Dr. Helene Gayle leans back, thinks for a moment, brows furrowed.

The question from her audience: Where will the first African-American woman to be president and chief executive officer of Chicago’s oldest and largest community foundation, the Chicago Community Trust, focus her efforts?

“One of the biggest things holding Chicago back from being all that it can be is the inexcusable inequity that continues to exist,” Gayle said, at a National Association of Black Journalists forum on Monday.

“When you look at the fact that if you live in this lovely central area, your life expectancy is as high as anywhere — 87 — but go 3 miles west, and it’s 67. There’s no reason there should be that kind of disparity in a city and region this wealthy,” she said. “And of course, life expectancy is just a barometer for so many other things.”

In October, Gayle, 62, took the reins of the $2.54 billion foundation and has spent the past eight months getting to know the city she now calls home: all the good, the bad and the ugly.

It is the bad and ugly the foundation has sought to tackle over the course of its 103 years. Unlike its national and global counterparts, its grant-making is laser-focused on programs impacting the city and six-county metropolitan area, from education to health and economic development, human services to civic and cultural vitality.

Gayle, named one of Forbes’ “100 Most Powerful Women,” is also the first woman and only the seventh president of the storied foundation. Previously CEO of an East Coast-based nonprofit, McKinsey Social Initiative, she accepted the baton from former president Terry Mazany, who served 13 years.

“The same person that recruited me to CARE called me and said she thought I might be interested in the position because she knew the sorts of things that I was passionate about,” said Gayle, who served as president and CEO of the global humanitarian organization CARE USA, from 2006 to 2015.

Before that was the Bill & Melinda Gates Foundation, where she spent five years directing its global HIV/AIDS programs and working on other global health issues. And prior to that was 20 years with the Centers for Disease Control, where she led federal and global HIV/AIDS programs.

“Like for so many people, this election in 2016 was a moment of real deep reflection. And having spent almost 30 years of my life focused on global issues, I felt this real sense that this is a scary moment for us as a nation,” Gayle said.

“And if I could do something to give back, to think about some of the issues that divide us, and how to impact that, in a city that is important, not just for its own sake, but because people look to Chicago for leadership, I saw it as a real opportunity,” she said. “We want to create models of bringing communities together, healing some of the divides.”

Gayle was born and raised in Buffalo, New York, a middle child among five. Her mother was a social worker; her father operated a barber and beauty supply company. The Civil Rights Movement framed her formative years.

“I was very influenced by the social change of the time that was swirling around me, and very involved as a student. When I went to college, what I wanted to major in was ‘Liberating all oppressed people,'” she laughed.

“We lived in a neighborhood that was very much segregated, but went to suburban schools, where we were the only black kids for the most part, the early part of our education,” she said.

“But like here in Chicago and many other cities that were part of the Great Migration, black communities were very distinct, and much more economically diverse. I go back to Buffalo now, and the same neighborhoods that used to be doctors, lawyers, teachers and professionals — working-class neighborhoods — are now hollowed out.”

It is that hollowing out that has left dire consequences for marginalized communities, said Gayle, who studied psychology at Barnard College, went to medical school for pediatrics, then veered into public health.

“At the end of the day, the violence we’re seeing is a public health issue, because people die from it, and it’s contagious. But at the root of it is lack of education and employment. And these same issues of inequity and lack of opportunity are also at the root,” said Gayle, named among Foreign Policy magazine’s “Top 100 Global Thinkers,” and Newsweek’s Top 10 “Women In Leadership.”

“I’m still getting to know Chicago, and there’s no simple answer. But solutions must include bringing back economic vitality to communities that have been disinvested, giving people decent jobs, stable housing, putting policies in place to undo and correct some of these things, like redlining, that have been there historically,” she added.

“We’ll be looking to really focus around the racial wealth gap. We know that the middle class in America across all races is being hollowed out, but it still disproportionately affects communities of color. And I think unless you take a racial lens to this, and continue to put in place remedies to really fix what is a long-term systemic issue, we’re going to be missing the boat.”