2013 Impact Summit: Transparency & Equity
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Commissioner Choucair's presentation at the 2013 Community Indicators Consortium's Impact Summit: Transparency & Equity in Chicago.
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2013 Impact Summit: Transparency & Equity
- 1. 2013 CIC Impact Summit: Advancing Transparency & Equity October 17, 2013 Bechara Choucair, MD Commissioner Chicago Department of Public Health @Choucair City of Chicago Mayor Rahm Emanuel #CICSUMMIT Chicago Department of Public Health Commissioner Bechara Choucair, M.D.
- 2. 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
- 3. FACTORS INFLUENCING HEALTH McGinnis et al. The Case for More Policy Attention to Health Promotion. Health Affairs, Vol. 21 (2)
- 4. WHAT IS THE DIFFERENCE? Smallest Impact Examples Counseling & Education Clinical Interventions Long-lasting Protective Interventions Changing the Context Eat healthy, be physically active Rx for high blood pressure, high cholesterol, diabetes Immunizations, brief intervention, cessation treatment, colonoscopy to make individuals’ default decisions healthy Largest Impact Fluoridation, trans fat, smoke-free laws, tobacco tax Socioeconomic Factors Poverty, education, housing, inequality
- 5. POLICY, SYSTEMS & ENVIRONMENTAL CHANGE (PSE) • Makes default decisions healthy • Big impact & sustainable • Relatively little time and resources needed • Engages diverse stakeholders
- 6. POLICY, SYSTEMS & ENVIRONMENTAL CHANGE (PSE) Written statement of organizational Policyposition, 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
- 7. 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
- 8. 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
- 9. LEADING CAUSES OF DEATH, 2009 Chicago Cause of death United States Percent of total Rank deaths * Percent of total Rank deaths * 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
- 11. 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
- 12. Tobacco Use Targets •Reduce smoking prevalence among adults to 12% •Reduce smoking prevalence among youth to 10.3%
- 13. Obesity Prevention Targets •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
- 14. HIV Prevention Target •Reduce the annual number of HIV infections by 25% from 1,082 to 812
- 15. 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
- 16. TOBACCO USE
- 17. TOBACCO USE SMOKE-FREE CAMPUSES 3 Colleges / Universities 6 Hospitals 6 Behavioral Health Organizations 686 Public Housing Units Over 3,250 units of private smoke-free housing
- 19. OBESITY PREVENTION Chicago Streets for Cycling Plan 2020
- 20. OBESITY PREVENTION 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.
- 21. OBESITY PREVENTION Dearborn Street - Before Dearborn Street - After
- 22. OBESITY PREVENTION Bike Sharing in Chicago 3,000 bikes 300 stations by the end of summer 2013
- 23. 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
- 24. OBESITY PREVENTION 14 licensed carts operating 41 vendors trained 30 carts planned for 2013
- 26. 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
- 27. BUILDING ON POLICY SUCCESSES Mayor Emanuel Takes Action to Protect Chicago’s Kids from Menthol Cigarettes
- 28. BUILDING ON & ENGAGING PARTNERSHIPS
- 29. 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
- 30. Advancing Healthy Chicago Through Technology • Chicago Health Atlas • City Open Data Portal • FoodBorneChi
- 31. Chicago Health Atlas is a collaboration • Informatics researchers from multiple healthcare institutions • Chicago Regional Extension Center (CHITREC) • Chicago Community Trust • Chicago Department of Public Health
- 32. 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
- 33. Chicago Health Atlas is a website ChicagoHealthAtlas.org
- 34. 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
- 35. Neighborhood Pages Health Information Exchange
- 36. City Level Comparisons Health Information Exchange
- 38. 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
- 39. Number of customized data objects released to individuals or institutions (rather than to public), cumulative, 2011 – May 2013
- 40. Flu App
- 41. 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
- 42. FoodBorne Chicago • 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
- 43. FoodBorne Chicago RESIDENT TWEETS CLICKS & REPORTS ONLINE RESULTS
Hinweis der Redaktion
- I’m very pleased to have the opportunity to speak with you today about public health in Chicago. First, I’ll briefly introduce the Chicago Public Health Agenda, the blueprint for our work to make Chicago the healthiest city in the nation. Next, I’ll talk about the indicators that we’ve developed to monitor the progress of our efforts, and how we developed them. Finally, I’ll talk about how CDPH and our partners are using data, metrics and technology to improve public health.
