DorchesterDorchester CollaborativeCollaborative Meeting:Meeting: HealthHealth StatusStatus ofof DorchesterDorchester ResidentsResidents

PresentedPresented byby JohnJohn Auerbach,Auerbach, BostonBoston PublicPublic HealthHealth CommissionCommission

Tuesday,Tuesday, JanuaryJanuary 18,18, 20052005 Boston Neighborhoods

Charlestown

East Allston- Boston Brighton Back Bay North South End End Fenway South Boston Roxbury

Jamaica Plain

Dorchester Roslindale West Roxbury Mattapan

Hyde Park

*Dorchester communities included in the January 18, 2004 presentation have been geographically redefined to avoid overlapping boundaries and to contain all of the Dorchester population. MAP PREPARATION: Boston Public Health Commission Research Office Dorchester Communities

The following six areas contain all Dorchester census tracts (previously defined as North and South Dorchester). Each area is distinct (census tracts appear in only one area). The boundary definitions start on the west side of the area and proceed north, east and south, and then return to the starting street.

The six communities described below by census tracts and street boundaries are defined for statistical purposes only and should not be confused with neighborhood boundaries defined by the Boston Public Health Commission, the City of Boston, or by neighborhoods themselves.

Codman Square/Southern Franklin Field Area Census Tracts: 919, 923, 1001-1005 Boundaries: Blue Hill Avenue, Talbot Street, RR, Geneva Avenue, Bowdoin Street, Washington Street, Centre Street, Dorchester Avenue, Gallivan Blvd, Morton Street, Blue Hill Avenue

Although Grove Hall extends into Roxbury, the Roxbury section has not been included in the geographical definition used in this presentation.

Dorchester Grove Hall Area Census Tracts: 901-906, 924 Boundaries: Blue Hill Avenue, West Cottage Street, Dudley Street, Magnolia Street, Robin Hood Street, Hartford Street, Wayland Street, Magnolia Street, Quincy Street, Columbia Road, Railroad Tracts, Talbot Avenue, Blue Hill Avenue, Harvard Street, Austin Street, American Legion Hwy, Blue Hill Avenue

Fields Corner Census Tracts: 916-918, 920-922 Boundaries: Columbia Road, Quincy Street, Bowdoin Street, Church Street, Freeport Avenue, Morrissey Blvd, Ocean, Victory Road, Morrissey Blvd, Neponset Avenue, King Street, Dorchester Avenue, Centre Street, Washington Street, Westville Street, Bowdoin, Geneva Street, Columbia Road Uphams Corner Area Census Tracts: 907-908, 912-915 Boundaries: Hartford Street, Robin Hood Street, Magnolia Street, Dudley Street, E. Cottage Street, RR, Norfolk Avenue, E. Cottage Street, Pleasant Street, High Street, Church Street, Quincy Street, Magnolia Street, Wayland Street, Hartford Street

Savin Hill/Harbor Point Census Tracts: 909-911 Boundaries: Pleasant Street, E. Cottage Street, Crescent Avenue, around Columbia Point, city boundary to harbor, Morrissey Blvd, Freeport Street, High Street, Pleasant Street

Lower Mills/Neponset Census Tracts: 1006-1009 Boundaries: Dorchester Avenue, King Street, Neponset Avenue, Pope’s Hill, Freeport Street, City Boundary, River Street, Standard Street, Manchester Street, Maryknoll Street, Morton Street, Gallivan Blvd, Dorchester Avenue WhoWho LivesLives inin Dorchester?Dorchester? Population by Race/Ethnicity Dorchester, 1990 and 2000

Census Census Race/Ethnicity 1990 2000 Total Population 121,011 128,503 White, non-Latino 38% 24% Black, non-Latino 46% 45% Latino 12% 14% Asian/Pacific Islander (1990) 3% N/A Asian (2000) N/A 8% Other Race* <1% 4% Two or More Races N/A 5% *"Other race" includes Native Americans (1990), and Native Hawaiians/Other Pacific Islanders, Alaska Native/American Indians, and Other Races (2000). DATA SOURCE: Modified Age-Race-Sex file for Boston census tracts, 1990 US Census; US Department of Commerce, Bureau of the Census, American Fact Finder, Census 2000. DATA ANALYSIS: Boston Public Health Commission Research Office Population by Race/Ethnicity Dorchester Communities, 2000

