How Healthy Chicago is AddressingChicago Department of Public Health                                         Health Dispar...
Slide DisclosureI have no relevant financial relationships with themanufacturer(s) of any commercial product(s) and/or pro...
Presentation Outline1. Healthy Chicago Public Health Agenda and Health   Disparities2. Addressing Pediatric Health Dispari...
Presentation Outline1. Healthy Chicago Public Health Agenda and Health   Disparities2. Addressing Pediatric Health Dispari...
HEALTHY CHICAGO              CHICAGO DEPARTMENT OF PUBLIC HEALTHTRANSFORMING THEHEALTH OF OUR CITYCHICAGO ANSWERS THE CALL
HEALTHY CHICAGOChicago Department of Public Health                                      Infrastructure
Healthy Chicago: Promoting Health Equity• Improvement in the public’s health requires a  commitment to health equity and t...
Social Justice and Health Disparities• Health disparities are differences in the rate of  disease, incidence, prevalence, ...
Promoting Social Justice                         Reduces Health Disparities     • Food Stamps (1961)     • Civil Rights Ac...
All-Cause Mortality by Race/Ethnicity,           Chicago, 2008 Race/Ethnicity        Adjusted Rate                       p...
Chicago: Person, Place, Time**From Sampson R. Great American City. 2012; p. 105 & 106.
Presentation Outline1. Healthy Chicago Public Health Agenda and Health   Disparities2. Addressing Pediatric Health Dispari...
Priority: Healthy Mothers and Babies
Healthy Mothers and Babies• Mother, infant, and child well-being shapes the  future of public health and health disparitie...
Chicago Infant Mortality Rate, 2008, by    Race/Ethnicity, per 1000 Births                14                              ...
Breastfeeding• Breast-fed infants have reduced risks of many  diseases; babies and mothers experience  emotional, mental h...
Percent of Illinois Women Who Initiated       Breastfeeding, 2004-2008 Combined          100                              ...
Baby-Friendly Hospital Initiative             • The WHO’s Baby-Friendly               Hospitals program has been          ...
Maternal and Child Home Visits• 16,859 home visits were provided in 2012 to  pregnant women and new mothers• Clients are e...
Priority: Adolescent Health
Adolescent Health and Disparities• Behavioral patterns and choices in adolescence play  a role in disease risk later in li...
Reducing Disparities through School                  Policy• Established Office of Adolescent and School Health• Hired CPS...
Teen Pregnancy• 38% of Chicago high school students report being  sexually active (2011 YRBS)• 2009 birth rate for 15-19 y...
Teen Birth Rate by Race/Ethnicity of                                              Mother, Chicago and the United States,  ...
Teen Pregnancy & STIs Initiatives• Teen pregnancy prevention initiative   – 4500 students received curriculum and supports...
Priority: Obesity Prevention
Obesity Prevention• Obesity increases the risk of heart disease,  cancer, and stroke• Racial, ethnic, income, and gender d...
Prevalence of Obesity in 2-19 Year-Olds in              the U.S., 2009-2010Source: Ogden et al., JAMA 2012. Online via htt...
http://www.cdc.gov/nchs/data/databriefs/db51.pdf
Food Access in Chicago CommunitiesData provided by Chicago’s Department of Housing and Economic Development, 2012.
Addressing Access to Healthy Food• Urban agriculture ordinance• Produce carts• Healthy corner store project• New grocery s...
Promoting Healthy Lifestyles• PlayStreets provides  safe, supervised  outdoor spaces for  play and physical  activity• Day...
New Obesity Report is Coming Soon                • New report on child and                  adolescent overweight         ...
Priority: Tobacco Use
Tobacco Use Among Youth• Tobacco use is the most preventable cause of death  and its use is associated with many illnesses...
High School Students who Smoked One or More Cigarettes in Previous Month, by        Race/Ethnicity, U.S., 2011 Race/Ethnic...
Cigarettes and Chicago Youth, 2011• 2011 Youth Risk Behavior Surveillance Survey• 13.6% of high school students smoked at ...
New Tobacco-Related Legislation            and Enforcement• Business license reform ordinance includes  measures to addres...
Expanding Smoke-free Policies         Smoke-free Policy Adoption:         • Over 1,600 units of public           housing a...
Smoking Cessation Services for         Vulnerable Populations• Dedicated resources to support cessation of  clients/staff ...
Priority: Violence Prevention
Violence Prevention• Gun violence disproportionately affects  disenfranchised communities• In 2011, 11% of Chicago high sc...
