Intro: Coming to you from Chicago, you're listening to More Than Medicine with Dr. Ngozi Ezike. Dr. Ezike is the President and CEO of Sinai Chicago. She's a Board-Certified Internist and Pediatrician who has dedicated her career to addressing issues of health equity and health justice.

Sinai Chicago is the largest private safety net health system in the state of Illinois; with a service area of over 1.5 million people living in communities of Chicago's west and southwest sides. More Than Medicine is about the fight for health equity and justice; working to not just heal wounds, but truly address the root causes of hurt and distress in our communities and our nation.

Ngozi Ezike, MD (Host): Hello, everyone. I'm Ngozi Ezike. 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 and our nation. Today, we have the wonderful opportunity to talk with a lifelong resident of Chicago's west side who has dedicated her career to improving the health and economic vitality of the community where she grew up, with social justice and health equity at the foundation of all of her work.

Please, please, please join me in welcoming Executive Director of West Side United, Ayesha Jaco. Thank you so much for joining me, Ayesha.

Ayesha Jaco, MA, BS: Thank you so much for the invitation, Dr. Ezike. It's an honor to join you today.

Host: I'm so excited for this conversation. I'm really excited for our listeners to hear about you and how you got started with your career and how that led you to West Side United. So, why don't you just go ahead and share with us?

Ayesha Jaco, MA, BS: Sure. So as you mentioned, I am born and raised on the west side of Chicago. Born here at Bethany Hospital, where if I look out of our offices at the Nichols Tower, I can see that building across the expressway. My grandmother was a migrant from Mississippi, and came to Chicago in the mid-1950s to make a better life for her family. And so, that's really where the journey begins with my family being part of the final wave of migrants from Mississippi to the west side all the way through the late '60s. And so in that, I learned very early, being an '80s baby, about the west side and some of the nuances, like the Sears Company and the anchor that it was for North Lawndale.

My early academic years were also in Lawndale at Crown Community Academy. Both of my parents were activists. My dad, a southsider, born at Robert Taylor Projects; my mom with the west side lineage. And so, I got to see Chicago in its totality, traveling from the south side to the west side, the north side. And part of my father's activism was in martial arts. And so his idea, being a Vietnam veteran, also just steeped in the martial arts, was that they could be a vehicle for transformation for the community. And so, as a child, I saw him put these schools in places that had the highest need. North Lawndale was one of the locations for his dojo at Ogden and Christiana where we stayed in a building and at the bottom was one of his dojos. Another location was on the south side, right next door to the Stony Island Arts Bank. And after that, he put locations in Bronzeville and his last one in South Shore.

And so, his mantra to me and my siblings was to make our communities better than we found them. And so, we saw that play out with him through the martial arts and how, you know, some of the most seemingly troubled kids would come there and just transform. It was a haven. My mom was the household on the block that had the healthy food on the pot, lentils, and all these books. And so, she also spurred and cured the curiosity of a lot of people in our neighborhood in East Garfield Park, which is where my family ultimately settled and where I spent most of my time right up until going to college.

It's ironic that East Garfield Park today has the lowest life expectancy when we think about the disparity between downtown and the west side. And throughout my childhood, in this community, my home was the beacon of light where there were things outside happening in terms of some of the violence; the fact that we didn't have a grocery store in the community, there were not many activities for neighborhood children to do, my family, through my father's karate schools and the world my mother created inside; really gave us a trajectory just to think bigger, to think different, and to survive, really, the west side of Chicago.

So, that was very, in my formative years, the idea of community empowerment, was something that stuck with me. I've been in Chicago for all of my academic career, or in Illinois. So, I went to Curie High School on the southwest side, downstate to Illinois State, and then back up to Columbia College, where I studied nonprofit management.

And so, coming out of grad school, I knew that I wanted to work in the nonprofit sector. Leading into that, I was the college student in the neighborhood, packing up my car, taking kids to the library, the Mabel Manning Branch to be exact, right by the United Center for Tutoring. And I also have studied dance for all of my life. And so, again, looking at my father's model and where I could put my skin on it, it was through the arts and education. And so, I graduated, came out and began working for youth outreach services. I was directing their substance abuse prevention division and that placed me to provide services across eight communities on the northwest side of Chicago. So as far west as Austin, as far northwest as Belmont-Cragin, Portage Park, Dunning, as far northeast as Albany Park. And so in that, each year, we would reach about 20,000 families through substance abuse prevention programming in schools on site. And so, that really opened my eyes in terms of just how to be innovative working through the state's Department of Human Services and the Bureau for Substance Abuse Prevention. And what I could bridge in terms of providing programs to diverse families, based on my background, the arts, et cetera. Throughout that time, I had also began working in Austin through After School Matters, running a dance program. And so, it was like me merging the best of both of my worlds.

