A Study of Public Health in North Dorchester

Dorchester is a neighborhood that is situated in the most southeast portion of Boston. Its neighboring neighbors include South Boston, Roxbury, Jamaica Plain, Roslindale, Hyde Park, and Mattapan. Instead of focusing on Dorchester as a whole, my focus will be primarily on North Dorchester. North Dorchester is a neighborhood with lots of residential buildings, but there are four major institutions that also reside in this neighborhood.

These include the John F. Kennedy Presidential Library and Museum, Edward M. Kennedy Institute, the Massachusetts Archives, and the University of Massachusetts, Boston (Boston Public Health Commission 177). What this analysis will cover is the demographics, overall health, and significant social determinants of health within North Dorchester as well as potential interventions and policies that will improve the health quality of this neighborhood.

In the Boston Public Health Commission report from 2012-2013, the population of North Dorchester is not provided in the report. However, we do see statistics of the population in 2010 by age group by gender. For both males and females, the age group that shows majority are those aged 25 to 44. According to the Boston Public Health Commission report, males in this age group occupy 29% of the male population by age group whereas females in the same age group occupy 30% (Boston Public Health Commission 178). Since this age group is the majority of people who reside in North Dorchester, we can probably tell that these residents are working class people. The rest of the population in North Dorchester, 70% for females and 69% for males, have residents either newborns to age 24 or aged 45 and over.

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In terms of households in North Dorchester, it explains the type of households in this neighborhood as well as the income levels that residents earn. In the census 2010, as provided by the Boston Public Health Commission report in 2012-2013, the type of household 65% of the residents in this neighborhood are family households while the remaining 35% of residents are in a non-family household (Boston Public Health Commission 179). This shows that the majority of residents are families who live in this neighborhood. However, that does not mean to say that the remaining 35% are not in a family.

This could mean that the 35% of nonfamily households could be renting out apartments in this neighborhood. These people who rent out apartments could be living alone or with other people. Based on the types of people who live in these apartments, the income levels present an image to the overall health in North Dorchester.

Just as important as looking at what types of people live in North Dorchester is the incomes that these residents earn. The incomes earned by residents actually are determinants of the outcomes of their overall health. According to the Boston Public Health Commission report, the data shown for female headed households with children under 18 years old are 47% when compared to all families whom reside in this neighborhood (Boston Public Health Commission 179). This big of a percentage shows that there is a lot of income problems that these women face to make ends meet, not only for paying the bills and getting food, but also to make sure their children have a more successful life then themselves.

Living below the poverty level really poses that problem which is why a lot of this family type struggle to live on a day to day basis. When compared to the percentage of all families that have incomes below poverty level (26% of families), it is seen that the majority of them have higher incomes, which results in a better outcome than female headed households with children under the age of 18 years old.

In North Dorchester, the vast majority of land is occupied by residential buildings. These residential buildings vary from single and multifamily houses to apartment complexes. The housing tenure in North Dorchester, as provided by the Boston Public Health Commission, shows that 69% of the housing in 2010 is renter occupied while the remaining 31% are actually owner-occupied (Boston Public Health Commission 180). This tells us that the majority of the residents who live in North Dorchester are renters of the units occupied in the housing sector. This does have some relation to the statistic from earlier that 35% of the people who reside in North Dorchester are nonfamily households.

Out of those 35% of people, those renters either live alone or share a larger unit with a few other people and split the rent to save some money on the total rent for other life necessities. With that said, there is a link between the residents in North Dorchester and the education level that residents receive.

In any neighborhood, the level of education one person gets determines the outcomes he or she goes through after they receive their accreditation. North Dorchester is no different than any other neighborhood in that scenario. What Boston Public Health Commission found in their 2012-2013 report was that only 21% of people earned a Bachelor's degree or higher while a quarter of the population earned below a high school diploma (Boston Public Health Commission 180).

Due to the large number of people not receiving their high school diploma, it seems like that their education level puts them at a disadvantage in terms of getting a higher income, let alone a job with below poverty wages. The lower the education level, the less the income levels one will potentially get. The higher the education level, the better chances a person will get to having a better job with a better income. Depending on the education level that is proportional to the income levels, this can affect the overall health of a person.