Working to Reduce Community Violence• Partnership between CDPH, Chicago Police  Department, and Ceasefire   – One-year pil...
Addressing Childhood         Exposure to Violence (CEV)• Partnering with CPD to expand data collection on  scope and types...
Teen Dating Violence Prevention• Chicago is one of four cities implementing a CDC  teen dating violence prevention initiat...
Preventing Bullying• Convening 15-agency bullying prevention workgroup  – Strengthen partnerships, support data sharing an...
Presentation Outline1. Healthy Chicago Public Health Agenda and Health   Disparities2. Addressing Pediatric Health Dispari...
What’s Next?•   Implementation of Food Plan•   Immunizations to underserved communities•   Vision services for CPS students
What’s Next?•   Engaging community stakeholders in policy•   Healthy CPS (Chicago Public Schools)
facebook.com/ChicagoPublicHealthGplus.to/ChiPublicHealth@ChiPublicHealth312.747.9884CityofChicago.org/HealthHealthyChicago...
How Healthy Chicago is Addressing Disparities in Chicago
How Healthy Chicago is Addressing Disparities in Chicago
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How Healthy Chicago is Addressing Disparities in Chicago

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How Healthy Chicago is Addressing Disparities in Chicago

  1. 1. How Healthy Chicago is AddressingChicago Department of Public Health Health Disparities in Chicago February 26, 2013 Bechara Choucair, MD Commissioner Chicago Department of Public Health @choucair on Rahm Emanuel Bechara Choucair, MD Mayor Commissioner
  2. 2. Slide DisclosureI have no relevant financial relationships with themanufacturer(s) of any commercial product(s) and/or provider(s)of commercial services discussed in this CME activity.I do not intend to discuss an unapproved/investigative use of acommercial product/device in my presentation.
  3. 3. Presentation Outline1. Healthy Chicago Public Health Agenda and Health Disparities2. Addressing Pediatric Health Disparities -Healthy Mothers and Babies -Adolescent Health -Obesity Prevention -Tobacco Use -Violence Prevention3. Future Work to Address Pediatric Health Disparities
  4. 4. Presentation Outline1. Healthy Chicago Public Health Agenda and Health Disparities2. Addressing Pediatric Health Disparities -Healthy Mothers and Babies -Adolescent Health -Obesity Prevention -Tobacco Use -Violence Prevention3. Future Work to Address Pediatric Health Disparities
  5. 5. HEALTHY CHICAGO CHICAGO DEPARTMENT OF PUBLIC HEALTHTRANSFORMING THEHEALTH OF OUR CITYCHICAGO ANSWERS THE CALL
  6. 6. HEALTHY CHICAGOChicago Department of Public Health Infrastructure
  7. 7. Healthy Chicago: Promoting 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
  8. 8. Social Justice and Health Disparities• Health disparities are differences in the rate of disease, incidence, prevalence, morbidity, mortality or survival rates• The root causes of disparities are inequalities• U.S. history of discrimination has made race, ethnicity, sexual orientation, and gender identity determinants in access to health care and in health status
  9. 9. Promoting Social Justice Reduces Health Disparities • Food Stamps (1961) • Civil Rights Act (1964) • Voting Rights (1965) • Desegregation of Medical Facilities (1963-1965)Gamble and Stone, U.S. Policy on Health Inequities: The Interplay of Politics and Research, Journal of Health Politics,Policy and Law, Vol. 31, No. 1, Feb. 2006
  10. 10. All-Cause Mortality by Race/Ethnicity, Chicago, 2008 Race/Ethnicity Adjusted Rate per 100,000 Non-Hispanic Black 1049.3 Non-Hispanic White 795.5 Hispanic 499.4 Non-Hispanic Asian 410.1
  11. 11. Chicago: Person, Place, Time**From Sampson R. Great American City. 2012; p. 105 & 106.