And so, in doing that, I had a younger brother who also took to the arts, who's a musician, who wrote a music curriculum, and who would go to Wacker Drive and pass out coats. So again all under the guise of our father's mantra, we were doing these different things. And when I first graduated school, started substitute teaching and CPS on the west side across most of the elementary schools. And so, we would adopt families and provide warm meals that we would drop off, so Boston market, and then that ultimately led to gift cards.

And so, my brother who has a very successful music career, at that time, it had just taken off, and this music curriculum he wrote went into a drawer. Things were going, but he was no longer there to lead the activities with me. So, we created the Lupe Fiasco Foundation, and I found myself in the realm of hiphop and philanthropy. So at this time, you've got Common Grounds Foundation launching, the Kanye West Foundation that was based in L.A., but serviced Chicago. You had Dwayne Wade's Foundation headquartered here. So, we became this nucleus for activism and hiphop in Chicago. And our work specifically at the foundation was around food equity, global capacity-building for young people, and education. And so, I pivoted out of social services and ran that foundation. We were in partnership with Northeastern Illinois University at their Center for Inner City Studies. Did that for almost a decade. And I ran into a bit of founder syndrome. It seems like we had served our purpose. You had Chance the Rapper coming with his foundation. They were passing out coats that were turning into sleeping bags, and so food equity; there was a lot of work happening in this space.

And I was looking for something else to do to have greater impact. And I picked up a copy of The Death Gap by Dr. David Ansell in 2017, and it blew my mind because going back to my roots in North Lawndale and his referencing of the Ogden Corridor where Sinai sits and running into the medical district. I felt like his patients were like my grandmothers and great aunts and aunties, who in some cases passed away or in most cases passed away prematurely due to conditions that happen to be the leading drivers in mortality for African Americans. And so, I was just blown away. And it really touched my heart because the book also outlined the fact that your ZIP code determines your quality of life. And that was something that we always thought was the norm growing up on the west side of Chicago, that what we inherited was just the way it was.

And so, as I grew in my career, I knew that not to be the case, but to have someone call out their privilege and map out solutions, just blew me away. And I'd like to say through serendipity, as I thought about my next chapter, I came across this position and it referenced the death gap and it referenced the West Side United, this new initiative.

And in May of 2018, I came on as the first staff hired in a place that was fairly new to me where I had a lot of background in nonprofit management, community engagement, arts education. And by this point, I had provided programming for about 50,000 families across the city. And I was brought in initially to look at program development and community engagement. I was impressed by the intentionality of the partners, the vision, the mission. And that's where my journey with West Side United began.

Host: Thank you for sharing. I mean, it's just a beautiful story. And you know, you never really know where your journey will take you, because I was listening and, first of all, your father's teaching about making the community better than how you found it. And so at first, I was like, "Okay, with arts and dance, you're going to follow in your father's footsteps to provide that." But then, from the hiphop, but then you've worked with state government to be able to leverage those resources to serve. It's just a beautiful journey that you took us on to land where you are now.

And now, when you work with hospitals and other nonprofits and religious institutions, everyone's working together towards that same mission of eliminating this significant life expectancy gap, which can be up to 16, 18 years, depending on which community you're looking at. Why do you feel that that really resonated with you? You know, what is your why since reading that book?

Ayesha Jaco, MA, BS: Sure. So prior to reading that book, I had lost my father at 54 years old who passed away from complications due to congestive heart failure and diabetes. My grandmother, who lived in East Garfield Park, passed away in 2006, two weeks later after being diagnosed with ovarian cancer. I had an aunt who died from heart disease prematurely. So, my why is because of them, just wanting to be in a space where I could help course correct where my spheres of influence are. So, I think about my grandmother and she was in the church eight days out of the week. You know, and I thought, "if her church had a community health worker, she might still be here," because somewhere in the ministry, that probably would have been part of an agenda to make sure that the congregation were getting their regular checkups, et cetera. And when I came to West Side United, that was one of the first initiatives that we got off the ground, the expansion of a community health worker model that ultimately landed in Little Village at Enlace.

