Bechara Choucair, MDCommissioner

Chicago Department of Public Health

@choucair #HealthyChicago

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

City of ChicagoMayor Rahm Emanuel

HEALTHY CHICAGOPatient-Centered Medicine Scholars

Program M2 Service Learning Program SeminarJanuary 28, 2014

Outline

1. Healthy Chicago Public Health

Agenda

2. Healthy Chicago Priorities

3. Next Steps for Healthy Chicago

Healthy ChicagoPublic Health Agenda

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

The Secrets to Our Success

Partnership Policies

Technology

Public Awareness

Healthy Chicago Partnerships Are Primary

Healthy Chicago Priorities

Percent of adults (18 years and older) who are current smokers, Chicago, 2012 (BRFSS)

> $50,000*

$35,000-49,999

$15-$34,999

< $15,000

65+

45-64

25-44

18-24

College Grad

Some post HS

HS or GED

Less than HS

Hispanic

NH Black

NH White

Female

Male

Total

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0

*Data not available

Highest among:

• Males• Blacks

& Whites

• Least educated

• Low income

Percent

*Data not available

Percent of high school students who smoked cigarettes on at least 1 day (during the 30 days before the survey), Chicago, 2011 (YRBSS)

12th Grade

11th Grade

10th Grade

9th Grade

Hispanic

NH Black

NH White*

Female

Male

Total

0 2 4 6 8 10 12 14 16 18 20

Highest among

• Males• Hispanics• 11th &12th

Graders

Percent

Chicago Recognized as Public Health Leader in Tobacco Control

Surgeon General ties cigarettes to diseases beyond cancer

Prevention Through Policy

More Smoke-Free EnvironmentsUniversity of Illinois at Chicago became a Tobacco-Free Campus for total of:• 5 smoke-free institutions of higher

learning• 6 smoke-free hospital campuses

Chicago Housing Authority designated 2 new 100% smoke-free complexes for

total of:• 610 smoke-free units in six

developments• 3,250 units of private multi-unit

housing

Percent of adults (18 years and older) who are overweight or obese, Chicago, 2009 (BRFSS)

*Data not available

> $50,000

$35,000-49,999

$15-$34,999

< $15,000

65+

45-64

25-44

18-24*

College Grad

Some post HS

HS or GED

Less than HS

Hispanic

Non-Hispanic

Black

White

Female

Male

Total

0 10 20 30 40 50 60 70 80 90

Highest among

• Blacks• HS

Grad/GED

Percent

Estimates of overweight or obesity prevalence for CPS students in kindergarten, 6th or 9th gradesby race-ethnicity, Chicago, 2010-11

Estimates of obesity prevalence for CPS students in kindergarten, 2003-12

New Physical Education Policy

• Establishes high standards for physical education instruction and instructional practices for schools across the district. 

• Requires at least 30 minutes of daily physical education (or equivalent of 150 minutes per week) at the elementary school level.

• Requires daily physical education in the same time increments as other core courses at the high school level (grades 9-12). Some individual student waivers are available.

January 22, 2014Chicago Board of Health Unanimously Adopts New Physical Education Policy

ImprovingPhysical Education

Increasing Access to Healthy Foods

Build Healthier Neighborhoods

Grow Food

Expand Healthy Food Enterprises

Strengthen the Food Safety Net

Serve Healthy Food and Beverages

Improve Eating Habits

Before After

Promoting Physical Activity

• 3,000 bikes• 300 stations• 100 more in

2014• 750,000+

trips• >1.7 million

miles

Age-adjusted death rates (per 100,000) due to heart disease by race-ethnicity,Chicago, 1999-2009

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090

50

100

150

200

250

300

350

400

450

329.9

303.5 296.3287.3

278.5

258.6 258.8

238.7228.8 230

220.7

All race-ethnicities NH White NH BlackHispanic United States

Age-adjusted death rates (per 100,000) due to stroke by race-ethnicity, Chicago, 1999-2009

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090

10

20

30

40

50

60

70

80

60.2 59.156.9

54.8 55.4

49.4 48.3

43.446.8

44.2

40.3

All race-ethnicities NH White NH Black Hispanic United States

Keep Your Heart Healthy 1,128 screenings

• 12 restaurants at Midway

• 9 million visitors

• 70 restaurants citywide

Service, Technology &Environmental Change

Teen birth rates by race-ethnicity of mother,Chicago, 1999-2009

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090

20

40

60

80

100

120

85.280.5

76

69.365.6 64.8

61.965.1 66.1

61.457

All race-ethnicities Hispanic NH AsianNH Black NH White United States

• Over 5,200 15-19 year old girls give birth annually (2009)

• Over 10,000 cases of chlamydia and 3,200 gonorrhea cases occur among 13-19 year olds.

