The Well Being of Everett - The Institute for Community Health
Transcription
The Well Being of Everett - The Institute for Community Health
the well being of Everett 2008 the well being of Everett Character I would have all young persons taught to respect themselves, their citizenship, the rights of others and all sacred things; to be healthy, industrious, persevering, provident, courteous, just and honest; neat in person and in habit, clean in thought and in speech; modest in manner, cheerful in spirit and masters of themselves; faithful to every trust, loyal to every duty; magnanimous in judgment, generous in service, and sympathetic toward the needy and unfortunate; for these things are the most important things in life and this is not only the way of wisdom, happiness and true success, but the way to make the most of themselves and to be of the greatest service to the world. Albert Norton Parlin the well being of Everett 2008 table of contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 Summary of Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 City of Everett Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 I. Leading Health Indicators 1. Physical Activity and Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 2.Tobacco . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 3. Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 4. Mental Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 5. Responsible Sexual Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 6.Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 7. Chronic Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 8. Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 9. Access to Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 II. Quality of Life Indicators 1. Environment, Recreation and Open Spaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 2. Social Capital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 3. Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 4. Arts and Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45 Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46 Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48 Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50 the well being of Everett 2008 2 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 Cambridge Health Alliance Eliot Community Human Services Everett Board of Health Everett Chamber of Commerce Everett Human Services Everett Literacy Program Everett Public Library Everett Public Schools Everett Substance Abuse Coalition First United Parish Immaculate Conception Church Joint Committee for Children’s Health Care in Everett (JCCHCE) Malden Everett Family Network Mystic Valley Elder Services Our Lady of Grace Church Portal To Hope Revere Family Health Center Tri-City Community Action Program 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 2008 Everett Health Data 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 2008 Everett Health Data Report provides current information about key health indicators, such as overweight and obesity, substance abuse, mental health, responsible sexual behavior, violence, chronic illness, cancer and access to care.The report also provides information on additional areas that affect the health and well being of the community including education, housing, income levels, employment and crime. 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. The report contains significantly more data for youth than adults because over 5000 youth are surveyed every two years through the Youth Risk Behavior Survey. A future report will include data on adults gathered from a new survey of health related behavior which was conducted early in 2008 in the cities of Everett, Cambridge, Somerville and Malden by the Institute for Community Health. It is our hope that the 2008 Everett Health Data Report will be both accessible and provocative, and that it will increase the community’s curiosity about the health of Everett residents. We welcome each member of the Everett community to join us in making Everett an even healthier and more vibrant city. Whidden Memorial Hospital Zion Baptist Church Carlo DeMaria, Jr. Mayor City of Everett Dennis D. Keefe, Chief Executive Officer Cambridge Health Alliance the well being of Everett 2008 3 Summary of Recommendations Physical Activity/Nutrition G Support Everett Walks and Talks as part of a community-wide campaign to encourage physical activity and healthy eating. Tobacco G Increase access to information on the risk of second hand smoke and smoking cessation resources. G Chronic Disease G G Increase advocacy, support and access to treatment information for drug users and their families. G G G Organize a mental illness anti-stigma community education campaign. Support JCCHCE’s development of volunteerstaffed parent forums/discussion groups. G G Create a youth-led community-wide educational campaign aimed at decreasing sexually transmitted diseases and preventing pregnancy. Expand existing sexuality education at all grade levels to include more sessions on decision making, values and setting personal goals for all students. Responsible Sexual Behavior - Adults G Increase community education on modes of transmission, access to resources and services for people of all ages. Violence G Increase funding for Portal to Hope to expand domestic violence trainings and create systematic reporting. Enrich and enhance citywide campaign to inform residents of available insurance and help residents access health care services with particular emphasis on newcomers to Everett including immigrants. Nature, Environment Health, Recreation: G Help develop and promote a Bike To Sea program. Social Capital: G Responsible Sexual Behavior -Youth G Organize community-wide cancer education and screening programs. Access to Health Care Expand the substance abuse educational curriculum throughout the Everett Public Schools. Mental Health Increase primary care services for adults and children in Everett. Cancer Substance Abuse G Create after-school teen center with leadership from teens, police and other community leaders. Increase the number of intergenerational, interethnic and interracial community building projects. Housing and Jobs: G G Advocate that new housing development projects include affordability below 60% of the Area Median Income so that low- to moderateincome Everett residents will be able to access housing. Advocate that new community/economic development projects include provisions of jobs for local residents, training to help increase likelihood that they can get the jobs, and that the jobs are living-wage ones. Arts and Culture: G Expand and promote cultural programs for children and families promoting the diversity and richness of the community. 4 the well being of Everett 2008 A Demographic Description of Everett People and Geography: The city of Everett, since its incorporation in 1892, has been a working-class community. Everett has 38,037 residents living in only 3.4 square miles (See Figure 1). Bordering on the Mystic River, Malden, Revere and Chelsea, Everett is 4 miles north of downtown Boston on the eastern edge of Massachusetts’ Middlesex County. Historically, Everett has attracted immigrants, especially from Italy and Ireland and most recently from Brazil, El Salvador, and Haiti. In the past 20 years the city has become much more ethnically, racially and linguistically diverse (See Figure 2: Foreign Born Residents). For example, Census 2000 reported that the number of foreign-born Everett residents increased by 106% in 10 years to 8,323 or 21.9% of the total population. The race and ethnicity changes have been even more dramatic with a 164% increase in Hispanic population, a 121% increase in the black population and a 12% decrease in the white population. These changes have continued over the past eight years as reported by the Massachusetts Department of Education which indicates that from 2000 to 2007 enrollment at Everett public schools by Latino and Black, non-Hispanic students has increased by over 72% and 56% respectively. White non-Hispanic children decreased by 20% (See Figure 3: School Enrollment by Race/Ethnicity). Everett’s diversity is also evident linguistically with 29% of residents speaking a language other than English at home and approximately 17% having limited English proficiency. From 1970 to 1990, Everett’s population decreased by 16 %. Since then, Everett’s population has experienced a 4% growth from 1990 to 2006. Data Source: United States Census Bureau, 2000 the well being of Everett 2008 5 Almost a quarter of Everett residents are foreign-born (22%) compared to 12% of residents statewide. Brazilian and Salvadorian residents make up 32% of Everett’s foreign-born population. Note: Data reflects 8,323 foreign-born Everett residents Data Source: United States Census Bureau, 2000 From 2000 to 2007, enrollment at Everett public Schools among White, nonHispanic children decreased by 20%. Latino and Black, non-Hispanic student enrollment increased by 72% and 56% respectively during the same time period. Data Source: Massachusetts Department of Education, 1999-2007 6 the well being of Everett 2008 From 1992 to 2008 the proportion of Everett students