  12. 12. Presentation Outline1. Healthy Chicago Public Health Agenda and Health Disparities2. Addressing Pediatric Health Disparities -Healthy Mothers and Babies -Adolescent Health -Obesity Prevention -Tobacco Use -Violence Prevention3. Future Work to Address Pediatric Health Disparities
  13. 13. Priority: Healthy Mothers and Babies
  14. 14. Healthy Mothers and Babies• Mother, infant, and child well-being shapes the future of public health and health disparities• Critical areas of disparities include racial/ethnic disparities in infant mortality rates, low birthweight babies, and breastfeeding• The U.S. infant mortality rate is higher than the average of 16 other industrialized countries Source: IOM, 2013. http://www.iom.edu/~/media/Files/Report%20Files/2013/US-Health-International-Perspective/ USHealth_Intl_PerspectiveRB.pdf
  15. 15. Chicago Infant Mortality Rate, 2008, by Race/Ethnicity, per 1000 Births 14 13.3 12 10Rate per 1000 8 8 6 5.4 4.7 4 2.5 2 0 Chicago Hispanic Non-Hispanic Non-Hispanic Non-Hispanic Asian Black White
  16. 16. Breastfeeding• Breast-fed infants have reduced risks of many diseases; babies and mothers experience emotional, mental health and developmental benefits• Breastfeeding increases health equity• In Illinois, breastfeeding initiation rates are lowest for non-Hispanic blacks, those with high school education or less, Medicaid recipients, and WIC recipients Pregnancy Risk Assessment Monitoring System, 2000-2006
  17. 17. Percent of Illinois Women Who Initiated Breastfeeding, 2004-2008 Combined 100 92 98 90 90 84 85 87 80 70 64 60 52Percent 50 Low Income 40 Higher Income 30 20 10 0 White Black Hispanic Asian Data Source: Pregnancy Risk Assessment Monitoring System (PRAMS)
  18. 18. Baby-Friendly Hospital Initiative • The WHO’s Baby-Friendly Hospitals program has been shown to dramatically increase breastfeeding • 15/19 Chicago hospitals are participating • Through 10 steps, hospitals provide significant support for mothers
  19. 19. Maternal and Child Home Visits• 16,859 home visits were provided in 2012 to pregnant women and new mothers• Clients are educated on the most current information on their pregnancy and well-baby care
  20. 20. Priority: Adolescent Health
  21. 21. Adolescent Health and Disparities• Behavioral patterns and choices in adolescence play a role in disease risk later in life• The large student population at Chicago Public Schools is largely Hispanic (45%), African American (41%), and low income (85% receive free/reduced price lunch), providing opportunities to promote health equity
  22. 22. Reducing Disparities through School Policy• Established Office of Adolescent and School Health• Hired CPS Chief Health Officer• Improved nutritional standards for school meals• Healthy snack and beverage policy
  23. 23. Teen Pregnancy• 38% of Chicago high school students report being sexually active (2011 YRBS)• 2009 birth rate for 15-19 year-olds in Chicago was 57/1000 Source: Youth Risk Behavior Survey, 2011
  24. 24. Teen Birth Rate by Race/Ethnicity of Mother, Chicago and the United States, 100 98.7 1999-2009 91.1(per 1,000 females aged 15-19 years) 90 90.1 88.6 88.9 88.8 85.2 84.9 86.3 81.9 82.5 83.3 80 80.5 80.3 79.2 76 76.8 77.7 72.8 73.9 75 70 69.3 68.6 Teen Birth Rate 65.6 64.8 65.1 66.1 60 61.9 61.4 60.5 57 50 48.8 47.7 45.3 43 41.6 41.1 41.9 42.5 41.5 40 40.5 39.1 30 26 23 19.5 20 19.3 16.9 16.4 17.5 16.4 15.8 12.8 14.2 15 12.8 10 11.4 10.7 11.7 12 8.6 9 8.5 8 8.1 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 United States Chicago: All race-ethnicities Chicago: Hispanic Chicago: Non-Hispanic Asian Chicago: Non-Hispanic Black Chicago: Non-Hispanic White Births in Chicago, 1999-2009 , Chicago Department of Public Health, 2012.
  25. 25. Teen Pregnancy & STIs Initiatives• Teen pregnancy prevention initiative – 4500 students received curriculum and supports (2012)• STI screenings – 9,215 educated; 6,147 screened; 436 identified
  26. 26. Priority: Obesity Prevention
  27. 27. Obesity Prevention• Obesity increases the risk of heart disease, cancer, and stroke• Racial, ethnic, income, and gender differences for BMI Source: BRFSS, 2010.
  28. 28. Prevalence of Obesity in 2-19 Year-Olds in the U.S., 2009-2010Source: Ogden et al., JAMA 2012. Online via http://www.nmqf.org/presentations/12OgdenCJCP3.pdf
  29. 29. http://www.cdc.gov/nchs/data/databriefs/db51.pdf
  30. 30. Food Access in Chicago CommunitiesData provided by Chicago’s Department of Housing and Economic Development, 2012.
