Latest / Becker’s Healthcare Podcast / Helen Margellos-Anast, President of the Sinai Urban Health Institute at Sinai Chicago

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Helen Margellos-Anast, President of the Sinai Urban Health Institute at Sinai Chicago · Becker’s Healthcare Podcast

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Welcome to the Becker's Healthcare podcast. I'm Kelly
0:40
Gucci, senior editor and enterprise lead at Becker's,
0:42
and I'm pleased to welcome today Helen Margolis
0:45
Annis, president of Sinai Urban Health Institute, part
0:48
of Sinai Chicago to the podcast today. Helen,
0:51
thank you so much for joining us.
0:53
I'm really looking forward to this conversation because
0:55
your work stands at the nexus of community
0:57
health, health equity, data driven strategy, areas that,
1:00
of course, are all vital to improving outcomes
1:02
and addressing disparities in urban health care settings
1:05
today. So before we dive in, I'd love
1:07
to start by having you introduce yourself and
1:09
share a little bit about your background, your
1:10
journey into public health leadership, and what really
1:13
drew you to Sinai Urban Health Institute.
1:16
Sure. Thank you. So yes. So I as
1:18
you said, I'm Helen Margolis Annis. I,
1:21
actually
1:22
joined Sinai Urban Health Institute very close to
1:25
its inception. So I have my master's of
1:27
public health in epidemiology.
1:30
And
1:31
I actually was looking for an opportunity after
1:34
finishing my Miles per hour
1:36
to do so. All I knew is I
1:37
wanted to do something really meaningful,
1:40
and I knew I wanted it to be
1:41
in The United States. I wasn't really interested
1:43
in international health, which is where a lot
1:45
of people with those sorts of aspirations end
1:47
up moving to. So I happened to come
1:51
across, it was divine providence,
1:54
I happened to come across this posting for
1:56
the newly formed signer urban health student in
1:58
Chicago.
1:59
And as soon as I started reading about
2:01
the research that was going to be done
2:03
around understanding
2:05
health inequities at a hyperlocal level, working very
2:07
closely with communities to
2:09
understand what is driving those health inequities
2:12
and working towards innovative solutions. This is not
2:15
necessarily how it was described at the time,
2:17
but that was the gist of it.
2:19
I knew I needed to be a part
2:20
of this and thankfully I was able to
2:22
join. So I joined as
2:23
a social epidemiologist
2:25
and evaluator only a few months after Suhii
2:27
was founded in 2000. I joined in 2001.
2:30
And I have been blessed to have moved
2:33
from that social epidemiology role where I did
2:36
a lot of research on understanding those health
2:38
inequities more into
2:39
the innovation side and intervention side. I became
2:43
very drawn to the action side of using
2:45
data to get to the right actions
2:47
and partnering with community to do that. So
2:48
I moved into a director of community health
2:50
innovations role and then eventually senior research director
2:53
over all of Suki's offerings and in May
2:55
2020 into my current role as president.
2:58
And then I'm really committed also to
3:00
leadership and understanding how we can collaborate towards
3:03
addressing wicked public health and health issues. And
3:06
so I completed my doctorate of public health
3:09
in public health leadership
3:10
just last year in 2025.
3:12
So that's a bit about my journey.
3:14
Wow. What a amazing trajectory and journey, that
3:17
you've been on. And
3:19
I wanted to ask maybe,
3:21
of course, like you said, with your most
3:23
recent role here as president,
3:25
what was the most important initiative you led
3:27
in the last year, and what did you
3:30
do, and what were the results of that?
3:33
Yeah. So before I do, let me just
3:34
say a little bit about Sinai Chicago because
3:35
I think that's important and Suki.
3:38
So Sinai Chicago is the largest private safety
3:40
net health system in Illinois.
3:42
We serve over 100,000 patients and families that
3:45
live on Chicago's West And Southwest Sides, areas
3:47
of the city that have been disinvested for
3:49
decades and that experience
3:51
significant health inequities.
3:53
So, over seventy percent of our patients are
3:55
insured by Medicaid or Medicare. And actually the
3:57
majority of those are Medicaid.
3:59
We also have a large proportion that remain
4:02
that are either uninsured or self pay, and
4:04
only 5%
4:05
that are privately insured. So that's really important
4:08
to understand as the context from which Suhii,
4:10
the part of Sinai
4:12
that I lead does our work. We're really
4:15
focused on that that population of people who
4:18
communities that have experienced tremendous
4:21
challenges to optimal health and supporting those communities
4:24
to meet their
4:26
their needs and to live their healthiest lives.
