The Well-Being of Everett - Cambridge Health Alliance

Transcription

The Well-Being of Everett
2014 Health Assessment Report
Authorization to reproduce this document in whole or in part is
granted. While permission to reprint this publication is not necessary,
the citation should be: The Well-Being of Everett, 2014 Health
Assessment Report.
For information on this publication or to request copies,
contact 617-394-7632 or krobrien@challiance.org.
This publication and other resources are available on the Internet at
www.challiance.org/EverettWellbeing2014
©2014 Cambridge Health Alliance, Institute for Community Health.
All rights reserved.
The Well-Being of Everett 2014
Table of Contents
1. Letter from Mayor DeMaria Jr. and Patrick Wardell,
CEO at Cambridge Health Alliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3. Summary of Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4. City of Everett Demographics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
5. Social Determinants of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Economy, Housing and Employment. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Built and Natural Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- Community. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
13
17
23
30
34
6. Leading Health Indicators. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
- Physical Activity and Nutrition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
- Tobacco. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
- Substance Abuse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
- Mental Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
- Violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
- Sexual and Reproductive Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
- Maternal Child Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
- Chronic Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
- Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
- Access to Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
7. Youth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
- Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
- Physical Activity and Nutrition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
- Tobacco. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
- Substance Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
- Mental Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
- Violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
- Sexual and Reproductive Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
8. Data Sources and Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
9. Acknowledgements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
10. Programs, Partners, and Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
11. Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
- Tables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
- 10 Essential Public Health Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Everett Community Health Partnership
Dear Everett Residents
ECHP Mission
To improve the health and quality of life of the
people of Everett by creating opportunities for
individuals, families and organizations to work
collaboratively and strategically in addressing
important challenges facing the community.
ECHP Members (partial list)
A Better Tomorrow Services, Inc.
Boys and Girls Club of Everett
Cambridge Health Alliance
Eliot Community Human Services
Everett Chamber of Commerce
Everett Health, Human Services, Planning &
Police Departments
Everett Public Library
Everett Public Schools
Everett Substance Abuse Coalition
For Kids Only Afterschool
Grace Episcopal Church
Hallmark Health
Immaculate Conception Church
Joint Committee for Children’s Health Care
in Everett
La Comunidad, Inc.
Malden YMCA
MGH Everett Family Care Medicine
Mystic Valley Elder Services
North Shore Evangelical Missionary Church
Our Lady of Grace Church
Portal To Hope
Tri-City Community Action Program
Whidden Memorial Hospital
Zion Baptist Church
The City of Everett, in partnership with the Cambridge Health
Alliance and the Institute for Community Health and the
other members of the Everett Community Health Partnership,
have produced The 2014 Everett Health Assessment Report.
The goal of this report is to inform the community about the
health status of Everett and to provide a baseline for planning
and improving the many crucial community health programs
that serve the people of Everett.
The 2014 Everett Health Assessment Report provides current
information about key health indicators, such as physical
fitness and nutrition, substance abuse, mental health,
sexual behavior, violence, chronic illness, cancer and access
to care. Additionally, the report provides information on
social determinants of health that affect the community
including education, employment, housing, the built and
natural environment, and community-building resources.
Each section of the report includes information on the many
strengths and assets of Everett as well as recommendations
for expanding and building on these existing resources to
improve the community’s health. This year we have included
a section dedicated to youth health and well-being as they
represent the future of Everett.
It is our hope that The 2014 Everett Health Assessment
Report will be both accessible and provocative, and that it
will increase the community’s curiosity about the health of all
Everett residents. We welcome each member of the Everett
community to join us in making Everett an even healthier
and more vibrant city.
Carlo DeMaria, Jr.
Mayor, City of Everett
Patrick Wardell,
Chief Executive Officer,
The Well-Being of Everett • 2014 Health Assessment Report
1
Introduction
What is the Well-Being of Everett Report?
The Well-Being of Everett Report provides the
reader with a summary of the health of our city.
It compiles data related to public health from
a variety of sources. It highlights the strengths
and assets in our community, identifies areas of
concern, and makes recommendations to help
guide future work.
Why Create the Well-Being of Everett Report?
The Well-Being of Everett Report is intended
to serve as a tool for local leaders, community
agency members, directors and other
stakeholders to continue to learn together
about the public health issues of the community.
It provides a baseline for planning and improving
the many crucial community health programs
that serve the people of Everett. It helps identify
where we are making progress and where we
have substantial gaps in health and well-being for
vulnerable groups in Everett. Furthermore, it will
help identify policy or programming opportunities
to help address these gaps. The hope is that this
book will facilitate a dialogue between agencies
and residents, stimulating collaborative work
toward making Everett a healthier city.
Who Created the Well-Being of Everett Report?
This Report is the result of contributions from
across the City of Everett – from community
members, agencies and service providers, to city
and public school employees. The coordination
of this effort was led by the Everett Community
Health Partnership (ECHP) and the Institute of
Community Health (ICH) at Cambridge Health
Alliance, in collaboration with the City of Everett
Health Department. A list of authors, partner
organizations, and other contributors is featured
in the acknowledgements section.
2
Why is there a Section on the
Social Determinants of Health?
The Everett Community Health Partnership is
committed to ensuring that everyone in Everett
has access to good healthcare. We are equally
committed to ensuring that everyone in Everett
has access to other critical determinants of
good health: a good education, a living wage
job, healthy food, safe and affordable housing,
a supportive built and natural environment and
social inclusion and support. The need for policies
and programs that address these societal level
factors will require continued collective action
by residents and community leaders.
Well-Being of Everett Report User Guide:
The Report is divided into four main chapters:
1) Demographics 2) Social Determinants of
Health (Education, Housing, Economy and
Employment, Built and Natural Environment and
Community) 3) Leading Health Indicators and
4) Youth. Each section in the Social Determinants
and Health Indicators chapters follows a similar
format: introduction of the topic, data and data
analysis, topical information, strengths and assets
and recommendations for future collaborative
action. The Report can be found on the websites
of the Everett Health Department and the Everett
Community Health Partnership at Cambridge
Health Alliance.
Summary of Recommendations
SOCIAL DETERMINANTS OF HEALTH
LEADING HEALTH INDICATORS –
COMMUNITY-WIDE
Education
• Address the needs of out-of-school youth and
other vulnerable youth populations to ensure
access and support for high school completion.
Physical Activity and Nutrition
• Continue to expand public spaces for all
residents to engage in physical activity.
• Develop stronger systems of communication
and support for non-English speaking parents
to improve educational outcomes and high
school completion rates for their children.
• Offer media programming and education
on healthy eating options, including recipes,
shopping tips for low-cost meals and cooking
demonstrations.
Employment
• Ensure that new development projects include
provisions for creating good jobs at a living
wage and job training for local residents.
Tobacco
• Increase access to information on smoking
cessation resources in local businesses, city
buildings and local media outlets including
cable television.
Housing
• Ensure adequate representation of Everett’s
diverse community (including renters) in
discussions of the Housing Production Plan.
Built and Natural Environment
• Adhere to Complete Streets Resolution and
accompanying Healthy Design Guide in all
future planning projects to ensure that healthy
and active transportation options are available
to all.
Community
• Increase the number of intergenerational,
interethnic and interracial community
building projects.
• Encourage and support mechanisms to
increase representation of Everett’s diverse
populations on City Council, Boards and
Commissions.
Substance Abuse
• Develop support networks for parents, family
members, and friends coping with their loved
ones who are struggling with addiction and
dealing with substance abuse disorders.
• Advocate for increased funding for prevention
and treatment services dedicated to substance
abuse for all ages.
Mental Health
• Develop educational opportunities to reduce
stigma associated with mental health issues
and the importance of asking for help.
• Expand access to mental health services at
home in a cost-effective way, especially for
adults who are homebound and seniors.
Violence
• Support and facilitate help-seeking where
family violence occurs.
Sexual Health and Reproduction
• Develop a plan to reach out to the men having
sex with men (MSM) population to increase
awareness of testing and treatment services
available in Everett.
3
Maternal Child Health
• Adopt supportive work policies for new
and expecting families, family leave for
part-time workers, personal days to attend
prenatal doctor appointments and follow up
postpartum appointments.
Tobacco
• Review and expand tobacco compliance
efforts to reduce tobacco sales to minors.
Chronic Disease
• Expand community and health providers
focus on understanding the factors impacting
lung diseases in Everett.
Substance Abuse
• Increase information and outreach to middle
school parents regarding the importance of
talking to their children about alcohol and
other drug use.
• Increase primary care services for adults
and children in Everett.
• Fund a Wellness Program within the Health
Department based on programs piloted by
Energize Everett to increase fitness, nutrition
and cooking programs throughout the city.
Cancer
• Organize community-wide efforts to educate
Everett residents about cancer risk and
encourage residents to take advantage of
screening, early detection and potential
curative treatment for common cancers.
Access to Healthcare
• Increase access to affordable dental/oral
healthcare for all residents.
LEADING HEALTH INDICATORS - YOUTH
Physical Activity and Nutrition
• Continue and expand Family Fitness Nights,
which allows and encourages non-structured
active play for youth and families in school
gyms after hours.
• Continue and expand schoolyard gardens
to all Everett Public Schools, and work to
incorporate produce into school meals in
spring and fall.
4
• Continue tobacco prevention education in
the schools to raise awareness of the harm of
tobacco products including e-cigarettes.
Mental Health
• Provide Youth Mental Health First Aid trainings
to teach parents, family members, caregivers,
teachers, school staff, peers, neighbors,
health and human service workers, and other
caring citizens how to help adolescents who
are experiencing mental health or addiction
challenges, or are in crisis.
Violence
• Increase supportive programs and mentoring
for adolescent girls who are at high risk of
becoming victims of violence and abuse.
• Increase funding for programs working with
youth such as the Everett Boys and Girls Club,
ROCA, For Kids Only Afterschool program, and
the Joint Committee for Children’s Health Care
to continue to support youth positively in
their development.
Sexual and Reproductive Health
• Conduct outreach to Everett youth up to age
24 to increase awareness of services at the
Teen Health Center at Everett High School
including students at Pope John and the local
charter schools.
Demographics
Based on the 2011 American Community Survey
Estimate, the current population of Everett is
41,079, representing an 8% increase from the
2000 US Census level. With its residents living in
3.4 square miles, Everett is the fifth most densely
populated city in Massachusetts with 12,082
people per square mile.
The highest proportion of Everett residents
(24.5%) is between 45 and 64 years old.
This finding is similar to the data for Massachusetts
overall. Between 2000 and 2011, the age groups
that increased as a proportion of the total
population number included children under 5
years old (5.9% to 6.7%) and adults aged 45 to
64 (24.5% to 27.4%), while proportion of adults
aged 65 and older decreased between 2000
and 2011 (14.8% to 11.7%). Other age groups
remained stable. Compared to Massachusetts,
Everett has a younger resident population with
a median of 35.6 years compared to 38.9 years
in MA.
More specifically, Everett has higher proportions
of children under five, more adults age 25 to 34,
and fewer adults 65 years old and over compared
to MA. Furthermore, the birth rate among women
age 20 to 29 in Everett is almost twice the state’s
birth rate in this age group.
For additional information on the youth of Everett,
please see the Youth section of this report.
BASED ON THE 2011
AMERICAN COMMUNITY
SURVEY ESTIMATE,
the current population
of Everett is 41,079,
representing an 8%
increase from the
2000 US Census level.
The Well-Being
Well Being of Everett • 2014 Health Assessment Report
5
xx
Age Distribution of Residents (2000 & 2011)
Everett 2000
Percent of Population
100
90
80
70
60
50
40
30
20
10
0
Everett 2011
MA 2011
5.9 6.7 5.6
12.312.112.2 12.411.814.3
Under 5
Years
5 to 14
Years
15 to 24
Years
18.418.1
16.415.314.0
12.9
25 to 34
Years
24.5
19.9
35 to 44
Years
27.4
45 to 64
Years
14.8
11.713.7
65 Years
or Older
SOURCE: US Census, 2000; US Census ACS, 2007-2011
Functional Needs of Everett Residents age 65 or older
Count
Residents age 65 or older
%
4,913
With any Disability
2,285
46.5%
Hearing Difficulty
619
12.6%
Vision Difficulty
268
5.5%
Cognitive Difficulty
440
9.0%
1,624
33.1%
228
4.6%
1,047
21.3%
Ambulatory Difficulty
Self-Care Difficulty
Independent Living Difficulty
Source: US Census Bureau, American Community Survey, 2012 3-year Estimates
Increasing Diversity
Both the City of Everett itself and the Everett Public Schools have
become markedly more diverse in the past decade. Between 2000 and
2011, the proportion of Black or African American and Hispanic or
Latino residents in Everett have each doubled, while the non-Hispanic,
White population has decreased from 75% to 62%. Compared to
Massachusetts as a whole, Everett now has significantly higher
proportions of Black or African American residents (13% vs. 6%) and
Hispanic or Latino residents (18% vs. 9%), but fewer Asian residents
(3% vs. 5%).
6
Seniors
Seniors remain a significant
segment of Everett residents
(over 10% of the population
is age 65 or older). There are
many dedicated resources
and services available for
Everett seniors to access.
The Council on Aging,
housed at the Connolly
Center, offers social,
economic and healthfocused activities to help
seniors in Everett stay
healthy and active. Mystic
Valley Elder Services, based
in Malden, also connects
seniors and adults of all
ages living with disabilities
to services and resources
that support their health,
well-being, and independence. In Everett, nearly
half of seniors (46.5%) live
with some type of disability,
so having programs and
agencies, such as the Council
on Aging and Mystic Valley
Elder Services, dedicated to
seniors is very important for
the health of seniors, their
families, and our community.
Percent of Population
100
90
80
70
60
50
40
30
20
10
0
Race/Ethnicity of Residents (2000 & 2011)
Everett 2000
76.9
75.2
Everett 2011
61.6
MA 2011
18.2
9.5
Hispanic or
Latino
White, Non
Hispanic
13.2
9.3
6.1
6
Black or African
American
3.2
5.3
3.3
6.3
3.9
2.4
Other+
Asian
+Includes American Indian, Alaska Native, Native Hawaiian, Other Pacific Islander, Some Other Race
and multiple races
Public School Enrollment by Race/Ethnicity
% of Everett Public School District % of MA
2009 2010 2011 2012 2013
2013
African American 15.8 16.6 18.2 18.1 18.7
8.6
Race/Ethnicity
Asian
5.0
5.1
5.9
25.9 29.3 32.5 34.7
37
16.4
0.6
0.6
0.2
51.6 47.4 42.6 39.8 36.7
66.0
Native Hawaiian, Pacific Islander
0.1
0.1
0.1
0.1
0.1
0.1
Multi-Race, Non-Hispanic
0.6
0.9
1.0
1.6
1.8
2.7
Hispanic
Native American
White
5.4
5.1
0.6
5.1
0.6
0.6
SOURCE: Massachusetts Department of Elementary and Secondary
Education, School and District Profiles
• Additionally, Everett’s schools
have become increasingly
diverse with the largest growth
in Hispanic, Brazilian and
Haitian students. Changes in
local, state, national and global
economics tend to impact
the student population shifts
in the Everett schools.
7
Percent of Foreign-Born Population
100
90
80
70
60
50
40
30
20
10
0
Region of Birth for Foreign-Born Residents (2000-2011)
Everett 2000
72.7
Everett 2011
58.1
MA 2011
35.6
35.3
25.8
18.3 19.5
8.7
Latin
America
Central
America
19.8
11.5
South
America
28.7
24.3
12.4
Europe
13.1
6.9
7 7.5 8.1
Asia
Africa
2 0.3 3.2
North
America
• The number of foreign-born residents in Everett has increased from
8,323 (22%) of the total population in 2000, to 14,794 (36%) of the
total population in 2011.
• In 2011, compared to Massachusetts, Everett has twice as many
foreign-born residents from Latin America; nearly three times as
many from South America, while substantially fewer from Asia
and Europe.
• Most foreign-born residents in Everett (72.7%) are from Latin
America, reflecting an increase of 14% since 2000. The specific
countries with the largest increases are Brazil, Peru and the
Dominican Republic. The countries with the greatest percentage
decrease were Italy, Columbia and Vietnam.
xx
8
Specific Origin of Hispanic or Latino Residents
Everett 2000
Everett 2011
Count
%
Count
%
%
Hispanic or Latino
3,617
9.5%
7,473
18.2%
9.3%
Central American
1,201
3.2%
4,224
10.3%
1.6%
Costa Rican
22
0.1%
0
0.0%
0.1%
Guatemalan
127
0.3%
806
2.0%
0.6%
Honduran
90
0.2%
498
1.2%
0.2%
Nicaraguan
10
0.0%
0
0.0%
0.0%
Panamanian
4
0.0%
0
0.0%
0.1%
Salvadoran
888
2.3%
2,757
6.7%
0.6%
Other Central American
60
0.2%
163
0.4%
0.0%
South American
463
1.2%
1,003
2.4%
0.9%
Argentinean
15
0.0%
12
0.0%
0.1%
Bolivian
16
0.0%
48
0.1%
0.0%
Chilean
8
0.0%
0
0.0%
0.1%
Colombian
290
0.8%
160
0.4%
0.4%
Ecuadorian
14
0.0%
83
0.2%
0.1%
Peruvian
81
0.2%
542
1.3%
0.1%
Uruguayan
3
0.0%
0
0.0%
0.0%
Venezuelan
14
0.0%
16
0.0%
0.1%
Other South American
22
0.1%
142
0.4%
0.0%
Puerto Rican
542
1.4%
810
2.0%
4.0%
Dominican Republic
79
0.2%
533
1.3%
1.6%
1,096
2.9%
445
1.1%
0.4%
Mexican
186
0.5%
395
1.0%
0.6%
Cuban
50
0.1%
63
0.2%
0.2%
Other Hispanic or Latino
MA 2011
SOURCE: Everett 2000 data based on year 2000 US Census
Everett and MA 2011 data based on 2007 -2011 American Community Survey Estimates
• The most substantial increases in population between 2000 and
2011 were with the number of Everett residents whose countries
of origins were: El Salvador, Guatemala, Puerto Rico (territory),
the Dominican Republic, Peru, Honduras and Mexico. The largest
decrease was Columbia.
9
Language Spoken at Home for Residents Age 5 and Older (2011)
Arabic
1.3
0.4
Italian
2.6
0.7
French Creole
0.9
Portuguese
Everett
MA
6.3
12.8
2.9
15.8
Spanish
7.7
54.3
English Only
0
20
SOURCE: US Census ACS, 2007-2011
40
60
78.6
80
100
Percent
• Everett is also linguistically diverse. Forty-six percent of residents
speak a language other than or in addition to English, a much higher
proportion than Massachusetts overall (79%).
• The top 5 languages other than English spoken in Everett are
Spanish (16%), Portuguese (13%), French Creole (6%), Italian (2.6%),
and Arabic (1%).
Public School Enrollment by First Language not English,
Everett and MA (1994-2013)
Everett
MA
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
20
11
20
12
20
13
Percent of Students
100
90
80
70
60
50
40
30
20
10
0
School Year
SOURCE: MA Department of Elementary and Secondary Education (ESE)
• The proportion of Everett public school students whose first
language is not English has increased steadily from 26% in 2000
to 50% in 2013 and is now substantially higher than
the Massachusetts average.
10
xx
Disability Status of Everett Residents (2012)
Count
%
Everett Residents
41,190
With any Disability
5,121
12.2%
Hearing Difficulty
1270
3.0%
Vision Difficulty
959
2.3%
Cognitive Difficulty
2,108
5.0%
Ambulatory Difficulty
3,083
7.4%
904
2.2%
1,844
4.4%
Self-Care Difficulty
Independent Living Difficulty
Source: US Census Bureau, American Community Survey, 2012 3-year Estimates
In Everett, 12.2% of the population is living with some sort of
disability. The City works to comply with the Americans with
Disabilities Act (ADA) regarding access to infrastructure such
as buildings and streets, and the Everett Public Schools offer
special education services for students from ages 3 to 21.
Disability
Disability is defined as a
long-lasting physical,
mental, or emotional
condition. This condition
can make it difficult for a
person to perform basic
activities such as walking,
climbing stairs, self-care,
learning or remembering.
Individuals with disabilities
may be less visible, undercounted, or underserved
and therefore experience
disadvantages in health and
well-being compared with
the general population.
The potential for a lack of
access to healthcare
services and medical care
may increase a person’s
risk for various health and
mental health conditions.
11
Social Determinants
of Health
xx
12
Social Determinants
of Health
The places where we live, learn, work,
and play contribute to our overall health.
People experience different life conditions
depending on multiple factors such as income,
age, race, and address. Health status is affected
in positive or negative ways by these conditions
and related behavioral choices. There has been
increased attention given in recent years to the
roles of the social determinants of health in
preventing disease and supporting healthy
communities.
There is more to good health than lifestyle
choices, genes and access to healthcare.
Research shows that the social circumstances
in which we are born, live and work—our jobs,
schools, built space, transportation, even quality
of civic life—get under the skin, influencing our
behaviors, access to resources, chronic stress
levels, and ultimately increasing or decreasing
our chances for health.
According to Dr. David Williams at Harvard School
of Public Health, “Housing policy is health policy.
Educational policy is health policy. Anti-violence
policy is health policy. Neighborhood improvement
policies are health policies. Everything that we can
do to improve the quality of life of individuals in
our society has an impact on their health and is a
health policy.”
“EVERYTHING that we can
do to improve the quality
of life of individuals in
our society has an impact
on their health and is a
health policy.”
-Dr. David Williams
13
The Health Impact Pyramid
Increasing Population
Impact
Counseling
& Education
Increasing Individual
Effort Needed
Clinical Interventions
Long-Lasting Protective
Interventions
Changing the Context to Make
Individual’s Default Decisions Healthy
Socioeconomic Factors
SOURCE: Frieden, T.R. AM J Public Health 2010; 100:590-595, Copyright 2010 Americian Public Health Association
SOURCE: Frieden, T. R. Am J Public Health 2010; 100:590-595
Copyright©2010 American Public Health Association
The Centers for Disease Control and Prevention
(CDC) illustrates how socioeconomic factors can
impact an individual’s health through the Health
Impact Pyramid above. The risk factors that most
greatly impact a community and individual’s
health can be lessened through policy, systems
and environmental change interventions aimed at
the social determinants of health, represented by
14
the bottom two layers of the pyramid.
Interventions aimed at these layers create more
accessible and lasting healthy choices for
individuals. Although the top three tiers of the
pyramid are still important in managing good
health, they require larger effort at the individual
level to be effective.
The following two versions of “Tips for Better Health” illustrate the difference between the
conventional advice we usually hear on the best ways to stay healthy, and the social determinants
approach to staying healthy. It showcases the need for developing and implementing policies
addressing the social determinants of health to truly create a healthy community.
Conventional 10 Tips for Better Health
1. Don’t smoke. If you can, stop. If you can’t,
cut down.
6. Cover up in the sun, and protect children
from sunburn.
