Pioneering Community Health Presentation, 9th Annual YMCA of the USA Healthier Communities Initiatives Learning Institute
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Commissioner Choucair presents "Pioneering Community Health" at the 9th Annual YMCA of the USA Healthier Communities Initiatives Learning Institute on November 5, 2014
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Pioneering Community Health Presentation, 9th Annual YMCA of the USA Healthier Communities Initiatives Learning Institute
- 7. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. HEALTHY CHICAGO CHICAGO DEPARTMENT OF PUBLIC HEALTH TRANSFORMING THE HEALTH OF OUR CITY City of Chicago Mayor Rahm Emanuel
- 8. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel
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- 11. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel IT’S NOT JUST ABOUT INDIVIDUAL BEHAVIOR IT’S ABOUT HOW WE BEHAVE AS A CITY HEALTHY CHICAGO Chicago Department of Public Health
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Editor's Notes
- Chicago is a diverse urban city with challenges. These challenges are an opportunity for positive transformation.
- Barriers to Equity oriented workforce – Lack of education and training around social determinants of health among health professions Lack of diversity – African Americans and Hispanics underrepresented in health professions – professionals who share their patients’ culture are more likely to readily identify issues in patients’ communities Traditional Payment Model – consider funding upstream The Enviornment is starting to change 2012 – IOM Report called for greater coordination between public health and primary care More recently, WHO International classification of Diseases included for the first time – social determinants along with physical signs and symptoms in definitnng medical disorders. Actionable Data – There isn’t enough information about how patients live and work and their environmental context or behavioral approaches
- This slide underscores the need to consider upstream interventions to achieve equity. I’d like to remind you of a public health parable that articulates this framework – Three friends see children being carried away in a rushing river. One goes downstream to catch the children before they reach the rapids; another fashions a raft. The third friend swims away in the opposite direction. When her friends ask why, she answers. I’m going upstream to find out who or what is throwing these children in the river.
- We have operationalized this thinking in our public health agenda, Healthy Chicago.
- In 2011, shortly after taking office, Mayor Rahm Emanuel released Healthy Chicago, city first comprehensive health agenda across 12 prioties, providing over 200 actionable strategies for businesses, community organizations, faith groups, health systems, and others to complete as part of our collaborative effort to improve health. One of the things unique about Healthy Chicago was that it focused on policy, systems, and environmental changes that are meaningful, sustainable, and measureable.
- As many of you know, our Healthy Chicago agenda identifies 12 priority areas. We started out with 193 strategies, but have added more as we have created opportunities to improve the health of Chicagoans. We now have 241 Healthy Chicago strategies and 92% of them have either been fully implemented or are currently in progress.
- The advent of population health management, community based care coordination, technology, and data provide a promising opportunity to address health disparities. Together multi-sector collaborations can acquire a richer understanding of contextual, environmental and behavioral factors that contribute to disparate outcomes in health.
- At the core of Healthy Chicago is the recognition that the choices and behaviors of individuals are heavily influenced by their environments. We can’t direct people to eat healthier foods when their neighborhoods lack a large grocery store and their corner stores are only selling junk foods and sugar-sweetened beverages. These are burdens that the City must take on. The advent of population health management, community based care coordination, technology, and data provide a promising opportunity to address health disparities. Together multi-sector collaborations can acquire a richer understanding of contextual, environmental and behavioral factors that contribute to disparate outcomes in health.
- In Chicago, we also acted swiftly to regulate the use of e-Cigarettes in public places. We were the FIRST of the 20 largest cities in the U.S. to introduce this kind of legislation. (NYC and L.A. introduced shortly thereafter. NYC passed it first. L.A. implemented it first.) We limited the use of e-cigarettes in public places for three reasons: We are concerned e-cigarettes are re-normalizing smoking and have the potential to reverse decades of tobacco control progress. We heard compelling testimony from waiters and bouncers that e-cigarettes create confusion in bars and restaurants and were causing problems with enforcement of the smokefree law. Chicago’s e-cigarette ordinance makes enforcement of the existing smokefree law easier. And, finally, we are convinced the aerosol from e-cigarettes is not just water vapor. Laboratory test have provide more than enough evidence to be concerned. We believe everyone has the right to breathe clean indoor air. And, in Chicago until these products are proven safe, we will not allow that right to be eroded.
- Also research that narrowly examines social factors such as income inequality, housing segregation, and other socioeconmic differences as predictors of inequity that lead to divergent health outcomes is critical. Although this data is important to the discourse
- Health disparity gaps can be further closed through advancing mobile health technology Development of innovative interventions and care models that use mobile and wireless devices such as smartphones Bluetooth enabled patient monitoring, tablets and cloud based software. – Digital health and telemedicine provide opportunity to reach underserved in unique ways such as text, virtual coaching, and digital therapeutics. This leads to data that is rich for research and then translating it into interventions for action. This data allows analysts, researchers, and pracatitioners to stratify risk, access outcomes, and understand cost as well as whether a particular population is responsive to that modality.
- Also research that narrowly examines social factors such as income inequality, housing segregation, and other socioeconmic differences as predictors of inequity that lead to divergent health outcomes is critical. Although this data is important to the conversation and the field it doesn’t always point us toward better solutions. Even less common our studies that translate findings into individual or population level change Given the academic cycle, it may take significant type for translation into action. As such, research falls short of keeping pace with direct impacts on health from economic challenges, policy decisions, and environmental changes. EMR as a tool for surveillance and pop health management can change that paradigm – accompanying analytical and interpretive tools are critical such as predictive analytics, qualitative data, social media, non-health data, and unstructured data.
- Healthy Chicago is working