Community Health Assessment: Boston, MA

Discover some tidbits about Boston, that I too didn't know until this nursing school assignment.


Background

I picked Boston, Massachusetts for my community project because it was where I was born and raised. I am fortunate to have experienced all things Massachusetts has to offer and have watched Boston transform over the last 31 years. Boston is located at a latitude of 42°21'30.35"N and longitude -71°3'35.17"W. It is the largest city in New England facing the Atlantic coast, found on a hilly peninsula in Massachusetts Bay. Boston, Massachusetts is home to the Freedom trail, Faneuil hall Marketplace, and the Boston Commons. The Boston Commons is a central public park that dates back from 1634, it is the oldest city park in the United States. It consists of 50 acres of land bounded by Beacon Street, Charles Street, Boylston Street, Tremont Street, and Park Street. Boston’s most well-known landmark would be Fenway Park baseball stadium. Fenway Park is home to the Red Sox’s and around since 1912. Boston is also best known for its famous baked beans, the Boston Marathon, and the famous bar from Cheers.People have inhabited the area since about of 2400 B.C.


The Massachusetts tribe of Native Americans were one of the original people to call the Shawmut Peninsula home. A Captain named John Smith in 1614 explored the coastline of what he decided to call New England, with hopes to make the area sound more attractive to settlers. Within some years, half the Native Americans within the region had died of smallpox introduced by European explorers. Boston was originally called Tremontaine for the three hills within the world. The Puritans later changed the settlements name to Boston, to pay homage to the town in Lincolnshire, England, from which many Puritans originated. Boston is considered the premium place of education and religion. One of the first schools founded was Boston Latin School. It was founded on April 23, 1635 and is considered the oldest public school in America. It offered free education to boys both rich and poor. Until the completion of the schoolhouse in 1645, classes were held in the home of the first headmaster. Benjamin Franklin, John Hancock, and Samuel Adams are just a few that attended this school.


Being a Quaker was punishable by imprisonment or death, celebrating Christmas was banned, and in 1643 the town welcomed the first ship into harbor. As Boston grew and prospered, tensions between colonists and English governors increased, especially after nation Parliament passed the Molasses Act of 1733, which levied a tax on molasses, a critical import for Boston rum makers. In 1773, the Tea Act levied taxes on imported tea, leading to the Sons of Liberty staging the Boston party by dumping some 45 numerous teas into harbor. Many of the key events of the Revolutionary War also occurred in or near Boston, including the Battles of Lexington and Concord and Paul Revere’s ride. The town celebrated when nation evacuated the town in 1776. Boston continued to grow within the 1800s and was the first state within the Union to abolish slavery. Fleeing the Potato Famine, Irish immigrants flooded into Boston, and were later joined by Italian, Eastern European, Chinese and other nationalities. In 1897, the first Boston Marathon was held. Boston entered a period of decline within the 20th century, as older factories were abandoned for contemporary manufacturing facilities and cheaper labor elsewhere.


Ballplayer Babe Ruth was traded to the New York Yankees team in 1918. This led to the Boston Red Sox baseball team not winning the World Series for 86 years. They called it the curse of Bambino. One year later, 21 people died due to a Molasses Flood, when an outsized tank of the sweet sticky stuff exploded in Boston’s North End. In 1942, the Cocoanut Grove Fire killed 492 people, in one all told the deadliest nightclub fires in world history. In 1974, racial violence erupted citywide over court-ordered school busing. The Isabella Stewart Gardner Museum was robbed in 1990 of some its most priceless artworks. In 2013, the Boston Marathon Bombing resulted within the deaths of three spectators. This Boston event impacted many of my friends and their families. Despite these challenges, the town has emerged within the 21st century as a prosperous and cosmopolitan center of technology, education, politics, sports, and medical research, with a population of about 694,583 2018 and 4.7 million within the greater Boston area making it the most populous city in New England.


TheOld State House is a historic building located at the intersection of Washington Street and State Street. It was built in 1713, it was the seat of the Massachusetts General Court until 1798. It is one of the oldest public buildings in the United States.


