1. Health Equity for a Healthy Chicago
Chicago Department of Public Health
The Social Determinants of Urban Mental Health:
Paving the Way Forward
September 20, 2012
Bechara Choucair, MD
Commissioner
Chicago Department of Public Health
@choucair on
Rahm Emanuel Bechara Choucair, MD
Mayor Commissioner

2. Presentation Outline
1. A Public Health Framework
2. Healthy Chicago Public Health Agenda
3. Progress Toward Health Equity

3. Presentation Outline
1. A Public Health Framework
2. Healthy Chicago Public Health Agenda
3. Progress Toward Health Equity

4. What is Public Health?
• Public health is the science and art of
protecting and improving the health of
communities
• Public health focuses on prevention

5. Responsibilities of
Public Health Departments

6. National Public Health Objectives:
Healthy People 2020
• Social determinants of health is new
• Goal: Create social and physical
environments that promote good health
for all

7. Factors Influencing Health
Environmental
Conditions, 5%
Genetics, 30%
Behavioral
Choices, 40%
Social
Medical
Circumstances
Care, 10%
15%

8. Health Impact Pyramid
Increasing Increasing
Population Impact Individual Effort
Needed
Frieden T. American Journal of Public Health | April 2010, Vol 100, No. 4

9. Presentation Outline
1. A Public Health Framework
2. Healthy Chicago Public Health Agenda
3. Progress Toward Health Equity

10. HEALTHY CHICAGO
CHICAGO DEPARTMENT OF PUBLIC HEALTH
TRANSFORMING THE
Chicago Department of Public Health
HEALTH OF OUR CITY
CHICAGO ANSWERS THE CALL
Rahm Emanuel Bechara Choucair, MD
Mayor Commissioner

11. Healthy Chicago’s Guiding Principles
• Good health is based on multiple complex, inter-
related factors, e.g., social and environmental
• Health improvement efforts require diverse partners
• Improved public health requires a commitment to
health equity and the elimination of disparities
• A healthy city begins with a strong social fabric and
sense of community

12. HEALTHY CHICAGO
Chicago Department of Public Health
Chicago Department of Public Health
Rahm Emanuel Bechara Choucair, MD
Mayor Commissioner

13. Healthy Chicago:
Promoting Health Equity
• Healthy environments are key
• Persons of lower SES are often exposed to
fewer factors that promote health and more
factors that damage health
• Making healthy choices must be easy and
desirable

14. Presentation Outline
1. A Public Health Framework
2. Healthy Chicago Public Health Agenda
3. Progress Toward Health Equity

15. Priority: Maternal and Child Health
• Breast-fed infants have reduced risks of many
diseases
• Babies and mothers experience emotional,
mental health and developmental benefits from
breastfeeding
• 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

16. Accomplishment:
Baby-Friendly Hospitals
• 13 Chicago hospitals are participating in the
Baby-Friendly Hospital Initiative to support
breastfeeding and increase breastfeeding rates

17. Priority: Tobacco Use
• Tobacco is the most preventable cause of death and
its use is associated with many illnesses
• Declines in tobacco use over the years are smaller
among lower income adults than other groups
• 28% of Chicago adults who have a high school
education or less smoke, while 15% of college
graduates smoke (2009)
American Cancer Society: A Chartbook (2009). BRFSS, 2009.

18. Accomplishments:
Smoke-free & Tobacco-free Policies
Smoke-free
• Over 1,600 units of public
housing
Tobacco-free
• 4 hospital campuses; 2 are in
discussion
• 3 higher education campuses
• 6 substance abuse & mental
health service agencies

19. Priority: Obesity Prevention
• Obesity increases the risk of heart
disease, cancer, and stroke
• In Chicago, 40% of blacks are obese, as
compared with 30% of the overall population
(2009)
• 40% of adults with a high school education level
are obese, compared with 21% of college
graduates (2009)
BRFSS, 2009.

20. Accomplishments:
Access to Healthy Food
• Urban agriculture ordinance
• Healthy Produce Carts
• Healthy Corner Stores

21. Cross-cutting Accomplishments
• Engaging diverse sectors
• Engaging communities
• Data

22. Cross-cutting Accomplishments:
Partnership with Chicago Public Schools
• Chief Health Officer
• School Wellness Policy
• Competitive Foods Policy

23. Cross-cutting Accomplishments:
Engaging Communities
• Community policy recommendations
• LGBT Action Plan

24. What’s Next?
• Continued partnership development
• Health in all Policies

25. facebook.com/ChicagoPublicHealth
Gplus.to/ChiPublicHealth
@ChiPublicHealth
312.747.9884
CityofChicago.org/Health
HealthyChicago@CityofChicago.org