2019 ANNUAL REPORT

Table of Contents

Chief Public Health Officer Message ...... 2

Who We Are ...... 3

Building a 21st Century Health Department...... 4

Community Health Improvement Plan (CHIP) Update—Year 4. . . . . 6

Healthy Eating and Active Living...... 7

Mental Health and Substance Use...... 11

Violence...... 14

Healthy, Safe, and Affordable Housing...... 16

Our Work...... 20

Collaborations and Leadership...... 30

Financial Overview...... 31

CHIP Partners...... 32

Acknowledgments...... 33 MESSAGE Chief Public Health Officer

DEAR FRIENDS, Until government at all levels puts health The Cambridge Public Health Department equity and racial justice on the agenda, embarked on its second comprehensive health disparities will persist. Starting in community health assessment in 2019 to 2020, our department will be using a health identify the city’s most pressing social and equity and racial justice lens to better health concerns. understand and address the city’s new health priority areas, which will be the focus of the Residents’ stories and data collected Cambridge Community Health Improvement from a variety of sources revealed that Plan (2020–2025) . even in Cambridge—a city that has made substantial investments in education, social I am proud of the health department’s services, housing, and health care—some accomplishments in 2019. In addition to residents face greater barriers to achieving spearheading the forthcoming community good health than others. For instance, health assessment and community non-white residents who participated in health improvement plan, we successfully the department’s 2019 community health completed our first year as a nationally survey were twice as likely to rate their accredited health department, produced health as “fair” or “poor” than their white the final report of the City Manager’s Opioid neighbors (23% to 10%). Working Group, and were one of six local health departments across the country The drivers of health inequities in the selected to pilot a process for building and U.S. are well documented and include measuring community resilience. lack of access to quality education, jobs, housing, and health care. For people of Read on for more stories about Cambridge color, immigrants, people with disabilities, and its journey to better health. and the LGBTQ+ community, these issues are often compounded by racism and Claude A . Jacob discriminatory practices and policies. Chief Public Health Officer Cambridge Health Alliance City of Cambridge

2 Who We Are

PUBLIC HEALTH IS ABOUT VISION PROTECTING THE HEALTH OF AN The Cambridge Public Health Department is a leading, innovative, and model agency ENTIRE POPULATION. For us, that that facilitates optimal health and well-being for all who live, learn, work, and play in means all people who live, learn, work, or Cambridge. spend time in Cambridge. Cambridge is a MISSION close-knit community of people of different The Cambridge Public Health Department improves the quality of life for all who live, races, ethnicities, cultures, languages, learn, work, and play in the city by preventing illness and injury; encouraging healthy faiths, incomes, and lifestyles. To increase behaviors; and ensuring safe and healthy environments. opportunities for all people to live healthier lives, the Cambridge Public Health VALUES Department provides services, analyzes and Collaboration shares information, implements policies, Innovation and enforces regulations in ways that benefit Professionalism and Excellence everyone. After all, improving quality of life Social Justice and Equity is what public health and Cambridge are all about .

3 Building a 21st Century Health Department

As Cambridge changes and grows over time, ACCREDITATION AND THE health department and its partners have the Cambridge Public Health Department REACCREDITATION PROCESS already begun establishing a new five-year (CPHD) is building a 21st century health health plan for the city. department to better meet the growing In 2018, CPHD achieved national public health needs of the community. In accreditation through the Public Health To create a second CHIP, the department the past, a public health department’s role Accreditation Board (PHAB). CPHD undertook launched its second CHA, gathering was more narrow, focusing on prevention of this voluntary and rigorous process to information from the Cambridge community to disease in limited areas. Today, public health update, improve, and systematize the health identify what impacts the health of residents. is defined by more than just an absence of department’s standards and performance in The second community health assessment disease and includes a more expansive look fostering healthy communities in Cambridge. officially launched in April 2019 with a at the conditions that impact well-being and Every five years, CPHD will embark on survey; series of focus groups; community healthy living. The department must also reaccreditation, a process already launched, engagement activities; and a review of existing be ready for new and emerging diseases, to ensure that the health department social, economic, and health data collected conditions, or emergencies that may arise. continually monitors its performance and by local and state agencies, including Through the process of reaccreditation and ability to protect and promote the health of all Massachusetts Department of Public Health, building an academic health department, in Cambridge. US Census Bureau, and the Centers for Disease Control and Prevention. CPHD is transforming itself into a department An integral part of the accreditation process is equipped for the 21st century. developing a community health assessment The survey was both printed and accessible (CHA), which collects information about the online, and translated into a range of health of the population and the factors that languages reflecting the rich diversity of impact health, and identifies both assets Cambridge’s residents. Nearly 1,400 people WE WOULD LIKE TO and areas for improvement. In addition, this completed the survey. In collaboration with HEAR FROM YOU! process serves to engage the Cambridge city partners, the health department also ከእርስዎ መስማት እንፈልጋለን! community, partners, and organizations in conducted focus groups with a diversity of نود أن نسمع منك! creating a vision for a healthy Cambridge. Cambridge populations, including American- 我们希望收到您的消息！ Nou ta renmen tande w! The results of the CHA inform a community born Black residents, homeless youth, Nós gostaríamos de ouvir você! health improvement plan (CHIP), a five-year immigrants, the LGBTQ+ community, and Esperamos contar con su presencia! roadmap that lays out goals, objectives, and people with disabilities. Interns from the bit.ly/2019-Cambridge-Health-Survey strategies for advancing health priorities. As City of Cambridge Mayor’s Youth Summer A Healthy City for All CAMBRIDGE COMMUNITY HEALTH ASSESSMENT Cambridge’s first-ever CHIP wraps up, the Employment Program (MYSEP) also reached

The 2019 Cambridge Health Survey was promoted in 4 multiple languages. Building a 21st Century Health Department out to residents in public spaces—such as health department is working with other city and comprehensive services. The department parks and the Cambridge Public Library— departments and organizations to create also sees this as an opportunity to become and asked residents for their feedback on topic-specific workgroups, recommend more involved in the community by building health issues such as access to healthy and members for these workgroups, and write partnerships and sharing information with affordable food. objectives, strategies, and metrics for the local institutions as well as teaching students upcoming CHIP. Meanwhile, the new second and community members about the role of the At a citywide summit in November 2019, the CHA is slated to be finalized and published in public health department and public health in department convened more than two dozen winter 2020. As for the second CHIP, the new general. representatives from the Cambridge Police plan will go live in July 2020. Department, Cambridge Fire Department, the In summer 2019, CPHD hosted seven interns, Department of Human Service Programs, and from organizations and institutions such ACADEMIC PARTNERSHIPS other city and community partners to learn as the City of Cambridge’s MYSEP, Tufts the results of the second CHA and help select CPHD also has a robust plan for developing University, and the Harvard T.H. Chan School the priority areas for the city’s second CHIP. into an academic health department. of Public Health. The interns worked on an Based on the data and input from subject Akin to a teaching hospital, an academic array of projects including creating substance matter experts, the three priority areas were health department allows for collaborative use prevention materials, constructing a selected: mental health, healthy eating and partnerships with academic institutions to framework to understand factors that promote active living, and community and social better train future public health professionals, mental well-being in early childhood, and resilience with cross-cutting themes of health and to work together to advance research reaching out to the Cambridge community equity and eliminating racism. Currently, the to gain resident’s feedback on prominent health issues for the CHA. In fall 2019, The department’s 2019 summer interns: Krishan Dhanda, Nicole Sabatino, Jayne Lindamood, Sitara Mahtani, CPHD embarked on its second Real World Jane Carpenter, Maya Clemente, and Rebecca Baron. Public Health field course, a joint venture with Tufts University. During the course, five public health graduate students participated in hands-on activities with CPHD staff to learn about their work as part of a local public health department. Students also completed literature reviews on select public health topics identified by CPHD staff such as examining local risk of deer ticks and Lyme disease and providing healthier food at meetings. 5 YEAR 4 UPDATE Community Health Improvement Plan (CHIP)

The community health improvement plan (CHIP) sets the city’s health agenda.

