Ngozi Ezike, MD (Host): Hello, everyone. I'm Dr. Ngozi Ezike, and thank you for tuning in to More Than Medicine. This podcast is about the fight for health equity and justice, how we need to work to not just heal wounds, but truly address the root causes of hurt and distress in our communities.

This episode, I am so excited to be joined by a very special guest that really needs no introduction, but it is my sincere pleasure and privilege to welcome our Mayor of Chicago, Brandon Johnson. Mayor Johnson, welcome!

Mayor Brandon Johnson: Hey, thank you so much, Dr. Ezike. It is truly my honor to be with you. And again, thank you for your leadership and congratulations on an incredible career of providing health equity for so many people across, not just the city of Chicago and the state of Illinois, but around the globe.

Host: Thank you so much, Mayor. So, I'm going to jump right in. I know I usually start by asking people to tell us a bit about themselves. Of course, you are known. But as our listening audience sometimes spreads beyond city boundaries. I would really love for everyone to know about you. You were elected as the 57th Mayor of Chicago in April of 2023, and you previously served on the Cook County Board of Commissioners from 2018 to 2023. Can you start off by telling us a little bit about yourself? But what I really want to get into is how and when you said, "Yes, I want to be the chief executive of city government in Chicago."

Mayor Brandon Johnson: Yeah. Well, listen, I am incredibly humbled to be in this capacity and leading at this very critical time in our nation's politics, quite frankly. Serving as the 57th mayor of the city of Chicago has truly been a very humbling experience, and I'm grateful to have the opportunity to serve in this capacity. What has always been a part of my ambition was to be of service and particularly within the public space. And so, you know, I worked hard over the course of my life, to finish my education, to become an educator. Before teaching though, I was doing some work in community development and working in the not-for-profit space, just serving young people, serving families, being a part of neighborhood development. But I knew that my contribution had to lean into my desire, my love for education.

So, well, over 15 years ago now, I started teaching in the public schools here in Chicago, started teaching at Jenner Academy as a middle school Social Studies and Reading teacher. Jenner Academy is in the historic neighborhood Cabrini-Green and learned a lot about myself and learned a lot about politics in that role. And then eventually, I went on to teach at the high school level, Westinghouse on the west side of Chicago, where my wife and I are raising our three children. And it was really through that work as a teacher, it really gave me a very close view of the dichotomy that exists within the political frame in Chicago. Those who have, keep and get more and those with less, there's always an extraction that seems to be like the normal form of politics. And it's been an incredible journey. I've been raised to be of service. My parents were both leaders in our respective communities and they were pastors. Large family, there was 10 of us. My parents were also foster parents and raised us in a single family home with one bathroom where I learned to negotiate really early in life, which usually requires you to be in alignment with women. So, that's where my first political organizing took place. If you want to get out of the bathroom, out of the house, clean in the bathroom, make sure that you are in allyship with the sisters.

Host: That's important words to live by, Mayor, for sure. That's fantastic. Well, I am so excited to hear about what you're saying. Of course, serving families and children are just are the bedrock of being able to serve and support a community. So, all of the work you've done in education, it all aligned and has seemed like it has all prepared you to be where you are right now to serve in this public space.

Mayor Brandon Johnson: really has. You know, I think to that point too, when you're teaching in, Chicago or any place where families have been underserved and there's been disinvestment, when children show up in your classroom, they're not just showing up to discuss the five causes of the American Revolution or to learn a comma splice or how to draw conclusions. They're showing up hungry. They're showing up without dental care. They're showing up without healthcare. They're showing up with a great deal of trauma. And to your point, it was really in that lived and working experience that I saw firsthand what the failures of government, the failures of society looked like, because the classroom really is a microcosm of what's happening in the larger space within the neighborhoods. And so, you're absolutely right that the convergence of the societal needs, as well as the inequities, they suddenly showed up in my classroom every single day.

Host: And it's not something that you can ignore because it affects the learning that you're trying to impart. So, our research on the Sinai Urban Health Institute, we recently published an article as it was looking at the large cities, including the greatest freaking city in the world, as you love to refer to Chicago. It showed how Chicago had racial health equity ingrained into its road map for closing health gaps. You know, can you articulate a little bit to our listeners why treating health equity and addressing that is such a point of focus?

