1. Community Health Assessment 2012

2. Chelsea Health Indicators Updated August 2012 (in process)

3. Table of Contents IndicatorSlide Number Map4 Demographics5-9 Economic Factors Education11-15 Employment and Income16-18 Health Outcomes Morbidity and Mortality20-29 Health Behaviors Tobacco Use31-32 Diet and Exercise33-34 Alcohol Use41-45 Other Drug Use46-61 Sexual Activity62-76 Mental Health77-81 Clinical Care Access to Care83-88 Quality of Care89-96 Cancer97-110 Maternal and Infant Health 111-114 Social Factors Family and Social Support 115-117 Community Safety118-132 Physical Environment Environmental Quality134-151 Built Environment152 Qualitative Data153-157 Conclusion158

4. Map of Chelsea

5. DEMOGRAPHICS

6. Population by Race/Ethnicity: Over Half Latino 2010 Census  Total Population in 2010: 35,177 – 0.27% increase from 2000; 22.5% increase from 2010  Population Density very high**: 17,540 persons per square mile (MA rate: 812) *Source: MA Department of Education 2010-2011 **Source: 2005 Regional Epidemiologic Services Health Data Watch Supplement, prepared for Chelsea HHS 81.3% of Chelsea Public School Students are Latino*

7. Population by Race 2010 Census Data Total Population in 2010: 35,177 – 0.28% increase from 2000 Chart does not include Hispanic/Latino Population Hispanic or Latino Population in 2010: 21,855 (62.1% of Total Population) –Up from 28.3% of total population in 2000

8. Foreign-Born Residents by Place of Birth: Most from Latin America 2000 Census  36.1% total foreign born (triple 12.1% state rate)  58.4% speak language other than English at home (triple 18.7% state rate)  43.8% of total population age 5 and older speak Spanish (43.8% Spanish; 9.1% Indo-European Languages; 3.8% Asian/Pacific Islander languages)  30.8% of total population age 5 and older speak English “less than very well”

9. Population by Age Group Cities in Boston Region and Massachusetts: 2010 Chelsea Generally Young compared to surrounding communities AgesCity of Boston ChelseaEverettLynnRevereMA Total 0-19 years 22%28%25%28%23%25% 20-24 years 14%8%7%8%7% 25-44 years 33%35%32%28%31%27% 45-64 years 20% 24%25% 28% 65+ years 10%9%12%11%15%14% Source: 2010 Census

10. SOCIAL AND ECONMIC FACTORS

11. Education Graduation Rates, Educational Attainment, Population Breakdowns

12. Educational Attainment 2007-2011 American Community Survey (US Census Bureau) *Given for those ages 25 and older. American Community Survey 5 year estimates

13. Chelsea School Indicators Compared to State 2011-2012 MA Dept. of Education *Retention Rate is the percentage of enrolled students who were repeating the grade in which they were enrolled the previous year. Source: Massachusetts Department of Education.

14. Chelsea School District Cohort 2011 Graduation Rates Plans of High School Graduates: 2010-2011* *Source: 2010-2011 MA Department of Elementary and Secondary Education

15. Chelsea Public Schools New Student Origins - 2011 Chelsea Public Schools had 155 new immigrant students representing 24 different countries including: El Salvador (55) Honduras (16) Puerto Rico (15) Guatemala (14) Santo Domingo (12) Sudan (5) Cape Verde (5) Source: Chelsea Public Schools – New Student Data 2011 Calendar Year

16. Public School Enrollment Over Time 2001-2012* *Dates represent the ending year of the academic calendar. Source: Massachusetts Department of Elementary and Secondary Education

17. Employment and Income Poverty Rates, Unemployment Rates, Temporary Aid

18. High Poverty & Unemployment 2007-2010 American Community Survey, US Census Bureau  Chelsea’s very low per capita income ($14,628) ranks Chelsea 349 th out of all 351 Massachusetts municipalities (2000 Census)  The median household income for Chelsea is $40,487 compared to the statewide median household income of $64,509. (2010 5-Year ACS) * 2011 Unemployment Rate, Massachusetts Labor and Workforce Development.

19. Source: 2010 American Communities Survey (3-year Estimate), US Census Bureau *Source: 2011 Labor and Workforce Development, Massachusetts. City of Boston ChelseaEverettLynnRevereMA Total Per Capita Income $32,261$18,630$23,066$21,764$23,346$33,969 Those living below 100% poverty 21.1%25.6%13.2%19.5%16.6%10.8% Less than a High School Education 15.5%36.3%23.1%21.7%22.5%11.1% Speak language other than English at home 35.5%70.1%47.8%40.9%45.0%21.5% Foreign born 26.7%46.1%38.2%28.5%32.3%14.8% Percent Unemployed (2011)* 7.1%9.6%7.5%8.4%8.3%7.4% Socio-Demographic Indicators Cities in Boston Region and Massachusetts: 2010

20. HEALTH OUTCOMES

21. Mortality and Morbidity Morality Rates by Disease, Level of Health, Low Birth Weight Births

22. Mortality: Overall & Chronic Disease Higher than State for Heart Disease, Stroke and Diabetes 2006-2010 Vital Records Source: MassCHIP, Mortality (Vital records) Accessed: 6/19/13

23. Overall Mortality 2000-2010* *Source: Mass Dept. of Public Health MassCHIP database (Vital Records) Accessed: 6/18/13