And then, there was, following that, support around co-location of mental and behavioral health services. And I thought about the young people in my community growing up that had challenges, but didn't have resources or the fact that mental health was taboo, or at least seeking help in terms of some of the cultural beliefs. The other piece was having an older brother in East Garfield Park lose 25 friends over a 10-year period, and in most cases within a two and a half block radius. And knowing those young men and knowing that, at the end of the day, what they were doing or aiming towards was a better quality of life for their families. And so, their alternatives to seeking employment or building wealth were untraditional, dangerous, illegal routes, but that's what they gravitated towards. And so, I carry those people with me when I come into this health equity space that's aimed at addressing the social drivers and creating a better quality of life by looking at some of those same barriers that ultimately took the lives prematurely of my own family members and people in my community. So, my why is fueled in that. My why is also that I have an 11-year-old and a two-year-old who I want to blow out at a minimum 85 candles on their birthday cakes. And so, the question is, when you think about the average life expectancy for African Americans in this region is at 70, those are things that I think about as I work with the team and our partners around the importance and my personal drivers.

Host: No, thank you so much for sharing that. That's so powerful. You know, at Sinai Chicago, we say that we're about more than medicine, that it's personal. And I can see through thinking about the years that your father didn't have, your aunt, your grandmother, like all those friends of your brothers. You are working for all of them, you couldn't save them, but there are so many others through this important work that you can change the trajectory and hopefully the life expectancy, the quality of life for other individuals. So, I'm grateful for your story. I'm sorry for those in your family that didn't achieve their full life expectancy, but I'm so grateful for the work you're doing to make sure that others don't go that same way.

So thinking about how you really actualize this important work, can we get into the nitty gritty and talk about some of the great programs that you are involved with. I know some of them, Sinai is directly involved with and how that is really getting at the goal of getting people their full life and their full quality of life.

Ayesha Jaco, MA, BS: Absolutely. And so, this work is really leveraged by the power of institutions like Sinai, Chicago, Cook County Health, Lurie Children's, Ascension, UI Health, Rush, coming together to amplify their collective power and each of them bring different expertise. So when we think about Sinai and the history and community and serving; Sinai is a lead in that with the Sinai Community Institute. It has set precedence over the last 30 years on how you were given best practices as well on how you engage and effectively deal with community and things on the ground ranging from maternal-child health and other spaces that's inspiring. So to have leaders like you, Debra Wesley, and everyone else that touches our work is important. Having government-led entities or affiliate entities like UI Health, the University Health System, County and its history and what it's done and the history of it being a training ground where people all over the world wanted to come to learn because they know they get a range of experience and access. Having Rush and it's reputation around quality; Lurie, and it's focusing in on specialty care for children; and then Ascension and it's connection to a larger national network and where it sits.

So, it's been quite a journey of setting a table and having the institutions and their intentionality come together, understanding that if combined they'd be the number one employer in the state of Illinois. And that collectively, this work warrants this sort of shared impact. That has been very important and critical. And as we go around the country and talk about this work, the first thing people want to know is, "How did you get hospitals around the table? How did you get people to leverage their expertise and what they bring in a unique way, but also to fly under this agnostic banner, West Side United?" Like, we're trying to figure that out in New York. We're trying to figure that out in Boston. We're trying to figure that out in Milwaukee.

And I think to the strength of leaders like you and other CEOs, that's part of the magic of this work, as well as then the engagement with community. Again, where Sinai is a leader, where once the hospitals decided to work together to leverage their shared power as anchor institutions, to leverage their hiring, their investment capabilities through social impact investing or direct investments like the work you're doing within the Ogden Commons and beyond, for us to think about career pathways and building the wealth trajectories of community members from the west side and beyond who, in some cases, work for 30 years at institutions and retire in the same positions without owning where they live, et cetera. So, that power was important, but also the magic of community was bringing along residents to help define our strategy, and that's embedded at every level of governance. So, we've got our executive leadership council with hospital representation, but also equal representation from community. They help drive where resources go and do so many other things that make this work impactful and sustainable.

And so getting into the weeds of what we do, the first thing was how do we, as a hospital-driven collaborative, leverage our hiring capabilities? And so March 5th, 2020, we unveiled our 1,000-day plan, which was the same day Rush admitted it's first COVID patient. And the idea was that we would accelerate more, hire more, invest more, spend more, because collectively there's a 4-billion spend that we have annually, or at least at one point. And so, what would it mean if we redirected that to local vendors on the west side? What would it mean if for those that have the unrestricted revenue to invest, put that back out to community in partnerships with community development financing institutions for low interest loans? What if we thought about supporting small businesses within our corridors on the west side by providing a small business grant pool?