In 2015, governmental and community partners began implementing the city’s first five-year CHIP.

The 2015–2020 plan lays out goals, objectives, and strategies for making tangible progress in four health priority areas: healthy eating and active living; mental/behavioral health and substance use; violence; and healthy, safe, and affordable housing.

In 2019, the health department and partner organizations worked on CHIP strategies identified for implementation in Year 4 (July 2018–June 2019) and developed a Year 5 action plan. The following pages describe progress in each priority area during Year 4.

6 CHIP HEALTH PRIORITY Healthy Eating and Active Living

GOAL: Make it easy for people to improve health and well-being through healthy eating and active living.

Cambridge is nationally recognized for its YEAR 4 HIGHLIGHTS (July ’18 – June ’19) collaborative and innovative approaches to The Cambridge SNAP Match Coalition, healthy eating and active living. Two decades • led by the Cambridge Public Health ago, a team of public health professionals, Department, gave out over $30,000 in city staff, parents, and the Cambridge Public matching funds in 2019 (a nearly 100% Schools came together to address obesity increase from 2017) to help residents among the city’s school children. This with low income buy fresh, local food collaboration resulted in school cafeterias at Cambridge farmers markets. SNAP serving healthier and locally grown foods, Match funds allow shoppers using federal the establishment of school gardens in all SNAP (Supplemental Nutrition Assistance elementary schools, and the adoption of Program) benefits to double their school nutrition policies. purchasing power up to a $15 value per visit at participating Cambridge farmers The Cambridge SNAP Match Coalition gave out over Since the late 2000s, city and community $30,000 to help residents with low income buy food at local partners have focused on policy and systems markets. farmers markets. change for creating a healthy, sustainable, and equitable food and fitness environment • The Food and Fitness Policy Council began throughout Cambridge. Accomplishments have a multi-year project to develop a citywide included establishing the Cambridge Food and food plan, which will serve as a blueprint Fitness Policy Council; introducing salad bars for creating a more equitable food and international cuisine in school cafeterias; environment in Cambridge. In fall 2018, increasing the purchasing power of residents health department staff inventoried and with low income at farmers markets; launching classified all retail stores in Cambridge a popular bike share program; renovating city that sell food: supermarkets, drugstores, parks and playgrounds; and creating safer neighborhood markets, convenience streets for people who are walking, biking, or stores, and supercenters (Target stores). taking transit. The following spring, staff assessed 30 out of 32 qualifying stores for healthy food availability and affordability.

7 CHIP HEALTH PRIORITY Healthy Eating and Active Living

• As part of the Food and Fitness Policy • City leaders allocated funding in fall 2018 Council’s urban agriculture initiative, that allowed the school district to provide the Metropolitan Area Planning Council free breakfast to all students (K–12) and and health department released the first to expand its free lunch program to include health lens analysis of urban agriculture all students who qualify for reduced-price conducted in Massachusetts. The report meals under federal guidelines. About explores the potential community health 400 children whose families earned too impacts of the city’s existing and proposed much to qualify for free lunch were helped urban agriculture policies. In June 2019, by this program during the 2018–2019 the health department published Urban school year. In addition, the city funded Agriculture in Cambridge, a 22-page guide a free breakfast program for all children to beekeeping and community gardening enrolled in city preschools. Over 400 public school children benefited from the city’s in the city. expansion of the school lunch program to include all students who qualify for reduced-price meals. • The International Flavors Program, a • The Healthy Markets Program works partnership of the Cambridge Public with local convenience stores and Schools’ Food and Nutrition Services trying new foods, and design a nutrition neighborhood markets to promote and the health department, continued education curriculum. The department healthy foods and beverages. In Year 4, to introduce cuisine on school menus continued its partnership with several the program shared grant and business that reflect the district’s diverse student early education child care centers to assistance opportunities with the six body. In Year 4, the program introduced assess and improve their nutrition and participating stores, provided the stores a Puerto Rican stew, fricasé de pollo, on physical activity practices. In June 2019, with reusable shopping bags to give school menus and conducted taste tests the department launched an initiative with to customers who purchased healthy and lunchroom surveys to get children the city’s Birth to 3rd Grade Partnership items, and assisted one store owner in enthusiastic about the new dish. and the Harvard T.H. Chan School of becoming an authorized SNAP retailer. As Public Health to better understand how of June 2019, four participating markets To make healthier food and activity • to motivate early child care providers to accepted SNAP benefits, two of which also choices more available to children in adopt evidenced-based nutrition, physical accepted WIC benefits. Healthy Markets a variety of care settings, the health activity, and screen time guidelines. is an initiative of the health department, department collaborated with two after- This project is supported by a Harvard Community Development Department, school programs to develop healthier Catalyst grant. and Inspectional Services Department. menu offerings, engage children in

8 CHIP HEALTH PRIORITY Healthy Eating and Active Living

• The health department, through its • The Cambridge Tap Water Task Force Cambridge in Motion campaign, awarded a continued to promote tap water as a total of $5,000 in mini-grants to ten local healthy beverage choice and make organizations in spring 2019 to develop drinking water more accessible in public activities that promote healthy eating and places. In fall 2018, the city approved the active living. The mini-grant program, now installation of water bottle fillers in the in its eighth year, is a partnership of the city’s nine remaining parks without water health department, the Healthy Children access. This $90,000 project was funded Task Force, and the Food and Fitness through the city’s Participatory Budgeting Policy Council. Initiative. The task force is a partnership of the health department, Cambridge Public Schools, Department of Public Works, and Water Department. Through the participatory budgeting process, residents The city remains committed to Vision voted to spend $90,000 in city funding to install water A $500 mini-grant awarded to the Cambridge YWCA • bottle fillers in the city’s nine parks without water access. supported free monthly yoga classes in summer 2019. Zero, a multi-departmental initiative to eliminate all traffic-related fatalities and serious injuries in Cambridge. Lowering speed limits is a fundamental Vision Zero completed evaluation of the separated strategy because when vehicles travel at bike lanes on portions of Brattle Street 20 mph or less, the likelihood of a crash and Cambridge Street. Findings indicated causing serious injury or death is greatly that the number of people biking had reduced. In Year 4, the city planned for increased while the number of crashes the expansion of 20 mph “safety zones” involving bicyclists, pedestrians, and on smaller, primarily local access streets. vehicles had decreased. The city also expanded its separated bike network by installing separated bike lanes • The Cambridge City Council adopted the on Massachusetts Avenue from Sidney Cycling Safety Ordinance in April 2019. Street (near Central Square) to the Charles The ordinance ensures that whenever River as well as a bike-bus priority lane on roadway improvements are made sections of Mount Auburn Street. The city under the city’s Five-Year Sidewalk and

