Your zip code shouldn’t determine your lifespan with Dion Dawson

0:02This is TED Health, a podcast from TED, and I'm your host, Dr. Shoshana Ungerleider. I want to get real for a second. In America, your chances of living a long, healthy life often depend less on your doctor and more on your neighborhood. Public health experts refer to these factors as social determinants of health. Housing, income, and access to fresh and nutritious food all contribute to a person's overall well-being. And when entire communities lack access to grocery stores or affordable housing, you see the consequences, like higher rates of chronic disease, shorter life expectancy, and the daily stresses to keep a roof over your head or put good food on the table.

0:43For decades, the common solution to address food access and affordability specifically has been the food pantry. It has its limitations. Recipients are presented with mostly donated and near-expired food, and there's no guarantee of quality or nutrition value. And that model hasn't changed since the 1960s. So what does that mean for today's families. Many would argue that in the long run, the food pantry doesn't solve the problem. It actually reinforces it. 2025 TED fellow Dion Dawson decided to dream differently. As the founder and chief dreamer of Dion's Chicago Dream, he developed a new approach to helping food insecure households by providing boxes of wholesome fruits and vegetables to thousands of families every week.

1:29And that food is purchased, not donated. It's a model that challenges the systems we've inherited and measures success not only in pounds of produce, but also in reduced stress, stronger communities, and the dignity that comes from knowing your health matters. But before we dive in, a quick break to hear from our sponsors.

1:55And now, 2025 TED Fellow, Dion Dawson.

2:01If you look historically at food responses, the pantry model has been unchanged since the 1950s. Everywhere, in places that looked like mine, it was inefficient. It didn't champion quality or the end-user experience. And it just bothered me. I'm Dion Dawson, founder and chief dreamer of Dion Chicago Dream. We're a nonprofit social enterprise that focuses on providing access to healthy food consistently, making sure that your zip code does not determine how long you live. We deliver a 10-pound box of fresh fruits and vegetables to more than 4 ,300 households in the Chicagoland region per week. It could be everything from a pineapple to different types of apples, citruses, Swiss chard, spinach, pomegranates.

2:51Since 2020, we've provided a little over 3.5 million pounds of fresh produce that we've purchased, packed, and delivered. And we've never charged any of our recipients today. Our produce and our quality is top notch. We've never taken a single piece of donated produce. We purchase everything. It may cost us a little more, but that's fine. You don't want to dictate what people think they deserve. If we're thinking about people living longer, healthier lives, you want to give them the best opportunity to be healthy. You can't do that with expiring food. One of the things that we wanted to do a little different is make sure that we're talking to people.

3:25We do a biweekly touchpoint where we collect scores in six different areas like ease of delivery, quality of produce, staff treatment, and even stress after delivery. And so we can see that we're lowering stress levels daily by more than 80%. It's quite simple, just serving people and delivering quality food, produce. When this all started, I was working overnight at Amazon. I knew absolutely nothing. I didn't know any statistics. I'd never done nonprofit management or grant writing, none of it. That blind ignorance will get you way further when you just don't know what you're up against. On Juneteenth in 2020, a Gen Zer came up to me that I'd grown up with and said, hey, what are you doing for Juneteenth?

4:11And I had no idea. You know, I just, I tried to kind of play along, but he said, no, what are you doing? And I just said, I'm going to feed a hundred families. I didn't think about it. I don't know where it came from. And from there, it was two GoFundMe campaigns later and buying 800 pounds of food and bagging chicken leg quarters at four in the morning. What started as someone challenging me to do something for the community for Juneteenth turned into a day and an event that made me feel like I had never felt before. And wanting to chase that feeling of not having to convince myself that I wasn't the problem or not having to convince myself that something was good, but just feeling good.

4:53From there, it was on. It just lit a fire in me. We're up to 48 employees, about 15 vehicles. We're opening up a 20 ,000-square-foot location later this year. We've grown in an environment where growth has been difficult. The average black-led nonprofit never makes it to a million in revenue. We did it in 18 months. As a company, we've never been in the red. It's a social enterprise, nonprofit that is still a business. Early on, it was really about individual donors and grants. And then over the years, we've tried to continue to figure out how to diversify the revenue so that we can be sustainable.

5:32We've never missed a payroll. We've never lost an employee. We've never had a volunteer. I just think that if someone does a job, they should get paid for it. It's a commitment back to people. Without a wealth building vehicle attached to whatever social impact work you're doing, then you're just perpetuating the circumstances that you're trying to fight. You can still do good business and do good by people. And you don't have to build like everyone else. There were so many people early on that tried to guide us into taking donated food, into using volunteer hours and trading board seats for money.

6:04And because of us rebuffing a lot of those things, here we are almost five years later. And this work has really not only defined a lot of people's lives, but it's allowed me to wake up and go to sleep knowing and never questioning. I have no goals. I just believe that anything is possible. Part of just being a dreamer is understanding that I decide what I focus on. We've gotten the opportunity to write our own story. It's really about joy, happiness, being okay, knowing that you gave everything you had. All of these are things that are important, and we don't champion them enough. It's always about reminding each other what difficult is.

6:47A difficult day, as the chief dreamer of Deion's Chicago dream, pales in comparison to the worst I've ever had as Deion Dawson. You evolve. You learn. This is the first time in my life where I can honestly say I've never stopped learning every single day. I learn, I apply, I try, probably failed more in this five years than in my first 30, but I don't have it figured out. I think that's the fun part. Yeah, that's pretty, pretty crazy.

7:27That was 2025 TED Fellow, Dion Dawson. I gotta say, after listening to Dion just now, I feel both challenged and inspired. As a doctor, I can tell you this. When someone comes to me with poorly controlled diabetes and high blood pressure, yes, I can change the medications. But if that person lives in a neighborhood where the only food choices are fast food chains or corner stores stuffed with salty chips or ultra processed snacks and sugary beverages, then my prescription is only going to go so far. We can't medicate our way out of structural inequity. And this is what Dionne's work illustrates so powerfully.

