“Don’t miss the humility of Christ,” Pastor Marshall Hatch proclaims from the pulpit, his words echoing across the limestone sanctuary. “See the sign that he’s in a small place, in a small town, on the bad side of the small town.” He pauses and lets the image sink in, the congregation murmuring in agreement.

Inside the church, the holiday service is well under way. African American women in smart red dresses and pillbox hats and men in dark three-piece suits pack the pews, the scent of aftershave mixing with the sweet smell of poinsettias. And despite the grey skies outside, light streams down on the congregation through a large stained glass window in the shape of a slave ship. Encircling the ship is the word: REMEMBRANCE.

On the morning of Christmas Eve, a couple wearing thin jackets and sneakers push a shopping cart through the snow on Kildare Avenue in the heart of West Garfield Park. They stop for a moment, catching their breath, in front of the towering New Mount Pilgrim Missionary Baptist Church, before continuing their journey north.

The average Loop dweller lives to be 85 years old. The average West Garfield Park resident dies 16 years earlier, at 69. That’s the same life expectancy as Iraq.

A mere six miles away is West Garfield Park. It takes 16 minutes to get there by train.

The downtown neighborhood has a median household income just under $100,000 and the lowest cancer death rate in the city.

Pastor Marshall Hatch and his son Marshall Hatch Jr. stand inside New Mount Pilgrim Baptist Church, the largest church in West Garfield Park. Here, in West Garfield Park, a community that has the same life expectancy as Iraq. Residents here live on average to 69, according to the most recent census, a full 16 years less than that of residents in the Loop just six miles to the east. It’s a neighborhood that has been plundered for years by housing discrimination, segregation, and police violence. It is struggling with poverty, school closings, drug addiction, and shootings. Walk just a few minutes southwest of New Mount Pilgrim and you’ll come to what DNAinfo called the city’s “most dangerous block” in 2016. In the last two years, only seven of the 48 funerals the church held were for people who lived to the age of 85—the average life expectancy of someone in the Loop. In the same period, it held 16 funerals for people under the age of 50 and a dozen for gun violence victims. In 2016, it held funerals for police shooting victims Quintonio LeGrier and church member Bettie Jones. The final funeral of 2016 was for a 33-year-old man who was killed by police just two blocks away from the church after he had shot his pregnant girlfriend in the stomach. “Things are getting worse in Garfield Park,” Pastor Marshall Hatch said in an interview a few days earlier. “People are under a lot of stress. There’s a lot of desperation.” By some accounts, Chicago is undergoing a golden age with higher life expectancies and historic employment highs. Thanks to a job boom in the Loop and its surrounding neighborhoods, private-sector employment grew 16.6 percent in the city in the last seven years. For the first time in half a century, the city is outpacing the suburbs in job growth. Chicago also had a record number of construction cranes last year and hit a five-year high for the number of construction permits issued, both measures of a thriving economy. For the second year in a row, Time Out recently named Chicago as the best city in the world when it comes to “happiness, culture, affordability, city pride, and how people feel about their neighborhood.” But as the city racks up accolades, neighborhoods like West Garfield Park are being left behind, their residents dying at a far younger age than the national average. What will it take to bridge that gap and save lives? While life expectancy has improved across the city in recent decades, the gap between poorer neighborhoods like West Garfield Park and richer areas like the Loop has persisted. When looked at by race, non-Hispanic blacks have the lowest life expectancy in the city, followed by non-Hispanic whites and Hispanics. The expansive South Side dominates the city’s 35 worst communities for life expectancy, but the smaller West Side is home to some of the worst health outcomes in Chicago. West Garfield Park has the lowest life expectancy in Chicago, and four other West Side neighborhoods—East Garfield Park, Humboldt Park, Austin, and North Lawndale—all have life expectancies well below the average in Chicago (78 years), Illinois (79), and the United States as a whole (79). Life expectancy is used as a kind of shorthand for the health of a population, because it wraps up critical problems into one measurement.