9 CHIP HEALTH PRIORITY Healthy Eating and Active Living

Street Reconstruction Plan, designs will 11 Cambridge public elementary and all • The Community Development Department incorporate planned bicycle facilities five upper schools, providing bicycle and (CDD) hosted 35 bicycle education as indicated in the Cambridge Bicycle pedestrian safety training to almost 600 workshops that helped over 600 residents Plan. This ordinance reinforces the city’s students in second grade and an on-bike improve their cycling confidence and commitment to improve infrastructure in training program to almost 500 students skills. The city installed approximately 170 support of Vision Zero goals. in sixth grade. The program also collected bike racks and 15 seasonal bike stalls, information on how Cambridge students which created 536 bike parking spaces in • The Safe Routes to School program, travel to school and disseminated A Guide high-demand locations. In total, the city launched by the Community Development to Walking and Biking to School (in English maintains over 3,000 permanent bike Department in 2015, continued to support and Spanish) for children and parents. racks and 15 seasonal bike stalls, creating and encourage safe walking and biking Through workshops at Cambridge Rindge almost 7,000 bike parking spaces across to school. In Year 4, the program served and Latin School and the Mayor’s Summer Cambridge. Youth Employment Program, over 900 teens learned about bicycle maintenance • To engage the public in sustainable and rules of the road for bicyclists. transportation and traffic safety, CDD Through the Safe Routes to School program, sixth graders at Rindge Avenue Upper School participate in mailed the third annual Getting Around an “on bike” training. • The Bluebikes bike share program is Cambridge magazine to 52,000 publicly-owned by the municipalities of Cambridge households and translated Boston, Brookline, Cambridge, Somerville, its popular Getting Around Cambridge and most recently, Everett. The program map into Amharic, Bangla, French, and expanded in Year 4 to 300 stations Spanish. As part of the Vision Zero system wide, including eight new stations initiative, the health department published in Cambridge, bringing the city’s total A Guide to Cycling in Cambridge for Older to 67 stations. Bluebikes offers several Adults in May 2019. The guide was shared reduced-price membership programs, at community events, posted online, and and introduced a youth discount program distributed at bike shops, senior centers, in Year 4 that offers a $25 annual and other venues. membership to high school students ages 16–19.

10 CHIP HEALTH PRIORITY Mental Health and Substance Use

GOAL: Support and enhance the mental, behavioral, and emotional health of all, and reduce the impact of alcohol, tobacco, and other drugs. The city selected mental health and • The Cambridge Public Schools’ social substance use as a health priority because emotional learning (SEL) initiative has many residents and service providers were established a district-wide framework concerned about the prevalence of untreated for supporting students who have mental disorders and addiction in Cambridge; experienced trauma and toxic stress, the cost and availability of services; and how developing schools’ capacity to build stigma and other underlying issues may keep peaceful and safe learning environments. people from seeking help. In Year 4, school-based teams assessed Elementary school children practice mindfulness as part YEAR 4 HIGHLIGHTS (July ’18 – June ’19) their practices against a common set of SEL competencies, building professional of the school district’s social emotional learning initiative. • Mental Health First Aid is a groundbreaking development plans based on educator public education program offered by the and student needs. A system for reporting • The health department and school Cambridge Public Health Department that on SEL benchmarks by grade level was district presented McLean Hospital’s helps the community identify, understand, developed, and the district launched an Deconstructing Stigma program to all and respond to signs of mental health annual Student School Climate Survey Cambridge Rindge and Latin School issues and substance use disorders. The that focuses on SEL competencies at the (CRLS) students in spring 2019. The department has trained 373 people in upper school level. student sessions focused on challenging adult Mental Health First Aid since 2013 misperceptions about mental illness, and 132 people in Youth Mental Health Within schools, systems for student while similar presentations to parents and First Aid since 2017. A total of 103 people support were strengthened, including staff emphasized how to speak to teens completed the eight-hour course for adults recognizing the impact of stress on adults about depression and anxiety. During or youth in 2019. and supporting adult coping and self-care. winter and spring finals at CRLS, the Teachers and social workers continued to health department and student leaders learn how to apply mindfulness techniques organized “chill zones” where students in elementary and upper school could eat free snacks and participate classrooms and counseling offices across in yoga, meditation, and other stress- the district. relieving activities.

11 CHIP HEALTH PRIORITY Mental Health and Substance Use “People who suffer from the disease of addiction are among • The Cambridge Police Department • The city encouraged residents to safely the most vulnerable members established a Family and Social Justice dispose of unwanted medication by of our community. As a city, we Section in July 2018 that brought together maintaining a 24/7 medication disposal have a responsibility to help these its family justice, social justice, and kiosk at the police department on 125 individuals get the care they need, clinical support units, with the goal of Sixth Street, sponsoring community “take- as well as to enhance coordination better serving and protecting vulnerable back” events at household hazardous among partners to improve the populations. waste collection days and the senior center, and offering prepaid medication city’s response to this crisis. The City Manager’s Opioid Working Group • disposal mailers to the public. The health Claude A. Jacob released a final report in March 2019 with department produced an advertisement Chief Public Health Officer recommendations and an action plan on safe medication storage and disposal and member of the City Manager’s for strengthening Cambridge’s response that was displayed on public transit buses Substance Use Advisory Committee to the opioid crisis. The City Manager in Cambridge and other communities established the Cambridge Substance Use throughout May. In Year 4, the city ” Advisory Committee in June to implement collected over 18,800 units of unwanted the report recommendations. The medication. The health department released the 21-member committee is staffed by the • city’s second comprehensive opioid health department. overdose data report in March 2019. The report analyzes 2017 data from Pro EMS “A lot of people thought, ‘A prescription pill, how dangerous could it be?’ But it was essentially synthetic heroin,’” said ambulance service, Cambridge Health RUNNIN’ director Alex Hogan at a health department-hosted screening of his documentary about oxycodone addiction Alliance, and other sources to show among Somerville youth in the early 2000s. where overdoses are occurring in the city, which populations are most impacted, and the role of naloxone in preventing overdose deaths. • Cambridge Police Department detectives reached out to hundreds of opioid users on the street and in hospitals through the department’s PARTNER Initiative. Detectives referred motivated individuals

12 CHIP HEALTH PRIORITY Mental Health and Substance Use

to the department’s licensed social worker with city partners, hosted a documentary and recovery coach, who then connected screening and other awareness events for them with appropriate treatment centers National Recovery Month in September and helped coordinate care. This initiative 2018. aims to empower opioid users and their families with strategies for problem- • Staff from the health department and solving and managing addiction, as well as Cambridge Public Schools conducted connecting them to services. The coaching individual interviews with 742 seventh and team supports people who are active ninth graders in Year 4 to assess each drug users, have recently overdosed, are student’s risk for substance use, as part The health department and Pro EMS led an of a state-mandated screening. overdose recognition and response training for city actively seeking treatment, or are in early leaders in fall 2018. recovery. • The health department continued • OPEN (Overdose Prevention and Education implementing two separate federal Network), a four-city coalition led by the grants aimed at reducing prescription health department, co-facilitated opioid drug misuse and underage drinking. recognition and response trainings for In Year 4, the department released A local businesses and city leaders; and This health department advertisement on safe medication Cambridge Parent’s Guide to Preventing storage and disposal was displayed on buses in Cambridge Youth Substance Use and Promoting Well- and other communities. Being and partnered with youth centers to host five community conversations for families on talking with teens about substance use. In 2019, the department gave mandated 21 Proof trainings to 206 bartenders, waiters, managers, and owners of Cambridge establishments licensed to pour or sell alcohol. The training provides participants with the skills and knowledge to reduce illegal alcohol sales to intoxicated or underage customers.

