2013 Impact Summit: Transparency & Equity

Bechara Choucair, MDCommissioner

Chicago Department of Public Health

@Choucair #CICSUMMIT

2013 CIC Impact Summit: Advancing Transparency &

Equity

October 17, 2013

Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

PRESENTATION OUTLINE

1. What Influences Public Health? Policy, Systems & Environmental Change (PSE)

2. Healthy Chicago Public Health Agenda

3. PSE Successes: Tobacco, Maternal and Child Health, Obesity, and Adolescent Health

4. Advancing Healthy Chicago Through Technology

FACTORS INFLUENCINGHEALTH

McGinnis et al. The Case for More Policy Attention to Health Promotion. Health Affairs, Vol. 21 (2)

Socioeconomic Factors

Changing the Contextto make individuals’ default

decisions healthy

Long-lasting Protective Interventions

ClinicalInterventions

Counseling & Education

Examples

Poverty, education, housing, inequality

Immunizations, brief intervention, cessation treatment, colonoscopy

Fluoridation, trans fat, smoke-free laws, tobacco tax

Rx for high blood pressure, high cholesterol, diabetes

Eat healthy, be physically active

Smallest Impact

Largest Impact

WHAT IS THE DIFFERENCE?

POLICY, SYSTEMS &ENVIRONMENTAL CHANGE (PSE) • Makes default

decisions healthy

• Big impact & sustainable

• Relatively little time and resources needed

• Engages diverse stakeholders

POLICY, SYSTEMS &ENVIRONMENTAL CHANGE (PSE)Policy- Written statement of

organizational position, decision or course of action, including ordinances, resolutions, mandates, guidelines, & rules

Systems- Changes in organizational procedures (personnel, resource allocation, & programs)

Environment- Physical, observable changes in the built, economic, and/or social environment

PRESENTATION OUTLINE

1. What Influences Public Health? Policy, Systems & Environmental Change (PSE)

2. Healthy Chicago Public Health Agenda

3. PSE Successes: Tobacco, Maternal and Child Health, Obesity, and Adolescent Health

4. Advancing Healthy Chicago Through Technology

HEALTHY CHICAGOPUBLIC HEALTH 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

LEADING CAUSES OF DEATH,2009

ChicagoUnited States

Cause of death

Percent of total deaths

Rank*

Percent of total deaths

Rank*

Heart disease

27.3 1 24.6 1

Cancer 23.1 2 23.3 2

Stroke 4.9 3 5.3 4*Based on number of deaths

Healthy ChicagoPriority Areas

Healthy Chicago Indicator Development• Determine a baseline and set a

target

• Measure progress annually, or as new public health data becomes available

• Look back retrospectively to understand temporal trend

• Make use of Healthy People 2020 Goals and Objectives

Tobacco Use

Targets

•Reduce smoking prevalence among adults to 12%

•Reduce smoking prevalence among youth to 10.3%

Obesity PreventionTargets•Reduce adult and childhood obesity by 10%•Decrease the proportion of youth and adults consuming less than 5 servings of fruits and vegetables per day by 10%•Reduce the number of Chicagoans living in food deserts to 200,000 by 2015 and to zero by 2020

HIV Prevention

Target•Reduce the annual number of HIV infections by 25% from 1,082 to 812

PRESENTATION OUTLINE

1. What Influences Public Health? Policy, Systems & Environmental Change (PSE)

2. Healthy Chicago Public Health Agenda

3. PSE Successes: Tobacco, Obesity, and Adolescent Health

4. Advancing Healthy Chicago Through Technology

TOBACCO USE

TOBACCO USE

SMOKE-FREE CAMPUSES 3 Colleges / Universities 6 Hospitals 6 Behavioral Health Organizations 686 Public Housing UnitsOver 3,250 units of private smoke-free housing

TOBACCO USE

Joint Enforcement

OBESITY PREVENTION

ChicagoStreets for Cycling Plan 2020

Over 200 miles of on-street bikeways, including almost 35 miles of barrier and buffer protected bike lanes.

3000 bikes to share at 300 stations by end of summer.

OBESITY PREVENTION

Dearborn Street - Before Dearborn Street - After

OBESITY PREVENTION

Bike Sharing in Chicago

3,000 bikes

300 stationsby the end of summer 2013

OBESITY PREVENTION

Health Goals Increase the number

of pedestrian trips for enjoyment, school, work, and daily errands

Increase the mode share of pedestrian trips for enjoyment, school, work, and daily errands

OBESITY PREVENTION

14 licensed carts operating 41 vendors trained 30 carts planned for 2013

OBESITY PREVENTION

OBESITY PREVENTION

ADOLESCENT HEALTH

Revised Wellness Policy Competitive Foods Policy Expanded STI Screening $26M New grants

• CTG – Healthy CPS• Teen Dating Matters• Teen Pregnancy• Farm to School • Wellness Champions

BUILDING ON POLICY SUCCESSES

Mayor Emanuel Takes Action to Protect Chicago’s Kids from Menthol Cigarettes

BUILDING ON & ENGAGING PARTNERSHIPS

PRESENTATION OUTLINE

1. What Influences Public Health? Policy, Systems & Environmental Change (PSE)

2. Healthy Chicago Public Health Agenda

3. PSE Successes: Tobacco, Obesity, and Adolescent Health

4. Advancing Healthy Chicago Through Technology

Advancing Healthy ChicagoThrough Technology

•Chicago Health

Atlas

•City Open Data

Portal

• FoodBorneChi

Chicago Health Atlas is acollaboration• Informatics researchers from

multiple healthcare institutions

• Chicago Regional Extension Center (CHITREC)

• Chicago Community Trust

• Chicago Department of Public Health

Chicago Health Atlas is adatabase

• De-identified electronic health record data for ~1 million Chicagoans

• In-patient and out-patient visits spanning 2006-2011

• Individual patient records matched across institutions

Chicago Health Atlas is awebsite

ChicagoHealthAtlas.org

Developing Procedures and Best Practices• Public health indicators from City Data

Portal can be viewed for temporal and neighborhood trends

• Incorporating CDC guidelines for classification of map categories

• How to make metadata easily accessible to users

• How to deal with aggregated geographies and time periods

Health Information Exchange

Neighborhood Pages

Health Information Exchange

City Level Comparisons

Open Data Portal

data.cityofchicago.org

Public Health Context

• Most frequent requests are for statistics by neighborhood (community area or zip code)

• Neighborhood summaries published once every 3-4 years by paper/PDF

• Many data objects generated in response to requests

Number of customized data objects released to individuals or institutions(rather than to public), cumulative,2011 – May 2013

Flu App

FoodBorne Chicago • Web application based on

machine learning

• Mathematical algorithm

• App “taught” to ID food poison tweets

• App “learns” relevant tweets

• Collects Chicago food poisoning tweets

• Human classifier determines responses

• Actionable – submissions are investigated

• Sentinel for outbreaks• Inspection status:• Residents see results

online• Open 311• Data Portal

• 85 inspections since released• Future: Emergency

Response, Flu

FoodBorne Chicago

RESIDENT TWEETS CLICKS & REPORTS ONLINE RESULTS

FoodBorne Chicago

@foodbornechi FoodBorneChicago.org

FoodBorne Chicago

@ChiPublicHealth

312.747.9884

facebook.com/ChicagoPublicHealth

[email protected]

www.CityofChicago.org/Health