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

City of ChicagoMayor Rahm Emanuel

Bechara Choucair, MDCommissioner

Chicago Department of Public Health

@ChiPublicHealth #HealthyChicago

Healthy Chicago: Partnering For Health

Grand Rounds at UC Davis

November 19, 2013

PRESENTATION OUTLINE

• Healthy Chicago Public Health

Agenda

• Healthy Chicago Partner-supported Successes

• Academic and Research Partnerships

HEALTHY CHICAGOCHICAGO DEPARTMENT OF PUBLIC HEALTH

TRANSFORMING THE HEALTH OF OUR CITYCHICAGO ANSWERS THE CALL

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

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

HEALTHY CHICAGO TARGETS

PHAB ACCREDITATION

1st Big City Health Department

toReceiveNational

Accreditation

Innovation & Change Requires a Strong Public Health Infrastructure

IT’S NOT JUST ABOUT INDIVIDUAL BEHAVIOR

IT’S ABOUT HOW WE BEHAVE AS A CITY

PRESENTATION OUTLINE

• Healthy Chicago Public Health Agenda

• Healthy Chicago Partner-supported Successes

• Academic and Research Partnerships

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 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

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.

PSE CHANGE IN 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.

OBESITY PREVENTION

Dearborn Street - Before Dearborn Street - After

OBESITY PREVENTION

Bike Sharing in Chicago

3,000 bikes

300 stations

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

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

14 licensed carts operating

41 vendors trained 30 carts planned for

2013

OBESITY PREVENTION

Increasing Healthy Food Access

OBESITY PREVENTION

OBESITY PREVENTION

A Recipe forHealthy Places

• Released in January 2013

• Includes six community- based planning strategies to support healthy eating

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

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

• Healthy Chicago Public Health Agenda

• Healthy Chicago Partner-supported Successes

• Academic and Research Partnerships

PUBLIC HEALTH & MEDICINE

Public Healt

h

Clinical Medicin

e

Health Outcome

s

PUBLIC HEALTH & ECONOMIC DEVELOPMENT

Public

Health

Economic Developme

nt

Health Outcom

es

ACADEMIC AND RESEARCH PARTNERSHIPS• Data Portal

• Chicago Health Atlas

• CHAMP

• Chicago Center for Diabetes Translational Research

• Keep Your Heart Healthy

• Tobacco Policy Evaluation

• Epidemiology Advisory Group

• Predictive Analytics

Collaborative

Innovation

PublicHealth

Academia/

Business

NonProfits/CBOs

Government

Civic Tech

Community

ADVANCING HEALTHY CHICAGOTHROUGH COLLABORATION

HACK NIGHTS

A FEW OF OUR COLLABORATIVEINNOVATORS

Civic Tech

Community

Smart Chicago

Collaborative

CHITREC

Tom, Cory, Scott, Joe, Dan, Chris, Dr. Kho…

OPEN DATA PORTAL

data.cityofchicago.org

PUBLIC HEALTH CONTEXT

• Most frequent requests are for statistics by neighborhood

• Neighborhood summaries published once every 3-4 years by paper/PDF

• Many data objects generated in response to requests

Number of customized data objects released to individuals or institutions (rather than to public), cumulative, 2011 – May 2013

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 A

database• 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 A website

ChicagoHealthAtlas.org

DEVELOPING PROCEDURES AND BEST PRACTICES• Public health indicators from City

Data Portal can be viewed for temporal and neighborhood trends

• Incorporating CDC guidelines for classification of map categories

• How to make metadata easily accessible to users

• How to deal with aggregated geographies and time periods

Health Information Exchange

CITY LEVEL COMPARISONS

Health Information Exchange

NEIGHBORHOOD PAGES

CHAMP: PEDIATRIC ASTHMA ED PILOT PROGRAM

• Recruit children who are seen in ED due to asthma

• Piloting program to use CHWs and address housing-based hazards and triggers

• Partnering with University of Illinois Hospital to improve pediatric asthma control and reduce the ED visits

• CDPH’s Healthy Homes Program inspectors will assess housing-based hazards and triggers

• CHWs to educate and assist families with changes

• Also partnering with Asthampolis to obtain GIS data when child is using inhaler

CHAMP: PEDIATRIC ASTHMA ED PILOT PROGRAM

DIABETES TRANSLATIONALRESEARCH• CDPH is partnering with

Chicago Center for Diabetes Translation Research in its mission to conduct innovative high-impact research to reduce morbidity and mortality related to diabetes

• Analyze data from multiple sources (EHR, hospital discharge data, vital statistics, and Healthy Chicago Community Survey) to better understand diabetes and related behaviors

KEEP YOUR HEART HEALTHY

• Collaboration among CDPH, Northwestern University, and GE Foundation to reduce the risk of heart disease

• Pilot in two Chicago neighborhoods

Three main components:

• Identify individuals most at risk for developing heart disease

• Link individuals to medical care and direct services through referrals so risk factors can be brought under control

• Work with individuals on ongoing basis to make changes to diet, exercise, and other areas to reduce their risk

KEEP YOUR HEART HEALTHY

TOBACCO EVALUATION

University of Illinois at Chicago Institute for Health Research and

Policy and the Tobacco Prevention Project

Three Tiers of Evaluation:1. Community Partner Evaluation2. Mental Health and Substance Abuse

Survey3. Courage to Quit Evaluation

EPIDEMIOLOGY ADVISORY GROUP• CDPH established Advisory Group as forum for academic and practice partners to discuss data and methods

• Member Organizations:– Chapin Hall– Cook County Health & Hospitals System– Illinois Department of Public Health– Lurie Children’s Hospital—Child Health Data Lab

– Northwestern University– Sinai Urban Health Institute– University of Chicago– University of Illinois at Chicago

Future –Predictive AnalyticsMaking Data Actionable

Food InspectionsOptimizing

Cigarette Sales ViolationsPredicting

Enhanced Partnerships with Health SystemsAllocating Resources & Predicting Community Need

@ChiPublicHealth

312.747.9884

facebook.com/ChicagoPublicHealth

HealthyChicago@CityofChicago.org

www.CityofChicago.org/Health