Adonis Diaries

Posts Tagged ‘Chicago Department of Public Health

 

The 5-year journey as Chicago Department of Public Health: Bechara Choucair, M.D.

In the U.S., we tend to believe our health is largely a result of our genes and our personal choices. But, as research shows, health is most influenced by our environment.

You could say our ZIP code has more to do with our health than our genetic code.

Though I will soon step down as commissioner of public health, it is this reality that first led me to this job — if we can improve the health of a neighborhood, we can improve the health of our residents.

posted this Dec. 30, 2014

5-Year Journey: One Blog 

Mayor Rahm Emanuel understands this. When he first took office, he directed the Chicago Department of Public Health (CDPH) to create a comprehensive public health agenda for the entire City.

That plan, Healthy Chicago, provides 200 strategies to build healthier neighborhoods, which will in turn provide our residents — especially our youth — with more opportunities to get and stay healthy.

And it’s working.

Since launching Healthy Chicago, we have reported declines in childhood obesity rates and teen smoking rates while making real progress in our fight to close breast cancer disparities. There is more work to do, but we are moving in the right direction across the board.

We know that 90% of adult smokers started when they were minors.

So Healthy Chicago includes a series of initiatives aimed at discouraging our children from ever lighting their first cigarette.

We increased the city’s cigarette tax because
research shows that increased cost is the single most effective way to prevent kids from picking up the habit
.

We supported the regulation of e-cigarettes, ensuring these products are not physically accessible to youth and championed a new ordinance restricting the sale of flavored tobacco — including menthol — within 500 feet of schools

This effort is paying off. Earlier this year, the Centers for Disease Control and Prevention released new data showing that less than 11% of Chicago high school students reported smoking in 2013 — a historic low and five points below the current national average. The CDC also reported that Chicago’s adult smoking rates have hit a new record low of less than 18%.

While it is critical that we reduce the number of tobacco users in Chicago, addressing this challenge alone will only get us so far. It is just as important to encourage all residents to adopt healthier lifestyles across the board.

Over the last 3 years, we have worked to reduce childhood obesity.

We have expanded the number of bike lanes across the city and launched one of the nation’s premier bike sharing programs. The CDPH also launched PlayStreets to provide nearly 27,000 Chicago children and their families more opportunities to get outside and play in their own neighborhoods.

We are also working to keep our children healthier when they are in school.

We guaranteed recess for every student, strengthened nutritional standards in our cafeterias and expanded our free dental and vision programs. Last school year we provided an Action Plan for Healthy Adolescents, dental exams and cleanings for 113,000 students and distributed nearly 30,000 pairs of eyeglasses.

By helping our children today, we are creating a healthier future for tomorrow.

One of the most important ways to protect the health of our children and every Chicago resident is by protecting the air we all breathe in every neighborhood of our city.

Mayor Emanuel fought to shut down the two remaining coal power plants in the city and joined the CDPH to issue the most comprehensive set of regulations to cut down on the harmful emission of petroleum coke on the city’s southeast side.

We also launched innovative programs like FoodBorne Chicago, using Twitter to identify and respond to potential cases of food poisoning. Partnering with the University of Chicago, we have developed a new way to identify and repair homes most likely to have children exposed to lead-based paint.

We also made changes that seemed controversial at the time but are starting to pay off today.

This includes reforming the city’s mental health and primary care programs. With mental health, we consolidated our clinics ensuring they had the staff and resources to serve uninsured residents.

We also secured $14 million in funding to strengthen the overall mental health infrastructure, including $4 million for children’s services on the South and West Sides.

With primary care, we transitioned city clinics to non-profit partner organizations which have expanded services, improved the quality of care and increased patient visits by nearly 70 percent in the first year and a half — all while saving taxpayers an additional $12 million.

That is why we were honored as the 2014 Health Department of the Year by the National Association of County and City Health Officials. And that is why the CDPH will continue to move the needle forward.

Serving as Chicago’s health commissioner has been a profound honor and the highlight of my career. I am proud to say I leave behind a department that is stronger than it was when I arrived and a city that is healthier. There is no greater job satisfaction than that.