Codman Savin Square/ Lower Hill/ Franklin Fields Grove Mills/ Harbor Uphams Race/Ethnicity Boston Field Corner Hall* Neponset Point Corner

Total Population 589,141 30,301 26,219 21,562 21,753 11,048 17,620

White, Non-Latino 50% 7% 19% 2% 60% 49% 26%

Black, Non-Latino 24% 72% 41% 65% 23% 15% 30%

Latino 14% 13% 14% 23% 4% 10% 18%

Asian 8% 3% 13% 0.4% 8% 22% 7%

Other Race** 2% 2% 7% 5% 1% 2% 11%

Two or More Races 3% 4% 6% 5% 3% 3% 8%

*Dorchester section of the Grove Hall area **"Other race" includes Native Hawaiians/Other Pacific Islanders, Alaska Native/American Indians, and Other Races. DATA SOURCE: Census 2000, US Department of Commerce, Bureau of the Census, American FactFinder DATA ANALYSIS: Boston Public Health Commission, Research Office Population by Age Dorchester, 2000

N=128,503 Ages 65+ 8% Ages 0-17 30%

Ages 45-64 19%

Ages 18-24 11% Ages 25-44 32%

DATA SOURCE: US Department of Commerce, Bureau of the Census, American Fact Finder, Census 2000 DATA ANALYSIS: Boston Public Health Commission, Research Office Population by Age Dorchester Communities, 2000

Codman Savin Square/ Lower Hill/ Franklin Fields Grove Mills/ Harbor Uphams Boston Field Corner Hall* Neponset Point Corner

Total Population 589,141 30,301 26,219 21,562 21,753 11,048 17,620

Ages 0-17 20% 33% 31% 37% 22% 23% 29%

Ages 18-24 16% 10% 11% 10% 9% 15% 11%

Ages 25-44 36% 31% 32% 30% 35% 37% 33%

Ages 45-64 18% 20% 19% 16% 20% 17% 18%

Ages 65+ 10% 7% 7% 7% 14% 9% 9%

*Dorchester section of the Grove Hall area DATA SOURCE: Census 2000, US Department of Commerce, Bureau of the Census, American FactFinder DATA ANALYSIS: Boston Public Health Commission, Research Office Selected Socioeconomic Indicators Boston Overall, North Dorchester, and South Dorchester, 2000

Indicator Boston N. Dorchester S. Dorchester

% of Population with Less than High School Diploma or GED (Adults Ages 25 and Over) 21% 31% 23%

% of Population Below Poverty Level* 20% 23% 18%

% of Children (Under 18) Below Poverty Level* 26% 31% 24%

% of Adults 65 and Older Below Poverty Level* 18% 20% 15%

Median Household Income** $39,629 $34,132 $38,987

*Based on income in 1999 **Estimated median household income in 1999 DATA SOURCE: US Deparment of Commerce, Bureau of the Census, American FactFinder, Census 2000, Summary File Sample Data DATA ANALYSIS: Boston Public Health Commission Research Office BirthsBirths Births by Race/Ethnicity by Maternal Ancestry Dorchester, 2002

ASIAN N=232 10.5% BLACK N=1024 46.4% Vietnamese 82.3% African-American 56.5% Chinese 10.4% Haitian 13.4% Other* 7.4% "American" 8.2% Other West Indian/Carribean 7.1% * Cambodian, Asian Indian, Filipino, Korean, Japanese, European, Jamaican 6.4% and Other Other African 3.8% Cape Verdean 2.4% Barbadian 1.2% Other** 1.1%