Windshield Survey

If you talk to a Boston native, Boston is made up of East Boston, Chinatown, Downtown Crossing, West End, Waterfront, Seaport District, South Boston, Dorchester, Mattapan, Roxbury and Jamaica Plain, Hyde Park, Roslindale and Brookline. I will only cover the downtown area for now.. Starting from the heart of the city on Beacon Street, you will see our State House. Across the street from the state you, you can enter in tranquil park called the Boston Commons. A portion of the Freedom Trail is within this park. While walking through this park you will see Frog’s Pound, benches, trees, grass and historic statutes like Paul Revere, representing the history of the city. Depending on the season, you will see photographers capturing couples on Lagoon Bridge in the midst of heavy foot traffic coming and going. Lagoon Bridge is a cute little walking bridge over the pound that connects one side of the park to another. After exploring the Boston Commons, you can choose to leave the park on 4 different main streets. The park boxed in by Tremont Street, Beacon Street, Charles Street cuts across creating two sections of the park, Arlington Street and Boylston Street. If you choose to leave the park from Tremont Street, you’ll be able to explore the downtown crossing area. I would consider this the urban outside shopping hub. In contrary, if you continue to walk down Beacon Street, we’ll arrive at the intersection of Brimmer and Beacon, here you will see the infamous Cheers Pub. While there, you would have passed and continued to see historic brownstone condo’s, brick sided apartments, business buildings, heavy traffic, a bike lane, people walking on sidewalks, subway stations, bus stops and traffic lights. After passing the busy portion of Beacon Street, it turns into more of a city brownstone neighborhood with less chaos. Here is where you will also see permit parking for the residents of the area. Making a left onto Arlington Street (Boston Common street border), one mile down you will come across Newbury Street. This is the high-end shopping strip of Boston. Here you will find store boutiques, ice cream parlors, restaurants, bakeries, and places to pamper yourself. The end of Newbury street is will lead you to Massachusetts Avenue. This is where you will find Berklee College of Music, Boston Magazine, Christian Science Plaza, Mary Baker Eddy Library, Symphony Hall, hotels, café’s, restaurants, construction, and more bus and subway stops. Massachusetts Avenue is about 5.5 miles in length, so staying within the Boston area, we can continue to walk and arrive at the Harvard Bridge (over the Charles River).


Along this path you would have discovered more bikers, runners, rent a bike stations, tour buses. If we decided to make a left onto Boylston Street, where Berklee sits at the corner of Boylston and Massachusetts Ave, we would then see Boston Architectural College and next door one of Boston’s Fire Departments. Continuing down Boylston Street, here you will find more restaurants, hotels, historic churches, shopping stores and the Boston Public Library. On this street is where the prudential center resides. Here in this building you have more shopping opportunities, restaurants, exhibits. You can even buy a car if you choose to. The Prudential Center is also where you could buy a ticket to hop on a Duck Tour trolley and explore all of what Boston has to offer. Stuart Street is parallel to Boylston Street and this is where you can attend a show at the Wang Theatre. Night clubs and Tufts Medical Center sit nearby. As a young kid, I loved driving through the city at night. It made me feel like I had my own version of New York City. As an adult, I still adore this place. It has a little something for everyone and as child of an immigrant, I never felt like my family didn’t belong. People here are warm on the inside and little tough on the outside. This city is home to a population of resilient people.


Population census 2018: 694,583


Population Assessment

Composition/characteristics


Culture

The ethnic composition of the population of Boston, MA is composed of 309k White, 156k Black or African American, 139k Hispanic or Latino, 64.9k Asian,19.4k Two or More Races, 5.51k Other Race, 1.71k American Indian & Alaska Native and 165 Native Hawaiian & Other Pacific Islander. The most common foreign languages spoken in Boston, MA are Spanish 108,761 speakers), Chinese (Incl. Mandarin, Cantonese - 27,839 speakers), and Haitian (26,768 speakers).

  • Language other than English spoken in the home > 5 years old: 38%

  • Foreign born persons 2014-2018: 28.50 %

  • Veterans, 2014-2018: 16,547

  • Marriage Rate: 5.7%

  • Divorce Rate: 2.2%


Education

  • Public schools: 125

  • Private schools: 25

  • Universities & Colleges: 35

  • HS graduate or higher >25 years 2014-18: 86.4%

  • Bachelor’s degree of higher >25 years 2014-2018: 48.5%

Economy/Income/Housing/Poverty

  • Median Age: 32.1

  • Persons in poverty: 20.5%

  • Total health care and social assistance receipts/revenue (2012): 16,734,496

  • In civilian labor force >16 years old (2014-2018): 68.8%

  • In female civilian labor force >16 years old (2014-2018): 66.4%

  • Total unemployment rate 2020: 2.6%

  • Number of Employees: 382,784

  • All firms 2012: 59,268Median gross rent cost 2014-2018: $1,539

Boston, Massachusetts grew from 683,015 to 695,926, a 1.89% increase and its median household income grew from $66,758 to $71,834, a 7.6% increase in 2018. The median property value in Boston, MA is $575,200, and the homeownership rate is 34.1%. Most people in Boston commute.

