Fewer Residents Smoke, Mortality Rates Continue to Decline
BOSTON - Fewer Boston residents are smoking tobacco and fewer are dying of cancer, heart disease, injuries, stroke, and substance abuse - the five leading causes of death - as the city continues to make progress in improving the health of residents, according to the new Health of Boston report released today.
But there are health challenges that remain: Boston’s black and Latino residents continue to experience higher levels of chronic disease, mortality, and poorer health than white residents. For black residents, these inequities in health begin early in life and persist throughout their lifetime. For Latinos, they manifest in certain diseases such as in high hospitalization rates for diabetes.
These are some of the findings of the annual Health of Boston report, which this year is the largest, most comprehensive review of data ever done by the Public Health Commission. For the first time, the 311-page report examines not only health conditions affecting Boston residents but also quality of life issues, such as the availability of fresh fruits and vegetables, that can have an impact on a neighborhood’s health.
"The Health of Boston is our annual blueprint for assessing the condition of Boston’s public health and informing the work that we do," said Mayor Thomas M. Menino. "It is not a document to be placed on a shelf to collect dust, but one to be shared with residents, policymakers, and community partners so that we all know what the challenges are and what we need to do to address them."
Among the highlights:
- In 2007, cancer remained the leading cause of death in Boston, followed by heart disease, injuries, stroke, and substance abuse. However, mortality rates continued to fall, with 3,812 deaths in 2007, compared to 4,412 deaths in 2002.
Estimated life expectancy in Boston was 78.5 years for those born between 2005 and 2007. Latino residents and women had the highest life expectancy, 80.3 years and 81.4 years, respectively. Blacks had the lowest life expectancy - 73.8 years - compared to 79.1 years for whites.
- The percentage of screened children with elevated blood lead levels continued to decline - by a whopping 91 percent - between 1995 and 2008. In 1995, 13.5 percent of children screened for lead in the blood had elevated lead levels while in 2008 the figure was 1.2 percent, coinciding with Boston’s emergence as a national leader in lead prevention programs.
- Similarly, Boston’s tough anti-smoking efforts also seem to have paid dividends. The report found a decrease in the percentage of high school students who smoke, falling to 7 percent in 2007 from 15 percent in 2001. There also was a decline in the percentage of adults who smoke, 16 percent in 2006 compared to 24 percent in 2001. Boston’s workplace smoking ban was approved in 2002.
- Although substance abuse deaths declined by nearly 7 percent between 2006 and 2007, Latinos had the highest mortality rate. Between 1999 and 2007 the Latino substance abuse death rate increased more than 500 percent, signaling the need for the type of intensive treatment programs and grassroots efforts undertaken by the Commission’s Substance Abuse Bureau. Last year, for example, the Commission opened the first new city-operated substance abuse treatment program for women in Boston in a decade, serving primarily Latino and black women. It also provided millions of dollars in funding to neighborhood No-Drug Coalitions, particularly in areas with large Latino populations, such as Jamaica Plain/Roxbury.
- On the subject of sexual health, the report showed a 66 percent jump in Chlamydia infections among Boston residents in 2007, when compared to 1999. For every year between 1999 and 2007, black Boston residents had a far higher rate of new cases of Chlamydia, gonorrhea, and HIV, compared to white and Latino residents. The Public Health Commission plans to launch an awareness campaign later this year to provide information about sexually transmitted infections and promote safe sex practices among sexually active residents.
For the first time, the Health of Boston took inventory of available resources in Boston neighborhoods, understanding that while individual characteristics may influence health status - socioeconomic status, race and ethnicity, and environment also are important determinants of health.
The report found that residents in Boston have excellent access to many services and supports that promote good health. Every Boston neighborhood has numerous places of worship, a public library, a community center, and a large supermarket. Most neighborhoods also have a health center and a YMCA or Boys and Girls Club. But Farmer’s markets, community gardens, and food pantries were less evenly distributed.
While about 70 percent of residents in the Back Bay and West Roxbury felt their neighborhoods were very safe, 25 percent or less of residents in Mattapan, North Dorchester, and Roxbury felt that way. However, 60 percent of Boston residents agreed or strongly agreed that there are adults in their neighborhood who can be counted on to look out for children and teens. And 70 percent or more of residents in each Boston neighborhood agreed or strongly agreed that people in their neighborhood are willing to help each other.
But by far the biggest challenges identified in the report are the racial and ethnic health inequities. Black and Latino residents of Boston continue to be in poorer health than white residents, a fact that led Mayor Thomas M. Menino to make tackling health disparities a priority of his administration. The city has since established a Center for Health Equity and Social Justice at the Public Health Commission.
Those health disparities are most glaring in data on infant mortality and chronic diseases.
Infant mortality: For the last 15 years, the percentage of low birthweight babies and preterm births has remained highest among black infants compared to other racial and ethnic groups. Infant mortality rates have consistently been highest for black infants since such data have been collected by race, and 2007 was no exception. Although black infants accounted for 27 percent of all Boston births in 2007, they were 48 percent of all infant deaths. Also troubling was a 12.2 percent increase in Boston’s adolescent birth rate between 2005 and 2007; the rise followed a nearly 54 percent drop in the adolescent birth rate between 1995 and 2005.
To address these problems, the Public Health Commission has strengthened its programs designed to decrease teen pregnancy and those aimed at supporting pregnant women of color who are at greatest risk of having preterm or low birthweight infants, the two major predictors of infant mortality. In addition, the Commission’s Healthy Start Initiative and Healthy Baby/Healthy Child programs have implemented new strategies to help women address health and social needs throughout their pregnancy and in the early years of childrearing.
Chronic diseases: Diabetes, heart disease, obesity, asthma, and high blood pressure continue to disproportionately affect black and Latino residents. The report found that for Latinos the hospitalization rate for diabetes increased 200 percent between1998 and 2006. Black residents consistently had the highest heart disease hospitalization rate from 1998 to 2007. Additionally, more black and Latino students are overweight compared to Asian and white students, and black and Latino women are more likely to be obese than their white counterparts. In recent years, the Commission has redoubled its efforts to address unhealthy eating as a major risk factor through banning trans fats in restaurant food, improving the nutritional content of school lunches, offering community nutrition workshops, supporting additional Farmers’ markets in neighborhoods of color, and working with childcare programs to promote healthy eating.
Dr. Barbara Ferrer, executive director of the Public Health Commission, said the Health of Boston report will be rolled out to residents in a series of community forums, beginning in May. She also said the Commission would use the data to help align resources where they are most needed.
The full report and a video can be found at www.bphc.org/hob.