So, the answering the questions what if, based on the ability and low-hanging fruit that we had as a collective, really jump-started our work to be impactful as we aim to eradicate the life expectancy gap. And so, some of our early wins are really related to us being able to produce collective dashboards that show as a collective, West Side United, has hired over 5,000 west side residents within the last five years, that we've spent with local businesses 180 million; that through social impact investing work, we've been able to support with investments 15 million dollars that went out to west side projects that range from affordable housing to capital improvements. And then, when you talk about the cost of direct investments with entities like Sinai doing Ogden Commons or UI Health building new clinics; those numbers go up exponentially. And so, the impact has really been around, being able to connect residents and local businesses into some of those programs and we see success.

Host: That's incredible. So, Ms. Trailblazer, under your leadership in just five years, you're talking about West Side United investing more than 195 million dollars to improve health outcomes and to spur economic and workforce development and really enhance the quality of life for west side residents, including giving 5,000 individuals jobs. I mean, this is phenomenal. And I love how West Side United puts the residents at the center of the decision-making. You said that you have their voices there telling us what they want and what they need. Can you give me a quick example of something that you heard directly from these councils, from these residents, in terms of a direction to go and how we implemented that specifically?

Ayesha Jaco, MA, BS: One overarching piece was, as we began to think about how to build out this work and hospitals decided to sit around the table and work together, the next stage was talking to community members to see what resonated. And one glaring message from community was to not create anything for them without them. And so, that led to the formation of a community advisory council, a planning committee first that dissolved, that was of CBO leaders residents from our 10 ZIP codes and that is now a community advisory council that, as mentioned, sits across from hospital leadership. They also sit on every West Side United working group, so they help drive strategy, determine where grants should go through our RFP process.

But one other piece was us working with organizations in West Garfield Park to actualize their vision for a wellness center in that community. And so, there are lots of strands when we think about Garfield Park in 2019 and Mayor Lightfoot's Invest Southwest Initiative and how this corridor or a corridor in Garfield Park, the Madison Corridor, one of the most famous, was not in the running for that because there was not a set table by community to drive a plan for that community or to galvanize resources.

And so, as a convener, West Side United stepped in to be a member of this collaborative, this burgeoning collaborative, that ultimately became the anchor that ultimately garnered the Chicago Prize, the second Pritzker Traubert Chicago Prize, which was a 10-million dollar capital investment prize that is going towards a 50-million dollar development that is going to bring a wellness center.

So, that was all out of listening to a request from community and also being responsive to the need, and to step in as a partner to bring resources and brainpower to help make that vision a reality. So, that's one example I'd like to share.

Host: That's incredible. I'm so excited for that big win with the Chicago Prize and can't wait to see how that continues to unfold. Super congratulations. So with all this great work and you already getting all these important entities sitting at the table, the community organizations, the hospitals; it sounds like this is almost ready to go on autopilot. So, what are the actual barriers? Why shouldn't we expect to achieve the equity and the justice that we're seeking? It sounds like we've got the pieces and the players. What are the outstanding barriers?

Ayesha Jaco, MA, BS: I think we have to think about collective measurement, because to date, we can show you as we think about the path to eradicating the gap; we can show you the number of hires, the number of dollars invested. And so, this next chapter in our life cycle really is about aligning with everyone on the ground, around how we ultimately plug in to impact median income, unemployment rates, high school graduation, some of the cross-cutting pieces that are part of our metrics framework that I should add; was created under the leadership of Sinai Urban Health Institute. So at that time, Dr. Sharon Holman, the USC School of Public Health.

So, our road to measurement and really activating and going deeper in these spaces, is going to be critical and we need all hands on deck. And so, we're currently aligning when we think about the implications of homicide; that is one of the leading drivers. And so, there are associated metrics with that. And we as West Side United, as a convener, don't go in those spaces. But for the organizations that do, how do we align and plug into a measurement framework that allows us to work together? And we need to do that in every area to stand up this work. And so, there's alignment also with Healthy Chicago Equity Zones coming out of the Chicago Department of Public Health, where Sinai is the regional lead for the West Side. And so, we are under that umbrella, working very closely for that continued alignment. So, I think it's just now that we've got our healthcare institutions around the table, we need to align better across at the CBO level and around those different associated metrics. We also need other industries. So we need tourism and hospitality to take that industry to take on the hiring goals, the procurement goals, because this really is an all-hands-on-deck approach. And so, moving into the near future, that is part of what we're looking at.

We're also transitioning to a 501(c)(3). So right now, we're incubated at Rush University Medical Center. And over the next 9 to 12 months, we'll be a multiple-member 501(c)(3) where we still have our hospital partners around the table, but we're emerging now out into an environment where we don't want to be seen as competitors to the organizations that we've helped along the way through resourcing, and that sort of thing. So, it's defining our identity, where we coexist in that space as well, in our future state, as a continued convener and contributor versus competitor. And so, we'll be working to work with our funding community and partners around how we sustain in this new iteration in terms of how we're structured. But the most critical piece is in trying to eradicate the gap, we need to be very clear around measurement, what we're tracking, and we're very much committed to this next chapter.