Mayor Brandon Johnson: Yeah. It's a very important part of our work where we have been working hard to create a roadmap to lead us towards a more equitable and just society. And .What has played out in Chicago, and quite frankly, it's probably, you know, a dynamic that exists beyond the city of Chicago, where we are seeing these life expectancy gaps or these health gaps. And I'm raising my family in Austin on the west side of Chicago, and it's known for the vibrant sort of working class community, but it also unfortunately shares this historic disinvestment. And as a result of that, there are a number of children who suffer from asthma. You have a higher rate of individuals who are suffering from diabetes. And the life expectancy gap between some of the most poorest neighborhoods in Chicago, like Garfield Park or Austin or Roseland and Inglewood versus Streeterville, which is in the downtown corridor of the city of Chicago, you know, where the life expectancy on the west and south sides of Chicago, like the neighborhood I'm raising my family in, is barely 60 years old versus 83 in other more affluent neighborhoods. So, we're talking about a 20-year gap, but it also is an important note that it's not just the very obvious health conditions. It's the fact that we don't have access to healthcare facilities and services that can ultimately lead towards a healthier lifestyle. But also on top of that, the neighborhood as a whole, very limited access to grocery stores that have food choice that can lead towards a more healthier lifestyle. So, it's a roadmap that identifies that these inequities play out beyond just the healthcare institution. It's the overall gross neglect that has created this very pervasive, perpetual cycle of low life expectancy because there's just limited access to the very basic needs of life.

Host: Yeah. And I mean, you said it all. It is so much more than just what you can do if you get to see a doctor or medicines that you can or cannot swallow. It's really about all these other things, like having access to fresh produce; having safe places to exercise if the doctor says get more walking in and you say, "I can't leave my home"; not having adequate transportation, not having jobs that will provide you with insurance so you can access care. So, absolutely all of those pieces tie together and I know that you are looking at all of this in totality to make sure that we hit all the different points that affect people's health.

You know, I had the privilege of being part of your transition team, and I got to join fellow business, civic, and healthcare leaders on the Health and Human Services Subcommittee. I want to just dive for a moment into the transition report that was released in July. And I quote, "Healthcare, including mental health for all, must be more than a slogan. It must become our reality." Can you share some of the important plans to accomplish this to make sure that this is an action statement and not just words on a paper?

Mayor Brandon Johnson: Yeah. Thank you for that question. And thank you for your service in that capacity. In fact, of all the areas that my administration is committed to addressing, healthcare is front and center. That is the wish and that's the prayer that we should always have, is that we are the prosperous and are in good health.

And in fact, because my father did serve many years as a pastor, he talked an awful lot about the words of Jesus as he challenged people that our heart and our treasure will be aligned, right? So where your heart is, your treasure will be also. So when we talk about action, we're talking about making sure we're making investments into the health and wellbeing and the prosperity for the residents of Chicago.

And one of those dynamics is really tied into a movement. And the movement has titled itself Treatment Not Trauma. And it's an important part of our policy point. Because with our Treatment Not Trauma effort, we're not only committed to reopening mental health clinics, which my budget lays out how we can start that process by reopening our mental healthcare services in at least two of our facilities. And this working group is going to help direct us of how we can, you know, ultimately lead towards opening up more facilities. But it's also about making sure that we have an alternative response to the 911 calls that come through that are really more mental health crises. And you know, policing in Chicago and really around the country has been the go to for everything. And making sure that healthcare is an actionable, deliverable component of my administration. It's making investments in those, this Treatment Not Trauma movement. And again, an alternate response where if someone is having a mental health crisis, that a mental healthcare professional shows up to provide the necessary intervention that's needed. And again, you know, once that crisis has been addressed, that the ongoing care, the Chicago Department of Public Health has to continue to lead in providing those critical services.

And it is more personal for me, and I've shared this along the journey that my older brother, Leon, who is now an ancestor, had untreated trauma. And the stigma that comes with having trauma, particularly within black and brown communities, it went untreated. And, you know, we lost my brother because of his untreated trauma. He left the planet addicted and unhoused. And so, actionable, deliverable services for people of Chicago, it's a matter of life. And that's why we have to be more action-oriented in how we deliver public services for the people of Chicago, and particularly when it comes to healthcare and especially mental healthcare.

Host: Thank you so much. And again, please let me just, offer my condolences on the loss of your brother. But you share that and you really are firm about the actionable, deliverable components that will help not create additional stories like your brother's, obviously Sinai Chicago wants to support this and play a role in this. What do you see as the role of the health systems in Chicago, the hospital systems, to be a part of your vision?

Mayor Brandon Johnson: Yeah, thanks. That's a really good question. And this is where I see that we have tremendous opportunity and growth here. The space that you are leading has been a real safety net and an outlet for so many different families and individuals. And one of the things that I am clear about, having worked in the public space, that in many instances, you need partners and hospitals to be a part of the solution.

