Presentation by Commissioner Choucair at Northwestern University Feinberg School of Medicine Physician Assistant Program for a Public Health Presentation in Behavioral and Preventive Medicine I Course.
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Healthy Chicago - Physician Assistant Program
1. Chicago Department of Public Health
Commissioner Bechara Choucair, M.D.
City of Chicago
Mayor Rahm Emanuel
Healthy Chicago
August 6, 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
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
6. Healthy Chicago:
Promoting Public
Health Equity
• Improvement in the public’s health requires a
commitment to health equity and the elimination of
racial and ethnic disparities
• Healthy environments are key
• Persons of lower SES are often exposed to fewer
factors that promote health and more factors that
damage health
• Healthy choices must be easy and desirable
14. 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
18. 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
19. HIV Prevention
Integrated services planning to:
Strengthen prevention
Increase linkage & retention to care
Increase treatment access
20. HIV Prevention
More HIV+ MSM are:
Aware of HIV status
Accessing care
Taking HIV medication
21. Adolescent Health
CPS hires chief health officer
Dually reports to CDPH
CDPH creates Adolescent and
School Health Office
22. 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
23. Adolescent Health
• From 28 schools to 40+
• 6147 tested in 2011-2012
• 436 positive; 98% treated
STI Education/Screening
• 9,900 students, parents,
educators
• 12 high need middle/high
schools
• Evidence-based curricula,
social media, youth
ambassadors
Teen Dating Violence
• 4500 students in 28
schools
• 18 topical lessons
• Peer group meetings
• Community service
projects
Teen Pregnancy
24. Outreach to CHA residents
Partnerships to expand access
Quality improvement initiatives
Upgraded mammography
machines
beyond p nk
Chicago
!
Cancer Disparities
25. City partners with 7 FQHCs
1115 Waiver granted
CDPH public health services
remain
Access to Care
26. 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
27. Access to Care
Oral health services expanded to
106 high schools
Over 105,000 served in 2012-2013
28. Access to Care
City invests $1.4M in new
vision program
30,000 students to get
optometry exam and
eyeglasses as needed
29. Access to Care
ADVOCACYADVOCACY
CHILDREN’S INSURANCE COVERAGECHILDREN’S INSURANCE COVERAGE
COUNTYCARECOUNTYCARE
SMALL BUSINESS ENROLLMENTSMALL BUSINESS ENROLLMENT
ENROLL CHICAGO!
34. 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
40. • 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?
41. 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
42. 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
43. 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
44. 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
45. Put your thumbprint on policy!
How can you maximize the
Impact you will have on
society?
46. 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.
47. 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
48. 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