- I’m very pleased to have the opportunity to speak with you today about public health in Chicago. First, I’ll briefly introduce the Chicago Public Health Agenda, the blueprint for our work to make Chicago the healthiest city in the nation. Next, I’ll talk about the indicators that we’ve developed to monitor the progress of our efforts, and how we developed them. Finally, I’ll talk about how CDPH and our partners are using data, metrics and technology to improve public health.
- Mayor Emanuel and CDPH released the Healthy Chicago Agenda in August 2011. The Agenda identifies 12 priority areas, health status targets for 2020, and 193 strategies to meet our goals. The strategies cover areas of policy, programs, and education and awareness activities. By working on strategies in all these areas, the goals are addressed comprehensively. Healthy Chicago is also a shift from one-time programmatic interventions to sustainable system, policy and environmental changes. Policy, Systems, and Environmental Change is a relatively new way of thinking in public health. Healthy Chicago is changing the environment in Chicago to make healthy choices practical and available to all community members. By changing laws and shaping physical landscapes, a big and sustainable impact can be made with little time and few resources. This type of work engages diverse stakeholders, because we are exerting public health leadership where people live, play, and work.
- To come up with our priority areas for Healthy Chicago, we started at the most fundamental level, we asked, “What are we dying of?” And we found that in Chicago, not unlike in the US as a whole, half of all deaths are due to heart disease and cancer. So very simply, we knew we needed to prioritize prevention of the conditions that precede these deaths, such as obesity for example, and the risk factors, such as smoking, that contribute to them.
- Healthy Chicago lays out strategies for addressing 12 public health priorities, which are:
- Following the identification of each priority area, we selected indicators as a means to monitor the progress of our efforts and set targets for 2020 using Healthy People 2020 as a guide. These indicators also served as a means to examine where we were currently and where we had been. I’ll now go through each of the priority areas, and highlighting some of our indicators along the way so that you to better understand the landscape of public health in Chicago.
- Smoking rates among adults are about the same for Chicagoans and United States, approximately 20%. In comparison, Chicago’s smoking rates for high school students are 25% lower than the US (18%).
- Almost 70% of Chicago adults are overweight or obese (BRFSS, 2009), and almost 30% of high school students are overweight or obese (YRBSS 2011). These percentages are similar to the US rates of overweight and obesity. Just over 20% of Chicago adults consume 5 or more servings of fruits and vegetables daily (BRFSS, 2009), consistent (same as) the rest of the US.
- Like the rest of the country, new HIV infection diagnoses continue to decrease in Chicago. CDPH conducts behavioral surveillance as well as traditional surveillance to monitor HIV. MSM and African-Americans are the subpopulations affected most in Chicago and the United States.
- I’m very pleased to have the opportunity to speak with you today about public health in Chicago. First, I’ll briefly introduce the Chicago Public Health Agenda, the blueprint for our work to make Chicago the healthiest city in the nation. Next, I’ll talk about the indicators that we’ve developed to monitor the progress of our efforts, and how we developed them. Finally, I’ll talk about how CDPH and our partners are using data, metrics and technology to improve public health.
- Partnerships have been key to the Healthy Chicago successes we’ve seen thus far. On this slide are many of the agencies we work with on Healthy Chicago priorities – Hospitals, community development corporations, public agencies, FQHC’s, universities, businesses and more – have all played an important role.
- I’m very pleased to have the opportunity to speak with you today about public health in Chicago. First, I’ll briefly introduce the Chicago Public Health Agenda, the blueprint for our work to make Chicago the healthiest city in the nation. Next, I’ll talk about the indicators that we’ve developed to monitor the progress of our efforts, and how we developed them. Finally, I’ll talk about how CDPH and our partners are using data, metrics and technology to improve public health.