And one of the ways in which, you know, we can do that is just through referral services, right? I mean, whatever it is that we're able to offer through the Chicago Department of Public Health, you know, as we build out, there are some restraints and there are some gaps that we have. And Sinai and other hospitals that are positioned like the one that you're leading can be of support. And I am. Very much convinced and committed that in order for us to address these critical needs, that you have to have a more collaborative approach to how we deliver services. And because, quite frankly, when it comes to healthcare, just like people have personalities or styles that are unique to them, there are hospitals and safety net spaces that community members have already come to trust and appreciate. And that's important because, you know, listen, once you find a doctor or a healthcare facility that you feel comfortable with and that you trust, you know, you don't want to remove that from people, right? That's something that I'm very much committed to doing, and I'm looking forward to those partnerships and the type of collaboration that we can do that can lead towards healthier lifestyles for people.

Host: Well, we are absolutely here for you and looking to be that gap filler that you described and just to lock arms with you and CDPH to make sure that we can really be that true catch for all people of Chicago. So, really looking forward to continued collaboration. And again, I appreciate how important continuity and maintaining trust with an established provider, so we are here for all of it.

I'm going to switch gears just a little bit, but it's all related. You can't take away health from economy. You have to have healthy workers to have a prosperous economy. So when you talk about vision of an equitable and prosperous economy, what additional ideas do you have to provide opportunities for all Chicago businesses and all residents to be able to thrive and grow?

Mayor Brandon Johnson: Yeah. Look, this is the part that honestly I'm very excited about in this role, is that wherever I've gone, Dr. Ezequiel, I've been all over the city of Chicago over these last five months or six months, I don't remember how long it's been yet. And everywhere I go, whether it's a small business owner, whether it's a child care provider, bus operator, you know, a corporate CEO, everyone is asking, what can they do to help? That is really the essence of who we are as a city. That is the soulfulness of our city, where the diversity of our city is really second to none. And in fact, when it comes to the economy, we're one of the very rare diverse economies that exists in the country, not one industry has more than 14% of the economic largesse of Chicago, so we don't have like an overinflated particular industry that we rely on.

And all of the assets that we have in the city are absolutely just remarkable, right? Whether it's access to water, two airports, the rails, a public transportation system, we have incredible infrastructure. Conservatively, it's estimated that we can hold 700,000 more individuals in the city, so that there's all this potential, right? We have the top universities, I can go on and on, the fastest growing downtown anywhere else in the country. And so, the way I see it is that whether it's business, the philanthropic community, our public spaces, government, our hospitals, we have to create neighborhoods that have the ability to provide like real holistic wraparound support for families.

And so whether it's a grocery store, which I've floated this idea of a city-owned run grocery store, banks inside of libraries, affordable housing and pathways to home ownership, that I have an opportunity as the executive of the city of Chicago to create and build neighborhoods, that provide a holistic, surrounding, loving environment where we build systems of care. And so, whether it's making sure that we have access to child care and providing opportunities for child care businesses, child care operators to thrive, whether it's, again, making sure that people have access to healthcare and healthcare facilities, as well as grocery stores where fresh food, vegetables and fruits can be made available and accessible, that is real opportunity that we have when it comes to business and government and building an economy that works for everyone.

The last thing that I'll say is you mentioned something that's really key and that's the worker, the workers, the workers. I come from the labor movement. My father was part of the working class, part of the labor movement. He was also pretty handy person as well. He was a general contractor. And the opportunities that we see available now, we have to connect those opportunities to our education system. And for manufacturing jobs where the average salary is a year, in many instances, most instances, Bachelor's degrees are not required, whether it's biotech, the life sciences. There's much opportunity for growth economically to build the workforce and connect our education system to the workforce, that's going to be needed in all of those industries, including logistics. That is the opportunity that we have to build a better, stronger state for Chicago, and that's what I'm most excited about as you can hear.

Host: I can hear it. I can hear the passion and I just want to brag a little bit about Sinai just in case you're not aware, because we are working in all of those areas. You know, you mentioned grocery store. We're working on a collaboration to bring the first grocery store to North Lawndale. We just opened a project across the street, Ogden Commons, 1 Lawndale, which has a bank. It has a brand new state-of-the-art surgical facility. It has a coffee shop, a restauranteur's about to just move in. And then right behind that, we have a housing development that broke ground earlier this year and it's going to open up next spring with 92 units of housing for low-income residents. We have studios, one bedroom, two bedrooms, and I think a couple of three bedrooms. So, we are Just fully aligned in terms of thinking about the individual and the community holistically and making sure that all the needs that would support a family, Sinai doesn't just put Band-Aids on, we're working on all of those pieces. So, really excited to be falling in line with your mission for this great city.

