Council hearing zeros in on racial health disparities

Boston City Councillors Kim Janey and Ed hosted a hearing last Friday that took up the issue of public health disparities in Boston’s communities of color and also looked into how certain resources and measures could improve health outcomes across the city.

Councillor Matt O’Malley, who is also chair of the Committee on Healthy Women, Families and Communities, facilitated the discussion while council President Andrea Campbell and Councillor Lydia Edwards sat in on the session.

“Through the Boston Public Health Commission’s most recent report, ‘Health of Boston,’ we know that black and Latino residents, Asian residents, and other racial groups in our city are significantly more likely than their white counterparts to suffer from poor health outcomes,” said Janey, who represents Roxbury and parts of Dorchester in District 7.

The Health of Boston report found that compared with white residents, people in communities of color experience higher rates of pre-term births, low birth weights, obesity, and hypertension. They are also less likely to complete medical tests within the recommended time frames; experience higher exposure to vehicle pollution and language barriers; and are particularly impacted by Boston’s housing crisis, which can add tremendous stress and affect overall health.

“Whether we’re looking at asthma, diabetes, heart disease or cancers,” added Janey, “these illnesses impact communities of color disproportionately. We see this across the commonwealth, but here in Boston, where we have the best hospitals, it’s important that we close these gaps.”

Said Flynn, who represents South Boston and Chinatown, “I know that there are innate challenges for the residents in my district in terms of public health. I’ve noticed in Chinatown that there are many residents, including children and seniors, dealing with asthma. Chinatown is surrounded by I-93, the Mass Pike, South Station and it’s along a major truck route. The residents of Chinatown are inhaling toxins every day.”

Three panelists – Monica Valdes Lupi, the executive director of the city’s Public Health Commission; Dr. Carolyn Rubin, assistant professor of Public Health and Community Medicine at Tufts University; and Dr. Joseph Betancourt, founder, senior advisor and faculty member of the Disparities Solutions Center (DSC) at Massachusetts General Hospital – shared their expertise in answering questions posed by councillors.

Lupi said that although Boston’s Public Health Commission has made progress in studying and finding ways to address disparities, there’s still much more work to do. “Racial and ethnic health disparities continue to persist,” she said, “despite being in a city like Boston that’s in the shadows of outstanding, globally recognized hospitals and community health centers. As a Commission, we understand that the influence of racism and other exclusionary practices contribute to an unequal distribution of critical health promoting resources among racial and ethnic groups.”

She later noted that “health equity is not possible without addressing the issues involved with racial justice.”

Rubin, who directs an academic community research partnership called Adapt, said that the city needs to organize to effectively commission local studies that engage communities of color. Through Adapt, a partnership between Tufts and six Chinatown agencies, Rubin says, he works on creating a collaborative research environment that incorporates community feedback.

She added: “The way that I know about public health in Chinatown is through a series of smaller, discrete studies that Adapt has been able to support, and spending time listening to residents in the community.”

Rubin said that air quality, lack of open space, displacement as a public health issue, and longstanding concerns over problem gambling are some of the most commonly cited issues that community members in Chinatown struggle with.

Overall, Rubin said, the city should financially support local studies that engage communities, invest in the talent of kids who grow up in Boston, and move toward understanding the city’s population makeup to avoid thinking about people of color in monolithic groupings.

Betancourt said that addressing social determinants, improving access, and improving health care are the three “vehicles” that will move Boston towards addressing public health disparities.

“What we need,” he added, “is a rejuvenated major campaign, with legitimate targets and accountability around health disparities. As we think about new partnerships, I believe that our city can serve as convener and use its leverage to bring together not just the health care systems and community-based organizations, but private industry. With the absence of a concerted effort and some real targets, we’ll be back here in ten years talking about the same thing.”