COMMUNITY VOICES: A Q&A from U Chicago Medicine,
As senior pastor at University Church in the Hyde Park neighborhood and inaugural chair of UChicago Medicine’s Community Advisory Council, the Rev. Julian DeShazier talks about building trust and relationships.
In this series, the University of Chicago Medicine examines health-related challenges faced by communities served by the South Side-based academic health system through interviews featuring a variety of perspectives. This is the second in a 10-part series.
Q: You already had a full plate as a pastor, among many other responsibilities and activities that include being a musician. Why did you get involved in the health equity issue?
A: For me, the priority of the church is to be a part of the most important conversations going on in the community. Ten years ago I got involved in health care inequity on the South Side, which soon became defined as the lack of a level 1 adult trauma center. We got behind those activists and did all we could to help them talk to the University of Chicago and eventually to negotiate for a trauma center. After it opened and UChicago Medicine’s Community Advisory Council was formed, the hospital shared with members what was going on with the challenges of health care delivery on the South Side, and we decided that this would be an important part of our work.
This interview was conducted by independent health writer Deborah Shelton on behalf of UChicago Medicine. Neither the Tribune newsroom nor the Editorial Board was involved in producing the content.
Q: Did growing up in nearby Washington Park influence your view of health care? What did you see or experience that gave you insight about what the needs are?
A: It was really more about my mother’s experience because I was so young, not even 5 years old, when we moved south like so many people making that exodus further south out of Chicago. When I ask her now about what that move was about, it was about lack of access. It was about how hard it was to get to the doctor or to get what you need. Not only around health care, but her worrying about the schools and the sense that the community in which she lived wasn’t properly equipped for her to raise a son. Now that I’m older and serving in Hyde Park, right next to where I grew up, I’m still hearing that decades later from people who are living here.
That means that institutions, in coming up with solutions, should listen to the people who live here and are affected most. I hope this is an opportunity as we address health care, at the macro level, to involve the people who are most affected and let them help decide what’s going to happen. In order for this to be successful, it’s not just, “Did we get the funding? Or did we fix a hospital or save a hospital, or bring in whomever?” That can’t be the only metric. It has to also include, “How well did we listen to the folks who live here?”
Some of these problems on the South Side are generations old and built by lack of trust and lack of relationships. So, we have an opportunity to interrupt that right now.
Q: How do health inequities impact your parishioners?
A: I see it on a week-to-week basis. Whether it’s folks who are living with mental illness who are a part of our congregation and don’t have adequate resources to take care of themselves and get the help that they need— or whether it’s folks who have lived with long-term chronic conditions and are always trying to navigate the system and asking for prayers because they are scared. Even if they have access, they are made more anxious by having to navigate that system. That’s a problem. And I see it a lot.
I see the challenges. A lot of the statistics are all too real for us right now around diabetes, asthma, maternal health, the repeat ER visits. I have people in the congregation who’ve been personally affected by that. And that makes it even more urgent to offer myself and whatever skills, leadership and presence I can bring to help represent them. That’s what I’m here to do.
Q: How significant is the opening of UChicago Medicine’s adult trauma center?
A: I would certainly call it a success in the sense that the people who were advocating for the trauma center were people who lived in the community and were experiencing the greatest consequences of not having proper care close to them. They were advocating for it for years before I got involved. And at the end of the day, there is a level 1 adult trauma center open. And I give all the credit to them. It was something that the community needed, they asked for it, they fought for it, and it happened.
The trauma center is busy, every day. So we recognize that not only was the trauma center needed, but that more things have to be addressed as a result. The fight continues because violence is still occurring. It’s not just theoretical that people were at risk of dying, being shot and being victims of violent crime, and needed a place to go. The newer work that’s happening is looking at violence from a public health perspective.
Q: Is structural racism at the root of many of these problems?
A: Racism is not only a part of the problem of health care inequity, it has been embedded within the nature of health care delivery. And so if the proposed solutions are not clear about racism, they are going to be naïve, at best, and foolish, really. I think that’s where the accountability comes from.
People who are leading these institutions have acknowledged it and said, “Alright, help us figure it out.” That gives me hope that this isn’t a conversation that’s naïve about the reality of racism. If we are honest and if we bring the appropriate resources and involve the people most affected, a good result will almost always come out of that.
Q: You’ve seen efforts in the past to improve health care access on the South Side. How do you define success?
A: I think the big “a-ha” moment in all of this work is recognizing that the real victory is not going to be saving one hospital. We don’t want anybody to lose access. And if Mercy Hospital closes, that will result in yet more inequity and a lack of access and worse outcomes. But the solution isn’t just to save a hospital; it is to approach this problem at a systematic level. How are they all going to work together and collaborate? To say, if we’re going to do this, we’re going to have to talk about racism. Otherwise, we’re going to find that the problems are going to continue to affect people.
Another part of those conversations and listening sessions that was really powerful was the emphasis on the interconnected nature of all of these systems, that health outcomes are worse when poverty exists and when affordable housing isn’t present. People were asking hospital leaders to connect health to housing and to paying a cell phone bill. To be honest, the most overwhelming part of this is to recognize we’ll have to look at how everything connects. Ultimately, we’re going to talk about food, we’re going to talk about housing. We’re going to have to talk about Medicaid. It’s a massive issue.
Q: Are current attempts to achieve health equity different from past efforts to improve health care?
A: Yes, definitely. I’m seeing people do the work.
If it was people just talking pie-in-the-sky kind of stuff, in a very broad way that wasn’t specific, without strategy and actually putting ideas to paper, I wouldn’t be hopeful about this at all. People are bringing the appropriate resources and energy towards fixing it. The problem is being met with an appropriate amount of urgency so that I feel confident that we’re going to meet this moment in a real way. I’m a millennial. I was raised to be cynical of institutions and to not trust them, in particular, on the South Side. But I’m seeing something positive that has me full of hope in this moment.
Listening to the community is happening. And it’s happening in the right kind of way. When the community has responded back saying, “Hey, have you thought about this, or we don’t like this, or we’re worried about this,” they’ve [UChicago Medicine] gone back and made some of those changes. And so I’ve been able to see institutions of power on the South Side respond to the people who live there. For decades, this kind of listening was not happening. This kind of relationship-building has not happened before. So this is a new kind of moment.
And when people say they are going to do something, we’re going to be there to make sure that it happens, and to help it happen. And so there’s a deep bond, hopefully, of mutuality, that is forming here. And we’ve got to be accountable to make sure that continues throughout this entire process and beyond.