 

Twitter helps Chicago find sources of food poisoning

NEW YORK (Reuters Health) – When Chicago health officials saw Twitter users complaining about local food poisoning episodes, they reached out on Twitter to those users and often ended up charging the restaurant in question with a violation.

“We know that the majority of cases of food-borne outbreaks really never end up getting reported to the local health department anywhere in the country,” Dr. Bechara Choucair told Reuters Health in a phone call.

“We realize the people might not pick up the phone and call the doctor, but they might go to Twitter and complain to the world that they got food poisoning from eating out,” he said.

 

Choucair and his colleagues in the Chicago Department of Public Health wondered if there was some innovative way for them to identify new cases of foodborne outbreaks in Chicago that are regularly missed.

So they enlisted a technological collaborative group called Smart Chicago to help them.

“Smart Chicago collaborative helped us develop an app that literally sifts through hundreds of thousands of tweets every day that are coming from Chicago or linked to Chicago that might include a reference to a food borne illness,” Choucair said.

The app, called Foodborne Chicago, uses an algorithm to identify tweets that might be related to food poisoning symptoms in or near Chicago.

The app then responds to the person who sent the original tweet, saying, “That doesn’t sound good. Help us prevent this and report where you ate here,” and includes a link to an online form for reporting the details.

Foodborne Chicago tweets as @foodbornechi.

 

As Choucair and his coauthors noted in a paper in Morbidity and Mortality Weekly Report, published by the U.S. Centers for Disease Control and Prevention, the program was launched in March 2013.

During the first 10 months of the program, Foodborne Chicago identified 270 tweets describing complaints of food poisoning.

A total of 193 complaints were then submitted through the website, which lead to unannounced health inspections at 133 restaurants.

 

The health inspectors found at least one critical violation in 20% of those restaurants. The usual rate for one critical violation during regular health inspections is about 16

About 16 percent of the restaurants reported through Foodborne Chicago failed inspections and were closed.

“The overwhelming majority of people are really excited to know that their local government is listening – but not only just listening – is actually taking their complaint seriously and acting on it,” Choucair said.

Chicago isn’t the only city to use new technology to track food poisoning. The New York City Department of Health and Mental Hygiene examined restaurant reviews from an online review website to identify foodborne illness complaints.

“I think it’s really progressive of health departments to start looking at signals online to figure out where to put their resources,” Ben Chapman told Reuters Health in a phone call.

Chapman is a food safety specialist and researcher with North Carolina State University in Raleigh. He wasn’t involved in the study.

‘The focus is on trying to identify outbreaks that may not have been seen from traditional public health signals through hospitals or reportable disease databases, so yeah, it’s really good stuff,” Chapman said.

Chapman said there could be an issue with resources when people have to follow up with extra inspections based on all those tweets and online signals.

“But the good outweighs the bad,” he said.

Chapman said there is a movement for health departments to integrate their inspection reports directly into websites like Yelp, so that people can take that information into consideration when they’re searching for restaurants.

Choucair said his team would like to see this app utilized by other health departments across the country.

“The codes for the app are open to the public, we want people to use it,” he said.

For developers, the open-source software is available on GitHub, here: bit.ly/1zA0DPT.

SOURCE: 1.usa.gov/1mrYzmR CDC Morbidity and Mortality Weekly Report, online August 15, 2104.

 

 

Clinical medicine versus public health? What Dr. Bechara Choucair said?

From the Commissioner of public health of the city of Chicago in his Commencement Address at Feinberg School of Medicine at Northwestern University on May 4, 2011

Any intersection between clinical medicine and public health?

Clinical medicine and public health are often seen separate.

We often understand these two words as different disciplinary silos in which many of us spend entire careers. Ted Schettler, the Science Director of the Science and Environmental Health Network, frames both disciplines with respect to focus, scale, ethics, education and the nature of the science.

1. Focus: Clinical medicine focuses primarily on the individual, while public health focuses on the community.

2. Time frame: Relevant time frames in Clinical Medicine are usually single lifetimes, while public health thinks in terms of generations.

