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Public Health and Vulnerable Populations

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These slides give an overview of public health and the role of local public health departments in keeping people healthy, presents housing, health and some of the vulnerable populations who are the primary focus of our work, and shows the Healthy Chicago Public Health Agenda - the blueprint for our work at the Chicago Department of Public Health. Lastly, it highlights some of our work and accomplishments with vulnerable groups.

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Public Health and Vulnerable Populations

  1. 1. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel Healthy Chicago Public Health and Vulnerable Populations July 16, 2013 Bechara Choucair, MD Commissioner Chicago Department of Public Health
  2. 2. Presentation Outline 1. Public Health Overview 2. Housing, Health, and Vulnerable Populations 3. Healthy Chicago Public Health Agenda 4. Current Work and Accomplishments
  3. 3. Population Health Kindig D, Stoddart G. What is population health? American Journal of Public Health 2003 Mar;93(3):380–3. • The health outcomes of a group of individuals, including the distribution outcomes within the group • Focuses on improving health inequities
  4. 4. Core Functions & Essential Services
  5. 5. Chicago Department of Public Health Mission: To make Chicago a safer and healthier place by working with community partners to promote health, prevent disease, reduce environmental hazards and ensure access to health care for all Chicagoans.
  6. 6. Presentation Outline 1. Public Health Overview 2. Housing, Health, and Vulnerable Populations 3. Healthy Chicago Public Health Agenda 4. Current Work and Accomplishments
  7. 7. Factors Influencing Health
  8. 8. Housing Influences Health Pollack C, et al. Where We Live Matters for Our Health: The Links Between Housing and Health. Robert Wood Johnson Foundation. September 2008. • Safe homes that are free from physical hazards • Positive physical, environmental, social, and economic conditions in neighborhoods • Housing costs less than 35% of a family’s income
  9. 9. Conditions within the Home • Lead-based paint affects brain and nervous system development • Substandard housing conditions can lead to respiratory conditions such as asthma • Radon, pollutants, and asbestos can lead to cancers and respiratory illness • Steep staircases, lack of security devices, and substandard heating can cause injuries
  10. 10. Neighborhood Conditions • Neighborhood crime, violence, pollution • Safe places to play and exercise • Grocery stores selling fresh produce • Convenience stores, fast food outlets & liquor stores • Employment, transportation & health care • Strong neighborhood ties and high levels of trust
  11. 11. Housing Affordability • “Affordable housing” is less than 35% of income • Shortages of affordable housing limits choice of neighborhood • High-cost housing prevents families from meeting other basis needs, including nutrition, heat, health care, prescriptions • Housing affordability impacts homelessness
  12. 12. Homelessness and Health • Respiratory diseases, HIV/AIDS, alcohol and drug dependence, mental health problems, accidents and violence are more common • Homes are important for overall well-being, providing a sense of security, privacy, and control • The majority of homeless patients at FQHCs do not have health insurance or ability to pay for health care • Life expectancy is about 30 years less for those on the streets
  13. 13. Poverty in Adults Connected to Poor Health Status and Health Behaviors • Higher rates of chronic health problems • Higher rates of negative health behaviors • Less likely to have access to health care and medication In poverty Not in poverty Depression 31% 16% Obesity 32% 26% Smoking 33% 20% Uninsured 38% 14% Can’t afford medicine 38% 17% Data Source: Gallup-Healthways Well-Being Index, 2012
  14. 14. Uncontrolled Diabetes Hospital Discharge Rates, Chicago Residents, 2007
  15. 15. Uninsured Have Higher Rates of Morbidity and Mortality In 2010, over 26,000 people between ages of 25-64 died prematurely due to lack of health coverage •5 times less likely to have regular source of care •4 times more likely to delay/forgo preventive care screening due to cost o Uninsured women half as likely to get mammogram than insured Data Source: Dying For Coverage: The Deadly Consequences of Being Uninsured. Families USA. June 2012
  16. 16. Uninsured Have Higher Rates of Morbidity and Mortality • 6 times as likely to go without needed medical care • More likely to be diagnosed at advanced stage of illness o At least 25 percent more likely to die prematurely • 60 percent of uninsured report problems will medical bills or medical debt Data Source: Dying For Coverage: The Deadly Consequences of Being Uninsured. Families USA. June 2012
  17. 17. Racial/Ethnic Minorities More Likely to have Poor Health Outcomes All Cause Mortality, 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 Data Source: Illinois Department of Public Health, 2008 Vital Statistics
  18. 18. Presentation Outline 1. Public Health Overview 2. Housing, Health, and Vulnerable Populations 3. Healthy Chicago Public Health Agenda 4. Current Work and Accomplishments
  19. 19. Healthy Chicago Policy 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
  20. 20. HEALTHY CHICAGOHEALTHY CHICAGO Chicago Department of Public HealthChicago Department of Public Health Infrastructure
  21. 21. 22 Healthy Chicago Partnerships
  22. 22. Presentation Outline 1. Public Health Overview 2. Housing, Health, and Vulnerable Populations 3. Healthy Chicago Public Health Agenda 4. Current Work and Accomplishments
  23. 23. Access to Care • Provide immunizations, family case management, WIC, HIV primary care, STI testing, and mammography • Serve mental health consumers through six clinics, prioritizing the uninsured • Invested $500,000 for expanded psychiatry services awarded to 8 partners • Partnered with FQHCs to provide primary care services for the uninsured
  24. 24. Access to Care • Over 113,000 students from 504 schools received dental health services through school-based oral health program (2011-2012) • New vision program will serve 30,000 students • Collaborate with state and local health authorities and providers to promote Medicaid Expansion and the Marketplace
  25. 25. Patient Protection and Affordable Care Act (ACA) • Health care reform will provide access to care for many at-risk populations o Medicaid Expansion o Health Insurance Marketplace • We are working to ensure that enrollment agents will be available at area shelters • Health care system will be challenged to provide comprehensive health care for formerly uninsured • Public health will continue to address population health needs for this vulnerable group
  26. 26. Adolescent Health Chicago Public Schools (CPS) Partnership •85% of CPS students receive free/reduced price lunch •Established Office of Adolescent and School Health o Oral health, vision services, teen pregnancy, and sexually transmitted infection prevention services •Hired CPS Chief Health Officer •Teen Pregnancy Prevention Initiative
  27. 27. HIV Prevention • In 2012, CDPH and delegate agencies provided housing services to over 2,600 residents, HIV testing to 43,000 persons, and STI clinical care to 21,000 persons. • Integrated planning for prevention, care and housing services for HIV o Strengthen prevention o Increase linkage & retention to care o Increase treatment access
  28. 28. Violence Prevention • CeaseFire partnership • Domestic violence assistance • Data collection partnership with police department • Psychological First Aid training • Chicago Dating Matters Initiative, $1.75 M federal grant
  29. 29. Obesity Prevention Neighbor Carts •Produce carts with whole fruits and vegetables •Vendors are homeless and at-risk individuals •At least one-half of the carts must be placed in neighborhoods underserved by grocery stores •30 carts operating by the end of 2013
  30. 30. Healthy Chicago Action Plans
  31. 31. Become a Healthy Chicago Partner • Partner to address specific health issues or multiple Healthy Chicago priorities • Adopt Healthy Chicago policies and practices in your agency • Receive our monthly updates and share your ideas
  32. 32. facebook.com/ChicagoPublicHealth@ChiPublicHealth 312.747.9884 www.CityofChicago.org/Health HealthyChicago@CityofChicago.org

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