Dr. Helene Gayle on Our Moment in Time

You’re listening to the Getting Smart podcast where we unpack what is new and innovative in education. I’m your host Jessica and today we’re featuring an interview with Dr. Helene Gale. Dr. Gale is the CEO of the Chicago Community Trust, one of the nation’s leading community foundations. The Trust works with donors, nonprofits, community leaders and residents to lead and inspire philanthropic efforts that improve the quality of life for the residents

of the Chicago region. For 30 years, Dr. Gale was one of the world’s leading experts on infectious diseases, leading global efforts at the CDC and then at the Gates Foundation and finally at Care International. Dr. Gale’s global to local story gives her a unique perspective on issues of race and class and set the stage for the Trust’s attack on the racial and ethnic wealth gap. Let’s listen in as Dr. Gale talks to Tom about the path forward for

Chicago and America. Dr. Helene Gale, welcome to the Getting Smart podcast. Hi, it’s great to be with you. Hey, it’s good to reconnect after many years. Helene, we overlapped at the Gates Foundation like 15 years ago. Sounds like you’re in DC this week where you had a chance to reconnect

with a couple of those people. Yeah, it’s been great. That experience was such an important experience and I think those bonds will last for a lifetime. That alumni group is just some of the most talented and mission focused people on planet Earth, right?

Yeah, and I just think we were there at such a special time too. I mean, in the early days when we were still just kind of, you know, we had that zeal and that zest and that passion and we were figuring it out as we went along. It was a special moment, I think. It really was. Helene, you, is it right that you trained as a pediatrician? I did. I did, yeah.

Why? And then you went back, you went back to Hopkins for a Masters in Public Health. Why that focus from individual kids to populations? Yeah, I actually did my public health at the same time as I did my medical degree and then went and did my residency in pediatrics. So I had kind of planted the public health seed before doing my, you know, clinical specialty in pediatrics. And I, you know, I guess it

was from the fact that, you know, growing up, I always kind of thought of myself as a activist. I was very involved in, you know, the causes of the day and, you know, went to school because I wanted to have something that I could do that would give back, if you will, and hopefully make positive social change. I went into medical, went to medical school and chose medicine because I thought that health was a very tangible way that you could

make a social contribution. But as I was thinking about this trade-off of individual care, I, you know, started hearing more about public health. I went and did a public health degree, but also wanted to have that clinical training. So I went ahead and did my specialty. But after, after I finished my pediatric residency, I felt like having seen so many cases where individuals came in and out of the hospital or in and out of the emergency room, and the

real reason that brought them there was less of the individual disease and more the systems that weren’t in place or the home environment that they came from or, you know, the issues that we now call the social determinants of health. And I felt that if I wanted to make the greatest impact while I loved taking care of individual patients, if I thought about my patient as communities or nations or the world, which is what public health is, then

I thought that I could have a greater overall contribution and impact at a population level. So, Helene, you went on to have an incredible 30-year career in public health. There was a couple of decades where you were kind of the Dr. Fauci for the globe, where you were the global expert on infectious diseases. You ran the CDC Center for HIV, sexually transmitted diseases and TB. And then as we mentioned at the outset, you launched similar efforts

at the Gates Foundation. What an incredible experience in both of those roles, really, to take on the most challenging diseases on a global scale. I don’t know what the question is in there. Well, first of all, thank you for that contribution. I don’t know that I ever ascended to the heights of Tony Fauci as I joke with him. He’s

become the Marcus Wellbe of the world. He has. But there’s a few of us that know you were Dr. Fauci for the planet before. But it was a fascinating, wonderful opportunity. I went to Centers for Disease Control thinking I would go for the two-year training program. It’s called the Epidemic Intelligence Service. And I kind of thought I would go for a couple of years, get the practical training in public

health, just like I’d had the practical training in pediatrics and medicine, and then go back and do something more perhaps closer to medicine and care. And I got to CDC and just found that it was such a special place and stayed for 20 years, probably doing 10 different jobs during that time. And it allowed me, I think, to really deepen and develop my skills in public health. But I also came right around the time when HIV was starting to unfold.

