North Lawndale Chicago: Community Health Needs Assessment

Introduction

North Lawndale is located within Chicago, Illinois. Much like many other communities throughout the nation, it is attempting to lower healthcare costs while keeping surrounding residents safe from the COVID-19 pandemic. Chicago and the state of Illinois are unique in that they spend a disproportionate share of income on healthcare. According to the city of Chicago's budget, nearly 25% of expenditures are devoted to healthcare — above the national average of 17.7%. Projections suggest that Chicago's healthcare budget could rise to upwards of 30% by the year 2030.

North Lawndale is no exception. The community grapples with an aging population, high healthcare costs, capacity constraints, and a lack of the healthcare innovation necessary to drive down costs. In addition, North Lawndale faces adverse demographic trends that exacerbate many of the negative healthcare developments occurring in the region. These include a higher unemployment rate relative to the national average, a greater proportion of economically vulnerable residents, lower educational attainment, and lower income levels. As a result of these converging healthcare and demographic challenges, North Lawndale is an ideal candidate for a community health needs assessment. Each of these elements is discussed in detail below, and each carries grave implications for similar communities across the nation (Immergluck, 1996).

Demographic Background

According to the 2020 census, North Lawndale has a population of approximately 35,000 residents. Population trends are declining, as more residents are leaving the state than entering it. The year-over-year population decline is roughly 5%. Over the last decade, the population has decreased by approximately 16% — significantly higher than Chicago's overall population decline of 7%. There are roughly 11,000 households with an average size of about three people. Of those households, approximately 3,700 are owner-occupied; the remainder are rentals. The median housing cost is approximately $1,000 per month, with an average home value of $227,400.

Roughly 54% of residents are female and 46% are male. A large majority of residents (87%) are African American. The community also suffers from lower educational attainment than the national average: only 8% of the population holds a college degree, compared to the national average of 29%, and only 4% hold a master's degree, compared to the national average of 12%.

Lower educational levels translate directly into lower incomes, as the overall population lacks high-demand skills. Roughly 71% of the population earns less than $50,000 per year. The median household income is $30,483 — nearly half the national average of $62,843. Only 18% of the population earns above $75,000 per year, and approximately one-third of residents live below the poverty line. The unemployment rate is roughly 9%, well above the national average. Notably, the largest employment sector in the area is healthcare, where roughly 18% of residents work.

These conditions make data-driven community engagement especially important. Because a large portion of the population is middle-income or below, an adverse health outcome can have a devastating financial impact. As has been demonstrated by COVID-19, the costs of poor health — including absenteeism, lost wages, and death — are avoidable through preventative approaches informed by data (Theodore, 1997; Krieger, 2005).

Socioeconomic Background

North Lawndale carries a hardship index score of 87 on a scale of 0 to 100. From a socioeconomic perspective, this score is driven primarily by five factors. The first is crowded housing: approximately 10% of residents live in overcrowded conditions, compared to a Chicago average of 5%. As noted above, nearly 30% of the population lives at or below the poverty line — exceeding both the Chicago average of 20% and the national average of 25%. Even more alarming, the unemployment rate for residents over the age of 16 stands at 21%, compared to Chicago's average of 13%. High unemployment is strongly correlated with increased crime, which further exacerbates economic decline. It also means that many individuals are unlikely to carry adequate health insurance, leaving the community especially vulnerable during pandemics such as COVID-19 (McGrath, 1995).

A lack of high school diplomas compounds these challenges: approximately 27% of North Lawndale residents lack a high school diploma, compared to 20% of the Chicago population overall. Educational deficits reduce the pool of skilled workers, suppress wages, and discourage businesses from relocating to the area. Without specialized labor to sustain a viable market, job opportunities dry up, driving a net migration out of the community.

This cycle of low education, low employment, and low income is reflected clearly in per capita income figures. North Lawndale's per capita income is approximately $12,034 — less than half of Chicago's $28,000 and well below the national average of $33,740. Without the necessary skills to attract and grow businesses, the community struggles to generate the tax revenues and household wealth needed to invest in education, health, and infrastructure.