2013 impact summit: transparency & equity
DESCRIPTION
Commissioner Choucair's presentation at the 2013 Community Indicators Consortium's Impact Summit: Transparency & Equity in Chicago.TRANSCRIPT
Bechara Choucair, MDCommissioner
Chicago Department of Public Health
@Choucair #CICSUMMIT
2013 CIC Impact Summit: Advancing Transparency &
Equity
October 17, 2013
Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.
City of ChicagoMayor Rahm Emanuel
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 INFLUENCINGHEALTH
McGinnis et al. The Case for More Policy Attention to Health Promotion. Health Affairs, Vol. 21 (2)
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?
POLICY, SYSTEMS &ENVIRONMENTAL CHANGE (PSE) • Makes default
decisions healthy
• Big impact & sustainable
• Relatively little time and resources needed
• Engages diverse stakeholders
POLICY, SYSTEMS &ENVIRONMENTAL CHANGE (PSE)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
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
HEALTHY CHICAGOPUBLIC 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
LEADING CAUSES OF DEATH,2009
ChicagoUnited States
Cause of death
Percent of total deaths
Rank*
Percent of total deaths
Rank*
Heart disease
27.3 1 24.6 1
Cancer 23.1 2 23.3 2
Stroke 4.9 3 5.3 4*Based on number of deaths
Healthy ChicagoPriority Areas
Healthy Chicago Indicator Development• Determine a baseline and set a
target
• Measure progress annually, or as new public health data becomes available
• Look back retrospectively to understand temporal trend
• Make use of Healthy People 2020 Goals and Objectives
Tobacco Use
Targets
•Reduce smoking prevalence among adults to 12%
•Reduce smoking prevalence among youth to 10.3%
Obesity PreventionTargets•Reduce adult and childhood obesity by 10%•Decrease the proportion of youth and adults consuming less than 5 servings of fruits and vegetables per day by 10%•Reduce the number of Chicagoans living in food deserts to 200,000 by 2015 and to zero by 2020
HIV Prevention
Target•Reduce the annual number of HIV infections by 25% from 1,082 to 812
PRESENTATION OUTLINE
1. What Influences Public Health? Policy, Systems & Environmental Change (PSE)
2. Healthy Chicago Public Health Agenda
3. PSE Successes: Tobacco, Obesity, and Adolescent Health
4. Advancing Healthy Chicago Through Technology
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
14 licensed carts operating 41 vendors trained 30 carts planned for 2013
OBESITY PREVENTION
OBESITY PREVENTION
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. What Influences Public Health? Policy, Systems & Environmental Change (PSE)
2. Healthy Chicago Public Health Agenda
3. PSE Successes: Tobacco, Obesity, and Adolescent Health
4. Advancing Healthy Chicago Through Technology
Advancing Healthy ChicagoThrough Technology
•Chicago Health
Atlas
•City Open Data
Portal
• FoodBorneChi
Chicago Health Atlas is acollaboration• Informatics researchers from
multiple healthcare institutions
• Chicago 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
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
Neighborhood Pages
Health Information Exchange
City Level Comparisons
Open Data Portal
data.cityofchicago.org
Public Health Context
• Most frequent requests are for statistics by neighborhood (community area or zip code)
• 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
Flu App
FoodBorne Chicago • Web application 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
• Actionable – submissions are investigated
• Sentinel for outbreaks• Inspection status:• Residents see results
online• Open 311• Data Portal
• 85 inspections since released• Future: Emergency
Response, Flu
FoodBorne Chicago
RESIDENT TWEETS CLICKS & REPORTS ONLINE RESULTS
FoodBorne Chicago
@foodbornechi FoodBorneChicago.org
FoodBorne Chicago
@ChiPublicHealth
312.747.9884
facebook.com/ChicagoPublicHealth
www.CityofChicago.org/Health