And interestingly, when I first went to CDC, people said, you know, when you go and you have the opportunity to interview with many different parts of CDC, and then there’s a match program to match you with a different program. And everybody told me, stay away from that HIV thing, because it’s not that important. And, you know, we’ll figure it out in a year or two and do something that’s of real public health significance. Well,

I did do my first assignment somewhere else, but ultimately decided that, you know, it was clear by that time that HIV was going to be one of those defining public health issues. And, you know, for me, I think the interface between something that was very scientifically fascinating and just starting to evolve, but also something that clearly had a lot of social dynamics as part of it. And we knew early on that HIV, you know, while

anybody could get the virus, it wasn’t distributed randomly. And a lot of the social drivers, you know, whether you were poor, whether you were part of a group that was marginalized or stigmatized like infection drug users or gay men, or ultimately really having a big impact on communities of color who had been, you know, left out of access to health services. You know, we knew that this had a real interface between risk factors that were socially determined,

as well as the disease itself. And then I went on to do a lot more globally, where again, that interface between global poverty and risk for HIV, gender and lower status in societies, etc. And that putting people at risk, you know, I think for me who always had this interest in kind of society along with health, it was a very captivating issue to spend time in and have that opportunity to have a population and ultimately a global impact on preventing HIV.

It’s interesting that 20 years later that we now think of HIV as really as a chronic illness that we still don’t have a cure, much less a vaccine, but have been pretty successful globally treating it as a chronic illness. I wonder, I was thinking this morning about the current pandemic that we’re facing and how you’re thinking about that. Is this something that like HIV could be around for a hundred years to come? Well, you know, I think there are probably some differences, but also some

similarities. I mean, clearly we have seen that it is disproportionately impacting populations that were already financially and also health wise, more unstable. But from a medical perspective, I think they’re very different. You know, this is the more serious condition than the flu. It’s probably more like the flu than it is like HIV, a respiratory transmitted infection, a vaccine is probably going to be found sooner than we obviously don’t yet have an HIV vaccine.

There’ll be more focus on vaccines than on treatment. Treatment now for HIV is really how we’ve been able to manage it as a long term chronic infection. And treatment in some ways has also allowed us to further prevent the spread of HIV. So I think there’s similarities, but there are also some real differences, you know, in terms of the biology and the science of it. Would you like to add a editorial comment about how we’ve done as a country dealing with COVID?

Oh, my goodness. Well, you know, I think unfortunately, we have not had the coordinated national response that something like this requires. And, you know, if you look at it, there’s kind of a you know, a whole smorgasbord, if you will, of ways in which people have states have handled this and the states that have really stuck to public health guidance and have listened and worked closely with public health systems within the states or the cities, you know, are the states

in the cities that have done the best and those who have not have not done as well. That said, it shouldn’t be, we should not have treated this in a way that didn’t have a strong national response, a strong coordinated response at the national level, and a strong coordination with, as the US, with the rest of the globe. And I think it’s unfortunate to see this sort of, you know, lack of leadership at the national level, because it’s cost us hundreds of thousands of

infections and causing a lot of death and suffering on parts of many, many far too many Americans. Halene, after almost a decade leading care, a great international aid agency, about three years ago, you took on the leadership at the Chicago Community Trust. Tell us what that is and why it was of interest. Well, Chicago Community Trust is one of the oldest community foundations in the nation. And community foundations are kind of this interesting animal,

this interesting creation, if you will, somewhere in between a traditional foundation and a nonprofit. We have both a side where we bring in money, but we also make grants. And, you know, we are, we, people who care about their community and want to invest in their communities and trust their resources with us, believe that we understand where to be our greatest in the community, so that we’re able to use those assets to make positive social change at the local level.

You know, I kind of stumbled into this job. I was in between care and doing a kind of short-term role, helping to launch a new organization. And I got a call from a headhunter. You know, I had just moved to DC. I was ready to plant my roots there. But I think partly because I had spent so much of my time globally. And when we had the election 2016, which really kind of shook me to my core in many ways, because I recognized how we were more divided than perhaps I had realized

as a nation. And I think we were experiencing a lot of social turmoil, if you will. And so for me, I really felt having spent 30 some years of my life focused globally and somewhat nationally as well, that being in a, in a, at a local level where you can get things done, where you’re part of a community would be an interesting opportunity for me as I kind of moved to the end part of my career. And so and Chicago is a fascinating city. I hadn’t spent a lot of time in Chicago, but you know,

I knew a lot about Chicago, people who had come from Chicago, or some of the most inspirational people, including our former president and others. So, you know, it was a city that I’ve always admired. And so when I got the call to consider it, talk to people, I was really compelled by the opportunity and really, you know, do believe that so much of what needs to happen, so much of the innovation that, that needs to happen as we, as we rethink how we operate as a society, I think will happen

at the local level. So it’s been a fabulous opportunity. I love it more than I thought I would and finding it incredibly satisfying. It is one of the world’s great cities. It has what might be my favorite city skyline. It’s right on a great lake. It has some of the best public parks in, certainly in America. It’s a major business center. It’s, there’s a huge number of education companies and nonprofits in Chicago. So it’s important to our education sector.

