health in chicago - barriers and opportunities
DESCRIPTION
Commissioner Choucair from the Chicago Department of Public Health presenting a lecture course at the University of Chicago Pritzker School of Medicine's Health Care Disparities Lecture Series.TRANSCRIPT
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 [email protected]
@ChiPublicHealth
312.747.9884
facebook.com/ChicagoPublicHealth
www.CityofChicago.org/Health