24. Cancer Mortality Rates 2000-2010* *Source: Mass Dept. of Public Health MassCHIP database (Vital Records) Accessed: 8/25/12, 6/19/13

25. Heart Disease Mortality Rates 2000-2010* *Source: Mass Dept. of Public Health MassCHIP database (Vital Records) Accessed: 8/25/12, 6/19/13

26. Diabetes Mortality Rates 2000-2010* *Source: Mass Dept. of Public Health MassCHIP database (Vital Records) Accessed: 8/25/12, 6/19/13

27. Health Status Poor (self-reported) 2008 BRFSS* *Source: 2008 Five-City Behavioral Risk Factor Surveillance (BRFSS) Survey (501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008)

28. Level of Health (self-reported) 2012 Quality of Life Survey Source: Chelsea 2012 Quality of Life Survey. Survey sample of 959 respondents represents a more White, educated, female perspective and is not representative of the community at large.

29. Low Birth Weight Births High for Blacks and Whites 2009 Vital Records*  Very low birth weight births high: 2.4% Chelsea rate (vs. 1.4% statewide) (2007)** *Source: MassCHIP Perinatal Report for Chelsea, Vital Records (2009) **Very low birth weight births defined as births 1500g or 3lbs, 5 oz., % by birth weight. Source: MassCHIP Vital Records (2007)

30. Low Birth Weight Births 2000-2009 Vital Records* *Source: Mass Dept. of Public Health MassCHIP database (Vital Records) Date accessed: 5/30/13 Low birth weight is defined as an infant with a birth weight of less than 2500 grams (5 lb 8 oz) Calculated by percent by birthweight in grams

31. HEALTH BEHAVIORS

32. Diet & Exercise Obesity Indicators, Physical Activity, Fruit & Vegetable Consumption

33. Obesity-Related Indicators (Self-Reported) 2008 BRFSS* 78.4% of these respondents currently on blood pressure medications 45.4% of these respondents currently on cholesterol medications *501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008 **Source: MassCHIP, UHDDS Hospital Discharges, 2006 28.5% of these respondents currently taking insulin  High obesity hospitalization rate**: 67.8 (age-adjusted per 100,000) (state rate 48.3) (2006) MA Data not available

34. Overweight or Obese Students Chelsea Public Schools 2010 *Chelsea Public Schools Nurses Data, 2010 34.3% of MA students are overweight or obese 19% of MA children ages 6-11 are overweight or obese

35. Physical Activity (Self-Reported) 2008 BRFSS* *501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008 **Moderate Physical Activity Recommendations: 30 min/day, 5+ days/week ***Vigorous Physical Activity Recommendations: 20 min/day, 3+ days/week

36. Chelsea High School YRBS: Fitness and Wellness 2009-2011 YRBS Chelsea YRBS High School Data from 2005-2011 (Grades 9-12, In 2011 1,078 completed surveys of students with parental permission )

37. Frequency of Physical Activity in a Typical Week 2012 Quality of Life Survey* Physical activity consists of exercising for at least 30 minutes or more (such as running, swimming, gardening, walking) *Source: Chelsea 2012 Quality of Life Survey. Survey sample of 959 respondents represents a more White, educated, female perspective and is not representative of the community at large.

38. Fruit and Vegetable Consumption 2012 Quality of Life Survey* *Source: Chelsea 2012 Quality of Life Survey. Survey sample of 959 respondents represents a more White, educated, female perspective and is not representative of the community at large. **Fruit consumption question: “During the past 7 days, how many times did you eat fruit or drink 100% fruit juices? (Do not count punch, Kool- Aid, sports drinks, or other fruit-flavored drinks.)” / ***Vegetable consumption question: “During the past 7 days, how many times did you eat other vegetables such as carrots, peas, broccoli, green salad, etc? (Do not count potatoes)”

39. WIC Nutrition Program Participation High Percentage of Child Participants in Chelsea 2007* *Source: MassCHIP WIC Program Utilization, 2007. Chelsea ParticipationMassachusetts Participation Participants

40. Tobacco Use Current, Lifetime, Age of Onset

41. Smoking Rates (Self-Reported) 2008 BRFSS* *501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008  During the past year:  64.5% of current smokers trying to quit  63.8% of current smokers advised not to smoke by healthcare professional

42. Alcohol Use Current, Lifetime, and Excessive Drinking, Parental Perception

43. Chelsea High School YRBS: Alcohol & Driving 2005-2007-2009-2011 YRBS Source: Chelsea YRBS High School Data from 2005-2011 (Grades 9-12, In 2011, 1,078 completed surveys of students with parental permission)

44. Substance Use Rates (Self-Reported) 2008 BRFSS* *Source: 501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008 **Binge Drinking defined as: 5 or more drinks (male) and 4 or more drinks (female) at one time ***Other Drugs defined as: powder cocaine; crack cocaine; heroin; methamphetamine; Hallucinogens; MDMA/Ecstasy; Other Of these respondents: 38.0% had engaged in binge drinking** in past 30 days Amongst these respondents, top three drugs ever used were: Powder Cocaine (71.7%); Hallucinogens (32.1%), Heroin (24.5%)

45. Substance Use Rates (self-reported) 2012 Quality of Life Survey* *Source: Chelsea 2012 Quality of Life Survey. Survey sample of 959 respondents represents a more White, educated, female perspective and is not representative of the community at large.

