An Intergovernmental Approach
to Public Health Improvement
IT’S NOT JUST ABOUT
INDIVIDUAL BEHAVIOR
IT’S ABOUT HOW WE
BEHAVE AS A CITY
Session Overview
• Healthy Chicago Overview
• Agency Engagement
– Housing and Economic Development
– Chicago Public School...
Healthy Chicago
• Released in August 2011
• Blueprint for public health improvement
• 12 priorities 193 strategies
• Few e...
It Takes A City
• Convened Interagency Implementation Council
– Leverage missions to improve public health
– Work collecti...
Healthy
Food Chicago:
A Recipe for Healthy Places
What type of epidemic is
obesity? Non-communicable –
looks like a disease of place
and environment.
Strategies
1. BUILD HEALTHIER NEIGHBORHOODS: Focus planning and programs in
communities with an elevated risk for obesity-...
City of Chicago
city licensing data
Feeding
America
data
Chicago Department
of Public Health data
A Recipe for Healthy Places
1. Build Healthier
Neighborhoods
Identified communities with
elevated risk for obesity-
relate...
2. Grow Food
Create systems of public open
spaces for large-scale food
growing, job training and food-
related education a...
2. Grow Food
Create systems of public
open spaces for large-
scale food growing, job
training and food-related
education a...
60% Population decline
1940 = 375,000 2010 = 147,967
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,...
Green Healthy Neighborhood Land Use Strategy
• Housing
• Retail
• Green infrastructure
• Cultural and historic resources
• Manufacturing
• Open space and trails
• Prod...
Defined Community garden
– Growing food for education, recreation or
beautification
– Permitted use in:
• Parks and Open S...
Zoning Text Amendment for Urban Agriculture Uses
Defined Urban farm
– Indoor, outdoor and rooftop growing
– Permitted uses...
Stephanie A. Whyte, MD, MBA
Chief Health Officer
Chicago Public Schools
Alignment with Citywide Agenda
Tobacco
Obesity
Adolescent Health
Access to Care
Violence
Comm. Diseases
HIV
Infrastructure
CPS Chief Health Officer
• First ever. Dually positioned...a member of CPS
Senior Leadership as well as direct report to
C...
Office of Student Health and Wellness
• The Office of Student Health and Wellness aims to
remove health-related barriers t...
May 29, 2013
LEAD FOCUS MOVE
PLAY EAT DINE
REWARDFUNDRAISECELEBRATE
Physical Education
• Increase quality
• Scope and sequence
• Curriculum map
• Professional development
• Increase quantity...
February 2013 30
Sexual Health Education Policy
• Revised in February 2013 to align topic areas with new
National Sexualit...
 Student oral health services increased 18%
 113,000 students served in 2011-2012
 Services expanding to 106 high schoo...
Access to Care, Adolescent Health, Violence
• From 28 schools to 40+
• 6147 tested in 2011-2012
• 436 positive; 98% treate...
Collaboration with City Agencies
Transportation
Public Health
Park District
Complete Streets Chicago
Complete streets - designing streets for all users
Implementing safety strategies from Pedestrian Plan
Managing vehicle sp...
CDOT Goals
• Eliminate traffic crash fatalities in ten years
• Reduce pedestrian and bike crash injuries 50% in five years...
Driving is down; transportation choices up
Annual Vehicle
Miles Traveled
Chicago Annual Vehicle Miles
Complete Streets Policy (2006)
“The safety and convenience of all users of the transportation
system including pedestrians...
Partners
• Complete Streets Guide and Make Way for Play made
possible by Healthy Places, initiative of Healthy Chicago
• C...
Complete Streets Design Guide
Modal Hierarchy:
Pedestrian First
The people of Chicago cultivate,
encourage, and enjoy mutual
respect on our streets.
People choose to be pedestrians
becau...
Tools for Safer Streets
Safety
our goals
› Eliminate pedestrian fatalities in ten
years
› Reduce serious pedestrian injuries by
50% every five yea...
Health
our goals
› Increase the number of pedestrian trips
for enjoyment, school, work, and daily
errands
› Increase the m...
