The NAACP’s recent health equity map, which shows how ZIP code can determine health outcomes, is a reminder of public health’s role in addressing inequities driven by poverty and a fragmented healthcare system. Chicago has long faced unequal health outcomes, especially in Black and brown communities dealing with poverty, cultural barriers to trust, and limited access to care, food and pharmacies.
Nearly half of American adults have high blood pressure, but only about 1 in 4 have it controlled below 130/80. In Chicago, public health officials estimate that 175,000 of an estimated 700,000 adults with hypertension face preventable risk of heart attack, stroke, heart failure, kidney disease, dementia and premature death. Controlling their blood pressure could prevent thousands of cardiovascular events and save hundreds of lives a year — about 4,000 Chicagoans died from heart disease in 2024, about 2,000 died from hypertension as a primary or secondary cause.
If an infectious disease killed 1,000 Chicagoans annually, it would be declared a public health emergency. But hypertension kills silently, one person at a time, and is the precursor to many heart attacks, strokes and kidney failure. Together, cardiovascular disease remains the nation’s leading cause of death and a major driver of Chicago’s life-expectancy gap.
This burden isn’t shared equally. Black adults develop hypertension earlier and more severely than white adults; Latino communities face similar risks and barriers to diagnosis. Uncontrolled hypertension concentrates in neighborhoods shaped by segregation, disinvestment, food insecurity and inadequate access to trusted care.
There are evidence-based processes for protecting entire populations rather than treating individuals one at a time. One example is the Chicago Department of Public Health and the University of Illinois Chicago’s partnership to build the largest air-monitoring system in the U.S., giving residents air-quality data to protect themselves. Similarly, CDPH’s Crisis Assistance Response & Engagement Program, better known as CARE, pairs emergency medical technicians with behavioral health specialists to protect against behavioral health crisis. And CDPH partners across Chicago and the healthcare ecosystem to do contact tracing to protect against communicable diseases.
To tackle high blood pressure and its social determinants — the top driver of the life-expectancy gap — the public-private initiative Live Healthy Chicago is leveraging Chicago’s academic medical centers, community organizations, federally qualified health centers, safety-net providers and city resources The campaign initially focused on 27 West and South Side neighborhoods where cardiovascular disease and premature mortality are concentrated alongside high socioeconomic stress.
The coalition is built around two numbers: 130/80 and 1,000. The first is the recommended blood pressure target; the second is the estimated number of lives saved annually if Chicagoans with hypertension reach that target.
The approach is community-focused: Identify people with hypertension, connect them to trusted care, provide effective treatment and stay with them until blood pressure is controlled. That means screening people in churches, barbershops, libraries and workplaces — not waiting for them to reach a hospital. It means community health workers guiding residents through a fragmented system and pharmacists and nurses working alongside physicians. It means home blood-pressure monitors, affordable medications and reliable follow-up. Every health system, clinic and insurer should track its blood-pressure control rate and have a plan to improve it.
Public health is how our city demonstrates its humanity. Live Healthy Chicago could serve as a national model for closing life-expectancy gaps by addressing a chronic disease that considers the humanity needed to connect. Chicago has already reduced homicide and overdose rates; the same resolve can now target heart health. Live Healthy Chicago aims to turn 130/80 and 1,000 into a movement transforming a silent epidemic into a celebration of lives saved.
Dr. Garth Walker is the new commissioner of the Chicago Department of Public Health.
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