again, I don't want to sound like a Debbie Downer, but we have a math problem.

HNI: What are some steps your organizations is taking to address these challenges?

Dr. Doriane Miller: I want to talk a little bit about partnerships and the importance of partnerships in addressing some of these challenges. I'm going to call out a partnership in particular that the University of Chicago has with RUSH, the project is called Live Healthy Chicago, in which we're trying to address both clinical identification and management, as well as community-based interventions for people who have high blood pressure. It's a wonderful opportunity.... being able to partner with RUSH, the BMO Institute for Health Equity and others to do work in the space is incredibly important. From an institutional standpoint, we are standing up the first free-standing comprehensive cancer center in the state of Illinois at the University of Chicago, with the opening in the spring of 2027. And that's directly in response to data that we generated through our Community Health Needs Assessment 14 years ago in order to look at this issue and to respond to the issues and the needs of the people that live in our community. And so again, just underscoring the question of making a generational investment in terms of tackling these problems.

Dr. Kimberley Darey:  Telehealth, for sure, is one of the access points that we really try to provide to patients. And then, more importantly, what we're trying to do is what we call — this isn't really innovation, but it really is more like partnership — warm handoffs. We happen to be a pretty popular Elmhurst Hospital, for instance, is a very popular hospital. People love our emergency department just because we have other competing hospitals in the area... they just like coming to my hospital, even though that's not their health home. But what we found is that, we want patients to really start establishing relationships, and how do we do that is some handouts, either back to their primary care doctors... and I will just touch a little bit on maternal health, I'm an OBG/YN by trade, but I do want to just mention that part of that disparity with the black maternal health issues is that many women don't have a place where they call their health home. So they are going from hospital to hospital, many times, delivering to some place that might be close to their house, but their doctor is in a whole other area. And so part of that is, once again, the insurance issues and lack of access, and so women don't get a chance to have... healthy women that suddenly are not able to see a doctor for the next 10 or 12 visits, they now have to bounce around and be treated like somebody that they don't know. And so when they're actually delivering, then you don't have that trust there. You don't establish those relationships at that hospital or with those doctors. And so it really does become a huge health risk and not even just black women that are pregnant, but women with low resources have the same issue. Women who are immigrants, those who are undocumented, still go through a lot of that change. So that's why we partner with so many FQHCs, for instance, and other community health clinics to say, 'Hey, listen, they're in your backyard, but our doctors will deliver you.' So we are working in those spaces to try to help them establish that trust, because when you don't trust someone with your care, that's when things just don't go right.

Dr. Ian Jasenof: Number one is that it starts with the infrastructure of who you are. So we have three major service lines doing research, and we have medical debt to behavioral health. We've made sure that we've hired the folks that are (medical doctors), (doctor of osteopathic medicine), et cetera, that are mission and vision aligned to be able to provide the type of line services as well. We also do workforce development. So we've worked with a few (federally qualified health centers) that actually have started a dental assistant program that's been very successful, and has been grant-funded. It's hired folks in the community. We've trained these individuals for future careers in the dental industry as well. Many of them have gone back to dental school, which is an amazing, full-circle direction in their careers. And also, we're looking for other avenues for expansion, which include cancer survivorship.

The reality is this: more patients now are living with cancer survivorship, and they have their own unique sense of what their needs are. And having an entire program developed for cancer survivorship is an amazing opportunity to bring to our patients to help lead better lives, longer lives, et cetera, and also bring the concept of genetic testing into the primary care world.

HNI: How are you preparing for the changes being brought by the federal government to programs like Medicaid and SNAP?

Sana Syal: In addition to work requirements for Medicaid, it also has work requirements for SNAP, and those go into effect February 1. So two weeks from now, individuals 18 to 64 (years old) who are not exempt have to prove that they are working or volunteering 80 hours a month, or they will lose their SNAP benefits for three years. So this is historic and the most detrimental threats to Medicaid and SNAP that we've seen in both programs' history. So I just want to emphasize the importance of this moment, and on top of that, when we look at SNAP participation in Illinois, there are about 1.8 million people in the state who have SNAP. Ninety percent of those individuals have Medicaid. And so there is a huge overlap with the individuals that are coming to our FQHCs, to our hospitals, and those that are coming to food pantries and soup kitchens for food. So nonprofits, in addition to FQHCs, we're preparing for more lines out at our pantries, because people will lose their SNAP benefits and won't be able to afford food at the grocery store. What we're doing right now to address some of that is on the ground, as much as possible, getting the word out about these work requirements, and the very first step is to check and see who is exempt from the requirements. And the same is going to go for Medicaid. First, rule out those that are exempt. And there are new individuals who are now going to be required to prove that they are working. Folks who are dealing with homelessness are now going to be asked to prove some amount of work, and certain immigrant and refugee populations will no longer have access to SNAP benefits. And so this is a huge moment where we need to rally and get the word out about these changes and their impact on them, because it inevitably impacts the cross-sector, both healthcare and community-based organizations.

HNI: How do you rebuild public trust in health?

Dr. Arti Barnes: So the big picture is that I think the trusted messenger... we have to acknowledge in all the surveys, we are not the trusted messenger. Whether we can become the trusted messenger in five years or in three years. I think we can work towards that, but the crisis is now. So I think the acknowledgement is that the faith-based leaders, the community leaders, the physicians, clinical providers, nurses, they're the ones that the community trusts. And if they trust us, maybe they can say, 'Look, this guidance came out from IDPH, and I trust them. I trust what's coming out from here. They have your interests at heart.' Then maybe there could be some transfers of trust. From a communications perspective, how can we deal with misinformation? And I can tell you, I've had multiple conversations with computational engineers who propose models for how they can use listening platforms to find out. But none of that really came to bear. They're all designed for market brands like ‘who in Boone County wants to buy Nike?’ rather than something like, 'Do they think cat hair can cure diabetes?' So what we realized was that there wasn't enough geographic specificity in all the current tech to tackle misinformation, and I feel that tackling misinformation will happen in two ways. Either grassroots, that means in the schools, in the communities, by community leaders. And/or through some kind of media intervention, and it has to be a mass-scale media intervention for the amount of misinformation out there.

Dr. Olusimbo Ige: I am big on on storytelling and sharing. If you wanted an electrician, how would you determine what electrician you want to choose? You will go to Thumbtack and see the number of stars they have or some type of review place? So what is the equivalent for public health? How do people rate our services and say, 'Oh, this is a fantastic place to work' or 'this is a fantastic job.' We have to make it visible. We have to have more opportunities to say that these are the two things that public health does and what it achieves. We have brag sessions in my department where people say, 'this is the cool thing that happened today.' And we do surveys all the time, and I'm very proud to tell you that when we talk about trust, we are always doing surveillance on that, and the health department is always one of the top three sources of information for Chicago. So that tells us that people know they can talk to us. I think this is how we will retain interest in public health at a time like this, by helping our communities know what public health does and the impact that it has and how useful it is. By creating platforms for community input and feedback, I think there are ways to continue to have support for public health.

Health News Illinois - Media Partner for this event. 

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