13 CHIP HEALTH PRIORITY Violence

GOAL: Establish a new community norm that strives for peace and justice, and provide • Transition House, in partnership with the a comprehensive approach to address all forms of violence. Domestic and Gender-Based Violence Prevention Initiative, organized a four- Cambridge remains committed to preventing physical, sexual, emotional, social, and/or session parenting group for Bengali and reducing all forms of interpersonal financial abuse. Domestic violence, sexual mothers and a two-session group for violence. Interpersonal violence encompasses assault, child abuse, elder abuse, and bullying Ethiopian mothers. In addition to parenting acts of violence between intimate partners, are all examples of interpersonal violence. topics, both groups addressed healthy between family members, and between relationships. individuals who may or may not be known Through multiple initiatives, city and to one another. Acts of violence may include community partners are raising awareness • Transition House and the Domestic about interpersonal violence, mobilizing and Gender-Based Violence Prevention groups to take action, and working to better Initiative conducted focus groups with 45 Every October, the Cambridge Police Department’s support survivors of violence. Spanish-speaking residents to identify command staff wear purple badges as part of the city’s opportunities for outreach and sharing YEAR 4 HIGHLIGHTS (July ’18 – June ’19) observance of Domestic Violence Awareness Month. information about domestic violence. The city observed Domestic Violence • The Domestic and Gender-Based Violence Awareness Month in October 2018. • Prevention Initiative hired the city’s first Events included the annual candlelight prevention specialist in June 2019. vigil at Cambridge City Hall; a “Support for The part-time prevention specialist is Survivors” event hosted by the Cambridge responsible for providing age-appropriate Police Department that featured a talk domestic and gender-based violence by a survivor of domestic violence; and a prevention education and training to free day-long training for 30 community children, youth, and young adults, as well and city service providers that covered as staff and caregivers who serve youth. the dynamics of abuse, working with survivors, and responding to disclosures. The training was led by Transition House and the city’s Domestic and Gender-Based Violence Prevention Initiative.

14 CHIP HEALTH PRIORITY Violence “Patients arriving at a hospital with chest pain or stroke symptoms • Mending Cambridge facilitated workshops based violence. Mending Cambridge is a are immediately believed and for the police department’s youth partnership of the Domestic and Gender- assured they will receive the care resource officers and the city’s Domestic Based Violence Prevention Initiative and they need. Sexual assault patients Violence Steering Committee on how to the Cambridge Public Health Department. deserve that same level of care. actively intervene if they witness sexual harassment or other forms of gender- • Led by the Cambridge Sexual Assault Joan Meunier-Sham, director of Response Team, the City of Cambridge the Massachusetts Department of committed to being a “Start by Public Health Sexual Assault Nurse Believing” community in April 2019. Examiner (SANE) Program and member of the Cambridge Sexual This international awareness campaign Assault Response Team The annual candlelight vigil at Cambridge City Hall encourages criminal justice professionals, during the first week in October commemorates people in Massachusetts who have lost their lives to health care providers, and the community domestic violence. to respond to disclosures of rape and ” sexual assault by expressing belief and support, rather than doubt or blame. • The police department designated a possible racial profiling, racially-biased deputy superintendent to serve as its policy, or use-of-force incidents. The point person for all hate crimes that occur office also evaluates the department’s in Cambridge. Responsibilities include compliance with statutes, ordinances, and serving as a community liaison, reviewing regulations that mandate accountability. incident reports for potential hate crimes, As part of a month-long awareness and working with the department’s • campaign, the Department of Human Criminal Investigations Unit to follow up on Service Programs’ Council on Aging investigating these crimes. and Somerville-Cambridge Elder • The police department established an Services hosted a forum in June 2019 Office of Procedural Justice in summer on preventing elder abuse. Purple 2019 to monitor data related to police- ribbons and educational materials were citizen interactions for indications of distributed to 2,500 people.

15 CHIP HEALTH PRIORITY Healthy, Safe, and Affordable Housing

GOAL: Ensure a socioeconomically diverse community through the preservation For people experiencing or at risk for and expansion of high-quality, healthy, and safe housing that is affordable across homelessness in Cambridge, city and income levels. community partners provide a range of services. The city’s Department of Human Safe, affordable housing is essential to a 2019, the city allocated over $154 million Service Programs facilitates a network of healthy life. People who live in unsafe or in CPA funds for affordable housing, which housing and service providers, known as the overcrowded housing can experience serious leveraged over $500 million in public and Cambridge Continuum of Care, to alleviate illness and injury due to poor indoor air private investments and resulted in the homelessness through prevention, assistance quality, lead paint, psychological distress, and creation and preservation of 1,802 affordable toward self-sufficiency, and provision of a other issues. units. In addition, the city will contribute $9.7 continuum of housing and support services. million to the Cambridge Affordable Housing * The Community Preservation Act is a financing tool for The city has made substantial investments Trust in fiscal year 2020, a $6.3 million Massachusetts communities to leverage funds to preserve open space, protect historic sites, and expand and preserve in affordable housing since the end of rent increase from the prior fiscal year. control in the 1990s. The city’s Community the supply of affordable housing. Development Department (CDD) manages and implements these efforts in partnership with The Community Development Department hosted meetings in seven Cambridge neighborhoods to discuss a proposal governmental, nonprofit, and private-sector that would facilitate the creation of new city-funded affordable housing. organizations.

Housing is considered affordable when tenants or homeowners pay no more than 30% of their household income on housing costs. In Cambridge, there are over 8,160 affordable units—about 15% of the city’s current housing stock.

The most significant funding mechanism for creating and preserving affordable housing in Cambridge is the Community Preservation Act* (CPA). Between fiscal years 2002 and

16 CHIP HEALTH PRIORITY Healthy, Safe, and Affordable Housing

YEAR 4 HIGHLIGHTS (July ’18 – June ’19) • The Cambridge nonprofit Just-A-Start Corporation completed reconstruction • The Cambridge City Council voted to of 16 affordable units at 50 York Street, allocate 80% (over $10.1 million) of the site of the former St. Patrick’s Place fiscal year 2019 Community Preservation Apartments that were destroyed by fire Act (CPA) funds for affordable housing, in late 2016. Just-A-Start also began the maximum amount allowed under construction of 23 new affordable units at Massachusetts law. In addition, the city its existing Linwood Court apartments in allocated 20% of revenue from building the Port neighborhood. permits to the Affordable Housing Trust. • The Cambridge nonprofit Homeowner’s CDD developed a zoning amendment Rehab, Inc. began construction of 98 new • The Cambridge nonprofit Just-A-Start Corporation proposal that would streamline the affordable rental units on Concord Avenue began construction of 23 new affordable units at permitting process and create less across from the Fresh Pond Reservoir. The Linwood Court apartments in the Port neighborhood. restrictive zoning requirements for department also worked with Cambridge- affordable housing projects in which based developer Capstone Communities all units are subject to permanent to create 40 new affordable rental units on affordability restrictions. If adopted, this Massachusetts Avenue in Porter Square. proposal would facilitate the creation • CDD continued its substantial efforts to of new city-funded affordable housing. • The Cambridge Housing Authority preserve affordable units in privately- In addition to public hearings held by completed the redevelopment of Jefferson owned residential buildings with expiring the Cambridge City Council, Housing Park State, which involved demolishing affordability restrictions. In Year 4, Committee, Ordinance Committee, and the existing dilapidated apartments the department continued to work on Planning Board, the department hosted and reconstruction of 104 new preserving the affordability of the 504 multiple well-attended drop-in sessions affordable units. units at Fresh Pond Apartments and Just- to discuss the proposal and answer A-Start preserved and began renovations questions. of the George Close Building (61 affordable units).

