How one hospital system is helping tackle health inequality

The Covid-19 pandemic brought increased awareness to health equity gaps in the US. But in the last couple of years, the Trump administration has targeted diversity, equity, and inclusion (DEI) initiatives across industries—and healthcare is no exception.

The US Equal Employment Opportunity Commission has rolled back affirmative action guidelines and ended certain demographic data collection, for instance.

A report by the Commonwealth Fund, a healthcare nonprofit, found that measuring and reporting health disparities “enables states and health systems to assess how well they are using resources to improve health outcomes for everyone.”

Similarly, at Chicago’s Rush University System for Health, Chief DEI Officer Ildemaro González told us that his “work has a lot to do with data.” His office uses that information to try to close the gaps in access to healthcare for the community.

Among the initiatives Rush organizes are food pantries for patients. It has also contributed to building the Sankofa Village Wellness Center, which provides primary care and dental services to residents in West Garfield Park, a low-income community on the western side of Chicago. The center also offers arts, financial education, and workforce development programs to 6,000 people each year, according to its website.

Healthcare Brew spoke with González to discuss some of Rush’s initiatives to track and tackle health inequities.

This interview has been lightly edited for length and clarity.

What are your general tasks?

One of the key aspects and our long-term goal is, as we get to know our community, we understand that there’s a 25-year gap in life expectancy [between some lower-income and higher-income neighborhoods]…There’s another number that we track closely, called the hardship index…[It] combines social economic measures like unemployment, population age, educational attainment, income, crowded housing, and poverty. The higher the score, the higher the economic hardship—and the increased likelihood of health disparities.

I’ve been here 18 months, and the first months, I would say, were about developing a plan, understanding all this data...Let me give you a specific example. If you’re “Maria,” and Maria has multiple chronic conditions and comes to any emergency room (ER) in the Rush system—and she speaks Spanish versus being fluent in English—her odds of being readmitted are higher upon discharge. That not only impacts Maria; that also impacts us because our financial results are impacted by readmission rates. It’s not good when patients are readmitted. So, once we knew that research, I spent days partnering with our language services team and other teams here to do a few things. We put in-person language services in the ER. We expanded the technology available for remote interpretation. We expanded over-the-phone interpretation.

What major community initiatives does Rush invest in to address health equity?

We understood that being healthy goes beyond the disease, and it’s impacted by all these social drivers of health. We have many individuals focused on “food is medicine.” We recently opened the Sankofa Wellness Village on the West Side, where we’re bringing people together with Erie [Family Health Centers], a federally qualified health center providing clinical care. We’re providing mental health. The Y has the whole sporting complex there. You could argue, as a healthcare system, “Well, this is happening outside my doors. Should I be [involved] in it?” We believe that we can be great influencers of these outcomes. We understand that if we don’t step in, it will impact our outcomes regardless. It will impact our finances anyway.

How would you describe DEI work in 2026?

2026, and for the foreseeable future, to me, is about a continued change in the legal and regulatory environment. We’ve spent days and nights and months looking into historical practices to ensure that everything is compliant, to ensure that no one is getting admitted or hired or promoted because of a protected class…and then ensuring we do DEI as a strategy to achieve our organizational objectives.

We are being more precise in the work we’re doing and the way we communicate it. At the end of the day, we come here every day to ensure that everyone gets the chance to be healthy. That’s really our work.