46. Chelsea High School YRBS: High Alcohol & Gateway Drug Use 2005-2007-2009-2011 YRBS** *Binge Drinking defined as drinking 5 or more alcoholic beverages in one night in past 30 days Chelsea YRBS High School Data from 2005-2011 (Grades 9-12, In 2011, 1,078 completed surveys of students with parental permission) **Methods of the Chelsea YRBS have changed, the most reliable data available is from 2011.

47. Other Drug Use Age of Onset, Treatment Admissions, Overdoses, Hospitalizations

48. Age of Onset of Other Drug Use* 2008 BRFSS (self-reported)** *Given as age of onset for those who had ever used un-prescribed illegal drugs, pain killers, sedatives, or tranquilizers (n=171) **501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008

49. Chelsea High School YRBS: Other Drug Use 2005-2007 YRBS Chelsea YRBS High School Data from 2005-2007 (Grades 9-12, In 2007, 406 completed surveys of students with parental permission)

50. Substance Abuse Admissions Crude rates of 3238.2 in Boston, 2889.1 in Revere, 2239.9 in Everett *Source: MassCHIP CHNA Health Status Indicators Report for Chelsea – 2010 BSAS

51. Admission to DPH Treatment Programs 2000-2010* *Source: MassCHIP CHNA Health Status Indicators Report for Chelsea – 2010 BSAS Accessed: 8/29/12

52. IDU Admission to DPH Treatment Programs 2000-2010* *Source: MassCHIP CHNA Health Status Indicators Report for Chelsea 2000 – 2010 BSAS Date accessed: 8/29/12

53. Substance Abuse Treatment Admissions: Primary Substances 2010* Source: MassCHIP, Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2010.  651 total admissions to treatment programs in 2010

54. Source: MassCHIP, Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2010. Substance Abuse Treatments – Alcohol Primary Substance Cities in Boston Region & Massachusetts: 2010

55. Substance Abuse Treatments – Alcohol Primary Substance 2000-2010* *Source: MassCHIP, Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2000-2010. Accessed: 8/29/12

56. Substance Abuse Treatments – Heroin Primary Substance 2000-2010* *Source: MassCHIP, Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2000-2010. Accessed: 8/29/12

57. Substance Abuse Admissions by Primary Substance 2010 Source: MassCHIP, Substance Abuse (BSAS) DPH Funded Program Utilization (2010)

58. Substance Abuse Treatments – Heroin Primary Substance Cities in Boston Region & Massachusetts: 2010 Source: MassCHIP, Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2010.

59. Substance Abuse Hospitalizations: Alcohol/Substance-Related & Opioid-Related High 2009 Source: MassCHIP, Hospital Discharges (UHDDS), 2009.  Opioid-Related Hospitalization in Chelsea up from 277.1 in 2006; MA (267.2 in 2006).

60. Alcohol/Substance Related Hospitalizations 2000-2010* *Source: MassCHIP, Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2000-2010. Accessed: 8/29/12

61. Opioid Related Hospitalizations 2000-2010* *Source: MassCHIP, Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2000-2010. Date accessed: 8/29/12

62. Opioid-Related Fatal Overdoses Cities in Boston Region & Massachusetts: 2006-2010 Age-adjusted to the 2000 US standard population. Source: MassCHIP, Mortality (Vital Records), 2006-20010 Accessed: 6/19/13

63. Sexual Activity Sexually Transmitted Infections, Teen Birth Rates

64. Chelsea High School YRBS: Sexual Activity 2005-2007-2009-2011 YRBS Chelsea YRBS High School Data from 2005-2011 (Grades 9-12, In 2011 1,078 completed surveys of students with parental permission )

65. Teen* Pregnancy Rates High: 3 rd Highest Rate in the State** 2006-2009 Vital Records *Women, ages 15 – 19 years **Source: MA Alliance on Teen Pregnancy (2009) ***Source: MassCHIP Perinatal Report for Chelsea, Vital Records (2008)  For 2008: Percent of births to adolescent mothers higher than state rates for Whites and Blacks - lower for Latinas***  Whites: 8.5% of Chelsea adolescent births (3.9% statewide)  Blacks: 11.7% of Chelsea adolescent births (8.9% statewide)  Latinas: 14.4% of Chelsea adolescent births (15.6% statewide)

66. Comparison of Teen Birth Rates Across Communities: Cities in Boston Region & Massachusetts: 2007-2009 Source: Births 2007-2009, Vital Records, MassCHIP Teen birth rates are number of births to women ages 15-19 per 1000 females ages 15-19.

67. Teen Birth Rates 2000-2010* *Source: Teen Births (age 15-19) 2000-2009, Vital Records, MassCHIP Accessed: 8/29/12, 6/19/13

68. HIV/AIDS Rates: High Compared to State  201 cumulative AIDS cases in 2006**  2 HIV/AIDS related deaths in 2006**  52.3% ages 18 and older have ever been tested for HIV (self-reported, 2008 BRFSS****) *2007-2009 Incidence Source: MA HIV/AIDS Surveillance Program (by request: March 2011) **Source: 2006 AIDS Surveillance Program ***2005 Regional Epidemiological Services Health Data Watch Supplement, prepared for Chelsea HHS ****501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008 Persons Living with AIDSHIV/AIDS Incidence & New Cases

69. HIV Incidence Rates 2000-2009* *MassCHIP HIV/AIDS Program BCDC Files 2000-2009 Accessed: 8/29/12

70. HIV Prevalence Rates 2000-2009* *MassCHIP HIV/AIDS Program BCDC Files 2000-2009 Accessed: 8/29/12

71. Other Infectious Diseases: High Hepatitis B & Tuberculosis Rates Source: MassCHIP, Epidemiology Program 2006 and 2007. -Cannot combine TB rates by year, 2007 rate = 14.7, Ma=3.5.

