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Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.
City of ChicagoMayor Rahm Emanuel
Healthy ChicagoAugust 6, 2013
Bechara Choucair, MDCommissioner
Chicago Department of Public Health@chipublichealth#HealthyChicago
Presentation Outline1.The Role of Public Health
2. The Healthy Chicago Public Health Agenda
3. Partnering with Healthy Chicago
Population Health
• The health outcomes of a group of individuals
• Focuses on improving health inequities
Core Functions & Essential Services
Healthy Chicago Public Health Agenda• Released in August
2011
• Identifies priorities for action for next 5 years
• Identifies health status targets for 2020
• Shifts us from one-time programmatic interventions to sustainable system, policy and environmental changes
Healthy Chicago: Promoting PublicHealth Equity• Improvement in the public’s health
requires a commitment to health equity and the elimination of racial and ethnic disparities
• Healthy environments are key
• Persons of lower SES are often exposed to fewer factors that promote health and more factors that damage health
• Healthy choices must be easy and desirable
Chicago:Person, Place, Time
From Sampson R. Great American City. 2012; p. 105 & 106.
Tobacco Use
Tobacco Use
SMOKE-FREE CAMPUSES
3 Colleges / Universities 5 Hospitals 6 Behavioral Health Orgs 8 CHA Developments
Joint Enforcement
Tobacco Use
Obesity Prevention
Over 200 miles of on-street bikeways, including almost 35 miles of barrier and buffer protected bike lanes
3000 bikes to share at 300 stations by end of summer
Obesity Prevention
Dearborn Street - Before Dearborn Street - After
Obesity Prevention
13 licensed carts operating 30 vendors trained 30 carts planned for 2013
Obesity Prevention
Heart Disease& Stroke
Keep Your Heart Healthy initiative National prevention effort CPR training for students CDPH, Northwestern and the GE Foundation Team Up to Save Lives through Innovative New Heart Initiative
HIV Prevention
Integrated services planning to:
Strengthen prevention Increase linkage & retention to care Increase treatment access
HIV Prevention
More HIV+ MSM are:
Aware of HIV status Accessing care Taking HIV medication
Adolescent Health
CPS hires chief health officer Dually reports to CDPH CDPH creates Adolescent and School Health Office
Adolescent Health
Revised Wellness Policy Competitive Foods Policy Expanded STI Screening $26M New grants
• CTG – Healthy CPS
• Teen Dating Matters
• Teen Pregnancy
• Farm to School
• Wellness Champions
Adolescent Health
• From 28 schools to 40+• 6147 tested in 2011-
2012• 436 positive; 98%
treated
STI Education/Screening
• 9,900 students, parents, educators
• 12 high need middle/high schools
• Evidence-based curricula, social media, youth ambassadors
Teen Dating Violence
• 4500 students in 28 schools
• 18 topical lessons• Peer group meetings• Community service
projects
Teen Pregnancy
Outreach to CHA residents Partnerships to expand access Quality improvement initiativesUpgraded mammography machines
beyond p nk Chicago
!
Cancer Disparities
City partners with 7 FQHCs 1115 Waiver granted CDPH public health services remain
Access to Care
Access to Care
City mental health sites consolidated to 6 Capacity for 4,000 clients preserved$500,000 awarded for expanded psych services to 8 partnersCARF certification
Access to Care
Oral health services expanded to 106 high schools
Over 105,000 served in 2012-2013
Access to Care
City invests $1.4M in new vision program
30,000 students to get optometry exam and eyeglasses as needed
Access to Care
ADVOCACYADVOCACY
CHILDREN’S INSURANCE COVERAGE
CHILDREN’S INSURANCE COVERAGE
COUNTYCARECOUNTYCARE
SMALL BUSINESS ENROLLMENT
SMALL BUSINESS ENROLLMENT
ENROLL CHICAGO!
Healthy Mothers& Babies
15 hospitals working towards Baby-Friendly Designation
Healthy Mothers& Babies
33% decline in teen birth rate50% drop in smoking while pregnant 10% increase in 1st trimester care
Communicable Disease Control
Communicable Disease Control
Expanded environmental health unit $3M lead abatement grant awarded Asthma partnership with UIC 600 radon kits given to residents 92 tons of household waste collected
Healthy Homes
Violence Prevention
Public HealthInfrastructure
Healthy ChicagoAction Plans
Building on PolicySuccesses
Mayor Emanuel Takes Action to Protect Chicago’s Kids from Menthol Cigarettes
Building & Engaging Partnerships
• Population-wide impact
• Little amount of money goes a long way
• Sustainable
Why Does the City Focuson Creating New PoliciesNot Just New Programs?
Focus on broad, systemic changes, not individual interventions or programs
Upstream solutions to improve health outcomes for everyone-Addresses root causes of poor health
Policy, Systems andEnvironmental Changes
What is the Difference?PROGRAMS/EVENTS
• Short term• Generally has beginning
and end of intervention• Distinct target audience• Reliant on funding or
other support for replication
• Doesn’t impact environment
• Lessons learned can inform policy
POLICY OR ENVIRONMENT
• Institutionalized• Equitable reach• Sustained beyond
individual champion or specific funding
• Ongoing without start and stop times
• May still need programmatic elements to achieve desired impactEngaging in the policy change process,
medical professionals can expand the reach, breadth, and sustainability of their clinical practice = IMPACT
What is the Difference?
Socioeconomic Factors
Changing the Contextto make individuals’ default
decisions healthy
Long-lasting Protective Interventions
ClinicalInterventions
Counseling & Education
Examples
Poverty, education, housing, inequality
Immunizations, brief intervention, cessation treatment, colonoscopy
Fluoridation, trans fat, smoke-free laws, tobacco tax
Rx for high blood pressure, high cholesterol, diabetes
Eat healthy, be physically active
Smallest Impact
Largest Impact
Policy Change Target
Neighborhood Community State National
Impact of clinical ractice
Popu
latio
n Sc
ale
Geographic Scale
Individual
Single Sector
Multiple Sectors
Entire Population
Impact of clinical practice
Healthy Chicago Target
Impact of policy changes
Put your thumbprint on policy!
How can you maximize the Impact you will have on society?
Why should you get involved?
Primary prevention part of mission? Health care professionals have a natural incentive to
improve the health of all people and the environment in which we live.
Position to influence behavior? It is essential to lead by example. People trust doctors with their lives – literally. People look to their doctors for health information. Time and time again, political polling demonstrates
that doctors are among the MOST RESPECTED sources of health information, which puts you in a unique position to influence public policy.
Healthcare system will bear burden of chronic disease.
Not feeling sophisticated enough to play at the State and Federal level?Work toward institutional policy
changes!
Little p: Institutional policies Worksite policies/investments NGO policies Individual school policies Norms and standards that drive other action
BIG P: Public policy Legislation Regulations Zoning/land use Taxes Public budgets
Become a Healthy Chicago Partner
• Northwestern: Go 100% smoke-free; test new policies that improve the food and beverage environment; etc.
• Adopt Healthy Chicago practices
• Ask if there is an open seat on the CPS School Wellness Committee for the school in your neighborhood
• Email us at healthychicago@cityofchicago.org
facebook.com/ChicagoPublicHealth@ChiPublicHealth
312.747.9884
www.CityofChicago.org/Health
HealthyChicago@CityofChicago.org