8:11We can't talk about health as just what goes inside a person's body. It's also about the broader context. These social determinants of health, as I mentioned earlier, they include housing, education, income, transportation, social support, and food access. They're the circumstances of everyday life, and yet we rarely associate them directly with health. We put health in a box of clinics and hospitals, and as if everything outside those walls doesn't count. And I'd say the opposite is true. What happens outside the hospital often determines if someone ends up in one. If you look back at history, this becomes clear.

8:52In the 19th century, life expectancy was far shorter, not simply because we lacked modern medicine, but because so many people lived in unsafe conditions. They had dirty water, overcrowded housing, no sanitation systems. What saved lives wasn't a pill, but clean water systems, sewers, safer housing, better working conditions, public health infrastructure, not just medical breakthroughs drove the massive improvements in how long people lived. By the early 20th century, efforts like child labor laws, workplace protections, access to healthier and safer foods, and mass vaccination campaigns added decades to the average lifespan.

9:36These were structural interventions, investments in safety, education, and food security that changed the baseline of health. Then mid-century, the GI bill in America expanded home ownership and education to millions of families. But redlining and racist house policies locked many Black families out of that opportunity. The result wasn't just economic. It shaped where grocery stores opened, how schools were funded, which neighborhoods had parks and clinics and safe streets. That history is still written into our health today. And if you want a modern example, just look at Flint, Michigan in 2014.

10:16Families there weren't getting sick because they failed to make healthy choices. They were poisoned by their water supply. Or think about the kids who grew up in neighborhoods near highways, where rates of asthma are dramatically higher because of air pollution. These aren't just random health outcomes. They're predictable. In the United States today, life expectancy can vary by more than 20 years between neighborhoods in the exact same town. Consider two kids born a few miles apart. One has had continuous access to fresh food, safe housing, and good schools. And the other doesn't have these systems of support.

10:53Their chances of living long and healthy lives are fundamentally different. Not because of biology, but because of the systems around them. This isn't accidental. It's the product of decisions, historical and modern, that invested in some communities and abandoned others. and that realization can feel heavy. But through Dion, I see a reminder that one person can imagine a different way, and instead of waiting for permission, that one person can start working towards change, big or small. Yes, not everyone will start a nonprofit organization, but there are many ways we can participate in public health, even if we don't recognize it most of the time.

11:36The ways we design our cities, vote to fund our schools, pay our wages and distribute food are all health questions and all opportunities to make a mark on your community's well-being. Because, by the way, health isn't individual. It's not just about personal choices. It's about systems and structures and the collective responsibility that we have to each other. I think about the patients I care for who experience lower blood pressure not just because of the medicine I give them, but because they were able to secure stable housing so they could sleep well at night. Or the families whose kids succeeded in graduating from high school and being the first in their families to go to college.

12:20Not because they took a supplement, but because their school offered free breakfast. These are health interventions, as valid as a doctor's appointment. And yet we rarely call them that. We put health in a box of clinics and hospitals, and as if everything outside those walls don't count. The opposite is true. What happens outside the hospital often determines if someone ends up in one. So what have we learned from this talk? I can tell you for me, it's the lesson that health equity is not abstract. It's quite concrete. It's the pineapple on a family's kitchen counter. It's the diminished anxiety that comes with food being delivered on a scheduled basis.

13:04It's the dignity of receiving equal quality as anyone else. And it's the understanding that these things have a ripple effect. Healthier families, stronger communities, reduced strain on hospitals, and more opportunities for children to grow old and healthy. As a doctor, I'm often asked, what's the one thing someone can do to improve their health? You might guess I'd go with eating a balanced diet or regular exercise or regular screenings. But it's a different and bigger answer that I would offer you today. The most important thing is whether the conditions of your life even allow you to make the healthy choices to begin with.

13:43Is your housing safe? Is access to healthy food available? Do you have the support of your neighbors and your community? Dionne's story gives us a glimpse of that potential. Choosing to build differently. To stop asking people to accept a fraction of the scraps. and instead say you're worth the very best. If we want to build a healthier future, we'll have to look beyond our clinics and make investments in the social determinants of health. That's the vision Dion is striving to achieve and it's one we can all help build.

14:23And that's it for today's episode. Before I let you go, I want to tell you about an exciting event that I'm organizing that I think might interest you. Outside of my podcast here at TED, I'm the founder of a nonprofit called Endwell. We're focused on making the end of life a part of life. It's a topic that I care deeply about, and you probably heard me talk about it on this show. So I want to personally invite you to join me for the Endwell Summit, streaming live and for free on November 20th. It's a day that's unlike any other conference I've ever been a part of. It's focused on how we live, care, and connect through life's most universal experiences.

15:02The day features powerful voices and stories that challenge how we think about mortality and meaning. And one of those voices is Emma Hemming-Willis, who's opening up about caregiving and courage. There'll be researchers, patients, artists, and so many others who are reshaping how we think about the end of life. Register to tune in from anywhere at endwellproject.org. That's E-N-D-W-E-L-L project.org.

15:33TED Health is a podcast from TED. Thank you so much for listening. And I'd love to hear your thoughts about this episode. Send me a message on Instagram at ShoshanaMD. This episode was produced by me, Shoshana Ungerleiter, and Jess Shane. Edited by Alejandra Salazar and fact-checked by Vanessa Garcia-Woodworth. Special thanks to Maria Lages, Farrah Degrunge, Daniela Balarezo, Constanza Gallardo, Tansika Sangmarniwang, and Roxanne Hylash.