Healthy Chicago 2.0: Working in Partnership to Achieve Health Equity

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1 Healthy Chicago 2.0: Working in Partnership to Achieve Health Equity Institute of Medicine Chicago June 11, 2015 Julie Morita, MD, Commissioner

3 Presentation Outline Healthy Chicago 2.0 Planning Process Assessments Action Team Progress Next Steps

4 Community Health Assessment and Improvement Plans Essential Public Health Service Required component: Public Health Accreditation Illinois Local Public Health Department Certification Hospital assessment and planning efforts: Healthy Chicago Hospital Collaborative Cook County Collective Impact

5 Mobilizing for Action through Planning and Partnerships (MAPP) Phase 1: Partnership Development Phase 2: Visioning Phase 3: The Four Assessments Community Themes & Strengths Forces of Change Local Public Health System Community Health Status Phase 4: Identify Strategic Issues Phase 5: Formulate Goals and Strategies Phase 6: Action Cycle Developed by National Association of County and City Health Officers (NACCHO) and the Centers for Disease Control and Prevention (CDC)

6 Community Development Academia Research Local Public Health System Community Centers Legal Advocates Schools Managed Care Entities Health Department Faith-based Orgs. Justice system Health Care Providers Mass Transit CHWs Community Health Centers Hospitals Civic Groups Philanthropy Housing Substance Abuse Mental Health Elected Officials Fire Employers Social Service Economic Development Environmental Health Parks

7 Partnership for Healthy Chicago Faith Based Academia/ Research Providers Other Government Business City Government Planning, Policy, and Advocacy Medical Legal Partnerships Social Services

8 Healthy Chicago 2.0 Vision and Values A city with strong communities and collaborative stakeholders, where all residents enjoy equitable access to resources, opportunities and environments that maximize their health and well-being Focus on Health Equity

9 Community Themes & Strengths Assessment Goal: To obtain feedback from community and other stakeholders on: Strengths/attributes of neighborhood/chicago Barriers to health and well-being Strategies to improve health Process: Mixed Data Collection Methods 1. Community Conversations 2. Online Neighborhood Survey 3. Smaller focus groups 4. Oral Histories *Data limitations: Limited and not representative of city sample In collaboration with University of Illinois at Chicago School of Public Health

10 Overarching Themes Education Social Cohesion Availability of Services Safety Neighborhood Upkeep Affordability Transportation Policies and Infrastructure Civic Engagement Quality of Life/Equity

11 Forces of Change Assessment Goal: To identify forces (trends, factors, or events) that are or will influence the health and quality of life of the community and the local public health system. Threats Opportunities Process: Gathered data at Community Conversations (Oct-Nov 2014) Partnership for Healthy Chicago further developed responses

12 Overarching Themes Health & Mental Health Housing Safety & Violence Cost-of-Living & Inequality Education Homelessness Food & Food Systems Discrimination & Stigma Climate & Environment Data & Technology Population Change Cultural Competence Policy & Politics

13 Local Public Health System Assessment Goal: To evaluate capacity to perform the Ten Essential Public Health Services, including: strengths, weaknesses and opportunities Process: Convened 75 public health stakeholders and subject matter experts for day-long meeting on Feb 24, 2015 Worked in 5 groups to discuss and score the system Data Limitations: Subject Matter Experts not available to discuss/score all measures

14 Local Public Health System Assessment (LPHSA) Findings Average Essential Public Health Services Performance Scores Overall Score 46.8 ES 1: Monitor Health Status 34.0 ES 2: Diagnose and Investigate 87.5 ES 3: Educate/Empower 48.6 ES 4: Mobilize Partnerships 39.2 ES 5: Develop Policies/Plans ES 6: Enforce Laws ES 7: Link to Health Services ES 8: Assure Workforce ES 9: Evaluate Services No activity: 0% Minimal: 1-25% Moderate: 26-50% Significant: 51-75% Optimal: % ES 10: Research/Innovations Overall Health Equity Score: Moderate 7 essential services scored minimal with regards to equity 3 essential services scored moderate with regards to equity

