Healthy Chicago 2.0

Visioning Community Themes & Strengths

Assessment

December 12, 2014

2

• Overview of Process

• Adopt Vision

• Community Themes & Strengths Assessment Findings • Online Survey • Focus Groups and Oral Histories • Community & Stakeholder Conversations

• Discussion of Findings

Presentation Outline

3

Phase 1: Partnership Development

Phase 2: Visioning

Phase 3: The Four Assessments

Phase 6: Action Cycle

Local Public Health System

Community Health Status Forces of Change Community Themes &

Strengths

Phase 4: Identify Strategic Issues

Phase 5: Formulate Goals and Strategies

4

Assessment Timeline

Community Themes & Strengths

Forces of Change

Local Public Health System

Community Health Status

*Dec 12th *Jan 30th *Feb 27th Early Feb

* During Partnership meeting

Strategic Issues

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

• Engage community in Needs Assessment

5

Forces of Change Assessment

• Goal: 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.

• Obtained feedback from Community & Stakeholder Conversations

• Partnership will review and discuss feedback at January 30, 2015 meeting

6

7

• Data analysis of “health” of individuals and community

• Analyze variables by hardship index (income, education, age, employment status, crowded housing)

Health, housing, employment, education, environmental health, climate change, poverty, food access, open space, transportation, built environment, etc.

Community Health Status Assessment

8

• Experts rate the public health system in Chicago

• Ten Essential Public Health Services

• CDC analyzes results

Local Public Health System Assessment

9

“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”

Adopt Healthy Chicago 2.0 Vision

10

• Overview of Process

• Adopt Vision

• Community Themes & Strengths Assessment Findings • Online Survey • Focus Groups and Oral Histories • Community & Stakeholder Conversations

• Discussion of Findings

Presentation Outline

Partners for Community Themes & Strengths Assessment

11

12

• Online survey (English/Spanish) • Focus groups with vulnerable populations • Oral histories (StoryCorps) • Community & Stakeholder Conversations

• Promoted through:

– CDPH Constant Contact list – Social Media (Facebook, Twitter) – Partner listservs

Mixed Data Collection Methods

Online Neighborhood Survey

• Data collection: Nov. 11 – Dec. 8, 2014 • 24 agree/disagree statements, 2 qualitative questions,

demographics • Administered online in English & Spanish • Promoted through:

– CDPH partners and stakeholders – CDPH + City Departments’ social media – Email to Aldermen – CHIdeas (http://www.chideas.org/) – Chicago Public Library

0

10

20

30

10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+

0

20

40

<20K 20-39K 40-59K 60-79K 80-99K 100K+

0

25

50

Excellent Very Good Good Fair Poor

0

20

40

60

< 9thGrade

9-12Grade

HSGrad

SomeCollege

Assoc.Deg.

Bach.Deg.

GradDeg.

0

50

100

Female Male Transgender

0

20

40

60

Hispanic Non Hispanic,Black

Non Hispanic,White

Non Hispanic,Other

Gender Age

Household Income

Health Status

Education

Race- Ethnicity

Sample Demographics (n=1,033)

Crowded Housing Households Below Poverty Unemployment High School Graduation Dependent Population Income

Hardship Index

(Range: 1 to 98)

Methodology source: An Update on Urban Hardship: http://www.rockinst.org/pdf/cities_and_neighborhoods/2004-08-an_update_on_urban_hardship.pdf

Sample Demographics (46% of sample) (25%) (18%) (11%)

Hispanic 14% 15% 22% 52%

Non Hispanic, White 72% 67% 34% 22%

Non Hispanic, Black 8% 14% 41% 22%

Graduate Degree 57% 47% 50% 29%

High School Only 7% 6% 15% 16%

$100,000+ 37% 29% 30% 11%

<$40,000 18% 20% 16% 32%

Q1 Q2 Q3 Q4

Results

Do you agree or disagree with the following statements (n=24)?

How would you make your neighborhood a healthier place to live?

How would you make Chicago a healthier place to live?