2. Stay on a balanced diet with plenty of
fruits and vegetables.
7. Make sure you practice safer sex.
3. Make sure you stay physically active and
exercise at least 3 times a week.
4. Manage stress by, for example, talking things
through and taking time to slow down, or
planning relaxing getaways.
8. Don’t forget regular check-ups with your
family doctor and get screenings for cancer.
9. Be safe on the roads: Follow the highway code
and wear your seatbelt.
10.Learn the first-aid ABC: airways, breathing,
circulation.
5. If you drink alcohol, do so in moderation.
What Your Doctor Didn’t Tell You, or
Social Determinant Tips for Better Health
1. Don’t be poor. If you can, stop. If you can’t,
try not to be poor for long.
6. Take family vacations and all the benefits you
are entitled to.
2. Live near good supermarkets and affordable
fresh produce stores.
7. Make sure you have wealthy parents.
3. Live in a safe neighborhood with plenty of
trees, parks and green space nearby.
4. Work in a rewarding and respected job with
good compensation, benefits and control
over your work.
5. If you work, don’t lose your job or get laid off.
8. Don’t live in damp low-quality housing, next to
a busy road or near a polluting factory.
9. Be sure to own a car if you have to rely on
neglected public transportation.
10.Learn how to fill in the complex housing
benefit application forms before you become
homeless and destitute.
SOURCE: Adapted from Dave Gordon, University of Bristol, and Dennis Raphael, York University, from Unnatural Causes at www.UnnaturalCauses.org
15
The Boston Public Health Commission’s Health
of Boston 2010 divides the social determinants
of health into three core areas: economic
conditions, environmental and neighborhood
conditions, and social conditions.
quality experience higher rates of asthma.
Lack of grocery stores that sell fresh produce and
the lack of safe and affordable places to engage in
physical activity contribute to poor diets, obesity,
and diabetes.
Economic conditions include employment,
income, education, and wealth. Socioeconomic
status has long been recognized as the single
strongest predictor of health.
Social conditions include neighborhood safety,
social networks, social capital, and civic
engagement. Social conditions such as exposure
to racism and lack of neighborhood safety lead to
chronic stress. Stress is directly linked to chronic
disease, particularly hypertension and heart
disease. Research has shown that supportive
social networks can serve as a buffer to stress and
depression, which in turn, protects against
physical and mental illness.
Physical environment and neighborhood
conditions include food access, parks and open
space, housing, air quality, liquor and tobacco
advertisement, and transportation. These
conditions work alone and with each other to
affect health. Neighborhoods with poor air
RESEARCH HAS SHOWN
that supportive social
networks can serve as
a buffer to stress and
depression, which in
turn, protects against
physical and mental
illness.
16
Education
17
Education
Percent of Population Over 25
Education is a key societal factor in supporting child and youth
development, skill-building for future jobs and/or secondary
education, and for supporting adults in job training or career
development. Poverty in early life can negatively impact educational
outcomes. Higher educational attainment is linked to higher future
income. In a city with a large non-English speaking population,
access to English language classes for adults is critical for educational
and career development, as well as supporting the education of
children and supporting parental engagement in all families.
100
90
80
70
60
50
40
30
20
10
0
Educational Attainment of Residents,
aged 25 Years or Older (2000 & 2011)
Everett 2000
Everett 2011
MA 2011
40.3 38.3
23.8
26.3
19.9
21.2
25.4 23.9
11.1
Less Than
High School
22.1
10.1 11.3
High School Some College
Graduate or Accociate’s
or Equivalency
Degree
Bachelor’s
Degree
11.6
3.4 3.8
Master’s
Degree
1.2 1.4
5.0
Professional or
Doctoral Degree
• In general, the percentage of Everett residents with a Bachelor’s or
higher degrees is lower than compared to Massachusetts overall.
• In 2013, the percentage of graduates from the Everett Public
Schools who planned to go to a 2-year or 4-year college after
graduating high school has increased dramatically from 59%
in 2007 to 80% in 2013.
• The proportion of Everett public school students whose first
language is not English has increased steadily from 26% in
2000 to 50% in 2013 and is now substantially higher than the
Massachusetts average. (See the chart in the Demographics
Section for Public School Enrollment by First Language
not English).
18
The Everett Public Schools
consists of 9 public schools,
pre-kindergarten through
12th grade, and enrolled
nearly 7,000 students in
the 2013-2014 school year.
This represents a percentage increase of 31% since
2005-2006. There is a public
charter school and two
private schools in Everett.
The city also maintains a
membership affiliation
with Shore Educational
Collaborative, a special
agency that provides
services for children and
adults with disabilities.
Additional Characteristics of
Everett’s public school population (K-12)
• 79% of Everett public school children qualified for free and
reduced cost lunches in the 2013-2014 school year compared to
a statewide average of 37%.
• Students in Everett exceeded the state rates for drop-out rates
(3.3% compared to 2.2% in MA), but do better than the state for
in-school suspensions (1.4% compared to 2.2% in MA).
• The graduation rate from Everett High School is currently 86.5%,
on par with the state graduation rate of 85%.
• In 2012, Everett spent $12,261 per pupil for grades K-12, which
is less than the state average of $13,636 per pupil. These funding
levels are fairly consistent with communities surrounding Everett
($12,153 in Malden, $13,032 in Medford, $13,277 in Revere, and
$16,506 in Somerville).
• The student/teacher ratio in Everett is 13.5 to 1, nearly the same
as Massachusetts which is 14.4 to 1.
Strengths and Assets
Stable Resident Base, with
Transitory Segments
The majority of our population has lived here for 5 or
more years. However,
from a community health
perspective, if over onethird of the residents have
been here for less than four
years, community-wide
campaigns may need to
take into account this
shifting segment of the
overall population.
Early Education
• Tri-City Community Action Program, Inc. (Tri-CAP) provides
comprehensive Head Start services for 55 Everett children, aged
3-5 years, and their families. School readiness is an integral part
of the Head Start program that addresses cognitive, emotional,
social and physical development. Parents receive encouragement
and support to be active participants in their child’s/children’s
education and learning, and in working with teachers and Family
Service Workers to set goals for their children, themselves, and
the household.
• The Everett Coordinated Family and Community Engagement
Program (CFCE) works on raising families’ awareness of the
importance of high quality early education and care programs
for children and promotes parent education, family engagement,
early literacy and community resources for children and families.
19
K-12
• The Parent Information Center is a registration center and
clearinghouse for support services for new families entering the
public school system.
• Everett Public Schools offers free, half-day pre-kindergarten and
full-day kindergarten education to all children enrolled at the
Webster School and the Adams School.
• Everett Public Schools has a partnership with Youth Harbors
to support homeless or at-risk of becoming homeless youth.
A case manager is available on site at the high school to assist
youth in locating safe housing, applying for benefits including
food stamps, health insurance, and providing job search
assistance including resume building.
• Everett Public Schools collaborates with Energize Everett in
school gardens at the K-8 schools and Everett High School, and
exercise programs at several K-8 schools.
• Everett Public Schools, recognized by the New England Scholastic
Band Association, has an award winning music program for
students in grades 2-12 with the Everett High School Band,
Percussion and Orchestra opportunities to enjoy and excel at
musical endeavors.
• Everett High School seniors can apply for more than 50 different
local scholarships from area businesses, organizations, and
non-profits to support their higher education plans.
• The Parents Advisory Council, PAC, is an active group of
parents working together with other parents, the schools and
community to support the parents of Special Needs Students.
• Everett Parent Teacher Organizations (PTO’s) are active at each of
the K-8 public schools.
• Everett offers families additional options for educating children
K-12. Students may attend the Pioneer Charter School of
Science, St. Anthony’s Parochial School and Pope John XXIII
High School.
20
After School
• Everett Public Schools, in conjunction with Everett City
Government, offers after school programming for 1st through
8th graders with the For Kids Only Afterschool program.
Scholarships are offered with public school funds as well as
city budgeted funds.
Parents
• For 20 years, Everett Public Schools has partnered with the
Joint Committee for Children’s Health Care in Everett (JCCHCE)
to collaborate on parent education and programming to support
families including the Parent University All Day Conference and
parent mini-workshops throughout the year.
Adults
• The Everett Adult Learning Center is an adult education program
operated by the City of Everett which teaches 220 students to
speak English as a second language (ESOL), citizenship, as well
as how to access training programs, earn a GED or ADP, continue
their education and get better jobs. The Everett Adult Learning
Center has a waiting list of over 195 people. The program has a
paid teaching and administrative staff, as well as a volunteer staff
of one-to-one tutors.
• There are several community-based organizations providing
ESOL classes for adults & parents such as: La Comunidad, Inc.,
LUMA Inc., and A Better Tomorrow Services, Inc.
• The Everett Public Libraries provide books and other resources in
multiple languages.
• Everett’s faith-based centers offer a range of health education
programs and community forums to enrich the cultural, spiritual
and educational opportunities for Everett residents.
21
xx
Recommendations
• Address the needs of out-of-school youth and other vulnerable youth populations to ensure access
and support for high school completion. Provide resources and services to ensure linkages
for training and job opportunities that will support their full participation in society.
• Develop stronger systems of communication and support for non-English speaking parents
to improve educational outcomes and high school completion rates for their children.
• Continue to work collaboratively to improve opportunities for early education and for all
pre-school children in the city to be ready to start school.
• Collaborate across various sectors in the city to strongly promote the strengths and diversity
of educational options available to families with children.
• In partnership with the Everett schools, strengthen efforts city-wide to support youth development
and realization of their personal aspirations and goals in school, in the community and at home.
• Continue to expand Adult Education offerings to reflect a wide range of interests and aspirations
for Everett residents.
• Increase access to English as a Second Language classes for adult newcomers to better meet the
current demand.
Please refer to the Youth Section for additional information on youth specific assets
and recommendations.
22
Economy, Employment
and Housing
23
Economy, Housing and Employment
Everett is home to many small businesses, most with fewer than
10 employees, that provide employment in the city. The number of
residents far outweighs the number of available local jobs, making
commuting a daily reality for most residents. A significant portion
of the local jobs, such as food services and retail, typically pay very
low wages, requiring some residents to work several jobs to support
their families.
Median Household Income
In Everett, the median household income increased from $40,661
in 2000 to $48,319 in 2011, which is a smaller increase than the
state as a whole over the same time period (MA: $50,502 in 2000 to
$65,981 in 2011). While there have been improvements for some,
high utilization rates of local food pantries indicate that despite the
improvements, there are still unmet basic needs. These households
are forced to make choices between food or fuel and have no safety
cushion of funds to tide them over in hard economic times.
24
Income and Housing Indicators
Everett
2000
Everett
2011
MA 2011
$40,661
$49,876
$19,845
$48,319
$58,045
$24,575
$65,981
$83,371
$35,051
Number of Occupied
Housing Units
Percent Owner-Occupied
Percent Renter-Occupied
15,435
15,681
2,522,409
41.4%
58.6%
40.3%
59.7%
63.6%
36.4%
Median House Value
(Owner-Occupied Units)
$178,800
$340,000
$343,500
Housing Units with a
Mortgage
Percent with costs 30% or
more of Income
more of Income
1,734
4,467
1,157,325
26.1%
57.9%
40.2%
10.0%
29.5%
15.6%
9,037
9,356
917,936
Income
(Inflation Adjusted Dollars)
Median Household Income
Median Family Income
Per capita income
Renter-occupied
Housing Units
Percent with costs 30% to 49%
of Income
more of Income
20.2%
23.8%
23.3%
17.5%
28.1%
24.4%
Median Gross Rent
$729
$1,115
$1,037
Everett and MA 2011 data based on 2007-2011 American Community Survey Estimates
A Healthy Community Means
Affordable Housing
A Healthy Community means
citywide affordable housing
in safe neighborhoods, free
from discrimination. Affordable housing is critically
important to the well-being
and health of children and
families. Without decent and
affordable housing, families
have trouble managing their
daily lives and their children’s
safety; health and development suffer. Families who pay
more than they can afford for
housing have too little left
over for other necessities
such as food, clothing and
healthcare. They may not be
able to pay for transportation
and childcare, making it
harder to go to work and
school each day.
Costly Housing
There are 15,681 occupied housing units in Everett, 59% of which
are renter-occupied (vs. 36% in Massachusetts). Of those who own
their homes, 58% have a mortgage that equates to 30% or more
of their household income (vs. 40% in MA.). Among renters, 28%
of those who rent pay an amount equal to 50% or more of their
household income for their monthly rent (vs. 24% in Massachusetts).
The number of renters who now pay more than 50% of their income
for rent has seen a percentage increase of 57% since 2000.
25
xx
Poverty Indicators
Everett Everett
MA 2011
2000
2011
Poverty Status of Individuals
Under 100% of Poverty Level (Doing Poorly)
11.8%
Between 100 to 200% of Poverty Level (Struggling) 16.4%
Over 200% of Poverty Level (Doing OK)
71.8%
Families
Number of Families
Percent of all Families in Poverty
Percent of Female Headed Families in Poverty
Percent of Female Headed Families with children
in Poverty
Children
Number of Children (under 18 years of age)
Percent of all Children in Poverty
11.6%
21.4%
67.0%
10.7%
12.9%
76.4%
9,610
9.2%
5.3%
9,885
9.5%
5.4%
1,603,940
7.6%
4.7%
4.6%
4.1%
4.1%
8,057
17.0%
8,935 1,405,216
14.3%
13.5%
Homeless Individuals and Families
High rents and a limited range of housing options have resulted in homelessness for many families and
individuals. On January 29, 2014, there were 365 people in the tri-cities (Everett, Malden and Medford)
experiencing homelessness (Tri-City Community Action Program).
Rise of Families in Poverty
The number of Everett families in poverty increased slightly from 2000 to 2011, keeping the rate 25%
higher than the state as a whole (9.5% in Everett vs. 7.6% in MA). However, the proportion of children
under 18 years of age living in poverty has decreased in Everett from 17% in 2000 to 14% in 2011.
Inequality Rising in United States
According to the United Nations Development Program inequality rankings of 2009, the U.S. is highly
unequal in terms of the gap between rich and poor, third among the world’s advanced economic
countries below only Hong Kong and Singapore. A major shift has occurred over the past 30 years,
so that between 1979 and 2007, 63.6% of pre-tax income growth in the U.S. went to the richest 10%,
while the bottom 90% of the population collectively saw only 36.4% of the growth in income.
26
Disability Linked to Poverty
According to the US Census Bureau, in the United States in 2000,
8.7 million people with disabilities were poor - a substantially
higher proportion (17.6%) than was found among people without
disabilities (10.6%). The highest poverty rates in both cases were
found among children aged 5 to 15. Young people with disabilities
had a poverty rate of 25%, compared with 15.7% for those
without disabilities.
Annual Unemployment Rate (1990-2010)
During the 1990s, unemployment in Massachusetts declined
steadily, rose slightly in the early 2000s and increased sharply
between 2008 and 2010. Unemployment rates in Everett were
slightly higher, but had a similar trend and pattern compared
with the state.
Annual Unemployment Rate in
Everett and MA (1990-2013)
Everett
MA
12
Percent
10
8
6
4
2
0
1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012
SOURCE: United States Department of Labor, Bureau of Labor Statistics
27
xx
Strengths and Assets (Employment):
• Everett Master Planning Process: The City of Everett recently engaged the community in several
master plans focusing on different parts of the city, such as the “Lower Broadway District Master
Plan,” (better known as “The Line”), the “Everett Central Waterfront Municipal Harbor Plan,
and the “Commercial Triangle,” (the commercial and residential areas around Revere Beach
Parkway and Second Street). These Master Plans have included substantial input from various
stakeholders, including residents and business owners, in order to bring these areas to their
highest potential to spur private investment, create good, sustainable jobs, and benefit long-time,
newly arrived, and future residents. These plans are available on the City of Everett website or
through the Department of Planning and Development.
• Tri-City Workforce Development Task Force is a coalition that advocates for jobs for local residents
and training to help equip the local workforce for new community development projects so that
they can afford increased housing costs that often accompany these projects.
• The Everett Chamber of Commerce has been supporting businesses since it began in 1950 and
now has 225 members.
• Several community-based efforts work on job development and/or job training, with a particular
focus on high school age students and young people. A partial listing includes the Everett High
School’s Allied Health Academy, Everett Boys and Girls Club, Mayor’s Summer Jobs Program,
Energize Everett, and opportunities for volunteering at the Cambridge Health Alliance,
along with other larger businesses and/or organizations.
Recommendations (Employment):
• Ensure new development projects include provisions for creating good jobs at a living wage
and job training for local residents.
• Support anti-displacement strategies to protect vulnerable populations pending a casino
development.
• Increase local employment opportunities in the city for Everett youth.
Strengths and Assets (Housing)
• The City of Everett, with assistance from the Metropolitan Area Planning Council (MAPC), along
with community input, is working to develop a Housing Production Plan that will guide housing
development and help the City meet the state-mandated affordable housing target. This planning
process will include discussions about local needs and demand, barriers to achieving housing
affordability goals, successful strategies already in place on which Everett can build, and potential
sites for new development.
28
• The City of Everett offers assistance for housing rehabilitation and first-time home buyers.
• Everett’s Fair Housing Committee meets to ensure compliance with the Fair Housing Act,
which prohibits discrimination in housing and helps advocate for quality affordable housing.
• Tri-City Community Action Program, Inc. (Tri-CAP) provides a number of services and resources
for individuals and families needing housing assistance including housing search assistance,
emergency financial assistance (when funds are available), and helping to resolve problems that
could lead to homelessness.
• Tri-CAP provides residents to apply for fuel assistance and legal services for people who are facing
eviction, loss of a subsidy, or other housing problem.
• Tri-CAP helps homeless individuals with transportation, clothing, benefits, mental health/
substance abuse counseling, access to healthcare resources, job search, housing search,
and stabilization in housing.
• Tri-CAP’s Housing Opportunities for People with AIDS (HOPWA) program provides housing search
assistance and other support services.
• The Tri-City Housing and Homelessness Task Force conducts an annual homeless census to
capture current information on adults, families and youth impacted by homelessness.
Recommendations (Housing):
• Ensure adequate representation of Everett’s diverse community (including renters) in discussions
of the Housing Production Plan.
• Advocate for new housing development projects to include affordability below 60% of the
Area Median Income, ensuring low to moderate income Everett residents will be able to access
the new housing.
• Ensure accessible housing by anticipating the needs of Everett’s current population with
disabilities and aging baby boomers interested in aging in place.
• Meet 10% affordable housing requirement of available housing as required by
Massachusetts Affordable Housing Zoning Law, Chapter 40B.
29
xx
Built &
Natural Environment
30
Built & Natural Environment
The built environment refers to human-made settings. These include
the planned use, layout and design of a community such as streets,
houses, playgrounds, schools, grocery stores, commercial and
residential zones, and public transportation.
Land Use Policy Tools: Zoning is the mechanism which brings
planning, policy and legislative work together to determine the future
character of a community through land-use planning. Zoning with a
public health focus can promote and protect community features,
such as mixed commercial-residential districts that encourage
walking and biking, the preservation of open space, improved
access to healthy food choices, and reduced exposure to pollution.
• The City of Everett recently engaged the community in several
master plans focusing on different parts of the city, such as the
Lower Broadway District Master Plan and Urban Renewal Plan,
the Everett Central Waterfront Municipal Harbor Plan, and will
soon begin the Commercial Triangle Master Plan, which includes
the commercial and residential areas around Revere Beach
Parkway. These plans have included input from various stakeholders,
such as residents and business owners, in order to elevate these
areas to their highest potential to benefit long-time, newly arrived,
and future residents. These plans are all available on the City of
Everett website through the Department of Planning and
Development.
Transportation
A healthy community
includes reliable and safe
access to all modes of
transportation for everyone
– pedestrians, bicyclists,
motorists and transit riders
of all ages and abilities
– and encourages active
and healthy transportation
modes such as walking
and bicycling.
• The City of Everett has recently passed a Complete Streets
Resolution, which recognizes the connection between
transportation and health and ensures that all future
transportation plans in the city make the street network better
and safer for drivers, transit users, pedestrians, and bicyclists.
• Everett has 8 bus routes that travel through the city and connect
to three nearby Orange Line subway stations – Malden, Wellington
and Sullivan. Public transportation is very important for Everett
residents, as 22.4% of workers in Everett rely on public
transportation to travel to work, and 18.2% of households in
Everett do not have access to a vehicle.
31
xx
Recreation and Open Spaces
• Everett strives to offer multiple recreational opportunities to
its residents. There are approximately 58 acres of parkland in
Everett, with at least one park in each of the six wards.
Recent renovations of several parks and tot lots reaffirm
commitment to offering youth and families safe, accessible
spaces to play and socialize. Everett’s Recreation Department
offers various low-cost activities to children and adults at two
main facilities – the Recreation Center and the old Everett High
School Field House. Recently, an elementary school opened one
night a week for Family Fitness Nights in collaboration with
Energize Everett. This successful activity has prompted the city to
engage in a Joint Use Agreement with Everett Public Schools to
allow usage of more school facilities after hours.
• Everett is committed to protecting and expanding our natural
resources by planting and maintaining trees, shrubs and flowers.
In an urban setting such as Everett, trees play a vital role in
energy conservation, noise and visual protection, beautification,
as well as curb the urban heat affect and offsets urban pollution.
The National Arbor Day Foundation has recognized and designated
the City of Everett as Tree City USA since 1996 for its dedication
to planting and maintaining over 4,500 trees.
• Everett has also recently supported further protection of the
natural environment, as well as answering a well documented
need for residents to grow their own food, by working with the
Everett Community Growers (ECG) to open Everett’s first
community garden on Florence Street.
In collaboration with the city’s Department of Planning and
Development, ECG is currently conducting an urban land inventory
and assessment to identify spaces for urban agriculture for
personal and commercial use. They are also compiling a report of
best practices and recommendations for a zoning ordinance to
support and encourage food growing and selling around the city.
• The Northern Strand Community Trail is a multi-use trail that
connects the communities of Everett, Malden, Revere, Saugus
and Lynn. Everett was the first of these communities to pave the
trail in 2012, and several other communities have followed
32
Everett’s lead in recent months. The bicycle advocacy group, Bike to the Sea, has led this project
for over 20 years, and encourages residents to become stewards of the trail in each community.
• Many community groups and residents, led by organizations such as Tri-City Community Action
Program and La Comunidad, Inc., around the Malden River watershed, have formed the Friends of
Malden River to create awareness and encourage action of issues of environmental justice and
water quality in the communities surrounding the Malden River.
Recommendations
• Adhere to Complete Streets Resolution and accompanying Healthy Design Guide in all future
planning projects to ensure that healthy and active transportation options are available to all.
• Ensure ongoing and future planning processes are accessible and welcoming for all
Everett residents.
• Representation of Everett’s diverse community should be a commitment from the city leadership
so that all residents are represented on Boards and Commissions that make planning decisions.
• Create and fund maintenance plan for Northern Strand Community Trail.
