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Bechara Choucair, MDCommissioner
Chicago Department of Public Health
@choucair #HealthyChicago
Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.
City of ChicagoMayor Rahm Emanuel
HEALTHY CHICAGOPatient-Centered Medicine Scholars
Program M2 Service Learning Program SeminarJanuary 28, 2014
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Outline
1. Healthy Chicago Public Health
Agenda
2. Healthy Chicago Priorities
3. Next Steps for Healthy Chicago
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Healthy ChicagoPublic Health Agenda
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Healthy ChicagoPublic 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
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The Secrets to Our Success
Partnership Policies
Technology
Public Awareness
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Healthy Chicago Partnerships Are Primary
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Healthy Chicago Priorities
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Percent of adults (18 years and older) who are current smokers, Chicago, 2012 (BRFSS)
> $50,000*
$35,000-49,999
$15-$34,999
< $15,000
65+
45-64
25-44
18-24
College Grad
Some post HS
HS or GED
Less than HS
Hispanic
NH Black
NH White
Female
Male
Total
0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0
*Data not available
Highest among:
• Males• Blacks
& Whites
• Least educated
• Low income
Percent
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*Data not available
Percent of high school students who smoked cigarettes on at least 1 day (during the 30 days before the survey), Chicago, 2011 (YRBSS)
12th Grade
11th Grade
10th Grade
9th Grade
Hispanic
NH Black
NH White*
Female
Male
Total
0 2 4 6 8 10 12 14 16 18 20
Highest among
• Males• Hispanics• 11th &12th
Graders
Percent
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Chicago Recognized as Public Health Leader in Tobacco Control
Surgeon General ties cigarettes to diseases beyond cancer
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Prevention Through Policy
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More Smoke-Free EnvironmentsUniversity of Illinois at Chicago became a Tobacco-Free Campus for total of:• 5 smoke-free institutions of higher
learning• 6 smoke-free hospital campuses
Chicago Housing Authority designated 2 new 100% smoke-free complexes for
total of:• 610 smoke-free units in six
developments• 3,250 units of private multi-unit
housing
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Percent of adults (18 years and older) who are overweight or obese, Chicago, 2009 (BRFSS)
*Data not available
> $50,000
$35,000-49,999
$15-$34,999
< $15,000
65+
45-64
25-44
18-24*
College Grad
Some post HS
HS or GED
Less than HS
Hispanic
Non-Hispanic
Black
White
Female
Male
Total
0 10 20 30 40 50 60 70 80 90
Highest among
• Blacks• HS
Grad/GED
Percent
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Estimates of overweight or obesity prevalence for CPS students in kindergarten, 6th or 9th gradesby race-ethnicity, Chicago, 2010-11
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Estimates of obesity prevalence for CPS students in kindergarten, 2003-12
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New Physical Education Policy
• Establishes high standards for physical education instruction and instructional practices for schools across the district.
• Requires at least 30 minutes of daily physical education (or equivalent of 150 minutes per week) at the elementary school level.
• Requires daily physical education in the same time increments as other core courses at the high school level (grades 9-12). Some individual student waivers are available.
January 22, 2014Chicago Board of Health Unanimously Adopts New Physical Education Policy
ImprovingPhysical Education
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Increasing Access to Healthy Foods
Build Healthier Neighborhoods
Grow Food
Expand Healthy Food Enterprises
Strengthen the Food Safety Net
Serve Healthy Food and Beverages
Improve Eating Habits
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Before After
Promoting Physical Activity
• 3,000 bikes• 300 stations• 100 more in
2014• 750,000+
trips• >1.7 million
miles
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Age-adjusted death rates (per 100,000) due to heart disease by race-ethnicity,Chicago, 1999-2009
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090
50
100
150
200
250
300
350
400
450
329.9
303.5 296.3287.3
278.5
258.6 258.8
238.7228.8 230
220.7
All race-ethnicities NH White NH BlackHispanic United States
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Age-adjusted death rates (per 100,000) due to stroke by race-ethnicity, Chicago, 1999-2009
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090
10
20
30
40
50
60
70
80
60.2 59.156.9
54.8 55.4
49.4 48.3
43.446.8
44.2
40.3
All race-ethnicities NH White NH Black Hispanic United States
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Keep Your Heart Healthy 1,128 screenings
• 12 restaurants at Midway
• 9 million visitors
• 70 restaurants citywide
Service, Technology &Environmental Change
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Teen birth rates by race-ethnicity of mother,Chicago, 1999-2009
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090
20
40
60
80
100
120
85.280.5
76
69.365.6 64.8
61.965.1 66.1
61.457
All race-ethnicities Hispanic NH AsianNH Black NH White United States
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• Over 5,200 15-19 year old girls give birth annually (2009)
• Over 10,000 cases of chlamydia and 3,200 gonorrhea cases occur among 13-19 year olds.
