IOMC Panel: Childhood Obesity in Chicago: Causative Factors and Proposed Solutions
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The Institute of Medicine of Chicago (IOMC) Panel on Childhood Obesity in Chicago: Causative Factors and Proposed Solutions. Dr. Choucair, along with Moderator Lisa Laurent, MD, Adam Becker, PhD, MPH, Elif Oker, MD and Karen Walker, MD discuss childhood obesity in Chicago.
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IOMC Panel: Childhood Obesity in Chicago: Causative Factors and Proposed Solutions
- 1. City of Chicago Mayor Rahm Emanuel Chicago Department of Public Health Commissioner Bechara Choucair, M.D.
- 4. Source: Margellos-Anast et al., Public Health Reports 2008. Online via http://www.suhichicago.org/files/publications/PHR_child_obesity.pdf
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Notas do Editor
- Commissioner Choucair: During his first 100 days in office, Mayor Rahm Emanuel released “Healthy Chicago,” the City’s first-ever comprehensive public health agenda. Healthy Chicago is a blueprint for action that serves as a framework for a focused, yet comprehensive, approach to how the Chicago Department of Public Health will lead and collaborate with community partners to improve the health and well-being of Chicagoans.Obesity prevention is one of the top priorities of Healthy Chicago — and for good reason.
- The three approaches I am presenting today include: (1) school-based obesity prevention initiatives, (2) intergovernmental collaboration to reduce childhood obesity, and (3) multisectoral and community development efforts.
- When designing our approach to decreasing Chicago’s obesity crisis, we quickly learned that working on local PSE takes the support of city and sister agencies because the health dept. simply does not have the jurisdictional authority or access to all the tools it needs to implement certain policy changes. This is an example of identifying a need for a strong partner at CPS and creating the Chief Health Officer position.
- USDA just recently announced new competitive food guidelines. While other jurisdictions work to figure out what this means for them, Healthy CPS, an initiative of Healthy Chicago, will be "WELL ON ITS WAY," to substantially improving the food environment in schools. New CPS policies regarding competitive foods meet or exceed the newly proposed USDA rule. In fact, we believe the CPS policy puts Chicago in the top 5% of all school districts in the country with regard to nutrition standards in schools. We will continue implementing policies that will surpass the USDA rules -- policies aimed at making Chicago the healthiest city in the nation. Another initiative we will be launching through our CDC Community Transformation Grant is to work with mobile vendors and area corner stores near schools to provide healthier foods directly outside the school environment.
- This map shows the distribution of the 145 schools that are have taken on the Healthier US School Challenge, a key component of First Lady Michelle Obama’s Let’s Move initiative.Certification reflects a school-wide commitment to student wellness through student access to healthy food at school (including school meals, celebrations and fundraising),nutrition education and physical activity. By the end of the 2011-12 school year, 56 schools were certified for the HUSSC, with an additional 66 pending approval by the USDA.(The shading scale in this map refers to the estimated prevalence of overweight or obesity by community area.)
- Chicago Public Schools serves 403,000 students in 681 schools. It is the nation’s third-largest school district. We designed Healthy CPS, a strategic plan that provides a real, innovative and system-wide set of strategies to address student health and well being. At a Let’s Move event recently held in Chicago, the First Lady underscored something we all know — childhood obesity and student academic performance are intrinsically linked. Healthy CPS is grounded in the premise that good health is essential for good learning.
- Now, let’s talk about Chicago’s inter-governmental approach to tackling childhood obesity.
- In Chicago, we were lucky to already have established an Inter-Departmental Task Force on Childhood Obesity (IDTF) working to address Chicago’s obesity crisis through a multi-disciplinary approach. The IDTF is an 11 city agency task force led by the Chicago Department of Public Health and facilitated by the Consortium to Lower Obesity in Chicago Children (CLOCC). Since the IDTF’s creation in 2006, it has received national recognition and exposure for its innovative work. In 2011, the IDTF was recognized for its multi-disciplinary design by the National Association of County and City Health Officials and more recently the City of Chicago was awarded by the National League of Cities for its achievement in the Lets Move! Cities, Towns and Counties program. The City received this award in large part because of the accomplishments made possible by the IDTF collectively.Through our CPPW obesity prevention grant and our new Community Transformation grant, we were able to leverage the existing IDTF relationships to quickly ramp-up and work across disciplines. For example, we worked with our Dept. of Housing and Economic Development to offer tax increment financing incentives for our new produce cart program. We have 13 carts up and running across Chicago, many of them in low food access neighborhoods. We expect 30 more on the streets this spring.As another example, we worked with the Chicago Department of Transportation to launch our Play Streets program, and we also worked with CDOT to increase Chicago’s capacity for physical activity by installing 27 miles of protected bike lanes, creating two miles of other on-street bikeways, making 7 bridges bicycle-friendly.