Livable Streets: Placemaking in the Public Way
Photo: Bike Walk Lincoln
Park
Mike Chino
Gordon Walek
Doug Knuth
Bike Walk ...
Make Way for Play
Bicycle Planning in Chicago
The Bike 2000 Plan
•1992 “Plan to make Chicago bicycle-friendly by 2000”
•29 recommendations o...
Dearborn Street Complete Street
Dearborn Street - Before Dearborn Street - After
Bike Sharing in
Chicago
Summer 2013
4,000 bikes
400 stations
Safe Routes Ambassadors
• Pedestrian and bicycle
safety training for 2nd
and 5th
graders
– in-class presentation
– outdoor...
Stay In Touch!
Website
www.chicagodot.org
Twitter
@ChicagoDOT
Facebook
facebook.com/CDOTNews
53
IT’S NOT JUST ABOUT
INDIVIDUAL BEHAVIOR
IT’S ABOUT HOW WE
BEHAVE AS A CITY
FOOD ACCESS
FOOD ACCESS
Tobacco Use
Other Priorities
Key Supports
facebook.com/ChicagoPublicHealth@ChiPublicHealth
312.747.9884
www.CityofChicago.org/Health
HealthyChicago@CityofChicago.org
Healthy Chicago: An Intergovernmental Approach to Public Health Improvement
Healthy Chicago: An Intergovernmental Approach to Public Health Improvement
Healthy Chicago: An Intergovernmental Approach to Public Health Improvement
Healthy Chicago: An Intergovernmental Approach to Public Health Improvement
Healthy Chicago: An Intergovernmental Approach to Public Health Improvement
Healthy Chicago: An Intergovernmental Approach to Public Health Improvement
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Healthy Chicago: An Intergovernmental Approach to Public Health Improvement

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Presentation from NACCHO 2013 Annual Conference featuring Erica Salem, MPH, Deputy Commissioner, Chicago Department of Public Health, Kathleen Dickhut, BA, MSLA, Deputy Commissioner, City of Chicago Department of Housing and Economic Development, Luann Hamilton, BA, MS, Deputy Commissioner, Chicago Department of Transportation, and Stephanie Whyte, MBA, FAAP, Chief Health Office, Chicago Public Schools.

This session highlights how non-public health City of Chicago agencies work with the Chicago Public Health Department to develop and implement a broad array of policy, systems, environmental, and programmatic solutions to public health challenges. While the work is occurring under a unified framework, each agency is able to contribute while fulfilling its unique mission.

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  • Health where you live, work and play – and for large numbers of Chicago ’s their work is being student.
  • Healthy CPS aligns with Healthy Chicago in the following areas. I will focus on the three highlighted in green.
  • I joined the district on February 14, 2012 Member of CPS SLT and Direct report to Commish at CDPH New office is one of six Chief Education office departments (OSES, ECE, OPCC, PL, C&I) OSHW has existed since July 2012. Is charged with being collaborative and innovative Has two major priorities
  • The mission of OSHW is to remove health-related barriers to learning via health policy , health education , health promotion and direct health services such that students may succeed in college and career. In order to accomplish this mission, providing the appropriate support to schools is essential. District resources are slim and our external partnerships are critical for providing schools support.
  • This graphic delineates the department responsibilities… Of note, the nurses are not housed within OSHW. The Student Health team manages direct health services accessibility for: Vision & Hearing screenings, vision exams, and Oral health services Sexually transmitted infect project (STI project) Mobile Health providers School-based health Centers (SBHC) The Student Wellness team manages health promotion around: Recess and physical education healthy classroom rewards & healthy fundraising nutrition education Collaborations exist between OSHW and OSES (nurses, health policy); NSS (school food, wellness/cf policy); OPCC ( YD & PBSS) and C&I (literacy framework, math & science frameworks). OSHW has direct link to “education” with CSHE, PE, NE and HE. PE teachers are welcomed conduits .
  • Walk through each component of LearnWELL.