72. Tuberculosis Prevalence Rates 2005-2008* *MassCHIP HIV/AIDS Program BCDC Files 2000-2009 Accessed: 8/29/12

73. High STD Rates: Especially for Chlamydia, amongst teens 2007-2009: 3-year Incidence Rates  In 2006: Chlamydia age- specific rate for 15-19 year olds at 2563.7 – two and a half times state rate of 1079.6 Source: MA DPH Division of Sexually Transmitted Disease Prevention – by Request March 2011

74. Chlamydia *Source: MA DPH Division of Sexually Transmitted Disease Prevention – by Request March 2011 **Source: MassCHIP, Sexually Transmitted Disease Program (2010)

75. Gonorrhea *Source: MA DPH Division of Sexually Transmitted Disease Prevention – by Request March 2011 **Source: MassCHIP, Sexually Transmitted Disease Program (2010)

76. Syphilis *Source: MA DPH Division of Sexually Transmitted Disease Prevention – by Request March 2011 **Source: MassCHIP, Sexually Transmitted Disease Program (2010)

77. STD Incidence Rates 2000-2010* Source: MassCHIP, Sexually Transmitted Disease Program 2000-2010

78. Mental Health Depression Rates, Services Needed

79. Mental Disorders High, Suicides Low *Source: MassCHIP, 2006 Hospital Discharges (UHDDS) & Vital Records 2006-2007  High Mental Disorder hospitalization rate (2007-2009*)  Chelsea rate: 1251.61 (age-adjusted, per 100,000)  State rate 779.7  High Mental Disorder death rate (2006-2008*)  Chelsea rate: 55.74 (age-adjusted, per 100,000)  State rate 36.69  Suicide rate low compared to state (2006-2008*)  Chelsea rate of 4.4 (age-adjusted, per 100,000)  State rate 7.06

80. Mental Health (self-reported) Depressed Feelings High 2008 BRFSS*  3.4% of surveyed respondents reported being unable to afford needed mental health care or counseling *Source: 2008 Five-City Behavioral Risk Factor Surveillance (BRFSS) Survey (501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008)

81. Mental Health Services Needed in Past Year 2012 Quality of Life Survey* 13.5% of respondents reported feeling sad or hopeless almost everyday for 2 weeks or more in a row that they stopped doing usual activities 41% were unable to get mental health services if they were needed Source: Chelsea 2012 Quality of Life Survey. Survey sample of 959 respondents represents a more White, educated, female perspective and is not representative of the community at large.

82. Chelsea High School YRBS: Depression & Suicide 2005-2007-2009-2011 YRBS Chelsea YRBS High School Data from 2005-2011 (Grades 9-12, In 2011, 1,078 completed surveys of students with parental permission )

83. CLINICAL CARE

84. Access to Care Insurance Coverage, Utilization

85. Health Care Coverage (self-reported) Medicaid & Medicare Coverage/Uninsurance High 2008 BRFSS* *Source: 2008 Five-City Behavioral Risk Factor Surveillance (BRFSS) Survey (501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008)  State rate of coverage: 92.8%  State uninsurance rate: 7.2%

86. Health Care Utilization (self-reported) High Community Health Center Utilization 2008 BRFSS* *Source: 2008 Five-City Behavioral Risk Factor Surveillance (BRFSS) Survey (501 Chelsea residents contacted between 1/25/08 and 5/27/08) **Place of last routine checkup given for those who had one within past 5 years  During past year, 19.8% of adults reported needing medical care but being unable to afford it. Of these:  42.5% were unable to afford a needed doctor’s appointment  43.5% were unable to afford needed prescription medications Time Since Last Routine CheckupPlace of Last Routine Checkup**

87. Percent Able to Receive Needed Medical Care 2012 Quality of Life Survey Source: Chelsea 2012 Quality of Life Survey. Survey sample of 959 respondents represents a more White, educated, female perspective and is not representative of the community at large.

88. Where Chelsea Survey Respondents Receive Routine Health Care 2012 Quality of Life Survey Source: Chelsea 2012 Quality of Life Survey. Survey sample of 959 respondents represents a more White, educated, female perspective and is not representative of the community at large.

89. Last Time Survey Respondents Received Dental Care or Eye Exam 2012 Quality of Life Survey Source: Chelsea 2012 Quality of Life Survey. Survey sample of 959 respondents represents a more White, educated, female perspective and is not representative of the community at large.