17 CHIP HEALTH PRIORITY Healthy, Safe, and Affordable Housing

• The Community Development Department participants, and hosted more than • The city organized housing-related placed 140 low-to-moderate-income 24 public information sessions for activities to celebrate Affordable Housing households in affordable inclusionary residents seeking affordable housing. Month, including an event to mark the rental apartments and reviewed plans 30th anniversary of the establishment of to create an additional 127 inclusionary • The Human Rights Commission and the the Cambridge Affordable Housing Trust. units in the coming years. Community Development Department organized and expanded the city’s third • The Department of Human Service • The department assisted 18 new annual Fair and Affordable Housing Programs received more than $4.5 homebuyers in purchasing affordable Open House in April 2019. City agencies million in federal Continuum of Care homes, including four buyers purchasing and nonprofit organizations provided Program funding that supported over homes through the city’s HomeBridge information on enforcement of housing 250 permanent supportive housing beds program. The department also offered discrimination laws, tenant rights, voucher for people who were formerly homeless. 10 multi-session homebuyer workshops, programs, eviction and foreclosure Over half of the beds were designated provided individual homebuying prevention services, affordable housing, for people who had been chronically counseling to more than 120 workshop and financial assistance for first-time homeless. The award included funding for homebuyers. two new rapid rehousing projects serving unaccompanied homeless youth and domestic violence survivors, respectively. Members of the Cambridge Affordable Housing Trust at the 30th anniversary celebration in May 2019. • To help homeless individuals who do not use the existing shelter system stay warm and safe on cold winter nights, the city’s nighttime warming center provided access to showers, a hot meal, and a safe place to shelter from inclement weather to 589 individuals. The city extended the temporary shelter’s operating period to the entire winter season (December 1 to April 15). The warming center is operated by Bay Cove Human Services, in partnership with the Citywide Senior Center and Windsor House, through a 18 contract with the city. CHIP HEALTH PRIORITY Healthy, Safe, and Affordable Housing

• The Continuum of Care’s Cambridge • The city’s Multi-Disciplinary Homeless is a collaboration of more than 20 city Coordinated Access Network aims to Street Outreach Team identified and departments and agencies, including assess and prioritize the community’s engaged people at high risk for poor the city’s police, veteran’s services, and most vulnerable homeless clients for health outcomes. In Year 4, the team human services departments; Cambridge limited housing resources. In Year 4, conducted over 1,250 hours of street Health Alliance’s Healthcare for the the network assessed 241 clients, while outreach, visiting with over 1,150 Homeless program; Pro EMS; substance another 100 clients exited homelessness individuals who were chronically homeless use treatment programs; and youth to stable housing. to monitor their well-being and help them services programs. access medical care. The outreach team • The city’s Multi-Service Center and Just-A-Start provided housing search

guidance, assistance with moving costs, The construction site of Finch Cambridge on Concord time-limited rental subsidies, and tenancy Avenue. This development is the city’s largest support services to 65 households. Among affordable housing project in 40 years. this group, 33 households moved from emergency shelters to permanent housing in Year 4. This work was supported by two federal rapid rehousing grants. • The Multi-Service Center provided federally funded homelessness prevention services to 65 households, which included assistance with preventing evictions, resolving landlord-tenant disputes, and paying back rent.

19 Our Work

The Cambridge Public Health Department (CPHD) offers an array of vital services. Some programs respond to urgent health matters, such as investigating foodborne illness or treating sick and injured children in the public schools. Others set the stage for a healthy life, such as the Let’s Talk! early childhood literacy program.

The department is a key source of credible information and data on health issues impacting the city. Through health marketing campaigns, data reports, and outreach activities, the department empowers residents to make healthy choices and seeks to engage the public in local health issues.

Finally, the department advocates for change and develops policies that improve the health and well-being of all people in Cambridge. This work includes building broad coalitions to address health and social issues, developing strategies for responding to new health threats, and enforcing local health laws.

20 SPOTLIGHT

Our Work In the News Here is a snapshot of Cambridge Public Health Department (CPHD) activities in 2019. The Cambridge Public Health Department through a community health survey and 118 works closely with local media outlets to share timely information with the public. Stories ADMINISTRATIVE adults and youth through focus groups. In November, the department convened more featuring CPHD staff and programs published than two dozen governmental and community in 2019 include: partners to hear results from the assessment National Accreditation. In September, In Cambridge, flu numbers match typical and help select priority areas for the city’s the Cambridge Public Health Department season as cases continue to climb statewide second community health improvement plan. successfully completed its first year as a Cambridge Chronicle nationally accredited health department. The National Leadership. Claude Jacob, Chief In biotech’s biggest hub, companies department continued to work closely with Public Health Officer, serves as a member open their labs to an unlikely partners to implement strategies for the first emeritus of the National Association of inspector: the city’s veterinarian five-year community health improvement plan County and City Health Officials’ Council of Boston Globe STAT that will conclude in June 2020. To maintain Past Presidents, which advises the NACCHO accreditation, the department embarked on a Board of Directors. Mr. Jacob also serves on Cambridge man was 1st Mass. case new five-year community health assessment, the Board of Directors of the Public Health of West Nile this year, city says soliciting input from nearly 1,400 people Accreditation Board. NBC 10 Boston Do-Gooders, Key Players, and Game CPHD staff (pictured) participated in a forum with city and community Changers: Cambridge in Motion leaders in November 2019 to select the city’s new health priorities. Scout Magazine

Cambridge remains at low risk for EEE, health officials say Cambridge Chronicle Cambridge begins enforcement of vaping ban at city’s six shops, 40 retailers Patriot Ledger

Are you equipped to respond to an opioid overdose? Spare Change News

New first aid kits in Cambridge buildings include Narcan to treat opioid overdoses 21 Cambridge Chronicle Our Work

COMMUNICABLE DISEASE PREVENTION

Communicable disease reports 206 that required follow-up by public health nursing and epidemiology staff in 2019. Children listen to Dragons Love Tacos at a Cambridge People who received free flu Book Bike event in August 2019. 828 shots from health department staff at public flu clinics and other venues. COMMUNITY HEALTH AND of 596 people. In addition, the program Patient visits to the Schipellite WELLNESS organized 15 events just for dads, which had 1,987 Chest Center at Cambridge a total attendance of 147 men, and offered a Hospital for evaluation and treatment of Early Literacy. To support parents in talking 13-week Nurturing Fathers workshop series. latent and active tuberculosis in 2019. The and reading with young children, the Agenda Cambridge Dads surveyed a diverse group of Cambridge tuberculosis program is operated for Children Literacy Initiative, through its Let’s 266 dads to better understand their needs by the health department. CPHD public health Talk! program, distributed 8,612 children’s and inform programming. Cambridge Dads nurses also made home visits to Cambridge books to families; made home and maternity is a partnership of the Agenda for Children residents with active or suspect TB. ward visits to 553 families; led 40 workshops Literacy Initiative and the Center for Families. for parents; started a quarterly Let’s Talk! The literacy initiative’s Pathways to Family newsletter; organized StoryWalks and multi- A boy receives a nasal spray flu vaccine at a CPHD flu Success program serves low-income clinic in fall 2019. session playgroups for young children; and immigrant parents and their elementary co-organized Family Literacy Fun Day and the school-aged children, with a focus on family sixth season of Cambridge Book Bike . engagement and family literacy. During the The Cambridge Dads program strives to two program cycles offered in 2019, staff ensure that dads are informed, engaged, and organized 24 Saturday morning programs for feel supported in their role as parents. The a total of 22 participating families. In May, program hosted 16 family events for fathers the program launched Pathways Community and children, which had a total attendance Nights, a weeknight event for families that was held monthly.