whose first language was not English increased from 8.5% to 43.8%. The proportions of students with limited English proficiency increased from 3.9% to 9.7% during the same period. In addition to changes in the ethnic make-up, Everett’s population has shifted towards younger age groups in recent years. According to Census 2000 data, nearly a quarter of the city’s residents (over 9,000) are youth below the age of 19. Almost 7,000 of them were school-aged (5-19), Data Source: Massachusetts Department of Education, 2008 with a slightly higher percentage of females to males.The number of youth, as a percentage of overall population, has been increasing in Everett in the last 10 years (See Figure 5: Population by Age Distribution). Almost a quarter of Everett’s population consists of youths under the age of 20 (23% in 2000). Note: Data reflects 35,701 residents in 1990 and 38,037 residents in 2000 Data Source: United States Census Bureau, 2000 the well being of Everett 2008 Income: Everett’s per capita income is $19,845, which is significantly lower than the statewide average of $25,952.The poverty rate in Everett is 11.8% with more than 1,300 area children living at less than the 100% poverty level.The number of persons living below the poverty line increased 31% from 1990 to 2000. The number of families with dependent children receiving temporary aid increased 15% between 2000 and 2005. The number of Women’s, Infants and Children (WIC) participants increased 38% in this same period. (WIC Program Utilization Data, Bureau of Family and Community Health, Massachusetts Department of Public Health). Employment: The Metro North Employment Board, the Workforce Investment Board for the tri-city area (Everett, Malden and Medford) reports that in April 2005 the region had the second highest number of people claiming unemployment benefits in the state. (from TriCAP 2006-2008 plan). Unemployment in Everett has been at 4.85 percent (2006) for the past five years; this has been consistently higher than the rate in Massachusetts (Regional and State Unemployment News Release. Bureau of Labor Statistics, U.S. Department of Labor. February 29, 2008. http://www.bls.gov/news. release/srgune.htm.) Most of Everett and Massachusetts residents are private wage and salary workers, comprising roughly 80% of the workforce. The remaining classes of workers are public sector, government employees (13.5% in both Everett and Massachusetts), selfemployed/non-incorporated workers, and unpaid family workers. Housing: There are approximately 16,000 households in Everett, the majority of which are renter-occupied (56%). Median advertised monthly rent for a two-bedroom apartment 7 in Everett in 2007 was $1,000 (down from $1,200 in 2001). 38% of median income is needed to pay rent in 2004.The median single family home price in Everett in 2004 was $332,000.The maximum home price affordable to the median income household was $212,120; the maximum home price affordable to a first time homebuyer in Everett was $140,639 (Heudorfer B. and Bluestone B. The Greater Boston Housing Report Card: An Assessment of Progress on Housing in the Greater Boston Area. Prepared by the Center for Urban and Regional Policy (CURB) at Northeastern University for the Boston Foundation and Citizens’ Housing and Planning Association (CHAPA). September 2005. http://www.chapa.org /pdf/HousingReportCard2004.pdf). High rents and a limited range of housing options have created homelessness for families and individuals.The Tri-City Continuum of Care has documented more than 200 homeless individuals and nearly 100 homeless families residing or seeking services in the tri-city area (Tri-CAP 2006-2008 Community Action Plan). Disability: Disability is defined as a long-lasting physical, mental, or emotional condition.This condition can make it difficult for a person to do 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 wellbeing compared with the general population. The potential for a lack of access to health care services and medical care may increase a persons risk for various health and mental health conditions. 8 the well being of Everett 2008 A quarter (24%) of Everett residents between the ages of 16 to 64 years have one or more disabilities – higher than statewide and national proportions of 17% and 19% respectively. Note: Data reflects 8,611 Everett residents. Data Source: United States Census, 2000 Crime: In the United States violent crime rates have declined since 1994, reaching the lowest level ever in 2005.The violent crimes included in this statistic are rape, robbery, aggravated and simple assault, and homicide. (Bureau of Justice Statistics: www.ojp.usdoj.gov/bjs/). This trend has been mirrored in Massachusetts and Everett with violent and overall crime decreasing over the past 10 years. In 2005 (the latest year for which there are statistics) crime decreased significantly from 2004 in every major category except burglary. (see Figure 27 on page 27). However, Everett’s crime index, or risk of experiencing any type of crime, remains steadily above that of the state. On a scale in which 100 represents the national average, Everett’s total crime index (a measurement including all forms of crime) is 95, which is considerably higher than the state index of 78 (Massachusetts State Police, Crime Report Unit). Education: The Everett Public Schools consists of 7 public schools, pre-kindergarten through 12th grade, and enrolls over 5,000 students each year. Three of the City’s five K-8 schools are less than 10 years old and a new state-of-the-art high school facility opened in August 2007. There are 3 private schools in Everett. The city also maintains a membership affiliation with Shore Educational Collaborative, a special agency that provides services for behaviorally and academically challenged individuals. In the 2006-7 school year 42% of Everett public schools students spoke a language other than English at home, a 45% increase since the 2000-2001 school year. Six hundred students representing 11.5% of the student population claim limited English proficiency, a 22% increase since 2000/1. In Massachusetts, 15.1% of students indicate that English is not their first language and 5.8% claim limited English proficiency. Sixtyfour percent of Everett students are considered the well being of Everett 2008 9 A higher percentage of Everett public school students come from low income families and speak a first language that is not English compared to their statewide counterparts. Data Source: Massachusetts Department of Education, 2008 low-income, a 28% increase since the 2000-2001 school year. Students in Everett exceed the state rates for in-school suspensions (11.3%) and dropoutrates (3.6%). Additional educational indicators of concern falling below the state rates include average number of days absent (11.0%) and graduation (77%). The student/teacher ratio in Everett is nearly the same as the state’s, at 13.5 to 1 in Everett and 13.2 to 1 across Massachusetts. In 2007 Everett spent $9,894 per pupil for grades k-12, significantly less than the state average of $11,210 per pupil. The Everett Literacy Program is an adult education program operated by the city of Everett which teaches 180 students to speak English as a second language (ESOL), citizenship, as well as how to access training programs, get a GED or ADP, continue their education and get better jobs.The Everett Literacy Program has a waiting list of over 300 people.The program has a paid teaching and administrative staff funded by the Massachusetts Department of Education, as well as, a volunteer staff of oneto-one tutors. the well being of Everett 2008 10 Physical Activity and Nutrition Why is this important? Increasing rates of early weight gain have led to predictions that youth today may be the first generation to have shorter life spans than their parents. A significant number of Everett children and adults are either obese, overweight, or at risk of becoming overweight. Obese adults are at increased risk for diabetes, high blood pressure, cardiovascular disease, cancer, arthritis, depression, and respiratory illnesses. Overweight among children and teenagers is also a serious health issue. Overweight children are at risk for developing high blood pressure, type 2 diabetes, and other conditions once common only among adults. Promoting and supporting an environment in Everett that makes it easy for children and adults to be physically active and to eat within the 2005 National Dietary Guidelines are among the most important things we can do for their long term health and current quality of life. The proportions of high school students in Everett volunteering, participating in organized activities and playing sports are lower than their statewide counterparts. Data Source: Everett School Health Survey, 2005 and 2007 Less than a quarter (23%) of middle and high school Everett students meet the daily fruit and vegetable consumption recommendations in 2007. Data Source: Everett School Health Survey, 2005 and 2007 the well being of Everett 2008 11 - The PEP grant includes training staff at all schools in Project Adventure, an innovative program of non-competitive, adventurebased learning. All schools will receive Project Adventure