90. Quality of Care Cancer Screenings, Hospitalization Rates, Maternal & Infant Health

91. Chronic Disease Hospitalization 2007-2009 Vital Records Source: MassCHIP, Incidence (Vital records)

92. Heart & Lung Disease High Hospitalization Rates 2007-2009* *Source: MassCHIP Hospital Discharges (UHDDS) (2007-2009)

93. Heart Disease Hospitalization Rates 2000-2009* *Source: MassCHIP Hospital Discharges (UHDDS) (2000-2009) Date accessed: 8/29/12

94. COPD Hospitalization Rates 2000-2009* *Source: MassCHIP Hospital Discharges (UHDDS) (2000-2009) Date accessed: 8/29/12

95. High Preventable Hospitalization* Rates 2005-2008** *There are 24 “preventable hospitalization” illnesses, including: angina, asthma, bacterial pneumonia, chronic obstructive pulmonary disease, congestive heart failure, and diabetes. **Source: Partners Community Benefit Report (

96. Preventable Hospitalization Rates 1999-2009* Angina, Asthma and Bacterial Pneumonia are considered potentially preventable conditions. Source: MassCHIP Uniform Hospital Discharge Dataset System Date accessed: 8/29/12

97. Oral Health 2008 BRFSS* *501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008 **Permanent Tooth Removal due to tooth decay or gum disease 78.1% statewide In 2008, 12% of surveyed respondents reported being unable to afford needed dental care (including checkups)

98. Cancer Screenings, Mortality & Incidence Rates

99. Cancer Incidence & Mortality: Chelsea vs. Mass. Mortality rates are aggregate age-adjusted rates for 2006-2008 (Vital Records) Incidence rates are aggregate age-adjusted rates for 2003-2007(Vital Records)

100. Breast Cancer Incidence & Mortality Amongst Females 2000-2008* *Source: MassCHIP Cancer Registry Date accessed: 8/29/12

101. Comparison of Breast Cancer Mortality Across Communities: Cities in Boston Region & Massachusetts, 2006-2008 Source: Mass Chip, Mortality (Vital Records) 2006-2008 Age-adjusted to the 2000 US standard population

102. Colorectal Cancer Mortality by Gender / Race Mortality rates are aggregate age-adjusted rates for 2006-2008 (Vital Records) Incidence rates are aggregate age-adjusted rates for 2003-2007(Vital Records)

103. Colorectal Cancer Incidence & Mortality 2000-2008* *Source: MassCHIP Cancer Registry Date accessed: 8/29/12

104. Comparison of Colorectal Cancer Mortality Across Communities: Cities in Boston Region & Massachusetts, 2006-2008 Source: Mass Chip, Mortality (Vital Records) 2006-2008 Age-adjusted to the 2000 US standard population

105. Lung Cancer Incidence & Mortality 2000-2008* *Source: MassCHIP Cancer Registry Date accessed: 8/29/12

106. Comparison of Lung Cancer Mortality Across Communities: Cities in Boston Region & Massachusetts, 2006-2008 Source: Mass Chip, Mortality (Vital Records) 2006-2008 Age-adjusted to the 2000 US standard population

107. Comparison of Cervical Cancer Mortality Across Communities: Cities in Boston Region & Massachusetts, 2006-2008 Source: Mass Chip, Mortality (Vital Records) 2006-2008 Age-adjusted to the 2000 US standard population

108. Cancer Incidence & Mortality Amongst Females Cervical Cancer: High Incidence and Mortality Incidence rates 2003-2007; Mortality rates 2006-2008 Source: MassCHIP, Cancer Registry (2003-2007) and Vital Records (2006-2008)  Chelsea female Lung cancer mortality down from 40.5 (2004-2006)

109. Cancer Incidence & Mortality Amongst Males Prostate Cancer: Low Incidence, High Mortality Incidence rates 2003-2007; Mortality rates 2006-2008 Source: MassCHIP, Cancer Registry (2003-2007) and Vital Records (2006-2008)

110. Female Cancer Screening Rates (Self-Reported) 2008 BRFSS* *501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008 75% of these respondents had exam in past year 76.3% of these respondents had exam in past year MA rate not available

111. Colon Cancer Screening Rates (Self-Reported) Generally Low Rates 2008 BRFSS* *501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008 **Eligible Respondents: all respondents age 50+ (n=240) Of these respondents:  92.8% had a colonoscopy, and of these 28.6% had exam within past year MA rate not available Of these respondents:  45.5% had exam within past year

112. Maternal & Infant Health Birth Rates, Inadequate Prenatal Care

113. Birth Rates High – Especially for Blacks and Latinas 2009 Vital Records  Low Infant Mortality Rates (per 1,000 births): 1.4 vs. 5.0 Statewide  Low percentage of women smoking during pregnancy: 3.9% vs. 6.8% Statewide Source: MassCHIP Births and Infant Deaths, Vital Records (2009)

114. Inadequate or No Prenatal Care*: Especially High for White Mothers 2009 Vital Records *Inadequate prenatal care defined as mothers not receiving “adequate prenatal care” (Classified by APNCU Index) Source: MassCHIP Perinatal Report for Chelsea, Vital Records (2009) n/a  Chelsea’s overall % of births with inadequate or no prenatal care decreased from 16.0% in 2005, while the Statewide % increased from 8.4% in 2005

115. Inadequate or No Prenatal Care 2000-2009* *Inadequate prenatal care defined as mothers not receiving “adequate prenatal care” (Classified by Kotelchuck Index) Source: MassCHIP Perinatal Report for Chelsea, Vital Records (2000-2009) Date accessed: 8/30/12

116. Family and Social Support Community Cohesiveness, Single-Parent Households

117. Community Cohesiveness 2012 Quality of Life Survey* On a scale of 1-5 (1 Strongly Disagree to 5 Strongly Agree) respondents ranked Chelsea as a…  58% volunteer their time to community service  89% know at least some of their neighbors’ first names Source: Chelsea 2012 Quality of Life Survey. Survey sample of 959 respondents represents a more White, educated, female perspective and is not representative of the community at large.

