Chicago Department of Public Health Transforms City Health
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Commissioner Choucair's keynote presentation at the 2014 Wisconsin Public Health Association Annual Conference
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Chicago Department of Public Health Transforms City Health
- 1. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel
- 2. 2 Challenges to Change • Dwindling local health department resources – 12% overall decrease in personnel since 2008 for all LHDs – Large jurisdictions hit the hardest • Infrastructure developed over 100 years ago – Tradition creates inertia that impedes change efforts • Political environments – One of several City agencies – Accountable to both Mayor and City Council • Interest groups
- 3. 3
- 4. Counseling and Education Clinical Interventions Long-Lasting Protection Interventions Changing the Context to Make Individuals’ Default Decisions Healthy Socioeconomic Factors Increasing Population Impact Increasing Individual Effort Needed
- 5. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel HEALTHY CHICAGO CHICAGO DEPARTMENT OF PUBLIC HEALTH TRANSFORMING THE HEALTH OF OUR CITY
- 6. 6 February – May 2011 August 20112010 Evolution of Healthy Chicago
- 7. 7
- 9. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel IT’S NOT JUST ABOUT INDIVIDUAL BEHAVIOR IT’S ABOUT HOW WE BEHAVE AS A CITY HEALTHY CHICAGO Chicago Department of Public Health
- 13. Tobacco
- 14. 1 4 Opportunities Considerations Tobacco: Opportunities and Considerations
- 15. Tobacco
- 16. 16 Tobacco Victories • Increased Cigarette Tax • Banned Flavored Tobacco Sales Near Schools • Regulate E-Cigarettes
- 18. 18 Ban of Flavored Tobacco Sales Near Schools • 4 Town Hall Meetings following Mayoral request • Over 200 residents, local and national content experts participated • Ordinance passed in December 2013 • Chicago is first City to include menthol in flavored tobacco regulations • Report included over 25 policy recommendations at local, state and federal levels. • Adopted by Board in October 2013 • Submitted to Mayor in November 2013
- 19. 19 Regulating Electronic Cigarettes Partners advocated for: • Keeping e-cigarettes behind counters • Prohibiting sales to minors • Requiring tobacco licenses for e-cigarette sales • Adding electronic smoking devices under the Clean Indoor Air Ordinance. January 15th passage of ordinance Aldermen noted they wanted to: • “stand with public health” and • “be on the right side of history”
- 20. Public Awareness Campaigns Reinforce Need for Change BURNED by Menthol campaign generated 22,775,407 media impressions Take Pride, Leave Cigarettes generated 12,492,530 impressions
- 21. 21 More Smokers Seeking Cessation Support • 24,496 calls in 2013 • 10,000 more calls than 2012 • >73% of callers were African American or Hispanic • More than half were uninsured
- 22. University 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 22 More Smoke-Free Environments
- 23. 23 Chicago Leads the Nation Mayor Emanuel receiving African American Tobacco Leadership Council’s Visionary Elected Official Award The federal government is currently considering: • Cigarette tax increase • Stronger rules on menthol • Regulating electronic cigarettes
- 24. 24 Adult Smoking is Down
- 25. 25 Youth Smoking is Down…
- 26. 26 … and Taxes are Up
- 27. Obesity
- 28. 2 8 Opportunities Considerations Obesity: Opportunities and Considerations
- 29. Obesity
- 30. 30 Obesity Successes • Increased access to healthy & affordable food • More opportunities for physical activity • Focus on CPS students
- 31. • Build healthier neighborhoods • Grow food • Expand healthy food enterprises • Strengthen the food safety net • Serve healthy food and beverages • Improve eating habits • Healthy vending machines in all City buildings • Launched Healthy Vending Challenge • Follow efforts of Parks and CPS Increasing Access to Healthy Food Citywide Food Plan Healthy Vending
- 32. • 15 carts in neighborhoods for 2013 • 15 planned for 2014 • ~20 jobs created • 40 persons trained in retail sales Farmers for Chicago • Partnership with Growing Power • 5 acres of vacant lots available • Training for local farmers and help installing equipment • 15 acres overall operate as farms or breaking ground Produce Carts Urban Farms Increasing Access to Healthy Food
- 33. Increased Opportunities for Physical Activity
- 34. • 2,035 bikes, 300 stations • 12,133 annual memberships • 131,984 24-hour passes • >1M trips, >2million miles Dearborn St. Complete StreetDivvy Bike Share Program • 200 miles of on-street protected, buffered and shared bike lanes • More than 13,000 bike racks, and sheltered parking • A 645-mile network of biking facilities by 2020 will provide a provide a bicycle accommodation within half-mile of every Chicagoan. Before After
