Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Healthy Chicago: Approach to Health DisparitiesChicago Department of Public Health                                        ...
Presentation Outline1. Healthy Chicago Public Health Agenda2. Addressing Health Disparities through Healthy   Chicago Prio...
Presentation Outline1. Healthy Chicago Public Health Agenda2. Addressing Health Disparities through Healthy   Chicago Prio...
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...
Chicago: Person, Place, Time**From Sampson R. Great American City. 2012; p. 105 & 106.
All-Cause Mortality by Race/Ethnicity,           Chicago, 2008 Race/Ethnicity        Adjusted Rate                       p...
Presentation Outline1. Healthy Chicago Public Health Agenda2. Addressing Health Disparities through Healthy   Chicago Prio...
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• 16,672 home visits were provided in 2011 to  pregnant women and new mothers• Clients recei...
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 C...
Teen Pregnancy• 39% of Chicago high school students report being  sexually active (2009 YRBS)• 2009 birth rate for 15-19 y...
Teen Birth Rate by Race/Ethnicity of                                                Mother, Chicago and the United        ...
Teen Pregnancy, STIs and Dating Violence                    Initiatives• Teen pregnancy prevention initiative   – 4500 stu...
Priority: Tobacco Use
Tobacco Use Disparities• Tobacco use is the most preventable cause of death  and its use is associated with many illnesses...
Percentage of Adult Cigarette Smokers,       U.S., by Education, 2010      Education                                Percen...
Percentage of Adult Cigarette Smokers,        U.S., by Income, 2010Poverty Status                                    Perce...
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 ...
New Tobacco-Related Legislation            and Enforcement• Business license reform ordinance includes  measures to addres...
Priority: Obesity Prevention
Obesity Prevention• Obesity increases the risk of heart  disease, cancer, and stroke• 33.6% of Chicago adults are overweig...
Prevalence of Obesity among Adults,              by Race/Ethnicity, U.S. and Illinois                                   20...
Adult obesity rates vary bygender, income, and race/ethnicity
Prevalence of Obesity in 2-19 Year-Olds in              the U.S., 2009-2010Source: Ogden et al., JAMA 2012. Online via htt...
Child obesity rates vary inconsistently by   race/ethnicity, income, and gender                           http://www.cdc.g...
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...
Priority: Breast Cancer Disparities
Breast Cancer Disparities• In 1980, breast cancer mortality rates for Black and  white women in Chicago were equal (38/100...
Three Hypotheses Explaining Chicago         Breast Cancer Disparities• African American women receive fewer  mammograms• A...
Improving Access to and Quality of               Mammography• The Chicago Breast Cancer Quality Consortium• The Breast Can...
Addressing Breast Cancer Disparities             through Policy• Expanding CDPH’s partnerships with hospitals• Improving M...
Breast Cancer Disparities Surveillance• Applied for State registry breast cancer  incidence data
Breast Cancer Disparities Advisory Group• Breast cancer stakeholders provide input on our  activities• Survivors, family m...
Priority: HIV Prevention
HIV Disparities• Urban areas such as Chicago have significantly  higher rates of HIV than the U.S. as a whole• Racial disp...
HIV Infection Rates per 100,000                      population in Chicago (as of 8/25/2011)                   1400       ...
HIV Infections: Method of Transmission            (Chicago 2009)                       Other                        1%    ...
HIV Behavioral Surveillance         • CDPH conducts annual           behavioral surveys among           populations at inc...
HIV Behavioral Surveillance Findings,           Chicago, 2008-2011• Young Black MSM only subgroup with annual  increases i...
HIV Prevention and Care• Implementation of Enhanced Comprehensive HIV  Prevention Plan (ECHPP)• Partner services and linka...
Presentation Outline1. Healthy Chicago Public Health Agenda2. Addressing Health Disparities through Healthy   Chicago Prio...
What’s Next?•   Implementation of Food Plan•   Implementation of LGBT Action Plan•   Immunizations to underserved communit...
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
How Healthy Chicago is Addressing Disparities in Chicago
Upcoming SlideShare
Loading in …5
×