9 Domains % Agree

17 Themes

17 Themes

Neighborhood Need (Rank)

City Need (Rank)

1

2

3

Rank Q1 Q2 Q3 Q4

1 Built Environment Healthy Food Healthy Food Safety

2 Healthy Food Neighborhood Upkeep Safety Healthy Food

3 Social Cohesion Safety Neighborhood Upkeep

Neighborhood Upkeep

4 Neighborhood Upkeep Built Environment Built Environment Parks

5 Safety Economic Opportunity Parks Education

Neighborhood Needs (Rank)

Rank Q1 Q2 Q3 Q4

1 Safety Safety Safety Safety

2 Healthy Food Healthy Food Healthy Food Healthy Food

3 Built Environment Built Environment Equity Equity

4 Equity Education Built Environment Education

5 Education Equity Neighborhood Upkeep

Neighborhood Upkeep

City-wide Needs (Rank)

Schools in my neighborhood

have what they need to provide

a high quality education

Children in my neighborhood have access to

high quality education

Education

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

Q1 = 9th Q2 = 9th Q3 = 13th Q4 = 5th

Q1 = 5th Q2 = 4th Q3 = 6th Q4 = 4th

Neighborhood Need (Rank)

City Need (Rank)

There are places for people to

gather in my neighborhood

I feel like I belong in my

neighborhood

I know and talk to my

neighbors

I have felt discriminated against in my

neighborhood

Social Cohesion

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

Q1 = 3rd Q2 = 6th Q3 = 5th Q4 = 10th

Q1 = 9th Q2 = 11th Q3 = 12th Q4 = 8th

Neighborhood Need (Rank)

City Need (Rank)

I feel law enforcement is

responsive in my

neighborhood when needed

I feel safe in my neighborhood

Property crime is a problem in

my neighborhood

Violent crime is a problem in

my neighborhood

0

25

50

75

100

Q1 Q2 Q3 Q4

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

0

25

50

75

100

Q1 Q2 Q3 Q4

Safety

Q1 = 5th Q2 = 3rd Q3 = 2nd Q4 = 1st

Q1 = 1st Q2 = 1st Q3 = 1st Q4 = 1st

Neighborhood Need (Rank)

City Need (Rank)

I have enough money to pay

for my and my family’s basic

needs

Houses and apartments in

my neighborhood are affordable

Affordability

I have access to a personal

checking account to

store my money

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

0

25

50

75

100

Q1 Q2 Q3 Q4

Q1 = 7th Q2 = 15th Q3 = 11th Q4 = 13th

Q1 = 7th Q2 = 10th Q3 = 14th Q4 = 9th

Neighborhood Need (Rank)

City Need (Rank)

I know what is going on in my neighborhood

People in my neighborhood have input on

important community and

city decisions

Civic Engagement

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

Q1 = 16th Q2 = 17th Q3 = 15th Q4 = 8th

Q1 = 18th Q2 = 17th Q3 = 18th Q4 = 18th

Neighborhood Need (Rank)

City Need (Rank)

The streets and sidewalks in my

neighborhood are in good

shape

Houses and apartments in

my neighborhood

are in good shape

Neighborhood Upkeep

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

Q1 = 4th Q2 = 2nd Q3 = 3rd Q4 = 3rd

Q1 = 11th Q2 = 6th Q3 = 5th Q4 = 5th

Neighborhood Need (Rank)

City Need (Rank)

Health services I use are easy to get to from

my neighborhood

My neighborhood

provides social and

recreational opportunities

for me and my family

I have access to healthy food

in my neighborhood

Basic amenities, such as a

grocery store, pharmacy or

library are easily accessible to me

Availability of Services

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

Availability of Services

Q1 = 11th Q2 = 11th Q3 = 9th Q4 = 6th

Q1 = 6th Q2 = 15th Q3 = 10th Q4 = 7th

Q1 = 2nd Q2 = 1st Q3 = 1st Q4 = 2nd

Q1 = 2nd Q2 = 2nd Q3 = 2nd Q4 = 2nd

Access to Health Services

Access to Healthy Food

Neighborhood Need (Rank)

City Need (Rank)

Neighborhood Need (Rank)

City Need (Rank)

My neighborhood is well served

by public transit

I see a lot of people walking or biking in my neighborhood

Transportation

0

25

50

75

100

Q1 Q2 Q3 Q40

25

50

75

100

Q1 Q2 Q3 Q4

Q1 = 1st Q2 = 4th Q3 = 4th Q4 = 9th

Q1 = 3rd Q2 = 3rd Q3 = 4th Q4 = 6th

Q1 = 10th Q2 = 8th Q3 = 18th Q4 = 15th

Q1 = 8th Q2 = 12th Q3 = 7th Q4 = 14th

Public Transportation

Active Transportation

Neighborhood Need (Rank)

City Need (Rank)

Neighborhood Need (Rank)

City Need (Rank)

