►
Description
Docket #1054 - Hearing to discuss public health disparities in Boston's communities of color
A
Mber,
my
name
is
Matt
O'malley
I
am
the
chairman
of
the
City
Council's
Committee
on
healthy
women,
families
and
communities.
We
are
here
today
to
discuss
docket
number
one
zero,
five
four,
which
is
a
hearing
to
discuss
public
health
disparities
in
Boston's
communities
of
color
I,
want
to
thank
my
dear
colleagues
and
friends.
The
co-sponsors
of
this
herring
order,
councillors,
Eadie
Flynn
and
councillor
Kim
Janey
for
introducing
this
order
and
their
incredible
partnership
and
leadership
on
this,
and
so
many
other
issues
on
the
council.
A
The
objective
of
this
hearing
is
to
discuss
public
health
disparities,
as
well
as
resources
and
measures
that
can
improve
public
health
outcomes
as
chair
of
the
environment,
sustainability
and
parks
committee,
as
well
as
this
committee
I
know
that
our
environmental
issues
directly
linked
to
public
health
and
the
well-being
of
our
constituents.
We
hope
this
Harrington
will
bring
more
awareness
of
the
issues.
For
example
the
high
expulsion.
A
Excuse
me
the
high
exposure,
the
particle
pollution,
as
well
as
many
ways
to
address
social
determinants
of
health,
such
as
food
insecurity
and
housing,
delighted
to
have
our
panel
I'll
get
to
in
a
minute
before
the
code.
After
the
co-sponsors
give
some
opening
remarks,
Monica
Valdes
Lupi,
who
was
the
executive
director
of
the
Boston
Public
Health
Commission
carolyn
Rubin,
who
is
the
assistant
professor
of
public
health
and
community
medicine
at
Tufts
University
and
dr.
Joseph
Betancourt,
director
of
disparities
Center
at
Mass,
General
Hospital.
A
This
is
a
public
hearing
as
such
I
ask
all
those
in
attendance
to
please
silence
their
cell
phones
if
conversations
have
to
be
had
please
take
them
outside.
This
is
being
streamed
on
lines
broadcast
on
cable
television
and
any
folks
that
would
like
to
offer
testimony
after
this
panel.
Please
sign
up
to
on
the
sign
up
sheep
to
our
left.
A
I
told
my
two
colleagues
that
there's
hopefully
we'll
be
fine,
but
there
is
a
fire
happening
right
now
in
West
Roxbury
that
I'm
gonna
monitoring,
so
if
I
have
to
duck
out
I
will
leave
it
in
the
capable
hands
of
my
colleagues
but
I'll,
be
in
and
out
throughout
the
course
of
the
morning.
So
we'll
begin
with
councillor
Kim
Jana
any
opening
statements.
Oh.
B
Thank
you
so
much.
Thank
you.
Mr.
chair
and
I
want
to
thank
councillor
Flynn
for
his
leadership
and
his
partners
upon
this
very
important
hearing.
I
want
to
thank
our
panel
for
being
here
and
for
their
good
work,
all
of
the
city,
agencies
and
healthcare
partners
in
our
city,
who
are
doing
amazing
work,
and
certainly
all
the
advocates
that
are
here.
We
know
that
this
is
an
important
issue
through
the
most
recent
report
of
the
Boston
Health
Commission,
the
health
of
Boston.
B
We
know
from
that
report
that
black
and
Latino
residents,
Asian
residents
and
and
other
racial
groups
in
our
city
are
significantly
more
likely
than
their
white
counterparts
to
suffer
from
poor
health
outcomes
and
whether
we're
looking
at
asthma
we're
looking
at
diabetes,
we're
looking
at
heart
disease.
Looking
at
cancers,
these
illnesses
impact
communities
of
color
in
a
way
that
we
need
to
do.
B
We
need
to
come
up
with
some
solutions,
which
is
why
I'm
glad
that
we're
here
at
this
hearing,
we
see
this
across
the
Commonwealth,
but
here
in
our
city
of
Boston,
where
we
have
the
best
hospitals.
It's
important
that
we
close
these
gaps
and
even
when
we
measure
ourselves
against
other
states
across
the
country,
even
if
we
appear
to
do
better
than
some
of
our
other
states,
it's
important
that
we're
closing
the
gaps
between
these
different
racial
groups.
B
C
Thank
You
councillor,
O'malley
and
council
Mellie
have
been
a
strong
leader
on
this
important
issue
for
many
years,
so
I
want
to
say
thank
you
for
your
leadership
into
councillor
Janey
and
being
a
co-sponsor
of
this
hearing.
Councillor
Janey
I've
learned
a
lot
from
over
the
last
two
years,
especially
on
this
important
issue.
That's
impacting
communities
of
color
across
across
our
city.
Thank
you
to
our
panelists,
dr.