3. Ethics: From an ethics perspective, clinicians advocate for individual people. Public health practitioners advocate for the community, for a group of people.

4. Rights: In clinical medicine we focus on individual rights of a patient. In public health, we think about human rights, social justice, and environmental justice.

5. Education: From an education perspective, in clinical medicine we focus on the biomedical model with more emphasis on cure than prevention (although this is shifting now). In public health, we learn more about sociology, epidemiology, cultural anthropology, economics and more.

Think for a moment about the evidence of the science.

In clinical medicine we love to talk about controlled, double-blind clinical trials. We don’t find that type of approach often in public health.

Clearly, there are differences: differences in focus, differences in scale, differences in ethics, differences in education and differences in the nature of science.

But the reality is that the health of the individual and the health of the community are inter-related and inter-dependent. Maintaining two disciplinary silos is NOT the answer.

Bridging the gap is critical if we are serious about improving the quality of life of our residents.

Bridging the gap starts with education.

We have to enhance the understanding of public health principles among our students in the clinical field and we have to enhance the understanding of clinical medicine principles among our public health students.

Bridging the gap happens in research. We have to expand our research portfolio to focus on health disparities and other population level research.

Bridging the gap will not be successful unless we translate what we learn in research all the way into public policy.

And finally, it is people like you, like the faculty here and like me, who will take the lead in bridging this gap.

The good news is that here in Chicago, there are great people who have done great work in bridging this gap. I am forever grateful for their contributions.

At the Chicago Department of Public Health, we are exploring how to fully exploit the intersection of public health and medicine. We are excited about having the opportunity to use, as the foundation of such efforts, the proliferation of HIT initiatives, particularly in under served communities.

A major federally-funded initiative to help us achieve this goal is CHITREC, housed here at Feinberg and funded through stimulus funds (American Recovery & Reinvestment Act).

CHITREC (Chicago Health Information Technology Regional Extension Center) provides technical assistance to primary care providers serving predominantly uninsured, under insured, and medically under served populations in developing an Electronic Health Records system that will improve health outcomes.

CHITREC is collaboration between Northwestern University and the Alliance of Chicago Health Center Services, a health center-controlled network. It builds upon extensive collective Electronic Health Records implementation and clinical informatics experience.

We anticipate that as the participating providers come on line, there will be wonderful opportunities to use the wealth of data available through an Electronic Health Record to measure population health and be able to pinpoint where particular interventions are needed to improve outcomes.

Other federal funding, including the 2010 Patient Protection and Affordable Care Act, has provided additional opportunities for investments in the electronic data infrastructure supporting population health. Chicago Department of Public Health (CDPH) is positioned to become a leader in the public health applications of Health Information Technology. Current CDPH activities include:

  •  Funding of 26 acute care hospitals in Chicago to assist in their efforts toward establishing capacity to transmit data of public health significance to CDPH;
  • Partnering with the Centers for Disease Control and Prevention (CDC), GE Healthcare and the Alliance of Chicago in a pilot evaluation the feasibility of targeted, pubic health-oriented clinical decision support for ambulatory providers, delivered at the point of care through Electronic Health Records;
  • Supporting Stroger Hospital of Cook County and two major Federally Qualified Healthcare Center (FQHC) networks (ACCESS Community Health Network and the Alliance of Chicago) in their efforts to establish robust transmission of immunization administration data to the Illinois immunization registry;
  • Engaging with the Illinois Office of Health Information Technology in statewide efforts to build a sustainable Health Information Exchange (HIE);

Feinberg PPH: Commencement Address given by Bechara Choucair, May 4, 2011

Note: Dr. Bechara Choucair is Commissioner of public health of the city of Chicago.  I liked his Commencement Address at Feinberg School of Medicine at Northwestern University and decided to publish the speech and three sections of the speech on wordpress.com.

This speech covered all the grounds and it is impressive.  I found it acceptable to edit out sentences that are not closely related to the subject matter in order to shorten the message.


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