Prevention Through Policy
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Teen Outreach Program (TOP)
• 3,000+ students in service learning clubs
• 60,000+ hours of community service in addition to the TOP curriculum
• More than 200 TOP students trained to become Peer Health Ambassadors.
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HIV infection rate (per 100,000), Chicago, 2011
NH Black
NH White
Hispanic
Male
Female
United State
Chicago
0 10 20 30 40 50 60 70
Highest Among• Males• Blacks
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Percent distribution of HIV infection, Chicago, 2011
> 60
50-59
40-49
30-39
20-29
< 20
Heterosexual
MSM & IDU
IDU
MSM
NH White
NH Black
Hispanic
Male
Female
0 10 20 30 40 50 60 70 80 90
Highest among
• Males• Blacks• MSM• Ages 20-29
Percent
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• Over 9M condoms distributed
• $36M in prevention, service and housing funding
• Network of over 70 agencies
In past 10 years,, reported HIV/AIDS cases down by 46% and 43% respectively• Youth only group continuing to see
a rise in new HIV infections.
• 84% of persons diagnosed with HIV in 2010 were linked to medical care within 3 months.
• Less than half of all people living with HIV are taking HIV medications or are virally suppressed
STI Initiative• 42 schools• 11,000+
educated• 6,915 screened
o 545 w/ chlamydia
o 137 w/gonorrhea
o 65 had both infections
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Distribution of uninsured adults by race-ethnicity, Chicago, 2010-2011
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Primary Care Transition
• 53,000 patient visits
• 13,000 uninsured patients
• Patient access up 32%
• Greater service array
• Improved patient experiences
• Increased efficiencies save ~$12M
Primary Care Transition
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Vision Services
• 225 Schools• 21,125 Total Exams• 13,513 Total Glasses• Investment increased to $2M to
support 45,000 students in 2014.
Oral Health Services• 7% increase in students served
• 121,479 students in 595 schools
• 356,736 sealants applied
• Expansion to include CPS high schools
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Infant mortality rates by race-ethnicity,Chicago, 1999-2009
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090
2
4
6
8
10
12
14
16
18
20
11.5
10.5
98.6
9.6
8.4 8.57.9 7.9 8 8
All race-ethnicities Hispanic NH AsianNH Black NH White United States
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Percent of low birth weight births by race-ethnicityof mother, Chicago, 1999-2009
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090
2
4
6
8
10
12
14
16
10.19.7
10.1 10 10.1 10 10.2 10.29.9
9.6 9.7
All race-ethnicities Hispanic NH Asian NH Black NH White United States
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• 15,000 home visits conducted
• 95% of WCH clients enrolled in both WIC and Family Case Management
• ~28,000 pregnant women & infants enrolled in WIC with 125,000 visits
15th hospital in pathway
$200,000 grant to serve 1,500 women
Services, Systems &Public Awareness
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2012
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High Risk Inspections Completed
Gains in Food Protection
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.
Dr. Black to lead Carbapenem-resistant Enterobacteriaceae (CRE) Task Force launched May 2013.
West Nile Virus
• 290 traps set
• 105,085 catch basins monitored
• 33 WNV cases reported
Other Communicable Disease Control Successes
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• 12 high need middle/high schools
• 788 middle school students completed program
• Parent training initiated
• 13 Youth Ambassadors trained
Teen Dating Violence
Prevention Through Partnerships
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5,340 units
inspected
Environmental Health
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390,439 lbs recycled in 2013
Permitting & Inspections
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Partner Engagement
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Preparing Together
236 trained in Psychological First Aid
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Back to SchoolImmunizations
backtoschool.cdphapps.org data.cityofchicago.org
PredictingCigarette Sales Violations
Advancing Healthy ChicagoThrough Technology
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"This is an important achievement and recognition that highlights the city of Chicago's ongoing commitment to health and wellness." --Mayor Rahm Emanuel
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Next Steps for Healthy Chicago
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More Work to be Done…
• Pass a Smoke-free Parks Policy
• Increase Taxes on Other Tobacco Products
• Discontinue the Use of Coupons, Gifts, etc.. for Tobacco Products
• Improve Medicaid Reimbursement Policy for Pediatric Prevention Obesity Services
• Develop a Comprehensive Plan to Address the National HIV Strategies at the Local Level
• Advocate for the Implementation of a New Laboratory Guidance for Detection of Emerging Antibiotic-resistant Pathogens
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facebook.com/ChicagoPublicHealth@ChiPublicHealth
312.747.9884
www.CityofChicago.org/Health