Jacobs School Hosts Trailblazing Health Activist

He considered quitting. Instead, he met a group of friends who together began studying the U.S. health care system’s fraught history. “This group of students and I discovered our ‘why.’ And it’s guided me ever since,” Ansell said. “From that day on, I realized for myself, no matter where I went or what position I got, that I would need to be a human rights activist, because in this country we don’t believe that health is a human right.”

Ansell, now senior vice president for community health equity at Rush University Medical Center and associate provost for community affairs at Rush University in Chicago, recounted his activism experience as the featured speaker at the Beyond the Knife endowed lecture.

His talk, “Diversity and Equity in an Age of Erasure: Words Matter but Actions Speak Louder,” took place on Feb. 27 at the Jacobs School of Medicine and Biomedical Sciences.

The Beyond the Knife endowed lecture series, now in its fifth year and hosted by the Jacobs School’s Department of Surgery, aims to address and mitigate the effects of systemic racism and inequality in health care.

Allison Brashear, MD, MBA, UB’s vice president for health sciences and dean of the Jacobs School, welcomed the audience of learners, educators, and community members inside the school’s packed M&T Auditorium. She emphasized the lecture series’ continued importance.

“It really brings to light conversations surrounding racism and the impact of that on health care in the U.S.,” she said, highlighting past topics, including gun violence, injustices in American gynecological practices, and racial dynamics in medicine. “These topics are so important for our community and are so important for our learners to hear.”

Steven D. Schwaitzberg, MD, SUNY Distinguished Service Professor and chair of surgery, thanked many of the people, sponsors, local businesses, and other collaborators involved with the lecture. “It takes a village, and I want to thank our whole team,” he said before reminding the audience of the significance and relevance of the issues being discussed. “We live in turbulent times. But we must remain engaged, we must remain energized.”

Before Ansell took the stage, the Rev. Mark E. Blue, pastor of the Second Baptist Church of Lackawanna and president of the Buffalo Branch of the NAACP, delivered opening remarks. He spoke about ongoing issues and action surrounding Buffalo’s East Side, particularly Jefferson Avenue revitalization and an Urban Land Institute initiative.

He discussed efforts to “bring back the vitality and bring back Jefferson to where we can look at it and have pride in where we grew up. I am dedicated to that,” he said. “We are not here to listen to complaints. But we are here to go forward and to listen to the things we can do to change our community for the better.”

During the first part of Ansell’s lecture, he discussed his early head-on confrontations with disparities in health care.

After Ansell devoted himself to activism while in medical school, he and some of his friends chose just one hospital where they wanted to complete training. “We only put one place on our match list: Cook County Hospital,” he said.

Ansell would go on to spend 17 years at Cook County Hospital, a longstanding Chicago public hospital, completing his internal medicine residency there and eventually becoming division chief of general medicine and primary care.

While working at Cook County Hospital in the 1980s, Ansell recalls “walking into a public hospital and seeing what became known as health disparities,” he said. “It was really an incredible experience, but also a devastating experience to witness.”  

He remembers seeing women in labor transferred to the hospital and dying. He recalls people with gunshot wounds, people on ventilators, all transferred, and soon dead.  

Disconcerted, he and some of his colleagues began a study looking at about 500 hospital patients, their diagnoses, and reasons for being transferred to the county hospital. The patients were told that there weren’t enough beds at other hospitals — but the real reason they were transferred, Ansell and his colleagues found, was that the patients were uninsured. 

After the study was published in the New England Journal of Medicine, a 1986 law made this practice of “patient dumping,” or transferring impoverished patients from private to public hospitals, largely illegal. Ansell later wrote the 2011 book “County: Life, Death and Politics at Chicago’s Public Hospital” as a memoir of his accounts. His second book, “The Death Gap: How Inequality Kills,” was published in 2017. 

In 2005, Ansell joined Rush medical center as its first chief medical officer. During the second half of his lecture, he shared more about some of the former and ongoing health equity work at Rush and in the Chicago community.

For residents in Garfield Park, a neighborhood adjacent to Rush, life expectancy has reached only about 64 years old, Ansell recalled. While some blamed violence, the actual causes have involved everything from neighborhood conditions to fragmented social structure, Ansell said.  

After Ansell and his colleagues conducted a community health needs assessment, results indicated that people primarily wanted jobs that pay well, support for local businesses, mental health support, and opportunities for children, among other needs. “And no one asked for a doctor,” he said.

While presenting these findings to boards and other leaders at Rush and within the Chicago community, Ansell stressed the need to address structural racism and economic deprivation, the root causes of so many issues, he said. “If we don’t address the wealth gap, we’re never going to solve the health gap.”

To help fill these gaps, Ansell described some of Rush’s efforts to create change and economic opportunities, which included a collaborative approach teaming up with other hospitals and health care leaders. In 2019, Rush partnered with a medical supply distributor to open a new facility within Chicago’s West Side to supply its hospital system and provide local jobs.

Rush also connected with a laundry vendor on the city’s West Side last year, Ansell said, to launch a linen cleaning facility in a previously vacant building, creating hundreds of jobs for area residents. The hospital system previously outsourced its laundry cleaning across state lines. 

Before his presentation, Ansell, who is also the Michael E. Kelly, MD, Presidential Professor of Internal Medicine at Rush Medical College, spoke with a group of Jacobs School students and leaders from organizations including the Student National Medical Association, Latino Medical Student Association, the Asian Pacific American Medical Students Association, and Black Men in White Coats.

He encouraged the students to organize and offered advice for taking on social and medical issues. “Whatever you do, do it collectively. You’ll get more done,” he said.

“This is a community-oriented medical school,” Ansell said of the Jacobs School, and he discussed how the surrounding communities “have faced historic injustices.” To that end, he advised bringing in more members of the community to act as health mentors and to help form direct relationships.

Further, Ansell told the students that when local town hall and political meetings are held, they should not just show up but “show up in your white coats” and stress the importance of Medicaid and other programs potentially facing cutbacks.

Following Ansell’s talk, a panel of speakers shared insights on disparities affecting Western New York. The panelists included Ansell; Andrew L. Davis, president and chief operating officer of the ECMC Corporation; Leonard E. Egede, MD, the Charles and Mary Bauer Professor and Chair of the Jacobs School’s Department of Medicine; and Zeneta B. Everhart, Masten District council woman for the City of Buffalo.

The panel further emphasized improving public health by addressing wealth disparities and bolstering East Side businesses. “To convince businesses to come in, you have to present a plan to them that shows that their return on that investment is going to be real,” Davis noted.

Everhart stressed the need for more holistic planning and fewer short-term cash infusions that don’t create lasting change. “How are we going to change the landscape of our neighborhood?” she asked. “I like to see things that are going to be generational and transformational. I don’t want to see things that are one-offs.”

Egede said that the corporate, academic and government sectors need to work together to enhance the community and create investments. He also emphasized that enabling land and property ownership is central to building wealth. “If you can’t own land and you can’t own property, then you can’t transfer wealth. When you can’t transfer wealth, it doesn’t matter how hard you’re working, it creates this cycle that makes things very difficult.”    

Ansell reminded that, after good leadership and good planning come together, “action equals change.” Schwaitzberg then closed the lectureship and reminded the audience that the problems in Buffalo are well known. He said that Ansell showed how a committed group in Chicago was able to bring a team of competitors together around a common cause, leading to positive change and attacking the death gap.