15 Overarching Findings Strengths Diverse partnerships Community interest New data systems Quality improvement efforts Weaknesses Work in silos Data not timely No comprehensive resource guide Not enough workforce training No evaluation of research Opportunities More cross-departmental efforts Develop standards for community involvement Educate funders on root causes Create 311/211 system Fund coalition building

16 Community Health Status Assessment Goal: To analyze community health & quality of life indicators. Process: ~10 million records of health data ( ) Data Committee and UIC School of Public Health Social determinant lens to health data at the neighborhood level *Data Limitations: All survey data are self-reported; time periods for data not consistent across sources

17 Chicago is a diverse but segregated city, socioeconomically and racially/ethnically, which leads to a disproportionate burden of poor health among certain communities

18 Economic Stability The Hardship Index allowed us to assess economic characteristics (poverty, income, education, housing, employment and dependency) at the neighborhood level. High Hardship strongly correlates to: Inadequate Prenatal care Teen births Self-rated poor health status Smoking Low fruit and vegetable consumption No physical activity Adult obesity Poor mental health Chlamydia incidence Hospitalizations related to heart disease, diabetes and COPD Cervical cancer incidence and mortality Premature mortality Homicides Drug-induced mortality Infant mortality Low hardship correlates to: Breast cancer incidence Suicide Alcohol-Related Mortality

19 Education The Education Opportunity Index allowed us to assess presence and quality of early education and elementary schools at the neighborhood level. Lack of educational opportunity is strongly correlated with: Obesity in children High teen birth rates Lower levels of early prenatal care

20 Neighborhood Infrastructure The Child Opportunity Index allowed us to assess infrastructure elements (education, health, environmental and economic) that facilitate healthy child development at the neighborhood level. Lack of child opportunity in a neighborhood is strongly correlated with: Shootings Elevated blood lead levels Obesity in children Life expectancy at birth Diabetes-related mortality Diet-related mortality Teen births

21 Identified Strategic Issues Overarching strategic issues emerged from all four assessments and vision through: Three (3) Community Conversations Partnership for Healthy Chicago Partnership and CDPH staff prioritized the strategic issues Strategic Issue: Fundamental policy choice or critical challenge that must be addressed for a community to achieve the vision

22 Top Ten Strategic Issues Access to healthcare and social supports Behavioral Health System Chronic Disease Prevention Community Development (Housing, Built Environment Economic Development, Transportation) Data & Research Education Equity Maternal, Child and Adolescent Health Partnerships and mobilizing the community Protect the Public s Health Violence Prevention and Community Safety

23 Action Teams Created Action Teams for each strategic issue Solicited stakeholders/community residents & received > 200 applications Over 150 individuals for Action Teams Teams meet from May-July to develop specific goals, objectives and strategies for their priority area Strategies based on capacity of organizations to implement

24 Preliminary Goals capacity of health services/supports to achieve health equity behavioral health prevention programming to reduce illness and promote well-being. health promotion activities to improve community well-being consumer competence in and use of health system the number of Chicagoans living in stable, safe, and healthy housing. Improve economic vibrancy and diversity in all communities to reduce economic inequity. Develop a Chicago-wide health research agenda Improve surveillance of community-level screening for specific cancers, HTN, diabetes, adult obesity

25 Next Steps Release Healthy Chicago 2.0 in September Launch event Community launch events Develop detailed work plans for each Priority Area for Year 1 Monitor implementation Work with Healthy Chicago Hospital Collaborative to implement strategies Share progress, annually

26 cityofchicago.org/health

27 @ChiPublicHealth /ChicagoPublicHealth

HORIZONS. The 2013 Dallas County Community Health Needs Assessment

HORIZONS. The 2013 Dallas County Community Health Needs Assessment HORIZONS The 2013 Dallas County Community Health Needs Assessment EXECUTIVE SUMMARY The Dallas County Community Health Needs Assessment (CHNA) was designed to ensure that the Dallas County public health