• Continue and expand “free play” (non-program structured) spaces and opportunities for all
Everett residents.
• Support the expansion of spaces and opportunities for commercial agriculture so all residents
have access to affordable, fresh, healthy food and the ability to generate revenue from
agricultural products.
• Support an expansion of the Friends of the Malden River and create a new coalition to assess and
improve Everett’s air quality.
See city website with Master Plan link: www.ci.everett.ma.us/Everett_files/commdevelop/
120918%20LowerBroadwayPresentationFinal_Sept18.pdf
33
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Community
34
Community
Determinants of health include not only access to education, jobs,
housing, and a safe physical environment, but social factors as well.
Some of these elements are social supports and social networks,
but also freedom from discrimination based on race, ethnicity,
gender, age or sexual orientation. Community resources that facilitate
health and personal growth may also include access to arts and
cultural experiences, faith-based communities, open channels of
communication, and opportunities to be civically engaged.
The presence of social supports is linked to individual and community
health outcomes, with related better health and lower mortality
rates. In addition to helping reduce the negative impacts of stress,
social networks provide support for individuals in coping with jobs,
housing, childcare and other resources that influence socioeconomic
impacts on health. Some of the sources of negative stressors, which
can cause chronic stress, are driven by societal issues such as
discrimination, racism, or other “isms” that impact status and access
to fairness and justice in society.
Health Disparities and Health Inequities: What’s the difference?
The National Institute of Health defines health disparities as
“differences in the incidence, prevalence, mortality and burden
of diseases and other adverse health conditions that exist among
specific population groups in the United States.” Health disparity
equates with inequality related to differences between individuals
or groups, whereas health inequity refers to underlying avoidable
societal conditions that are unfair or unjust. Health inequities are
socially produced, creating systemic differences in health between
different socioeconomic populations.
Healthy Community
A healthy community,
according to the World
Health Organization, is
“… one that is continually
creating and improving
those physical and social
environments and expanding
those community resources
that enable people to
mutually support each
other in performing all
the functions of life and
in developing to their
maximum potential.”
Racism
Race is a social construct, a biological myth that carries significant
implications for health. Research related to health disparities,
increasing the focus on social determinants of health, when
controlled for social factors such as socioeconomic status and
educational attainment indicated people of color experience worse
health outcomes than whites. The chart that follows indicates some
of the factors impacted by racism, as demonstrated in numerous
studies. Ethnic health inequities also follow a similar pattern of poor
health outcomes.
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Education
Job Opportunity
Food Assistance/
Food Environment
Racism
Socioeconomic
Status
Environmental
Exposure
Health
Outcomes
Health Behaviors
Access to
Health Services
Safe & Affordable
Housing
Community Violence
Health Equity Framework—Social Determinants of Health Inequities.
SOURCE: Boston Public Health Commission Center for Health Equity and Social Justice
Increasingly, there is growing recognition that the chronic stressors associated with racism threaten
health. Racism can manifest as internalized, interpersonal or institutional – changing the day to
day experiences of where people of color live, work, learn and play, impacting health across the
full spectrum of life from maternal health to achieving average life expectancy. Anti-immigrant
sentiments, which presently mirror past discrimination in earlier economic downturns, often present
with subtle or even blatant racial undertones. Effective efforts to improve health outcomes
increasingly need to take into consideration these issues in order to challenge deep-seeded
health inequities.
36
• Based on literature, participation in faith-based communities can be a critical social support
for many people. Everett is home to many churches, one synagogue, and a mosque. Over the
past decade, there have been significant changes in the religious demographics in both the
White Protestant and Catholic churches. The immigrant-based faith communities have been
growing and thriving, often sharing spaces with existing congregations or by outright purchase.
In the past, the local faith community has met regularly to discuss shared concerns and issues
impacting their populations.
• Art, Culture and Social Activities
–
–
–
–
–
–
–
–
–
–
–
Everett Art Club
Annual Spring and Fall City Cleanups
Annual Cityfest
Annual Everett Public Schools Homecoming Parade
Friends of the Everett Libraries’ Annual Book Sale and Speaking Program
Annual Citywide Independence Day Events
Martin Luther King Day Celebration organized by Zion Baptist Church.
Musical performances by Everett Public Schools Music Department
Family Fitness Nights offered by Recreation Department and Energize Everett
Annual Bike to the Sea Day
Holiday activities of Office of Human Services
• Places in our community where people gather informally, such as cafes, plazas, libraries and parks
–
–
–
–
–
–
Parlin Library
Shute Memorial Library
Everett Farmers Market
Various parks and tot lots
Northern Strand Community Trail
Independently owned coffee shops and bakeries
• The Everett Community Growers brings together residents of diverse backgrounds under
the common goal of achieving food justice by increasing access through food growing in the
City of Everett. They began the city’s first community garden, the Florence Street Community
Garden in 2012, and plan to secure more spaces around the city to grow food for both personal
use and commercial use, hoping to alter city ordinances to allow selling of backyard and
community garden produce.
• One Everett is a coalition of residents of Everett, La Comunidad, Tri-CAP, Joint Committee for
Children’s Health Care in Everett, Everett Community Health Partnership, Jobs With Justice,
the Everett Teachers Association and Action for Regional Equity focused on increasing living-wage
jobs for Everett residents and parent involvement in the Everett Public Schools.
37
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• The Multicultural Affairs Commission (MAC) was created in 2004 to directly tackle conflicts
and create bridges between long-time residents and new immigrant groups. Among its many
initiatives are a quarterly meeting with the Everett Police Department and members of the
immigrant community and political forums hosting candidates for local and state elections.
• Annual May 1st (May Day) International Workers Day Rally and March organized by various
immigrant and labor rights organizations in Everett, East Boston, Chelsea and Revere.
• La Comunidad, Inc. is a non-profit organization working to provide a better future to the Latino
American Community in the City of Everett and surrounding areas. It is directed and operated
by Latino staff members and volunteers, and is committed to educating and providing services in
the following areas of interest: Immigration, Social Services, Education, Labor Rights, Community
Organizing, and sharing public information.
• A Better Tomorrow, a non-profit community organization, provides leadership and direction to
immigrant families living in America, specializing in supporting recent Haitian immigrants. Some
of their services include: bilingual parenting education, advocacy, case management, healthcare
access, ESL, and computer applications skills. They also operate a food pantry on the 1st and 3rd
month of each month from 4-6pm.
• Latinos Unidos en Massachusetts (LUMA) is a non-profit community organization, based in
Everett, which works for the rights of the immigrant community and promotes the
Latin American culture.
Recommendations
• Increase the number of intergenerational, interethnic and interracial community building
projects.
• Encourage and support mechanisms to increase representation of Everett’s diverse populations
on City Council, Boards and Commissions.
• Increase community participation in Everett’s Multicultural Affairs Commission’s efforts to make
Everett a welcoming community for immigrants.
• Increase youth-led, community-wide events celebrating healthy behaviors.
• Increase collaborative projects with faith-based community.
38
Leading Health Indicators
& Recommendations
39
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Adult Physical Activity & Nutrition
Why is this important?
Adequate physical activity and a healthy balanced diet can reduce the
risk of many chronic health issues. There is a better chance of creating
healthy habits when healthy choices are available and supported
within the home and community. Exercise alone can decrease the
chances of developing cardiovascular disease, type 2 Diabetes,
metabolic syndrome, and certain types of cancers. It can also
strengthen bones and muscles, improve mental health and mood,
control weight, and increase chances of living longer.
The Centers for Disease Control and Prevention (2012) state: Physical
exercise is crucial for the well-being of children, adolescents, adults,
and older adults. It is especially important for older adults considering
the number of health problems which come with age. Physical activity
in older adults can strengthen weakened muscles, reducing the risk
of falls.
A nutritious diet can decrease the risk of chronic diseases such as
type 2 Diabetes, hypertension, and certain types of cancers. It can
also reduce the risk of obesity and micronutrient deficiencies (i.e. the
lack of essential vitamins which can lead to visual impairments and
severe infections). Obesity continues to be a problem in the United
States with 17% of children and 35.7% of adults considered to
be obese.
Based upon data from the 2008 5-City Behavioral Risk Factor
Surveillance Survey, 69.1% of Everett adults reported they participated
in physical activities during the past month. More specifically, 42.1%
reported engaging in at least 30 minutes of moderate physical activity
at least 5 days a week and 31.4% reported engaging in at least 20
minutes of vigorous physical activity at least 3 days a week.
Citations
The Centers for Disease Control and Prevention (CDC);
Physical Activity (2012)
www.cdc.gov/physicalactivity/index.html
World Health Organization (WHO); Nutrition & Obesity, (2014).
www.who.int/topics/en/
www.who.int/topics/en/
40
Obesity
The World Health
Organization affirms that
obesity can lead to serious
health problems, including
but not limited to strokes,
respiratory problems,
osteoarthritis, coronary
heart disease and sleep
apnea. As of 2008, the
medical costs of obesity in
the United States totaled to
approximately $147 billion.
Physical Activity
• The City of Everett has recently passed a Complete Streets Resolution, which recognizes the
connection between transportation and health. The resolution ensures all future transportation
plans in the city will make the street network better and safer for drivers, transit users,
pedestrians, and bicyclists.
• The Recreation Department offers various low-cost activities to children and adults at two
main facilities – the Recreation Center and the old Everett High School Field House. Recently,
an elementary school opened one night a week for Family Fitness Nights in collaboration with
Energize Everett.
• Seniors have access to various exercise and physical fitness programs at the Connolly Center.
• Everett is part of the Northern Strand Community Trail, a multi-use trail that connects the
communities of Everett, Malden, Revere, Saugus and Lynn. Everett was the first of these
communities to pave the trail in 2012, and several other communities have followed Everett’s
lead in recent months.
Nutrition
• The Everett Farmer’s Market runs in the summer and fall months and accepts SNAP, WIC and
senior coupons.
• Focusing on small markets and convenience stores, Energize Everett works with store-owners to
sell more fresh food in neighborhoods throughout the city.
• Healthy Vending – all municipal buildings including schools have healthy food options in vending
machines.
• For families in Everett in need of additional support to feed their families, there are two pantries
available: Bread of Life located at 460 Broadway and A Better Tomorrow located at 3 Charlton St.
• The Cambridge Health Alliance runs programming and educational sessions for seniors at the
Connolly Center on healthy eating and diabetes control, in addition to other health and wellness
topics such as brain, bone and heart health.
• Increased visibility of Energize Everett’s social media outlets, including Facebook, Twitter and
newsletters to promote and educate the community on healthy living.
• Community gardens have increased access to fresh vegetables for residents.
41
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Recommendations
Physical Activity
• Continue to expand public spaces for all residents to engage in physical activity.
• Support local businesses to provide opportunities for employees to participate in health and
wellness programs.
• Continue to expand physical fitness programs for seniors at the Connolly Center to fully engage
all members.
• Expand the number of secure bike racks throughout the city.
Nutrition
• Offer media programming and education on healthy eating options, including recipes, shopping
tips for low-cost meals and cooking demonstrations.
• Expand Healthy Markets in every ward.
• Provide healthy and nutritious recipe information to expand awareness of healthy
cooking options.
• Demonstrate healthy eating alternatives at community-wide events.
42
Adult Tobacco
Tobacco use is the single most preventable cause of death and
disease in the United States. According to Massachusetts Department
of Health and Human Services, over 8,000 MA residents die each
year from the effects of smoking. The use of tobacco products and
secondhand smoke are directly related to chronic diseases, including
emphysema, bronchitis, cancer, heart disease, pregnancy-related
problems, and many other serious health problems.
Despite the many risks of cigarette smoking, much of the potential
harm can be decreased just by quitting.
Citations
The Centers for Disease Control and Prevention (CDC); Tobacco (2013)
www.cdc.gov/tobacco/
Tobacco
Tobacco kills more people
each year than car accidents, AIDS, homicides,
suicides and poisonings
combined. Research
indicates that 80% of adult
smokers began smoking
before the age of 18.
What are Electronic Cigarettes?
The emergence of electronic cigarettes, more commonly referred to
as e-cigarettes, has gained national and local attention as a method
of tobacco cessation to help people quit smoking. Additionally, it
has garnered attention as a means to recruit new users to nicotine
products, with a particular attention on young people, through the
marketing of candy-flavored devices. The debate on the effectiveness
and regulation of this product is currently ongoing with the Federal
Drug Administration. Just what e-cigarettes are and what role they
should play in helping people quit smoking depends very much
on who you speak with about this topic. For more information on
tobacco cessation, we encourage you to speak with your primary care
provider or contact the tobacco quit line at 1-800-QUIT-NOW.
Tobacco Use
Based upon data from the 2008 5-City Behavioral Risk Factor
Surveillance Survey, 29% of Everett adults reported they were
current smokers, twice as many compared to Massachusetts (15%).
Furthermore, nearly 10% of Everett adults reported they were heavy
smokers (smoking more than 20 cigarettes a day).
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Smoking Cessation
Based upon data from the 2008 5-City Behavioral Risk Factor Surveillance Survey, almost 56% of Everett
smokers reported that in the prior 12 months they had stopped smoking for one day or longer because
they were trying to quit, compared to 63% statewide. More than 80% of Everett smokers reported that
a doctor, nurse or other health professional advised them not to smoke in the prior 12 months.
Please refer to the Youth section for more information about tobacco use among youth.
• The Six City Tobacco Control Collaborative is a joint project of the health departments of
Cambridge, Chelsea, Everett, Revere, Somerville and Winthrop, through funding from the
Massachusetts Department of Public Health. The goal is to develop, promote and enforce
local tobacco control policies in all cities served.
• Everett Board of Health, with the support of the Everett Community Health Partnership –
Substance Abuse Coalition and TEASA (Teens in Everett Against Substance Abuse) youth
members, banned the sale of tobacco products at Everett pharmacies in 2010. At the time,
Everett was one of the first cities in Massachusetts to pass a city ordinance regarding the sale
of cigarettes and other tobacco products.
• Smoking cessation options have increased locally and statewide. Everett residents are utilizing the
state-run cessation helpline (1-800-QUIT-NOW) to obtain information about quitting and the type
of methods available to best fit personal needs.
• All patients seen in the Cambridge Health Alliance, primary care and in-patient settings are
screened for tobacco use. The medical provider determines in cooperation with the patient,
resources and referrals to help reduce tobacco use.
Recommendations
• Increase access to information on smoking cessation resources in local businesses, city buildings
and local media outlets, including cable television.
• Increase availability of tobacco cessation programs and the different methods adults can use,
with the support of a medical provider or on their own.
• Cambridge Health Alliance runs the smoking cessation program, “Quit for Life”, which provides
help for long-term smoking patients determined to quit smoking/tobacco use. Expansion of this
program is needed in Everett.
• Expand education efforts to adults and youth on the risks associated with secondhand smoke.
• Increase awareness of cessation supports available through all health insurances, including Mass
Health.
Please refer to the Cancer and Chronic Disease sections for more information on health conditions.
related to smoking.
44
Adult Substance Abuse
Substance abuse continues to be a critical public health problem
impacting individuals, families, and communities. Approximately
23.9 million Americans over the age of 11 used illegal drugs or
abused prescription medications in 2012 alone. In 2011, Eastern
Massachusetts had the highest rate of emergency room visits caused
by illegal drug use of any metropolitan region in the United States.
Everett has been significantly affected by the widespread abuse of
tobacco, alcohol, and illegal drugs, including prescription medications.
Brain imaging shows that long-term drug use can change parts of
the brain that are critical to judgment, decision-making, learning,
memory, and behavior control (NIDA, 2012). Research continues to
support that prevention is the most effective measure to reduce
the onset of substance use or limit the development of problems
connected to use and abuse. Prevention efforts can be directed to
both the individual and the community. Changing conditions and
policies can effectively reduce the availability of substances as well
as the demand.
Guidelines/Definitions for the following charts:
Admissions into substance abuse programs through the state
program, the Bureau of Substance Abuse Services, include the
following services:
•
•
•
•
•
•
Acute inpatient
Post-detox treatment
Residential treatment
Outpatient treatment
Opioid treatment
Family treatment and other treatment programs
Preventing Substance Abuse
Preventing substance
abuse is important because
it impacts the whole
community - individuals,
families, businesses, local
government, schools, law
enforcement and more.
Destructive consequences
are related to lost work
productivity, healthcare, and
crime. Substance abuse and
addiction can lead to severe
and chronic health problems,
mental health disorders,
family disintegration, failure
in school, relationship
violence, increased crime,
child abuse and neglect.
45
xx
Trend in Admissions to Substance Abuse Treatment (2000-2010)
Crude Rate per 100,000
2500
2239.9 (N=831)
1872.5 (N=119,224)
2000
1500
1893.4 (N=721)
1589.9 (N=104,831)
1000
500
0
Everett
MA
2000
2001
2002
2003
2004
2005
2006
2007
2009
2008
2010
Year
SOURCE: Bureau of Substance Abuse Services, MADPH, Program Utilization Data on Substance Abuse Programs
• Between 2006 and 2010 the rate of admissions to substance abuse
treatment steadily increased in Everett from 1,690 per 100,000 to
2,239 per 100,000. The rate in Everett is currently 41% higher than
the overall rate in Massachusetts.
Admissions to Substance Abuse Treatment, by Age (2010)
Age Adjusted Rate per 100,000
8000
7000
6757
6748
6000
Everett
5000
4526 4562
4009
4000
3356
3000
MA
3746
2666 2800
2460
2000
1000
0
589
1044
2175 2082
1676
1385
579 759
15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59
Years
Years
Years
Years
Years
Years
Years
Years
Years
Age Group
SOURCE: Bureau of Substance Abuse Services, MADPH, Program Utilization Data on
Substance Abuse Programs; Data for other age groups not available or reported for Everett
• In 2010, the age-adjusted rates of admissions to substance abuse
treatment were highest among Everett residents age 20 to 29 year
old. Rates in Everett were higher than rates in Massachusetts for
most age groups except for 15-19 year olds and 55 to 59 year olds.
• Across all age groups, males in Everett were more likely to be
admitted into substance abuse treatment services compared to
females (67% males vs. 33% females). Among 25 to 29 year olds
specifically, 73% of admissions were males.
46
Proper Disposal of
Medications
The misuse of non-prescribed
medications is wide spread
across Massachusetts and
throughout the United
States. Prescription drugs
left unattended or forgotten
in family medicine cabinets
are one of the most accessible
gateways to opiate and
heroin abuse. In an effort to
keep expired, unwanted, and
unused medication out of
the environment, Everett
maintains two locations for
residents to dispose of
medications safely.
Medication drop boxes are
located at the Everett Police
Department and the Health
Department. In addition the
city sponsors National
Prescription Drug Take-Back
Days throughout the year.
Additional information can
be found online at
www.mass.gov/eohhs/gov/
departments/dph/programs/
substance-abuse/prevention/opioid-overdose-prevention.html
Trend in Primary Substance Used Among Everett Residents
EnteringSubstance Abuse Treatment (2000-2010)
Crude Rate per 100,000
1600
Alcohol
Cocaine
Crack
Heroin
Marijuana
1400
1200
1000
800
1339.64 (N=497)
835.07 (N=318)
477.09 (N=177)
600
400
735.28 (N=280)
200
0
2001
2000
2002
2003
2004
2005
2006
2007
2008
2009
2010
Year
SOURCE: Bureau of Substance Abuse Services, MADPH, Program Utilization Data on Substance Abuse Programs
Data for Crack in some of the years is not available or reported for Everett
• Heroin and alcohol were most often reported as the primary
substances used among Everett residents entering substance
abuse treatment. However, while alcohol has slightly declined
and remained steady over the past 10 years, heroin as a primary
substance has increased rather dramatically since 2003.
Admissions to Substance Abuse Treatment for Heroin, by Age (2010)
6000
5000
4914.5
4844.4
Everett
MA
4000
2891.7
3000
2000
2481.6
1977.9
2328.7
1632.0
1077.3 1146.8
1000
0
763.3 862.6
515.1 465.5
316.5
40 to 44
35 to 39
45 to 49
50 to 54
Years
Years
Years
Years
Age Group
SOURCE: Data for other age groups not available or reported for Everett
Bureau of Substance Abuse Services, MADPH, Program Utilization Data on Substance Abuse Programs
20 to 24
Years
25 to 29
Years
30 to 34
Years
• In 2010, substance abuse treatment admission rates for heroin
were highest among Everett 20-29 year olds. The admission
rates for heroin in Everett were substantially higher than
Massachusetts for all age groups examined.
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Trend in Emergency Department Visits
Related to Opioids (2002-2009)
700
642.1 (N=254)
Everett
MA
600
500
400
330.5 (N=132)
300
200
100
0
244.2 (N=16,033)
153.6 (N=10,067)
2002
2003
2004
2005
2006
2007
2008
2009
Year
SOURCE: Massachusetts Division of Health Care Finance and Policy, Uniform Hospital Discharge
Data System (UHDDS)
• A similar pattern of difference between Everett and Massachusetts
is observed for opioid-related hospitalizations during the same
time period.
Trend in Opioid related Deaths (2002-2009)
45
40
Everett
MA
40.67 (N=15)
35
30
25
21.43 (N=8)
20
15
10
5
0
5.57 (N=363)
9.25( N=627)
2.91 (N=1)
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Year
SOURCE: Registry of Vital records and Statistics, Research and Evaluation, Massachussetts Department
of Public Health
• Between 2002 and 2009, age-adjusted opioid-related death rates
in Everett were generally higher than the state.
• More recent data obtained from death record review in Everett
for years 2010 through 2012 show a crude rate of 4.8 deaths per
100,000 residents in 2010; 14.2 deaths per 100,000 in 2011;
and 9.4 deaths per 100,000 in 2012.
48
• Everett Community Health Partnership’s Substance Abuse Coalition (ECHP-SAC) has actively
engaged community partners since 2002 to work on prevention strategies to reduce the incidence
of substance use and abuse among Everett’s youth, and over time adults.
• There are two prescription drop boxes available to residents for safe disposal of outdated
medications or unused prescription drugs. One is located at the Everett Police Department lobby
and is accessible 24 hours a day, 7 days a week. The second drop box is located at the Health
Department in City Hall and is available during business hours. Properly disposed medications are
less likely to get into the hands of the wrong person and seep into our water systems.
• The Cambridge Health Alliance and Everett Board of Health continue to monitor admissions data
related to substance abuse, helping to guide community prevention efforts.
• Adults seeking treatment for opioid dependence may now receive care as part of a complete
medication assisted treatment plan by their primary care provider. The Everett Family Health
Center, additional providers at the Cambridge Health Alliance, and other providers in the
region are trained and licensed to provide outpatient treatment dispensing office-based opioid
treatment.
• The Everett Outpatient Clinic, through Eliot Community Human Services, provides client-centered
substance abuse counseling (individual, group, and family) and psychiatry. Treatment is developed
collaboratively with the person served to address identified needs and incorporates their
strengths, life goals, and preferences.