4:28
So, the work that we do at SUHI
4:30
is really focused in three buckets. The first
4:33
is understanding health inequities
4:35
at that hyperlocal level, starting with oftentimes quantitative
4:38
data, existing data sources, surveys
4:41
that we might do, things of that nature
4:42
to really dig into what we're seeing that
4:45
might distinguish the communities that we are serving
4:48
or working with. And then really partnering with
4:51
communities to
4:52
bring additional insight into that. So qualitative data
4:55
to expand on what we've seen with the
4:57
numbers and to get the stories that drive
5:00
those inequities.
5:01
From there, we move into more implementation
5:03
and intervention work. So again, partnering meaningfully with
5:07
communities and other partners that are going to
5:09
support us in coming up with the right
5:11
innovative solutions to those inequities.
5:13
And then we wanna make sure that we
5:14
are measuring everything that we do. And that
5:17
includes the outcomes, of course, and the impact.
5:19
And then also the process so that we
5:21
can,
5:22
scale what is successful. So that is where
5:25
we're coming from. So when we think about
5:27
the last year, I'm going to highlight a
5:30
couple of initiatives,
5:31
one in two of the buckets. So the
5:34
first in the understand bucket.
5:36
We in 2025
5:38
completed a study called Empower Their Voice,
5:41
and it was motivated by the fact that
5:43
across The United States, girls' mental health is
5:46
known to be getting worse. So I'm talking
5:47
about adolescent girls.
5:50
We know far less about what mental health
5:52
and well-being looks like for girls in Chicago
5:55
and how it differs across neighborhoods and across
5:57
racial and ethnic groups. So we were really
5:58
interested in understanding that better. We didn't fully
6:01
understand at that time what is shaping girls'
6:04
mental well-being locally,
6:06
particularly the role of community violence, social media,
6:08
and everyday responsibilities and what that might play.
6:11
So the empower your voice study was designed
6:13
to fill that gap. It's a community it
6:15
was a community engaged multi method study that
6:18
partnered with more than a thousand girls across
6:20
Chicago to understand their mental well-being and the
6:22
conditions that influenced that.
6:24
We found, for example, that rates of depression
6:26
and anxiety among Chicago girls were nearly twice
6:28
the national average
6:30
and that these challenges did not exist in
6:32
isolation. We started to dig into some of
6:34
the drivers of those. And so as examples
6:37
of that, forty percent of girls reported contributing
6:39
to family duties or household finances. Again, these
6:42
are adolescent girls.
6:44
Seventy percent had witnessed or experienced community violence.
6:47
And these burdens were also found to not
6:49
be evenly distributed with black and brown girls
6:51
being disproportionately affected, carrying the greatest share of
6:53
those stressors.
6:55
So taken together, those findings made it clear
6:57
that girls' mental health in Chicago is shaped
6:59
by structural conditions not individual shortcomings
7:02
and that addressing mental well-being requires investment in
7:05
safer communities, supportive schools, and systems that truly
7:07
center girls voices and really gave us some
7:10
data from which we are now launching
7:12
more work in this space of supporting
7:15
girls in their mental health well-being.
7:18
Another initiative I wanted to highlight, is
7:22
the continued integration of community health workers into
7:24
Sinai Chicago.
7:25
So, Sinai is focused on ensuring we're reaching
7:28
all of our patients effectively and that we're
7:30
addressing their specific health needs. And one of
7:32
the areas we have focused a lot of
7:33
our research on, for over two decades is
7:36
the community health worker model. In fact, when
7:38
I joined Sinai those twenty five years ago
7:41
now, it was specifically as they evaluate what
7:43
is actually our first ever pediatric asthma intervention
7:46
that utilized community health workers.
7:48
So we've been doing this work for a
7:49
lot of, a long time. Community health workers,
7:51
for anyone who may not be familiar,
7:53
are frontline public health workers who are from
7:56
the communities that they serve.
7:57
So they don't have to have any specific
7:59
education
8:00
depending on the state they're in. They may
8:02
need to have
8:03
specific training,
8:05
to be certified as CHWs and be reimbursable.