But it’s a city and a state that also illustrates the inequity in America. It’s Illinois is a state plagued by some of the most inequitable school funding in America, where you can drive 15 minutes from downtown and be in a school that gets 50% more money than a downtown school that serves kids that are 100% in poverty. So in the best and sort of worst way, Chicago is a brilliant ecosystem of America. I love the fact that you’ve created an agenda. You’re,

you’re, you know, you’re not only responsive to the, the interest of donors, but that you’ve really created a beautiful strategy focused on a thriving and equitable and connected Chicago. At the heart of that is the idea of attacking the wealth gap. Why did you choose that and how are you trying to take on inequity in the wealth gap in Chicago? Yeah, and I, you know, when I came, you know, I took some time to get to know the city a bit and, you know, think about where

we might as an organization really prioritize and focus our resources. And, you know, there’s a lot of challenges in Chicago, obviously. You mentioned education, clearly a big one. You know, there’s a huge life expectancy gap in Chicago, probably the largest in the, in the nation, 30 years between living and gleaming downtown Chicago and go a few miles to some of the neighborhoods in South Chicago and life expectancy plummets by 30 years. So you live 90 years if you’re

downtown and in wealthy neighborhoods, 60 years if you’re in South Side Inglewood. You know, violence has plagued the city and you can go on and on and we could have chosen one of those issues. But as you look and peel things back, it’s clear that the, the root cause, underlying issue really is this sustained and growing wealth gap. And, you know, we see between African Americans and Latinx, 10-fold wealth if you compare a black family’s wealth to a white

family’s wealth, eight-fold if you compare Latinx to white families, you know, with white families being either eight or 10 times more wealthy, if you will, on average. And so, you know, underneath all of these issues is this staggering wealth gap. And, you know, I argue that while from a social justice standpoint, it is important and the right thing to do. African Americans and Latinx communities make up two-thirds of the population in Chicago. You can’t hold two-thirds of your

population back and expect that the rest of the city, the rest of the region, will move forward. So just from pure economics, as well as, you know, what’s the right and fair and just thing to do so that families are able to educate their children, put food on the table, have healthy outcomes, etc. We said this, this was the issue where we felt we could make the biggest contribution. And so we’ve kind of developed a strategy that looks at three aspects of work. One is at the

household level. How do you help to grow household wealth? And we put the focus on wealth because income, people talk a lot about income gap, but income is a slice in time. Wealth are the assets that you carry with you, that you pass on to your generation, and that allows you to have a certain sustained type of life and life outcome. So we looked at growing household wealth, which includes incomes and jobs, homeownership, entrepreneurship, and also debt, because we

know that people may accumulate assets, but if you go into debt because of student loans, predatory lending, etc., you aren’t going to be able to keep those assets, if you will. So household wealth. We also put a focus on driving investments in neighborhoods. A study came out recently that showed, as an example, that a single white neighborhood in Chicago had more mortgage lending than all of South Chicago, Black South Chicago neighborhoods

together. And we know that lending practices, where private dollars go to develop infrastructure, etc., is disproportionately going to white and prosperous neighborhoods. So how do you drive not only public dollars, but also particularly private dollars, which really stimulate economic growth? And then a third component is how do you help develop community power and community activism? And so we have a real focus on how are we making sure that we are working with communities

to lift up their voice, to spark action, and make sure that they’re at the table when decisions are made about their lives. So our, you know, our strategy is household, neighborhood, and community, and really trying to drive change at all those levels with, you know, relatively aggressive five and 10-year goals. But we think if we can make a difference, and it’s not us by ourselves, it’s working with partners, if we can make a difference in this, then I think there’s so

much that will, in so many ways in which Chicago and communities will benefit as a result of it. Have you seen investors step up to that agenda? Yeah, there’s a lot of it. There really is a lot of enthusiasm. And I would say that, you know, what’s happened in COVID and the disproportionate impact on communities of color has kind of amplified what we, you know, what the message that we started out with. And it has been quite

heartening and it’s sad, you know, sad circumstances. But I think the COVID impact on communities drives home the message of why this wealth inequality is such a foundational issue. And then add to that the racial tensions following the George Floyd murder. I think, again, it was one of those moments that really amplified in people’s minds. You know, if you didn’t think there was a problem, it’s pretty clear we still have a problem with race in America. And that that

problem is not just something that hurts individuals. It’s something that hurts communities and cities and our nation. And if we don’t do something about it, you know, I think it’s, it is one of those things that will continue to fray our society around the edges and ultimately at its core. I’m curious about the link to education in your plan or thoughts about what would improve the quality of an access to education, not just K-12, but lifelong learning

in Chicago? Well, you know, we’ve been involved with education for a long time at the trust and we’ll continue to be involved, although it’s, it isn’t as central right now, particularly the K-12. We’re working a lot more on workforce development, the pipeline of those who graduate, getting them into either the kind of apprenticeships, community college, or other things that will help young people who did not have opportunity really using education as a way of really driving their, their