challenge course equipment. Community Strengths and Assets G G G G G G G G “Everett Walks and Talks,” a program of the Joint Committee for Children’s Health Care in Everett (JCCHCE), includes walking events and groups for all ages, historical and environmental walks and marked routes. - Enhanced food service offerings that are free from trans-fat, and are rich in whole wheat and grains, fruits and vegetables and other low-fat foods. Weekly physical exercise/nutrition education for seniors provided at Connolly Center by Cambridge Health Alliance. Everett benefits from a long tradition of athletic excellence.The culture of the city promotes membership in a diverse range of sports programs for children of all ages continuing through high school. The City has a recreational complex located across from the new high school, which includes a skating rink and outdoor pool. A Bike and Walking to Sea Trail is being developed which will provide a nine mile path to the ocean. Women, Infants and Children (WIC) Program at City Hall provides healthy foods, nutrition education and referrals to moderate and low-income individuals. A recently opened food pantry at the First Methodist Church on Broadway is open two days each month. The Everett Public Schools have demonstrated a commitment to fostering a healthful environment for students through: - A $1.3 million Carole B.White Physical Education Program (PEP) grant to improve exercise and nutrition programs throughout the schools. - Pilot physical activity programs, such as “Fitness Buddies”, Fitness Night and “Recess Before Lunch.” Recommendations G G G G G G G G Support Everett Walks and Talks as part of the community-wide campaign to encourage physical activity and healthy eating. Measure heights, weights and Body Mass Index of all public school students Promote home cooking as a nutritious alternative to take-out and fast food. Development of a Teen Youth Center with nutrition education and fitness components. Help develop and promote the “Bike to Sea” pedestrian and bicycle trails. Implement school-wide campaign to educate youth and parents about excessive “screen time” specifically television viewing, computer use and video games, as well as the benefits of a non-sedentary lifestyle. Initiate a community rowing program. Reinstate the Farmers Market. 12 the well being of Everett 2008 Tobacco Why is this important? Tobacco use is the leading cause of preventable death and illness in Massachusetts, and in the nation. Tobacco kills more people each year than car accidents, AIDS, homicides, suicides and poisonings combined. Though they are not smokers themselves, an estimated 1,000 or more Massachusetts adults and children die each year from secondhand smoke. Studies have shown that children exposed to tobacco advertising are more likely to become smokers. Research indicates that 80% of adult smokers began smoking before the age of 18. By the time they graduate, more than half of Everett students report having smoked cigarettes at least once. One fifth of high school seniors report smoking tobacco in the last 30 days. Data Source: Everett School Health Survey, 2007 Everett high school students report someone else buying cigarettes for them as the primary method of obtaining tobacco (34% of students who currently smoke). Note: Data reflects 219 Everett high school student. Data Source: Everett School Health Survey, 2007 the well being of Everett 2008 13 Community Strengths and Assets Recommendations G G G G G Everett has been part of the Five City Tobacco Control Collaborative since 1993.This initiative is a state funded coalition that includes the Health Departments of Cambridge, Somerville, Chelsea, Everett and Revere. Its primary mandate is to develop and promote local tobacco control policies, and to enforce these policies in all five cities it serves. The Collaborative develops tobacco control policies in two basic areas: Youth Access (YA), which is intended to limit youth access to tobacco products; and Environmental Tobacco Smoke (ETS), which establish restrictions on smoking in public and workplaces. Sales of cigarettes to minors, monitored by the Tobacco Control Collaborative, have decreased annually since 2003. Youth are actively involved in tobacco prevention through state supported grants focused on youth education and advocacy efforts aimed at tobacco companies. G G G G G Encourage and support medical providers in screening and helping patients to quit. Increase access to information on smoking cessation resources in local businesses, city buildings and on city cable stations. Expand education efforts to adults and youth on the risks associated with second hand smoke. Eliminate local and national tobacco advertising and promotions that influence adolescents and young adults through advocacy efforts aimed at tobacco companies. Provide education to help increase parental monitoring and communication with children and youth on the risks associated with short and long term tobacco use. Participate in national initiatives, such as the Great American Smokeout and World No Tobacco Day. 14 the well being of Everett 2008 Substance Abuse Why is this important? Substance abuse is a major public health problem that impacts society on multiple levels. Substance abuse is associated with violence, sexually transmitted diseases, low worker productivity, child abuse, costly medical conditions, motor vehicle crashes and accidental injury. Substance abuse impacts the individual, family, and community. Many of America’s top medical problems can be directly linked to drug abuse including lung cancer, heart disease, HIV/AIDS, and mental health issues. Directly or indirectly, every community is affected by drug abuse and addiction, as is every family. We know as a community that substance abuse prevention needs to be a priority for both adults and youth. Youth exposure to alcohol and other drugs may interfere with adolescent brain development. Alcohol and drug use by youth increases the likelihood of becoming involved in other risky behaviors which can lead to victimization, injury, sexually transmitted infections, suicide and educational failure. Research has shown that prevention programs that aim to reduce risk factors for youth substance abuse can also reduce delinquency, teen pregnancy, school drop-out or violence, and increase school performance. Half of the substance abuse admissions to treatment facilities in 2005 among Everett residents were heroin-related (vs. 38% statewide). Note: Data reflects 3,813 admissions among Everett residents from 2000 to 2005. Data Source: Bureau of Substance Abuse Services, MDPH 2005 the well being of Everett 2008 15 Substance abuse treatment admission rates among Everett residents under 30 years are higher than statewide rates. People ages 20-24 and 25-29 are most at risk (5,365/100,000 and 4,367/100,000) respectively. Note: Data reflects 605 admissions among Everett residents in 2005. Data Source: Bureau of Substance Abuse Services, MDPH 2006 There is an average of 495 substance abuse-related emergency departments visits a year at Whidden Hospital in Everett. * DAWN cases include drug-related suicide attempts, detox related visits, and alcohol –related visits among people under 21 years old. Note: Data reflects 1,484 visits from FY05-FY07. Data Source: Drug Awareness Warning Network, 2007 16 the well being of Everett 2008 Everett high school students report lower current usage of alcohol, cigarettes, and marijuana compared to their peers statewide. * Binge drinking is defined as the consumption of five or more drinks in a row Data Source: Everett School Health Survey, 2003, 2005, 2007 The majority of Everett high school students report obtaining alcohol by asking someone older than they to give it or buy it for them (57%). Note: Data reflects 719 students Data Source: Everett School Health Survey, 2007 Heroin-related treatment admissions rates among Everett residents between the ages 15-19 years (1450/100,000) are almost 6 times higher than statewide rate of 255/100,000. Note: Data reflects 294 heroin-related treatment admissions among Everett residents in 2005 Data Source: Bureau of Substance Abuse Services, MDPH 2005 the well being of Everett 2008 Community Strengths and Assets G G G G G G Implementation of a nationally recognized science-based substance abuse prevention curriculum, Project Northland, for students in 6th, 7th and 8th grades, with positive results. Everett Community Health Partnership’s Substance Abuse Coalition (ECHP-SAC) is a collaborative community-based initiative funded by the federal agency, Substance Abuse and Mental Health Services Administration. Since 2002, the coalition, dedicated to prevention efforts, has been addressing substance abuse using multiple strategies in multiple settings to change the social norms on alcohol and drug abuse. Everett has a dedicated and active group of over thirty youth,Teens in Everett Against Substance Abuse (TEASA), who work in partnership with community leaders on prevention strategies to educate youth, adults, parents and businesses on risks associated with substance abuse. Whidden Memorial Hospital’s emergency department has expanded its capacity to screen patients with substance abuse disorders through a state-funded program called Screening, Brief Intervention, Referral and Treatment (SBIRT). The Drug Awareness Resistance Education (DARE) program has been reinstated in the Everett Public Schools. The Cambridge Health Alliance and Everett Board of Health continue to monitor overdoses, suicide, hospital and treatment admissions data on substance abuse, helping to guide community prevention efforts. 