Valdes
Lupi,
dr.
Betancourt
and
professor
Rubin,
for
coming
here
today
and
I
think
work
with
all
all
three
of
the
pianos
on
public
health
issues.
C
Since
I
started,
I
represent,
as
you
know,
I
represent
a
large
number
of
immigrants
in
residence
of
color
in
my
district,
particularly
in
Chinatown
in
the
south
end
I
have
a
large
number
of
Asian
Latin
X
residents
in
my
district
I
also
represent.
Probably
the
most
residents
living
in
public
housing
of
any
district
in
the
city
I'm
in
my
district
every
day
and
I
know
that
there
are
unique
challenges
for
these
residents.
C
In
my
district
in
terms
of
public
health,
for
example,
when
I'm
in
Chinatown,
when
my
son
went
to
Josiah
Quincy
school
and
I,
also
went
to
Don
Bosco
high
school,
there
have
seen
almost
every
day
notice
that
there
are
many
residents.
Children
dealing
with
asthma,
including
all
seniors
I've,
noticed
that
Chinatown.
C
Obviously
it's
surrounded
by
93,
it's
surrounded
by
MassPike,
it's
surrounded
by
salt
station
bus
terminal,
it's
surrounded
by
salt
station
train
station,
and
we
know
it's
a
major
truck
Road
from
Maine
to
Florida
and
the
residents
of
Chinatown
are
and
healing
that
talks
toxics
every
day.
We
also
know
that
Josiah
Quincy
school
is
located
right
next
to
the
Mass
Pike.
In
me,
a
playground
is
almost
on
top
of
the
Mass
Pike.
We
also
know
that
the
upper
school
is
located
right
there
with
it
with
the
basketball
quarters.
C
We
know
the
Reggie
Reggie
Wong
Park,
where
I
see
a
lot
of
Asian
men
and
women
playing
playing
basketball
and
especially
playing
volleyball.
It's
it's
at
it's
at
93,
it's
at
the
Mass
Pike.
The
physical
environment
itself
is
not
beneficial
to
these
residents.
Health.
In
fact,
the
Union
of
Concerned
Scientists
had
a
report
that
found
China
has
the
most
disproportionally
affected
neighborhood
in
terms
of
traffic
traffic
pollution
in
Massachusetts.
C
Asian-American
residents
are
exposed
to
36%
more
vehicle
pollution
than
presents
the
african-american
are
exposed
to
34%
more
vehicle
pollution
and
Latino
residents
to
26%
more
pollution.
Also,
the
Boston
Public
Health
Commission
most
recent
health
of
Boston
reports
that
african-american
asian-american
Latino
residents
of
Boston
are
significantly
more
likely
than
white
residents
to
suffer
from
poor
public
health
outcomes.
C
Public
Health
is
critical
to
a
person's
well-being
in
many
factors
impact
a
person's
ability
to
access
public
health
resources.
Our
communities
are
more
likely
to
face
language
barriers
when
trying
to
access
health
care
and
they
are
more
likely
to
face
housing
displacement
that
cause
more
stress
in
face
discrimination
by
the
opportunity
to
attend
the
ancient
task
force
against
domestic
violence
recently
and
I
had
the
opportunity
to
meet
with
them
at
their
Rock
at
their
office,
and
they
said
to
me
that
their
number-one
concern
their
number
one
priority
is
language
access
in
this
hearing.
C
I
hope
that
we
can
hear
from
the
pianist
in
residence
across
the
city.
Talk
about
their
observations
in
experiences
on
public
health
disparities
in
discuss
ways
that
we
can
begin
to
close
the
gap
on
these
disparities.
I
hope
that
we
can
discuss
ways
to
better
expand
language
access
data
gathering,
among
other
things,
I
know
how
hospitals
colleges
in
universities
are
also
playing
playing
a
role
as
I
mentioned,
Tufts
Medical
Center
has
a
very
effective
anti-smoking
program
in
Chinatown.
C
The
VA
is
part
of
the
debate:
Mass
General
Hospital
Tufts,
Beth,
Israel,
BU,
Medical
Center.
All
of
our
colleges,
all
of
our
universities
in
hospitals
are
playing
a
role
but
I'd
love
to
work
with
the
panelists
I'd
love
to
work
with
the
city
and
maybe
coordinate
our
experts
to
make
sure
we
have
one
strong
voice
speaking
out
in
support
of
Public
Health
as
in
impacts,
communities
of
color
I'd
love
to
see
us
coordinate
those
services
and
have
whether
it's
a
task
force
or
have
a
more
structured
program.