• The Everett Outpatient Clinic at Eliot Human Community Services is now the exclusive provider
for the Malden Drug Court and provides 24Q Evaluations (psychosocial summary and treatment
recommendations), customized individual and group counseling, driver alcohol education for first
and second offenders, as well as direct weekly consultation to the court and probation staff.
• The Parents’ Action Committee of Everett (PACE) was formed in 2012 by a group of bilingual
middle school parents who decided to take a stand to help prevent underage drinking. PACE’s
mission is to provide Everett parents with tools and resources to empower them to candidly
discuss the risks of alcohol with their children. A new campaign, the Power of 6, launched in 2013
at the Keverian School, will now be available to all parents within the Everett schools in the
2014-15 school year.
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• The Everett Police Department maintains a Special Investigations Unit to monitor illegal
drug activity in the city and region, resulting in reducing and eliminating access to drugs.
Everett residents are encouraged to report drug activity using the Drug Hot Line or the Drug Tips
form available on the Department’s website.
• ECHP-SAC’s youth group, Teens in Everett Against Substance Abuse (TEASA), now in its 9th
year, continues to mobilize over 40 high school students each year to work in partnership with
residents and community leadership on prevention efforts to educate youth, adults, parents,
policy makers and local businesses on risks associated with substance use.
• The Everett Police Department monitors alcohol sales to youth through compliance checks
conducted throughout the year.
• Regional approaches to addressing substance abuse and overdoses from opioids, including
heroin, and reducing misuse of prescription drugs are a priority under the Massachusetts
Department of Public Health’s Bureau of Substance Abuse Services. Everett is a member of a
newly formed partnership for prevention which includes the cities of Cambridge, Somerville and
Watertown.
Recommendations
• Develop support networks for parents, family members, and friends who are coping with their
loved ones who are struggling with addiction and dealing with substance abuse disorders.
• Advocate for increased funding for prevention and treatment services dedicated to substance
abuse for all ages.
• Provide more treatment services for individuals seeking help with addiction disorders.
• Promote the state-wide substance abuse treatment hotline to increase awareness of treatment
resources and options for individuals and families managing substance abuse.
• Expand awareness and educational opportunities for residents in Everett to recognize the signs
and symptoms of substance abuse. Assist with referrals for treatment and support for family
members and loved ones living with addiction.
• Expand education and awareness of the effects of selling alcohol to minors.
• Provide professional development and training such as Mental Health First Aid for city
employees, youth workers, after school program staff, teachers and coaches with regard to
recognizing signs and symptoms of substance use, and provide resources to help refer youth,
adults and families for support.
• Continue to practice safe monitoring of prescription drugs in the home, and utilize appropriate
resources such as the prescription drop boxes in the community to properly dispose of unused or
old prescriptions.
50
Adult Mental Health
An estimated 44 million Americans experience a mental health
disorder during any given year. Mental health problems can affect
anyone, regardless of age, sex, race, income, religion, or social status.
One in every five Americans will experience a mental illness during
their lifetime. Mental illness is so common in the United States that
currently, more hospital beds are filled for psychiatric problems than
for any other type of health problem.
Humans live in a complex world, with everyone experiencing stress
or emotional suffering at some point in their life. For many people,
a mental health issue will arise requiring professional attention.
Chronic, long-term mental illness can be highly debilitating and
cause severe disruptions in everyday functioning, thinking, feeling,
and relating to others. These disturbances can disrupt an individual’s
ability to cope with everyday activities (DMH, 2014).
There are several factors that contribute to the development of mental
illness. Trauma and stress early in life can have serious psychological
impact. Biological factors such as a genetic predisposition can also
increase the risk of developing a mental illness.
Mental Health
Preventing the development
of mental health problems
and getting adequate
professional treatment for
existing mental health
illnesses is crucial for
well-being. It is important
for people to learn and
identify early signs, so
support and treatment, if
necessary, can be accessed.
Trend in Mental Disorder Related Hospitalizations (2000-2009)
1400
1293 (N=508)
1200
1114 (N=420)
1000
800
824 (N=53,827)
786 (N=53,395)
600
400
Everett
MA
200
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Year
Data System (UHDDS)
• Between 2000 and 2009, the rate of mental disorder-related
hospitalizations slightly decreased in Everett from 1,293 to 1,114 per
100,000. However the rate has continued to be substantially higher
than the Massachusetts rate across the entire time period.
51
xx
Trend in Mental Disorder Related Hospitalizations,
by Age Group (2003-2009)
Age Specific Rate per 100,000
14000
13026
2003
12000
12261
11882
2005
2007
10000
10176
2009
8000
6000
4543
4000
2000
0
5350
4049
3224
968
963
Under 19
Years
561
20 to 64
Years
Everett
664
Under 19
Years
65 Years
or Older
20 to 64
Years
MA
65 Years
or Older
SOURCE: Massachusetts Division of Health Care Finance and Policy, Uniform Hospital
Discharge Data System (UHDDS)
• Rates of mental health disorder-related hospitalizations are higher
for Everett residents compared to Massachusetts across all age
groups, except for those 65 years or older where the rate for
Everett is slightly lower than Massachusetts.
*Mental Disorders is a very broad category which includes the following conditions:
dementias, drug/alcohol psychoses, schizophrenic or episodic mood disorders,
alcohol dependence syndrome, drug dependence, disturbance of conduct, etc.
(see the Data Definitions in the Appendix) for full detail.
9000
Trend in Emergency Department Visits Related to Mental
Disorders, by Age Group (2002-2009)
2003
8000
7890
2005
7000
2007
6000
2009
5000
5967
5194
4292
4000
2808
3000
2000
1804
1597
3746
1637
2982
2319
2086
1000
0
Under 19
Years
20 to 64
Years
Everett
65 Years
or Older
Under 19
Years
20 to 64
Years
MA
SOURCE: Massachusetts Division of Health Care Finance and Policy, Uniform Hospital
Discharge Data System (UHDDS)
52
65 Years
or Older
• The rate for mental disorder-related emergency room visits is
higher for Everett residents compared to Massachusetts across
all age groups.
• The trend in emergency room visits is rising in all age groups for
Everett and MA, though more sharply in Everett for those aged 20
or older.
What is Alzheimer’s?
Alzheimer’s is a type of dementia that causes problems with memory,
thinking and behavior. The symptoms usually develop slowly and
worsen over time, becoming severe enough to interfere with daily
routines. Alzheimer’s is not a normal part of aging, although the
greatest known risk factor is increasing age, and the majority of people
with Alzheimer’s are 65 and older. Up to 5 percent of people with the
disease have early onset Alzheimer’s (also known as early- or youngeronset), which often appears when someone is in their 40s or 50s.
Alzheimer’s is the sixth leading cause of death in the United States.
Alzheimer’s has no current cure, but treatments for symptoms are
available and research continues. Although current Alzheimer’s
treatments cannot stop the progression, they can temporarily slow
the worsening of dementia symptoms and improve quality of life
for those with Alzheimer’s, their families and caregivers.
Trend in Alzheimer’s Deaths (2000-2010)
30
Everett
MA
26
25
21
20
19
15
10
5
0
5
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Year
SOURCE: Registry of Vital Records and Statistics, Bureau of Health Statistics, Research and Evaluation,
Massachusetts Department of Health
53
xx
• The rate of death due to Alzheimer’s disease in Everett has
dropped steadily since 2004 and is now substantially lower
than Massachusetts.
Depressed Mood in prior 30 days, Among Adults (age 18+)
Everett (2008)
6%
27%
All/Most Days
Some/Few Days
No Days
67%
SOURCE: 5-City BRFSS 2008
Defined by question: During the last 30 days, how often have you felt so depressed
that nothing could cheer you up?
• In 2008, 6% of adults in Everett reported experiencing a
depressed mood on most/all days during the prior 30 days.
• This is a proportion similar to surrounding cities such as Chelsea
(6.6%), but higher than Cambridge (1.2%) and Somerville (2.4%).
54
• Cambridge Health Alliance provides a variety of clinical and professional expertise available to serve
the mental health needs of the Everett community, including Whidden Hospital, which maintains an
adult inpatient psychiatric unit, serving adults 18 and older, and a geriatric psychiatric unit, serving
adults 55 and over.
• The Everett Outpatient Clinic, through Eliot Community Human Services, provides person-centered
counseling and psychopharmacological services across the life span. The approach is to match
treatment with an individual’s strengths, dreams, and preferences as a means to restore hope
and cultivate recovery.
• Eliot Community Human Services’ Outpatient Clinic services include: Individual Counseling
(including Substance Abuse); Certified Problem Gambling Counseling; Couples Counseling;
Family Counseling; Specialized In-Home Psychiatry; Counseling and Peer Mentorship Services to
Mystic Valley Elder Services Clients; Group Counseling (art therapy, trauma, anxiety and depression,
anger management, and substance abuse); CSP (Case Management for recently hospitalized clients
with Beacon, Neighborhood, Massachusetts Behavioral Health Partnership (MBHP), and Network
Health Insurance); 24Q Substance Abuse Evaluation; Driver Alcohol Education Courses: First and
Second Offender.
• Eliot Community Human Services offers expertise in professional development and training on
mental health and well-being topics for city programs, schools and local agencies. Opportunities
in Everett have included: Trauma Informed Care, Motivational Interviewing, Understanding and
Treating Substance Abuse Disorders, Person-Centered Treatment Planning and Practice.
• The Mental Health First Aid training program has been offered to Everett residents and employees
from local social service agencies and city-run programs. Attendees gain knowledge of signs,
symptoms and risk factors of mental illnesses and addictions; identify multiple types of professional
and self-help resources for individuals with a mental illness or addiction; and increase their
confidence in and likelihood to help an individual in distress. Everett has two qualified trainees from
the Cambridge Health Alliance and Eliot Community Human Services.
• Mystic Valley Elder Services provides a range of services and programs to strengthen and support the
well-being, dignity and independence of elders, adults living with disabilities, and caregivers residing
in Everett.
55
xx
Recommendations
• Develop educational opportunities to reduce stigma associated with mental health issues and the
importance of asking for help.
• Expand access to mental health services at home in a cost-effective way, especially for adults who
are homebound and seniors.
• Increase opportunities for Mental Health First Aid training in the community to increase
understanding and appropriate referrals for adults needing behavioral health intervention or
support.
• Work to reduce social isolation for elders coping with loss and destigmatize issues of aging.
• Strengthen services for adults and families who are survivors of major mental health stressors,
such as loss of family members/loved ones, homelessness, suicide, natural disasters or violent
crimes.
56
Adult Violence
Violence impacts both individuals and communities. Violent crime is
linked to disability, mental health issues and increased medical costs,
and may result in premature death or injury.
Domestic or family violence includes parent/guardian abuse of
children and intimate partner violence (IPV). Intimate partner
violence includes acts of physical or sexual violence or abuse that
occur between partners or spouses and can affect any age and any
gender. IPV estimates rates among same-sex couples are similar to
those of heterosexual couples.
Elder abuse results in serious physical, sexual, or emotional injury or
financial loss to an elder, 60 years old or older.
Children exposed to violence are more likely to act out in school and
have a greater potential for perpetrating violence in the future.
While gang and gun-related violence remain a key area of concern
in the U.S., other forms of violence, especially bullying and cyberbullying, have been the focus of increasing research and public
attention.
Sexual violence is a common and under-reported crime. Sexual
violence includes rape, defined as non-consensual sexual penetration
and sexual assault, defined as non-consensual sexual touching. In
2000, the U.S. Department of Justice estimated that 1 in 6 women
and 1 in 33 men experienced an attempted or completed rape at
some time in their lives. Locally, the Massachusetts Department of
Public Health reports an estimated 17% of women and 6% of men
have experienced sexual violence at some point in their lifetime. In
Massachusetts, consent cannot legally be given if a person is under
the age of 16, mentally disabled or incapacitated. Such violence
can result in profound immediate and long-term consequences on
survivors’ physical and mental health.
What is Cyber-bullying/
cyber-harassment or
cyber-stalking?
Cyber-bullying is when a
child, preteen or teen is
tormented, threatened,
harassed, humiliated,
embarrassed or otherwise
targeted by another child,
preteen or teen using the
Internet, interactive or
digital technologies or
mobile phones. If an adult
engages in similar harmful
behavior, it is considered
cyber-harassment or
cyber-stalking. It is a serious
offense that can result in
misdemeanor or federal
criminal charges, depending
on the severity of the crime.
For more information, visit:
www.stopcyberbulling.org
57
xx
Number of Calls
Domestic Violence Calls in Everett, by Type (2011-2013)
200
180
160
140
120
100
80
60
40
20
0
173 177
162
2011
2012
2013
75
38
48
57
45
44
7
7
10
7
7
6
Restraining Domestic Abuse
Child
Domestic Abuse
Domestic
Abuse/Neglect or Neglect
Verbal
Assault & Order Violation
Battery
2
0
1
Elderly
Abuse
SOURCE: Microsystems Crime Track, Everett Police Department
• There were 568 domestic violence related calls for service received
by the Everett police for the two- year period of 2011 and 2012,
a 12% decrease from the two- year period of 2009 and 2010. The
majority of the domestic violence calls were related to assault and
battery (62%) followed by 209A-Restraining Order violations (17%).
• In 2013, 298 total domestic violence related calls were received,
a slight increase from 2012.
Trend in Violent Crime Rate (2000-2012)
Crimes per 100,000 Residents
900
800
851
Everett
MA
700
600
557
500
400
300
200
100
0
459
475
467
405
313
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Year
SOURCE: MA State Police Reporting Unit.
Data only includes offences known to law enforcement.
58
406
• The violent crime rate in Everett rose above that of Masschussets
in 2007 and remained higher until 2011. As of 2012, the violent
crime rate in Everett is similar to Massachussetts.
• In 2010, twenty-five cases of forcible rapes were reported,
resulting in the highest number ever reported in Everett.
* Violent Crime refers to homicide, forcible rape, robbery and
aggravated assault.
Everett Crime Prevention
Meetings
Trend in Property Crime Rate (2000-2012)
Crimes per 100,000 Residents
4000
3624
3500
3000
2544
2366
2500
2000
Everett
MA
2383
2348
2185
1500
1000
500
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Year
SOURCE: MA State Police Reporting Unit (2000-2012).
Data only includes offences known to law enforcement.
• Everett experienced a peak in property crime in 2008, after which
the property crime rate has decline sharply to its current level of
2,366 crimes per 100,000 residents, comparable to the state rate.
The Everett Police
Department Crime
Prevention meetings are
held on the third Tuesday of
every month at 7:00pm.
The meetings are open to
the public with open forum
discussion where citizens
have an opportunity to
discuss issues and concerns
with members of the Police
Department. Contact the
Everett Police Department
for more information on the
meetings. Also connect at
www.facebook.com/
EverettPoliceMa
59
xx
• The Everett Violence Project (EVAP) is part of the Everett Police Department and provides
services in support of law enforcement cases, including court advocacy, crisis intervention,
safety planning and referrals. In 2012, thirty-three (33) cases were referred to EVAP’s partner
program, Portal to Hope for their comprehensive services.
• The Whidden Emergency Room and other CHA outpatient primary care and specialty staff screen
all patients to assess for intimate partner violence.
• There is a strong collaboration between the Police Department, the school system and city
agencies around issues of injury and violence prevention, including a School Resource Officer
at the high school, who regularly meets with parents to resolve conflicts with youth.
• Portal to Hope is a non-profit organization committed to helping victims of domestic violence,
sexual assault and stalking crimes. A variety of programs and services are offered to assist victims
including: a 24-hour hotline, emergency shelter, legal aid for ensuring continued civil protections
through the legal court system, job placement and housing assistance, which help victims rebuild
their lives both personally and professionally, and youth programs designed to educate our
children and help break the cycle of violence.
Recommendations:
• Support and facilitate help-seeking where family violence occurs.
• Promote connectedness between family members and the community.
• Work with Action for Regional Equity, La Comunidad, and other community leaders to expand the
number of living wage jobs at Logan Airport and other large employers.
• Strengthen the Restorative Justice program and increase community awareness about its
services.
• Increase the capacity of parents and/or caregivers to raise nonviolent youth.
• Assure and promote alcohol and chemical dependency treatment for parents.
• Expand community efforts to support individuals reintegrating from incarceration, including
employment, housing, and referrals to appropriate health services.
• Increase funding for Portal to Hope.
Please refer to the Youth section for additional information on Violence.
60
Adult Sexual Health and Reproduction
The prevention and treatment of sexually transmitted infections
(STIs) remains a health concern in the field of sexual and reproductive
health. Untreated STIs can lead to long-term health issues, including
pelvic inflammatory disease, infertility, and cancer. Untreated STIs
during pregnancy can also lead to fetal and perinatal negative
outcomes. In the United States, there are an estimated 19 million
new diagnoses of STIs annually, with nearly half among those ages 15
to 24; the most common diagnosis being Chlamydia. In addition, it is
estimated that approximately 1.1 million Americans are living with the
human immunodeficiency virus (HIV) and that 1 out of 5 people are
unaware that they have it (DHHS, 2013).
In the United States, half of all pregnancies are unplanned. Of those
3.4 million unplanned pregnancies, approximately 305,000 are to
girls aged 15 to 19 years old (National Campaign, 2012). U.S. teen
pregnancy and birth rates have declined dramatically over the past
twenty years and are now at historic lows; however the U.S. teen
birth rates remain far higher than in other comparable countries and
continue to cost the U.S. $12.5 billion dollars a year (Guttmacher,
Unintended, 2013).
Citations
Guttmacher Institute; Contraceptive Needs and Services, 2010 (2013),
www.guttmacher.org/pubs/win/contraceptive-needs-2010.pdf
Guttmacher Institute; Unintended Pregnancy in the United States, (2013),
www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.html#13
National Campaign to Prevent Unplanned Pregnancy; National and State Data,
(2013), thenationalcampaign.org/data/landing
Family Planning Services
Public funding for family
planning services helps to
prevent unintended pregnancies; for every $1 spent
on family planning services,
$5.68 in pregnancy related
Medicaid expenditures is
saved (Guttmacher,
Contraceptive, 2013).
Family planning funding
also supports access to
contraception, cancer
screening and prevention,
HIV and STI testing and
treatment, pregnancy
planning, screening for
intimate partner violence,
and referrals for prenatal
care, substance abuse
treatment, and primary
care (DHHS, 2013).
The Centers for Disease Control and Prevention (CDC); Pregnancy (2014),
www.cdc.gov/pregnancy/The U.S. Department of Health and Human Services
(DHHS); Healthy People, Reproductive Health (2013), healthypeople.gov/2020/LHI/
reproductiveHealth.aspx
61
xx
Trend in HIV/AIDS Prevalence (Existing Cases)
(2000-2009)
Crude Incidence Rate, per 100,000
450
400
350
300
250
398.9
(N=148)
Everett
MA
228.5
(N=87)
261.0
(N=17,208)
200
150
200.0
(N=12,734)
100
50
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Year
SOURCE: Bureau of Communicable Disease Control Registries, MADPH 2000-2009
• Everett’s HIV/AIDS prevalence rate (all existing cases) rose from
228.5 per 100,000 cases in 2000 to 399 cases per 100,000, while
Massachusetts’ rate rose slightly from 200 to 261 per 100,000.
• Generally HIV/AIDS prevalence increases with age for both MA
and Everett.
Percent of Prevalent Cases
• As of 2012, 45.3% of residents living with HIV/AIDS in Everett
were aged 50+.
100
90
80
70
60
50
40
30
20
10
0
Mode of Transmission for Prevalent HIV/AIDS Cases
(as of December 2012)
Everett
MA
39.0
36.4
23.3
20.3
7.6
Male Sex with Injection Drug
Use (IDU)
Men (MSM)
11.0
4.1
14.3
3.4
MSM/IDU
SOURCE: HIV/AIDS Surveillance Program, MADPH
15.1
8.7
Heterosexual Presumed
Sex
Heterosexual
Sex
14.6
Unknown
• As of 2012, 39% percent of residents living with HIV/AIDS in Everett
were infected through males having sex with men; similar to the
state overall.
62
Trend in Chlamydia Incidence (New Cases) among Everett Residents,
by Age Group (2000-2010)
3000
15 to 19 Years
20 to 25 Years
25 to 29 Years
30 Years or Older
2500
2000
2436
1526
1500
1000
500
0
1022
1008
741
237
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Year
SOURCE: Bureau of Communicable Disease Control Registries, MADPH
*Rates for age 30+ are estimates only and data were not available for 2000-2005
• Between 2000 and 2010, the Chylamdia incidence rate increased
steadily for both Everett (165 to 451 cases per 100,000) and MA
(158 to 324 cases per 100,000).
• When examined by age, the Chylamdia incidence rate in Everett
showed a four fold increase among 20 to 25 year olds, a three fold
increase among 15 to 19 year olds and almost doubled among 25
to 29 year olds between the years 2000 and 2010.
Crude incidence Rate per 100,000
Trend in Hepatitis C Incidence (New Cases) (2000-2012)
250
Everett
MA
200
162
(N=69)
150
100
50
0
86
(N=33)
113
(N=7515)
63
(N=3987)
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Year
SOURCE: Bureau of Communicable Disease Control Registries, Epidemiology Program, MADPH
Crude rate calculated using US Census 2000-2012 population estimates
• Since 2005, the rate of new cases of Hepatitis C in Everett has
increased and remained higher than the Massachusetts rate.
63
xx
• Cambridge Health Alliance operates the Everett Family Health Center on Broadway.
Open Monday through Friday, the health center offers comprehensive primary care services,
HIV testing services, and reproductive health services. Services include access to low or no cost
reproductive care, HIV testing and counseling, and STI testing and treatment.
• Cambridge Health Alliance has a Hepatitis C clinic and offers a Hepatitis C testing/counseling
hotline. Services are provided in a variety of languages, including French, Haitian Creole,
Portuguese and Spanish. Additionally, CHA has a clinic that offers primary care,
HIV specialty care and obstetrics and gynecological services.
Recommendations
• Develop a plan to reach out to the men having sex with men (MSM) population to increase
awareness of testing and treatment services available in Everett.
• Increase awareness and visibility of the Cambridge Health Alliance bilingual Integrated
Counseling, Testing and Referral (ICTR) services at Everett Family Health Center during the hours
of 9 AM-5 PM, Monday through Friday, that include comprehensive HIV, Hepatitis C, and STI
testing, including access to confidential low or no cost STI treatment.
• Host HIV testing events, such as during World AIDS Day and National Testing Day, to increase
HIV testing.
• Develop a plan to increase awareness of lesbian/gay/bisexual/transgender (LGBT) health and to
address that community’s health needs.
64
Maternal and Child Health
Adequate care for an unborn child begins before conception with a
mother’s healthy lifestyle and good nutrition. Prenatal care, defined
as care while the baby is in the womb, is highly important for a child’s
well-being as it prevents a multitude of health problems after birth.