85.5

67.3

32.7 36.6

0

25

50

75

100

Q1 Q2 Q3 Q4

I am satisfied with the quality

of life in my neighborhood

Q1 = 19th Q2 = 19th Q3 = 16th Q4 = 19th

Q1 = 4th Q2 = 5th Q3 = 3rd Q4 = 3rd

Equity

Quality of Life & Equity

Neighborhood Need (Rank)

City Need (Rank)

Greatest Disparity? (Q1-Q4)

• Children in my neighborhood have access to high quality education (Q1-Q4=52%)

• Houses and apartments in my neighborhood are in good shape (52%)

• People in my neighborhood have input on important community and city decisions (50%)

• I am satisfied with the quality of life in my neighborhood (49%)

• I feel safe in my neighborhood (46%)

Jennifer Hebert-Beirne, PhD, MPH,

Assistant Professor

Jennifer Felner, MPH, PhD Student, TA

Students in Fall 14 Community Health Sciences 431:

Community Health Assessment

Partnership for a Healthy Chicago

Community Themes & Strengths:

Qualitative Research

Students in Fall 2014 CHSC 431:

Community Health Assessment Jennifer Anderson

Jinsun Baek

Kaijah Blackwell

Anna Browar

Brynn D. Foss

Kelsey Gruss

Nicole Gulich

Jonathan Hofacker

Demonica Jones

Reem Kieso

Christina Larson

Jill Massino

Mwia Mutua

Geoyia Nightengale

Jennifer Norsworthy

Christina Pate

Marisa Pochter

Raeesa Sadat

Tina Schuh

Anne Scobel

Sunny Seto

Grace Sherman

Desmona Strahan

Kimi Suh

Pete Thomas

Cristina Turino

Milona Van Kanegan

Sarah Wagener

Sarah Wright

Lindsay Zeman

Special Guests: Dolores and

Yvette Castaneda

MAPP: Community Themes & Strengths

• Provides a deep understanding of the issues

residents feel are important by answering the

questions,

• “What is important to our community?”

• “How is quality of life perceived in our community?”

• “What assets do we have that can be used to

improve community health?”

MAPP, Users Handbook

Constructs of Interest

Focus Group Guide Oral Histories Probes

Thinking of a broad definition of health what is

healthy about your community?

• What do you like about your

community?

• What are some things that support

healthy living in Chicago?

CDPH is concerned with health equity, or fair

opportunities for all to be healthy.

• Thinking of health equity what are the

biggest challenges to being healthy in

your community?

• What are some barriers to being

healthy in Chicago?

• When you think about the health of your

community: What are the barriers to

good health?

• What does living in the Little Village

community mean to you?

• How have your health needs and impacted

your life?

• Describe your experience when seeking

support or receiving services for health or

social needs.

• Can you tell me a story that happened in

your life that changed you?

• How has your work impact your health?

• Tell me about a person who has made a

positive difference in your life.

Data Collection and Analysis Process

• Recruitment: Community partners

• Purposive, convenience samples

• IRB approved, UIC & CDPH

• Consent to participate/StoryCorps, Inc.

• Data sharing agreement

• Logistics

• FG 8-11 members

• 90 minutes

• Qualitative data analysis – coding, memoing, theme

identification

The Day Reporting

Center of the Cook

County Sheriff’s

Office

Qualitative Data Collection

Focus Groups

• Female Parishioners • Douglas • N=10

Apostolic Faith Church

• Formerly Incarcerated ♂ • North Lawndale • N=10

Alumni Association

• Young Mothers • Austin • N=8

New Moms, Inc.

• Homeless Families • Englewood • N=11

Catholic Charities

Family Shelter

• Hotline Volunteers • Pilsen/Lower W. Side • N=9

Metro Tenants Association

Oral Histories

6 Residents of Little Village/S.Lawndale

• 2 men, 4 women

• 2 homeless

• 2 disabled

• 4 in Spanish

• 2 community activists

Overall Themes

Needs • Inaccessible

community resources

• Inequities & injustice in opportunities

• Accumulative stress, discrimination

• Familial financial insecurity

• Contested space, unsafe

Assets

• Agency and efficacy

• Community engagement, involvement

• Faith as nourishment & resilience

Crosscutting Issues

• Mistrust of and inability to navigate mainstream society

• Lack of autonomy, sense of Powerless

Apostolic Faith Church

Assets

Desire to be healthy

Faith Connects

Needs

Critical attn to SDoH

Real, long term

collaboration

Health Education not trickling down

Crosscutting Issues

Research integrity & commitment

Respect & trust in PH

practice

Alumni Association

Assets

Spirituality

Knowledge, but inaction

Individual responsibility & Self-determ.