  • Developed in partnership with child and adolescent health, health education, and SHE partners and stakeholders Old policy really lacks implementation guidance for schools, new policy addresses that and makes it more manageable for schools. Why 5 th grade only? the policy was amended in response to the high rates of STI infections beginning at age 10. The thought was to provide the education as early as possible to be more preventative and national standards at that time also supported providing sex ed beginning at fifth grade.
  • We are driving fewer miles on Chicago ’s streets. Annual vehicle miles traveled flattened out between 1997 and 2004 around 8.2 billion, and has been falling steady every year since to just over 7.2 billion in 2011 (Figure 1). This parallels national data showing annual vehicle miles traveled peaked in 2005 and has been steadily declining since. September 2012 Chicago DOT - Safe and Complete Streets
  • Complete Streets sets a pedestrian-first policy, from capital to maintenance. Streets are optomized for pedestrian first, then transit, bicycles and people who choose to drive. September 2012 Chicago DOT - Safe and Complete Streets
  • Strategies: Foster Play Streets Hold more Open Streets events Promote Car Free Day Support Walk and Bike to School Day Implement Pedestrian Awareness Week Establish Pedestrian Challenge event Incorporate Health Impact Assessments Develop a Health by Design Guide Collaborate on Wellness Benefits Support aging in place
  • Think about public space, and the public way differently. Streets perform multiple functions depending on user, time of day, different space. Link people to resources.
  • Toolbox for safe access to parks, promote outdoor activity and health
  • 3000 Funded through a recent $18M CMAQ program grant About 1000 more through a recently announced TIGER grant in partnership with CTA
  • Healthy Chicago: An Intergovernmental Approach to Public Health Improvement

    1. 1. An Intergovernmental Approach to Public Health Improvement
    2. 2. IT’S NOT JUST ABOUT INDIVIDUAL BEHAVIOR IT’S ABOUT HOW WE BEHAVE AS A CITY
    3. 3. Session Overview • Healthy Chicago Overview • Agency Engagement – Housing and Economic Development – Chicago Public Schools – Transportation – Other City Agency Contributions • Discussion
    4. 4. Healthy Chicago • Released in August 2011 • Blueprint for public health improvement • 12 priorities 193 strategies • Few explicitly identified strategies for other City agencies
    5. 5. It Takes A City • Convened Interagency Implementation Council – Leverage missions to improve public health – Work collectively on policy change – Project-specific partnerships – Heighten awareness of public health impacts of respective work
    6. 6. Healthy Food Chicago: A Recipe for Healthy Places
    7. 7. What type of epidemic is obesity? Non-communicable – looks like a disease of place and environment.
    8. 8. Strategies 1. BUILD HEALTHIER NEIGHBORHOODS: Focus planning and programs in communities with an elevated risk for obesity-related diseases 2. GROW FOOD: Create systems of productive landscapes 3. EXPAND HEALTHY FOOD ENTERPRISES: Support businesses and social enterprises that produce and distribute healthy food 4. STRENGTHEN THE FOOD SAFETY NET: Ensure that residents can eat well regardless of income 5. SERVE HEALTHY FOOD AND BEVERAGES: Change the culture of eating at work meetings, festivals, sports gatherings, community activities and places of worship 6. IMPROVE EATING HABITS: Help people discover appealing, nutritious foods A Recipe for Healthy Places Check out the food plan - www.cityofchicago.org/hed
    9. 9. City of Chicago city licensing data Feeding America data Chicago Department of Public Health data
    10. 10. A Recipe for Healthy Places 1. Build Healthier Neighborhoods Identified communities with elevated risk for obesity- related diseases
    11. 11. 2. Grow Food Create systems of public open spaces for large-scale food growing, job training and food- related education activities A Recipe for Healthy Places