Health

96.4% of the population of Boston, MA has health coverage, with 51.9% on employee plans, 26.4% on Medicaid, 6.68% on Medicare, 10.9% on non-group plans, and 0.432% on military or VA plans. Persons with a disability under 65 years (2014-2018) is 8.6% and persons without health insurance under 65 years old is 4.2%.

Systems Assessment

Transportation

There are many ways to get around Boston. In 2018, the most common way to travel was driving. 38.5% of the population drive, followed by 32.2% using public transit and 15.4% walk. The mean travel time for workers age 16 and older (2014-2018) is 30.4 minutes.

If you choose to drive, you will be spending $2.017 per gallon to fill your tank. If you choose public transportation, you have a few options. Boston's most popular public transportation options is the subway, commuter rail, water taxis, bus and ferries. These methods are all owned by the Massachusetts Bay Transportation Authority (MBTA). It will cost you $2.75 with a paper ticket to ride the train one way, but if you have a Charlie Card, each ride will be only $2.25. The fare you pay to ride the train includes a free transfer to the buses. If you are riding a train on the commuter rail, it will cost you anywhere from $2.40 to $13.25. If you choose the bus, you would be investing $1.70 for a one-way ride.



Communication

Boston has a few newspapers including the Boston Globe, Metro Boston, Boston Herald, and The Boston Sun. Their local news is WCVB Boston, WHDH and Boston 25.


Recreation/Arts

There are lots of things to do in Boston. There are parks, baseball fields, tennis courts, trails, beaches, museums, theatres and lounges. Emerald Necklace parks are the most popular. Emerald Necklace consists of 1,100-acre chain of nine parks linked by parkways and waterways. It totals about 7 miles. The parks include the Boston common, public garden, commonwealth avenue mall, Back Bay Fens, The Riverway, Olmsted Park, Jamaica Pond, Arnold Arboretum and Franklin Park. The Emerald Necklace stretched from Back Bay to Dorchester. It has invited green space to connect people and nature, just as landscape architect Frederick Law Olmsted intended when he designed it more than 100 years ago.

This space offers quiet time on a shaded bench and activities like sailing, hiking, and golf. With an arboretum and a zoo, the Emerald Necklace has a little something for anyone. Boston is also home to the Boston Opera House, Charles Playhouse, Cutler Majestic Theatre, Colonial theatre, Modern theatre, Orpheum theatre, paramount theatre, and the lyric stage company of Boston. Boston has a variety of entertainment from comedy, plays, poetry and concerts. The most visited museums by both locals and tourists include The Museum of Fine Arts, The Museum of Science, Boston Aquarium, Boston Children’s museum, The Institute of Contemporary art, Museum of African American History, New England Holocaust Memorial and John F Kennedy Presidential Museum.



Political/Government

The Mayor of Boston is Martin Walsh. He was sworn in as the City’s 54th Mayor on January 6, 2014. He has helped strengthen Boston’s schools, increased funding to extended learning time and advanced curriculum at more schools, and secured tuition-free community college for Boston Public Schools graduates. The city has also upgraded their digital infrastructure. The agenda for the city has been focused on promoting racial and economic equity while supporting at-risk groups such as immigrants and the elderly. In 2017, Walsh and the Boston City Council joined other cities by designating Boston as a sanctuary city in opposition of President Donald Trump’s immigration policies. Future plans include goals to reduce congestion and make Boston totally carbon-free by 2050.


Religion

The city of Boston at one point was the center of Catholicism. Currently, the city has religious diversity. Of 62.84% of the people in Boston who said they were religious, affiliating with a religion, 48.22% are Catholic; 0.50% are LDS; 4.86% are protestant Christian, 0.71% are Jewish, 1.02% are from an eastern-based faith and 1.09% are followers of Islam.