8:08
But there's the main thing that we're looking
8:09
for in a community health worker is that
8:10
they're from the community,
8:12
that they speak, quote, unquote, the language of
8:14
the community that they're culturally sensitive to to
8:17
the community that they know the assets that
8:19
are present in that community and that they
8:20
can navigate people connect with them in very
8:23
trusting ways quickly and then navigate them to
8:26
the resources they need to,
8:28
have optimal health and well-being.
8:30
So we've been working on this since our
8:32
inception in 2000. We started more in chronic
8:34
disease prevention and management research, having developed models
8:38
in asthma, diabetes, and breast cancer. We then
8:40
have developed some models around screening for social
8:42
treatments of health and connecting people to resources
8:44
more broadly in complex care management and most
8:47
recently in behavioral health.
8:49
This integration into Sinai really started in 2019.
8:53
We began thinking about how do we take
8:55
the research we've done and integrate it more
8:57
into our direct services.
8:59
And while it has not been a smooth
9:00
road, there have been bumps along that. We've
9:02
learned a lot along the way, and we've
9:03
kept at it, and we've now integrated into
9:05
many areas of Sinai Chicago
9:07
and continue toward are continuing to work towards
9:10
integrating into even more. And there's been a
9:12
lot of progress in that space this past
9:14
year. So we have,
9:16
the base program here is the CHWs Assisting
9:19
Patients Program.
9:20
And this program starts in the ED and
9:23
on the inpatient side generally and continues back
9:26
to home.
9:27
The role of the CHWs is to establish
9:29
a relationship with the patient, screen them for
9:31
their social needs, and connect them actively to
9:34
medical and social care as needed post discharge.
9:37
They also continue to connect with patients for
9:38
at least thirty days post discharge and longer
9:41
if needed to ensure discharge instructions are clear,
9:43
that appointments are made and kept, and that
9:45
all barriers are addressed.
9:47
We also receive referrals from other parts of
9:49
the health system, other social workers, providers who
9:52
may if we don't connect directly with a
9:54
patient while they are with us, and so
9:56
we also will follow-up with patients post discharge
9:58
as needed.
10:00
And some of the metrics again, as I
10:01
said, we started trying to do this work
10:03
in 2019.
10:04
It really launched in 2020 and the metrics
10:06
I'm going to give you are through December
10:09
2025
10:09
but it really accelerated in the past year.
10:12
We really have added more community health workers
10:14
and have gotten more integrated into our system.
10:16
So over that period, we have screened over
10:19
18,000 people for social needs.
10:22
The greatest needs have been around needing transitions
10:25
to primary care with about twenty percent of
10:27
our patients needing that support.
10:29
Food insecurity is another big one. About a
10:31
quarter of our patients have food insecurity and
10:33
need support in that space.
10:35
Transportation to get to appointments and to access
10:38
this what they need, about twenty percent. And
10:40
then other prevalent needs have been utilities and
10:43
housing.
10:44
We find that our average patient has two
10:46
needs that they need support with and there's
10:48
a wide range but the average patient has
10:50
two.
10:51
And we have seen some impact in our
10:53
thirty day readmission rates between those who are
10:55
screened and other patients and those who participate
10:57
in our program and the rest of the
10:58
population
10:59
with readmission rates among screened patients being nearly
11:02
eight percent lower.
11:04
So that's a program that we have basically
11:06
integrated to every part of our system on
11:08
the inpatient side at this point. We have
11:10
a community health worker specifically focused on behavioral
11:12
health, and supporting women,
11:15
through the maternal child health process from prenatal
11:17
through delivery and postpartum
11:18
into supportive oncology,
11:20
into mammography. And we're working to integrate more
11:23
into the outpatient setting. So we have this
11:25
connection of care between those settings
11:28
networked by our community health workers.
11:31
Thank you so much, Helen. Just amazing work
11:34
there. Sounds like from the girls' mental health
11:37
aspect, of course, community health workers, just
11:40
all of those results. So so wonderful to
11:42
hear about and wanted to ask you as
11:45
you continue this work, and just looking ahead,
11:47
any other just big priorities and headwinds you're
11:50
really focused on for 2026?
11:53
Yeah. So in terms of priorities, we will
11:55
continue this work that I just described around
11:57
integrating community health workers into Sinai.
12:00
We also want to and have been supporting
12:03
organizations beyond Sinai in doing the same. So
12:06
that is going to remain a huge priority
12:08
in 2026 and beyond.
12:10
We have learned a lot about how to
12:12
do this effectively over the time that we've
12:13
been doing our work. And actually in 2017,
12:16
we founded CROWD, which is our CHW center
12:19
for research outcomes and workforce development.
