No Mercy

The map says it all: when the ER at the Rockton Ave campus of MercyHealth closes, the ambulance ride time from my home outside of Northwest Rockford to the next closest hospital will increase by 70%. The reduction in access to critical care to the residents of the West Side of Rockford will be even more painful.

Perhaps the most striking loss is the gradual phase-out of the former Rockford Memorial Hospital’s emergency department and Level II trauma center. Studies in nearby Chicago, also experiencing a plague of gun violence, show that increased distances to transport gunshot wound victims contributes to increased mortality by as much as 20%.

There are now zero full-service hospitals on the West side of the Rock River. The next-closest hospital, Swedish American, is designated a Level 2 Trauma Center — meaning that not all emergency services are available 24/7 and some complex procedures (like cardiac surgery) will be “referred” to a Level 1 Trauma Center.

Aside from the victims of assault and traumatic penetrating injury, the relocation of a vast array of services formerly provided by the Rockton avenue campus will affect the nearby community in more subtle but nonetheless harmful ways.

The West Side of Rockford is an area suffering from some low scores among the “social determinants of health” already. The concept of social determinants of health basically says that there are many social factors that predict health outcomes.

• people have limited access to fresh food
• work longer / multiple jobs to afford rent/mortgage
• more likely to be exposed to pollution or lead
• labor they perform is more physically taxing
• may have trouble providing for adequate childcare

…and the list goes on. When residents have lower scores on those social determinants of health, what that really means is that people end up living shorter lives of lower quality.

Dying sooner, in more pain along the way.

So the place where people most need healing is being abandoned by the number crunchers.

It seems like this has been a foregone conclusion for months or years now, but let’s not forget that those in power saw this coming and allowed it to happen regardless. And not only did people like IL State Senator Dave Syverson (who has sat on the board of MercyHealth for 15 years) broker the deal, but politicians including former Mayor Larry Morrissey actually caved in to pressure from Javon Bea to discount building permit fees and allow sales tax abatements.

What exactly did Rockford’s leaders allow?

1) Since the new MercyHealth Riverside campus was situated in the “I-90 Enterprise Zone”, varied sales tax breaks were conferred on it by that choice alone.

According to the City of Rockford’s website:

“The Purpose of State Legislation Allowing the Creation of Enterprise Zones is to assist in the revitalization of distressed areas by offering financial and tax incentives to stimulate business growth and neighborhood improvement.”

Didn’t know that the area near Sportscore Two was “distressed.” /s

2) Although several news articles by local media have seemingly disappeared, making it hard to determine exactly what building permit fees were discounted, Javon Bea threatened during negotiations to move his project to a business park in Beloit if the City didn’t discount $1.8 million in building fees by half.

That’s potentially $900,000 that would have gone into the City’s coffers. Money that had otherwise been earmarked for additional emergency vehicles to defray the suspected negative effects of needing to shuttle people suffering from gunshot wounds, blunt force trauma or cardiac arrests to a more distant hospital.

Additionally from this article:

Morrissey said the city had already put an estimated $10 million in economic development incentives on the table.

They include:

— Property and sales tax breaks and investment tax credits because the MercyRockford site was put into the Interstate 90 Enterprise Zone.

— A five-year sales tax rebate agreement to help MercyRockford with the cost of building Interstate Boulevard and extending Lyford Road through the property.

— Pursuit of a state transportation grant that could pay for half the cost of Lyford Road, which Bea unaffectionately calls a “second version of Perryville Road” running through the heart of its property.

— Waiving water-connection fees to the property in exchange for an acre of land where the city may build an elevated water tank.

We can be grateful to the late Brian Leaf for his reporting on this issue, and we should be concerned that the caliber of investigation he (and other journalists) offered is in peril as the Rockford Register Star continues to hemorrhage experienced staffers. Alarmingly, the previous link and other articles from the RRStar about the deal between municipal leaders and MercyHealth seem to be inaccessible (404'd) on their website.

3) As a “nonprofit hospital,” MercyHealth isn’t required to pay property taxes on its facilities as long as they demonstrate they are providing the same dollar amount of “charitable care.” Healthcare law experts and labor advocates in Cook County, where nonprofit hospitals collectively receive a $200M/year tax break because of this issue (while charitable care only accounts for 1–2% of gross revenue), believe this is an unconscionably low bar.

Cash, class and race.

MercyHealth generates $1.1 Billion dollars in revenue each year.

It owns and operates many clinics, but the other hospitals it operates are in Walworth/Lake Geneva (93% of residents are White), Janesville (92% White), and Harvard (77% White).

It is currently building a new hospital in Crystal Lake (93% White) to the tune of $105 million.

Of course, the shiny new hospital they built off East Riverside is perfectly positioned to provide care to people who might have been eating well their entire lives, performing manual labor less often, with (relatively) plenty of time for rest and exercise.

That’s not to say that everyone on the East side has it easy — far from it — but on average, people living on the East side are fortunate to live in newer housing stock free of lead paint, with a lower cost burden of housing compared to income (to pick just two metrics that indicate health outcomes).

MercyHealth claims they are making operations more efficient in order to improve patient outcomes, but which patients? Surely not those who live near School or Kilburn or Auburn or Central.

Our society at large has been measuring success in dollars and cents alone for far too long. GDP, jobs figures and new capital investments can only go so far. The much-lauded economic benefits of new development should not blind us to the relative privation endured by many living on the West side.

A common saying goes: “All you have is your health.” That is true collectively as well. In the view of people who are truly human-centered, the one true measure of a city’s success is the overall health and well-being of its residents.

You might live closer to a different hospital, like Swedes or OSF or even the other MercyHealth on Riverside. You might say that these issues don’t affect you quite as much, and that might be true.

But there is no bright line between the “haves” and the “have nots” — rather, there is a “social gradient” of health outcomes, where people a bit lower from the top of the socioeconomic scale truly do live measurably shorter lives than those on the top, with declining results as one goes down that gradient.

And what happens to people on the West side of Rockford affects us all. In one part of town, people live shorter, harder lives. Communities and the organizations that support them decline. Housing is commodified and degraded and wealth is lost or never manifests. Property and violent crime rises. An entire city gets a negative reputation, businesses look elsewhere when expanding, potential residents cross Rockford off their list of prospects — and existing residents flee.

But it doesn’t have to go down like that.

The people of Rockford do not have some deficiency of character that should preclude us from living lives that are as long and healthy (on average) as the ones they live in places like Lake Geneva, Crystal Lake and Harvard.

So what to do? There is no clear-cut call to action, but a call to awareness (and anger) is warranted.

We should be frustrated with the powers that allowed this raw deal to happen, when it was clear from the beginning that this was possible and even likely — and we should hold them accountable.

We should be wary of people like Javon Bea who come bearing gifts (like a shiny hospital, or new jobs at the airport), but who ask us to give up something irreplaceable (like a centrally located hospital or an ancient gravel prairie) — and we should resist their incursions.

Finally, we should show the meaning of the word “mercy” to all of our neighbors. It would be a mercy if no matter what side of this town you live on, you could be more assured of living a long, healthy, happy life. Just as those social determinants of health show that Rockford struggles with multiple issues, that means we have many ways of approaching the problem and improving outcomes.

And we must.
Because Rockford — all of Rockford — deserves life.

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For more on social determinants of health, see Dr. Michael Marmot’s enlightening talk or read The Health Gap, authored by the same.