Published on 09/3/2007

PLACE MATTERS Suffolk County Team partners include the Boston Public Health Commission, the Boston Disparities Project, Boston STEPS, and the Boston Medical Center.

Please note: The following indicators are specific to Boston and will be used as a proxy for health assessment across the county as the metro area account for almost 90% of the county’s population.

Obesity and overweight and violence are two areas of public health concern for Suffolk County. Sixty four percent of Black and 55.6% of Latino adults were identified as overweight compared to 43.2% of White adults. Approximately, 14.6% of Black and 19.7% of Latino youth were overweight as compared to 7.6% of their White counterparts. Though rates for obesity and overweight are lower in Asian adults and youth, these rates are increasing. Black and Latinos are disproportionately represented as nonfatal and fatal shooting victims, where youth ages 14-21 make up half the victims. While Black Bostonians represent 24% of the Boston population, they are 74% of the victims of gun violence in the city. While representing 14% of the City’s overall population, Latino Bostonians are 24% of its stabbing victims. (BPHC Data Report, June 2005)

Why are the issues of obesity and overweight and violence important public health issues for Suffolk County?

People of color make up almost half of Boston’s population
Youth are significantly affected
Continuing increases in obesity and overweight and violence within a large proportion of the county’s population will lead to: 1) Significant increases in medical costs due to associated medical conditions, 2) Decreased labor and productivity
Both issues are interrelated in terms of populations affected, impact on health behaviors, and social conditions that lead to each

Social conditions that are driving obesity and overweight and violence in Suffolk County include:

Poverty
Lack of access to affordable healthy foods
Unequal distribution of physical activity opportunities
Educational inequality
Lack of employment opportunities
Residential Segregation
Community violence

Objective and Targeted Actions	Partners	Anticipated Results / Outcome(s)	Social Condition(s) Impacted
Objective: Ensure that all residents of Boston receive best care possible Actions: a. Complete and post Data Collection Regulation guidelines (Jul 2007) b. Develop and manage database system for data collection from all acute care city hospitals. (Jul 2007) c. Offer technical assistance (Jul 2007-2008) d. Identify key stakeholders and convene Health Equity Committee to identify QI indicators (Jul –Oct 2007) e. Report out on year one data collection (Jul2007- 2008)	Division of Healthcare Finance and Policy; Massachusetts Department of Public Health ; Massachusetts General Hospital’s Institute for Health Policy; Massachusetts League of Community Health Centers; Community Health Centers; Hospitals; COBTH	Use information from data collection system to identify and reduce disparities in clinical outcomes and practices, incorporating them into performance assessment and quality improvement activities	TBD upon reporting
Objective: Lead policy and advocacy efforts for racial and ethnic health disparities related legislation. Actions: a. Coordinate legislative advocacy efforts for racial and ethnic health disparities related bills including public education and outreach, preparing testimonies and organizing panels. Bills supported include: Health Disparities Bill, Violence Prevention Bill, Re-entry Bill, and Chronic Disease and Overweight Prevention Bill. (Ongoing)	Health care for All; Boston Public Health Commission programs including: Health Van, Asthma and Diabetes Program, Boston Steps, Reach 2010, School Based Health Centers, Healthy Baby Healthy Child, Community Initiatives Bureau	Establishment of a state level office to address racial and ethnic health disparities; Reduce obesity and overweight through support for implementation of school wellness policies; Reduce incidence of violence through voluntary regulations for the establishment of programs to protect victims of violence	All
