HEALTHY CHICAGO: A PUBLIC HEALTH BLUEPRINT

1. HEALTHY CHICAGO
CHICAGO DEPARTMENT OF PUBLIC HEALTH
HEALTHY CHICAGO:
A PUBLIC HEALTH BLUEPRINT
Bechara Choucair, MD
Commissioner
Chicago Department of Public Health
@choucair on

2. Overview of Presentation
• Chicago in Context
• The Chicago Department of Public Health
• Tale of Two Cities
• Healthy Chicago for a focused response
• Positioning Healthy Chicago for Success
– Engaging Academic Medical Centers
– Using Social Media

3. Chicago in Context

4. Chicago in Context
Illinois
Population
12,830,632
U.S. Population 308,745,538

5. Chicago in Context
Illinois has:
- 102 counties,
- 2,731 municipalities
- 912 public school systems
- 3,249 special districts

6. Chicago
Located within Cook County
Lake Michigan
2.7M residents
Over 8M residents in
Metroarea
Loop
229 Sq. miles
77 community areas
•range from 3,000 to 99,000
residents
•median is 31,000
Community areas provide
framework for:
• data analysis
• service delivery

7. African American = 32%
Hispanic = 29%
White = 32%
Asian = 5%
Other = 2%

8. The Chicago Department of Public
Health and Public Health in Chicago

9. Chicago Department of Public Health
• One of 40+ City Agencies
• 700 Employees
• ~170M Budget
– Significant Federal and State Grant funding
– Supports direct services and contractual agreements
• Partnership with other City Agencies

10. CDPH Organizational Chart

11. Challenges to Change
• Dwindling local health department resources
– 39,600 jobs lost; 57% have reduced or eliminated
services.
• 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

12. Chicago: A Tale of Two Cities

13. “Hardship Index”
- Crowded housing
- Poverty level
- Unemployment
- Adults without H.S. diploma
- Depencency ( 18 < 64 years)
- Per capita income.

17. HEALTHY CHICAGO
Chicago Department of Public Health
IT’S NOT JUST ABOUT
INDIVIDUAL BEHAVIOR
IT’S ABOUT HOW WE
BEHAVE AS A CITY

18. HEALTHY CHICAGO
Chicago Department of Public Health
Infrastructure

20. Tobacco Use

21. Tobacco Use: Smoke-Free Environments
• Hospitals
• 5 smoke-free campuses
• Schools
• Public and Catholic schools
• Housing
• 3,250 units of private smoke-free
housing
• 4 CHA smoke-free developments

22. Tobacco-free higher education campuses
• City Colleges of Chicago
• Roosevelt University
• Robert Morris University
IMPACT:
128,000 students
7,300 faculty and staff

23. Limiting Access to Tobacco
•Prohibit Tobacco Vending Machines
•Increase fines for illegal cigarette sales
(minors and unstamped)
•Increase access for City investigators
•$1.00 increase to State cigarette tax
•Undercover stings

24. Tobacco: Select Interventions
• Ask Advise Refer
• 33 clinics; 25+ EHR systems
• NRT Distribution to 5,000
• Tobacco Quit Line – 70% increase (20,400 calls)
• Citywide Media Campaign
• Signage at Beaches and Playlots
• Ads on public transportation

25. Obesity Prevention

26. Obesity Prevention Accomplishments
• Fresh produce carts
• Child care standards training
• Complete streets
• CPS student health records
• Healthy vending
• Chicago Food Plan
• Corner stores
.

27. Healthy Chicago PlayStreets
• Public-private partnership
• Under-resourced communities
• Promote physical activity
• Children and adults
• CareVan support services
• 70 events

28. HIV Prevention

29. Trends in HIV Infection Diagnoses in MSM by
Race/Ethnicity, Chicago, 2000-2010
Since 2008, Chicago
has had more Black HIV
diagnoses than Whites
and Hispanics
combined.
CDPH – STI/HIV Surveillance, Epidemiology and Research Section – 07/2012

30. Behavioral Surveillance Data Among Chicago MSM
(past 12 months)
Unprotected male-male anal sex 56%
Received free condoms 82%
Used any illicit drug (more than once a 42%
month)
Tested for HIV infection 64%
Tested for STI 52%
Participated in HIV behavioral Individual 18%
intervention
Participated in HIV behavioral Group 7%
intervention

31. How Data are Used
• Improving linkage to care and access to
treatment
• Help address local issues and concerns in “real
time”
• Inform new local prevention activities
• Evaluate impact of new policies/strategies
• Conduct research and community education
• Help explain trends in HIV incidence,
prevalence and new diagnoses

32. HIV+ MSM
Access to Treatment:
who know their status (n=72)
More MSM are on Antiretroviral Therapy
Black (n =30 ) White (n = 32) Hispanic (n =10 )
(%) (%) (%)
Seen doctor for HIV care 100 97 100
Currently on ART 80 91 80
2008 43 83 79
Know CD4 count 100 94 100
Know Viral Load 97 91 80

33. HIV Prevention Accomplishments
• Comprehensive prevention funding of $2.9M
• Advanced HIV prevention training to over 1,100 providers
• Enhanced policy and planning
• 9,200,800 condoms distributed since last August.
• Initiated the Chicago community condom project
• Integration of HIV community planning groups
• Enhanced partner services and linkage to care activities

34. Adolescent Health

35. Adolescent Health Accomplishments
• Infrastructure Improvements
– Office of Adolescent and School Health Established
– CPS Chief Health Office and Restructuring
• Expanded STI screening project to 28 schools.
Educated 9215, screened 6147, identified 436
• Adolescent Vaccine Initiative with high volume
providers

