health in chicago - barriers and opportunities

Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

Bechara Choucair, MDCommissioner

Chicago Department of Public Health

@ChiPublicHealth #HealthyChicago

Health in Chicago: Barriers and Opportunities

September 16, 2013

PRESENTATION OUTLINE

1. The Role of Public Health

2. The Healthy Chicago Public Health Agenda

3. Partnering with Healthy Chicago

4. Students for Healthy Chicago

POPULATION HEALTH

• The health outcomes of a group of

individuals

• Focuses on improving health inequities

CORE FUNCTIONS & ESSENTIAL SERVICES

PRESENTATION OUTLINE

1. The Role of Public Health

2. The Healthy Chicago Public Health Agenda

3. Partnering with Healthy Chicago

4. Students for Healthy Chicago

HEALTHY CHICAGOPUBLIC HEALTH AGENDA• Released in August 2011

• Identifies priorities for action for next 5 years

• Identifies health status targets for 2020

• Shifts work from one-time programmatic interventions to sustainable system, policy and environmental changes

GUIDING PRINCIPLES

• 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

From Sampson R. Great American City. 2012; p. 105 & 106.

CHICAGO:PERSON, PLACE, TIME

HEALTHY CHICAGOCHICAGO DEPARTMENT OF PUBLIC HEALTH

TRANSFORMING THE HEALTH OF OUR CITYCHICAGO ANSWERS THE CALL

HEALTHY CHICAGO TARGETS

IT’S NOT JUST ABOUT INDIVIDUAL BEHAVIOR

IT’S ABOUT HOW WE BEHAVE AS A CITY

PRESENTATION OUTLINE

1. The Role of Public Health

2. The Healthy Chicago Public Health Agenda

3. Partnering with Healthy Chicago

4. Students for Healthy Chicago

TOBACCO USE

TOBACCO USE

SMOKE-FREE CAMPUSES 3 Colleges / Universities 6 Hospitals 6 Behavioral Health Organizations 686 Public Housing UnitsOver 3,250 units of private smoke-free housing

TOBACCO USE

Joint Enforcement

OBESITY PREVENTION

ChicagoStreets for Cycling Plan 2020

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

Bike Sharing in Chicago

3,000 bikes

300 stationsby the end of summer 2013

OBESITY PREVENTION

Health Goals Increase the number

of pedestrian trips for enjoyment, school, work, and daily errands

Increase the mode share of pedestrian trips for enjoyment, school, work, and daily errands

OBESITY PREVENTION

OBESITY PREVENTION

14 licensed carts operating 41 vendors trained 30 carts planned for 2013

OBESITY PREVENTION

OBESITY PREVENTION

A Recipe for Healthy Places

•Released in January 2013•Includes six community- based planning strategies to support healthy eating

OBESITY PREVENTION

A Recipe for Healthy Places: Strategies

1. Build Healthier Neighborhoods

2. Grow Food

3. Expand Healthy Food Enterprises

4. Strengthen the Food Safety Net

5. Serve Healthy Food and Beverages

6. Improve Eating HabitsCheck out the food plan - www.cityofchicago.org/hed

OBESITY PREVENTION

HEALTHY MOTHERS & BABIES

15 hospitals working towards Baby-Friendly Designation

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

BUILDING ON POLICY SUCCESSES

Mayor Emanuel Takes Action to Protect Chicago’s Kids from Menthol Cigarettes

BUILDING ON & ENGAGING PARTNERSHIPS

PRESENTATION OUTLINE

1. The Role of Public Health

2. The Healthy Chicago Public Health Agenda

3. Partnering with Healthy Chicago

4. Students for Healthy Chicago

WHY POLICY?

• Population-wide impact

• Little amount of money goes a long way

• Sustainable

POLICY, SYSTEMS, & ENVIRONMENTAL CHANGE

• Focus on broad, systemic changes, not individual interventions or programs

• Upstream solutions to improve health outcomes for everyone– Addresses root causes of poor health

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 impact

Engaging 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

WHAT IS THE DIFFERENCE?

Neighborhood Community State National

Healthy Chicago Target

Popu

latio

n Sc

ale

Geographic Scale

Impact of clinical practiceIndividual

Single Sector

Multiple Sectors

Entire Population

Impact of policy changes

POLICY CHANGE TARGET

POLICY, SYSTEMS, & ENVIRONMENTAL CHANGE

Put your thumbprint on policy!

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 medical professionals with their lives –

literally. • People look to their medical professionals 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 READY TO PLAY AT THE STATE/FEDERAL LEVEL? Work toward institutional policy changes!

Little p: Institutional policiesWorksite policies/investmentsNGO policiesIndividual school policiesNorms and standards that drive other action

BIG P: Public policyLegislationRegulationsZoning/land useTaxesPublic budgets

BECOME A HEALTHY CHICAGO PARTNER!

• For example, test new policies that improve the

food and beverage environment at University of Chicago

• 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

@ChiPublicHealth

312.747.9884

facebook.com/ChicagoPublicHealth

HealthyChicago@CityofChicago.org

www.CityofChicago.org/Health