12:21
And through that center, we already have worked
12:24
with over 80 organizations and trained over 4,000
12:26
community health workers across the country. And what
12:29
we want to do is we want to
12:30
support organizations in bringing on community health workers
12:33
and
12:34
effectively integrating and sustaining them. So we're very
12:36
focused on continuing to grow that work.
12:39
And especially as in Illinois, we are right
12:42
now in 2026, we should be seeing,
12:45
Medicaid reimbursement for CHWs
12:47
beginning to be something that we can access.
12:50
That is that seems to still be on
12:52
schedule to happen.
12:53
And with that, we want to make sure
12:55
that all organizations that have CHWs have the
12:58
means to access Medicaid reimbursement.
13:00
It's going to be easier for healthcare systems.
13:02
It's going to be harder for smaller CBOs,
13:03
community based organizations. So that is a space
13:06
where crowd will continue to do some work
13:08
and,
13:09
and we're really interested in continuing that work.
13:12
Another area that Sinai is very focused on
13:15
and that SUHI is heavily supporting and leading
13:18
is we are building out science capacity to
13:20
engage as a clinical trials research site.
13:24
As you probably know, clinical trials are the
13:26
engine of medical progress. They often offer the
13:29
best opportunities for people to get access to
13:31
cutting edge, potentially life saving, and definitely life
13:34
improving treatments, especially for rare diseases or ones
13:37
that we do not yet know how to
13:39
treat well.
13:40
Yet too often patients served by safe net
13:42
providers, hospitals like Sinai, federally qualified health centers,
13:45
and community health centers are left out of
13:47
that process because those organizations
13:49
don't have the infrastructure to host clinical trials.
13:51
So we wanna change that, and we're doing
13:53
that at Sinai by embarking on some partnerships
13:55
and a journey to expand our ability to
13:57
do so and to be parts of those
13:59
trials. So we're very actively focused on getting
14:01
that going in the next few months.
14:04
We also, though, want to, again, support that
14:06
happening more holistically across the system. And so
14:09
by applying the lessons we've learned from decades
14:11
of community driven work, Suhii can support that.
14:14
We know what we need to do to
14:16
make trials also more accessible to people living
14:18
in our communities.
14:19
Because it's not only about the health systems
14:21
and, being able to offer them, it's also
14:24
about people being able to access them. And
14:26
something like taking half a day off work
14:28
to go to a hospital to to do
14:30
what you need to do to participate in
14:32
a trial is not a realistic reality for
14:34
for many people in our communities. So we're
14:36
also working towards figuring out ways to to
14:38
make them more accessible to our population
14:40
through some innovative methods.
14:42
And that same vein, we want to continue
14:44
to test the application of new technologies towards
14:46
reducing health inequities. That's another area that we're
14:48
really picking up and doing more work in.
14:51
And that has to date been more around
14:54
testing, the uptake, and outcomes associated with tech
14:57
wearable devices and apps,
14:59
so things like that. Food access apps is
15:01
one example,
15:02
and being on that end. But we also
15:04
wanna increasingly partner on the development side and
15:07
supporting the development of these apps and these
15:09
technologies so that they are more accessible to
15:12
all the communities and populations that need them.
15:16
And then finally, we will be continuing to
15:18
focus on business development towards long term sustainability.
15:22
That's probably more important now than ever
15:25
because of some of the headwinds that we
15:26
are experiencing.
15:27
So a little bit about some of the
15:29
most prevalent headwinds we're seeing and I'm anticipating
15:33
in our specific area.
15:35
First is the shifting governmental priorities and policies
15:38
with less resources being allocated towards the safety
15:40
net.
15:41
That is a challenge for us in terms
15:43
of identifying funding through some of our traditional
15:46
funding sources. And it's also a challenge for
15:48
our communities as they lose access to some
15:50
of the benefits that they that they have
15:51
access to now. So we're very focused on
15:54
addressing that headwind,
15:56
by supporting our communities and doing everything they
15:59
need to to keep their benefits. So if
16:01
they should be eligible to help them navigate
16:03
the process, which is going to be how
16:04
many people will likely fall off.
16:07
And then, you know, we'll be monitoring in
16:09
terms of Sinai and and the safety net
16:11
in our own funding as well what what
16:13
is coming.
16:14
Another headwind is really this lack of stability
16:17
and a lot of uncertainty that makes it
16:19
really difficult to plan and be strategic
16:21
more than three months ahead.