22 Our Work

Healthy Eating and Active Living. As part of a Cambridge Food and Fitness Policy Council initiative to create a more equitable food CPHD staff promoted tap water, active transportation, and income-eligible Bluebikes memberships at the city’s PARK(ing) environment in the city, staff assessed Day celebration in September 2019. grocery stores, neighborhood markets, and other establishments that sell food and ranked them according to healthy food availability, affordability, and walking distance The department collaborated with the of the district’s diverse student body, the from food insecure populations. Community Art Center’s after-school program CPHD school nutrition team helped organize The department continued to lead the to develop healthier menu offerings taste tests of an Ethiopian lentil salad, azifa, Cambridge SNAP Match Coalition, which and get children excited about trying in ten school cafeterias. allows shoppers using federal SNAP new foods. Staff developed a nutrition The department continued to facilitate the (Supplemental Nutrition Assistance Program) education curriculum for the Margaret Fuller bimonthly meetings of the Food and Fitness benefits to double their purchasing power Neighborhood House after-school program Council, co-lead the urban agriculture up to a $15 value per visit at participating that was taught by a CPHD public health initiative, support the city’s Safe Routes to Cambridge farmers markets. The coalition nutritionist. School program, and facilitate the Cambridge distributed over $30,000 in matching funds to The department continued its partnership Tap Water Task Force. residents in 2019. with three early education child care centers Mending Cambridge is a leadership group As part of its community outreach efforts, to assess and improve the centers’ nutrition that engages men in challenging stereotypes the department awarded a total of $5,000 and physical activity practices. In June, around masculinity and becoming active allies in mini-grants to ten local organizations in CPHD began developing an initiative to better in working to end gender-based violence. The spring 2019 to promote healthy eating and understand how to motivate early child care group facilitated workshops for the Cambridge active living; worked with six local convenience providers to adopt evidenced-based nutrition, Police Department’s youth resource officers stores and food markets to promote healthy physical activity, and screen time guidelines. and the city’s Domestic Violence Steering foods and beverages through its Healthy This initiative is supported by a Harvard Committee on how to actively intervene if they Markets Program; and published guides Catalyst grant. witness sexual harassment or other forms to cycling for older adults and urban As part of a longstanding collaboration with of gender-based violence; with city partners, agriculture in Cambridge. the Cambridge Public Schools’ Food and organized the annual domestic violence vigil Nutrition Services to serve cuisine reflective in October; and hosted a football game night

23 Our Work

with a facilitated pre-game discussion on the role of gender in sports. Mending Cambridge is a partnership of the city’s Domestic and Gender-Based Violence Prevention Initiative Michael Botticelli (center), Executive Director of the Grayken Center for Addiction at Boston Medical Center, and the health department. spoke at a health department event on fostering a recovery-friendly workplace in September 2019. Pictured with Claude Jacob (left) and former Mayor Marc McGovern (right). 103 People who completed Mental Health First Aid training for adults or youth The Men’s Health League collaborated with City Manager and staffed by the department, in 2019. The daylong training teaches AIDS Action Committee (a program of Fenway held its first meeting in October to begin participants how to help people experiencing Health) to engage black faith leaders in raising implementing the Opioid Working Group’s mental health challenges or substance use awareness about HIV prevention and stigma recommendations. In November, the disorder. in their churches. In June, the Men’s Health committee oversaw the installation of first League organized a Boys to Men Leadership aid kits with overdose reversal medication Brunch attended by over 100 people and (naloxone) and defibrillators in 20 city Players compete in the 26th annual Hoops ‘N’ Health co-hosted the 26th annual Hoops ‘N’ Health buildings. basketball tournament in June 2019. sports tournament and health fair, which drew over 230 players who participated in health The health department released the city’s workshops, screenings, and the basketball second comprehensive opioid overdose data tournament. In the fall, the program began report in February, which analyzed ambulance, hosting Men’s Health League monthly bike hospital, and naloxone distribution rides and, with AIDS Action Committee, co- program data from 2017. Staff produced organized a men’s sexual health discussion in an advertisement on safe medication November. The Men’s Health League played storage and disposal that was displayed an active role in Mending Cambridge. on public transit buses in Cambridge and other communities throughout May. For Substance Use Prevention. The City National Recovery Month in September, Manager’s Opioid Working Group, staffed by the department hosted awareness events, the department, issued recommendations including a talk by nationally recognized in March for strengthening Cambridge’s addiction expert Michael Botticelli on response to the opioid crisis. The Substance fostering a recovery-friendly workplace. Use Advisory Committee, established by the

24 Our Work SPOTLIGHT

Teen Vaping OPEN (Overdose Prevention and Education also had the option of completing an online Network), a four-city coalition led by the course in lieu of the department’s in-person health department, significantly increased training. Juul e-cigarette sales took off in 2017 when the number of opioid overdose recognition millions of teens gravitated to the company’s and response trainings offered to Cambridge The health department and school district sleekly designed devices and panoply of fruit and businesses, organizations, and residents. collaborated on several projects aimed at candy flavors, largely unaware that the products In 2019, OPEN gave 15 on-site trainings to reducing youth e-cigarette use. In the spring, contained the highly addictive chemical nicotine. CPHD staff and student leaders met with businesses and organizations (up from six In Cambridge, current use of e-cigarettes reported owners of markets located near the high trainings in 2018), and began offering monthly by public high school students jumped from 5% in school about moving vaping products out opioid overdose recognition and response 2014 and 2016 to 18% in 2018, according to the of sight of youth. In the fall, the department trainings to the community in September. biennial Teen Health Survey.

The department produced A Cambridge Amid the growing popularity of e-cigarettes, a Parent’s Guide to Preventing Youth A Cambridge Parent’s Guide to Preventing Youth Substance mysterious lung illness linked to vaping emerged in Substance Use and Promoting Well-Being Use offers tips for talking with tweens and teens about summer 2019 that led to the hospitalization of over substance use and positive ways to cope with stress. and partnered with youth centers to host 2,500 people in all 50 states by year’s end. five community conversations for families on To help curb youth vaping, Massachusetts talking with young people about substance permanently banned retail sales of all flavored use. In partnership with Arlington, Everett, tobacco products in December. Cambridge health and Somerville, the department promoted an officials applauded the new law, but remained online survey about small alcohol bottles (also A Cambridge concerned that teens would still find ways to vape. known as “nips”) and their perceived impact on youth and the environment, which was Parent’s “There is so much more we need to do to change taken by over 1,000 people, including 313 students’ perceptions about the risks of vaping Cambridge residents. and help those who are addicted,” said Tracy Rose-Tynes, MS, BSN, RN, the health department’s To reduce underage drinking in bars and Guide Nurse Manager of School Health Services. restaurants, the health department gave [ 1 ] mandated 21 Proof trainings to 206 In 2020, the health department and school bartenders, waiters, managers, and owners to preventing youth district will ramp up efforts to educate school of Cambridge establishments licensed to pour substance use & administrators, teachers, parents, and students promoting well-being or sell alcohol. Staff at these establishments about vaping, as well as support new prevention initiatives. 25 Our Work