118. Children in Single-Parent Household 2006-2010 American Community Survey (US Census Bureau) Source: American Community Survey 2006-2010 5 Year Estimates

119. Parent Disapproval Rates 2010 & 2011 Chelsea High School YRBS Percent of students that believe their parents would think it was very wrong if they used the following substances

120. Community Safety Crime Rates, Offensives, Domestic Violence, ER Visits

121. Violence/Injuries : Very High Homicide & Violent Injury Rates  Very high violent injury* rate at 100.7 (2004-2006**) Almost 3x state rate of 35.1  Very high homicide rate: 4 homicides in 2007 – crude rate 11.7 (more than 4x state rate of 2.8)  Motor-vehicle related deaths and hospitalizations: Injury deaths low: 2.9 crude rate (6.8 state rate) (2007***) Motor-vehicle related hospitalization rate low: 66.4 age-adjusted rate (65.2 state rate) (2007-2009****)  Weapon-related Injuries (2008-2010 WRISS*****) Highest amongst ages 20-24 (26.9% vs. 28.0% statewide) and ages 15-19 (24.1% vs. 20.7% statewide) Very high amongst males (95.9% vs. 88.1% statewide) Approx. half happen on the street (56.8% vs. 42.9% statewide) *Violent injuries defined as: gun and sharp instrument weapon injuries during violent incidents as seen in ED **Source: Partners Community Benefit Report ***Source: MassCHIP CHNA Health Status Indicators Report for Chelsea - 2007 Mortality (Vital Records) ICD-10 based ****Source: MassCHIP Hospital Discharges (UHDDS), 2007-2009 *****WRISS data from MassCHIP WRISS Report for Chelsea, 2008-2010

122. Mortality from Injury 2000-2009* *Source: MassCHIP, Vital Records (Mortality), All Injury & Poisoning Deaths 2000-2009 Date accessed: 04/23/13

123. Property & Violent Crimes Over Time 2005-2011* *Source: Chelsea Police Department Data

124. Crime Rates 2005-2010 Data Source: Massachusetts Crime Reporting Unit, www.ucrstats.com.

125. Percent of Offenses That Involved Weapons* Chelsea Police Dept. 2000-2007** *Includes: all firearms, sharp instruments, blunt objects, motor vehicle, personal (hands, feet, etc.), poison, and other/unknown. **Police data was only collected up to 10/17/2007. Extrapolations were made using monthly averages from 2000-2006 for a full year estimate, which are presented in the graph above.

126. Crime 2005 200620072008200920102011 2005-2007 2009- 20 11%Change Motor Vehicle Theft286310210254238180192238.57203.33 -14.8% Motor Vehicle Theft Theft from a Motor Vehicle29 91312101717.0013.00 -23.5% Theft from a Motor Vehicle Burglary/Breaking & Entering291359384414445454406393.29435.00 10.6% Burglary/Breaking & Entering Shoplifting3444548810510812179.14111.33 40.7% Shoplifting Vandalism994 100 7 110 6 122 7 105 49779241041.29985.00 -5.4% vandalism Gun Robbery1727303731 28.8331.00 7.5% Gun Robbery Forcible Rape2126192926343326.8631.00 15.4% Forcible Rape Weapons law violations6244626857836262.5767.33 7.6% Weapons law violations Aggrevated Assault344339340379330352306341.43329.33 -3.5% Aggrevated Assault DUI2238262736453332.4338.00 17.2% DUI Drug/Narcotic Violations739512212598117115106.43110.00 3.4% Drug/Narcotic Violations Drunkeness486498465434452508410464.71456.67 -1.7% Drunkeness UCR crime data for following slides

127. Selected Violent Crime Rates 2005-2011 Data Source: Massachusetts Crime Reporting Unit, www.ucrstats.com.

128. Selected ETOD Crime Rates 2005-2011 Data Source: Massachusetts Crime Reporting Unit, www.ucrstats.com.

129. Offenses by Weapon Involved: Firearms Offenses Increasing Chelsea Police Dept. 2000-2007* *Data for 2007 was only collected up to 10/17/2007. Extrapolations were made using monthly averages from 2000-2006 for a full year estimate, which are presented in the graph above. **Includes automatic firearms, handguns, automatic handguns, automatic rifles, and other automatic firearms

130. Emergency Room Visits for Assault-Related Injuries by Type of Wound 1998-2010* *Source: MA DPH, MassCHIP, 1998-2010 data / **Firearms include firearms, non-powder airguns, and other guns.

131. Arrests By Gender: Female Arrests Increasing Chelsea Police Dept. 2000-2007* *Data for 2007 was only collected up to 10/17/2007. Extrapolations were made using monthly averages from 2000-2007 for full year estimates, which are presented in the graph above. MalesFemales

132. Chelsea High School YRBS: Violence-Related Behaviors 2005-2007-2009-2011 YRBS Chelsea YRBS High School Data from 2005-2011 (Grades 9-12, In 2011, 1,078 completed surveys of students with parental permission) *Dating Violence is defined as having been hurt physically or sexually by a date or someone going out with

133. Domestic Violence / Child Abuse *DV data source: Chelsea Police Department **Child Abuse data source: 2006 Department of Children and Families, from MassCHIP Kids Count Report for Chelsea For 2008: 215 restraining orders issued; 137 still active as of 12/31/08

134. Allegations and Investigation of Child Abuse 1996-1997 & 2006-2009* **Child Abuse data source: 1996-2009 Department of Children and Families, from MassCHIP Kids Count Report for Chelsea

135. Dispatch Calls Received for Domestic Disturbances* Chelsea Police Dept. 2000-2006 *These calls were received by the police dept. as domestic disturbances, however not all were determined to be domestic disturbances after responding to the call.