17 G The Everett Police Department monitors youth alcohol sales through compliance checks throughout the year. Recommendations G G G G Provide increased support and access to treatment information for drug users and their families dealing with substance abuse disorders. Address the lack of treatment facilities available to meet the needs of the community by advocating for local and state resources to treat addiction for youth and adults. Expand the substance abuse educational curriculum throughout the Everett Public Schools, especially at the higher grade levels, with a stronger focus on health classes in the high school. Increase educational efforts to help parents recognize the signs and symptoms of early drug use. Provide resources for parents on how to talk with their children about substance use and abuse. 18 the well being of Everett 2008 Mental Health Why is this important? Mental health is sometimes thought of as simply the absence of a mental illness but is actually much broader. Mental health is a state of successful mental functioning, resulting in productive activities, fulfilling relationships, and the ability to adapt to change and cope with adversity. Mental health is indispensable to personal well-being, family and interpersonal relationships, and one’s contribution to society. Thus, in assessing the health of Everett, it is important to understand the proportion of individuals and families that are experiencing strong and persistent dissatisfaction with their lives, harming themselves, and/or interfering with the well being of others. Although suicide rates began decreasing in the mid-1990s, prior increases among youth aged 10 to 19 years and adults aged 65 years and older have raised concerns about the vulnerability of these population groups. It is, therefore, critical that we are mindful of depression, isolation and other mental illnesses which may lead to suicidal ideation and attempts. More than a quarter (28%) of Everett High School students report being depressed in the past 30 days.Thirteen percent of students considered or attempted suicide in 2007. Data Source: Everett School Health Survey, 2003, 2005, 2007 the well being of Everett 2008 19 On average, rates of hospital discharges for mental disorders among Everett residents are higher than statewide rates. Hospital discharge rates for mental disorders among Everett residents declined 19% from 2000 to 2005, while statewide rates remained stable for the same time period. Note: Data reflects 2,860 mental disorder hospital discharges among Everett residents from 2000-2005. Data Source: Hospital Discharge Database, MDPH 2005 Community Strengths and Assets G G G Cambridge Health Alliance provides a variety of clinical and professional expertise available to service the mental health needs of the Everett community, including: two adult inpatient psychiatric units located at the Whidden Hospital; a child psychiatrist at the Anna May Powers Health Center at the Keverian School; a teen health center at the Everett High School, which provides counseling and other mental health services from a staff psychiatrist, psychologist and social worker. Close collaboration between primary care providers, school guidance counselors, school nurses and social service providers allows for effective referrals to clinical settings. Everett High School staffs a full time licensed clinical social worker to assist any student who may benefit from counseling, assistance and/or referrals. G G G The Joint Committee for Children’s Health Care in Everett (JCCHCE) conducts semiannual Parent University educational forums which focus on the stress of parenting, as well as childhood mental health issues. For families of children 0 to 3, the MaldenEverett Family Network (MEFN) provides parenting classes and support groups to help foster healthy family interactions, and Tri-CAP’s Head Start pre-school program provides mental health support for children and families. Cambridge Health Alliance’s elder mental health care program, COPE (Consumer Outreach Program for Elders), provides care in people’s homes, as well as, community education for elders. COPE is staffed by a psychiatrist, social worker, and nurse practitioner. the well being of Everett 2008 20 G Eliot Community Human Services provides Everett with comprehensive, community-based outpatient care for children, adults and seniors which includes outreach, emergency services and outpatient medication programs. Recommendations G G G G G G G Organize an anti-stigma community education campaign. Support JCCHCE’s development of volunteerstaffed parent forums/discussion groups. Implement COPE-staffed elder suicide prevention program. Increase the participation of Everett teens in a variety of leadership development projects, including the statewide youth mental health advocacy project:Teens Leading The Way. Participate, with the JCCHCE, in Health Care For All’s child mental health legislative campaign. Identify and better utilize mental health resources that already exist in the community such as Arbor Counseling and Eliot Community Human Services. Develop volunteer-facilitated support group(s) for adult men. the well being of Everett 2008 21 Responsible Sexual Behavior: Youth Why is this important? Sexuality is a large part of adolescent growth and development. For healthy sexual development, children need stable and safe environments that promote social and emotional well-being. Along with positive expectations and sound preparation for their future adult lives, adolescents need education, skill training, self-esteem promoting experiences, and age-appropriate reproductive health services. Sixty-eight percent of Everett high school seniors report having had sexual intercourse. Among 8th graders, almost 20% of students report having had sexual intercourse. Note: Data reflects 2,828 Everett public school students in 2007 and 2,812 students in 2005. Data Source: Everett School Health Survey, 2005 and 2007 Seniors are less likely to report using a condom at last intercourse compared to underclassmen. Almost half of high school girls (48%) and 36% of boys reported talking to a parent or other adult about AIDs/HIV infection. Data Source: Everett School Health Survey, 2007 22 the well being of Everett 2008 On average, each year there are 22 newly diagnosed cases of Chlamydia among Everett youths between the ages of 15 and 19. Note: Data reflects 122 newly diagnosed cases of Chlamydia among Everett teens 15 to 19 years old. Data Source: Sexually Transmitted Disease Program, MDPH 2005 The number of births to Everett teen girls increased from 20 births in 2000 to 37 births in 2006. Since 2001, the teen birth rate in Everett has remained higher than the statewide teen birth rate. Note: Data reflects 188 births to teen girls in Everett (15-19 yrs) from 2000-2005. Data Source: Registry of Vital Records, MDPH 2005 the well being of Everett 2008 23 Community Strengths and Assets Recommendations G G G G G Sexuality education in the Everett Public Schools begins in the elementary school using a comprehensive research-based health curriculum, the Great Body Shop. Starting in the 4th grade students learn about risk-avoiding decision making skills. The Everett Teen Health Center, located at Everett High School, offers comprehensive primary care services for children and teens, including confidential reproductive health services. Since 2006, a science-based curriculum,Teen Outreach Program (Empowering Youth in the Community), evaluated to show reduction in school drop out, school failure and a reduction in teen pregnancy, has been available to 9th and 10th graders at Everett High School. High school students may elect health classes “Making Life Choices”, “Independent Living” and “Parenting Skills” to better prepare for adulthood. G G G G Expand existing sexuality education to all grade levels to include more sessions on decision making, values and setting personal goals for all students. Support education programs for peer educators and parents to help them speak to youth about appropriate sexual behavior and decision making. Create a community-wide educational campaign aimed at decreasing sexually transmitted diseases and preventing pregnancy. Sustain clinical services in order to treat and contain sexually transmitted infections for sexually active youth. Create a year round Youth Center for Everett teens. 