** Middle Eastern, Portuguese, Native American, European, and Other

LATINO N=383 17.4% WHITE N=380 17.2% Puerto Rican 43.6% "American" 55.4% Dominican 36.8% European 33.1% Other Central American 7.3% Other*** 11.6% Other Latino/Latina 6.3% Other South American 2.9% Colombian 1.6% *** Cape Verdean, Brazilian, Other Portuguese, Barbadian, Salvadoran 1.6% African-American, Chinese, Vietnamese, Cambodian, Middle Eastern, Native American, Other African

NOTE: Race/ethnicity and maternal ancestry are self-reported. DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission Research Office Infant Mortality Rate Boston and Dorchester, 1992-2002 14.0

12.0

10.0

8.0

6.0

4.0 Deaths per Live1,000 per Births Deaths

2.0

0.0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Boston 1010977867777 Dorchester 8101189109 8 8109

DATA SOURCE: Boston resident deaths and live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office Infant Mortality Rate by Neighborhood Boston, 1997-2002

14

s 12 11 11

10 9

8 8 8 8 7

6 5 6 5 5 4 4

Within Neighborhood 4 3 3 2 Infant Deaths per 1,000Infant per Deaths Live Birth n<5 n<5 n<5 0

r n n e y ton te ay i nd r s w ark la pa E al End u TON gh e P P a S en t ind h ch F de ica sl Roxbury ut BO Back Bay Mat North on/Bri Dor Hy Ro So Charlestown East Boston llst Jama South BostonWest Roxb A

DATA SOURCE: Boston resident deaths and live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office Adequate Prenatal Care By Dorchester Community, 2001-2002

100%

. 88% 83% 81% 78% 78% 80% 76% 75% 73%

60%

40%

20%

0%

d r r l e ll* int e rn o Percentage Birthsof Within CommunityAll hester in Fie e Ha ponset Corn c v e BOSTON o lds C r Dor ankl e G ls/N Fr Fi il re/ Uphams a r M Hill/Harbor Po we o Squ L n Savin a m od C *Dorchester section of the Grove Hall area DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission Research Office HospitalizationHospitalization Hospitalization by Neighborhood, Age-Adjusted Rates, Boston, 2002 250 n 210 200 171 175 166 146 153 140 141 138 138 150 128 129 119 124 105 107 100

50

0 Hospitalizations per 1,000 Populatio N * n n k e y d O y w ar an ur ton n a sto ap s ST B e P tt indal xb o th E Fenwayd Ro u BO ck st Bo Ma th B Ba Hy Rosl u So CharlestoEa Jamaica Plain So West Roxbury Allston/Brighton orth Dorchester N South Dorchester * Includes the North End DATA SOURCE: Acute Hospital Case Mix files, Massachusetts Division of Health Care Finance and Policy DATA ANALYSIS: Boston Public Health Commission Research Office Leading Causes of Hospitalization, Age-Adjusted Rates, Dorchester, 2002

. Pregnancy 33

Psychoses 6

Injury 5

Bronchitis & Asthma 4

Heart Failure & Shock 4 Chest Pain 4 Hitliti 1000 Gastroenteritis* 4

Simple Pneumonia & Pleurisy 3 Hospitalizations per 1,000 Population 1,000 per Hospitalizations Substance Abuse 3

Nutritional & Metabolic Disorders 3

0 5 10 15 20 25 30 35 40

*Also includes esophagitis and miscellaneous digestive disorders DATA SOURCE: Acute Care Hospital Case Mix Files, Massachusetts Division of Health Care Fianance and Policy DATA ANALYSIS: Boston Public Health Commission Research Office Asthma Hospitalization Rates Among Children Under Age 5 By Year, Boston, 1994-2002 20 n 18 16 14 12 10 8 6 4

Hospitalizations 1,000 per Populatio 2 0 1994 1995 1996 1997 1998 1999 2000 2001 2002 BOSTON 12119878899 Dorchester 17 14 11 10 10 12 12 12 13

