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Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.
City of ChicagoMayor Rahm Emanuel
Bechara Choucair, MDCommissioner
Chicago Department of Public Health
@choucair #HealthyChicago
TRANSFORMING THE HEALTH OF THE COMMUNITY
SNIVELY LECTURE FOR UC DAVIS COMMUNITY
November 19, 2013
PRESENTATION OUTLINE
1. What Influences Public Health? Policy,
Systems & Environmental Change (PSE)
2. Healthy Chicago Public Health Agenda
3. PSE Successes: Tobacco, Maternal and Child Health, Obesity, and Adolescent Health
4. Advancing Healthy Chicago Through Technology
FACTORS INFLUENCING HEALTH
McGinnis et al. The Case for More Policy Attention to Health Promotion. Health Affairs, Vol. 21 (2)
HEALTH IMPACT PYRAMID
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, SYSTEMS & ENVIRONMENTAL CHANGE (PSE)
• Makes default decisions healthy
• Big impact & sustainable
• Relatively little time and resources needed
• Engages diverse stakeholders
Environment
Systems
Policy
Policy - Written statement of organizational position, decision or course of action, including ordinances, resolutions, mandates, guidelines, & rules
Systems - Changes in organizational procedures (personnel, resource allocation, & programs)
Environment - Physical, observable changes in the built, economic, and/or social environment
POLICY, SYSTEMS & ENVIRONMENTAL CHANGE (PSE)
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
Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.
City of ChicagoMayor Rahm Emanuel
PHAB ACCREDITATION
1st Big City Health Department
toReceiveNational
Accreditation
Innovation & Change Requires a Strong Public Health Infrastructure
TOBACCO USE
TOBACCO USE
SMOKE-FREE CAMPUSES
• 3 Colleges / Universities • 6 Hospitals • 6 Behavioral Health
Organizations• 686 Public Housing Units• Over 3,250 units of private
smoke-free housing
TOBACCO USE
Joint Enforcement
Reducing Tobacco Access
and Affordability
MAYOR EMANUEL PROPOSES TOBACCO TAX INCREASE • A tax increase on all
cigarette products is one of many policy recommendations adopted by the Chicago Board of Health.
• Single most effective way to prevent kids from picking up the habit.
• City will use $2 Million to expand vision service for low-income children.
Currently, a pack of cigarettes is over $10 in the City of Chicago
Before tax: $4.00 +
Federal tax: $1.01
Illinois tax: $1.98
Cook County tax: $3.00
City tax: $0.68
MAYOR’S PROPOSED TOBACCO TAX INCREASE
Taxes Total $6.67
President Obama has recently called for a $0.94 increase in the federal tax
Tax increased from $0.98 to $1.98 in June 2012
Tax increase from $2.00 to $3.00 in March 2013
Last increase was $0.20 in 2006 under Mayor Daley
Mayor Emanuel has recently proposed a $0.75 increase in the City’s tax
Source: Campaign for Tobacco-Free Kids; Chicago Tribune
Cost breakdownFor pack of cigarettes
• Reduce youth smoking by 4.8%
• Prevent 6,400 Chicago children from picking up the habit
• Save 3,500 lives
• Save $229.33 million in long-term health care costs
TAX INCREASE WILL SAVE LIVES AND SAVE MONEY
MENTHOL USE AMONG YOUTH
Menthol
• Menthol’s minty flavor & Cooling sensation…
Attracts
• Covers up the tobacco taste…
Youth
• To reduce throat irritation associated with smoking.
If smokers begin before 18,75% more likely to smokeas adults
African AmericanYouth Who Smoke72% use menthol
LGBTYouth Who Smoke71% use menthol
Who would not be smokers!