24 the well being of Everett 2008 Responsible Sexual Behavior: Adult Why is this important? “Because sexuality is one of the human attributes most endowed with meaning and symbolism, it is of particular importance that addressing sexual health issues involve community wide discussion, consultation, and implementation.” (The Surgeon General’s Call to Action to Promote Sexual Health and Responsible Sexual Behavior, 2000) Acquired Immune Deficiency Syndrome (AIDS) resulting from HIV remains a serious public health concern; public awareness and education are important in order to reduce transmission rates and increase safe sexual behaviors. Responsible sexual behavior can reduce the risk of transmitting sexually transmitted infections (STI). Untreated STIs cause serious reproductive health problems, health complications in newborn babies, certain types of cancer, and increase the risk of the sexual transmission of the Human Immunodeficiency Virus (HIV). Chlamydia incidence rates among Everett adults increased 78% from 2000 to 2005 compared to a 42% increase in incidence statewide. Note: Data reflects 493 newly diagnosed cases of Chlamydia among Everett adults 20 years of age and older. Data Source: Sexually Transmitted Disease Program, MDPH 2005 30 25 20 25 Figure 25: Average Annual HIV Incidence Rate, Everett 2003-2005 20.7 24.8 22.8 23.3 23.2 18.4 15 10 MA Rate: 14.1 Somerv ille Malden Ev eret t Chels ea 0 Rev ere 5 Cambridge A ve ra ge R ate per 1 00 ,0 00 the well being of Everett 2008 An average of 7 people become diagnosed with HIV each year in Everett (based on 2003-2005 data). HIV incidence rates among Everett residents are higher compared to statewide rates but lower compared to rates in surrounding communities. Note: Data reflects 20 Everett residents diagnosed with HIV within 2003 and 2005. Data Source: HIV/AIDS Surveillance Program, MDPH 2005 Among the 110 people living with HIV/AIDS in Everett in December 2005, 30% contracted HIV through male to male sex, and 13% contracted HIV through intravenous drug use. Heterosexual sex was the mode of transmission for at least 11% of people living with HIV/AIDS in Everett. Note: Data reflects 110 Everett residents living with HIV/AIDS in December 2005. Data Source: HIV/AIDS Surveillance Program, MDPH 2005 the well being of Everett 2008 26 Community Strengths and Assets Recommendations G G G G G Confidential sexually transmitted infection’s (STI’s) and HIV testing is available at CHA primary care sites as well as the Whidden Memorial Hospital. Education is available for community agencies, school groups and/or parents through the Cambridge Health Alliance’s HIV community services on STIs, HIV and hepatitis C. Collaboration exists between Cambridge Health Alliance’s HIV community services and community based agencies including the Everett Board of Health on increasing counseling, testing and prevention education for all sexually transmitted infections. Tri-CAP’s Housing Opportunities for People with AIDS (HOPWA) program provides housing search assistance and other support services. G G G Increase community education on modes of transportation, access to resources and services for people of all ages. Increase awareness and visibility of the Cambridge Health Alliance bilingual Integrated Counseling, Testing and Referral (ICTR) Hotline (617-591-6767 during the hours of 9-5, Monday through Friday). Language capacity includes English, Spanish, Portuguese and Haitian Creole). Develop a plan to work in partnership with agencies, programs, businesses and others on awareness of resources on counseling, testing and prevention education. Increase visibility of public health events such as HIV and Counseling and Testing Week, and World AIDS Day. the well being of Everett 2008 27 Violence Why is this important? Violence is among the leading causes of death for people aged 15-44 years worldwide. For every person who dies as a result of violence, many more are injured and suffer from a range of physical, sexual, reproductive and mental health problems. Domestic violence is violence or abuse that occurs in the home between spouses, partners (including teenagers in violent dating relationships), children who experience or witness family violence, elders and roommates. Victims often suffer physical injuries such as bruises or broken bones.The abusive relationships also involve mental and emotional suffering resulting in depression and social isolation. Domestic violence affects all levels of society regardless of income or education. It typically goes unreported which perpetuates the activity by a dominating spouse, partner, parent or boyfriend/girlfriend. The Surgeon General’s 2001 Report on Youth Violence said that the most highly effective youth violence prevention programs combine components that address both individual risks and environmental conditions, particularly building individual skills and competencies, parent effectiveness training, improving the social climate of the school, and changes in the type and level of involvement in peer groups. Research shows that youth violence and delinquency have been associated both with poor academic performance and with an increased likelihood for dropping out of school. In the past decade, Everett has seen a 73% decline in rates of violent crime.The majority of violent crimes consisted of aggravated assaults (58% in 2005). * Violent Crime refers to homicide, forcible rape, robbery, and aggravated assault. Data Source: Massachusetts State Police, Crime Reporting Unit, 1996-2005 28 the well being of Everett 2008 Everett experienced a 19% increase in violent crime during the first half on 2007 compared to 2006. Compared to surrounding communities, crime increase in Everett is substantial. * Note: Data reflects first six months of 2006 and 2007 Data Source: COMPSTAT, Massachusetts State Police, 2007 High School students report a large increase in fighting at school from 9% in 2005 to 24% in 2007. Data Source: Everett School Health Survey, 2005 and 2007 the well being of Everett 2008 29 Bullying at school is more prevalent in the middle grades. In 2007, 31% of middle school students report being bullied at school compared to 17% of high school students. Data Source: Everett School Health Survey, 2005 and 2007 There were 347 domestic violence-related calls for service received by the Everett police in 2007, a 5% increase in calls from 2006. The majority of domestic violence calls in 2007 were related to assault and battery (58%) followed by 209A-Restraining Orderviolations (20%). Note: Data reflects 677 domestic violence-related calls for services in 2006 and 2007. Data Source: Everett Police Department 2008. the well being of Everett 2008 30 Community Strengths and Assets As a community Everett has taken a strong stand on violence prevention both at home and in the community. G G G G G Portal to Hope is Everett’s non-profit domestic violence agency which provides a 24-hour hotline, emergency shelter, legal aid for ensuring continued civil protections through the legal court system, job placement & housing assistance which helps victims rebuild their lives both personally and professionally and youth programs designed to educate our children and help break the cycle of violence. The Whidden Emergency Room staff screens all patients at triage with domestic violence questions. The Everett Public Schools was awarded a Shannon Anti-Gang Violence Program grant which supports regional and multi-disciplinary approaches to combat gang violence through coordinated programs for prevention, intervention and job development. There is 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. Everett has a well-established Conflict Resolution/Mediation program at the High School available for all school students and staff to use. Recommendations G G G G G G G G Increase funding for Portal to Hope; expand domestic violence trainings and create systematic reporting to Portal to Hope about domestic violence cases. Create an after-school year-round Youth Center for Everett teens. Expand school mediation program to elementary schools. Build stronger relationships between police and youth through joint projects, community and school trainings. Offer professional development trainings for school staff, especially in the 7th, 8th and 9th grades, on social skills and conflict resolution to ensure that they are well trained to handle sexual harassment and conflict amongst students. Continue to make sure all students feel safe in school by enforcing all policies with regard to harassment and bullying. Increase programming and mentoring opportunities for girls since they are more likely to experience violence than boys. Attend regional prevention efforts such as Massachusetts Coalition for Youth Violence Prevention. Being part of regional efforts keeps this a priority and helps our community better understand what is happening outside our borders. the well being of Everett 2008 31 Chronic Disease Why is this important? Chronic diseases—such as heart disease, cancer, and diabetes—are the leading causes of death and disability in the United States. Chronic diseases account for 70% of all deaths in the U.S., which is 1.7 million each year. These diseases also cause major limitations in daily living for almost 1 out of 10 Americans or about 25 million people. Although chronic diseases are among the most common and costly health problems, they are also among the most preventable. 