- I’d like to share with you some examples of how CDPH and our partners are advancing Healthy Chicago through technology. I’ll start with the Chicago Health Atlas, turn to the City of Chicago’s open data portal, and end with the FoodBorneChi app.
- First and foremost Chicago Health Atlas is a collaboration. It came to life through the work of informatics researchers at several institutions in Chicago who asked the question: How much overlap is there in patient care? Or, in other words, to what extent are individual patients seen at more than one institution or network for their health care. The researchers were convened under the umbrella of the Chicago Regional Extension Center. This is the agency that works to promote the use of electronic health records / and provide technical assistance / in our city. The Chicago Community Trust has several projects related to expanding access to the Internet across all areas of the city. It also provides great leadership and technical skill in our local open data movement. My institution, CDPH, has been able to provide a public health perspective on potential uses of the data, and give input on approaches to analyzing the data and disseminating results.
- Chicago Health Atlas is a big database, too. It has de-identified electronic health record data for about one million Chicagoans, with in-patient and out-patient visits spanning from 2006 through 2011, and individual patient records matched across institutions. Much more detail is on the way about all this.
- Thanks to the work at Chicago Community Trust, the collaborative has a website that's up and running at ChicagoHealthAtlas.org This serves as the public face of the project - the place where data on public health indicators - as well as community assets – is available to the public. The website is now live but still actively under construction. The first datasets included were the public health indicators that CDPH posted on the City of Chicago Data Portal. Data can be viewed for temporal and neighborhood trends, as well as places people can go in their neighborhoods to improve their own health. SCREENSHOT
- The creation of the website has involved the following: Identifying health-related data from potential partners across the city and evaluating the need for data-sharing agreements; From these partners, securing and importing point data ( such as locations of services or health-related events and infrastructure) and polygon data (meaning: counts, rates, or percents pertaining to a geographic area) And lastly, Developing procedures and best practices for ongoing integration and visual presentation of new datasets.
- Another strategy of Healthy Chicago is to increase the availability of public health data through the City’s website. To that end, we now make use of the City’s Open Data Portal to push out frequent updates of indicator data related to births, deaths, infectious diseases, environmental health, hospital discharges, and public health assets. The way it works, we don’t provide any data directly to the Chicago Health Atlas website; the developers subscribe to our feed on the Data Portal, and can update their views with new data as it becomes available.
- For epidemiologists in our department, the most frequent requests we get are for summary statistics by Chicago neighborhood. The majority of users are NOT seeking record level data sets, but instead, they just want US to do the calculations and provide indicators. Before the data portal expansion, our Department published summary statistics at the neighborhood level about once every 3 to 4 years in the form of a paper report of a PDF posted online. For many content areas we would generate data objects, such as tables, maps, or statistical graphics, primarily in response to requests. So, in other words, we were doing a high volume of customized analyses of the source data rather than having of library of reference data sets to pull the statistics from or refer users to.
- Flu App Example using data portal flu vaccination sites. Now 4 different retail clinics joined the app with us.
- FoodBorneChi is an example of Technology supporting Healthy Chicago that complements current telephone reporting using 311. It uses Twitter as a sentinel to search for mentions of “food poisoning.” In order to determine if a tweet is relevant to the city's interests, it must be classified as relevant or noise. This classification is done via machine learning. In this process, a mathematical, natural language model is constructed using existing tweets and a human classifier.
- Once the model is completely built, future tweets can be applied to the model, resulting in automatic classification. When a tweet is classified correctly, it then becomes actionable, and can be routed to the proper municipal department. Currently, we have completed 50 inspections through this app. Future uses can include emergency preparedness, disease outbreaks, etc.
- The steps a resident goes through to report a suspected food poisoning incident are easy. When users respond to our Twitter @-reply; They fill out a simple food poisoning report form on Foodborne. This form is submitted to the City of Chicago via its Open311 interface. This submission is equivalent to the person calling Chicago 311 to report their food poisoning. The 311 software routes the submission to the Chicago Department of Public Health, where investigators review the submission and take action, including conducting inspections, based on the report. The inspection in detail is also updated into the Data Portal.
- FoodBorneChicago is on Twitter @foodbornchi and the website is at foodbornechicago.org