  31. 31. Addressing Access to Healthy Food• Urban agriculture ordinance• Produce carts• Healthy corner store project• New grocery stores in low food access areas• Produce added to 19 stores• Farmer’s markets in underserved areas
  32. 32. Promoting Healthy Lifestyles• PlayStreets provides safe, supervised outdoor spaces for play and physical activity• Day care center standards for nutrition, physical activity, and screen time
  33. 33. New Obesity Report is Coming Soon • New report on child and adolescent overweight and obesity among CPS students will be released soon • Kindergarten, grade 6, grade 9 • 2010-2011
  34. 34. Priority: Tobacco Use
  35. 35. Tobacco Use Among Youth• Tobacco use is the most preventable cause of death and its use is associated with many illnesses• 18% of U.S. high school students smoked one or more cigarettes in the past month (2011) Source: Youth Risk Behavior Surveillance, 2011, Chicago
  36. 36. High School Students who Smoked One or More Cigarettes in Previous Month, by Race/Ethnicity, U.S., 2011 Race/Ethnicity Percent Who Smoke White, Non-Hispanic 20.3% Multiple Race, Non-Hispanic 18.1% Hispanic 17.5% Black, Non-Hispanic 10.5% Source: Youth Risk Behavior Surveillance, 2011
  37. 37. Cigarettes and Chicago Youth, 2011• 2011 Youth Risk Behavior Surveillance Survey• 13.6% of high school students smoked at least one day in the previous month• 30.1% of current smokers obtained their own cigarettes by buying them in a store or gas station Source: Youth Risk Behavior Surveillance, 2011, Chicago
  38. 38. New Tobacco-Related Legislation and Enforcement• Business license reform ordinance includes measures to address illegal tobacco sales -Fine increase for illegal sales -Additional fines for repeat offenders• City and county inspectors can write tickets for both County and City violations at the same time• Tobacco vending machines are now banned in Chicago
  39. 39. Expanding Smoke-free Policies Smoke-free Policy Adoption: • Over 1,600 units of public housing and nearly 3,250 units of multi-unit private housing • 6 hospital campuses • Parochial schools and 3 higher education campuses • 6 substance abuse & mental health service agencies
  40. 40. Smoking Cessation Services for Vulnerable Populations• Dedicated resources to support cessation of clients/staff at smoke-free behavioral health facilities• Prevention and cessation services for Chicago Housing Authority residents• Smoking cessation clinics for LGBT persons, in partnership with Howard Brown Health Center• Nicotine replacement therapy to nearly 15,000 persons receiving services at community health centers and Women, Infant, and Children’s (WIC) sites
  41. 41. Priority: Violence Prevention
  42. 42. Violence Prevention• Gun violence disproportionately affects disenfranchised communities• In 2011, 11% of Chicago high school students reported missing school in the last 30 days due to safety concerns Source: 2011 YBRS
  43. 43. Working to Reduce Community Violence• Partnership between CDPH, Chicago Police Department, and Ceasefire – One-year pilot in 3rd and 10th police districts• Community Anti-Violence Restoration Effort (CARE) – Strategic deployment of law enforcement and resources to address violence and crime – Strategies: community-based prevention, youth intervention, and response• National Forum on Youth Violence Prevention – 2012 Plan
  44. 44. Addressing Childhood Exposure to Violence (CEV)• Partnering with CPD to expand data collection on scope and types of CEV• Supporting Chicago Safe Start, a city/state collaborative working to prevent & reduce childhood exposure to violence, raise awareness & build services• Updating CEV curriculum• Developing violence prevention ambassador campaign
  45. 45. Teen Dating Violence Prevention• Chicago is one of four cities implementing a CDC teen dating violence prevention initiative• 11-14-year-olds• Curricula are currently being used in 3/12 schools• 5000 youth and parents will receive the training (2012-2016)
  46. 46. Preventing Bullying• Convening 15-agency bullying prevention workgroup – Strengthen partnerships, support data sharing and identify pathways to reduce bullying – Promote the inclusion of at-risk populations – Launched bullying prevention webpage
  47. 47. Presentation Outline1. Healthy Chicago Public Health Agenda and Health Disparities2. Addressing Pediatric Health Disparities -Healthy Mothers and Babies -Adolescent Health -Obesity Prevention -Tobacco Use -Violence Prevention3. Future Work to Address Pediatric Health Disparities
  48. 48. What’s Next?• Implementation of Food Plan• Immunizations to underserved communities• Vision services for CPS students
  49. 49. What’s Next?• Engaging community stakeholders in policy• Healthy CPS (Chicago Public Schools)
  50. 50. facebook.com/ChicagoPublicHealthGplus.to/ChiPublicHealth@ChiPublicHealth312.747.9884CityofChicago.org/HealthHealthyChicago@CityofChicago.org

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