An ideal pregnancy would be one in which the mother maintains a
healthy diet with minimal stress, refrains from drugs, alcohol, and
other harmful toxins, and has a full-term pregnancy (approximately 9
months). An ideal birth would include a healthy delivery of the baby
followed by caretaking in a stable, positive environment that supports
the physical and emotional needs of the mother and baby (CDC, 2012).
Pregnancy and childbirth are life-changing events which impact the
physical, mental, emotional, and socioeconomic needs of the pregnant
woman and her family.
Prenatal providers and counselors list nausea and loss of appetite as
the two most commonly observed physical complaints in pregnant
clients. Other concerns may center on financial needs, including
housing to properly care for and raise a child. Once the baby is born,
a new mother may need support and education on feeding the baby,
including breastfeeding.
Citations
The Centers for Disease Control and Prevention (CDC); Reproductive Health
(2012), www.cdc.gov/reproductivehealth/DRH/index.htm
What is WIC?
The Special Supplemental
Nutrition Program for
Women, Infants, and
Children (WIC) provides
federally-funded clinics for
low-income, nutritionallyat-risk, pregnant women,
new mothers, and children
up to five years of age.
WIC, which serves 53%
of all infants born in the
United States, supplies
clients with supplemental
foods, healthcare referrals,
and nutrition education
(USDA, 2014).
United States Department of Agriculture (USDA); Women, Infants, and Children
(WIC) (2014), www.fns.usda.gov/wic/women-infants-and-children-wic
65
xx
Trend in Birth Rate by Age of Mother (2000 - 2010)
2000
160
2002
Age Specific Rate Per 1,000
140
128.5
133.8
2004
120
100
80
101.3
85.8
79.3
2006
109.7 112.8
100.4
97.1
91.6
2008
90.7 86.8
78.6
2010
2010 MA
63.4
60
40
23.0
20
0
35 Years and Older
30 to 34 Years
20 to 29 Years
35.3
38.4 35.0
35.6
27.5 26.0
Everett
SOURCE: Source: Registry of Vital Records and Statistics, Bureau of Health Statistics,
Research and Evaluation, MADPH
• Between 2000 and 2009, the birth rate among women age 20 to
29 years steadily increased and was much higher compared to
Massachusetts. However, a sharp drop in the birth rate for this
age group in Everett occurred in 2010.
• The birth rate among women age 30 to 34 years show a steady
increase between 2004 and 2010, approaching the rate seen
at the state level for this age group.
Adequate Prenatal Care* Received, by Race
(3-year average; 2008-2010)
84.4
84.5
82.5
74.5
Percent of Total Births
100
90
80
70
60
50
40
30
20
10
0
White, NonHispanic
74.2
Black, NonHispanic
76.5
Hispanic
Everett
MA
82.4
81.9
Asian / Pacific Islander,
Non-Hispanic
SOURCE: Source: Registry of Vital Records and Staistics, Bureau of Health Statistics,
Research and Evaluation, MADPH; *Adequate care = care begun by month 4 and
80% or more of the expected visits received, based upon the Kotelchuck scale.
• During the time period 2008 to 2010, the proportion of Everett
mothers receiving adequate prenatal care did not differ significantly
by race compared to the state. Generally the proportion receiving
adequate prenatal care was lower for Black, non-Hispanic women
compared to White, non-Hispanic women in Everett
and Massachusetts.
66
30
Trend in Low Birth Weight (2000-2010)
Everett
MA
Percent of Total Births
25
20
15
10
5
0
7.8
(N=5,650)
7.0
(N=5,711)
6.7
(N=42)
6.1
(N=30)
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Year
SOURCE: Registry of Vital Records and Staistics, Bureau of Health Statistics, Research and Evaluation,
MADPH; Low Birth Weight is defined by weight less than 2,500 grams
• Since 2000, the proportion of low birth weight among Everett
residents has remained steady and similar to Masschussetts overall.
Why is Breastfeeding Important?
The health benefits of breastfeeding include increased infant protection
from infections and illnesses, decreased risk of breast and ovarian
cancers for mothers and decreased risk of obesity in children who are
breastfed for at least six months. A study published in the Journal of
the American Dietetic Association suggests economic benefits include a
savings of between $1,200 and $1,500 on infant formula in the first year
alone. www.breastfeedingmadesimple.com/EconomicsofBF.pdf
Over the past decade, the rate of mothers initiating or intending to
breastfeed after childbirth has increased among White, non-Hispanic
mothers (65% in 2000 and 78% in 2010) and Asian mothers (60% in 2000
and 86% in 2010). The rate among Black, non-Hispanic and Hispanic
mothers has historically been high (approximately 87% for both groups
in 2000) and has remained steady through 2010 (Registry of Vital
Records and Statistics, Bureau of Health Statistics, Research and
Evaluation, MDPH).
67
xx
• Everett’s Women, Infants and Children (WIC) Program, overseen by Hallmark Health Systems, is
conveniently located at Everett City Hall. WIC services are provided to pregnant, breastfeeding
and postpartum women, and to infants and children up to age five. They provide personalized
nutrition consultations, breastfeeding support, referrals to our community’s healthcare services,
and vouchers for free, nutritious food tailored to supplement the dietary needs of participants.
• In addition to the Everett location, Everett residents are able to receive services at additional
locations in the North Suburban WIC Program of Hallmark Health. They offer a variety of
resources and support services to strengthen families. A partial listing of programs open
to income-eligible Everett participants include: breastfeeding classes, breastfeeding peer
counseling, parenting support programs, farmer’s market coupons, prenatal exercise and
nutrition, mobile food market, free clothing store, and family support coordinator program
to help WIC families coordinate services such as SWAP, childcare, ESL, Mass Health and
fuel assistance.
• The Joint Committee for Children’s Health Care is available to assist pregnant woman and new
parents with health insurance, referrals to parenting groups, and other resources addressing
issues that arise with the arrival of a newborn child.
Recommendations
• Adopt supportive work policies for new and expecting families, family leave for part- time
workers, personal days to attend prenatal doctor appointments, and follow up postpartum
appointments.
• Provide supportive breastfeeding policies at work places.
68
Chronic Disease
Chronic diseases—such as heart disease, cancer, and diabetes—
are the leading causes of death and disability in the United States.
Annually, chronic diseases account for 70% of all deaths, with
heart disease, cancer, and stroke making up 50% of all U.S. deaths.
Furthermore, these diseases cause major limitations in daily living
for almost 1 out of 10 Americans. Although chronic diseases are
among the most common and costly health problems, they are also
among the most preventable. Reducing poverty and racism, as well
as adopting healthy behaviors, such as eating nutritious foods, being
physically active and avoiding tobacco use can prevent or control the
devastating effects of these diseases.
Not only can chronic diseases be debilitating and fatal, they are also
responsible for high levels of medical spending. The total amount of
public and private spending on healthcare in Massachusetts is $60
billion per year. Much of that is due to the rise of chronic diseases.
For example, diabetes has increased by 40% in only one decade.
Type 2 Diabetes was once unheard of, but is now the most common
type of diabetes in Massachusetts.
Leading Causes of Death (3-year average; 2008-2010)
155
150
Heart Disease
48
Lung Cancer
44
Mental Disorders, All
73
53
Everett
29
29
Chronic Lower Respiratory Disease, Other
MA
17
21
Pneumonia and Influenza
Cerebrovascular Disease
20
20
18
13
16
15
16
10
16
Breast Cancer (Female)
Poisoning, All
Colorectal Cancer
Septicemia
0
32
50
100
150
200
250
Age adjusted Rate per 100,000
SOURCE: Registry of Vital Records and Statistics, Bureau of Health Statistics, Research and Evaluation, MADPH
69
xx
• The leading causes of death between 2008 and 2010 in Everett
and throughout Massachusetts included heart disease, lung cancer
and mental disorders.
• The Everett rates were much higher than Massachusetts for lung
cancer and mental disorders while heart disease was slightly lower
in Everett than Massachusetts.
Leading Causes of Hospitalizations (3-year average; 2007-2009)
2594
Childbirth and Pregnancy Related
1982
Diabetes Mellitus Related
2093
COPD Related
1537
1585
Circulatory System Diseases
780
Mental Disorders
3533
2430
2397
Everett
MA
1150
1046
1118
913
1034
Digestive System Diseases
Asthma Related
Genitourinary Diseases
334
Alcohol / Substance Related
Musculoskeletal Diseases
284
Opioid Injuries
0
542
568
521
604
509
495
1000
2000
3000
• The leading causes of hospitalizations occuring between 2007
and 2009 for both Everett and Massachusetts included childbirth
and pregnancy, diabetes and chronic obstructive pulmonary
disease (COPD). Each of these rates was higher for Everett than
Massachusetts.
• Everett also had higher rates of hospitalization for mental disorders,
asthma, and opioid-related injuries.
• 26% of Everett adults reported having been told they have high
blood pressure (2008 BRFSS).
• 30% of Everett adults reported having been told they have high
cholesterol (2008 BRFSS).
• Childbirth and pregnancy related hospitalizations have been
included in the Leading Causes of Hospitalizations chart. This
includes mothers who gave birth, as well as women hospitalized for
pregnancy and childbirth-related conditions.
70
4000
14,000
Diabetes Related Hospitalizations, by Age Group (2009)
12,000
Everett
10,000
MA
12,140
10,937
8,093
8,000
6,070
6,000
4,000
3,282
2,096
2,000
0
332
1,150
185
15 to 29 years
667
30 to 44 years
45 to 59 years
60 to 74 years
75 years or
older
Age Group
SOURCE: Uniform Hospital Discharge Dataset System (UHDDS), Massachusetts Division of Health Care
Finance and Policy.
• Diabetes-related hospitalizations among Everett residents in 2009
were higher than the rates in Massachusetts for all age groups from
15 to 74 years old.
• Massachusetts had a higher rate among those age 75 years or older.
• Data reflects a total of 1,010 hospital discharges related to diabetes
among Everett residents in 2009.
• 10% of Everett adults reported having been told they have diabetes
(2008 BRFSS).
71
xx
4,500
Trend in Emergency Department Visits Related to COPD
(2002-2009)
Everett
MA
4,000
3,500
3907.9
(N=1,430)
3,000
2,500
2,000
1851.4
(N=709)
2037.8
(N=133,315)
1,500
1,000
1457.5
(N=93,909)
500
0
2002
2003
2004
2005
2006
Year
2007
2008
2009
SOURCE: Registry of Vital Records and Statistics, Bureau of Health Statistics, Research and
Evaluation, MDPH
• The rate of emergency department visits related to chronic
obstructive pulmonary disease (COPD) has increased sharply since
2006 in Everett and is now substantially higher than Massachusetts.
• This trend is observed among all age groups, however the sharpest
increases are observed among residents in the younger age groups
under age 45.
• The group with the highest rate is 15 to 29 year olds with an agespecific rate of 5,451.8 per 100,000 individuals in Everett for 2009
compared to Massachusetts at 3907.9 per 100,000 individuals.
72
6000
Emergency Department Visits Related to Asthma, by Age Group (2009)
5053.8
5000
4000
Everett
4121.6
MA
3451.3
3000
1967.9
1886.6
2000
1593.3
1638.6
857.5
1000
0
Under 15 years
14 to 29 years
30 to 44 years
45 years or older
• Age-specific rates of emergency room visits related to asthma for
Everett residents were much higher than Massachusetts for all age
groups in 2009. The age groups most affected were individuals
under 30 years of age.
• 14% of Everett adults reported having been told they have asthma at
some point in their lives (2008 BRFSS).
• 10% of Everett adults reported they currently have asthma (2008 BRFSS).
Trend in Emergency Department Visits for Acute Respiratory Infection (2002-2009)
4,000
3806.9
3,500
3316.2
3,000
2,500
2419.1
2,000
1,500
2087.6
1963.4
1843.4
1,000
Everett
MA
500
0
2002
2003
2004
2005
2006
2007
2008
2009
Year
Evaluation, MDPH
• The rate of emergency room visits for acute respiratory infections
among Everett residents was markedly higher than Massachusetts
between the years of 2002 and 2009.
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• Data from the Everett Health Department show increasing cases
of latent Tuberculosis (TB) among Everett residents: 160 cases in
2011, 198 cases in 2012 and 210 cases in 2013. Tuberculosis is
a disease caused by a germ called Mycobacterium tuberculosis
which is spread from person to person through the air. People with
latent TB are infected with M. tuberculosis, but do not have the
TB disease. Persons with latent TB are not infectious and cannot
spread TB infection to others.
Trend in Emergency Department Visits
Related to Falls (2002-2009)
4144.9
4,500
4,000
3,000
2,500
3018.6
2904.5
2720.5
2,000
1,500
Everett
MA
1,000
500
0
2002
2003
2004
2005
2006
2007
2008
Year
Evaluation, MDPH
• The rates of emergency department visits related to falls were
higher than Massachusetts from 2002 through 2009 and the
trend in Everett is increasing.
• For 2007 through 2009, falls were the second leading cause of
emergency room visits among Everett residents age 65 years
and over.
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2009
• The Everett Health Department provides communicable disease investigation and surveillance,
organizes immunization clinics, oversees public health and school nurses, provides health and
sanitary inspections, and plans public health roles in emergency preparedness.
• The Cambridge Health Alliance’s older adult health education program, in collaboration with the
Everett Foundation, provides weekly aerobic, strength and yoga classes, informational and screening
sessions at the Connolly Center and other locations in Everett.
• Screening for blood pressure, diabetes, and cholesterol control are provided along with health
information including nutritional counseling.
• The Cambridge Health Alliance’s Everett Family Health Center has been selected by the National
Committee for Quality Assurance with the highest designation of Level 3 Medical Home.
Recommendations
• Expand community and health providers focus on understanding the factors impacting lung diseases
in Everett.
• Increase primary care services for adults and children in Everett.
• Fund a Wellness Program within the Health Department based on programs piloted by
Energize Everett to increase fitness, nutrition, and cooking programs throughout the city.
• Expand cancer screening and education.
• Expand pre-diabetes screening and education.
• Increase access to affordable dental care for adults and children in Everett.
• Create more opportunities for community residents of all ages to volunteer in the city and in
community organizations to support health and wellness activities impacting Everett’s well-being.
• Address health disparities and the social determinants of health in health policies and programs.
• Increase access and expand awareness of support services for families managing chronic diseases
of family members.
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xx
Cancer
In 2014, there will be an estimated 1,665,540 new cancer cases
diagnosed and 585,720 cancer deaths in the United States. Cancer
remains the second most common cause of death in the U.S. after
cardiovascular disease (heart attack and stroke), accounting for
nearly 1 of every 4 deaths. One in three individuals in America
will develop some form of cancer in their lifetime; every family in
America will be touched by cancer.
Great progress has been made in recent years in the fight against cancer in terms of screening
and early detection, improved treatments, and significantly more cures. Many forms of childhood
leukemia, testicular cancer, cervical cancer, breast cancer and colon cancer can be completely cured
through early detection and state-of-the art treatment. We can have an important impact on the
well-being of Everett by providing public education about risk factors, ensuring the availability of
screening for early cancer detection, and providing state-of-the art treatment in our excellent, local
and Greater Boston-area hospitals and treatment centers.
Public health data shows that Everett has higher rates of specific cancers, particularly lung and
colon, than the state of Massachusetts. In the case of colon cancer, screening is known to decrease
mortality. For lung cancer, prevention is key. There is work to do to reduce smoking rates, which
remain high in Everett.
Leading Cancer Deaths (5-year average; 2006-2010)
50
Lung
Prostate
16
Colorectal
Breast (Female)
11
12
Pancreas
8
Ovary
6
Liver
4
Stomach
Leukemia
5
5
Lymphoma, Non Hodgkin
5
5
4
5
4
3
4
4
3
3
3
Esophagus
Bladder
Kidney
Brain/Central Nervous System
Multiple Myeloma
0
20
18
Everett
21
17
MA
9
8
7
6
10
20
30
40
50
76
65
23
60
70
• The leading causes of cancer deaths between 2006 and 2010 for Everett residents included
lung, prostate and colorectal cancers. While for Massachusetts, the top three causes of
cancer deaths were lung, prostate, and breast cancers.
• The age-adjusted death rates for lung, colorectal, ovarian, liver, stomach, and kidney cancers
were also higher than for Massachusetts.
Leading Cancer Incidences (5-year average; 2006-2010)
Prostate
114
Breast, invasive (female)
72
Lung
49
Colorectal
Breast, non-invasive (female)
30
26
Uterus
Thyroid
Melanoma / Skin
Kidney
7
Ovary
Pancreas
Leukemia
83
Everett
55
MA
20
23
17
16
23
15
16
15
Lymphoma, Non Hodgkin
Stomach
47
47
111
164
135
14
13
12
13
11
12
11
7
10
Liver
0
50
100
150
200
• The leading new cancer cases (termed incidence) between 2004 and 2008 for both
Massachusetts and Everett included prostate, breast and lung cancer.
• The state rates were much higher for both prostate and breast cancer compared to Everett.
However, incidence rates for lung cancer, colorectal, non-Hodgkin lymphoma, stomach and liver
cancer were all higher in Everett than Massachusetts.
Lung Cancer
Lung cancer is the leading cause of death from cancer for Everett residents with an average of
approximately 37 deaths per year. The rate of death to lung cancer is dramatically higher in Everett
compared to Massachusetts. Over the 5-year period 2006 to 2010, the age-adjusted rate was much
higher (nearly 30% higher) than Massachusetts.
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xx
Trend in Lung Cancer Incidence (1995-2009)
140
115.55 (N=48)
100
74.8(N=29)
80
60
69.95 (N=5,151)
69.6 (N=4,241)
40
09
20
20
07
20
06
20
05
20
04
20
03
20
01
02
20
20
00
20
99
19
98
97
19
19
19
19
0
96
20
08
Everett
MA
95
120
SOURCE: The Massachusetts Cancer Registry, Bureau of Health Statistics, Research and Evaluation MADPH
Trend in Female Breast Cancer Incidence (1995-2009)
200
172.9 (N=35)
160
135.93 (N=5,447)
140
145.1 (N=4,832)
120
132.9 (N=29)
100
80
60
Everett
MA
40
09
20
08
20
07
20
06
20
05
20
4
20
0
03
20
02
20
01
20
00
20
99
19
98
19
97
19
96
19
0
95
20
19
180
SOURCE: The Massachusetts Cancer Registry, Bureau of Health Statistics, Research and Evaluation MADPH
• The rate of new cases of breast cancer in Everett has generally
been lower than Massachusetts since 2000.
• The overall trend in breast cancer incidence since 1995 appears
to be slightly decreasing for both Everett and Massachusetts.
78
Cancer Screening
Prevention mammography is a method of screening shown to reduce
breast cancer mortality by approximately 20-25% over 10 years among
woman aged 40 years and older.
• Data from the 2008 5-City Behavioral Risk Factor Surveillance
Survey showed that 84% of Everett women ages 40 and older
reported having a mammogram in the prior 2 years and 82% of
Everett women reported having a Pap smear test in the prior
3 years.
In terms of colorectal cancer, 60% of deaths could be prevented if
people, 50 years and older, were regularly screened by testing for
occult (hidden) blood in stool, in addition to routinely scheduled
colonoscopies. Removing precancerous polyps or abnormal growths,
identified during a fecal occult blood test (sigmoidoscopy or
colonoscopy) can prevent colorectal cancer.
Survey showed that 39% of Everett adults ages 50 and older
reported having a blood stool test at some time in their life and 61%
of Everett adults ages 50 and older reported having a colonoscopy
within the last 10 years.
Sigmoidoscopy vs.
Colonoscopy
A sigmoidoscopy can be
used as a screening procedure to determine if a full
colonoscopy is necessary.
It is done in many instances
in conjunction with a fecal
occult blood test (FOBT),
which can detect the
formation of cancerous cells
throughout the colon. It has
been shown that up to 50%
of polyps and other findings
can be missed with a
sigmoidoscopy; thus, there
has been a trend towards
performing a colonoscopy
rather than sigmoidoscopy.
79
xx
• The American College of Surgeons Commission on Cancer recognizes the Cambridge Health
Alliance (CHA) as a Community Hospital Cancer Program for its high-quality cancer care.
In order to achieve this, CHA is surveyed every three years to evaluate the cancer care provided
in 36 specific compliance areas.
• In 2010, five CHA primary care sites were selected for Massachusetts’ new Patient-Centered
Medical Home Initiative and two of those were recognized with the highest designation of Level
3 Medical Homes by the National Committee for Quality Assurance.
• CHA provides access to uninsured and language services for those with limited English proficiency
for all cancer screenings.
Cambridge Health Alliance Cancer Services:
• Cambridge Breast Center - open access for mammography, diagnosis and treatment including the
Whidden Hospital location in Everett.
• Coordinated team approach to cancer care for all common cancers (e.g. breast, colon, skin,
cervix, testicular, prostate).
• Everett residents, including youth, consistently participate in community and regional cancer
awareness walks and fundraising efforts to support research as well as families coping
with cancer.
Recommendations
• Organize community-wide efforts to educate Everett residents about cancer risk and encourage
residents to take advantage of screening, early detection and potential curative treatment for
common cancers.
• Increase awareness of support networks for individuals
and families managing cancer.
• Organize public forum to present health data and
priorities for action, including cancer.
80
Access to Healthcare
Access to healthcare is critical to maintaining overall physical, social
and mental health and aids in the prevention and treatment of disease
and disability.
Everett broadly defines access to healthcare to include financial,
physical, cultural, and linguistic accessibility. Healthcare must be
affordable to be financially accessible. Financial accessibility is
enhanced when a healthcare institution and local physicians and
dentists accept a wide variety of insurance, assist patients in applying
for coverage and when there is no other option, provide free or
reduced priced care. Physical accessibility includes being accessible
to people with limited mobility. Cultural and linguistic respect and
inclusiveness ease the way for people who are less able or less likely
to use existing health services.
Additionally, access to healthcare also includes availability of
emergency services. However, the basic tenet of the access to
healthcare concept is a focus on decreasing the need for emergency
room visits through preventive medical, dental, nutrition and mental
health care. Access to regular medical and dental checkups and the
financial support to sustain relationships with primary care providers
and pay prescriptions are critical steps to accessing preventive care
throughout life for all residents.
Percent of Residents
Overall Rate of Health Insurance Coverage,
by Type (2010-2012)
100
90
80
70
60
50
40
30
20
10
0
Access
Access to healthcare refers
to the presence or absence
of various barriers to
seeking or receiving healthcare, including oral and
mental health care. Access
to healthcare is essential for
increasing quality of life,
length of life, and eliminating
disparities in health status.
Everett
MA
95.8
88.1
75.3
50.6
45.6
32.6
Any Health
Insurance Coverage
Public Health Insurance
Coverge
Private Health Insurance
Coverage
SOURCE: US Census ACS, 2010-2012
81
xx
• A lower proportion of Everett residents have health insurance
(88%) than Massachusetts overall (96%).
• Among those that do have health insurance, the type of
coverage is more likely to be public vs. private health insurance
among Everett residents.
Survey show 78% of Everett adults reported having visited a
doctor for a routine checkup in the prior year and 64% reported
having visited a dentist within the prior year.
