As we walk up to the red-brick tower with its unusual steeple roof and take the elevator to the boardroom on the 14th floor with its impressive view of the city, we travel back in time to when this long-forgotten business icon was once the vibrant economic heart of Chicago.

For almost one hundred years, this turn-of-the-century turret, which looks like a Tuscan campanile, had been the business beacon of retail giant Sears, overlooking an industrial facility that stretched a quarter mile in every direction. 

The burgeoning business provided jobs and livelihoods to thousands of people, turning Chicago’s West Side into one of the most affluent areas of the city. But things started to unravel in the 1970s when Sears moved its management to glitzy downtown and closed its blue-collar operations too, triggering a veritable business exodus.

Taking up its headquarters in the freshly built Sears Tower – then the world’s tallest building – Chicago’s West Side, meanwhile, had undergone a massive transformation. More than 100,000 mostly white residents left the area as Sears’ capital and workforce drained out, leaving many Black residents, who had arrived here starting in the 1930s, without a job.

It left parts of Chicago’s West Side as one of the city’s poorest districts. Today, it stands out for the low life expectancy of its 550,000 residents. Depending on the zip code, the life expectancy gap compared to Chicago’s wealthiest districts can reach twenty or even thirty years.

Although data suggests the gap can be attributed to racial and ethnic differences, sustainable solutions are rare. The structural and economic barriers are so deeply ingrained in the country’s social and healthcare systems that no simple solution seems to exist.

An epiphany

David Ansell, however, believes there is a solution. To show how change is possible, he invited us to the old Sears Tower where, for him, medicine and the economy are inherently linked – a connection that took him years to understand.
Ansell had already been working in Chicago for more than a decade and had started a new position in 1995 at Mount Sinai Hospital in Chicago’s Douglass Park neighborhood when he spotted the silhouette of the old Sears Tower.

Having never seen the tower before, he inquired about it. “I asked, ‘What is that?’ Someone said, ‘That’s the Sears Tower.’ I replied, ‘No, the Sears Tower is downtown.’” The sight of the tower was an epiphany. 

“It was then I realized something I could have never learned in medical school: This area once spanned four blocks of Sears, employing 22,000 people. But when Sears left the community, the capital that had once sustained the neighborhood was moved downtown.”

Ansell, who had started his career at Cook County Hospital in 1978, which was known for its activist stance to help the poor and underserved, was no stranger to the hardships faced by hundreds of thousands of residents in Chicago who could not afford healthcare. 

But seeing the old Sears Tower, he realized that medicine was not enough to help them. “I understood there was really no way that medicine was the cure for this. This was not about more doctors or more hospitals. The root cause of the problem was economic deprivation.”

Closing the gap

From then on, Ansell was on a mission. It not only entailed thinking about how to provide help to the weakest but also developing new strategies to overcome the racial and economic barriers responsible for what he came to understand as the death gap.

After his time at Mount Sinai, Ansell joined Rush University Medical Center in 2005 to lead the institution as its first chief medical officer, helping it to become one of the top-performing academic medical centers in the nation. But this was not enough for Ansell, who remained dedicated to ripping down structural barriers.

During his time at Mount Sinai, he founded the Sinai Urban Health Institute in 2002, which focuses on researching equal access to healthcare and community health interventions. At Rush, he helped establish programs such as the Metropolitan Chicago Breast Cancer Taskforce, now known as Equal Hope, as well as the Rush BMO Institute for Health Equity.

Ansell saw the need for more change. “I didn’t have the means to influence it until I joined Rush, an institution with resources. My job was to make Rush a top-quality hospital, which was achievable with those resources. But something clicked for me – I realized I needed to focus on the real problem.”

In 2016, Ansell convinced Rush to change its mission and work towards closing the life expectancy gap between West Side Chicago and the city’s richest districts, such as the Loop, with its world-famous skyscrapers, luxury shops, and its privileged way of life. “It’s not enough to have high-quality healthcare; we must also focus on closing the life expectancy gap,” said Ansell, who in 2016 became Rush’s first leader of health equity.

Standing in the boardroom of the old Sears Tower, Ansell pointed towards the Chicago skyline with the stately black Sears Tower, now officially called Willis Tower, and said: “The Loop has an average life expectancy of 85 years – if it were a country, it would rank among the best in the world. But just seven stops down the Blue Line, in neighborhoods like this one, life expectancy drops to 66 or 67, like the lowest counties in the United States.”

Ansell wants to reverse this massive difference. “That gap is unjust,” he continued, “unfair, and unnecessary. We know we can fix it, but it requires more than simply better healthcare. We need to address the root causes – structural racism and economic deprivation – by creating opportunities for wealth-building. That has become my mission.”

King’s legacy

As part of his new curriculum, his work spectrum is now more that of a manager. Although he still sees patients regularly, he now is also on the lookout for new business opportunities which both create monetary value but have also a lasting effect on healthcare.

“When you look at the Sears Tower, it’s a powerful, physical reminder of what happens when neighborhoods lose access to jobs and wealth creation,” Ansell said. “People die not just from disease, but from the economic decline that follows. This is what sociologists call being ‘triple disadvantaged.’ Understanding this goes beyond medicine – it requires knowledge of sociology and economics.”

To change the status quo, Ansell together with his team and community stakeholders has set up innovative programs and business ventures. Among them are the community health equity initiative West Side United and the cardiovascular outreach program E3 (Engage, Empower, Evaluate), which is sponsored by Novartis. Together with capital partners, he has also launched a linen service, which is responsible for washing Rush’s bedclothes and other linen.

Setting up the business was far from easy, Ansell said. After an analysis showed that Rush could make at least 700,000 US dollars in annual savings with the new, outsourced linen service, he had the backing of Rush’s board. Now he is not only working to keep it running but striving to expand it. Furthermore, he is working towards creating a new wellness center in the neighborhood.

As we look out of the window and take in the landscape, he points us to another location. “Just a mile north of the linen laundry, the Sankofa Village Wellness Center is being built in Garfield Park. This is the same neighborhood where Martin Luther King Jr. lived while advocating for economic justice, housing, and education rights, realizing that the struggle was deeper than civil rights alone,” Ansell said.

He continued: “King famously said, ‘What good is it to be invited to the lunch counter if you can’t afford the hamburger?’ King came to Chicago to demonstrate this, knowing that fighting for economic justice would be even tougher. It was in these neighborhoods where he organized before his assassination.”

Ansell, inspired by King, has a big task ahead. But even at age 72, when most people are enjoying their retirement, little seems to stop him. After around 30 minutes in the boardroom of the old Sears Tower, Ansell must leave for another meeting at Rush, while we linger for a few moments before heading down to follow in his path and learn more about his teams’ work.