Healthy Chicago - Physician Assistant Program
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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......

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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  • 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
  • 4. Core Functions & Essential Services
  • 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
  • 7. Chicago: Person, Place, Time From Sampson R. Great American City. 2012; p. 105 & 106.
  • 8. Tobacco Use
  • 9. Tobacco Use SMOKE-FREE CAMPUSES  3 Colleges / Universities  5 Hospitals  6 Behavioral Health Orgs  8 CHA Developments
  • 10. Joint Enforcement Tobacco Use
  • 11. 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
  • 12. Obesity Prevention Dearborn Street - Before Dearborn Street - After
  • 13. Obesity Prevention  13 licensed carts operating  30 vendors trained  30 carts planned for 2013
  • 14. Obesity Prevention
  • 15. 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
  • 16. HIV Prevention Integrated services planning to:  Strengthen prevention  Increase linkage & retention to care  Increase treatment access
  • 17. HIV Prevention More HIV+ MSM are:  Aware of HIV status  Accessing care  Taking HIV medication
  • 18. Adolescent Health  CPS hires chief health officer  Dually reports to CDPH  CDPH creates Adolescent and School Health Office
  • 19. 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
  • 20. 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
  • 21.  Outreach to CHA residents  Partnerships to expand access  Quality improvement initiatives Upgraded mammography machines beyond p nk Chicago ! Cancer Disparities
  • 22.  City partners with 7 FQHCs  1115 Waiver granted  CDPH public health services remain Access to Care
  • 23. 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
  • 24. Access to Care  Oral health services expanded to 106 high schools  Over 105,000 served in 2012-2013
  • 25. Access to Care  City invests $1.4M in new vision program  30,000 students to get optometry exam and eyeglasses as needed
  • 27. Healthy Mothers & Babies 15 hospitals working towards Baby-Friendly Designation
  • 28. Healthy Mothers & Babies  33% decline in teen birth rate 50% drop in smoking while pregnant  10% increase in 1st trimester care
  • 29. Communicable Disease Control
  • 30. Communicable Disease Control
  • 31.  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
  • 32. Violence Prevention
  • 33. Public Health Infrastructure
  • 34. Healthy Chicago Action Plans
  • 35. Building on Policy Successes Mayor Emanuel Takes Action to Protect Chicago’s Kids from Menthol Cigarettes
  • 36. Building & Engaging Partnerships
  • 37. • 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?
  • 38.  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
  • 39. 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
  • 40. 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
  • 41. 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
  • 42. Put your thumbprint on policy! How can you maximize the Impact you will have on society?
  • 43. 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.
  • 44. 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
  • 45. 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
  • 46. 312.747.9884