DATA SOURCE: 1997-2000 Acute Case Mix, Massachusetts Division of Health Care Finance and Policy; 1994-1996 discharge data, Massachusetts Health Data Consortium, Inc. Rates are calculated using resident population estimates from MISER for 1991-1998, Massachusetts Department of Public Health 1999 Preliminary Population Estimates, and the US Census 2000 for resident population by zip code. DATA ANALYSIS: Boston Public Health Commission Research Office. Asthma Hospitalizations Among Children Under Age 5 by Neighborhood, Boston 1998-2002 16 15

. 14 12 12 10 10 10 9 8 8 7

5 5 6 6 5 4 3 4 3 3

2

Hospitalizations per 1,000 Population 1,000 per Hospitalizations 0

r n te on ay an nd ON own t ark p sto T t os P xbury S hes e o Bo O rles rc t B Fenw R B a yd Matta th Back Bay* Do as H Roslindale South E Ch E ou Jamaica Plain S West Roxbury Allston/Brighton *Includes the North End DATA SOURCE: Acute Care Hospital Case Mix Files, Massachusetts Division of Health Care Finance and Policy DATA ANALYSIS: Boston Public Health Commission Research Office LeadLead ScreeningScreening Prevalence of Elevated Blood Lead Levels* by Neighborhood Boston, 2003 6%

5% 5% 5%

4% 4% 4%

3% 3% 3% 3% 3% 3%

2% 2% 2% 2%

1% 1% 1% 1% Percentage Screening Positive n<5 n<5 0%

k r ay on r ter le ry e t s End u End B ston est bury STON o h th x O t Bos Fenwayyde Pa Roxb B Back s Mattapanorche North n/Brighton harlestown H D Roslinda Dorc Sou st Ro o C Ea e Jamaica Plain South Bth W Allst ou North S *Blood levels of 10 micrograms per deciliter (ug/dL) or higher DATA SOURCE: Lead Screening Data: Boston Public Health Commission Office of Environmental Health DATA ANALYSIS: Boston Public Health Commission Research Office CommunicableCommunicable DiseasesDiseases Hepatitis C Incidence Rates by Neighborhood Boston, 2002 350

300 286 284

250 209 200 188 190 191 155 142 150 119 98 89 86 100 71 73 62 54 50 New Cases per 1,000New Population 0

N * n y n n le r d ton to ai ton n ay own s wa l pa da bury B t Park P n xbury x Bo en e a li heste k les F c atta s Ro rc BOSTO ac ar st ai M orchester o a Hyd D Ro uth Bos South E B E o est Ro Ch am S th D J u W Allston Brigh o North S Includes the North End DATA SOURCE: Communicable Disease Database, Boston Public Health Commission, Communicable Disease Control Division DATA ANALYSIS: Boston Public Health Commission, Communicable Disease Control Division GRAPHIC: Boston Public Health Commission Research Office Sexually Transmitted Disease* Incidence Rates by Neighborhood, Boston, 2002

2,000 1,828

1,600 1,496

1,130 1,126 1,200 862 915 758 731 800

421 393 383 401 374 280 400 208

New Cases per 100,000 Population New 100,000 per Cases 57

0 d ry k n er le ton bury s ster En x n lai st da xbu e th ton o h ON ay** tow s he rc B s e Par a P R o T Fenwayd Sou le t Bo y Mattapan Roslin D H South Both West Ro BOS n/BrightonBack har to C Eas Jamaic Sou ls North Dorc Al *Chlamydia, gonorrhea, and syphilis combined ** Includes the North End DATA SOURCE: Communicable Disease Database, Boston Public Health Commission, Communicable Disease Control Division DATA ANALYSIS: Boston Public Health Commission, Communicable Disease Control Division GRAPHIC: Boston Public Health Commission Research Office HIV/AIDS Incidence Rates by Neighborhood Boston, 2002 200.0 170