    12. 12. 2. Grow Food Create systems of public open spaces for large- scale food growing, job training and food-related education activities A Recipe for Healthy Places
    13. 13. 60% Population decline 1940 = 375,000 2010 = 147,967 0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 100,000 Population Englewood West Englewood New City Woodlawn Washington Park Green Healthy Neighborhood Land Use Strategy
    14. 14. Green Healthy Neighborhood Land Use Strategy
    15. 15. • Housing • Retail • Green infrastructure • Cultural and historic resources • Manufacturing • Open space and trails • Productive landscapes Green Healthy Neighborhood Land Use Strategy
    16. 16. Defined Community garden – Growing food for education, recreation or beautification – Permitted use in: • Parks and Open Space (POS) 1&2 • Residential (R) • Business (B) • Commercial (C) • Downtown (D) – Use standards: • Site area – maximum of 25,000 square feet • Accessory structures – maximum of 575 square feet • Incidental sales of produce generated on site is allowed • Composting allowed per 7-28-715 of the Health and Safety Code Zoning Text Amendment for Urban Agriculture Uses Districts that permit community garden uses
    17. 17. Zoning Text Amendment for Urban Agriculture Uses Defined Urban farm – Indoor, outdoor and rooftop growing – Permitted uses in: • Indoor: B3, C1 - C3, DS, all M, all PMDs • Outdoor: C1 - C3, DS, M2&M3, PMD 9,10&13 • Rooftop: (S) B3, C1-C3, all D, M1-M3, all PMDs – Use standards: • Accessory retail sales – maximum 3000 square feet (In M and PMD) • More flexible screening and landscape requirements • Parking requirement of 1 space per 4 employees • Composting allowed per 7-28-715 of the Health and Safety Code Districts that permit urban farm uses
    18. 18. Stephanie A. Whyte, MD, MBA Chief Health Officer Chicago Public Schools
    19. 19. Alignment with Citywide Agenda Tobacco Obesity Adolescent Health Access to Care Violence Comm. Diseases HIV Infrastructure
    20. 20. CPS Chief Health Officer • First ever. Dually positioned...a member of CPS Senior Leadership as well as direct report to Commissioner of Health Department • Oversees the CPS newly created Office of Student Health and Wellness (OSHW). • Responsible for Healthy CPS – an initiative of Healthy Chicago • External partnerships & intentional collaborations. • Two main responsibilities: o Prioritize student health and wellness with district. o Create a Healthy Chicago Public School system. May 29, 2013
    21. 21. Office of Student Health and Wellness • The Office of Student Health and Wellness aims to remove health-related barriers to learning such that students may succeed in college and career. • Our vision is “the Chicago Public School district will become the national benchmark for student health and wellness.” • Our primary objectives: Health policy Health education Health promotion Direct services May 29, 2013
    22. 22. May 29, 2013
    23. 23. LEAD FOCUS MOVE PLAY EAT DINE REWARDFUNDRAISECELEBRATE
    24. 24. Physical Education • Increase quality • Scope and sequence • Curriculum map • Professional development • Increase quantity • High school PE pilot • 30+20+10 • Minds in Motion
    25. 25. February 2013 30 Sexual Health Education Policy • Revised in February 2013 to align topic areas with new National Sexuality Education Standards (January 2012). • Education that builds foundation of knowledge and skills related to human development, relationships, decision- making, abstinence, medically-recommended contraception and disease prevention. • Teaches sexual health education beginning in Kindergarten through 12th grades with minimum teaching minutes for all grades. – Grades K-4 - foundational instruction including: anatomy and physiology, reproduction, healthy relationships and personal safety. – Grades 5-12 - expands on the foundational instruction to include: abstinence, healthy relationships (including informed decision-making, sexual orientation, gender identity and personal safety) medically-recommended contraceptives, transmission and prevention of sexually transmitted infections (including HIV).