Mayor Brandon Johnson: That is exciting. And look, I'm very. Blessed to have a lot of the services that our family relies on, on the west side of Chicago. Like I said, I live in Austin. Our children, you know, attend summer camp in East Garfield. We go to church in North Lawndale, so I'm very familiar with the work that you all are doing over there. And that is really the motto from housing, transportation, healthcare, good paying jobs, the ability to be able to access the amenities of life that will help us close that health gap and to strengthen the life expectancy for so many residents. I'm so impressed and grateful to know that there are models out there that we can not just collaborate with, but use as a way to expand.

Host: Yeah. No, I mean, I was just watching that Netflix special that was talking about the areas around the world that have the highest concentration of centenarians. People who live over a hundred years and just looking at some of the things that they think are correlated to that. It was, you know, safe spaces so that people could walk around, you know, the hills so that people are walking up and down hills and eating food that was grown straight out of the soil. Just all these things that you can think about that really a lot of our communities don't have and part of the explanation for why there's-- we're talking about people living a hundred years and then we have communities that are not even hitting 70. And I know COVID did quite a number on that and, you know, so we have extra work that we need to make up. But as you are so invested and so passionate, what, if anything, is actually going to hold us back from achieving the equity and the justice that we're so actively seeking?

Mayor Brandon Johnson: Yeah. Thank you for that. Look, I'm a middle child, so I am always optimistic about life, so it's very difficult to get me to think other than, you know, positively. The only thing that could essentially hold us back, certain elements that would be beyond our control. But outside of that, the only limitations that we have are the ones we place in ourselves. And, again, serving as a middle school teacher really is training ground to become mayor of the city of Chicago. Because as you know with adolescent development, you talk to a 12 or 13-year-old, at any given moment, their experience or their mood can fluctuate between the world is coming to an end and they're going to change the world. And right now, I believe the political state that we're in is similar to that of an adolescent where you have anxiety and fear on one end pulling in a direction. And then, you have hope and aspiration pulling in one direction. And I'm confident that the city of Chicago that there are more of us that are pulling in the direction of hope and aspiration and that's what I'm most thrilled about. And as long as we recognize that those who have paved the way for this moment to come into a reality, it is now our responsibility to set up the next 100 years for the people of Chicago and really, Chicago, serving as a model, as a beacon of light and hope for the rest of the world.

And it's funny that you mentioned about life expectancy and people living to be 100. I read something that one in three people born within the last 10 to 15 years, one in three will live to be 100. And so, I have three children, so we have this ongoing bet of which one of our three will make it to 100. And the way one of them keeps up his room, you know, he may not see his next birthday, but, you know, let's edit that part out. But yes, I mean, the excitement of knowing that and putting that into like real practical terms that we are the generation of leaders that can set communities up where life expectancy and the quality of life could be far greater than what a generation ago could have ever imagined. And that certainly, you know, keeps me motivated and I'm glad that you have time to watch Netflix series because that's one thing that I do miss about this new job. I don't get a lot of opportunities to watch anything on Netflix, Dr. Ezike.

Host: Oh, no. This was recommended as something I needed to, you know, set my sights high in terms of what our goals are for the community. And you said that you're a middle child, so you're optimistic. Well, I'm a firstborn, and I always describe myself not as hopelessly optimistic, but hopefully optimistic. And so, I share your optimism. And, you know, I always describe it as I want to be almost delusional. I want to believe that what I don't see today, but what I hope to see, that that's going to come to pass. And I think when we have people who are all rowing in the same direction, trying to get us there, it's only a matter of time. But we do all need to work together, and I think we have that groundswell that's going to keep moving us and propelling us in that right direction.

Mayor Brandon Johnson: Here, here. I agree. I agree.

Host: I just want to thank you so much for taking this time. Again, you have probably the busiest job in the city and you made time to share some of your vision and I think it will inspire many. And I thank you for sharing because the passion is so clear there. And as you said, from, I think it's the Book of Luke, for where your treasure is, there your heart will be. And we can hear where your heart is. Mayor, I just want to say, you know, we're praying for guidance and wisdom to follow you in this important role that you have been called to, and please know that you have Sinai Chicago and so many partners that are here to usher you along the way. Thank you so much, Mayor Johnson, for joining us.

Mayor Brandon Johnson: Thank you, Dr. Ezike. It's been truly my honor.

Scott outro: Thank you for listening to More Than Medicine with Dr. Ngozi Ezike. If you haven't already, make sure to subscribe to Sinai Chicago's YouTube channel, as well as follow @SinaiChicago on Twitter, Facebook and Instagram for information on upcoming podcasts. Until next time.