36. Cancer Disparities

37. Cancer Disparities Accomplishments
• Strengthened collaboration with Metro Chicago
Breast Cancer Task Force
• Completed Mammogram Reminder pilot project
• State Cancer Registry application
• Collaboration with CHA

38. Heart Disease and Stroke

39. Heart Disease & Stroke Accomplishments
• Million Hearts Risk Check Challenge
• Partnership with Office of National Coordinator for HIT
• Creation of mobile application for risk assessment and
service locations.
• CPR training to school staff and students

40. Access to Care

41. Access to Care Accomplishments
• 113,126 students from 504 schools received
dental health services, 18% more students
than prior year
• Partnership with City and State agencies to
address needs of mentally ill.
• $500,000 for expanded psychiatry services
• FQHC partners identified for CDPH
clinical care

42. Healthy Mothers and Babies

43. Healthy Mothers and Babies Accomplishments
• 14 of 19 labor and delivery hospitals working towards Baby-
Friendly designation.
• Increased WIC support for breastfeeding through lactation
counselor training
• Established preconception and inter-
conceptional care standards
• 16,672 nurse home visits

44. Communicable Disease Control

45. Communicable Disease Control
& Prevention Accomplishments
• TB clinical partnership with Cook County
• State legislation requiring infection control training for
staff in long term care facilities
• Convened Long Term Care Advisory
Committee
• Distributed 1,144,801 doses of
vaccine to providers
• Restaurant Self-inspection pilot

46. Healthy Homes

47. Healthy Homes Accomplishments
• Successful advocacy efforts to change Torrens
Indemnity Fund
• $3 million Abatement grant awarded
• Public awareness campaign promoting radon
testing
• Expansion of Lead Program to
Healthy Homes Program

48. Violence Prevention

49. Violence Prevention Accomplishments
• Establish data collection partnership with police department
• Chicago Dating Matters Initiative, $1,75 M federal grant
• Psychological First Aid training to youth-serving substance
abuse providers.
• Convened Bullying Prevention Workgroup (15 agencies)
• CeaseFire partnership

50. PH Infrastructure Accomplishments
• 18 sets of public health data posted on City’s data portal.
• New Office of Epidemiology and Public Health Informatics
and expanded epidemiology capacity
• Largest local public health department pursuing first time
accreditation
• CPS Data sharing

51. Positioning Healthy Chicago for
Success

52. HEALTHY CHICAGO
CHICAGO DEPARTMENT OF PUBLIC HEALTH
Positioning Chicago for Success

53. Increasing Increasing Individual
Population Impact Effort Needed

54. Shifting our Perspective: Tobacco Example
Increasing
Increasing Individual
Population Impact
Effort Needed
Smoke-free
Campuses

55. Linking Healthy Chicago to Budget
• Vision should guide resource allocation
• Focus on core public health functions
• Built budget around Healthy Chicago

56. Building Support
• Government
– Local
– Regional
– State
– Federal
• National partnerships
• Community organizations

57. Engaging Academic Health Centers
• To understand and capitalize on the intersection
between public health and primary care
• To explore health outcomes, community resources
and assets
• To translate research into local policy

58. Partnerships
• Health-App-Chicago - Health Practices Addressing Public
Health Priorities in Chicago
• U of C’s Center for Diabetes Translational Research
Collaboration
• Northwestern University Feinberg School of Medicine
• UIC’s Institute for Health Research and Policy
• Student Advisory Committee

59. CTSA’s
• Health APP Chicago:
• Linking Public Health, Research, and Primary Care
• Steering Committee of CTSA faculty and CDPH
• Subgroups to develop specific reports
• Reconvening to determine next steps
• Clinical Best Practices to Improve Population Health
• Pilot effort in selecting best practices available
• Topic: Diabetes and Cardiovascular Disease

60. University of Chicago
Center for Diabetes Translational Research
Collaboration
• Enhanced epidemiology capacity for diabetes
• Increased utilization of data sets (Hospitalization &
ER)
• Dedicated staff position
• Collaborative policy development
• School-based diabetes interventions

61. Northwestern University
Feinberg School of Medicine
• Mobile Produce Vending Evaluations
• Department of Family & Community Medicine
• Report: A Profile of Health & Health Resources within
Chicago’s 77 Communities
• Dr. Romana Hasnain-Wynia
• http://tinyurl.com/3opzvqu

62. University of Chicago At Illinois
Institute for Health Research & Policy
• Evaluation of Tobacco Interventions
• Impacts of media campaign on awareness and attitudes
towards dangers of second-hand smoke
• Assessing intensity and reach of 23 interventions
• Survey of mental health and substance abuse providers on
attitudes towards smoke-free policies and integration of
tobacco cessation into treatment services

63. Students For Healthy Chicago
• University of Chicago
• University of Illinois at Chicago
• Rush University
• Loyola University
• Northwestern University

64. Social Media
1. Know Your Audience
2. Goal Oriented
3. Develop Engaging Content
4. Website Serves as Hub
5. Push Similar Messages Through Multi-Channels:
Facebook Blog
Twitter YouTube
Google+ Instagram
SlideShare
1. Engage in a Conversation
2. Measure
3. Re-Evaluate
TIP: Links, Photos & Videos are best

65. Social Media

66. Social Media Week
#SMWChiHealth
88,629 Twitter Accounts Reached
532,748 Total Potential Impressions
Panel discussed how to utilize social
media to engage public, raise
awareness and improve population
health.

67. Twitter Chat
CDC NPIN’s #NPINChat
62,350 Twitter Accounts Reached
635,491 Total Potential Impressions
Chat served to highlight the STD
education and testing opportunities
that arise from health department and
school board collaborations.

68. Topics Discussed in September

69. Most Popular Hashtags in Sept

70. #1 Shared Post This Year