16:23
That's really been a challenge that that I've
16:25
been navigating will con that we will continue
16:27
to navigate,
16:28
keeping that long term vision while also realizing
16:31
that the environment around us might be shifting
16:33
regularly.
16:35
And another headwind that we face, and this
16:37
is not new, but it's something that we,
16:39
as we at Suhe and at Sinai try
16:42
to continue to become more innovative and bring
16:44
bring in more business opportunities,
16:46
is that we don't have a lot of
16:48
resources to invest beyond the day to day
16:50
care of of our patients.
16:52
And Suhii has been building some of that
16:54
up through some of our innovation work and
16:56
reinvestment.
16:57
But that that's a challenge because we don't
16:59
have necessarily resources to invest in business planning
17:01
and communication. And so we need to continue
17:03
to figure out ways to do that in
17:05
partnership.
17:07
The lofty
17:08
goals and, big headwinds as well, all at
17:10
the same time. Mhmm. And so anything else,
17:14
Helen, that you would want to mention as
17:16
far as maybe the hardest thing you'll have
17:18
to do in the coming year and also
17:19
just where you see the best opportunities for
17:20
organizational growth as well?
17:23
Sure. I think in terms of the hardest
17:24
things, one is
17:26
what I was speaking to a moment ago,
17:28
which is making sure that we stay strategic
17:30
and keep our long term vision in mind
17:33
while we're navigating
17:35
some uncertainty in the coming months and potentially
17:37
years.
17:38
So that's something that
17:40
I've been doing. I mean, we've been doing
17:42
for the past year, and we need to
17:44
continue to do. So not losing sight of
17:46
our vision, but continuing to move forward. That
17:49
is going to be challenging, but we need
17:50
to keep doing it. The other, for me,
17:52
in terms of hard things to do again,
17:55
this is continuing from last year is managing
17:57
the morale of my team.
18:00
That's a big challenge in this current environment.
18:02
So I run an applied public health research
18:04
institute that is affiliated with Illinois' largest private
18:07
safety net health system.
18:08
And we know the work we do is
18:10
critical, important, and has changed so many lives,
18:13
and that why is what motivates
18:15
myself and the majority of my team to
18:17
to stay and do this work.
18:19
We have a team that a lot of
18:20
us have been with Suhii for a very
18:22
long time. So there is this intrinsic motivation.
18:26
We we are the work we do, and
18:28
yet that work from many
18:30
places currently is being devalued. So we are
18:34
right now disregarding science in some areas, devaluing
18:37
the importance of evidence based practice,
18:39
deprioritizing
18:40
and even villainizing public health. And that's challenging
18:42
for my team. So I need to keep
18:44
them and myself focused on
18:48
not being so responsive
18:50
to some of the things we experience externally
18:53
and leaning even more into the partnerships that
18:56
we have
18:57
that, give us strength and together through multi
19:01
sector partnerships,
19:03
I think we're going to make a lot
19:04
of headway. I know we're going to make
19:05
a lot of headway. So that really in
19:07
terms of opportunities for growth is where we're
19:09
focused, more strategic partnership, bringing better visibility to
19:12
Sinai, SUHECI, and the committees we serve, recognizing
19:15
the problems we're dealing with and those that
19:17
really hold health inequities in place are not
19:19
simple ones. They're complex, they're worth their problems,
19:21
and they're requiring multi sector partnership.
19:24
So we learned a lot on how to
19:26
best partner with communities to develop trusting relationships
19:29
that allow us to diagnose root causes and
19:31
develop the right innovative solutions.
19:33
We wanna keep
19:35
continuing and deepening our existing partnerships with academic
19:37
institutions, governmental public health, community based organizations,
19:41
and others, while also bringing in new partners
19:44
from other sectors such as business and industry
19:46
and tech companies.
19:48
And I think that in addition to giving
19:50
us growth opportunities
19:51
together, that is really how with our collective
19:53
wisdom and with a
19:55
collaborative learning culture, we can begin to make
19:58
transformational change that will bring us to the
20:00
place where all communities are thriving in health.
20:03
Absolutely. Well, thank you so much, Helen, for,
20:06
this wonderful and interesting conversation. Exciting to hear
20:09
about what lies ahead, and I really do
20:11
appreciate your time and look forward to working
20:13
with you again soon.
20:15
Thank you. Thank you for having me.