• The 2008 data also show that 14% of Everett adults were not
able to afford medical care when they needed it at some point in
the prior year. Of these persons, the top three types of care they
most often mentioned not being able to afford were 1) dental
care, 2) doctor appointments, and 3) prescription medications.
(Note: the 2008 BRFSS survey was conducted during the early
years of MA health insurance reform).
Oral Health in America: A Report of the Surgeon General (2000)
This report found that the interdependence of oral health and
general health and well-being is widely underestimated. In addition
to a lack of awareness of the importance of oral health among the
public, this report found a significant disparity between racial and
socioeconomic groups in regards to oral health and ensuing overall
health issues.
82
What If Someone Does Not
Have Insurance Coverage?
The Health Safety Net
is a program for Massachusetts residents who are not
eligible for health insurance
or cannot afford to buy it.
To be eligible, one must be
uninsured or underinsured,
with no access to affordable
health coverage. Additionally, people of any income
with large medical bills they
cannot pay are also eligible.
Citizenship or immigration
status does not affect eligibility; however one must be
a resident of Massachusetts.
Outreach and Education
• Helping uninsured residents enroll in insurance plans is the foundation for improving access to
health services. The Joint Committee for Children’s Health Care in Everett (JCCHCE) has performed
this function since 1994, with a multilingual telephone helpline and team of outreach workers to
assist Everett residents apply for Mass Health and other state funded health insurance programs.
• Cambridge Health Alliance provides enrollment in health insurance for patients seen at the Whidden
Hospital and the Everett Family Health Center. Services are available in multiple languages.
• Community-based human service organizations such as La Comunidad Inc., A Better Tomorrow
Services Inc., and Tri-City Community Action Program Inc, work with clients to connect them to
healthcare services and local providers.
• Parent education is available under the Parent University programs organized by JCCHCE in
partnership with Everett Public Schools, CHA, Hallmark Health, Eliot Community Human Services,
and other providers, offering workshops to guide parents on a range of parenting issues.
• Everett Public Library maintains a collection of resources and information on disease prevention
and management.
Healthcare Services
City of Everett – Everett Health Department
• Public health nurses work to assure residents of Everett have access to services including
vaccinations and management of reportable communicable diseases. 650 flu vaccines were provided
over the course of the last 12 months.
• Data from the 2008 5- City Behavioral Risk Factor Surveillance Survey show 78% of Everett adults
ages 65 and older reported having a flu vaccine in the prior year and 76% reported having a
pneumonia vaccination at sometime in their life.
• School nurses from the Everett Health Department provide support and services in public school
settings to assure students are ready to learn.
• Anna May Powers Health Center (at Keverian School): Mental health services.
• Teen Health Center (at Everett High School): Primary care, confidential reproductive healthcare,
and mental healthcare.
• Everett and Revere Family Health Center: Primary care (adult, adolescent, pediatrics, OB/GYN),
confidential testing and counseling; Specialty Care (cardiology, pulmonology, gastroenterology,
endocrinology, nephrology, sports medicine and orthopedics, podiatry); Other services: nutrition,
diabetes education, mental health services, lab testing.
83
xx
• Malden Health Center: Primary care for all ages, women’s health, sports medicine, x-ray,
ultrasound, lab testing, special programs for diabetes and asthma.
• Whidden Memorial Hospital’s expanded services:
—
—
—
—
—
—
Emergency Department
Diagnostic Radiology
Department of Surgery & Orthopedics Specialty Suites
Medicine Specialty & Hospitalist Programs
Breast Center
Medical/Surgical beds
Primary Care and Community Care:
• Hallmark Health: Community Health Education program, Healthy Families and
Everett WIC programs.
• MGH Everett Family Care: Primary care (adult, adolescent, pediatrics, OB/GYN).
• Eliot Community Human Services: Mental health services for children, youth and adults including
outreach, emergency services and outpatient medication programs.
Recommendations
• Increase access to dental/oral healthcare for all residents.
• Enrich and enhance citywide campaign to inform residents of available insurance options and
assist residents to access healthcare services, with particular emphasis on newcomers to Everett,
including immigrants.
• Restore dental screenings for children.
• Expand primary care services in Everett.
• Increase collaboration on outreach with Literacy Program and Multicultural Affairs Commission.
• Outreach directly with all faith-based sites and communities.
• Identify needs and provide education on available healthcare options for low-income residents
and undocumented immigrants.
84
Youth
85
xx
Youth Introduction
This section provides current information about
key youth health indicators such as tobacco,
substance abuse, mental health, violence,
physical activity and nutrition, and sexual and
reproductive health.
The report includes substantial data obtained
through the Everett Student Health Survey,
commonly referred to as the Youth Risk Behavior
Survey. Bi-annually since 2003, the Cambridge
Health Alliance, in partnership with the Everett
Public Schools, has administered the anonymous
survey to students in grades 6th-12th. The data
has been instrumental in supporting school and
community-based health and wellness education
and program development.
There are many exciting collaborations and
innovative programs taking place in Everett that
THERE ARE MANY EXCITING
COLLABORATIONS and
innovative programs taking
place in Everett that value
youth input; positioning our
city to become a leader in
health promotion, youth
leadership, prevention
and more.
86
value youth input, positioning our city to become
a leader in health promotion, youth leadership,
prevention and more.
Everett’s youth are the future leaders of Everett
and beyond. Investing in their development
and well-being positively directly impacts
the economic, social and political assets of
a community. Without effective support for
children and youth, negative outcomes such as
school drop-out, poor labor market entry, risky
sexual behaviors, substance abuse, crime and
violence are bound to have an impact.
We hope that this section allows you to reflect
on the youth of Everett and how you, your
organization and the leadership of the city can
influence the quality of life and opportunity for
its young residents.
Youth Physical Activity and Nutrition
Adequate physical activity and a healthy balanced diet can reduce the
risk of many chronic health issues. For children and adolescents, regular
exercise can improve bone health, cardiovascular and muscular fitness,
decrease body fat, and improve educational outcomes.
A nutritious diet can decrease the risk of chronic diseases such as type
2 Diabetes, hypertension, and certain types of cancers. Furthermore,
it reduces the risk of obesity. Obesity continues to be a problem in the
United States with 17% of children considered to be obese. The World
Health Organization affirms that obesity can lead to serious health
problems, including but not limited to strokes, respiratory problems,
osteoarthritis, coronary heart disease and sleep apnea. As of 2008,
the medical costs of obesity in the United States totaled to
approximately $147 billion.
Self Perceived Weight Status
• In 2013, about 50% of Everett middle school students describe their
weight as ‘about the right weight’, while 34% students describe
themselves as ‘slightly’ or ‘very’ overweight.
Screen Time
• Between 2005 and 2013, the proportion of middle school students
with TVs in their bedrooms declined slightly, from 80.9% to 73.8%.
• Between 2005 and 2013, the proportion of students who watch 3+
hours of TV on an average school day slightly declined from 55.7%
to 49.4% in middle school and 40.7% to 36.1% in high school, but
remains higher than the state overall (27%).
• In 2013, Everett middle and high school students played more
computer/video games on an average school day compared to
Massachusetts overall (52% Middle School and 40% High School
compared to 28% and 32% statewide in Middle and High school).
Source: Everett Student Health Survey 2013
87
Physical Activity
• In 2013, 32% of Everett Middle School students and 33% of
Everett High School students reported they achieved 60 or more
minutes of physical activity for at least 5 of the prior 7 days.
Everett High School students reported playing on at least
1 sports team in the prior 12 months.
Everett High School students reported walking to school on
most days of the week.
Nutrition
• In 2013, almost one-third of Everett High School students and
40% of Everett Middle School students reported eating breakfast
every day in the prior week.
• In 2013, 24% of Everett High School students and 26% of
Everett Middle School students reported eating fruit or drinking
100% fruit juice one time in the prior day.
• In 2013, 25% of Everett High School students and 25% of
Everett Middle School students reported eating vegetables one
time in the prior day.
• In 2013, 1/3 of Everett High School students and 25% of
Everett Middle School students reported not drinking any
sweetened drinks in the prior day.
88
Physical Activity
• The Everett High School Fitness Center is open for students and teachers after school until 3:30.
Physical Education and Health classes use the fitness center every period of the school day as well.
• Physical Education, Health, and classroom teachers have been trained in Project Adventure activities
and workshops such as “Creating Healthy Habits,” “Portable Adventure” and other trainings,
including how to use the high and low elements courses at each school and the climbing walls.
Teachers use these trainings and the curriculum in their classes and in several after school clubs.
• Four of the K-8 schools and the Everett High School maintain exercise climbing walls used in physical
education and health classes.
• Students in grades 5-8 participate in the Boston Athletic Association Relay Challenge held the
weekend before the Boston Marathon.
• New activities such as yoga, crew and lacrosse teams are available at the high school and yoga
classes are provided at the Parlin Library for middle school age children.
Nutrition
• Everett Public Schools received a MCAS grant to build and expand the schoolyard gardens at the high
school, Keverian and Parlin schools. The program uses the STEM training/Kids Consortium Service
Learning model to work in the gardens and create healthy food throughout the spring and summer.
• The Everett High School Culinary Arts Program, along with the Health Education Department, filmed
healthy cooking classes that are available for viewing on the Everett Schools TV station.
• The K-8 schools practice recess before lunch where available, and many schools have found this
change to be very beneficial.
• The Everett High School Allied Health Academy participates in the School Breakfast Public Service
Announcement contest through the Department of Education.
• The Child Nutrition Outreach Program (CNOP) works to increase participation in two underutilized
federal child nutrition programs, the National School Breakfast Program and the Summer Food
Service Program. Funded by the Massachusetts Department of Elementary and Secondary Education
(DESE) and administered by Project Bread, CNOP has been supporting school nutrition directors,
superintendents, principals, and other school personnel since 1994.
• The Everett High School Green Club develops schoolyard gardens as well as city gardens with the
Everett Community Growers, helping to expand community gardens throughout the city.
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Recommendations
Physical Activity:
• Continue and expand Family Fitness Nights, which allows and encourages non-structured active
play for youth and families in school gyms after hours.
• Continue to expand programming for new physical and recreation activities at the schools and in
the community.
• Create and fund maintenance plan for Northern Strand Community Trail, and work to create
better access to existing recreational facilities along the Trail.
• Actively apply Complete Street guidelines when repairing roads to encourage bike and pedestrian
street use.
• Install more bike racks and safe storage options for bicycles throughout the city, including
schools, to encourage biking.
Nutrition:
• Continue and expand schoolyard gardens to all Everett Public Schools, and work to incorporate
produce into school meals in spring and fall.
• Encourage students to examine their food environment and take action to create more healthful
retail outlets by participating in Energize Everett’s Healthy Market Program.
90
Youth Tobacco
Tobacco contains nicotine, a highly addictive drug, causing many young
people to progress from smoking occasionally to smoking every day.
Nearly all tobacco use begins prior to age 18. Each day in the United
States, over 3,800 young people under 18 years of age smoke their first
cigarette, and over 1,000 youth under age 18 become daily cigarette
smokers. The vast majority of Americans who begin daily smoking
during adolescence are addicted to nicotine by young adulthood.
(www.surgeongeneral.gov/library/reports/preventing-youth-tobaccouse/exec-summary.pdf)
Young people start smoking for many reasons – social, physical and
environmental influences. In 2011, cigarette companies spent $8.37
billion on advertising and promotional expenses in the United States
alone; up from $8.05 billion in 2010.(1) The five major U.S. smokeless
tobacco manufacturers spent $451.7 million on smokeless tobacco
advertising and promotion in 2011 an increase from $442.2 million
spent in 2010.(2)
CDC resources:
1. Federal Trade Commission. Cigarette Report for 2011. [PDF–386 KB]
Washington: Federal Trade Commission, 2013 [accessed 2013 June 20].
2. Federal Trade Commission. Smokeless Tobacco Report for 2011.[PDF–180.59
KB] Washington: Federal Trade Commission, 2013 [accessed 2013 June 20].
Tobacco
Tobacco use is the single
most preventable cause of
death and disease in the
United States. Preventing
children and youth from
tobacco use has a significant and long-lasting
impact on the health of
everyone. In children,
secondhand smoke can
cause asthma, respiratory
infections, ear infections,
and Sudden Infant Death
Syndrome (SIDS).
For additional information
on tobacco, please refer to
the Adult Tobacco section.
Prevention is critical to ensure young people stay tobacco-free.
91
xx
Percent of Students
100
90
80
70
60
50
40
30
20
10
0
Trend in Cigarette Use Among Everett Middle and
High School Students (2005-2013)
2005
2007
2009
2011
47.3
2013
24.8
19.9
7.3
Middle School,
Ever
5.5
18.2
6.2
1.9
Middle School,
Past 30 Days
High School, Ever
High School,
Past 30 Days
SOURCE: Everett Student Health Survey
• Currently, 2% of middle school students and 6% of high school
students report having used cigarettes in the prior 30 days.
• Lifetime and 30-day cigarette use has continued to decrease since
2005 among Everett middle school and high school students.
• In 2013, 58% of middle school students and 61% of high school
students believe people are at great risk for harming themselves
by smoking one or more packs of cigarettes daily.
92
• Teens in Everett Against Substance Abuse (TEASA), has been an active member of the 84.org,
a state-wide youth movement initiative in Massachusetts encouraging teens to focus on positive,
healthy lifestyles rather than smoking.
• TEASA youth members meet with legislative leaders at the State House yearly to raise awareness of
the tobacco industry’s tactics and advertising to recruit young smokers.
• In 2014, TEASA successfully worked with the Board of Health to raise the purchasing age of
e-cigarettes to 18. In 2010, youth leaders advocated to ban the sale of tobacco products in
local pharmacies.
• TEASA provides educational and outreach events in the schools and community to raise awareness
of the risks associated with tobacco use, including newer products that are designed to reach new
smokers. Examples include: candy flavored cigarillos, chewing tobacco and smokeless tobacco
products containing many of the same carcinogens that are found in cigarettes.
• Youth participate in national initiatives such as the Great American Smoke Out, World No Tobacco
Day, and Kick Butts Day.
Recommendations
• Review and expand tobacco compliance efforts to reduce tobacco sales to minors.
• Continue tobacco prevention education in the schools to raise awareness of the harm of tobacco
products including e-cigarettes.
• Include smokeless tobacco products in tobacco use prevention throughout the schools and
community-run youth programming.
• Increase access to tobacco cessation programs for youth already smoking.
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Youth Substance Use
Adolescent substance use and addiction is a national public health
problem impacting communities across the nation, including
Everett. Exposure to alcohol, marijuana and other substances may
interfere with adolescent brain development leading to adverse
lifetime consequences. Drug and alcohol use can increase other
risk behaviors, leading to injury, violence, victimization, sexually
transmitted diseases, teen pregnancy, suicide and poor educational
performance and completion.
Youth are bombarded with mixed messages from the media, peers,
family dynamics, and other places. Prevention efforts targeting the
environment as well as individuals are effective in changing behaviors
and health outcomes. Addressing social norms and perceived harm
of substance use are critical in the implementation of prevention
programs. Research shows prevention efforts improve school
attendance, graduation rates, and reduce violence and mental health
disorders, among other positive outcomes. Prevention programs that
use a skills-based approach have demonstrated improving youth and
community health outcomes.
Binge Drinking
Binge drinking is defined
by the National Institute on
Alcohol Abuse and Alcoholism
as a pattern of drinking that
brings alcohol concentration
(BAC) levels to 0.08 g/dL.
This typically occurs after
4 drinks for women and 5
drinks for men—in about
2 hours.
Alcohol use by persons under
age 21 years is a major public
health problem. Alcohol is
the most commonly used and
abused drug among youth in
the United States, more than
tobacco and illicit drugs.
Research indicates youth
who start drinking before age
15 years are five times more
likely to develop alcohol
dependence or abuse later
in life than those who begin
drinking at or after age
21 years.
www.cdc.gov/alcohol/
fact-sheets/underagedrinking.htm
94
Percent of Students
100
90
80
70
60
50
40
30
20
10
0
Trend in Alcohol Use Among High School Students
(2003-2013)
66.7
68
2003
2013
2005
MA
2007
53.7
2009
2011
40
37.9
23.3
22.7
19.2
11
Alcohol, Ever
Alcohol, Current
SOURCE: Everett HS Survey, 2003-2013; MA YRBS, 2011
Early Initiation
(before age 13)
11.3
22
Binge drinking,
past 30 days
• Between 2003 and 2013, alcohol use has decreased among
Everett High School students and is now substantially lower than
Massachusetts as a whole.
• In 2013, high school girls were more likely to report lifetime alcohol
use (57.2%) compared with boys (50.6%) and slightly more likely to
report use within prior 30 days of the survey (24.5% vs. 22.2%).
No difference in binge drinking was seen by gender.
• Among Middle School students, in 2013, middle school girls were
more likely to report lifetime alcohol use (18.4%) compared with
boys (14.6%) and more likely to report use within prior 30 days of
the survey (5.9% vs. 3.9%).
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xx
Usual Source of Alcohol Among Everett High School Students
Who Reported Drinking Alcohol (2013)
I get it from friends my own age
18.8
Older friends give it to me
18.4
I ask someone of legal age to
buy it for me
17.5
6.8
My parents give it to me
Older brothers/sisters give it to me
5.7
Take it from my/friend's parents
without them knowing
5.9
1.1
I buy it myself at a store/tavern/bar
Other
25.9
0
20
SOURCE: Everett HS Survey 2013
40
60
Percent of Students
• Among high school students who reported ever consuming alcohol,
48% of them report obtaining it by asking someone older to give or
buy it for them.
• Among middle school students who reported ever consuming
alcohol, 35% of them report obtaining it by asking someone older
to give or buy it for them.
96
80
100
Percent of Students
100
90
80
70
60
50
40
30
20
10
0
Trend in Marijuana Use Among
High School Students (2003 - 2013)
2003
2013
2005
MA
2007
2009
35.7 38.3 37.6
38.7
43.1
2011
31.9 34.2
17.2
20.9 22.0 23.6
27.9
17.1 19.9
Marijuana Past 30 Days
Marijuana Ever
High School
SOURCE: Everett MS and HS Surveys, 2003-2013; MA YRBS, 2011
• Marijuana use, lifetime and 30-day use, among Everett High
School students was slowly rising from 2003 to 2009 after which
the rate had dropped somewhat and is now below the rate of
Massachusetts overall. Similar trends were observed among
Everett Middle School students.
• Currently, about 34% of high school students report ever trying
marijuana, while 20% report using marijuana in the prior 30 days.
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High School trends in other illicit drugs, percent of students
2003
2005
2007
2009
2011
2013
MA, 2011
Ecstasy, Ever
10.3
8.4
10.2
5.6
1.9
2.3
5.8
Inhalants, Ever
7.4
9.0
11.0
7.9
7.1
5.0
n/a
Cocaine, Ever
7.3
6.9
6.5
5.2
1.8
1.7
5.0
Methamphetamines, Ever
2.3
1.8
1.6
1.0
0.2
0.3
2.7
Heroin, Ever
1.8
1.6
0.8
0.8
0.0
0.3
2.1
Other Types of
Illegal Drugs*, Ever
7.7
6.1
4.8
4.3
2.3
2.6
n/a
*Other illegal drugs include: LSD, PCP, mushrooms, Ketamine, Rohypnol, or GHB
• The rates of lifetime use for other illicit drugs, including ecstasy,
inhalants, cocaine, methamphetamines and heroin have decline
dramatically for high school students since 2007 and are currently
lower than the state rates.
• Overall, use of other illicit drugs among middle school students
was low in 2013, less than 0.5%. The exception being inhalant
use, which was reported by 8.5% of middle school students in
2013, down from 14.5% in 2005.
• While only 31% of high school students thought it would be
very risky to drink one or two drinks daily and 19% believed it
would be very risky to smoke marijuana once or twice a week,
65% believed it would be very harmful to take prescription
medications not prescribed to them.
• Data related to non-medical use of prescription drugs show that
in 2013, 2.1% of high school students had tried to get high using
someone else’s prescription medication. A further 4.4% of high
school students had tried to get high using over-the-counter
medications. These rates represent a steady decrease in such
use since 2003.
• Use of oxycontin without a prescription was reported by 1.6% of
high school students in 2013 while less than 1% reported using
steroids without a prescription.
98
Percent of Students
Percent of Everett Students Identifying Substances as
“Very Easy” or “Sort of Easy” to Obtain, by Grade (2013)
100
90
80
70
60
50
40
30
20.9
20
10
0
72.8
70.6
64.4
6th
11th
7th
12th
8th
9th
10th
37.5
19.7
13.2
8.7
Cigarettes
Alcohol
Marijuana
Prescription drugs not
prescribed to you
• In 2013, the perception that substances were ‘very easy’ or ‘sort of
easy’ to obtain increased with grade level, regardless of type
of substance.
• In 2005, nearly half (46%) of high school and middle school students
lived with someone who smoked cigarettes. This has declined to
about 30% for both groups in 2013.
• Similarly, the rate of high school and middle school students living
with someone that uses illegal drugs (other than marijuana) has
declined from about 6% in 2005 to under 2% in 2013.
• Overall, the trend in the percent of students who reported having
someone living in their household using substances was similar for
Everett middle and high school students.
• Currently, 14% of high school students and 10% of middle school
students report that they live with someone they think drinks too
much alcohol. In addition, 12% of high school students and 5% of
middle school students report marijuana use by someone they
live with.
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xx
• Everett’s youth group, Teens in Everett Against Substance Abuse (TEASA), now in its 9th year,
continues to mobilize over 40 high school students each year to work in partnership with
residents and community leaders on prevention efforts to educate youth, adults, parents,
policy makers and local businesses on risks associated with substance use.
• TEASA has organized local educational and awareness events such as Kick Butts Day, Great
American Smoke Out, alcohol prevention rally for Alcohol Awareness Month, debates on
medical marijuana, presented survey data on tobacco products sold in Everett, and presented
the findings of the bi-annual Youth Risk Behavioral Survey to students at the high school and at
community meetings.
• Everett Public Schools continue to implement Project Northland, a nationally recognized
science-based substance abuse curriculum, for students in 6th - 8th grades with positive results.
• The Everett Police Department conducts alcohol compliance checks to monitor sales to minors
throughout the year.
Recommendations
• Increase information and outreach to middle school parents regarding the importance of talking
to their children about alcohol and other drug use.
• Expand the substance abuse educational curriculum in all grades throughout all Everett schools
to ensure that children and youth are learning about the impact of alcohol and other drugs on
their developing bodies.
• Prescription drug abuse has become a national epidemic. Continue to provide awareness and
education to children and youth on the harm of using prescription drugs without the guidance
of a medical professional.
• Increase availability of early prevention information to help parents, teachers and others
working with youth to recognize the signs and symptoms of early drug use.
• Provide support for youth at the schools and in the community who are struggling with
substance use dependency. Refer students to treatment and recovery programs to help them
complete high school and work towards a balanced life of sobriety and post-high school career
development.