All factors contributing to life expectancy ~ 25% Genetic and biological ~ 75% Social and behavioral Social and behavioral factors contributing to life expectancy Sources: Scientific American, Univ. of Wisconsin Population Health Institute

Despite all the talk about genes and biological factors, researchers say they only account for about 20 to 30 percent of a person’s health outcomes. The rest is determined by a series of social and behavioral factors—which can, theoretically, be changed by individuals and the institutions that serve them. In other words, a person’s ZIP code matters more than their genetic code when it comes to health. The connection between one's health and factors like income and neighborhood violence can easily be seen at the individual level. People who live in violent places may feel anxious and be reluctant to walk around their neighborhoods. The stress and lack of exercise can exacerbate health issues. In fact, “low-income children face a bewildering array of psychosocial and physical demands that place much pressure on their adaptive capacities and appear to be toxic to the developing brains,” according to a 2011 report published by Stanford University. But not all social and behavioral factors contribute equally to a community’s health. Community safety and education, for instance, contribute more to the length and quality of a population's health than access to health care. This means that even if a community has a hospital, people living there could still have a shorter lifespan if the neighborhood is low-income or violent. It is a paradox felt deeply on the West Side, which is home to one of the largest urban medical districts in the country. The Illinois Medical District has a 560-acre footprint and four large hospitals. Sitting in the wealthier Near West Side neighborhood, the IMD is a stone’s throw away from North Lawndale and East Garfield Park. Advertisement In an analysis by Sinai Urban Health Institute that will be released next month, North Lawndale was in the top 14 community areas in the city for access to clinical care, but in the bottom six communities for social and economic factors and the bottom 10 for both length of life and overall health outcomes. Similarly, though West Garfield Park ranked 52nd out of 77 for clinical care, it’s dead last in the city for both health outcomes and length of life. “We can’t just treat our way out of [this problem],” says Julie Morita, the commissioner of the Chicago Department of Public Health. “Where you live makes a big difference in how long you can expect to live. And in order for us to really change that, we really have to focus on the social factors that impact health.” The social and economic factors that created the death gap on the West Side did not develop overnight. The area was once home to a manufacturing hub that provided jobs to residents and economic stability. But many of these companies left in the wake of the 1968 riots following Martin Luther King Jr.’s assassination. At the same time, decades of racist federal policies contributed to the area’s decline. The Federal Housing Authority refused to insure mortgages in African-American neighborhoods, preventing a whole population from buying homes and building equity. The federal government also subsidized builders to mass-produce homes in the suburbs on the condition that only whites could live there. The result was devastating poverty and violence. “If you look at when crime started going up, it’s when factories started leaving,” says Dan Cooper, the executive director of the Center for Equitable Cities at Adler University. “When you have higher poverty and people can't afford to own homes, you have more crime and disorder.”

Voices from the West Side What does Chicago’s 16-year life expectancy gap look like for people living in West Side neighborhoods? >> Scroll to the right in the gallery below to see more. Melissa Chrusfield, 39 “Let’s just give it a freaking shot. Let’s give these people some resources and see if they might want to use them, you know? Let’s treat them like humans.” Read more of Chrusfield's story DeAndre Turner, 23 “The violence here has affected me a lot of times. I lost three friends literally the next day behind each other. Three in a row.” Read more of Turner's story Adesha Holloway, 18 “If you actually come out here and visit it won’t be all guns and drugs. You would be amazed at what you can find when you look into it.” Read more of Holloway's story