- 35. • 61 events • 13,173 participants • Twice the number from 2012
- 36. . Focus on CPS Students New PE policy requires • 30 minutes of daily PE (or 150 minutes weekly) at elementary schools • Daily PE for high schools $2.25M grant will support implementation
- 37. Estimates of obesity prevalence for CPS students in kindergarten, 2003-12
- 38. Access to Care
- 39. 39 Opportunities Considerations Access to Care: Opportunities and Considerations
- 41. • 108 librarians trained • > 100 events at 26 branches Engaging Libraries
- 43. 4 3 2013 study of 3,402 artists found: • 43% did not have insurance  88% said they couldn’t afford it • 37% of the 1,927 with coverage paid for it themselves  6 times greater than general pop that pays for private, non-group insurance. • 55% did not understand or were unclear about the ACA • 3 hour event; 50 navigators • 1-hour appointments • 125 persons completed or began enrollment process
- 44. • 12,000 licensed public chauffeurs in Chicago • 300 present daily for license renewal at a single City location with waits of up to 2 hours • Many self-employed • Chicago study of cab drivers found:  70% uninsured (v. 20%)  4.6% eat enough produce (v.22%)  6% meet exercise standards (v. 21%)  ~ 50% of drivers in NYC and San Francisco uninsured Reaching Chicago’s Taxi Drivers • 3 onsite navigators • Education in waiting area • 7-9 enrollments daily
- 45. • Chicago City Colleges • 7 campuses • ~ 120,000 students • ~6,000 faculty • Events at 6 campuses • 206 Enrolled • 472 Educated The Young Invincibles
- 46. Public Housing Residents Through CHA events and partners, 537 residents have either enrolled or started the insurance enrollment process Operation Warm
- 47. 11 Community Service and Senior Centers 655 enrolled Family and Support Services & CDPH Sites Uptown and Englewood HIV Sites Enrollment at Family Flu Clinics 423 enrolled
- 48. Aviation ~200 non-City employees work at O’Hare 6-hour education & enrollment event Focus on small businesses later in year
- 49. Enroll 15,000 students over 2 years Grant period: Oct. 2013 – Sept. 2015 LISC - $1,550,000 Four Partners • North River • South West Organizing Project • Logan Square Neighborhood Assn. • Enlace The Children’s Initiative Over 20,000 uninsured children were eligible for coverage prior to the passage of the ACA
- 50. Illinois ACA Insurance Enrollment 10/1/ 2013 through 4/15/ 2014 ~ 504,000 Illinois residents gained coverage
- 55. Open Data Portal Spurs Innovation
- 56. 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
- 57. 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
- 58. Chicago Health Atlas is a Website ChicagoHealthAtlas.org
- 62. FoodBorne Chicago Open People Tweet about their health 4 days before seeing their doctor Surveillance Tweets lead us to illnesses in real time Actionable Submissions are investigated if warranted Social Media is Changing How We Communicate Meeting conversations on Twitter with a Public Health Service
- 63. FoodBorne Chicago Completing the Service Circle CLICKS & REPORT RESIDENT TWEETS ONLINE RESULTS
- 65. FoodBorne Chicago • 2,848 Tweets Classified • 313 Tweets Responded To • 275 Reports Submitted • 175 Inspections
- 66. Predictive Analytics Food Inspections Currently • 32 Inspectors • 623 Inspections/Inspector • 15,176 Food Establishments • 2,715,000 Chicagoans Centers for Disease Control and Prevention • Many food borne illnesses go unreported • 1 in 6 Americans (48 million people) get sick • 128,000 are hospitalized • 3,000 die of foodborne diseases To Meet Requirements of Inspections • Do we increase productivity? • Do we increase workforce?
- 68. Predictive Analytics Food Inspections Project managed by: • CDPH Food Safety Division • Department of Innovation and Technology • Civic Consulting Alliance • Allstate
- 69. Predictive Analytics Food Inspections Test of Model
- 70. While Data Mining for the Analytics Project… • While the number of food inspections is trending up, the number of fails is down, as is the rate of fails. • Nine months of 2013 had fewer fails than any of the same months in the previous 3 years. • Every month of 2013 had a lower rate of fails than any of the same months in the previous 3 years.
- 71. Predictive Analytics Lead Where Discover where greatest risk for lead is in homes for inspectors to test. Who Discover areas of highest risk for child lead poisoning to prevent poisoning. Actively Prevent Illnesses Prioritizes inspections instead of passively waiting for lead poisoning to occur.
- 72. Why Healthy Chicago is Making a Difference Partnerships Policies Technology and Innovation Public Awareness
- 73. City Participation is Growing