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Using Evidence to Combat Childhood Obesity:
        Health Commissioners’ Perspective

         Robert Wood Johnson Foundation
Healthy Eating Research 7th Annual Grantee Meeting
                  March 14, 2013

              Bechara Choucair, MD
                 Commissioner
       Chicago Department of Public Health
                  @choucair on
Presenter Disclosures

              Bechara Choucair, M.D.

(1) The following personal financial relationships with
    commercial interests relevant to this presentation
    existed during the past 12 months:
     “No relationships to disclose.”
PRESENTATION OUTLINE

1. Snapshot of Chicago’s Childhood Obesity Epidemic Data

2. Chicago’s Political Landscape
   “Never let a serious crisis go to waste.”
             Rahm Emanuel
                     Mayor, City of Chicago

3. Discussion About Three of Chicago’s Childhood Obesity
   Prevention Initiatives
ADJUSTED ESTIMATES OF OBESITY PREVALENCE
AMONG CHICAGO PUBLIC SCHOOL STUDENTS IN
              KINDERGARTEN




                                             National estimate                                       2008 2003
                                             For 2-5 year olds                                     CLOCC estimates
                                                                                                   (CPS & Archdiocese)
        Orange bars denote 95% confidence limits (i.e., the margin of error associated with each estimate).
RESULTS OF 2002 NEIGHBORHOOD SURVEY




Source: Margellos-Anast et al., Public Health Reports 2008.
Online via http://www.suhichicago.org/files/publications/PHR_child_obesity.pdf
2010-11 SCHOOL DATA ASSESSMENT

Report available at: http://bit.ly/15tkiUr
                    • Assessed records of 88,527
                      Chicago Public School
                      students in the three grades
                       – 44% Hispanic
                       – 42% non-Hispanic black
                       – 9% non-Hispanic white
                       – 3% non-Hispanic Asian
2010-11 SCHOOL DATA ASSESSMENT

Report available at: http://bit.ly/15tkiUr
                     • 59,794 students (67.5%) had
                       recent, valid, and complete
                       data sufficient for BMI
                       percentile calculation
                     • Obesity prevalence was 25%
ADJUSTED ESTIMATES OF OBESITY PREVALENCE AMONG
CHICAGO PUBLIC SCHOOL STUDENTS (KINDERGARTEN, 6, 9)



Five highest estimates           (%)
South Lawndale (30)              32.9
Hermosa (20)                     31.3
East Side (52)                   30.9
Lower West Side (31)             30.5
West Lawn (65)                   30.2

Five lowest estimates           (%)
Lincoln Park (7)                12.7
Mount Greenwood (74)            12.9
Loop (32)          13.5
Armour Square (34)              14.1
Lake View (6)                   14.2

             Adjusted for non-response and standardized to District-wide grade-level enrollment
HEALTHY CHICAGO
                         POLITICAL LANDSCAPE:
Chicago Department of Public Health


                       HEALTHY CHICAGO AGENDA




                                                Infrastructure
POLITICAL LANDSCAPE:
CORPORATE AND COMMUNITY PARTNERS
THREE OF CHICAGO’S APPROACHES TO
CHILDHOOD OBESITY PREVENTION INITIATIVES


                     SCHOOL-BASED
                    INTERVENTIONS




                                MULTI-SECTOR
       INTERGOVERNMENTAL              &
          COLLABORATION          COMMUNITY
                                DEVELOPMENT
                                   EFFORTS
SCHOOL-BASED INTERVENTIONS



            SCHOOL-BASED
           INTERVENTIONS


                     MULTI-SECTOR
 INTERGOVERNMENTAL         &
    COLLABORATION     COMMUNITY
                     DEVELOPMENT
                        EFFORTS
SCHOOL-BASED INTERVENTIONS




               CPS hires chief health officer
               Dually reports to CDPH
               CDPH creates Adolescent and
                School Health Office
SCHOOL-BASED INTERVENTIONS

                Revised Wellness Policy
                Competitive Foods Policy
                Enhanced PE for all
                students
                 $26M New Grants
                   • CTG – Healthy CPS
                   • Teen Dating Matters
                   • Teen Pregnancy
                   • Farm to School
                   • Wellness Champions
Healthier US School Challenge Certification as of December 2012 with Prevalence of
Overweight or Obesity among Chicago Public School Students in Grades Kindergarten, 6, and
                                              9




                                                                 Overweight or obesity
                                                                 Prevalence estimate (%)




    70 schools certified

    75 pending certification
Report available at: http://bit.ly/YDOFEq
INTERGOVERNMENTAL APPROACH



          SCHOOL-BASED
         INTERVENTIONS




                     MULTI-SECTOR
                           &
   INTER-GOV’T        COMMUNITY
  COLLABORATION      DEVELOPMENT
                        EFFORTS
INTERGOVERNMENTAL APPROACH

 Inter-Departmental Task Force
 Produce Cart Initiative
 Play Streets, Bike Lanes
INTERGOVERNMENTAL APPROACH
MULTI-SECTOR & COMMUNITY
 DEVELOPMENT APPROACHES


              SCHOOL-BASED
             INTERVENTIONS




                     MULTI-SECTOR
                           &
INTERGOVERNMENTAL
   COLLABORATION      COMMUNITY
                     DEVELOPMENT
                        EFFORTS
MULTI-SECTOR & COMMUNITY
     DEVELOPMENT APPROACHES
Report available at: http://bit.ly/X5nH90
                       Citywide Food Plan
                       LISC Partnership
MULTI-SECTOR & COMMUNITY
 DEVELOPMENT APPROACHES
             • Baby Friendly Expansion
             • Improvements to Chicago’s
               Day Care Center Standards
facebook.com/ChicagoPublicHe
alth
Gplus.to/ChiPublicHeal
th
@ChiPublicHealt
h
312.747.988
4
CityofChicago.org/Hea
lth
HealthyChicago@CityofChicago
.org