In a red cinderblock office building on a stretch of Harrison that’s dense with nonprofits and churches, Darnell Shields leafs through a pile of community planning documents on a plastic table painted to look like marble. As the executive director of Austin Coming Together, he is in charge of coordinating the work of 68 local organizations, churches, and businesses to improve education, safety, and economic development in the far West Side neighborhood. Austin is the largest community area in Chicago by geography and sits next to West Garfield Park. It is the day before Thanksgiving and the office is empty save for Shields and one other employee. Shields is dressed casually in jeans, sneakers, and a grey thermal tee. A lifelong resident of the Austin neighborhood, he is intimately familiar with the challenges that are contributing to the death gap on the West Side. “I look at Austin as a true victim,” says Shields. As a child, his father moved his family from south Austin to north Austin to flee a wave of violence that hit the area in the late 1970s as factories closed and drugs came in. But within a decade that wave had made its way north and transformed his neighborhood from a family-friendly area to one challenged by gang strife. With that change came corruption and the feeling that the city government was abandoning the neighborhood, Shields says. The case of the Austin 7 in the ’90s only reinforced this sentiment, when a group of police officers assigned to investigate drugs and gangs on the West Side were convicted of racketeering and providing protection for narcotics dealers. “There’s been so much disadvantage in this community. I want people to recognize that, because that’s real. That’s our history,” Shields says. “However, along with that, I want people to recognize how resilient this community is.” Advertisement That resilience is apparent in the work Shields has done over the last nine years as a community organizer. At ACT, he is helping residents develop a comprehensive “quality of life” plan to improve the well being of Austin residents by 2025, targeting improvements in elementary education, decreasing the poverty level for families with young children, stabilizing housing values, and decreasing the violent crime rate. ACT has been working with the nonprofit Local Initiatives Support Corporation, or LISC, since 2016 to create the neighborhood’s first such plan and expects to complete it later this year. LISC has helped 18 neighborhoods create similar plans, which have leveraged over $872 million in real estate and program investments. The ambitious plan is a direct response to people and institutions outside of Austin pitting local leaders against each other in recent years, “forcing them to compete with one another for scarce resources and influence,” according to a quarterly community report published by ACT and Austin Weekly News. This competition has led to “the loss of job opportunities from our family members, the closing of our children’s schools, the theft of properties from our neighbors, and loss of public subsidies to help our most vulnerable community members.” According to the report, the new plan counters this competition by harnessing the “collective power” of the neighborhood and focusing efforts on narrow goals. Shields says he has seen some positive efforts on the West Side to address issues like job development and low-income housing. Last year, for example, his organization partnered with Chicago Public Schools, Manufacturing Renaissance, and the Jane Addams Resource Corporation to launch an advanced manufacturing training center in an Austin high school. Since training began last February, that program has served 26 trainees and placed seven trainees into employment earning an average wage of $14.62 per hour. But he says that the rising gun violence in recent years has been a major obstacle to change. “Whether you’re looking to progress education or economic development on the West Side, violent crime is an impediment. No matter what we put our resources in, if we don’t address this feeling of safety, this sense of safety that folks need to have, we’re not going to really be able to maximize what we do,” Shields says. ACT is working to address the problem of violence by coordinating efforts to bring about more spaces where residents can access support services and build more trusting relationships with service providers, he adds. Darnell Shields has been working with community organizations in Austin for the past nine years. A mile to the northeast, in her office at the Academy for Scholastic Achievement, Vanessa Ford agrees that the area faces an uphill battle despite its strong nonprofit community. She serves as the director of development at the alternative school that teaches high-risk youth between the ages of 16 and 21. “There’s a lot of groups on the West Side who’ve been at this a long time and who are making change,” she says. “But they make change in individual lives, like in the kids that we get to actually go on and get a high school diploma and create a life for themselves. That’s a tremendous change, but it’s small.” ASA graduates 75 percent of its senior class every year and most of its graduates go on to two- or four-year colleges. But the four-decade-old school has seen a drop in enrollment in recent years as violence and the poor economy have driven people out of the West Side. Austin alone shrunk by over 20,000 people between 2000 and 2015, according to a Chicago Tribune analysis, knocking it from its 40-plus-year reign as the city’s most populous neighborhood. The change has been difficult to watch. Ford’s husband grew up on the West Side and the couple bought an old house in East Garfield Park because “he’s always wanted to stay here and be a part of the change, the redevelopment of it, the regrowth of it.” But it has been a “painfully slow recovery,” she says. Ford says that she’d like to see redevelopment in the area and for the schools to get better—she didn’t send her children to schools on the West Side because of her concerns about the quality of the education they’d get. But she sees the coordination of financial resources as the biggest obstacle to large-scale changes on the West Side. As a grant writer for the last 15 years, she says that resources that are supposed to help her neighborhood often bypass longstanding local organizations like ASA. “It seems like all the money goes to the big nonprofits that aren’t necessarily tied in with the grassroots,” she says. This includes money from the nearby hospitals in the medical district, which she says “has a huge footprint over here. They have huge resources that sometimes you feel trickle down to the neighborhood level and sometimes they don’t. You always feel like the big ones can do a better job [than what they’re doing now].”

“Our job as doctors is to heal and prevent suffering. In this situation, the healing needs to be aimed at neighborhoods.” — David Ansell, senior vice president of equity at Rush Life Expectancy: 85 Loop 79 Near West Side 72 E. Garfield Park 69 W. Garfield Park