MENTHOL USE AMONG YOUTH
If smokers begin before 18,75% more likely to smokeas adults
African AmericanYouth Who Smoke72% use menthol
LGBTYouth Who Smoke71% use menthol
MAYOR EMANUEL TAKES BOLD ACTION ON MENTHOL! • Less than 48 hours
after the FDA’s report was released, Mayor Rahm Emanuel took swift action, directing the Chicago Board of Health to seek local policy options for curbing the use of menthol cigarettes among youth.
• No other city or state has attempted to regulate the sale or distribution of menthol.
#NoMoreMenthol
TOBACCO USE
PSE CHANGE IN OBESITY PREVENTION
ChicagoStreets for Cycling Plan 2020
PSE TO SUPPORT HEALTHY MOTHERS & BABIES
15 hospitals working towards Baby-Friendly Designation
Over 200 miles of on-street bikeways, including almost 35 miles of barrier and buffer protected bike lanes.
OBESITY PREVENTION
Dearborn Street - Before Dearborn Street - After
OBESITY PREVENTION
Bike Sharing in Chicago
3,000 bikes
300 stations
OBESITY PREVENTION
OBESITY PREVENTION
14 licensed carts operating 41 vendors trained 30 carts planned for 2013
OBESITY PREVENTION
Increasing Healthy Food Access
OBESITY PREVENTION
A Recipe forHealthy Places
• Released in January 2013
• Includes six community- based planning strategies to support healthy eating
OBESITY PREVENTION
A Recipe for Healthy Places: Strategies1. 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
OBESITY PREVENTION
Obesity rates for CPS Kindergartners continues to drop!
Results include:1 in 4 (2003) 1 in 5 (2012).
1,000 more CPS kindergartners at a healthier weight
Improvements seen for every racial/ethnic group
OBESITY PREVENTION
PSE CHANGE TO PROMOTE ADOLESCENT HEALTH
Public Health Commissioner
Office of Adolescent and School
Health
Public Schools CEO
Office of Student Health & Wellness
The Office of Student Health & Wellness:
A Collaboration between the Chicago Department of Public Health and
Chicago Public Schools
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
ADVANCINGHEALTHY CHICAGOTHROUGH TECHNOLOGY
WHEN THE CITY…..
CHICAGO BENEFITS FROM….
Collaborative
Innovation
PublicHealth
Academia/
Business
NonProfits/CBOs
Government
Civic Tech
Community
ADVANCING HEALTHY CHICAGOTHROUGH COLLABORATION
HACK NIGHTS
CHICAGO HEALTH ATLAS IS A
collaboration• Informatics researchers from multiple healthcare institutions
• Chicago Health Information Technology Regional Extension Center (CHITREC)
• Chicago Community Trust
• Chicago Department of Public Health
CHICAGO HEALTH ATLAS IS Adatabase
• De-identified electronic health record data for ~1 million Chicagoans
• In-patient and out-patient visits spanning 2006-2011
• Individual patient records matched across institutions
CHICAGO HEALTH ATLAS IS Awebsite
ChicagoHealthAtlas.org
OPEN DATA PORTAL
data.cityofchicago.org
APPLICATIONS USING MAPS • Local
Service for residents to find free vaccinations in their neighborhoods
• Platform Independent
Web app works on any computer Operating Systems (PC & Mac) or Mobile (iOS, Android, Windows, Blackberry)
• Retail Partnerships
Flu App has over 330 locations!
FLU SHOT FINDER BACK to SCHOOLIMMUNIZATION FINDER
• Web app based on machine learning
• Mathematical algorithm
• App “taught” to ID food poison tweets
• App “learns” relevant tweets
• Collects Chicago food poisoning tweets
• Human classifier determines responses
APP USINGMACHINE LEARNING &SOCIAL MEDIA
FOODBORNE CHICAGO
RESIDENT TWEETS CLICKS & REPORTS ONLINE RESULTS
FOODBORNE CHICAGO
BUILDING ON & ENGAGING PARTNERSHIPS
@ChiPublicHealth
312.747.9884
facebook.com/ChicagoPublicHealth
www.CityofChicago.org/Health