Host: Well, this is just phenomenal. And I think you so appropriately were presented with a very special award at the Sinai Community Institute's 30th Anniversary Gala for this incredible work that you're doing in the community, and it was appropriately named the Tikkun Olam Award, which is loosely translated means repairing the world. And anyone listening to this podcast and hearing about the work you're doing will see how fitting that award is and was for you and the work that you're doing. How did it feel to be recognized by SCI at the gala with this special award?

Ayesha Jaco, MA, BS: Well, thank you so much again for recognizing the work that we have produced in partnership with you and many of the other awardees. So, it felt amazing. That was a Grammy moment for us walking the red carpet and, most importantly, standing alongside other warriors from NLEN, Latinos Progresandos, NLCCC, The Englewood Barbie, right? All of these amazing leaders and organizations; it felt great to be amongst that class. And it was inspirational to continue to dig in together to really, magnify the work that you've already done. It was also a treat to see Deborah Wesley in the video, going back to the '90s and just, again, being immersed in the trail that Sinai has blazed. It was just a great moment. So, thank you again.

Host: Yes. No, congratulations. Sinai is so proud to partner with West Side United. We're proud to be the regional lead for the west side and we stand with you. This is personal to us too, to scale over these injustices in terms of not being able to have the lifespan and the quality of life. So, as we really build on the great work you're doing and you think about all the great work happening in the community, what makes you, like, very hopeful? What are the signs that we are absolutely moving in the right direction?

Ayesha Jaco, MA, BS: I think that the systems continue to show up and deliver on their promise, which is to be present and to keep community at the forefront. That is very hopeful. In my early part of my career, I was on the other side of the table and had experienced what it felt like to be overpromised and to have services be underdelivered or to be in situations where things dried up once the money dried up. Or to be part of research and then for researchers to pack up and never come back to share the findings. And so, what I've seen in this space in terms of the partners and industry, people really roll up their sleeves.

I'm excited that just as SUHI co-wrote and guided our metrics framework. They continued on in other endeavors with us, and the theory of change that is guiding the Garfield Park Rite to Wellness Collaborative in the Sankofa Wellness Village is informed by partners like SUHI, who was part of that architectural build out of that framing, and that you have Rush around the table. So, it's just great to see this equity, the urgency of addressing the gap and the equity lens play throughout and become the identity in some cases of missions and across organizations, et cetera. And the fact that community voice is in the driver's seat, and that's the continued way again, as people want to know, how do you get systems around the table and to stay committed. The other big question is how do you get community? And I think we are figuring that out and able to share those best practices. And I'm happy that they are still pretty much at the focal point of what we do.

Host: It's incredible work and, again, more than honored to be a part of it, and how the Urban Health Institute, SUHI, is able to really bring that scientific rigor in terms of the metrics and making sure, you know, if it's not measured, it doesn't count, you didn't do it. And so, we want to be able to document and show the work and be able to have it stand up against any kind of criticism in terms of this is what it was, this is what it is now. So, glad to be there in that way as well.

So, I highlight you and the ground work that you've done that other cities can look at this model and say, "Wow, this is something that we can do in our city too." So again, I want to thank you. I want to thank your dad for inspiring you to commit your life to making your community better than how you found it. And you are already doing that and you've got a long future ahead of you as such a young woman that the sky is the only thing that can contain you in terms of the great work and the great milestones that you will achieve for the communities that you're serving.

I just want to thank you so much for joining me and for just sharing this incredible career that's not even close to being finished, we're just getting started. But your tireless work in advocating true equity in all the spheres, in healthcare, for economic opportunity, for workforce development. With people like you, we can build community health and economic wellness on Chicago's west side. And I'm so happy to be a part of it. So, thank you again, and I just wish you all the energy and strength to continue this important and critical work.

Ayesha Jaco, MA, BS: Thank you so much. And it's an honor to learn from people like you who walk in your genius and to see your evolution and everything you've done for our country, the state, the city, being at Sinai now. So, it's an honor to be able to look across the room and to share space with you and to learn from you. So, thank you for all of your contributions and I look forward to continuing this work with you at Sinai and everyone involved.

Host: Yeah. For sure, sister. Thanks so much.

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 at Sinai Chicago on Twitter, Facebook, and Instagram for information on upcoming podcasts. Until next time!