136. PHYSICAL ENVIRONMENT

137. Environmental Quality Air Pollution, Blood Lead Count, Asthma Hospitalizations

138. Environmental Health Issues*  Chelsea is the only city/town in the state with every neighborhood designated as an “environmental justice population” by the Executive Office of Environmental Affairs (EOEA)**  Oil Spills in Chelsea Creek***: Since Dec. 2005, ~41,866 gallons of oil have spilled into the Chelsea Creek There have been a total of 35 oil spills in the last 15 years – totaling 96,653 gallons of oil  Diesel Exhaust & Cancer****: Chelsea’s overall levels exceed the U.S. average by five times Chelsea’s high levels of diesel exhaust exceed the EPA’s established “reference concentration” (maximum level before cancer-causing health effects occur) by 20% Chelsea falls in the Clean Air Task Force’s highest category for “expected lifetime cancer cases from diesel pollution” – 501+ Chelsea residents likely to develop cancer from diesel pollution***** *Source: all information above taken from January 2007 Chelsea City Council Meeting Minutes, http://www.chelseama.gov/Public_Documents/ChelseaMA_CouncilMin/I00DAB445.0/Chelsea%20City%20Council%20Januar.doc http://www.chelseama.gov/Public_Documents/ChelseaMA_CouncilMin/I00DAB445.0/Chelsea%20City%20Council%20Januar.doc **Source cited: http://www.mass.gov/envir/ejhttp://www.mass.gov/envir/ej ***Source cited: U.S. Coast Guard Lieutenant Commander Claudia Gelzer ****Source cited: Environmental Protection Agency (EPA), http://www.epa.gov/ne/eco/airtox/diesel.htmlhttp://www.epa.gov/ne/eco/airtox/diesel.html *****Source cited: Clean Air Task Force database used The Lingering Thread Report (2005)

139. Symptoms or Illness in Past Year due to Outdoor Air Pollution* 2008 BRFSS *501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008

140. Air Quality Index 1999-2009* “Air quality indices (AQI) are numbers used by government agencies to characterize the quality of the air at a given location. As the AQI increases, an increasingly large percentage of the population is likely to experience increasingly severe adverse health effects.. The Environmental Protection Agency (EPA) uses the following AQI range: 0-50=Good, 51-100=Moderate, 101-150= Unhealthy for Sensitive Groups, 151- 200=Unhealthy, 201-300 Very Unhealthy, 301-500=Hazardous Source: Chelsea, MA Air Quality http://www.usa.com/chelsea-ma-air-quality.htm

141. Levels of Sulfur Dioxide 1999-2009* Source: Chelsea, MA Air Quality http://www.usa.com/chelsea-ma-air-quality.htm based on the air quality database from the U.S. Environmental Protection Agency http://www.usa.com/chelsea-ma-air-quality.htm

142. Levels of Nitrogen Dioxide 1999-2009* Source: Chelsea, MA Air Quality http://www.usa.com/chelsea-ma-air-quality.htm based on the air quality database from the U.S. Environmental Protection Agency http://www.usa.com/chelsea-ma-air-quality.htm

143. Levels of Particulate Matter 1999-2009* Source: Chelsea, MA Air Quality http://www.usa.com/chelsea-ma-air-quality.htm based on the air quality database from the U.S. Environmental Protection Agency http://www.usa.com/chelsea-ma-air-quality.htm

144. Asthma *501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008 **In households with children under 18 only: n=203 (out of 501) respondents ***Source: 2005 Hospital Discharges (UHDDS), from MassCHIP CHNA Health Status Indicators Report for Chelsea ****Source: Regional Epidemiological Services Health Data Watch Supplement, prepared for Chelsea HHS Self-Reported Asthma Status – 2008 BRFSS* Of these respondents: 37.8% reported their asthma interfering with their daily activities at least moderately in the past month

145. Asthma *501 Chelsea residents were contacted for the 2008 BRFSS survey between January 25th and May 27th, 2008 **In households with children under 18 only Self-Reported Asthma Status – 2008 BRFSS*

146. Asthma Hospitalizations* *Asthma ( ICD 9: 493), Asthma is primary cause of hospitalization; Age-Adjusted Rates. Source: 2002-2009 Hospital Discharges (UHDDS), from MassCHIP 1999-2009  Chelsea asthma hospitalization rates were significantly higher than the Massachusetts State rates in 2002, 2003, 2006, 2007, 2008 and 2009.