gave multiple presentations to school state and federal preparedness requirements, a catastrophic event, with an emphasis on administrators, teachers, and parents about staff worked with state partners to prepare for identifying critical personnel who would the teen vaping (see “Teen Vaping” spotlight). an annual federal audit of CPHD’s emergency receive earliest available prophylaxis. dispensing site plan. Community Resiliency Mini-Grants. The EMERGENCY PREPAREDNESS Regional Public Health Emergency department awarded five $500 mini-grants AND COMMUNITY RESILIENCY Preparedness. CPHD belongs to the Health to residents to host activities that promote and Medical Coordinating Coalition that community well-being and social cohesion. serves 60 communities in metro Boston and Funded projects included neighborhood block Local Emergency Preparedness. The the Urban Area Strategic Initiative (UASI), a parties and community listening sessions. department conducted three drills to evaluate nine-city coalition of public safety officials. In local capability to rapidly dispense emergency 2019, UASI communities continued preparing Resilience Catalyst Project. CPHD was one vaccines and medication, which included an a multi-year training and exercise program of six local health departments across the emergency dispensing site facility set-up drill to meet updated federal requirements for country selected to pilot a process for building at a public flu clinic in November. To meet dispensing vaccines and medication during and measuring community resilience. In 2020, the department will apply the process to preventing adverse childhood experiences, as well as adverse community environments, Pleasant Street residents attend a block party supported by a $500 community resiliency mini-grant from the health department. suicide, and opioid misuse. This national initiative is funded by the Centers for Disease Control and Prevention and led by George Washington University, in partnership with the American Public Health Association and the National Association of County and City Health Officials.

Climate Change. The department and city partners updated the City of Cambridge Heat Emergency Response Guide in June. As a member of the city’s Climate Change Steering Committee, the department developed activities and events for Climate Preparedness

26 Our Work

Week (September 24-30), including co- and surrounding communities. Each visit Cambridge. Several deer ticks were discovered organizing the screening of the documentary lasts approximately two hours and includes a around Blair Pond near Belmont. Analysis of Cooked: Survival by Zip Code about the clinical assessment and home evaluation for these ticks did not reveal the presence of any 1995 Chicago heat wave, and participating in asthma triggers. disease. a panel discussion after the film. In addition, staff produced five short video clips to raise Healthy Homes completed an asthma control More “tick hunts” will be conducted in the awareness about climate change and building pilot project, conducted at Cambridge Health future and surveillance locations will continue resiliency in Cambridge. Alliance’s Windsor Street Care Center and to be identified based on public reports of a Cambridge elementary school, as part deer and tick sightings. Residents who find of a statewide effort to advance the use suspected ticks in Cambridge can submit a ENVIRONMENTAL HEALTH of national asthma guidelines. Of the 23 photo for identification through a free service children who completed the screening form offered by the health department. at the school site, 22% had scores indicating their asthma was not well-controlled. In 2020, Mosquito-Borne Disease. Four residents Home visits by the department’s 82 the Cambridge Public Health Department statewide tested positive for West Nile virus Healthy Homes program to families of plans to expand these screenings to all public in 2019, including two Cambridge residents. children with asthma who reside in Cambridge school students (ages 4–11) with an asthma The health department ensured that over diagnosis to help children and their families 7,000 storm drains on city and university learn how to better control asthma symptoms. property were treated with larvicide and that Tufts University scientist and tick habitat expert Sam all municipal storm drains received a second Telford (right), leads CPHD staff and volunteers on a “tick hunt” in October 2019, as part of an effort to better Tick-Borne Disease. Lyme disease and treatment in August to reduce mosquito understand Lyme disease risk in Cambridge. babesiosis are the most common tick- populations during peak breeding season; borne illnesses reported among Cambridge oversaw the posting of over 70 mosquito residents. Both diseases are transmitted to advisory signs in designated parks and people from the bite of an infected deer tick. playgrounds; and published regular updates The health department suspects that most on the department’s website and Twitter residents diagnosed with these diseases were account . infected outside the city. To better understand local risk, the department began working with At the department’s request, the East a Tufts University scientist who is an expert Middlesex Mosquito Control Project, which on tick habitats and tick-borne infections. provides mosquito control services to In October, the scientist, CPHD staff, and Cambridge, continued surveillance for the volunteers explored likely tick habitats in 27 all cannabis businesses. Eligible applicants must satisfy a number of requirements Our Work prior to permitting, including working with the Cambridge Public Health Department to create and distribute educational materials to Asian tiger mosquito (Aedes albopictus). This its customers. mosquito species—which can transmit the Zika, chikungunya, and dengue viruses—was SCHOOL HEALTH detected in 2018 and 2019 on the border between Cambridge and Somerville. This discovery signaled the possible emergence of new mosquito-borne disease risk in the area in the future and will inform further 49,294 Cambridge Public surveillance for this species. Schools (CPS) student visits to School Health Services* nurses for illness, injury, medication Safe Needle Disposal. In August 2019, staff The Cambridge Public Health Department conducts administration, and medical procedures from the health department and the city’s annual inspections of local beehives, as part of the beekeeping permitting process. during the 2018–2019 academic year. police, fire, and human services departments School nurses also cared for 1,648 children began developing strategies for reducing diagnosed with a physical, intellectual, or the number of discarded needles in public developmental disability. places and ensuring the safety of anyone REGULATORY who might come in contact with them. The Vision & Hearing. School nurses provided group collected information and data to vision screenings to 3,979 students (resulting better understand the scale of the problem in 540 referrals for care), hearing screenings in Cambridge. Initial findings indicated that 1,042 Licenses and permits to 3,176 students (resulting in 45 referrals), the vast majority of needles were found issued in 2019 related to laboratory and postural screenings to 1,959 students in streets, public bathrooms, plazas, and biosafety, laboratory animals, indoor ice (resulting in 73 referrals) during the 2018– alcoves in Central and Harvard squares, as rinks, beekeeping, tanning salons, body art, 2019 academic year. well as homeless encampments. In the bodywork, burials, and funeral directors. coming year, the group will focus on raising CPS kindergartners who met awareness about existing protocols for needle Recreational Cannabis. Staff participated 99% state immunization requirements by early disposal; improving data-sharing between city in a city work group that drafted a Cannabis November 2019, including 11 children with departments and service providers involved in Business Permitting Ordinance for Cambridge. medical or religious exemptions. sharps retrieval; and exploring the feasibility In September 2019, Cambridge City Council of expanding the number of sharps collection amended and passed the ordinance, which kiosks in the city. created an independent permitting process for