. 160.0 144

120.0

80.0 76 62 61 56 57 61 52 48 40.0 31 23 19 N<5 17 19

New Cases per 100,000 Population 100,000 Cases New per 0.0

* n le y ton ay ai ton ur l da End b Bay P tapan n os h estown Bos a t li B hester ox k l t Fenw ic a chester Roxbury R BOSTON ac M or os h orc t B as Hyde Park R Sout Char E h D es Jama rth D Sout t W Allston /Brighton ou *Includes the North End No S DATA SOURCE: Communicable Disease Database, Boston Public Health Commission, Communicable Disease Control Division DATA ANALYSIS: Boston Public Health Commission, Communicable Disease Control Division GRAPHIC: Boston Public Health Commission Research Office ViolentViolent InjuryInjury Victims of Non-Fatal Assault-Related Gunshot and Stabbings, Ages 15-44, by Neighborhood, Boston, 2000-2003 3.5

3.0 3.0 2.7 n 2.4 2.5 2.0 2.0 1.5 1.5 1.3 1.2 0.9 1.0 0.7 0.8

Victims per 1,000 Populatio 0.6 0.5 0.3 0.2 0.1 0.2 0.0 n y a le * n r n a rk y w te to a da y y ON o s Plain ap ton ur T t nw lin s End b ighton Ba s he e P Roxbur o h x k le c Fe d ca Matt os t o r r R B R BOS o Hy mai h Bac D East Bos a ut Sou Cha J est So W Allston/Br DATA SOURCE: Weapon-related injuries. Massachusetts Department of Public Health, Weapon-Related Surveillance System DATA ANALYSIS: Boston Public Health Commission Homicides Boston, 2004 N= 64 Homicides

Dorchester 30% Rest of Neighborhoods 39%

Roxbury 31%

DATA SOURCE: Boston Police Department GRAPHIC: Boston Public Health Commission Research Office DeathsDeaths Leading Causes of Death, Dorchester, 2000-2002

Age-Adjusted Average Annual Rates

Cancer (All) 226 Heart disease 212 All Injuries* 59 Stroke 56 Nephritis/Nephrosis 30 COPD 30 Pneumonia/Influenza 29 Diabetes 28 Septicemia 22 Substance Abuse 21 HIV/AIDS 17

0.0 50.0 100.0 150.0 200.0 250.0 300.0 Deaths per 100,000 Population

*Deaths due to all injuries combined include unintentional deaths (accidents, motor vehicle related), intentional deaths (homicide and suicide), and injuries with intent unknown at the time when the death certificate was issued. DATA SOURCE: Boston resident deaths, Massachusetts Department of Public Health. DATA ANALYSIS: Boston Public Health Commission Research Office Cancer Mortality by Neighborhood, Boston, 2000-2002

Age-Adjusted Average Annual Rates 400.0

303 300.0 241 231 227 229 218 217 222 218 215 198 195 196 200.0 178 177 185 182

100.0 Deaths per 100,000 Population

0.0

n n k n d y w ar ter n ale ur Bay P lain pa s E d b k osto P ta h righton B e t hester B Fenway at rche Rox rc uth End BOSTON Bac arlesto st yd M o Nor o h H D Roslin uth Boston S C Ea o S Jamaica rth uth Do West Roxbury Allston/ o No S DATA SOURCE: Boston resident deaths, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission Research Office SelectedSelected BFRSSBFRSS ResultsResults Overweight/Obese Adults by Neighborhood Boston,1999 and 2001

80% 66% 70% 61% 58% 60% 58% 60% 55% 55% 53% 49% 51% 46% 48% 50% 41% 38% 35% 35% 40% 32% 30% 20%

Percentage of Respondents of Percentage 10% 0% r te End y y k in an ter ale s wn la p d e th to P es ighton ck Ba s enwa slin Roxbury rch r a le F rch o Sou B ica Matta o North EndR BOSTON B st Boston a Hyde Par South Boston West Roxbury ton/ Char E ama uth Do s J rth D o ll o S A N

DATA SOURCE: Behavioral Risk Factor Surveillance System, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission Research Office Inadequate Physical Activity by Neighborhood, Boston, 2001

90% 81% s 80% 72% 68% 69% 68% 70% 64% 63% 63% 58% 60% 57% 56% 55% 50% 50% 45% 42% 39% 40% 37% 30% 20%