147. Asthma- Related Hospitalizations* *Asthma ( ICD 9: 493), Asthma is primary cause or Asthma is an associated cause of hospitalization; Age-Adjusted Rates. Source: 2002-2009 Hospital Discharges (UHDDS), from MassCHIP 1999-2009*  Chelsea asthma hospitalization rates were significantly higher than the Massachusetts State rates 2002-2009

148. Asthma Hospitalizations* *Asthma ( ICD 9: 493), Asthma is primary cause hospitalization. Chelsea and Mass Rates. Source: 2006 Hospital Discharges (UHDDS), from MassCHIP National Rates Source: 2006 Hospital Discharges (UHDDS), from CDC website: http://www.cdc.gov/nchs/data/nhsr/nhsr005.pdf 2006 Crude Rates per 10,000

149. Child Asthma Hospitalizations* *Asthma ( ICD 9: 493), Asthma is primary cause of hospitalization. ** Unclear if National Rates are Age-Adjusted. Chelsea and Mass Rates. Source: 2006 Hospital Discharges (UHDDS), from MassCHIP National Rates Source: 2006 Hospital Discharges (UHDDS), from CDC website: http://www.cdc.gov/nchs/data/nhsr/nhsr005.pdf 2006 Age-Adjusted Rates per 10,000** Age < 15 **

150. Source: Division of Health Care Finance and Policy. Calendar Year 2005. Hospital Discharges Pediatric Asthma Hospitalization Rates by Town Children Ages <5 Boston, Massachusetts Region, 2004-2005

151. Pediatric Asthma Hospitalization Rates by Town Children Ages <5 Boston, Massachusetts Region, 2007-2009 *Asthma ( ICD 9: 493), Asthma is primary cause of hospitalization; Age-Adjusted Rates. Source: 2007-2009 Hospital Discharges (UHDDS), from MassCHIP

152. Pediatrics Asthma Hospitalizations Children <5 2000-2009* Source: 2000-2009 Hospital Discharges (UHDDS), from MassCHIP Date accessed 8/30/12 N/A

153. Blood Lead Counts in Young Children (6 months – 5 years): Much Higher than State Rates 2008-2010 CLPPP* *Source: 2006 Lead Poisoning Prevention Program (CLPPP), in MassCHIP Kids Count Report. Rates expressed per 1,000 children screened. **Immediate Risk of Lead Poisoning defined as 20-24 ug/dL ***Elevated Blood Levels defined as >15 ug/dL ****Lead poisoning blood levels defined as >=25 ug/dL

154. Blood Lead Counts in Young Children (6 months – 5 years): Lead Poisoning Cases**, 2000-2010 CLPPP* *Source: 200-2010 Lead Poisoning Prevention Program (CLPPP),, in MassCHIP Kids Count Report. Rates expressed per 1,000 children screened. **Total lead poisoning blood levels defined as >=15 ug/dL Date accessed 8/28/12

155. Built Environment Access to Recreational Facilities, Health Foods, and Fast Food

156. 2012 Focus Group Findings Top Most Important Problems in Chelsea 1.Crime & Violence 2.Housing – high cost, no rentals, no affordable housing, crowded, unclean 3.Environment – cleanliness and associated health issues like asthma. Road maintenance & parking issues 4.Health Issues (asthma) – related to environment 5.Language Barriers – especially around unemployment, not enough ESL or skills training, school issues, prejudice Source: Focus groups reached 109 diverse residents between February and March 2012 Data presented at the Community Health Assessment Strategic Planning Meeting on June 13 th, 2012.

157. 2012 Focus Group Findings Top Most Important Problems in Chelsea 6. Drug Use 7. Teen Pregnancy 8.Poverty 9.Education – adult and teen resources needed. Parent classes needed. School configuration not ideal. 10.Access to healthy food / Obesity Source: Focus groups reached 84 diverse residents between February and March 2012 Data presented at the Community Health Assessment Strategic Planning Meeting on June 13 th, 2012.

158. 2012 Quality of Life Survey Findings Top 10 Most Important Problems in Chelsea 1.Drug abuse/addiction/overdose (47%) 2.Crime & Violence (46%) 3.Alcohol abuse & addiction (32%) 4.Education (20%) 5.Domestic Violence (15%) 6.Mental Health (14%) 7.Teen Pregnancy (14%) 8.Environment (13%) & Asthma (8%) 9.Poor Diet/inactivity (11%) Obesity (10%) 10.Housing / Homelessness (8%) *Source: 2012 Quality of Life Survey. Surveys were distributed in February and March through the web and in print—available in English, Spanish and Mandarin. 959 surveys were received and respondents represented a more White, educated, female perspective. Data presented at the Community Health Assessment Strategic Planning Meeting on June 13th, 2012.

159. Conclusion The Evaluation and Research staff at the MGH Center for Community Health Improvement (CCHI) compiled and summarized all information in this report. Both primary and secondary data sources were used in order to produce a comprehensive report on the leading health issues facing Chelsea as of August 31, 2012. The main source of data is listed within each chart as well as the date range and any other important information relevant to the data. The MGH Center for Community Health Improvement has made efforts to ensure the accuracy of all data in this report. Some of the numbers and rates contained in this report were obtained from MassCHIP, The Massachusetts Department of Public Health’s internet-accessible data warehouse. MassCHIP is regularly updated so the numbers and rates contained in this report may differ slightly from those reported in the current version of MassCHIP. Other sources include the Youth Risk Behavior Survey, the Behavioral Risk Factor Surveillance System, U.S. Census, and community Quality of Life Surveys and Focus Groups completed as part of CCHI’s 2012 Community Health Assessment. Please contact Maddie Eagan, mmeagan@partners.org, with any questions regarding the data in this presentation.mmeagan@partners.org

160. MGH CCHI Evaluation and Research Danelle Marable, Director dmarable@partners.org / 617-724-6857 Erica Clarke, Project Manager esclarke@partners.org / 617-643-3955 Nessa Regan, Project Manager nregan1@partners.org / 617-643-7178 Maddie Eagan, Research Assistant mmeagan@partners.org / 617-724-7016