    26. 26.  Student oral health services increased 18%  113,000 students served in 2011-2012  Services expanding to 106 high schools Public Schools and Public Health  City invests $1.4M in new vision program  30,000 students to get optometry exam and eyeglasses as needed
    27. 27. Access to Care, Adolescent Health, Violence • 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
    28. 28. Collaboration with City Agencies Transportation Public Health Park District
    29. 29. Complete Streets Chicago
    30. 30. Complete streets - designing streets for all users Implementing safety strategies from Pedestrian Plan Managing vehicle speeds through automated enforcement 100 miles of innovative bike lanes in Mayor Emanuel’s first term Bike share bringing 4,000 bikes to 400 stations Summer 2013 Make streets safe for all users
    31. 31. CDOT Goals • Eliminate traffic crash fatalities in ten years • Reduce pedestrian and bike crash injuries 50% in five years • Reach 50% of commute trips made by walking, biking, transit, and working from home by 2030 (currently 38%)
    32. 32. Driving is down; transportation choices up Annual Vehicle Miles Traveled Chicago Annual Vehicle Miles
    33. 33. Complete Streets Policy (2006) “The safety and convenience of all users of the transportation system including pedestrians, bicyclists, transit users, freight, and motor vehicle drivers shall be accommodated and balanced in all types of transportation and development projects and through all phases of a project so that even the most vulnerable - children, elderly, and persons with disabilities - can operate safely within the public right of way.”
    34. 34. Partners • Complete Streets Guide and Make Way for Play made possible by Healthy Places, initiative of Healthy Chicago • Collaboration between Chicago Department of Public Health, and Consortium for Lowering Obesity in Chicago Children (CLOCC) at Lurie Children’s Hospital of Chicago • Funded by Centers for Disease Control and Prevention’s Communities Putting Prevention to Work
    35. 35. Complete Streets Design Guide
    36. 36. Modal Hierarchy: Pedestrian First
    37. 37. The people of Chicago cultivate, encourage, and enjoy mutual respect on our streets. People choose to be pedestrians because the experience is the safest, most connected, accessible, and above all, the most enjoyable. Because we are committed to a strong pedestrian environment as an essential part of our complete transportation system, we area a healthier, more livable city. Visionstatement
    38. 38. Tools for Safer Streets
    39. 39. Safety our goals › Eliminate pedestrian fatalities in ten years › Reduce serious pedestrian injuries by 50% every five years how we’ll do it › Design and build safer streets for pedestrians › Encourage and enforce safe driving, walking, and biking behaviors › Make Chicago’s streets secure from crime and violence
    40. 40. Health our 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 how we’ll do it › Develop and support pedestrian programs and events › Develop and support pedestrian encouragement policies
    41. 41. Livable Streets: Placemaking in the Public Way Photo: Bike Walk Lincoln Park Mike Chino Gordon Walek Doug Knuth Bike Walk Lincoln Park
    42. 42. Make Way for Play
    43. 43. Bicycle Planning in Chicago The Bike 2000 Plan •1992 “Plan to make Chicago bicycle-friendly by 2000” •29 recommendations on education, encouragement, engineering & enforcement • Chicago Streets for Cycling Plan 2020 • 2012 citywide network plan of 600 miles of bike facilities • Safe and comfortable for all Chicagoans • Focus on protected bike lanes and neighborhood greenways Bike 2015 Plan •2006 “Vision to make bicycling an integral part of daily life in Chicago” •150 strategies to increase bicycle use and reduce crashes
    44. 44. Dearborn Street Complete Street Dearborn Street - Before Dearborn Street - After
    45. 45. Bike Sharing in Chicago Summer 2013 4,000 bikes 400 stations
    46. 46. Safe Routes Ambassadors • Pedestrian and bicycle safety training for 2nd and 5th graders – in-class presentation – outdoor on-foot activity • Priority to high pedestrian crash areas • 125-150 schools & 12- 16,000 students/year • Evaluation report fall 2013
    47. 47. Stay In Touch! Website www.chicagodot.org Twitter @ChicagoDOT Facebook facebook.com/CDOTNews 53
    48. 48. IT’S NOT JUST ABOUT INDIVIDUAL BEHAVIOR IT’S ABOUT HOW WE BEHAVE AS A CITY
    49. 49. FOOD ACCESS
    50. 50. FOOD ACCESS
    51. 51. Tobacco Use
    52. 52. Other Priorities
    53. 53. Key Supports
    54. 54. facebook.com/ChicagoPublicHealth@ChiPublicHealth 312.747.9884 www.CityofChicago.org/Health HealthyChicago@CityofChicago.org

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