Needs

Inaccessible resources

Financial instability

Lack of opportunity

Crosscutting Issues

Accumulated stress

Unhealthy counter-culture

New Moms, Inc.

Assets

‘Nosy neighbors’

Youth as power

Needs

Safety

Resources & services

Basic living support

Advocacy

Crosscutting Issues

Powerlessness

Social support

Vulnerability

Catholic Charities

Family Shelter

Assets

Social network

& support

Hope

Needs

Unmet health care needs

Quality community

schools

Youth engage. opportunities

“Homes not rooms”

Crosscutting Issues

Lack transport. → isolation

Distrust of formal support

Instability

Lack of autonomy

Discrimination

Assets

Community capacity

Social support

School programs

Healthcare facilities

Needs

↑ Community involvement

Health education

Enforce housing regs. & public safety

Inadequate health literacy

Crosscutting Issues

Inequities in healthcare

Food justice

Rights, regs. & policies

Community engagement

Discrimination

Assets

Resiliency, Cultural Riches

Faith & spirituality

Social support &

accompaniment

Needs

Fear, violence → more safety

Isolation/ “living in a

bubble”

Aging, living w/

disabilities

Crosscutting Issues

Stress burden &

accumulation of stress

Difficulty nav. mainstream

systems, institutionalized

racism

Oral Histories

Community & Stakeholder Feedback

• Forces & trends impacting health status/system

44

Conversations in Communities (167 participants)

Other Groups Chicago Board of Health meeting

Violence Prevention Providers

Chicago Interdepartmental Task Force on Childhood Obesity

Partnership for Healthy Chicago

CDPH Management/Staff

Mikva Youth Group

n=299

“What are the attributes of your neighborhood/Chicago that improve health and well-being?”

Resources • Parks/Open Space/Physical Activity • Healthy Food/Grocery Stores • Transportation/Divvy Bikes • Affordable Housing • Community services, some low-

cost/free • Health Care Centers, including

school-based • Faith-based institutions • Lots of small businesses

Programming • Nutrition • Crisis Intervention Teams • Restorative Justice • Violence Prevention • Seniors—Wellness programs • Youth--focus on prevention and

homelessness • Medicaid enrollment in prisons/jails

Strengths/Attributes Policies • Affordable Care Act • Environment/tobacco control • Education

– Recess

– Roll back of Zero Tolerance

• Economic – Living Wage

• Maternity leave • Food access

Culture/Cultural Resources • Diversity of Population • Public Artwork • Many longstanding trusted institutions

Power Distribution/Engaged Communities • Participatory Budgeting • Volunteerism/voter registration • Community activism

Collaboration • Health system collaboration • Community involvement in needs

assessments • Medical/Legal partnerships

“What are the barriers to achieving health and well-being?” Overall Barriers: • Lack of Long-Term Funding • Lack of Political Will • Lack of attention to health issues • Inequity in Income, Resources, Community-

owned assets • Employment/Jobs • Public Transportation • Health Care/Mental health services • Housing • Parks • Quality schools • Institutionalized racism/disproportionate

minority contact with police

Which may lead to: • Violence, causing fear

and stress • Isolation/lack of

community involvement/distrust

• Environmental health disparities

• Lack of information about available resources

“What can we (the public health system/communities) do over the next 3-5 years to improve health and well-being?” Ensure focus on vulnerable

populations/communities • Youth Minorities

• Disabled Trauma-impacted

• Bilingual

Enhance and sustain collaboration and community involvement • Multi-sectoral partners

• CDPH needs to be a leader

• More Community-Based Participatory Research

Strengthen laws/enact policies and utilize governmental influence • Health in All Policies • Environmental

– Petcoke

– Residential Healthy Homes Inspections

– Smoke-free

• Healthy Foods • Establish Taxes

– Tobacco

– Pass IL Fair Tax Law

– Making IL tax increase permanent

Strategies to improve health

Improve/expand services, resources, workforce • Health services

– Oral health – Health & social service in schools – Worksite wellness – Assess real needs/gaps for mental

health and substance abuse

• Social Determinants of Health – Employment (including youth) – Beautification of community – Accessible transportation – Community resources – Increase funding for schools – Increase restorative justice

programming

Enhance Communication/ Technology • 211/Resource guides • Grow technology use in health sector/providers

Discussion and Feedback

Cross Cutting Themes

• Inequity connected to poor health

• System mistrust and distrust

• Community Infrastructure and Needs

• Community Involvement/Engagement

• Policy and Resources