An Interview with Bechara Choucair, a Leader in the Journey to a Healthy Chicago!

PhD/MPH student Aabha Sharma interviewed Dr. Bechara Choucair, Commissioner of the Chicago Department of Public Health. Mayor Richard M. Daley appointed Dr. Choucair on November 25, 2009.

Born in Beirut, Lebanon, Dr. Choucair earned a Bachelor of Sciences degree in Chemistry (with distinction) and a Medical Diploma from American University of Beirut. From 1997-2000 he did his Family Practice Residency at the Baylor College of Medicine in Houston, Texas. In 2009 he earned a Master’s Degree in Health Care Management from the University of Texas at Dallas.

From 2001-05, Dr. Choucair served as Medical Director of Crusader Community Health in Rockford, Illinois. From 2005-09, he was Executive Director of Heartland International Health Center. He has served as Vice-chair of Community Medicine, Department of Family & Community Medicine, Feinberg School of Medicine, Northwestern University.

Awards he has earned include the Loretta Lacey Maternal and Child Health Advocacy Award, Illinois Maternal and Child Health Coalition, 2009; Health Professions Training and Education Award, National Association of Community Health Centers, 2008; American Academy of Family Physicians Foundation, Pfizer Teacher Development Award, 2007; and Forrest Riordan Humanitarian Award, 2005.

AS: Healthy Chicago has been going on strong. You were recently invited to the White House because of your tobacco prevention efforts. Congratulations! Could you please elaborate on plans that the Chicago Department of Public Health has for tobacco menthol prevention? What are some of the ongoing programs and what goes on at the backstage of these campaigns? How do you set priorities on which public health issue to address?

BC: Public Health is all about making the environmental and systems changes necessary to create a more healthy community – if we are successful more people will have more opportunities to get and stay healthier. This is the approach we take for all our priorities, including tobacco prevention.  What can we change to help make sure our kids are not enticed by tobacco and instead choose never to light up in the first place?

So to make those long-term, sustainable environmental changes we really focus on three areas: policy, programs and public education.

Policy: In Chicago, we have passed three laws this year that are extremely important – first, we raised taxes on cigarettes. Now, we have highest cigarette tax in the country because we know there’s price elasticity. If cigarettes are more expensive it is more likely that kids won’t pick up on it. Second, we restricted the sales of menthol flavored cigarettes and all flavored tobacco within 500 feet of our schools, meaning that retailers located close to our schools can’t sell these specific products that we know Big Tobacco has used to entice and hook young people. We are the first jurisdiction in the country to include menthol-flavored products in these restrictions. Third, we became the first big city in the nation to introduce an ordinance to regulate e-cigarettes in the same way we regulate traditional cigarettes, putting them behind the counter and ensuring our indoor spaces remain e-cigarette free.

The CDPH’s “BURNED” ad campaign encourages young people to avoid taking up smoking.

Programs: 70% of smokers want to quit smoking, so we have to continue making sure that people have access to free resources to help them quit. Therefore, on the programmatic side, we encourage people to call our state’s tobacco Quitline, 888-QUIT-YES. Chicago calls to the tobacco Quitline more than doubled in the last half of 2013 and we are seeing more and more people pick up the phone and call.

Public Education: Raising awareness is key. Unless there’s awareness on these issues, no policy changes can be passed or implemented that will help make behavioral changes. It is also hard to provide the push for smokers to quit, and most importantly, prevent non-smokers from picking up the habit unless you have public awareness and education. The ad campaigns that you are seeing all over the city do this – we want to make sure that smokers know there are resources available to help them initiate quitting smoking. At the same time, we are also sending messages to youth that they should think twice before starting to experiment with cigarettes.

AS: I recently saw an article that states that CVS is going to stop selling cigarettes. I definitely think that will boost the tobacco campaign not just in Chicago but also everywhere in the country. 

BC: Definitely! Mayor Emmanuel has already come forward and congratulated CVS for their decision.

AS:  Last year Chicago was one of the best in terms of obesity prevention, especially child obesity. What are the other priorities for 2014?    

BC:  Back in August 2011 Mayor Emmanuel launched the Healthy Chicago agenda and in that agenda we identified 12 public health priorities. And we said if we focus our efforts on making differences in those 12 priorities, we think we will be able to create the healthiest city in the nation and that’s what we have been doing. Tobacco and obesity are obviously two extremely important priorities but we are also focusing on adolescent health, violence prevention, cardiovascular disease, cancer disparities and healthy homes. There is a lot of work going on in those areas. One example in terms of adolescent health is the Healthy Adolescent program for Chicago that we just launched. It identifies over 65 strategies that we think will significantly improve adolescent health in Chicago. Some of these strategies include expanding the vision and dental programs at CPS schools. You might have seen our campaigns for preventing teen pregnancy – using teen pregnant boys has been an effective strategy to raise awareness that teen pregnancy is not just a girls’ problem. One of the policies regarding adolescent health was recently passed as well. This physical education policy focuses on bringing daily PE back to schools for students.

During the 2012 National Nutrition Month, the CPHD invited Chicagoans to share their healthy plates on Facebook.

AS: CDPH is progressive in terms of its public health campaigns compared to the rest of the country. How has this been possible? 

BC:  In my mind, the most important thing in improving the health of a community is the partnership. We have enough partners with us to stand with us and help us achieve our goals. It’s all about creating coalitions and developing a culture that has public health as top priority. That’s what we have in Chicago – we have great partners for all our priorities. For the tobacco prevention campaign, for example, we worked with the American Lung Association and Respiratory Health Association. For obesity, we worked closely with CLOCC – the Consortium to Lower Obesity in Chicago Children. We work closely with Blue Cross Blue Shield and the Parks districts and Partners of Transportation as well. We have a long list of amazing engaged partners to make a difference. It’s the coalition between the business, government, public and private sectors that has made all the difference. Another thing that is important in Chicago is having the political leadership that’s necessary to make those differences and having a mayor like Emmanuel who is a very vocal and supportive public health advocate all throughout his career and as mayor of Chicago – this really makes the difference. So, creating the right partnerships and having the right political leadership to make a difference is the core of why public health has done so well in Chicago and will continue to do so in Chicago.

AS: I hope Chicago continues to be an example for the rest of the country. I can feel how passionate you are about your work. I hope it continues to go on strong like right now. Thank you so much for your time. 

Follow Dr. Choucair on Twitter at @choucair

See our article on Dr. Choucair’s talk at Northwestern’s Institute for Public Health and Medicine Seminar Series here.

Aabha Sharma is a PhD/MPH student at Northwestern University.