• Continue to provide prevention resources and opportunities for youth leadership in the area of
substance abuse prevention.
100
Youth Mental Health
Emotional health is a vital part of overall health and well-being.
A person’s emotional health, including thoughts and feelings,
influence his or her ability to lead a satisfying and productive life.
The mental health of a community depends on the opportunities its
members have to experience safe, caring and secure environments in
families, schools, work settings and community life.
For adolescents, this period of time can be a challenging
developmental stage with episodes of confusion, wonder and
discovery. Self-esteem and peer relations are critical aspects for youth
development. Understanding and supporting the needs of all youth
are critical to launching self-assured and positive members of society
who are healthy in mind, spirit and body.
Percent of Students
100
90
80
70
60
50
40
30
20
10
0
Depression and Self Harm in prior 12 Months, Among
Middle and High School Students (2003 & 2013)
Everett 2003
Everett 2013
MA 2011
25.6
28.6
19.5
26.3
25.2
15
13.3
9.1
13
12.6
Definition of Self-Harm
Self-harm and self-injury
are defined as intentional
harm or injury of one’s
self, usually done without
suicidal intentions.
The most common forms of
self-harm include cutting,
burning, scratching, hair
pulling, preventing wounds
from healing or other
similar behaviors. Tattoos
and body piercings are not
considered non-suicidal
self-injury, unless they are
created with the specific
intention to self-harm.
18
0
Middle School
High School
Depressed*
High School
Middle School
Hurt Self on Purpose+
*Described as feeling “so sad and hopeless almost every day for two weeks or more in a row
that you stopped doing some usualactivities”; +Includes cutting, burning or bruising
• Between 2003 and 2013, the percent of students feeling
symptoms of depression declined to about 20% of middle school
students and 26% of high school students. However, these rates
are higher than for Massachusetts overall.
• Self-harm was lower among Everett High School and Middle
School students compared to the state and middle school data
suggest a decline in this behavior between 2003 and 2013.
101
xx
Everett 2003
Everett 2013
Percent of Students
100
90
80
70
60
50
40
30
20
10
0
Suicidal Ideation in prior 12 Months, among Middle and
High School Students (2003 & 2013)
MA 2011
14.9
10.8
12.2
7
Middle School
13.3
9.7
3.4
High School
Seriously Considered Suicide
3.1
6.7
4
4.6
6.8
High School
Middle School
Attempted Suicide
• Everett Middle School students have a higher rate of suicidal
ideation (11%) compared to the state (7%) as well as compared
to Everett High School students (10%). However the rates of
ideation have declined since 2003 for both middle and high
school students.
• Attempted suicide was reported by 3% of middle school students
and nearly 5% of high school students, both lower proportions
than the state.
Percent of Students
100
90
80
70
60
50
40
30
20
10
0
Percent of Everett Middle and High School students
that have an adult to talk to about their problems (2013)
Middle School
75.1
54.4
55.5
40.7
29.1
School Adult
Family Adult
102
High School
67.5
Non-Family/School Adult
• In 2013, over half of Everett Middle and High School students report having an adult at school to
talk to, while 75% of middle school and 68% of high school students report having an adult in their
family to talk to about their problems.
• In 2013, the proportion of students describing their lives as ‘somewhat’ or ‘very’ stressful increased
with school grade, with 34% of 6th graders feeling somewhat or very stressed and 65% of 12th
graders feeling somewhat or very stressed.
• In 2013, 66% of Everett High School and 45% of Everett Middle School students worried ‘often’ or
‘everyday’ about school issues.
• Approximately 42% of Everett High School students and 33% of Everett Middle School students
worried ‘often’ or ‘everyday’ about social, appearance, or family issues.
• When examined by gender, girls were more likely to worry than boys for all issues whether they
were in high or middle school.
• Everett Public Schools has expanded school-based initiatives to promote mental health.
These initiatives help students cope with common issues, support healthy development,
and improve educational outcomes. By integrating resources into a comprehensive continuum of
support promoting healthy and positive youth development, it allows for early intervention and
provides assistance to those with more chronic and severe problems.
• The Everett Public Schools have a total of eight school adjustment counselors and school social
workers in the district. There is one person located in each elementary school and one at the high
school for a total of four licensed clinical social workers and four licensed adjustment counselors.
• Everett High School has one full-time licensed clinical social worker to assist students who may
benefit from counseling, assistance and/or referrals.
• Close collaboration between primary care providers, school guidance counselors, school nurses,
and social service providers allows for effective referrals to clinical settings with expertise in child/
youth/adolescent mental health needs.
• The Cambridge Health Alliance provides a range of clinical and professional expertise to serve the
mental health needs of children and their families in Everett. The Anna May Powers Health Center at
the Keverian School and the Teen Health Center at Everett High School provide counseling and other
mental health services from a staff social worker, psychologist and psychiatrist. Staff has bilingual
capacity in Spanish. Other languages are available utilizing interpreter services.
• Eliot Community Human Services provides child, youth and family centered behavioral healthcare
for children and their families. A new Youth and Family Clinic opens in June 2014, and will provide
trauma-focused individual, family, and group treatment utilizing multi-sensory and expressive
art interventions.
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xx
• The Joint Committee for Children’s Health Care in Everett conducts Parent University,
an annual educational forum focusing on the stress of parenting, as well as childhood behavioral
health topics.
• The Everett Youth Networkers, a collaboration of over 20 youth advocates and service providers,
are dedicated to creating opportunities for youth development impacting social and emotional
well-being. Opportunities in the community are forged to support youth in making positive life
choices by promoting structured activities, civic engagement, employment resources and healthy
recreational opportunities. These collective efforts are important in the social and behavioral
development of Everett’s youth.
• The Builders Club offers 7th and 8th graders community service projects in partnership with the
Kiwanis Club. For high school students, the Key Club offers opportunities for volunteering and
community services hours.
Recommendations
• Provide Youth Mental Health First Aid trainings to empower parents, family members, caregivers,
teachers, school staff, peers, neighbors, health and human service workers, and other caring
citizens how to help adolescents who are experiencing mental health or addiction challenges,
or are in crisis.
• Expand opportunities for youth to be involved in mentorship programs with local businesses,
community leaders, and schools.
• Strengthen services for children and youth who are survivors of major mental health stressors
such as homelessness, trauma, suicide, natural disasters and violent crimes.
• Strategize across the community to reach youth who are at-risk or have dropped out of school.
• Develop social norm messaging to reduce stigma associated with mental health for high school
and middle school aged youth.
• Provide culturally competent information including education and resources on mental health
issues to help reduce stigma and cultural differences regarding well-being.
• Increase early education and outreach for mental health issues to vulnerable youth.
• Increase the ability of the community to help youth and families with mental health concerns by
increasing knowledge and access of available resources.
104
Youth Violence
Youth violence refers to harmful behaviors that can start early and
continue into young adulthood. The young person can be a victim,
an offender, or a witness to the violence. Youth violence includes
various behaviors. Some acts of violence can cause emotional and
psychological harm while others can lead to serious physical injury or
even death (Center for Disease Control and Prevention).
Each year, millions of children and adolescents in the United States are
exposed to violence in their homes, schools, and communities as both
victims and witnesses. Even if they are not physically present, children
may be affected by intentional harm done by another. Children react
to exposure to violence in different ways, and many children show
remarkable resilience. Children who are exposed to violence often
experience lasting physical, mental, and emotional stress and may
be more prone to engaging in violent relationships including dating
violence, delinquency, further victimization, and involvement with
the child welfare and juvenile justice systems. Children exposed to
violence are more likely to act out in school and have greater potential
for perpetrating violence in the future, continuing the cycle of violence
into the next generation. The ultimate goal is to stop youth violence
before it starts.
Cyber Bullying
Cyber bullying is when
electronic technology such
as cell phones, computers,
or other digital technology
via social media sites, text
messages, online chats or
websites is used (Facebook,
Instagram, Twitter or other
platforms) to torment,
threaten, harass, humiliate,
embarrass or otherwise
target another person.
Bullying is unwanted, aggressive behavior that involves a real or
perceived power imbalance. The behavior is repeated, or has the
potential to be repeated, over time. Bullying includes actions such as
making threats, spreading rumors, attacking someone physically or
verbally, and excluding someone from a group on purpose.
(www.stopbullying.gov)
105
xx
Trend in Experience of Bullying in Prior 12 Months
(2005-2013)
100
2005
2007
Percent of Students
80
2009
2011
60
2013
40
36
31
33
40
41
MA 2011
36
20
16
0
17
16
Middle School
19
18
18
High School
• Bullying has increased slightly between 2005 and 2013 and
currently exceeds the Massachussets rate among middle
school students.
• Bullying is twice as common among middle school students
compared to high school students in Everett.
Trend in Experience of Violence in Prior 12 Months
Among Everett High School Students (2007-2013)
2007
2009
Percent of Students
100
90
80
70
60
50
40
30
20
10
0
2011
2013
27.2
16.7
5.4
3.3
10.2
5.6
8.6
6.2
19
10.7
9.4
5.1
Carried a
Engaged in Hurt physically Witnessed Received verbal Sexually
weapon physical fight or sexually by violence in or emotional harassed in
family
school
on school
abuse from
a date or
on school
property
someone in
property someone you
family
were giong
out with
• Since 2007, the rate for all indicators of violence have decreased
among Everett High School students.
• High school girls (7.3%) were more likely to report being sexually
harrassed in school than boys (3.1%) in 2013. A higher proportion
of girls (9.7%) were more likely to report being hurt physically or
sexually by a date or someone they were going out with.
106
• The Everett Public Schools have a conflict resolution and mediation program at the K-8 schools that
is available for all students and staff to use.
• Portal to Hope, a local organization that provides services to victims of sexual assault and domestic
violence, provides class presentations and information sessions at the high school to increase
awareness and access to their services and supports available to children, youth and families.
• The Everett Police Department has a full-time school resource officer located at the high school who
develops relationships with students and staff to ensure that the health and safety of all allows for a
productive learning environment.
• The City of Everett has been awarded funding from the Senator Charles E. Shannon Community
Safety Initiative, a state grant program administered by the Executive Office of Public Safety and
Security (EOPSS), to “support regional and multi-disciplinary approaches to combat gang violence
through coordinated programs for prevention and intervention.”
• Everett Public Schools use Second Step, Open Circle and Core Values programs for K-8 schools to
develop social competence and violence prevention. Everett High School uses the Michigan Model
Curriculum for Violence Prevention and skills-based lessons from www.healthteacher.com.
• Bullying prevention and intervention plans are being implemented through the Everett High School
Bullying and Cyber Bullying MARC curriculum. The Massachusetts Aggression Reduction Center also
provides presentations on cyber safety to each school in the district.
• The Brain Injury Association of Massachusetts (BIA-MA) provides education programs to students on
brain injury, drugs, alcohol and violence prevention.
• Everett High School provides a variety of violence prevention programs, including Northeastern
University’s Mentors in Violence Prevention and the Samaritans Preventing Self Harm programs.
• Grace Episcopal Church and the Everett Police work together with youth to implement a Restorative
Justice Program.
Recommendations
• Increase supportive programs and mentoring for adolescent girls who are at high risk of becoming
victims of violence and abuse.
• Increase funding for programs working with youth such as the Everett Boys and Girls Club,
For Kids Only Afterschool program, the Joint Committee for Children’s Health Care to continue to
support youth in their development.
• Implement a mediation program at the high school.
• Increase number of resource officers to better reach middle school aged youth.
• Expand the number of youth jobs in summer and year round.
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xx
Youth Sexual and Reproductive Health
Sexual and reproductive health education is an important part of
overall health education of teenagers. Sexual and reproductive health
education includes knowledge of emotional and physiological body
changes during puberty. This knowledge is becoming increasingly
important as youth today are entering puberty earlier in life and
are often unaware of the changes happening to their bodies. Sexual
and reproductive health education provides a framework for youth
to learn about healthy vs. unhealthy relationships and community
resources on this topic. According to the Centers for Disease Control,
9.4% of high school students report being hit, slapped, or physically
hurt on purpose by their boyfriend or girlfriend (CDC, 2011).
In the United States, youth who identify as lesbian, gay, bisexual,
transgender (LGBT) are twice as likely as their peers to have been
physically assaulted, kicked, or shoved at school. Nearly half of youth
who identify as LBGT feel they do not “fit in” in their community, as
opposed to only 16% of non-LGBT youth. Additionally, 4 out of 10
LGBT youth say the community in which they live is not accepting of
LGBT people (HRC, 2012). Sexual and reproductive health education
provides a platform for youth to learn about sexuality.
The prevention and treatment of sexually transmitted infections
(STIs) remains a health concern in the field of sexual and
reproductive health. Untreated STIs can lead to long-term health
issues, including pelvic inflammatory disease, infertility, and
cancer. In the United States, there are an estimated 19 million new
diagnoses of STIs annually, with nearly half among those ages 15 to
24 and with the most common diagnosis of Chlamydia.
In the United States, half of all pregnancies are unplanned. Of those
3.4 million unplanned pregnancies, approximately 305,000 (National
Campaign, 2012) are to girls ages 15 to 19 years old. U.S. teen
pregnancy and birth rates have declined dramatically over the past
twenty years and are now at historic lows; however the U.S. teen
birth rates remain far higher than in other comparable countries and
continue to cost the U.S. $12.5 billion dollars a year (Guttmacher,
Unintended, 2013).
Public funding for family planning services helps to prevent
unintended pregnancies; for every $1 spent on family planning
services, $5.68 in pregnancy related Medicaid expenditures is saved
108
(Guttmacher, Contraceptive, 2013). Furthermore, family planning
funding supports access to contraception, cancer screening and
prevention, HIV and STI testing and treatment, pregnancy planning,
screening for intimate partner violence, and referrals for prenatal care,
substance abuse treatment, and primary care (DHHS, 2013).
Citations
Guttmacher Institute; Contraceptive Needs and Services, 2010 (2013), www.
guttmacher.org/pubs/win/contraceptive-needs-2010.pdf
Guttmacher Institute; Unintended Pregnancy in the United States, (2013), www.
guttmacher.org/pubs/FB-Unintended-Pregnancy-US.html#13
National Campaign to Prevent Unplanned Pregnancy; National and State Data,
(2013), thenationalcampaign.org/data/landing
The Centers for Disease Control and Prevention (CDC); Pregnancy (2014), www.cdc.
gov/pregnancy/
The Centers for Disease Control and Prevention (CDC); Teen Dating Violence, (2011),
www.cdc.gov/violenceprevention/intimatepartnerviolence/teen_dating_violence.
html
The Human Rights Campaign (HRC); Growing Up LGBT In America, (2012), www.hrc.
org/youth/about-the-survey
Percent of Students
The U.S. Department of Health and Human Services (DHHS); Healthy People,
Reproductive Health (2013), healthypeople.gov/2020/LHI/reproductiveHealth.aspx
100
90
80
70
60
50
40
30
20
10
0
Trend in Sexual Behaviors Among
High School Students (2005-2013)
2005
2007
73.9
53.3
47.9 50.6
45.5 45.6
68.3
71.9 73.2 72.1
2009
2011
58
2013
42
MA 2011
17.4 18.8
Sexual Intercourse, Ever
Condom Use,
Last Intercourse*
23
22.4
12.8 15
Alcohol or Drugs Used,
Last Intercourse*
*Among students reporting ever having had intercourse.
109
xx
• In 2013, 46% of Everett High School students reported
every having had sexual intercourse, which represents a decline
since 2009. The proportion of students reporting condom use
during last intercourse has remained steady over the years,
with approximately 72% of sexually active students reporting
condom use.
• A sharp decline in the proportion of sexually active high school
students who used alcohol or drugs during last intercourse has
occurred since 2009.
• In 2013, among middle school students, 8% reported ever having
had sexual intercourse and 68% of sexually active used a condom.
Method Used to Prevent Pregnancy During Last
Intercourse Among Everett High School Students (2013)
Condoms
58.9
Birth control pills
20.5
Depo-Provera
5.6
Withdrawal
2.5
Some other method
3.9
Not sure
1.9
No method used
6.8
0
20
40
60
Percent of Students
Among students reporting ever having had intercourse
SOURCE: Everett HS Survey 2013
• In 2013, among sexually active Everett High School students,
more than half reported using condoms and about 20% used
birth control pills as the method used to prevent pregnancy
during last intercourse. On the other hand, about 15% relied
on unsafe/unreliable methods or no prevention method at all.
110
80
100
45
Age Specific Rate Per 1,000
40
Trend in Teen Birth Rate, Age 15 to 19 Years (2003-2010)
40.6
39.6
35
32.4
33.0
22.2
21.7
Everett
MA
40.6
34.9
34.9
30
25
20
23.0
21.3
22.0
24.3
20.1
19.6
15
17.2
10
5
0
2003
2004
2005
2006
2007
2008
2009
2010
Evaluation, MDPH
• Between 2003 and 2010, the teen birth rate was higher in Everett
than Massachusetts; however, a downward trend is evident for both
Everett and Massachusetts with a particularly sharp drop in Everett
after 2009.
111
xx
• Cambridge Health Alliance (CHA) operates the Everett Teen Health Center on the campus of
Everett High School. Open during the school year, this confidential and comprehensive clinic
offers primary healthcare, reproductive health education and counseling. Clients, up to age
24, receive many services at low or no cost and being an Everett High School student is not a
requirement to receive care.
• Cambridge Health Alliance runs two programs at Everett High School: Empowering Youth in
our Community (EYC), a health elective and Helping Hands at Work (HHW), an after-school
service-learning club. Both were developed to increase knowledge of health issues facing the
Everett community as well as to teach important skills such as decision-making, communication,
pregnancy and STI prevention, and goal setting.
• Sexual health education is required of all Everett High School students. This includes information
on abstinence, HIV/AIDS, STIs, reproduction, puberty, and pregnancy prevention. These classes
are supplemented by presentations from the Everett Teen Health Center about sexual health and
contraception. In addition, reproductive health is taught in the Everett middle schools, including
basic sexual health education on abstinence, puberty, anatomy, pregnancy prevention, and STIs.
• All Everett High School freshmen students receive a tour of the Everett Teen Health Center and
overview of services provided during health class.
Recommendations
• Conduct outreach to Everett youth up to age 24 to increase awareness of services at the Teen
Health Center at Everett High School including students at Pope John and the local charter
schools.
• Increase awareness of low or no-cost Chlamydia testing and treatment services available at the
Everett Teen Health Center for those aged 19 to 24 and younger.
• Evaluate prenatal care access for low-income and vulnerable populations.
• Develop a plan to increase awareness of LGBT health topics and to address the community
health needs.
112
Data Sources and Definitions
US Census Data
American Community Survey
Decennial Census
What is It?
Continuous demographic survey
Count of the population
Data
Average characteristics OVER TIME
How Often
Every 1 year (more timely)
Counts characteristics for a
SPECIFIC DATE
Every 10 years (less timely)
Households
11 million households per 5 years
18 million households per 1 year
Sampling Error
Higher Error
Lower Error
Accuracy
Less Accurate
More Accurate
Content Extensive and detailed demographic, Only Age, Sex, Race, Hispanic Ethnicity, economic and housing data and Household Relationships
The Massachusetts Community Health Information Profile (MassCHIP), developed by the
Massachusetts Department of Public Health, provides access to community and state level health
status, health outcome, program utilization, and demographic data sets.
The Institute for Community Health led the 5-City Behavioral Risk Factor Surveillance Survey (BRFSS)
in 2008. It was a health-related telephone survey that collected data on health-related risk behaviors,
chronic health conditions, and use of preventive services of Everett adults 18 years or older. The other
cities included in the survey were Cambridge, Chelsea, Revere and Somerville.
The Massachusetts Youth Risk Behavior Survey (YRBS) collects data on health risk behaviors among
Everett public school students, alternating years between middle school (grades 6-8) and high school
(9-12). Data collected include behaviors that contribute to unintentional injuries and violence, sexual
behaviors, alcohol and other drug use, tobacco use, dietary behaviors, and physical activity. In Everett,
the survey is also referred to as the Everett Student Health Survey.
Bureau of Labor and Statistics, U.S. Department of Labor is the principal Federal agency responsible
for measuring labor market activity, working conditions, and price changes in the economy to support
public and private decision-making since 1884.
Massachusetts Division of Health Care Finance and Policy, Uniform Hospital Discharge Data System
(UHDDS) provides definitions for acute care hospitals to report inpatient data elements in a
standardized manner, and collects data on hospital discharges and emergency visits.
Registry of Vital Records and Statistics, Bureau of Health Statistics, Research and Evaluation,
Massachusetts Department of Health collects, processes, corrects and issues copies of birth,
death and marriage records that occur in Massachusetts.
113
xx
Bureau of Substance Abuse Services (BSAS) oversees the substance abuse and gambling prevention
and treatment services in the Commonwealth. Responsibilities include: licensing programs and
counselors; funding and monitoring prevention and treatment services; providing access to
treatment for the indigent and uninsured; developing and implementing policies and programs;
and tracking substance abuse trends in the state.
The Massachusetts Department of Elementary and Secondary Education (ESE) collects a variety of
data from schools and districts in the state, some of which is published as a School or District Profile.
Free Lunch: Gross income limit - 130% FPL
Reduced Lunch: Gross income limit - 185% FPL
High Needs: Calculated based on the number of high needs students, divided by the adjusted
enrollment. A student is high needs if he or she is designated as either low income, or ELL, or
former ELL, or a student with disabilities. A former ELL student is a student not currently an
ELL, but had been at some point in the two previous academic years.
Special Education: Indicates the percent of enrollment who have an Individualized Education
Program (IEP).
Definitions
Count is the number of people in the population with the characteristic of interest.
Percentage or Proportion is the count of people with the characteristic of interest divided by the total
number of people in the population.
An age-specific rate is the count of people or events in a particular age group divided by the total
number of people in that age group and standardized to a population size of 1,000.
The crude rate is the total number of people or events divided by the total number of people in the
population and standardized to a population size of 100,000 people. If the event is related to age then
a crude rate is misleading when comparing between areas with different age distributions
(see age-adjusted rate).
The age-adjusted rate is a weighted average of the age specific rates for an event of interest that is
then standardized to a population size of 100,000. Useful when comparing rates between
diverse populations.