28 Our Work SPOTLIGHT Cambridge Healthy Children’s Oral Health. The Cambridge Healthy Weight Screenings. School nurses Smiles Healthy Smiles program provided classroom completed state-mandated body mass index education and dental screenings to first, third, (BMI) screenings of tenth grade students at The Cambridge Healthy Smiles program provides sixth, and ninth graders in all Cambridge Cambridge Rindge and Latin School in April. classroom education for school-aged children on public schools. Of the 1,769 students oral health awareness. The program also identifies screened for tooth decay and other conditions children’s oral health needs through dental during the 2018–2019 academic year, 30% 742 Seventh and ninth graders who screenings with the goal of improved oral and were referred for treatment. The Cambridge were individually interviewed to assess their overall health. Since 1997, the program has been Healthy Smiles team provides children with an risk for substance use, as part of the state- successful in identifying children at risk for dental oral exam and a proper bite check, in addition mandated Screening, Brief Intervention, and disease and referring them to local dentists for to a visual exam to detect tooth decay. Referral to Treatment (SBIRT) initiative. The treatment. interviews were conducted by school nurses and CPS staff. The program has been recently redesigned, providing 1,123 Upper school students who classroom education and screenings to children in took the Cambridge Middle Grades Health Clinical Oversight. School Health Services grades 1, 3, 6, and 9. Cambridge Healthy Smiles Survey in April, answering questions about continued to provide health care oversight and has also been tailored to the students’ age level and substance use, violence and safety, mental clinical guidance to five Cambridge nonpublic their dental development. For example, a topic for and sexual health, physical activity and schools, as well as city-managed preschools the older grades includes the effects of illicit drugs nutrition, and other topics. Findings from and camps. on the mouth. the biennial Teen Health Survey and Middle * School health services are provided to the Cambridge The program is using technology to make the Grades Health Survey are used to raise Public Schools through a collaborative agreement with the Cambridge Public Health Department. screening process more efficient and effective. awareness about student health issues Tablets are used during screenings, making each and inform prevention programming. The exam more comprehensive. The results are quickly survey program is a partnership of the health Children at the Peabody Preschool learn how to care for their teeth during a visit from the Cambridge Healthy compiled and sent out to parents. Cambridge Healthy department and Cambridge Public Schools. Smiles program in June 2019. Smiles is having great success communicating with In 2019, the health department awarded parents by using email referrals and any needed a total of $2,500 in mini-grants to four follow-up being made by school nurses. Cambridge Rindge and Latin School programs and organizations to use the data to raise These new updates have received very positive awareness about health issues affecting feedback. One parent reached out to the program students. The winning proposals addressed coordinator, and said: “Thank you for taking such vaping, mental health, and bullying. good care of our children’s smiles. We appreciate it!”

29 Collaborations and Leadership

REGIONAL AND STATE COLLABORATIONS NATIONAL BOARDS AND COMMITTEES National Association of County and City Health Officials Advisory Committee to the Massachusetts American Public Health Association Toxics Use Reduction Administrative Council Past Presidents’ Council • Health Administration Section • Boston Biosafety Committee (Boston Public • Injury and Violence Workgroup Health Commission) • Intersectional Council Gun Violence Prevention Working Group Public Health Accreditation Board Community Health Network Area 17 (CHNA 17) • Men’s Health Caucus • Board of Directors Massachusetts Food System Collaborative de Beaumont Foundation • Exploratory Site Visit to Qatar Massachusetts Healthy Cosmetology Committee • Practical Playbook National Advisory • Joint Task Force on Small Health Committee Departments Massachusetts Large Cities Public Health Collaborative • Building Expertise in Administration & Robert Wood Johnson Foundation (RWJF) Management National Advisory Committee Medical and Biological Waste Alternative • RWJF Culture of Health Prize Winning Treatment Advisory Group (Massachusetts Communities Department of Public Health) New York City’s First Lady Chirlane McCray with Claude Jacob at the 2019 Cities Thrive Mental Health Conference. Metro Regional Preparedness Coalition Department staff attended to learn, share, and build a network with mental health experts across the country. Ed Reed/Mayoral Photography Office, NYC Museum of Science

Suffolk-East Middlesex Mosquito Control Commission

30 Financial Overview

Environmental Health Clinical and Emergency Licenses, Permits, Service Fees Response and Other Fees Cambridge Health State, Federal, and 4% Alliance Facilities and 5% 5% Other Funding Administrative Services 11% School Health 7% Services 33%

REVENUE Chronic EXPENSES FISCAL YEAR 2019 Disease and 16% FISCAL YEAR 2019 Injury $7.9 M Prevention $7.9 M

16% 20% Communicable 84% Administration, Operations, Disease Prevention, and Quality Improvement Epidemiology, and Data Management City Appropriation

Note: Percentages may not add up to 100% due to rounding.

31 CHIP Partners

Here are some of the many city and LGBTQ+ Commission Cambridge YWCA community partners that are implementing the community health improvement plan. License Commission CitySprouts Peace Commission Community Conversations: Sister to Sister CITY OF CAMBRIDGE Police Department Eliot Community Human Services Birth to 3rd Grade Partnership Public Health Department Food For Free Cambridge Commission for Persons with Disabilities Substance Use Advisory Committee Institute for Community Health

Cambridge Public Schools Traffic, Parking & Transportation Department Institute for Health and Recovery

City Manager’s Office Veterans’ Services Learn to Cope

Community Development Department Water Department Margaret Fuller Neighborhood House

Conservation Commission Women’s Commission Massachusetts Department of Public Health Massachusetts Institute of Technology Department of Human Service Programs COMMUNITY PARTNERS Mount Auburn Hospital Department of Public Works Access: Drug User Health Program (AIDS Domestic and Gender-Based Violence Action Committee/Fenway Health) Pro EMS Prevention Initiative CASPAR (Bay Cove Human Services) Spaulding Hospital Fire Department Cambridge Community Center

Food and Fitness Policy Council Cambridge Economic Opportunity Committee

Human Rights Commission Cambridge Health Alliance

Inspectional Services Department Cambridge Housing Authority

32 Acknowledgments

Louis A. DePasquale CAMBRIDGE CITY COUNCIL CAMBRIDGE PUBLIC HEALTH City Manager DEPARTMENT STAFF Mayor Sumbul Siddiqui City of Cambridge Vice Mayor Alanna M. Mallon EDITORS Lisa C. Peterson Councillor Dennis J. Carlone Susan Feinberg, Rachel Heafield, Deputy City Manager Councillor Marc C. McGovern and Jodie Silverman City of Cambridge Councillor Patricia M. Nolan

Councillor E. Denise Simmons PHOTO CREDITS Assaad Sayah, MD Chief Executive Officer, Cambridge Health Councillor Jivan Sobrinho-Wheeler Cambridge Community Development Alliance & Commissioner of Public Health Department, Cambridge Police Department, Councillor Timothy J. Toomey, Jr. City of Cambridge Cambridge Public Health Department, Cambridge Public Schools, Cambridge YWCA, Councillor Quinton Y. Zondervan Sammi Chung, Suzy Feinberg, Rachel Heafield, Claude A. Jacob Molly O’Brien, Brad Pillen, David Oziel, Bethany Versoy, and Chad Makaio Zichterman. Chief Public Health Officer CAMBRIDGE PUBLIC HEALTH Cambridge Health Alliance SUBCOMMITTEE City of Cambridge Paula Paris, Chair DESIGN

Katharine Kosinski, MD Fenway Group Assaad Sayah, MD, ex officio

Ellen Semonoff Claude Jacob, Chief Public Health Officer for the Cambridge Public Health Department; Josh Posner, Chair of CHA (Cambridge Health Alliance) Board of Trustees; former Cambridge Mayor Marc McGovern; Assaad Sayah, MD, CHA Chief Executive Officer and Commissioner of Public Health for the City of Cambridge; Mary Cassesso, CHA Chief Community Officer and President of the CHA Foundation; and Cambridge City Manager Louis DePasquale.

Cambridge Public Health Department is a city department administered by Cambridge Health Alliance, a regional health care delivery system.

119 Windsor Street I Cambridge, MA 02139 617-665-3800 I cambridgepublichealth.org I @CambHealth