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