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Using Evidence to Combat Childhood Obesity: Health Commissioners' Perspective

  • 1. Using Evidence to Combat Childhood Obesity: Health Commissioners’ Perspective Robert Wood Johnson Foundation Healthy Eating Research 7th Annual Grantee Meeting March 14, 2013 Bechara Choucair, MD Commissioner Chicago Department of Public Health @choucair on
  • 2. Presenter Disclosures Bechara Choucair, M.D. (1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: “No relationships to disclose.”
  • 3. PRESENTATION OUTLINE 1. Snapshot of Chicago’s Childhood Obesity Epidemic Data 2. Chicago’s Political Landscape “Never let a serious crisis go to waste.” Rahm Emanuel Mayor, City of Chicago 3. Discussion About Three of Chicago’s Childhood Obesity Prevention Initiatives
  • 4. ADJUSTED ESTIMATES OF OBESITY PREVALENCE AMONG CHICAGO PUBLIC SCHOOL STUDENTS IN KINDERGARTEN National estimate 2008 2003 For 2-5 year olds CLOCC estimates (CPS & Archdiocese) Orange bars denote 95% confidence limits (i.e., the margin of error associated with each estimate).
  • 5. RESULTS OF 2002 NEIGHBORHOOD SURVEY Source: Margellos-Anast et al., Public Health Reports 2008. Online via http://www.suhichicago.org/files/publications/PHR_child_obesity.pdf
  • 6. 2010-11 SCHOOL DATA ASSESSMENT Report available at: http://bit.ly/15tkiUr • Assessed records of 88,527 Chicago Public School students in the three grades – 44% Hispanic – 42% non-Hispanic black – 9% non-Hispanic white – 3% non-Hispanic Asian
  • 7. 2010-11 SCHOOL DATA ASSESSMENT Report available at: http://bit.ly/15tkiUr • 59,794 students (67.5%) had recent, valid, and complete data sufficient for BMI percentile calculation • Obesity prevalence was 25%
  • 8. ADJUSTED ESTIMATES OF OBESITY PREVALENCE AMONG CHICAGO PUBLIC SCHOOL STUDENTS (KINDERGARTEN, 6, 9) Five highest estimates (%) South Lawndale (30) 32.9 Hermosa (20) 31.3 East Side (52) 30.9 Lower West Side (31) 30.5 West Lawn (65) 30.2 Five lowest estimates (%) Lincoln Park (7) 12.7 Mount Greenwood (74) 12.9 Loop (32) 13.5 Armour Square (34) 14.1 Lake View (6) 14.2 Adjusted for non-response and standardized to District-wide grade-level enrollment
  • 9. HEALTHY CHICAGO POLITICAL LANDSCAPE: Chicago Department of Public Health HEALTHY CHICAGO AGENDA Infrastructure
  • 11. THREE OF CHICAGO’S APPROACHES TO CHILDHOOD OBESITY PREVENTION INITIATIVES SCHOOL-BASED INTERVENTIONS MULTI-SECTOR INTERGOVERNMENTAL & COLLABORATION COMMUNITY DEVELOPMENT EFFORTS
  • 12. SCHOOL-BASED INTERVENTIONS SCHOOL-BASED INTERVENTIONS MULTI-SECTOR INTERGOVERNMENTAL & COLLABORATION COMMUNITY DEVELOPMENT EFFORTS
  • 13. SCHOOL-BASED INTERVENTIONS  CPS hires chief health officer  Dually reports to CDPH  CDPH creates Adolescent and School Health Office
  • 14. SCHOOL-BASED INTERVENTIONS Revised Wellness Policy Competitive Foods Policy Enhanced PE for all students  $26M New Grants • CTG – Healthy CPS • Teen Dating Matters • Teen Pregnancy • Farm to School • Wellness Champions
  • 15. Healthier US School Challenge Certification as of December 2012 with Prevalence of Overweight or Obesity among Chicago Public School Students in Grades Kindergarten, 6, and 9 Overweight or obesity Prevalence estimate (%) 70 schools certified 75 pending certification
  • 16. Report available at: http://bit.ly/YDOFEq
  • 17. INTERGOVERNMENTAL APPROACH SCHOOL-BASED INTERVENTIONS MULTI-SECTOR & INTER-GOV’T COMMUNITY COLLABORATION DEVELOPMENT EFFORTS
  • 18. INTERGOVERNMENTAL APPROACH  Inter-Departmental Task Force  Produce Cart Initiative  Play Streets, Bike Lanes
  • 20. MULTI-SECTOR & COMMUNITY DEVELOPMENT APPROACHES SCHOOL-BASED INTERVENTIONS MULTI-SECTOR & INTERGOVERNMENTAL COLLABORATION COMMUNITY DEVELOPMENT EFFORTS
  • 21. MULTI-SECTOR & COMMUNITY DEVELOPMENT APPROACHES Report available at: http://bit.ly/X5nH90  Citywide Food Plan  LISC Partnership
  • 22. MULTI-SECTOR & COMMUNITY DEVELOPMENT APPROACHES • Baby Friendly Expansion • Improvements to Chicago’s Day Care Center Standards