- Some additional Intergovernmental examples: Austin farmers market/link Grocery Store expansionHealthy vendingUrban agriculture ordinance passing
- Now, let’s talk about Chicago’s inter-governmental approach to tackling childhood obesity.
- Working with one of Chicago’s leading community development organizations, Local Initiatives Support Corporation (LISC), the Department is directly engaging with LISC to implement the Healthy Chicago Agenda, on matters ranging from gun violence to alcohol and tobacco sales, from fresh food access to breast feeding. As another example of a multisectoral, community-based approach, we worked with the Departments of Housing and Economic Development, and Family and Support Services, to release Chicago’s first Food Plan (A Recipe for Healthy Places), which uses obesity prevention as the foundation for expanding access to healthier foods across the city through various initiatives. It outlines strategies that are aligned with the Public Health Impact Pyramid to change the context in which people acquire and eat food. The plan’s strategies seek to foster business entrepreneurism, job growth, gardening, and other spin-off benefits that provide for a healthier city. More than 400 nutritionists, backyard gardeners, community activists, child care providers, food entrepreneurs, academics, neighborhood residents and others participated in more than two dozen public workshops and forums in developing its strategies. As a citywide plan adopted by the Chicago Plan Commission in January 2013, A Recipe for Healthy Places will serve as an official roadmap for city planning and policymaking, as well as a guide for groups and individuals seeking to achieve healthier lifestyles through food.
- There is strong evidence that breastfeeding has short and long term benefits for both the Mother and infant (from obesity prevention to many acute chronic diseases, sudden infant death syndrome, asthma and allergies). We are very of two recent developments that have made strong inroads in better encouraging breastfeeding:BABY FRIENDLY HOSPITAL EXPANSIONThe Chicago Department of Public Health supported the recent passage of the Illinois Infant Feeding Act, which requires all labor and delivery hospitals to adopt an infant feeding policy that promotes breast milk – which is a first, critical step to achieving the WHO’s “Baby Friendly Hospital” designation. Illinois was the first state to implement such a policy. (California also passed a similar law, but its implementation was delayed.) In Chicago, we are on the fast track to implementing the Infant Feeding Act. Even before the law was passed, Chicago was “WELL ON ITS WAY” to achieving this goal. Today, 15 of Chicago’s 19 Labor and Delivery Hospitals are working towards the WHO Baby-Friendly designation with the largest labor and delivery hospitals in the City moving into one of the final stages of the Baby-Friendly process.DAY CARE CENTER STANDARDSIn late 2009, the Chicago Dept. of Public Health and the Chicago Board of Health jointly release new standards for licensed Day Care Centers with the goal of improving the nutritional content of foods served, increasing Physical Activity and decreasing or limiting Screen Time. The evidence that served as a foundation for these new standards was supported RWJF Funded / Healthy Eating Research conducted by Dr. Mary Story’s– who is one of the hosts for today’s conference.Once the standards were passed and we conducted through our partners over 100 trainings held across the city. The Consortium to Lower Obesity in Chicago Children (CLOCC), was funded to conduct a “RWJF / Healthy Eating Research” evaluation of Chicago’s new standards for childcare centers. The results were promising. Although some barriers were identified – for example, implementing stronger nutrition standards is relatively easy compared to implementing improvements to physical activity, which requires investments in training. We also learned through this study and our LISC community work that Day Care Center providers have a strong desire for more breastfeeding information and guidance and we are reviewing this area in more in depth currently. Evaluation of Chicago’s standards for day care centers also suggested that the city-level standards would be strengthened if supported by improved statewide standards.And I’m pleased to say that due to Chicago’s Day Care Center improvements, the state of IL is now planning the same changes for all state licensed Day Care Centers!In fact, the Public Health Law Center at William Mitchell College of Law in St. Paul, Minnesota and the Child Care Law Center are finalizing white paper, regarding Chicago’s successful implementation of standards for licensed day care facilities. Financial support for this upcoming publication, which will serve as a roadmap for other policy makers to follow, was provided by a Healthy Eating Research Grant from the Robert Wood Johnson Foundation.
- Commissioner Choucair: I am proud to share with you some breaking news today. New data for the 2013-2014 school year show that the obesity rate for CPS kindergartners continues to decrease. Compared to 2003 data for from our terrific partners at CLOCC, this is a decrease from 24% to 19.1%. In other words, while almost 1 in 4 kindergarten-aged Chicago youth were obese in 2003, that number fell to less than 1 in 5 by 2012. That is quit a change in less than a decade. Looking at this school year’s students, approximately 1,000 more kindergartners walked through the doors on the first day of school at a healthier weight compared to a decade ago.And it is essential to note that this decline is being felt by all racial and ethnic groups, including African American and Hispanic children, who have historically had disproportionately high rates of obesity. While we ought to pause and celebrate this success, our City’s obesity rates remain far above state and national averages, and now more than ever this Task Force needs to roll up its sleeves and get to work.
- 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.