This address concluded the Third Annual Destination Chicago Program, where 20 incoming Feinberg Medical Students visit community organizations across Chicago to learn about community health and advocacy. This address was given to program participants and open to rest of the incoming class at the Northwestern School of Medicine.

1. Chicago Department of Public Health
Commissioner Bechara Choucair, M.D.
City of Chicago
Mayor Rahm Emanuel
Healthy Chicago: Partnering to
Transform Health
Destination Chicago 2013
August 5, 2013
Bechara Choucair, MD
Commissioner
Chicago Department of Public Health
@chipublichealth
#HealthyChicago

2. Presentation Outline
1. The Role of Public Health
2. The Healthy Chicago Public Health Agenda
3. Partnering with Healthy Chicago

3. Population Health
• The health outcomes of a group of individuals
• Focuses on improving health inequities

4. Core Functions &
Essential Services

5. Healthy Chicago Public
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

7. Tobacco Use

8. Tobacco Use
SMOKE-FREE CAMPUSES
 3 Colleges / Universities
 5 Hospitals
 6 Behavioral health orgs
 4 CHA developments

9. Joint
Enforcement
Tobacco Use

10. Obesity Prevention
 200 miles of buffer and protected bike lanes
 3000 bikes to share at 300 stations by end of summer

11. Obesity Prevention
 13 licensed carts operating
 30 vendors trained
 30 carts planned for 2013

12. Obesity Prevention

13. Heart Disease
& Stroke
 Keep Your Heart Healthy initiative
 National prevention effort
 CPR training for students
CDPH, Northwestern and the GE
Foundation Team Up to Save Lives
through Innovative New Heart Initiative

14. HIV Prevention
Integrated services planning to:
 Strengthen prevention
 Increase linkage & retention to care
 Increase treatment access

15. HIV Prevention
More HIV+ MSM are
 Aware of HIV status
 Accessing care
 Taking HIV medication

16. Adolescent Health
 CPS hires chief health officer
 Dually reports to CDPH
 CDPH creates Adolescent and
School Health Office

17. 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

18.  Outreach to CHA residents
 Partnerships to expand access
 Quality improvement initiatives
 Upgraded mammography machines
beyond p nk
Chicago
!
Cancer Disparities

19.  City partners with 7 FQHCs
 1115 Waiver granted
 CDPH public health services
remain
Access to Care

20. Access to Care
 City mental health sites consolidated to 6
 Capacity for 4,000 clients preserved
$500,000 awarded for expanded psych services
to 8 partners
CARF certification

21. Access to Care
 Oral health services expanded to 106
high schools
 Over 105,000 served in 2012-2013

22. Access to Care
 City invests $1.4M in new vision
program
 30,000 students to get optometry
exam and eyeglasses as needed

23. Access to Care
ADVOCACYADVOCACY
CHILDREN’S INSURANCE COVERAGECHILDREN’S INSURANCE COVERAGE
COUNTYCARECOUNTYCARE
SMALL BUSINESS ENROLLMENTSMALL BUSINESS ENROLLMENT
ENROLL CHICAGO!

24. Healthy Mothers
& Babies
15 hospitals working towards
Baby-Friendly Designation

25. Healthy Mothers
& Babies
 33% decline in teen birth rate
 50% drop in smoking while
pregnant
 10% increase in 1st
trimester care

26. Communicable Disease Control

27. Communicable
Disease Control

28.  Expanded environmental health unit
 $3M lead abatement grant awarded
 Asthma partnership with UIC
 600 radon kits given to residents
 92 tons of household waste collected
Healthy Homes

29. Violence Prevention

30. Public Health
Infrastructure

31. Healthy Chicago
Action Plans

32. Building on Policy
Successes
Mayor Emanuel Takes Action to Protect
Chicago’s Kids from Menthol Cigarettes

33. Building & Engaging Partnerships

34. • Population-wide
impact
• Little amount of
money goes a long way
• Sustainable
Why Does the City
Focus on Creating
New Policies
Not Just New Programs?

35. • Focus on broad, systemic changes, not individual
interventions or programs
• Upstream solutions to improve health outcomes for
everyone
– Addresses root causes of poor health
Policy, Systems and
Environmental
Changes

36. What is the Difference?
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

37. What is the Difference?
Socioeconomic Factors
Changing the Context
to make individuals’ default
decisions healthy
Long-lasting
Protective Interventions
Clinical
Interventions
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

38. Policy Change Target
Neighborhood Community State National
Impact of
clinical
ractice
PopulationScale
Geographic Scale
Individual
Single Sector
Multiple Sectors
Entire Population
Impact of
clinical
practice
Healthy
Chicago Target
Impact of
policy changes

39. Put your thumbprint on policy!
How can you maximize
the Impact you will have
on society?

40. 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 doctors with their lives – literally.
• People look to their doctors 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.

41. Not feeling sophisticated
enough to play at the State
and Federal level?
Work toward institutional policy changes!
Little p: Institutional policies
– Worksite policies/investments
– NGO policies
– Individual school policies
– Norms and standards that drive other action
BIG P: Public policy
– Legislation
– Regulations
– Zoning/land use
– Taxes
– Public budgets

42. Become a
Healthy Chicago Partner
• Northwestern: Go 100% smoke-free; test new policies
that improve the food and beverage environment; etc.
• 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 healthychicago@cityofchicago.org

43. facebook.com/ChicagoPublicHealth@ChiPublicHealth
312.747.9884
www.CityofChicago.org/Health
HealthyChicago@CityofChicago.org