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Public Health: Goals & Measures
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Indicator Measures
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How are we doing?
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7.1.1 Research funding for health care
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Massachusetts has consistently led other Leading Technology States in its capture of federal research and development funding and per capita deferral health research, which doubled between 1997 and 2002. In 2002, medical research institutions in Boston received $1,048 million in National Institutes of Health awards, a 3% increase over 2000, and institutions in Cambridge received a 55% increase. However, competition in life sciences research and development is increasing, and a number of states are aggressively pursuing a greater share of public research dollars by investing state funds in public university and other research. Venture capital investment overseas is increasing. |
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7.1.2 ‘Right Start’ rank in child health outcomes
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In 2002, the latest year for data, Boston ranked in the top 15 cities on six of eight measures of healthy births. Rates on most measures have improved markedly between 1990 and 2000, but changed little since then. However, Boston ranked 34th in the percentage of women giving birth to low-birthweight babies and 19th in the percentage of women with pre-term births – risk factors for learning disabilities and other developmental problems. Both rates reflected sharp and persistent racial disparities. |
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7.2.1 Percentage of residents without health insurance by gender and by race
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In 2004, an estimated 7.8% of the Metro Boston population and 7.4% of the MA population lacked health insurance entirely, and many more had inadequate coverage – representing an increase from 5.6% in Metro Boston and 5.9% in Massachusetts since 2000. Young adults age 19 – 24 and low-income households were the least likely to have health insurance, with 20% and 15% lacking coverage respectively. All children in MA are eligible for health insurance, but limitations on coverage have increased. These rates are better than the US as a whole, at 14%. The US is the only industrialized nation that does not offer universal health care coverage to its citizens. |
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7.2.2 Mental health services capacity for children and adolescents
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In 2002, the latest year for which data are available, wait times for placement in an outpatient mental health service had increased by more than 200% since 1998 for children and adolescents in pediatric hospitals, and 68% of facilities reported needing additional staff to meet demand. |
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7.2.3 Language interpreters at major hospitals and health centers
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Boston’s major hospitals and most community centers ease language barriers by employing staff with appropriate skills, but these services do not always meet the demand. Languages spoken in Boston’s network of community health centers reflect the needs of the residents of neighborhoods served. For example, 86% provide services in Spanish, 24% in Chinese dialects, 24% in Vietnamese, 22% in Haitian Creole, 22% in French, 22% in Portuguese, and 21% in Cape Verdean. |
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7.3.1 Leading causes of hospitalization and death in Boston
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Cancer and heart disease remain the leading causes of death in Boston, mirroring trends throughout the state and nation. In 2002, cancer was the leading cause of death and heart disease the second-leading cause among both men and women in Boston. |
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7.3.2 Drug- and violence-related injuries and deaths in Boston
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In 2004, the number of homicides in Boston was 61. The number of homicides in Boston in 2003 was 39, down from 60 in 2002. Between 1968 and 1995, homicides averaged 99 per year. From 1996 to 2003, the average has been 46 per year. Risk factors include alcohol and drug use, availability of firearms, and the cultural acceptance of firearms.
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7.3.3 Rates of STDs, hepatitis C and HIV infection, and AIDS mortality by race
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In 2002, the last year for which data are available, the citywide average rate of STDs in Boston was 58 incidents per 100,000 residents, an increase of 5% above the 2000 rate. The rate in South Dorchester was two times the city average. |
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7.4.1 Infant mortality and birth weight by race/ethnicity
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The infant mortality rate among black Bostonians declined by 35% between 1992 and 2002, the last year for which data are available, but the rate has been consistently higher than the rate for whites. Infant mortality among Latinos increased slightly between 1999 and 2002. |
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7.4.2 Asthma hospitalization rates by race/ethnicity, age and Boston neighborhood
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In 2002, the last year for which data are available, black and Latino children in Boston were hospitalized for asthma at more than three and a half times the rate for white children. The highest rates are in Roxbury and Dorchester. |
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7.4.3 Hospitalization and mortality rates by race/ethnicity
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Year after year, Boston’s black community has a higher overall mortality rate than other ethnic groups in Boston, with more than twice the death rates from prostate and cervical cancer and cervical cancer rates – both among the most preventable with early detection and treatment. |
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7.5.1 Women receiving adequate prenatal care
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In 2002, the last year for which data are available, more than 83% of Boston’s mothers received adequate prenatal care, including 90% of white mothers, about 85% of Asian and Latino mothers, and only 75% of black and other-ethnicity mothers. The trend has improved for all groups except black mothers since 1998. |
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7.5.2 Up-to-date vaccinations in Boston
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Boston’s immunization rate for the comprehensive 4:3:1 vaccine was 90% in 2003, up from 79% in 2000 and higher than the national average of 82%. |
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7.5.3 Suicide rates among youth
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All measures of suicidality have declined in Boston in the decade from 1993 to 2003, with marked improvement since the troubling spate of suicides in South Boston in the 1990s. |
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7.5.4 Youth who engage in risky behaviors
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Smoking among Massachusetts’ adolescents declined fast from 21% to 13% in 2003 - attributed to the state’s nationally recognized antismoking initiative directed at youth. However, Boston’s smoking cessation programs were scaled back in 2003 in response to state budget cuts. A greater of proportion of white youth (54%) had used alcohol and also had used drugs within the past 30 days in a 2003 survey of risky youth behaviors than youth in other racial groups in Boston. Sexual activity among youth declined from 42% in 1993 to 22% in 2003 according to survey results. |
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7.5.5 Percentage of youth who report a strong relationship with a parent or adult mentor
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According to the Boston Youth Survey, 79% of Boston youth ages 13-19 were able to talk to at least one parent about most issues and a little more than half said they had satisfactory communication with their fathers. The survey, taken in 2001, was conducted again in 2004, with results to be compiled. |
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7.6.1 Percentage of Boston residents who engage in healthy behaviors
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The percentage of Bostonians reporting leisure-time physical activity increased from 71% in 2000 to 76% in 2003, and in 2002, about 20% of those in all racial/ethnic groups in Boston smoked. |
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7.6.2 Obesity by age, gender and racial/ethnic group
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In Massachusetts, the percentage of overweight residents increased from 40% in 1986 to 53% in 2003. The percentage of obese residents increased from 10% in 1990 to 17% in 2003. In 2003, 51% of all Bostonians were overweight. The rate is higher for blacks (64%) and Latinos (63%). Excess weight is less common among Asians in Boston but has been increasing rapidly: from 18% in 1999 to 39% in 2003.
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