Percentage of Respondent of Percentage 10% 0%

n n n n N ter O to ow pa s End t nway End ester igh s e e Park th h th d atta /Br F ica Plai rche or Roxbury BOST n Back Bay M o N th Bostonorc t Roxbury Hy ma Roslindale u D Sou s to Charle East Boston a s J th D So We All or N South

DATA SOURCE: Behavioral Risk Factor Surveillance System, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission Research Office High Blood Pressure Among Adults by Neighborhood, Boston, 1999 and 2001 50% s

40% 38% 33% 33% 29% 29% 30% 25% 24% 25% 19% 20% 20% 16% 17% 14% 12% 10% 10% 6% Percentage of Respondent of Percentage 0%

n rk ry y o ay ale ur st ester End ighton nd h Bo sli c uth /Br t Fenw Roxbu r BOSTONn Back Bay s Mattapan o Hyde Pa Ro So CharlestownEa Jamaica Plain South Boston West Roxb Allst North Dorchester South Do DATA SOURCE: Behavioral Risk Factor Surveillance System, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission Research Office Adults Who Are Current Smokers by Neighborhood, Boston, 1999-2001 40%

31% 30% 25% 25% 22% 22% 23% 19% 20% 20% 18% 18% 18% 15% 16% 13% 12% 10% 8% Percentage ofRespondents Percentage

0% y n e ry er nd n u on E ur ain pa b b on ay* wn to l x ost est x to s P a o h uth TON B s e Park chester c S k ca r R c rle t Bo Fenwayyd Matt So st Ro /Bright a a H Do Roslindal BO B h South B We on Ch Eas uth Dor lst Jamai o Al Nort S * Includes the North End DATA SOURCE: Behavioral Risk Surveillance Survey, Massachusetts Department of Public Health and Boston Public Health Commission DATA ANALYSIS: Boston Public Health Commission Research Office SummarySummary DORCHESTER: SUMMARY of MAJOR FINDINGS

Dorchester is a racially and ethnically diverse neighborhood where 22% of Boston residents live.

Mortality: Between 1991 and 2000, mortality rates among Dorchester residents declined from 1,054 deaths per 100,000 population to 927 deaths per 100,000, a decrease of 12%. The mortality rate for Dorchester residents in 2000 was the third lowest during the 10-year period.

Heart Disease Mortality, Dorchester Communities: In 2000, the heart disease age- adjusted mortality rate for Codman Square/Franklin Field (175 deaths per 100,000 population) was 20% lower than the rate for Boston overall (219 deaths per 100,000).

Asthma Hospitalization Rates for Children Under Age 5: Between 1994 and 2000, the asthma hospitalization rate for Dorchester children under age 5 declined 29%, from 17 hospitalizations per 1,000 population to 12 hospitalizations per 1,000.

Infant Mortality Rates: Between 1991 and 1999, the infant mortality rate for Dorchester declined 11%, from 9 infant deaths per 1,000 live births to 8 infant deaths per 1,000 live births. Challenges

Cancer Mortality: For 2000, the cancer mortality age-adjusted rate for Dorchester residents (236 deaths per 100,000 population) was 7% higher than the Boston rate (221 deaths per 100,000).

Infant Mortality Rate (IMR): During 1996-2000, the Dorchester IMR (9 infant deaths per 1,000 live births) was 27% higher than the Boston IMR (7 infant deaths per 1,000 live births).

Incidence Rate of Sexually Transmitted Disease (STD): In 2000, the STD incidence rate for Dorchester (1,282 new cases per 100,000 population) was 78% higher than the Boston rate (721 new case per 100,000).

Violence-Related Injuries: Twenty-two percent of Boston’s population lives in Dorchester, but 41% of Boston victims of violence-related gunshot and sharp instrument injuries during 1998-2001 were Dorchester residents.

Asthma Hospitalization Rates for Children Under Age 5: During 1999-2000, the asthma hospitalization for children under age 5 in Dorchester (12 hospitalizations per 1,000 population) was 50% higher than the Boston rate (8 hospitalizations per 1,000).