Health Care Resources

Boston is home to healthcare innovations. They were first to discover the vaccine for smallpox, the first to use anesthesia back in 1846, the first to do fertilization of an ovum in a test tube and the first to successfully transplant a human organ. For newer advances, Boston now has new techniques to grow human skin to treat burn victims along with numerous cancer innovations. There are 25 acute care hospitals in Boston. This city is known for healthcare and research. Some of the top-ranking hospitals in the country include Mass General, Boston Children’s Hospital, and Brigham and Women’s Hospital. Boston also has specialty institutions like Arbour Hospital for psychiatric care and Jewish Memorial Hospital for long-term care. There are dozens of smaller community and specialty hospitals that lie within miles of the city’s best. Mass General was rated the number two hospital in the country and ranked nationally in 16 adult and 4 pediatric specialties. Brigham and Women’s was ranked nationally in 12 adult categories, while Children’s Hospital was rated the best pediatric hospital in the country. The Dana-Farber Cancer Institute, Beth Israel Deaconess Medical Center and Spaulding Rehabilitation Hospital also received top rankings.


Massachusetts has more people covered by health insurance, a lower obesity rate and more mental health care than other states. Smoking among adults is has decreased in the last five years, from 18% to 13.6%. Cancer deaths have dropped 4% over the same period. Two leading causes of death in Boston is cancer and heart disease. In 2015, they were followed by accidents, cerebrovascular diseases, and chronic lower respiratory diseases. In 2015, unintentional opioid overdose mortality accounted for 54% of deaths due to accidents. The increase in opioid abuse has been a major issue for Boston. Drug deaths increased 87% from 15.7 to 29.3 deaths per 100,000 in the last three years. There is also a high rate of preventable hospitalizations. In 2014, the state declared an opioid epidemic to be a public health emergency and now issues a standing order prescription for residents to purchase naloxone at any pharmacy.Average life expectancy at birth for a Boston resident was 80 years old. For females it was 82.8 years old and 77 years old for males the male residents. Looking at race, life expectancy is 86.9 years old for Asian residents, 77.6 years old for Black residents, 83.3 years old for Latino residents, and 79.5 years old for White residents.

  • 1 Urgent Care

  • 10 OT clinics

  • 25 acute care hospitals

  • 17 PT clinics

  • 18 dentists

  • 10 EMS

  • 18 Women’s Health facilities

  • 20 fitness facilities

  • 16 Holistic Medicine

Community Strengths

Boston is “strong”. Boston has tremendous assets in arts and culture, including vibrant theaters, landmark historic architecture, compelling public art, and award-winning artists and playwrights. It is home to more than 1,500 nonprofit arts and culture organizations, giving it one of the highest per capita concentrations of such groups among major American metropolitan areas. From renowned anchor institutions with many layers of programs and activities, to small organizations often serving specific neighborhoods and communities, these organizations play a central role in Boston’s creative life. Boston is also a place where arts education thrives. Artists come to learn and train in the city’s prominent art and music schools. Boston is successful in quality education, including in the arts, in schools across the district. Additional strengths of Boston include, that it is a walking city. There are 21 different communities and counting, and crime rate had a 5.4% decline from 2016. Boston has great parks, amenities, restaurants, great school districts, winning sport teams, great hospitals, amazing colleges and universities, entertainment and night life.



Nursing Diagnosis

Health problem of Opioid Abuse or risk of Opioid Overdose Among the population of Boston, Massachusetts Related to/ adduction, mental health, knowledge deficient and easy access to opioids As manifested by an 87% increase in drug deaths and preventable hospitalizations.




References

https://www.history.com/topics/us-states/boston-massachusetts

https://www.ranker.com/list/famous-boston-latin-school-alumni-and-students/reference

https://www.census.gov/quickfacts/fact/table/bostoncitymassachusetts/PST045218#PST045218

http://www.bostonplans.org/getattachment/1770c181-7878-47ab-892f-84baca828bf3

https://datausa.io/profile/geo/boston-ma#demographics

https://www.mbta.com/fares

https://www.emeraldnecklace.org/park-overview/

https://www.boston.gov/departments/mayors-office/martin-j-walsh

http://convention.myacpa.org/boston2019/inclusion/faith-spirituality-religion/

https://www.bostonmagazine.com/sponsor-content/top-reasons-why-boston-is-the-leader-in-medical-care/

https://harvardmagazine.com/2012/11/boston-hospitals

https://www.bphc.org/healthdata/health-of-boston-report/Documents/18_C15_Death_16-17_HOB_final-19.pdf

https://www.boston.gov/departments/arts-and-culture/boston-creates-strengths-challenges-opportunities

https://www.americashealthrankings.org/explore/annual/measure/CHD/state/MA

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