Objective: Neighborhood investment and capacity building in communities, community institutions, organizations and coalitions to improve social and economic environment in communities. Actions: a. Fund neighborhood-based activities around four key areas: workforce diversity, patient navigation, healthy food access and obesity prevention and violence prevention. (Dec 2006-Nov 2007) b. Provide technical assistance and training around messaging, program development, and participation in public policy. (Dec 2006-Nov 2007) c. Develop and implement monitoring and evaluation plan to measure and track city-wide progress in key target areas for new and continuing grantee partnerships. (Dec2006-Nov 2007) d. Develop and release Year Three RFP (Jun-Sept 2007) e. Summarize available research on social determinants in Boston that affect key project areas. (Ongoing) f. Year Two Report and other special issue reports for public use and policy development. (Jul- Dec 2007)	Community Institutions: Sociedad Latina, Mission Works, The Food Project, Dana Farber Cancer Institute, The Medical Foundation, Massachusetts Alliance for Portuguese Speakers, We Are Educators a Touch of Class, Louis D. Brown Peace Institute, Project R.I.G.H.T, Bunker Hill Community College, Victory Programs, Inc., Multicultural Aids Coalition (MAC), Hispanic Office of Planning and Evaluation (H.O.P.E.), Vietnamese American Civic Organization, American Red Cross of Massachusetts Bay, Pink and Black, Kelley Chunn Associates, Massachusetts Immigrant and Refugee Coalition Community health centers and hospitals including: Mattapan Community Health Center, Roxbury Community Health Center, Neponset Health Center, Boston Medical Center Boston Public Health Commission programs and bureaus including: Boston Trauma Project, Boston Steps, Community Initiatives Bureau, Racial and Ethnic Health Disparities Bureau, Reach 2010 Coalition	Increase healthy food and healthcare access, workforce diversity and prevent violence to reduce obesity and overweight and violence.	All
Objective: Establish intra and inter-sectoral linkages and partnering between community institutions and organizations and city agencies to increase access to healthy, affordable food options, increase access to healthcare, increase workforce diversity, and to reduce community violence. Actions: See action steps a) and b) under previous objective. Actively pursue funding particularly for Food Access and Violence Prevention. Food Access: Submit Kellogg Foundation proposal with partners (community members, farmers/growers, community health centers, hospitals, city agencies, tenants associations, faith-based organizations, universities): Boston Food and Fitness Collaborative. *Received 4/2/07* Violence Prevention: Robert Wood Johnson Grant application (due Jul 2007) Identify contracting staff for Boston Collaborative for Food and Fitness; organize neighborhood clusters to carry out food, fitness assessments. Develop assessment tools along with comprehensive review of existing literature related to food and fitness. Conduct assessments of social, cultural, economic and environmental factors at the city and regional levels in three areas: food, fitness and cross-cutting issues. (May-Aug 2007) Identify Director for newly created Violence Prevention program. (In process) Comprehensive review of community health center violence prevention protocols to inform health center protocol development to address community violence. (Jul-Dec 2007)	City agencies including: Boston Police Department, Boston Redevelopment Authority, Department of Neighborhood Development, Boston Center for Youth and Family Services, Boston Public Schools, Department of Parks and Recreation, Boston Housing Authority, The Boston Center for Youth and Families Community Institutions: Northeastern University, Sociedad Latina, Mission Works, The Food Project, Dana Farber Cancer Institute, The Medical Foundation, Massachusetts Alliance for Portuguese Speakers, We Are Educators a Touch of Class, Louis D. Brown Peace Institute, Project R.I.G.H.T, Bunker Hill Community College, Victory Programs, Inc., Multicultural Aids Coalition (MAC), Hispanic Office of Planning and Evaluation (H.O.P.E.), Vietnamese American Civic Organization, American Red Cross of Massachusetts Bay See Boston Food and Fitness Collaborative list Community Health Centers and Hospitals including: Mattapan Community Health Center, Roxbury Community Health Center, Neponset Health Center, Boston Medical Center, Massachusetts General Hospital, Brigham and Women’s Hospital Boston Public Health Commission programs and bureaus including: Boston Trauma Project, Boston Steps, Community Initiatives Bureau, Racial and Ethnic Health Disparities Bureau	Increase access to opportunity structures in order to reduce obesity and overweight and violence related injuries	All