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. Coronary Heart disease is the leading cause of death among Everett residents in 2005, followed by Lung Cancer and Poisonings (including overdoses). Poisoning injury death rates including overdoses in Everett are 2 times higher than statewide rates. Lung cancer mortality rates among Everett residents are 1.5 times higher than statewide rates in 2005. Note: Data reflects 170 deaths among Everett residents. Data Source: Registry of Vital Records, MDPH 2005 32 the well being of Everett 2008 Lung and heart disease, asthma-related complications, and diabetes were among the leading causes of hospitalizations among Everett residents in 2005. Hospital discharge rates for lung and heart disease are higher than rates statewide. Note: Data reflects 5,847 hospital discharges involving Everett residents in 2005. Data Source: Uniform Hospital Discharge Database, MDPH 2005 Coronary heart disease mortality rates among Everett residents declined by 43% from 2000 to 2005. Statewide rates declined 25% during the same time period. Note: Data reflects 434 coronary heart disease deaths among Everett residents between 2000 and 2005. Data Source: Registry of Vital Records, MDPH 2005 the well being of Everett 2008 33 The average annual poisoning-related death rates among Everett residents and residents of surrounding communities are higher than the statewide rate. Note: Data reflects 2,751 deaths statewide due to poisonings. Data Source: Registry of Vital Records, MDPH 2005 Except for those in the 20-29 year old age group, rates of diabetes-related emergency department visits among Everett residents outnumber rates of their statewide counterparts for all age groups. The elderly are particularly at risk. Note: Data reflects 527 emergency department visits for diabetes-related complications among Everett residents in 2005. Data Source: Emergency Department Database, MDPH 2005 Everett children under the age of 10 and adults between the ages of 20-29 are at particular risk for asthma-related emergency department visits. Note: Data reflects 370 emergency department visits for asthma-related complications among Everett residents in 2005. Data Source: Emergency Department Database, MDPH 2005 the well being of Everett 2008 34 Community Strengths and Assets Recommendations G G G Everett Board of Health: Provides communicable disease investigation and surveillance; organizes immunization clinics; oversees twelve school nurses; provide health and sanitary inspections; plans public health role in emergency preparedness; protects environment from damage and pollution. Older Adults Health Education (CHA in collaboration with Everett Human Services): Weekly aerobics, strength and yoga classes and informational/screening sessions at Everett Armory, Glendale Towers,Whittier Villa Co-op, Whittier Drive apartments and Golden Age Circle on such issues as: flu prevention, nutrition counseling, blood pressure, diabetes and cholesterol control. G Volunteer Health Advisors (VHA’s): VHA’s are people from the local community who offer their time, skills and experience to improve health in their community. VHA’s hold screenings in their neighborhoods to help people find health problems early, before they get serious.VHA’s also run support group meetings for people with serious diseases, like diabetes.VHA’s are an important connection between the community, JCCHCE, CHA and other local health providers.VHA’s serve communities speaking four main languages: English, Haitian-Creole, Portuguese and Spanish. G “Everett Walks and Talks” (JCCHCE): Funded by a Mass Department of Public Health grant, Everett Walks and Talks includes walking events and groups for all ages, historical and environmental walks and marked routes. G G G G Increase primary care services for adults and children in Everett. Expand citywide walking, fitness and nutrition program. Expand cancer screening and education. Expand health education programs in multiple languages via Volunteer Health Advisors from the CHA and JCCHCE. Identify and address risk factors such as the correlation between asthma and age of housing stock related to lead-based paint, home accidents/injuries per the national Healthy Homes initiative that Boston’s Public Health Commission has implemented. (http://www.bphc.org/bphc/healthyhomes_ main.asp) the well being of Everett 2008 35 Cancer Why is this important? Cancer is the second leading cause of death in America after cardiovascular disease (heart attack and stroke). Approximately 1.5 million new cases of cancer occur annually in the United States causing 550,000 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, better treatments, and significantly more cures. Many tumors are now completely curable. Many forms of childhood leukemia, testicular cancer, cancer of the cervix, breast and colon cancer can be completely cured by early detection and state of the art treatment.We can have an important impact on the well being of our communities and Everett, specifically, by providing public education about risk factors, insuring the availability of screening for early cancer detection, and providing state of the art treatment in our excellent local facilities. 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 the key. There is work to do to reduce smoking rates which remain high in Everett. A community wide effort involving all the political, community, business and church leaders in Everett would be most effective. Prostate, Breast and Lung cancer are the leading types of new cancer diagnoses in Everett. Data Source: Massachusetts Cancer Registry, MDPH 2005 36 the well being of Everett 2008 In the past six years, lung cancer mortality rates among Everett residents have consistently been higher than statewide rates. Note: Data reflects 181 deaths due to Lung cancer among Everett residents between 2000 and 2005. Data Source: Registry of Vital Records, MDPH 2005 An average of 25 women a year in Everett are diagnosed with breast cancer (2000-2004 data). Breast Cancer incidence rates in Everett have been lower than statewide rates beginning in 2001. Note: Data reflects 127 newly diagnosed cases of breast cancer among women in Everett from 2000-2004. Data Source: Massachusetts Cancer Registry, MDPH 2005 the well being of Everett 2008 37 Community Strengths and Assets Recommendations G G G Access for uninsured and language services for those with limited English proficiency. Cambridge Health Alliance Cancer Services - Cambridge Breast Center - open access for mammography, diagnosis and treatment including the Whidden Hospital location in Everett G G - Coordinated cancer care for all common cancers, e.g., breast, colon, skin, cervix, testicular, prostate G Unity of purpose and commitment to cancer death rate reduction by all community agencies, political leaders, churches and business leaders G Collect, analyze and present current cancer data, including cancer incidence, cancer screening and mortality data, led by the Institute for Community Health. Organize public forum to present health data and priorities for action, including cancer. Organize community wide effort to educate every resident of Everett about cancer risk and encourage residents to take advantage of screening and early detection and potential curative treatment for these common cancers. Begin screening according to established national guidelines (e.g., U.S. Public Health Task Force and American Cancer Society). 38 the well being of Everett 2008 Access to Health Care Why is this important? “Access to health care” refers to the presence or absence of various barriers to seeking or receiving health care, including oral and mental health care. Access to health care is essential for increasing quality of life and length of life and eliminating disparities in health status. Everett broadly defines access to include financial, physical and cultural/linguistic accessibility. Health care must be affordable to be financially accessible. Financial accessibility is enhanced when a health care 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 price care. Physical accessibility includes such factors as location, hours of operation and physical barriers 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. Measuring access to health care has been hampered by insufficient data on certain populations and an inability to access data sources. This has been partially addressed by the computerized school health record system which now makes it possible to efficiently monitor health problems and immunization status of public school students. With the assistance of the Institute for Community Health, a collaboration of Cambridge Health Alliance, Mount Auburn hospital and Massachusetts General Hospital, there will be additional data available in 2008 with the implementation of a behavioral risk factor survey of adults to gather information about health status and risk behaviors. This is the same survey that has been in use in Cambridge and Somerville since 2001. The number of first grade children in Everett receiving dental screening increased 19% from 273 children in 2002 to 326 children in 2005. Note: Data reflects 1,164 first graders in Everett school system who have received dental screening from 2002-2005. Data Source: Cambridge Health Alliance Dental services, 2005 the well being of Everett 2008 39 The mean number of decayed teeth per child in 2006 was higher for nonEnglish speaking children. Note: Data reflects 