How Healthy Chicago is Addressing Disparities in Chicago

487 views

Published on

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

How Healthy Chicago is Addressing Disparities in Chicago

  1. 1. Healthy Chicago: Approach to Health DisparitiesChicago Department of Public Health Patient-centered Medicine Scholars Program M2 Service Learning Program Seminar January 24, 2012 Bechara Choucair, MD Commissioner Chicago Department of Public Health @choucair on Rahm Emanuel Bechara Choucair, MD Mayor Commissioner
  2. 2. Presentation Outline1. Healthy Chicago Public Health Agenda2. Addressing Health Disparities through Healthy Chicago Priority Areas3. Future Work to Address Health Disparities
  3. 3. Presentation Outline1. Healthy Chicago Public Health Agenda2. Addressing Health Disparities through Healthy Chicago Priority Areas3. Future Work to Address Health Disparities
  4. 4. HEALTHY CHICAGO CHICAGO DEPARTMENT OF PUBLIC HEALTHTRANSFORMING THEHEALTH OF OUR CITYCHICAGO ANSWERS THE CALL
  5. 5. HEALTHY CHICAGOChicago Department of Public Health Infrastructure
  6. 6. 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
  7. 7. Chicago: Person, Place, Time**From Sampson R. Great American City. 2012; p. 105 & 106.
  8. 8. 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
  9. 9. Presentation Outline1. Healthy Chicago Public Health Agenda2. Addressing Health Disparities through Healthy Chicago Priority Areas3. Future Work to Address Health Disparities
  10. 10. Priority: Healthy Mothers and Babies
  11. 11. 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. lags behind 46 other nations in the infant death rate (2011)
  12. 12. 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
  13. 13. 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 • WIC recipients Pregnancy Risk Assessment Monitoring System, 2000-2006
  14. 14. 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)
  15. 15. Baby-Friendly Hospital Initiative • The WHO’s Baby-Friendly Hospitals program has been shown to increase breastfeeding • 15/19 Chicago labor & delivery hospitals are participating • Through 10 steps, hospitals provide significant support for mothers
  16. 16. Maternal and Child Home Visits• 16,672 home visits were provided in 2011 to pregnant women and new mothers• Clients receive the most current education on their pregnancy and well-baby care
  17. 17. Priority: Adolescent Health
  18. 18. 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 primarily Hispanic (45%), African American (41%), and low income (85% receive free/reduced price lunch), providing opportunities to promote health equityhttp://www.cps.edu/SchoolData/Pages/SchoolData.aspx
  19. 19. 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
  20. 20. Teen Pregnancy• 39% of Chicago high school students report being sexually active (2009 YRBS)• 2009 birth rate for 15-19 year-olds in Chicago was 57/1000 Youth Risk Behavior Survey, 2009
  21. 21. Teen Birth Rate by Race/Ethnicity of Mother, Chicago and the United 100 States, 1999-2009 98.7 91.1(per 1,000 females aged 15-19 years) 90 90.1 88.6 88.9 88.8 84.9 86.3 81.9 82.5 83.3 80 80.3 79.2 76.8 77.7 72.8 73.9 75 70 68.6 Teen Birth Rate 60 60.5 50 40 30 26 23 20 19.5 19.3 16.4 15.8 14.2 15 12.8 11.7 12 10 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.
  22. 22. Teen Pregnancy, STIs and Dating Violence Initiatives• Teen pregnancy prevention initiative – 4500 students received curriculum and supports (2012)• STI screenings – 9,215 educated; 6,147 screened; 436 identified• Teen dating violence prevention – 5000 youth and parents**anticipated 2012-2016
  23. 23. Priority: Tobacco Use
  24. 24. Tobacco Use Disparities• Tobacco use is the most preventable cause of death and its use is associated with many illnesses• 21% of Chicago adults smoke (2010)• National data show disparities across levels of education and income, as well as increased smoking for LGBT populationBRFSS, 2010; CDC MMWR: http://www.cdc.gov/mmwr/preview/ mmwrhtml/mm6144a2.htm#tab
  25. 25. Percentage of Adult Cigarette Smokers, U.S., by Education, 2010 Education Percent Who Smoke No HS Diploma 25.1% HS Graduate 23.8% Some College 23.2% Associates Degree 18.8% Undergraduate Degree 9.9% Graduate Degree 6.3%Vital Signs: Current Cigarette Smoking Among Adults – U.S., 2005-2010, MMWR,September 9, 2011
  26. 26. Percentage of Adult Cigarette Smokers, U.S., by Income, 2010Poverty Status Percent Who SmokeAt or above poverty level 18.3%Below poverty level 28.9%Unspecified 16.0%Vital Signs: Current Cigarette Smoking Among Adults – U.S., 2005-2010, MMWR,September 9, 2011