Suffolk County Team Profile

People of color make up almost half of Boston’s population
Youth are significantly affected
Continuing increases in obesity and overweight and violence within a large proportion of the county’s population will lead to: 1) Significant increases in medical costs due to associated medical conditions, 2) Decreased labor and productivity
Both issues are interrelated in terms of populations affected, impact on health behaviors, and social conditions that lead to each

Social conditions that are driving obesity and overweight and violence in Suffolk County include:

Poverty
Lack of access to affordable healthy foods
Unequal distribution of physical activity opportunities
Educational inequality
Lack of employment opportunities
Residential Segregation
Community violence

Objective and Targeted Actions	Partners	Anticipated Results / Outcome(s)	Social Condition(s) Impacted
Objective: Ensure that all residents of Boston receive best care possible Actions: a. Complete and post Data Collection Regulation guidelines (Jul 2007) b. Develop and manage database system for data collection from all acute care city hospitals. (Jul 2007) c. Offer technical assistance (Jul 2007-2008) d. Identify key stakeholders and convene Health Equity Committee to identify QI indicators (Jul –Oct 2007) e. Report out on year one data collection (Jul2007- 2008)	Division of Healthcare Finance and Policy; Massachusetts Department of Public Health ; Massachusetts General Hospital’s Institute for Health Policy; Massachusetts League of Community Health Centers; Community Health Centers; Hospitals; COBTH	Use information from data collection system to identify and reduce disparities in clinical outcomes and practices, incorporating them into performance assessment and quality improvement activities	TBD upon reporting
Objective: Lead policy and advocacy efforts for racial and ethnic health disparities related legislation. Actions: a. Coordinate legislative advocacy efforts for racial and ethnic health disparities related bills including public education and outreach, preparing testimonies and organizing panels. Bills supported include: Health Disparities Bill, Violence Prevention Bill, Re-entry Bill, and Chronic Disease and Overweight Prevention Bill. (Ongoing)	Health care for All; Boston Public Health Commission programs including: Health Van, Asthma and Diabetes Program, Boston Steps, Reach 2010, School Based Health Centers, Healthy Baby Healthy Child, Community Initiatives Bureau	Establishment of a state level office to address racial and ethnic health disparities; Reduce obesity and overweight through support for implementation of school wellness policies; Reduce incidence of violence through voluntary regulations for the establishment of programs to protect victims of violence	All
Objective: Neighborhood investment and capacity building in communities, community institutions, organizations and coalitions to improve social and economic environment in communities. Actions: a. Fund neighborhood-based activities around four key areas: workforce diversity, patient navigation, healthy food access and obesity prevention and violence prevention. (Dec 2006-Nov 2007) b. Provide technical assistance and training around messaging, program development, and participation in public policy. (Dec 2006-Nov 2007) c. Develop and implement monitoring and evaluation plan to measure and track city-wide progress in key target areas for new and continuing grantee partnerships. (Dec2006-Nov 2007) d. Develop and release Year Three RFP (Jun-Sept 2007) e. Summarize available research on social determinants in Boston that affect key project areas. (Ongoing) f. Year Two Report and other special issue reports for public use and policy development. (Jul- Dec 2007)	Community Institutions: Sociedad Latina, Mission Works, The Food Project, Dana Farber Cancer Institute, The Medical Foundation, Massachusetts Alliance for Portuguese Speakers, We Are Educators a Touch of Class, Louis D. Brown Peace Institute, Project R.I.G.H.T, Bunker Hill Community College, Victory Programs, Inc., Multicultural Aids Coalition (MAC), Hispanic Office of Planning and Evaluation (H.O.P.E.), Vietnamese American Civic Organization, American Red Cross of Massachusetts Bay, Pink and Black, Kelley Chunn Associates, Massachusetts Immigrant and Refugee Coalition Community health centers and hospitals including: Mattapan Community Health Center, Roxbury Community Health Center, Neponset Health Center, Boston Medical Center Boston Public Health Commission programs and bureaus including: Boston Trauma Project, Boston Steps, Community Initiatives Bureau, Racial and Ethnic Health Disparities Bureau, Reach 2010 Coalition	Increase healthy food and healthcare access, workforce diversity and prevent violence to reduce obesity and overweight and violence.	All
Objective: Establish intra and inter-sectoral linkages and partnering between community institutions and organizations and city agencies to increase access to healthy, affordable food options, increase access to healthcare, increase workforce diversity, and to reduce community violence. Actions: See action steps a) and b) under previous objective. Actively pursue funding particularly for Food Access and Violence Prevention. Food Access: Submit Kellogg Foundation proposal with partners (community members, farmers/growers, community health centers, hospitals, city agencies, tenants associations, faith-based organizations, universities): Boston Food and Fitness Collaborative. *Received 4/2/07* Violence Prevention: Robert Wood Johnson Grant application (due Jul 2007) Identify contracting staff for Boston Collaborative for Food and Fitness; organize neighborhood clusters to carry out food, fitness assessments. Develop assessment tools along with comprehensive review of existing literature related to food and fitness. Conduct assessments of social, cultural, economic and environmental factors at the city and regional levels in three areas: food, fitness and cross-cutting issues. (May-Aug 2007) Identify Director for newly created Violence Prevention program. (In process) Comprehensive review of community health center violence prevention protocols to inform health center protocol development to address community violence. (Jul-Dec 2007)	City agencies including: Boston Police Department, Boston Redevelopment Authority, Department of Neighborhood Development, Boston Center for Youth and Family Services, Boston Public Schools, Department of Parks and Recreation, Boston Housing Authority, The Boston Center for Youth and Families Community Institutions: Northeastern University, Sociedad Latina, Mission Works, The Food Project, Dana Farber Cancer Institute, The Medical Foundation, Massachusetts Alliance for Portuguese Speakers, We Are Educators a Touch of Class, Louis D. Brown Peace Institute, Project R.I.G.H.T, Bunker Hill Community College, Victory Programs, Inc., Multicultural Aids Coalition (MAC), Hispanic Office of Planning and Evaluation (H.O.P.E.), Vietnamese American Civic Organization, American Red Cross of Massachusetts Bay See Boston Food and Fitness Collaborative list Community Health Centers and Hospitals including: Mattapan Community Health Center, Roxbury Community Health Center, Neponset Health Center, Boston Medical Center, Massachusetts General Hospital, Brigham and Women’s Hospital Boston Public Health Commission programs and bureaus including: Boston Trauma Project, Boston Steps, Community Initiatives Bureau, Racial and Ethnic Health Disparities Bureau	Increase access to opportunity structures in order to reduce obesity and overweight and violence related injuries	All