1,164 first graders in Everett school system who have received dental screening from 2002-2005. Data Source: Cambridge Health Alliance Dental services, 2005 Community Strengths and Assets G Outreach and Education: G G G 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 been performing this function since 1994, with a multicultural team of outreach workers to assist Everett residents apply for Mass Health and other state funded health insurance programs. Cambridge Health Alliance provides enrollment services on site at the Whidden Hospital. The Tri-City Community Action Program’s Head Start Program in collaboration with CHA’s Dental Program is implementing a federal grant to provide screening and service referral, the development of culturally appropriate curriculum materials and oral health education for parents and staff. G G 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. Parent Forum, a support group, started in 2008 to offer on-going assistance and guidance. Everett Public Library maintains a collection of resources and information on disease prevention and management Health Care Services (including oral health and mental health): Cambridge Health Alliance: 1. Anna May Powers Health Center (at Keverian School): Mental health services 2.Teen Health Center (at Everett High School): Primary care, confidential reproductive health care, and mental health care. the well being of Everett 2008 40 3.Everett City Hall Dental Clinic: Dental care including cleanings, preventive treatments, filings, sealants, oral surgery, dentures and dental restorations. 4.Home mental health care for elders: COPE program (Consumer Outreach Program for Elders) provides services of psychiatrist, social workers, nurse practitioner and case manager. 5.Malden Health Center: Primary care for all ages, women’s health, sports medicine, x-ray, ultrasound, lab testing, special programs for diabetes and asthma. 6.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. 7.Whidden Memorial Hospital’s new and expanded services: G Emergency Department G Diagnostic Radiology G Department of Surgery & Orthopedics Specialty Suites G Medicine Specialty & Hospitalist Programs G Breast Center G Medical/Surgical beds Eliot Community Human Services: Mental health services for children, youth and adults including outreach, emergency services and out-patient medication programs. MGH Everett Family Care: Primary care (adult, adolescent, pediatrics, Ob/Gyn). Recommendations G G G G G G G G G Enrich and enhance citywide campaign to inform residents of available insurance and help residents access health care services with particular emphasis on newcomers to Everett including immigrants. Expand primary care services in Everett. Expand dental screenings in Everett schools to additional grades. Increase coordination between JCCHCE, Whidden Hospital and CHA Outreach. Increase collaboration on outreach with Literacy Program and Multicultural Affairs Commission. Outreach directly with all faith based sites and communities. Continuation of JCCHCE and the Everett Public Schools school-based outreach. Expand access to the definition of services and the renewal process. Increase support for training and professional development for outreach workers and coordinators. the well being of Everett 2008 41 Environment, Recreation and Open Spaces Why is this important? A Healthy Community means clean air, pure water, open space and residents committed to recycling. An unpolluted environment supports human development and fosters good health. It also means safe public parks, open spaces, playgrounds and a range of recreational opportunities that meet the needs of diverse persons of all ages. Recreation provides children, youth, adults and seniors with constructive and enriching alternatives for leisure-time activity. Air Quality: G Because of the massive number of Mystic Station Power Plant air quality violations (6,000 violations from June 1998 to November 2003) the owner of the plant was required to pay a $1,000,000 civil penalty and $5 million to environmental projects including, making the Bike Path between Somerville and Everett, funding an environmental assessment of the Malden River, restoring the salt-marsh in Chelsea and making Boston-area school buses and commuter trains more environmentally friendly. Water Quality: G G Mystic River was given a "D" in water quality by US Environmental Protection Agency in April 2007 because of high levels of Escherichia coli and Enterococcus (found in fecal material) bacteria. Mystic River in 2006 met water quality standards for swimming 52% of the time and met standards for boating 67% of the time; Malden River: 42% for swimming and 67% for boating. Recreation and Open Spaces The City of Everett strives to offer multiple recreational opportunities to its residents. There are approximately 58 acres of parkland in the City, with at least one park in each ward. The compactness of the city makes is very livable and the scarcity of open land causes citizens and community officials to value and protect available open lands. The commitment to protect our natural environment is further documented by the City of Everett’s dedication 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. The Bike to the Sea Path is a planned multi-use trail from Everett to Lynn. Planning work is ongoing but construction has not been programmed or funded. The only indoor recreation opportunity accessible to the general community is the relatively small Everett Recreation Center. Recommendations G G Increase community awareness and support for the Bike to the Sea Path. Increase community use of community school recreational facilities. the well being of Everett 2008 42 Social Capital Why is this important? Social capital can be described as “the connections between people.” It refers to the skills, relationships, social cohesion, and trust among community members. Community members engaged in social capital often exhibit common values, shared traditions, norms, informal networks and the attitude, spirit and willingness to engage in collective, civic activities. Additionally, “those communities with high levels of social capital are likely to have higher educational attainment, more effective government, faster economic growth and less crime and violence. Residents are likely to be happier, healthier and live longer.” The benefits of social capital flow from the trust, reciprocity, information, and cooperation associated with social networks. Community Strengths and Assets G G G G G G G G G G G The Kiwanis’s Key and Builders Clubs – youth community service and leadership development programs at all Everett schools. Youth-organized substance abuse prevention and educational events. Community advocacy surrounding emergency relief. Martin Luther King Day Celebration organized by Zion Baptist Church. Spring and Fall Festivals in Everett Square organized by the City and Chamber of Commerce. Everett Walks and Talks – Opportunity for intergenerational walks. JCCHCE’s Annual “7 mile” “Walk It Out For Kids”. G G G G July 4th Citywide Event organized by Everett City Council and Aldermen. Annual Everett Public Schools Homecoming Parade. Friends of the Everett Libraries’ Annual Book Sale and Speaking Program. Holiday programs of Office of Human Services: include Thanksgiving Baskets and Christmas Toys and Meals. Annual Tree Lighting at 3 locations. Recommendations G G Annual May Day Immigrant Rally and Walk. Memorial Day Celebration at Everett Public Schools. National “Take Back the Night” organized by the Everett Police Department. G G Increase the number of intergenerational, interethnic and interracial community building projects. 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. the well being of Everett 2008 43 Housing Why is this important? 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 health care.They may not be able to pay for transportation and child care, making it harder to go to work and school each day. The median price of a single family home in 2006 in Everett is $350,000.This is more than $130,000 dollars over what is affordable to the median income resident. Data Source:The Greater Boston Housing Report Card 2007, Citizen’s Planning and Housing Association Seventeen percent of housing units in Everett are occupied by residents paying more than half of their household income for rent or mortgage. Note: Data reflects 10,312 occupied housing units in Everett. Data Source: United States Census Bureau, 2000 the well being of Everett 2008 44 Median rent for a twobedroom apartment in Everett is lower than comparable rental units in surrounding communities. * Winthrop data is for 2006 Data Source:The Greater Boston Housing Report Card 2007, Citizen’s Planning and Housing Association Community Strengths and Assets Recommendations G G G G G G Everett’s Fair Housing Board meets to help ensure compliance with the Fair Housing Act that prohibits discrimination in housing and helps advocate for quality affordable housing. Continuum of Care that addresses issues of homelessness in the Tri-Cities. Tri-City Community Action Program, Inc.’s housing search assistance, Kaszanek Transitional House, services for homeless adults, and legal services. Tri-City Workforce