future and future opportunities. And so that’s where we’re focusing primarily. But obviously, we work a lot with the educational system. And I think, you know, Chicago used to be considered the worst educational system in America. In the last decade, they have made tremendous strides. We’re very concerned because, you know, in this COVID moment, the digital divide has really had an impact on students who live in communities where they

don’t have access to broadband and internet. So one of the things that we’ve done through some of the work that we’re involved with with COVID response is to pool our resources with others, to get broadband access to kids who are, you know, who are primarily doing online learning as a result of COVID. And really, putting a real focus right now on that as a specific area with an education that we want to work on is making sure that these kids don’t get left behind.

We don’t know if schools are going to reopen. We don’t know if they’re going to reopen fully, partially, what they, you know, what September will look like. And we don’t want those children to fall further and further behind. So I appreciate how you, your analysis went to root causes. I suspect that has something to do with being trained in epidemiology and public health. Is that fair to say? Yeah, well, yeah. And I think because public health does take such a root cause approach,

and we focus on this whole issue of the social determinants of health, things like education, like access to nutrition, like access to a living wage and safe neighborhoods, etc. Because we would know that, you know, 80 to 85% of the things that are modifiable around your health and health status have to do with the social determinants of health and health care probably contribute somewhere in the neighborhood of 15 to 20% of health outcomes. So we know that, you know, if you can make a

difference in these social determinants, you can have a huge impact on health outcomes. And so I think that approach is something that I carry with me. How do you get at the root causes? You know, sometimes you just have to put the fire out, you got to get the band-aids on there. But are you also making sure that you’re thinking about the issues that are really at the core of some of these long term sustained challenges? Any thoughts that you mentioned, schools reopening, do you have any

thoughts about how that ought to be orchestrated? Well, just like my comments about the response to COVID overall, you know, CDC put out some national guidelines, I think it’s important that we do think about this in a broad way, look at what the overarching public health principles are, understanding that reopening is going to have to be done at keeping in mind the local context. What you do in Chicago may be very different than what you do in Utah, which is very different

than what you would do in Florida, because we all have different, you know, epidemiologic circumstances. But I think some of the core principles that CDC and others have laid out, that look at the level of infection and then thinking how do you reopen safely with safety being at the core of it, and then thinking about based on how you can keep students safe, whether you can keep students in a congregate setting or not, then do your best to make sure

that if students aren’t able to get back into schools that we’re providing for their learning outside of the classroom. I wonder if you have any closing thoughts for or advice for in investors and policymakers, particularly at the state and local level, any insights there that you want to share? Well, first, I would just say how important I think getting involved in policy is. I think so often we think about what we do in terms of programs and initiatives, but

you know, how we change policies, I think has a huge impact on the success, whether it’s in education or health or, you know, any of the issues we deal with. One of the things that we have a big focus on in our work on closing the racial wealth gap is really policy and advocacy. Poor public policy got us to some of the situations that we’re in when you think about policies like redlining and other things that denied home access to African Americans. If we can

reverse some of those, the impacts of poor policy, I think we can make even bigger changes, and I think that’s the same for education. I would love to see us think about how we fund education differently as an example. You know, I think there’s a lot of things that can be done that could make a big difference in how we provide so that all children have the opportunity to have access to a high quality education, no matter where they live, no matter how high or low their

property taxes are, you know, I think it just should be a right in this country that children have access, equal access to high quality education. We really appreciate your focus on the wealth gap. I just think it’s really a smart strategy that aims at root causes. It’s a long-term view and a long-term fight, but the focus on growing household wealth and catalyzing neighborhood investment and then building this collective power, this collective advocacy is, it seems like

a super smart strategy. Congrats on your initial success there. Thank you, it keeps us busy. It’s a great city and better, I think, because you’re there in the fight. So Dr. Helingale, we appreciate your 30-year contribution to public health and your recent efforts to make Chicago a better place to live, learn, work and play. Thank you. My pleasure. Thanks for being on the podcast. My pleasure. Thanks. Good to talk to you. A big thanks to Dr. Gale for joining us on this

week’s episode. We appreciate her global contributions to limiting the devastating impacts of infectious disease and for her recent commitment to transforming opportunity in Chicago. For more on community development in Chicago, be sure to listen to episode 253 with Leah Mechantosh, where we explore the Lawndale miracle. I’ve got that linked in the show notes for you to make it easy. All right, that’s it for today listeners. Before you go, make sure you rate and review this week’s episode

and hit subscribe. For the Getting Smart podcast, this is Jessica, signing off.