In any neighborhood, city, or town, the health of one place can portray an image as to the personality of the area. The overall health of North Dorchester presents itself as unhealthy compared to Boston as a whole. While a lot of health indicators prove that statistic, the health issues that make North Dorchester unhealthy are cardiovascular disease, hepatitis C incidence, homicide, asthma emergency visits, and chlamydia incidence (Boston Public Health Commission 181).

A lot of these health issues, especially those mentioned earlier, have a high gap in North Dorchester's numbers when put them side by side with Boston's numbers. For cases like cardiovascular disease and homicide, this shows that people who live in North Dorchester are much more stressed than those in Boston as a whole, which is why the numbers for cardiovascular disease and homicide are so high. Even though North Dorchester as a whole is unhealthy, there has to be even more disparities when taking a look at race and ethnicity.

No matter where one person lives, there are always health disparities that have a link to race, and North Dorchester is no exception. As a melting pot of different races, there has to be some differences in the health between each race. In the case of North Dorchester, we see that Blacks and Latinos have a higher number of health issues than Whites and Asians (Boston Public Health Commission 184). Since Blacks and Latino have a lot more complications at higher rates, there must be something going on with the way that these two races are treated. It might be the fact that these two races are discriminated more often. More discrimination leads to lots of stress on them, which is why we see a huger number of heart disease hospitalizations, and adolescent birth rate for both Blacks and Latinos.

One of the most significant social determinants of health in North Dorchester is the lack of community gatherings. When taking a look at the map of North Dorchester, there are only two community centers and no boys and girls clubs (Boston Public Health Commission 177). Without these sorts of institutions for community gathering locations, this creates health problems for residents. In other words, people who have more stress about one, or even multiple things in their lives will have a hard time finding healthy ways to mitigate the things in life that are bothering them.

Also, North Dorchester has no boys and girls club, and the lack of one means that there is no place for kids in this neighborhood to thrive. This creates problems for kids to not be able to grow up with necessary skills to function in society since their parents, let alone their single parent, are so busy trying to make ends meet for the family.

Another significant social determinant of health in North Dorchester is the environment. While this neighborhood is part of the city of Boston, North Dorchester does not have some things that make it a safe and healthy environment. The environment that residents live in must be safe and healthy for their mental and emotional health.

According to Alison Abbot's conversation with Jim van Os, he brought up that "as we know that the brain interacts with the environment, nothing about mental health will become clear unless we can look at the environment' [Jim van Os] says" (Abbot 3). Basically, the environment one resides in is a determinant of a person's health. If an environment lacks green space, such as parks, playgrounds, and trees in the neighborhood as well as bike paths and sidewalks, a person's health will be poorer than a neighborhood with more of these environmental institutions.

If we take a look at any neighborhood in Boston, the kind of environment they have and how many of them there are can present an image of how healthy that neighborhood is. In the case of North Dorchester's case, there are very few open spaces, parks and playgrounds, bike paths, and even no public gardens (Boston Public Health Commission 177). With the lack of these environments, the residents of North Dorchester are less likely to reduce their stress. Also, that is the reason why there are higher rates of health issues. With that said, there are possible programs that will improve overall health of North Dorchester.

One possible program that I think can improve overall health in North Dorchester include implementing more green spaces. Even though we are in the city of Boston, there needs to be more parks, public gardens, and playgrounds. This way, people who reside in this neighborhood can go outside and/or exercise. When people are exposed to these kinds of environments, they

are more or so likely to feel calmer because of the different sense coming into play. From the sights of nature to the sounds of leaves and the grass blades moving in the wind really creates a very therapeutic atmosphere, hence the result of that very relaxed feeling. When people feel relaxed, they tend to feel happier and that will hopefully reduce the numbers in terms of the health issues that North Dorchester faces.

Finally, another program that I think will improve the overall health is bringing more community institutions. If we can transform the vacant spaces in North Dorchester into community centers or boys and girls clubs, we can get more people to come together to mingle around and make friends. By making friends, we have people to talk to, especially in times of stress. This is a form of social support because by supporting one another, we help other people by talking things out about issues each person faces. The social support can help reduce stress because of having our friends to talk to no matter how we feel. As for the boys and girls club, they can also make friends and be able to develop the necessary life skills to thrive in an ever changing world. This is why creating more institutions that involve community gathering is so important to improve overall health in North Dorchester.

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