114
ICD 9 Code Definitions
Chronic Disease Section
Circulatory System Disease Includes:
•
•
•
•
•
•
•
•
•
(390–392) Acute Rheumatic Fever
(393–398) Chronic rheumatic
heart disease
(401–405) Hypertensive disease
(410–414) Ischemic heart disease
(415–417) Diseases of
pulmonary circulation
(420–429) Other forms of heart disease
(430–438) Cerebrovascular disease
(440–448) Diseases of arteries,
arterioles, and capillaries
(451–459) Diseases of veins and
lymphatics, and other diseases of
circulatory system
COPD Includes:
•
•
•
•
•
•
•
•
•
•
•
•
(490) Bronchitis, not specified as
acute or chronic
(491) Chronic bronchitis
(492) Emphysema
(492.0) Emphysematous bleb
(492.8) Other emphysema
(493) Asthma
(493.0) Extrinsic asthma
(493.1) Intrinsic asthma
(493.2) Chronic obstructive asthma
(494) Bronchiectasis
(495) Extrinsic allergic alveolitis
(496) Chronic airway obstruction,
not elsewhere classified
Digestive System Diseases Include:
•
•
•
•
(520-529) Diseases of oral cavity,
salivary glands, and jaws
(530-537) Diseases of the esophagus,
stomach and duodenum
(540-543) Diseases of appendix
(555-558) Noninfective inflammation of
•
•
•
the colon
(560-569) Other diseases of intestines
and perioneum
(570-573) Diseases of liver
(574-579) Disorders of gallbladder,
biliary tract and pancreas
Genitourinary System Diseases Include:
•
•
•
•
•
•
(580–589) Nephritis, nephrotic syndrome,
and nephrosis
(590–599) Other diseases of urinary
system
(600–608) Diseases of male genital organs
(610–611) Disorders of breast
(614–616) Inflammatory disease of female
pelvic organs
(617–629) Other disorders of female
genital tract
Heart Disease Includes:
•
•
•
•
•
•
(410-414) Coronary heart disease
(428) Heart failure
(410-414) Ischemic heart disease
(429) Major cardiovascular disease
(410) Acute myocardial infarction
NOT: hypertension, atheroscelerosis;
cerebrovascular disease
Musculoskeletal System Diseases Include:
•
•
•
•
•
(710-719) Arthropathies and joint
disorders (includes rheumatoid arthritis)
(710) Systemic connective tissue disorders
(includes lupus, sclerosis)
(720-724) Dorsopathies
(injuries to the spine)
(729) Soft tissue disorders
(muscles, tendons)
(730-739) Osteopathies, chondropathis
(includes osteoporosis, fractures,
stress fractures)
115
xx
Nervous System Diseases Include:
•
•
•
•
•
•
•
•
(320-327) Inflammatory Diseases
Of The Central Nervous System
(330-337) Hereditary And Degenerative
Diseases Of The Central Nervous System
(338-338) Pain
(339-339) Other Headache Syndromes
(340-349) Other Disorders Of The Central
Nervous System
(350-359) Disorders Of The Peripheral
Nervous System
(360-379) Disorders Of The Eye And
Adnexa
(380-389) Diseases Of The Ear And
Mastoid Process
Poisonings Include:
116
•
•
•
•
•
•
•
•
Unintentional poisoning
Poisionings that may be accidental
Intentional self-poisoning by and exposure
to nonopioid analgesics, antipyretics and
antirheumatics
(X61) Intentional self-poisoning by and
exposure to antiepileptic, sedative-hypnotic, antiparkinsonism and
psychotropic drugs, not elsewhere
classified
exposure to narcotics and
psychodysleptics [hallucinogens], not
elsewhere classified
exposure to other drugs acting on the
autonomic nervous system
(X64) Intentional self-poisoning by
and exposure to other and unspecified
drugs, medicaments and biological
substances
exposure to alcohol
•
•
•
•
•
•
•
•
•
•
•
•
exposure to organic solvents and
halogenated hydrocarbons and their
vapours
exposure to other gases and vapours
exposure to pesticides
exposure to other and unspecified
chemicals and noxious substances
(X85) Assault by drugs, medicaments and
biological substances
(X86) Assault by corrosive substance
(X87) Assault by pesticides
(X88) Assault by gases and vapours
(X89) Assault by other specified chemicals
and noxious substances
(X90) Assault by unspecified chemical or
noxious substance
(Y10) Undetermined intent
(Y35.2) Legal intervention involving gas
Mental Health Section
Mental Health-Related Disorders Include:
Organic psychotic conditions
•
•
•
•
•
(290) Dementias
(291) Alcoholic psychoses
(292) Drug psychoses
(293) Transient organic psychotic
conditions
(294) Other organic psychotic conditions
Other psychoses
•
•
•
•
•
(295) Schizophrenic disorders
(296) Episodic mood disorders
(297) Paranoid states
(298) Other nonorganic psychoses
(299) Psychoses with origin specific to
childhood
Neurotic disorders
•
(300) Neurotic disorders
•
•
Personality disorders
(301) Personality disorders
Psychosexual disorders
•
(302) Psychosexual disorders
Psychoactive substance
•
•
•
(303) Alcohol dependence syndrome
(304) Drug dependence
(305) Nondependent abuse of drugs
Other (primarily adult onset)
•
•
•
•
•
•
(306) Physiological malfunction arising
from mental factors
(307) Special symptoms or syndromes,
not elsewhere classified
(308) Acute reaction to stress
(309) Adjustment reaction
(310) Specific nonpsychotic mental
disorders following organic brain damage
(311) Depressive disorder, not elsewhere
classified
Mental disorders diagnosed in childhood
•
•
(312) Disturbance of conduct, not
elsewhere classified
(313) Disturbance of emotions specific to
childhood and adolescence
Violence
Forcible rape: defined by the FBI’s Uniform Crime
Reporting (UCR) Program is the carnal knowledge
of a female forcibly and against her will. Attempts
or assaults to commit rape by force or threat
of force are also included; however, statutory
rape (without force) and other sex offenses are
excluded.
Substance Abuse
Substance Abuse Treatment Admissions are
admissions into substance abuse treatment
programs administered by the Bureau of
Substance Abuse Services (BSAS). Their
services include prevention services, residential
•
•
•
(314) Hyperkinetic syndrome of childhood
(315) Specific delays in development
(316) Psychic factors
Mental retardation
•
•
•
(317) Mild mental retardation
(318) Other specified mental retardation
(319) Unspecified mental retardation
Suicide and self-inflicted injury
•
•
•
(E950) Suicide and self-inflicted poisoning
by solid or liquid substances
by gases in domestic use
by other gases and vapors
•
•
•
•
•
•
•
(E953) Suicide and self-inflicted injury by
hanging, strangulation, and suffocation
submersion (drowning)
firearms, air guns and explosives
cutting and piercing instrument
jumping from high places
other and unspecified means
(E959) Late effects of self-inflicted injury
treatment under 30 days (short-term acute
treatment), residential treatment over 30 days,
ambulatory services (counseling and treatment),
aftercare/recovery support, homeless services,
and education and treatment alternative
sentencing programs convicted of driving under
the influence. www.mass.gov/eohhs/gov/
departments/dph/programs/substance-abuse/
providers/substance-abuse-services.html
Opioid-related Hospitalizations and ED visits:
underlying cause is non-fatal opioid-related
associated with opioid abuse, dependence, and/
or poisoning (overdose).
117
xx
Acknowledgements
Authors and Contributors:
(Alphabetical order based on last name)
Devan Cody
Jackie Coogan
Alba Cruz-Davis
Linda Cundiff
James Errickson
Kristin French
Marzie Galazka
Nicole Graffam
Jean Granick
Lindsey Grant
Loretta Kemp
Jodi Lava
Jaime Lederer
Carolyn Lightburn
Bob Marra
Chief Steven Mazzie
Sylvia L. N-Olivares
John Obremski
Kathleen O’Brien
Dan O’Leary
Elaine Silva Valerie Spain
Jamie Stein
Dr. Tom Stella
Melissa Trzepacz
Keith Wales
Kelly Warner
Joint Committee for Children’s Health Care in Everett
Joint Committee for Children’s Health Care in Everett/City of Everett
Department of Planning and Development, City of Everett
Everett Community Health Partnership
Department of Planning and Development, City of Everett
Joint Committee for Children’s Health Care in Everett
Everett Community Health Partnership, Cambridge Health Alliance
Eliot Human Services
Tri-City Community Action Agency, Inc.
City of Everett, Human Services
City of Everett, Adult Learning Center
Everett Health Department
Everett Health Department
Eliot Human Services
Data compilation and summarization by the
Institute for Community Health:
Lisa Arsenault
Grace Chan
Blessing Dube
Reann Gibson
Kelly Washburn
118
A special acknowledgement and appreciation
to our neighboring partners in Somerville and
Malden, Lisa Brukilacchio and Renee CammarataHamilton, respectively, for their support and
recommendations for The Well-Being of Everett
2014 Report.
Photography provided by:
Cambridge Health Alliance, Everett Public Schools,
Colin Barr, and Jean Granick.
Programs, Partners and Resources
Partners providing support for community health activities in Everett:
Partner
Action for Regional Equity
A Better Tomorrow Services Inc.
Boys and Girls Club of Middlesex County –
Everett Clubhouse
Website
www.action4equity.org
www.abticharity.org
Telephone
see website
617-381-0300
www.kidsclubs.org
857-363-2611
617-389-6270
617-394-7702 or
617-665-1305
Eliot Community Human Services
Everett Chamber of Commerce
www.challiance.org
www.challiance.org/Locations/
EverettFamilyHealthCenter.aspx
EverettTeenHealthCenter.aspx
www.eliotchs.org
www.everettmachamber.com
Everett Public Library
www.noblenet.org/everett
City of Everett
www.cityofeverett.com
cityofeverett.com/Everett_files/
commdevelop/index.htm
www. energizeeverett.org
cityofeverett.com/Everett_files/health/index.
htm
cityofeverett.com/Everett_files/human%20
services/index.htm
www. everettpolicema.com
www.everett.k12.ma.us
www.everettrec.com
www.facebook.com/
Everettcommunitygrowers
Everett Family Health Center
Everett Teen Health Center
Community Planning and Development
Energize Everett
Health Department
Human Services and Literacy Programs
Police Department
Public Schools
Recreation Department
Everett Community Growers
Everett Community Health Partnership Substance Abuse Coalition
For Kids Only Afterschool
Grace Episcopal Church
Hallmark Health
Immaculate Conception Church
Joint Committee for Children’s Health Care
La Communidad, Inc.
Malden YMCA
MGH Everett Family Care
Metro Mayors Shannon Grant Community
Safety Initiative
North Shore Evangelical Missionary Church
Our Lady of Grace
Portal to Hope
Tri-City Community Action Program, Inc.
Whidden Memorial Hospital
Zion Baptist Church
www.makethedifferenceE.org
www.fkoafterschool.org
www.graceepiscopal
www. churcheverett.org
www.hallmarkhealth.org
www.parishesonline.com/iceverett
www.jcchce.org
www.lacomunidadinc.org
www.ymcamalden.org
www2.massgeneral.org/primarycareweb/
primary_everett_hours.htm
www.mass.gov/eopss/funding-and-training/
justice-and-prev/grants/shannon-csi/
shannon-csi-grant-overview-and-annualreports.html
www.mves.org
www. nsemc.org
www. ologp.net
www.portaltohope.org
www. tri-cap.org
WhiddenHospitalCampus.aspx
www.zionchurchministries.com
617-843-0700
781-388-6200
617-387-9100
617-394-2300 (Parlin) &
617-394-2308 (Shute)
617-389-2100
617-394-2245
617-389-2120
617-394-2255
617-394-2260
617-389-2120
617-394-2400
617-394-2390
617-394-7632
617-591-6927 or
617-591-6808
978-740-5437
617-387-7526
781-979-3000
781-389-5660
617-394-2414
617-387-9996
781-324-7680
617- 394-7500
see website
781-324-7705
781-420-0416
617-884-0030
781-338-7678
781-322-4190
617-389-6270
617-389-8357
* The list above is intended to include a sampling of resources beyond the local programs and community partners.
The list is not comprehensive.
119
xx
Appendix
Tables
• According to the US Census 2011 American Community Survey, Everett’s
population size is 41,079 residents; an 8% increase compared to the 2000 Census.
Everett 2000
Everett
2011
MA 2011
38,037
41,079
6,512,227
Under 5 Years
5.9%
6.7%
5.6%
5 to 14 Years
12.3%
12.1%
12.2%
15 to 24 Years
12.4%
11.8%
14.3%
25 to 34 Years
18.4%
18.1%
12.9%
35 to 44 Years
16.4%
15.3%
14.0%
45 to 64 Years
19.9%
24.5%
27.4%
65 and Older
14.8%
11.7%
13.7%
35.6
35.6
38.9
Not Hispanic or Latino
90.5%
81.8%
90.7%
White Alone, Not Hispanic or Latino
75.2%
61.6%
76.9%
Black or African American Alone
6.0%
13.2%
6.1%
Asian Alone
3.2%
3.3%
5.3%
Other†
6.3%
3.9%
2.4%
Hispanic or Latino (any race)
9.5%
18.2%
9.3%
Total Households
15,435
15,681
2,522,409
Households with individuals under 18 years
30.2%
33.3%
31.6%
Households with individuals age 65 or older
26.8%
22.9%
25.1%
Householder age 65 or older living alone
11.8%
10.5%
10.7%
Demographics
Population Count
Age
Median Age (in years)
Race
120
Everett 2000
Everett
2011
MA 2011
Educational Attainment (Age 25 Years & Over)
26,399
28,542
4,419,291
Less Than High School
23.8%
19.9%
11.1%
High School Graduate (Includes Equivalency)
40.3%
38.3%
26.3%
Some college
21.2%
25.4%
23.9%
Bachelor’s degree
10.1%
11.3%
22.1%
Master’s degree
3.4%
3.8%
11.6%
Professional school degree
0.9%
0.9%
2.7%
Doctorate degree
0.3%
0.5%
2.2%
Native Born
78.1%
64.0%
85.3%
Foreign Born
21.9%
36.0%
14.7%
Foreign-Born Population
8,323
14,794
957,402
Europe
19.8%
12.4%
24.3%
Asia
13.1%
6.9%
28.7%
Africa
7.0%
7.5%
8.1%
Americas
60.1%
73.0%
38.6%
-Latin America
58.1%
72.7%
35.3%
--Central America
18.3%
19.4%
8.7%
--South America
25.8%
35.6%
11.5%
-Northern America
2.0%
0.3%
3.2%
Demographics
Nativity
Place of Birth For the
Foreign-Born Population
DATA SOURCES AND NOTES:
Everett 2000 data based on year 2000 US Census
†Other includes 'American Indian and Alaska Native Alone,' 'Native Hawaiian and Other Pacific Islander Alone,'
'Some Other Race Alone,' and 'Two or More Races'
121
xx
Top 20 Causes of Death (3-year average 2008-2010)
Everett
Cause of Death
Count
(N=892)
Massachusetts
Percent
Ageof all
Adjusted
Count
Causes Rate Per (N=157,676)
of Death 100,000
Percent of
all Causes
of Death
AgeAdjusted
Rate Per
100,000
Heart Disease
201
22.5
149.6
37,069
23.5
155.0
Lung Cancer
91
10.2
72.6
10,663
6.8
48.4
75
8.4
52.6
11,081
7.0
44.3
Chronic Lower Respiratory
Disease, Other
40
4.5
29.5
6,703
4.3
29.4
Pneumonia and Influenza
30
3.4
21.4
4,219
2.7
17.4
Cerebrovascular Disease
28
3.1
20.4
7,692
4.9
32.0
Breast Cancer (Female)
13
1.5
18.0
2,657
1.7
20.8
Poisoning, All
19
2.1
16.2
2,647
1.7
13.1
Colorectal Cancer
20
2.2
16.2
3,457
2.2
15.1
Septicemia
22
2.5
15.9
2,293
1.5
9.9
Nephritis, Nephrosis
20
2.2
14.4
4,020
2.6
17.1
Renal Failure
20
2.2
14.4
3,744
2.4
15.9
Prostate Cancer
7
0.8
13.5
1,867
1.2
21.6
Pancreas Cancer
17
1.9
12.8
2,520
1.6
11.2
Opioid Injuries
13
1.5
11.0
1,776
1.1
8.9
Diabetes Mellitus
13
1.5
10.1
3,103
2.0
13.6
Chronic Liver Disease
12
1.4
10.0
1,742
1.1
7.8
Alzheimer’s Disease
13
1.5
9.6
5,289
3.4
21.0
Liver Cancer
12
1.4
9.6
1,401
0.9
6.2
Homicide
9
1.0
7.5
552
0.4
2.8
122
Top 20 Causes of Hospitalization (3-year average 2007-2009)
Everett
Massachusetts
Cause of Hospitalization
Count
(N=16,460)
Percent
of all
Hospitalizations
Ageadjusted
Rate per
100,000
Childbirth, Pregnancy, Puerperium
2,084
12.7
3533.5
239,818
10.0
2594.0
3,015
18.3
2430.3
429,888
17.8
1982.3
COPD Related
2,922
17.8
2397.2
444,403
18.5
2092.9
2,007
12.2
1584.9
339,156
14.1
1536.8
Mental Disorders
1,309
8.0
1149.6
156,944
6.5
779.7
1,333
8.1
1118.4
220,619
9.2
1046.4
Asthma Related
1,185
7.2
1033.7
185,915
7.7
913.2
706
4.3
567.5
116,186
4.8
541.5
601
3.7
520.9
67,820
2.8
333.8
623
3.8
508.6
129,420
5.4
604.2
Opioid
579
3.5
494.9
56,506
2.4
284.3
Falls
528
3.2
407.1
87,115
3.6
389.1
Infectious & Parasitic
475
2.9
391.7
72,783
3.0
341.7
430
2.6
354.2
72,901
3.0
342.4
Bacterial Pneumonia
385
2.3
315.7
64,337
2.7
300.7
Skin Diseases
315
1.9
271.4
41,961
1.7
201.4
Nervous System Diseases
274
1.7
234.0
48,074
2.0
229.9
Bronchitis / Chronic & Unspecified
280
1.7
223.3
41,870
1.7
192.2
Blood Diseases
147
0.9
120.0
25,188
1.1
120.6
Acute Respiratory Infections
122
0.7
115.4
14,854
0.6
80.7
Percent
Count
of all
(N=2,409,215) Hospitalizations
Ageadjusted
Rate per
100,000
123
xx
Top 10 Causes of Hospitalizations, Ages 15-29 years
Everett
Massachusetts
Percent of
all Causes
Percent of
all Causes
Childbirth, Pregnancy, Puerperium
55.47
46.02
Mental Disorders
14.72
14.56
Opioid Injuries
8.81
7.16
COPD Related
7.59
9.88
Asthma Related
7.31
9.48
6.27
5.66
4.91
7.65
3
2.89
2.45
2.55
Skin Diseases
2.04
1.67
SOURCE: Registry of Vital Records and Statistics, Bureau of Health Statistics,
Research and Evaluation, MDPH
Top 10 Causes of Hospitalizations, Ages 65 years or older
Everett
Massachusetts
Percent of
all Causes
Percent of
all Causes
31.53
28.25
COPD Related
27.6
26.06
23.35
25.09
8.95
9.65
Falls
6.7
6.72
6.68
6.94
5.75
6.72
4.27
4.67
Asthma Related
4.25
5.59
Bacterial Pneumonia
3.92
4.2
SOURCE: Registry of Vital Records and Statistics, Bureau of Health Statistics,
Research and Evaluation, MDPH
124
Top 20 Causes of Emergency Department Visits (3-year average; 2007-2009)
Everett
Massachusetts
Count
(N=16,460)
Age
Adjusted
Rate per
100,000
Age
Count
Adjusted
(N=2,409,215) Rate per
100,000
4,250
5572.4
563,937
2817.4
Falls
3,728
3813.8
561,121
2872.3
3,442
3475.6
375,615
1985.3
3,364
3235.9
365,416
1966.9
COPD Related
2,963
3055.5
367,257
1888.1
Mental Disorders
2,834
2648.5
365,293
1850.9
Skin Diseases
2,742
2526.4
327,193
1672.3
2,635
2447.0
352,534
1818.5
Asthma Related
2,549
2436.0
251,810
1332.1
Injuries - Struck by, against
Injuries - Overexertion
Childbirth, Pregnancy,
Puerperium
Infectious & Parasitic
Injuries - Cut/Pierce
Traumatic Brain Injuries
2,476
2,216
1,118
2394.7
2180.2
2008.3
344,027
292,524
245,290
1841.4
1476.4
1274.2
2,150
1948.9
102,720
1074.9
2,167
1,642
1,664
1,392
1,354
726
607
1825.9
1556.9
1500.1
1227.2
1214.0
605.8
568.2
263,217
181,680
207,844
152,495
165,032
112,471
82,274
1237.7
984.0
1069.8
758.5
855.2
528.1
437.5
Evaluation, MDPH
125
xx
Top Causes of Emergency Department Visits, Ages 15 to 20
years (3-year average 2007-2009)
Everett
Massachusetts
Percent of
all Causes
Percent of
all Causes
8.4
6.1
5.7
5.6
5.5
5.5
Injuries - Struck by, against
5.1
6.4
Mental Disorders
4.9
5.9
COPD Related
4.8
4.4
Skin Diseases
4.7
4.8
Injuries - Motor Vehicle Related
4.6
4.6
Injuries - Falls
4.5
4.8
4.3
5.8
Asthma Related
4.3
3.6
4.3
4.4
Childbirth, Pregnancy,
Puerperium
4.2
3.7
SOURCE: Registry of Vital Records and Statistics, Bureau of Health
Statistics, Research and Evaluation, MDPH
126
Top Causes of Emergency Department Visits, Age 65 years
or older (3-year average 2007-2009)
Everett
Massachusetts
Percent of
all Causes
Percent of
all Causes
14.2
11.9
Falls
13.8
14.4
11.5
9.2
COPD Related
7.1
9.4
5.1
3.4
4.4
5.9
Skin Diseases
4.4
4.3
4.2
4.3
Traumatic Brain Injuries
4.2
3.4
3.7
5.0
3.4
2.4
Asthma Related
2.3
1.8
Acute Infections
2.0
2.2
SOURCE: Registry of Vital Records and Statistics, Bureau of Health
Statistics, Research and Evaluation, MDPH
127
xx
The 10 Essential Public Health Services
Public Health is a population based approach to promote health and prevent disease in order to
reduce the burden of printable illness and injury. Public Health efforts at their best help reduce overall
health costs and are essential in creating high quality of like for everyone who live in the United States.
The motto most community used to describe Public Health Efforts is “Prevent, Promote and Protect.”
The 10 Essential Public Health Services listed below can be defined as a consensus statement that
defines Public Health within the context of a larger health system. Public Health efforts are models
of partnership: In Massachusetts, the 10 Essential Services are provided to our residents through the
combined efforts of local and state public health entities
1. Diagnose and investigate health problems and health hazards in the community.
2. Inform, educate, and empower people about health issues.
3. Mobilize community partnerships and action to identify and solve health problems.
4. Develop policies and plans that support individual and community health efforts.
5. Enforce laws and regulations that protect health and ensure safety.
6. Link people to needed personal health services and assure the provision of healthcare when
otherwise unavailable.
7. Assure competent public and personal healthcare workforce.
8. Evaluate effectiveness, accessibility,
and quality of personal and
population-based health services.
9. Research for new insights
and innovative solutions to
health problems.
SOURCE: www.cdc.gov/nphpsp/
essentialservices.html
128

The Well-Being of Everett - Cambridge Health Alliance

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