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The Walgreens at 8628 S. Cottage Grove Ave. has anchored Chicago’s Chatham neighborhood for more than six decades. For many residents, it was not merely a convenience store but their primary contact with the healthcare system. It is now closed. Walgreens, recently taken private by Sycamore Partners, has been shrinking its footprint in communities where profit margins fall short of investor expectations.
What makes the closure particularly bitter is not just the abandonment, but what was destroyed along the way. Walgreens consolidated the market, crowded out independent pharmacies, and is now leaving the community to absorb the consequences.
It is a story of the incremental, insidious decline of health equity. The structural gaps that individually seem manageable are, collectively, catastrophic. What private equity may call a business decision, we are calling a public health crisis.
Health equity extends beyond insurance coverage and access to physicians. It also involves whether patients can obtain the medications prescribed to them. As a pharmacist and medical student on Chicago’s South Side, we see the consequences of uncontrolled hypertension, diabetic complications, and asthma exacerbations daily. The consequences reach beyond the pharmacy counter into visits to city clinics, emergency departments, and ICUs.
Geography is where that inequity begins; only 1.2% of predominantly white census tracts are pharmacy deserts, compared to 32.6% in predominantly Black neighborhoods. For patients in our underserved communities, filling a prescription isn’t a quick 10-minute stop after work. It often involves a series of Chicago Transit Authority (CTA) bus transfers, taking long lunch breaks, and physical stamina that many of our chronically ill patients simply do not have.
Then add affordability to the conversation. Even when a pharmacy is nearby, cost remains a significant obstacle. Illinois has made strides with the recent passage of the Prescription Drug Affordability Act, which bans predatory pharmacy benefit manager (PBM) practices that have raised drug costs and hurt independent pharmacies for decades. It includes a modest fee to support underserved pharmacies, recognizing that access matters. We support it fully. But a fee and pricing reform cannot rebuild the pharmacy infrastructure Chatham is about to lose. Affordability and physical access should not be conflated; solving one does not solve the other.
Mail-order pharmacies are often proposed as a solution, but their effectiveness is limited by factors many Chicagoans lack: stable housing, reliable delivery, internet access, and digital literacy. Others need medications urgently or require in-person counseling with language support. For many Chicagoans, the neighborhood pharmacy remains the healthcare system’s most accessible front door.
Independent pharmacies have historically been best positioned to address all these layers simultaneously. They are more likely to remain in neighborhoods that private equity–backed chain pharmacies have deemed unprofitable. They are more likely to know patients by name, offer flexible hours and delivery, and provide counseling in a patient’s first language.
The problem is that for decades, the system has been stacked against them. Large chains have benefited from federal drug pricing programs, massive purchasing power, and economies of scale that make it nearly impossible for independent pharmacies to compete. One example: federal programs like 340B intended to extend affordable medications to vulnerable communities. But in practice, these programs have historically funneled disproportionate benefits to the very chains that abandoned these communities — chains that already had every structural advantage. Redirecting that support by encouraging major health systems to partner with independent local pharmacies could strengthen community-based pharmacy infrastructure, giving these businesses a fighting chance.
This is one piece of a larger shift in thinking: hospitals, federally qualified health centers, and safety-net clinics must treat pharmacy access as part of their mission, not someone else’s responsibility.
Chicago’s South Side has long supported hospitals, universities, and businesses that flourish in part because of this community. Communities like Chatham deserve a pharmacy model that reflects its resilience and vitality.
The Walgreens on Cottage Grove has closed. Our response, though, should not be to wait for another chain to determine if Chatham and other neighborhoods are worth investing in again. Instead, we must develop an infrastructure that isn’t driven by investors’ quarterly profits, but firmly rooted in and accountable to the community, with the goal of remaining for the community.
Health equity is more than just a slogan. For the patients we serve, it’s a daily question: can they access the medications their doctors prescribed? In Chicago, too many neighborhoods’ answer is “no.” That reality is not inevitable. It is the result of policy choices — and it remains within our power to choose differently. The first step is naming what this is: not a market correction, but a public health crisis. We urge Chicago’s aldermen, public health leaders, and health systems to respond to it accordingly.
