Dorchester Health Initiative

Background and History                                                             

Dorchester, with a population close to 130,000 people, is home to nearly one-quarter of all Boston residents. Over the past twenty years, the population has grown as local Bostonians seeking affordable housing in an ethnically diverse neighborhood have flocked to its six communities. Dorchester has also become a destination for immigrants seeking communities similar to home. The current percentage of minority residents (71 percent vs. only 51 percent for Boston overall) reflects this cultural and ethnic diversity, however, because of language and cultural barriers, healthcare disparities, and other socioeconomic factors, this community is at increased risk for serious health and social problems.

Tufts Medical Center established the Dorchester Health Initiative (DHI)to address health issues disproportionately affecting residents of the various Dorchester neighborhoods. Through the DHI, Tufts Medical Center provides grant funding to innovative programs addressing the priority health needs of the Dorchester community identified with the assistance of the DHI Advisory Committee, comprised of community stakeholders with experience in serving the needs of Dorchester residents.

The Need 

Recently, the Boston Public Health Commission (BPHC) reported in the Health of Boston 2003 report that the minority population in Boston is more likely to be living below the poverty level, more likely to be uninsured, and more likely to have inadequate health care. Additionally, the Health of Boston 2004 report showed that minority residents are disproportionately affected by domestic violence, major health problems like cardiovascular disease and diabetes, and infant mortality. Dorchester specific data supports the findings of the BPHC, and Dorchester, with its high minority population, consistently ranks among the highest for most of the more serious health issues among Boston’s residents.  Health issues that were identified as priorities by the DHI Advisory Committee include: 

Violence

For the period of 1998-2001, Dorchester had the highest percentage of victims with violence-related injuries, with 41 percent (The Health of Dorchester, BPHC, 2002). In 2003, the B-3 and C-11 police precincts in Dorchester reported over 1,979 violent crimes, and in Boston overall, 54 percent of victims of violent crime were Black. To date in 2004, C-11 and B-3 precincts rank 2nd and 3rd in violent crime, and C-11 ranks first in homicide. From January-April 2004, Dorchester’s C-11 and B-3 police precincts reported:

• 668 violent crimes
• 28 non-fatal shootings, up from 18 last year
• 64 percent increase in shootings this Jan-May, compared to last year
• 60 sexual assaults

Asthma

Asthma hospitalization rates among children under age 5 in Dorchester are 12 cases/1,000. This rate is nearly one-third higher than the Boston average of 8/1,000 (The Health of Dorchester, BPHC, 2002). In 2001, the asthma hospitalization rates for black children under five in Boston were 11.4 percent, nearly four times the rate for of white children under five, at 3.4 percent (The Health of Boston, 2003, BPHC).

Cardiovascular Disease

The 1999 Behavioral Risk Factor Surveillance System report showed that Dorchester (and Mattapan—reported together) had the highest percentage of Boston adults ever diagnosed with high blood pressure (22.6 percent) or diabetes (5.5 percent), or considered overweight or obese (59.6 percent). Also, the report showed that Dorchester (and Mattapan, reported together) had the second highest percentage of Boston adults reported as current smokers (19.9 percent). In addition, 68 percent of blacks in Boston are overweight or obese, compared to 41 percent of whites, and the mortality rate in Boston from Diabetes among Blacks is 41.8/100,000, more than double that of whites at16.6/100,000 (Taking Action, Understanding Health Inequities, Barbara Ferrer, 2004).

Infant Mortality and Morbidity 

The infant mortality rate in Dorchester is 8.3 deaths/1,000 live births, compared to the overall rate for Boston at 6.7/1,000 (The Health of Dorchester, BPHC, 2002). According to the report "Taking Action, Understanding Health Inequities," by Barbara Ferrer Ph.D., MPH, former Deputy Director of the BPHC, infant mortality among Blacks in Boston is 12.4/1,000, nearly three times the rate for whites, 4.6/1,000. Pregnancy was the leading cause of hospitalization in Dorchester in 2000, with 32.1 cases/1,000 population, and adolescent births in Dorchester were 14 births/1,000 adolescents, while the rate for Boston is 12/1,000 (The Health of Dorchester, BPHC, 2002).  

DHI Funded Programs

Bird Street Community Center

A program that offers case management services for youth participating in Bird Street’s youth violence prevention program.  This is different than the previous program models which provided a wide array of programming to provide opportunities for art, dance, recreational and entrepreneurial opportunities for the youth in a safe and supportive environment, and responds to youth’s need for positive and supportive relationships with caring professionals to help them navigate the many challenges they encounter.

Codman Square Health Center

A diabetes and obesity prevention program which emphasizes one-on-one education and support for individuals experiencing difficulties in managing their health issues.  The program also provides for links to group activities offered by the health center.

Kit Clark Senior Services 

Neponset Health Center