Mo McNulty, PhD Student
What city is noted as being a leader in regulating tobacco, will tweet you back after you complain online about food poisoning, and has the only big-city health department that is accredited? Chicago, of course!
Bechara Choucair, the Commissioner of the Chicago Department of Public Health, spoke at last week’s IPHAM seminar about the Healthy Chicago agenda. Launched in August 2011, it is a comprehensive program with 12 priorities for action centered around various health issues. Each has its associated targets to reach by 2020, and everything has been made public for better accountability. Not everyone agrees with all of the targets and there has been a lot of debate surrounding some of the policies. Said Choucair, “I know they’re controversial – I get Twitter bombed all the time!” Below, some highlights from a few key priority areas:
The goal is prevention through policy. These policies include everything from raising cigarette taxes (Chicago has the highest cigarette tax in the country – $7.17 per pack!) to banning the sale of flavored tobacco products near schools (since kids are more likely to smoke flavored, especially menthol, cigarettes). A new rule, the banning of e-cigarettes in public, has been particularly controversial because of a lot of public misconceptions surrounding the product. One doctor in the audience pointed out that she had several patients who were unaware that e-cigarettes contained nicotine, and Choucair emphasized that while many people thought e-cigarettes only released water vapor, research from big tobacco companies showed that this vapor contained some cancer-causing chemicals. Although some say e-cigarettes can be used as smoking cessation devices, Choucair told an interesting story: when the industry was asked by the FDA to prove this claim, they responded by suing the FDA, saying e-cigarettes were not cessation devices but rather tobacco products. (Manufacturers’ websites often specifically state that they are not cessation devices.) Choucair’s response? “You want to regulate this as a tobacco product? We’ll be happy to!” Choucair knows that not everyone agrees with e-cigarette regulation, but said “Until we know they’re safe, we should do no harm.” Measures such as these have helped Chicago be recognized as a public health leader in tobacco control.
One approach to reaching this goal is to increase access to healthy foods: there are plans for 18 new stores to be opened in food deserts (low-access neighborhoods). 5 new farmer’s markets are also being planned on Chicago’s west side, where food stamp users should be able to get extra value for their stamps. The Healthy Chicago program also hopes to promote physical activity. Choucair believes that the first priority on Chicago streets should be pedestrians, followed by bikers, public transit users, and finally cars. A new successful initiative was the creation of Play Streets!, where specific streets are blocked off at certain times of day so that kids can play games and take classes. Choucair said that many parents have responded positively because they feel like their neighborhoods are safer for their kids. It’s been successful enough that they will be expanding it to more neighborhoods! Other new policies include making physical education more of a priority in Chicago Public Schools.
The Chicago neighborhoods of North Lawndale and Humboldt Park have screening programs through the Keep Your Heart Healthy initiative that link residents to health care professionals.
Choucair said he’s proud of the city’s aggressive sex education policy. Four Chicago neighborhoods with the highest teen STI rates have introduced school screening and education programs that have been shown to be effective at reducing infection rates. The city’s Unexpected campaign aims to show that teen pregnancy is not just a problem for young girls – it’s a boy’s problem too.
Access to Care
Healthy Chicago is trying to target specific groups who have traditionally been underinsured: they hosted events for artists to try to increase enrollment, and targeted cab drivers coming in to the agency to renew their licenses. “We are mobilizing other city agencies to make a difference,” Choucair said. He continued, “We’re trying to be very intervention-focused at CPS”; vision screening has been introduced to identify more kids who need glasses and give them follow-up exams.
Public Health Infrastructure
The FoodBorne Chicago program identifies and contacts Twitter users complaining about food poisoning, and encourages them to follow up with more information. There is also an app that identifies places to get free condoms – according to Choucair, “please don’t pay for your condoms!” Choucair also likes interacting with and responding to Twitter users (you can find him at @choucair or @chipublichealth).
Healthy Chicago is making a difference in the health of the city through policies, public awareness, technology, and developing partnerships with other Chicago agencies and companies. It’s certainly good for individuals to be mindful of their own decisions about health, but Choucair said that this was not enough on its own to impact public health. “It’s not just about individual behavior, it’s about how we behave as a city.”
This week’s IPHAM seminar is “Health Disparities in Kidney and Heart Disease: Poverty, Phosphate and the Food Industry.” It will be given by Myles Wolf, MD, Director of the IPHAM Center for Translational Metabolism and Health. Come see the talk Thursday February 6 at noon in the Baldwin Auditorium (in the Lurie Medical Research Center), or stream it live from your computer!