  27. 27. 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 • 3 higher education campuses • 6 substance abuse & mental health service agencies
  28. 28. 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
  29. 29. 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
  30. 30. Priority: Obesity Prevention
  31. 31. Obesity Prevention• Obesity increases the risk of heart disease, cancer, and stroke• 33.6% of Chicago adults are overweight; 28.7% are obese (2010)• BMI differences in specific racial, ethnic, income, and gender categories Source: BRFSS, 2010.
  32. 32. Prevalence of Obesity among Adults, by Race/Ethnicity, U.S. and Illinois 2006-2008 40 35.7 35 33.3 30.7 30 28.7Percentage 25 23.7 23.4 20 U.S. 15 Illinois 10 5 0 White Black Hispanic Source: BRFSS
  33. 33. Adult obesity rates vary bygender, income, and race/ethnicity
  34. 34. 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
  35. 35. Child obesity rates vary inconsistently by race/ethnicity, income, and gender http://www.cdc.gov/nchs/data/databriefs/db51.pdf
  36. 36. Food Access in Chicago CommunitiesData provided by Chicago’s Department of Housing and Economic Development, 2012.
  37. 37. 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
  38. 38. 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
  39. 39. Priority: Breast Cancer Disparities
  40. 40. Breast Cancer Disparities• In 1980, breast cancer mortality rates for Black and white women in Chicago were equal (38/100,000)• By 2005, the mortality rate of Black women was twice that of the white rate (41.3/100,000 vs. 19.2/100,000)• The Black rate remained about constant while the white rate declined by almost one-half
  41. 41. Three Hypotheses Explaining Chicago Breast Cancer Disparities• African American women receive fewer mammograms• African American women receive mammograms of inferior quality• African American women have inadequate access to quality treatment once breast cancer is diagnosed
  42. 42. Improving Access to and Quality of Mammography• The Chicago Breast Cancer Quality Consortium• The Breast Cancer Quality Screening and Treatment Initiative• Partnership with Chicago Housing Authority• Training for radiology technologists
  43. 43. Addressing Breast Cancer Disparities through Policy• Expanding CDPH’s partnerships with hospitals• Improving Medicaid reimbursement for mammograms
  44. 44. Breast Cancer Disparities Surveillance• Applied for State registry breast cancer incidence data
  45. 45. Breast Cancer Disparities Advisory Group• Breast cancer stakeholders provide input on our activities• Survivors, family members, advocates, service providers, researchers, & media
  46. 46. Priority: HIV Prevention
  47. 47. HIV Disparities• Urban areas such as Chicago have significantly higher rates of HIV than the U.S. as a whole• Racial disparities are pronounced
  48. 48. HIV Infection Rates per 100,000 population in Chicago (as of 8/25/2011) 1400 1226.2 1200Rate per 100,000 1000 800 756.5 632.5 600 444.4 430.1 400 200 0 Chicago Non-Hispanic Non-Hispanic Hispanic Non-Hispanic Black White Other
  49. 49. HIV Infections: Method of Transmission (Chicago 2009) Other 1% Heterosexual Sex 21% MSM and IDU 2% Injection Drug Use Male Sex 13% w/Male 63%
  50. 50. HIV Behavioral Surveillance • CDPH conducts annual behavioral surveys among populations at increased risk for HIV
  51. 51. HIV Behavioral Surveillance Findings, Chicago, 2008-2011• Young Black MSM only subgroup with annual increases in new HIV diagnoses• 20% of MSM in Chicago have HIV• 59% of MSM report having unprotected sex• 53% of MSM report using illicit drugs• Increase in awareness of HIV-infection, being in care, and taking antiretroviral therapy between 2008 and 2011
  52. 52. HIV Prevention and Care• Implementation of Enhanced Comprehensive HIV Prevention Plan (ECHPP)• Partner services and linkage to care• Condom accessibility• Provider training and capacity-building
  53. 53. Presentation Outline1. Healthy Chicago Public Health Agenda2. Addressing Health Disparities through Healthy Chicago Priority Areas3. Future Work to Address Health Disparities
  54. 54. What’s Next?• Implementation of Food Plan• Implementation of LGBT Action Plan• Immunizations to underserved communities• Vision services for CPS students
  55. 55. What’s Next?• Engaging community stakeholders in policy• Healthy CPS (Chicago Public Schools)
  56. 56. facebook.com/ChicagoPublicHealthGplus.to/ChiPublicHealth@ChiPublicHealth312.747.9884CityofChicago.org/HealthHealthyChicago@CityofChicago.org

×