Prevention Through Policy

Teen Outreach Program (TOP)

• 3,000+ students in service learning clubs

• 60,000+ hours of community service in addition to the TOP curriculum

• More than 200 TOP students trained to become Peer Health Ambassadors.

HIV infection rate (per 100,000), Chicago, 2011

NH Black

NH White

Hispanic

Male

Female

United State

Chicago

0 10 20 30 40 50 60 70

Highest Among• Males• Blacks

Percent distribution of HIV infection, Chicago, 2011

> 60

50-59

40-49

30-39

20-29

< 20

Heterosexual

MSM & IDU

IDU

MSM

NH White

NH Black

Hispanic

Male

Female

0 10 20 30 40 50 60 70 80 90

Highest among

• Males• Blacks• MSM• Ages 20-29

Percent

• Over 9M condoms distributed

• $36M in prevention, service and housing funding

• Network of over 70 agencies

In past 10 years,, reported HIV/AIDS cases down by 46% and 43% respectively• Youth only group continuing to see

a rise in new HIV infections.

• 84% of persons diagnosed with HIV in 2010 were linked to medical care within 3 months.

• Less than half of all people living with HIV are taking HIV medications or are virally suppressed

STI Initiative• 42 schools• 11,000+

educated• 6,915 screened

o 545 w/ chlamydia

o 137 w/gonorrhea

o 65 had both infections

Distribution of uninsured adults by race-ethnicity, Chicago, 2010-2011

Primary Care Transition

• 53,000 patient visits

• 13,000 uninsured patients

• Patient access up 32%

• Greater service array

• Improved patient experiences

• Increased efficiencies save ~$12M

Primary Care Transition

Vision Services

• 225 Schools• 21,125 Total Exams• 13,513 Total Glasses• Investment increased to $2M to

support 45,000 students in 2014.

Oral Health Services• 7% increase in students served

• 121,479 students in 595 schools

• 356,736 sealants applied

• Expansion to include CPS high schools

Infant mortality rates by race-ethnicity,Chicago, 1999-2009

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090

2

4

6

8

10

12

14

16

18

20

11.5

10.5

98.6

9.6

8.4 8.57.9 7.9 8 8

All race-ethnicities Hispanic NH AsianNH Black NH White United States

Percent of low birth weight births by race-ethnicityof mother, Chicago, 1999-2009

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090

2

4

6

8

10

12

14

16

10.19.7

10.1 10 10.1 10 10.2 10.29.9

9.6 9.7

All race-ethnicities Hispanic NH Asian NH Black NH White United States

• 15,000 home visits conducted

• 95% of WCH clients enrolled in both WIC and Family Case Management

• ~28,000 pregnant women & infants enrolled in WIC with 125,000 visits

15th hospital in pathway

$200,000 grant to serve 1,500 women

Services, Systems &Public Awareness

2012

High Risk Inspections Completed

Gains in Food Protection

.

Dr. Black to lead Carbapenem-resistant Enterobacteriaceae (CRE) Task Force launched May 2013.

West Nile Virus

• 290 traps set

• 105,085 catch basins monitored

• 33 WNV cases reported

Other Communicable Disease Control Successes

• 12 high need middle/high schools

• 788 middle school students completed program

• Parent training initiated

• 13 Youth Ambassadors trained

Teen Dating Violence

Prevention Through Partnerships

5,340 units

inspected

Environmental Health

390,439 lbs recycled in 2013

Permitting & Inspections

Partner Engagement

Preparing Together

236 trained in Psychological First Aid

Back to SchoolImmunizations

backtoschool.cdphapps.org data.cityofchicago.org

PredictingCigarette Sales Violations

Advancing Healthy ChicagoThrough Technology

"This is an important achievement and recognition that highlights the city of Chicago's ongoing commitment to health and wellness." --Mayor Rahm Emanuel

Next Steps for Healthy Chicago

More Work to be Done…

• Pass a Smoke-free Parks Policy

• Increase Taxes on Other Tobacco Products

• Discontinue the Use of Coupons, Gifts, etc.. for Tobacco Products

• Improve Medicaid Reimbursement Policy for Pediatric Prevention Obesity Services

• Develop a Comprehensive Plan to Address the National HIV Strategies at the Local Level

• Advocate for the Implementation of a New Laboratory Guidance for Detection of Emerging Antibiotic-resistant Pathogens

facebook.com/ChicagoPublicHealth@ChiPublicHealth

312.747.9884

www.CityofChicago.org/Health

HealthyChicago@CityofChicago.org