Development Task Force 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. Tri-CAP’s Housing Opportunities for People with AIDS (HOPWA) program provides housing search assistance and other support services. G Advocate that new housing development projects include affordability below 60% of the Area Median Income so that lowto moderate-income Everett residents will be able to access the new housing. Advocate that new community/economic development projects include provisions of jobs for local residents, training to help increase likelihood that they can get the jobs, and that the jobs are living-wage ones. the well being of Everett 2008 45 Arts and Culture Why is this important? Visual and performing arts foster creative problem-solving, discipline, tolerance, compassion, intuition and intelligence. Art and cultural events provide unique opportunities to come together as a community and demonstrate the energy, diversity and economic potential of our city. Arts promote healthy civic engagement. Arts and culture should be accessible to all. Everett has a number of well known and distinguished residents who have made a national name for themselves in the fields of literature, science, entertainment and music. By continuing to support programs that inspire and promote originality, Everett will continue to develop thoughtful and energetic minds capable of inspiring others, as well as the next generation. Community Strengths and Assets G G G G G G New state of the art theater and performance center at the high school opened in the fall 2007. There are a variety of art classes, dance, music,poetry club, other creative outlets for children, youth and adults available throughout the city. Everett’s city public access cable television station provides regular programming, show casing performances and cultural events taking place in the city. The Everett Arts’ Association has a long history of making art accessible to community residents through classes, speakers and art displays throughout the city. International Day at the high school celebrated food delicacies from many countries. G The Parlin and Shute Libraries offer a variety of art and cultural activities, including talks by authors, plays, passes to Boston area museums and more. Everett’s Historical Commission maintains a rich archive of documents capturing the history of the city through written papers, photographs and memorabilia. Recommendations G G Develop cultural programs for children and families promoting the diversity of the community through dances, food tasting and other activities. Ensure children of all ages are exposed to arts in the school and extracurricular activities. 46 the well being of Everett 2008 Acknowledgements and Authors We thank the City of Everett and Cambridge Health Alliance for their ongoing and crucial support of health improvement initiatives in Everett. This report and the work of the Everett Community Health Partnership would not thrive without their generous support. We thank the Institute for Community Health for providing regular health information to our community health programs and coalitions that strengthen our strategic planning and evaluation skills. We thank the Everett Public Schools for their commitment to ensuring the Youth Health Survey is a biannual assessment. Authors Philip Bronder-Giroux Tri-City Community Action Program, Inc. (Tri-CAP) Emily Chiasson Institute for Community Health Linda Cundiff Community Affairs, Cambridge Health Alliance Carolyn Lightburn Everett Human Services Loretta Kemp Tri-City Community Action Program, Inc. (Tri-CAP) Bob Marra Everett Community Health Partnership, Cambridge Health Alliance Jackie Coogan Joint Committee for Children’s Health Care in Everett Steven Mazzie Everett Police Department Meg English Everett Literacy Program Patrice Melvin Institute for Community Health Marzie Galazka Community Development, City of Everett Lindsay Mendenhall Institute for Community Health Jean Granick Everett Community Health Partnership Substance Abuse Coalition, Cambridge Health Alliance Deb O’Neill Health Department, City of Everett Karen Hacker Institute for Community Health Julie Whitson Everett Public School the well being of Everett 2008 47 Partners providing support for community health activities Cambridge Health Alliance Eliot Community Human Services Everett Board of Health Everett Chamber of Commerce Everett Office of Human Services Everett Literacy Program Everett Public Library Everett Public Schools Everett Substance Abuse Coalition First United Parish Immaculate Conception Church Joint Committee for Children’s Health Care in Everett Malden Everett Family Network Mystic Valley Elder Services Our Lady of Grace Church Portal To Hope Tri-City Community Action Program, Inc. Whidden Memorial Hospital Zion Baptist Church Disclaimer This report is an ongoing effort to reflect some community-defined indicators that relate to health broadly defined. This report also highlights the most current Youth Risk Behavior Survey data collected from Middle and High School students. For online access to this document please visit our website at http://www.challiance.org/COMMCONN/everettcommunitypartnership.htm Date: November 2008 the well being of Everett 2008 48 Appendix 1: A Demographic Description of Everett 1990 2000 % Change 18,119 9.2 TOTAL POPULATION 35,701 38,037 Female 19,112 19,918 White 33,381 30,321 -9.2 Asian 633 1,236 95.3 Male RACE Black Other Two or more races Hispanic/Latino (any race) Foreign Born 16,589 1,131 457 N/A 1,371 4,039 2,386 1,898 2,050 6.5 4.2 111.0 315.3 –– 3,617 163.8 8,323 106.1 LANGUAGES SPOKEN AT HOME Speak a language other than English at home 5,269 10,917 107.2 Under 5 years old 2,298 2,244 -2.3 15-24 5,070 4,705 -7.2 Speak English less than “very well” AGES 5-15 25-34 35-44 45-64 65 and older Median age Households with children under 18 POVERTY STATUS Persons below poverty Poverty rate for all persons Poverty rate for families % of families with related children under 18 living below poverty line 2,304 3,564 7,438 4,783 6,677 6,347 4,675 7,005 6,238 7,568 175.5 31.2 -5.8 30.4 13.3 5,871 5,602 4,056 4,658 14.8 4,456 31.1 –– 9.2% –– –– 14.3% 34.1 yrs 3,399 9.6% 35.6 yrs 11.8% -4.6 –– 22.9 –– the well being of Everett 2008 49 1990 2000 % Change Median household income $30,786 $40,661 32.1 Per capita income $14,220 $19,845 39.6 INCOME Median family income HOUSEHOLDS $37,397 $49,876 33.4 Total # households 14,528 15,435 6.2 Married-couple family 6,675 6,459 -3.2 Family households HOUSING UNITS 9,421 9,551 1.4 Renter-occupied units 8,522 9,044 6.1 Gross rent 35% or more of head of household income 33.8% 31.0% -8.3 21.8% 16.1% -26.1 Less than 9th grade 9.4% 8.8% -6.4 High school graduate 42.2% 40.3% -4.5 Median monthly rent Median value Owner-occupied units Selected monthly Owner costs 35%+ or more of household income EDUCATIONAL ATTAINMENT FOR PERSONS 25 AND OVER 9th-12th, no diploma Some college, no degree Associates degree Bachelor’s degree Graduate or professional degree $611 $156,500 17.7% 13.5% 5.9% 7.9% 3.4% $729 $164,500 15.0% 15.4% 5.8% 10.1% 4.6% 19.3 5.1 -15.3 14.1 -1.7 27.8 35.3 50 the well being of Everett 2008 Sources Introduction 1. Everett Health Data Report, 2007 A Demographic Description of Everett 1. United States Census Bureau, 2000 Violence 1. Massachusetts State Police, Crime Reporting Unit, 1996-2005 2. COMPSTAT, Massachusetts State Police, 2007 3. Everett School Health Survey, 2005 and 2007 2. Massachusetts Department of Education, 1999-2007, 2008 4. Surgeon General’s Report of Youth Violence, 2001 4. Tri-CAP 2006-2008 Community Action Plan Chronic Disease 1. Registry of Vital Records, MDPH 2005 3. CHAPA 2004 Report Card 5. Bureau of Justice Statistics Physical Activity and Nutrition 1. Everett School Health Survey, 2005 and 2007 2. National Dietary Guidelines, 2005 Tobacco 1. Everett School Health Survey, 2007 Substance Abuse 1. Bureau of Substance Abuse Services, MDPH 2005, 2006 2. Drug Awareness Warning Network, 2007 2. Uniform Hospital Discharge Database, MDPH 2005 3. Emergency Department Database, MDPH 2005 Cancer 1. Registry of Vital Records, MDPH 2005 2. Massachusetts Cancer Registry, MDPH 2005 Access to Health Care 1. Cambridge Health Alliance Dental Services, 2005 Environment, Recreation and Open Spaces 1. United States Environmental Protection Agency, April 2007 3. Everett School Health Survey, 2003, 2005, 2007 2. The National Arbor Day Foundation, 1996-2008 Mental Health 1. Everett School Health Survey, 2003, 2005, 2007 Housing 1. The Greater Boston Housing Report Card 2007, Citizen’s Planning and Housing Association 2. Hospital Discharge Database, MDPH 2005 Responsible Sexual Behavior 1. Everett School Health Survey, 2005 and 2007 2. Sexually Transmitted Disease Program, MDPH 2005 3. Registry of Vital Records, MDPH 2005 4. HIV/AIDS Surveillance Program, MDPH 2005 5. The Surgeon General’s Call to Action to Promote Sexual Health and Responsible Sexual Behavior, 2000 2. United States Census Bureau, 2000 The Well Being of Everett, 2008 Bob Marra Director, Everett Community Health Partnership (ECHP) Phone: 617-591-6947 l rmarra@challiance.org Jean Granick Director, ECHP – Substance Abuse Coalition Phone: 617-591-6927 l jgranick@challiance.org