C
Again,
I
want
to
say
thank
you
to
councillor
O'malley
I,
want
to
say
thank
you
to
councillor
Janey
and
our
panelists
for
your
tremendous
work
over
the
years
on
this
important
issue,
but
I'd
also
like
to
say
thank
you
to
the
social
service
providers
that
many
are
here
today
and
many
do
this
work
every
day
in
our
communities,
and
you
know
we're
proud
of
the
work
that
they're
doing
and
I'd
love
to
hear
some
of
their
concerns
and
how
we
all
can
work
together
to
improve
public
health
in
the
City
of
Boston,
Thank
You.
Mr.
C
A
E
Thank
You
Cora
I
just
want
to
just
quickly
thank
councillor
Flynn
for
your
leadership
here
and
also
council
Malley
and
councillor
Jani
for
a
hearing.
That's
gonna
happen
later
today,
related
to
maternal
health
and
for
you
guys
taking
the
lead
on
such
an
important
topic.
Thank
you
to
the
panelists,
all
the
providers
in
the
room,
those
who
are
emailing
because
they
can't
come
today.
Health
disparities
is
such
an
important
topic
one.
We
don't
necessarily
talk
about
enough
when
talking
about
systemic
inequities,
we
often
focus
on
and
I
know.
E
I
do
education
housing,
but
if
you
are
not
well
and
don't
have
access
to
act,
sorts
to
the
access
to
the
resources
to
maintain
your
wellness
in
overall
health,
and
that
doesn't
just
mean
prescriptions
and
and
making
sure
you're
treating
any
diseases
but
really
preventing
them,
and
then
also
how
does
mental
health
and
all
these
other
things
play
into
it?
It's
a
really
significant
topic,
so
I'm
really
excited
to
be
here,
to
listen,
to
learn
and,
of
course,
to
lend
my
support.
So
thank
you
again,
councillor
Flynn
for
your
leadership.
Thank.
A
You,
madam
president,
and
there,
in
addition
to
public
testimony
at
the
conclusion
of
this
panel,
we
also
accept
written
testimony
which
will
be
shared
with
the
committee.
I
want
to
thank
my
neighbor
and
friend
Cheri
dong,
who
is
the
director
of
community
health
improvement
programs
at
Tufts.
Medical
Center
who's
submitted
some
lengthy
testimony
detailing
some
of
the
work
at
Tufts
in
terms
of
smoking,
cessation
efforts
in
Chinatown,
as
well
as
addressing
pediatric
asthma
disparities.
A
D
F
Good
morning
and
thank
you,
chairman
O'malley,
for
inviting
us
all
to
testify
and
hear
from
us
on
all
the
work
that
we're
doing
across
the
different
sectors
that
we
represent.
I
also
want
to
thank
the
co-sponsors
of
today's
hearing,
counselors
Jeanne
and
councillor
Flynn,
for
your
leadership
on
these
issues
and
also
Thank
You
councillor
Campbell
for
joining
us
today.
So,
as
you
know,
the
Boston
Public
Health
Commission
is
the
local
health
department
for
the
city
of
Boston
and
we're
actively
engaged
and
committed
to
advancing
racial
justice
and
health
equity.
F
It's
actually
one
of
our
four
priority
areas
and
our
new
three-year
strategic
plan
and
at
our
core
you've
all
referenced.
Some
of
the
work
that
we
do,
but
at
our
core,
is
our
mission
to
protect
and
to
promote
the
health
and
well-being
of
all
Boston's
residents,
especially
those
who
are
most
vulnerable
you've
each
reference,
the
health
of
Boston.
F
So
thank
you
for
taking
the
time
to
review
the
work
and
the
analysis
that
our
team
has
done
from
our
research
and
evaluation
office,
because
it
is
something
that
we
have
been
paying
attention
to
for
for
nearly
two
decades
as
the
Public
Health
Commission
and
while
I'll
mention
some
of
the
great
progress
that
we've
made
city
to
address
and
to
attempt
to
close
these
gaps.
We
know
that
there's
a
lot
of
work
that
we
still
need
to
do
and
that
racial
and
ethnic
health
disparities
continue
to
persist.
F
Despite
being
in
a
city
like
Boston
and
the
shadows
of
outstanding.
You
know
globally
recognized
hospitals
and
community
health
centers
at
the
Commission.
We
understand
that
the
influence
of
racism
and
other
exclusionary
practices
contribute
to
an
unequal
distribution
of
critical
health,
promoting
resources
among
racial
and
ethnic
groups.
So
things
social
determinants
like
poverty
and
a
lack
of
educational
and
employment
opportunities,
often
have
their
origins
in
discriminatory
laws,
policies
and
practices
that
have
denied
people
of
color
and
equal
right
to
earn
income
and
accumulate
wealth.
F
Our
office
of
health
equity
leads
our
efforts
and
understanding
the
needs
of
our
community
and
planning
for
improvement,
while
also
implementing
everyday
practices
and
principles
that
will
promote
health
equity
in
all
of
our
work,
both
internally
and
externally.
Within
the
office
since
I've
returned
to
Boston,
we
have
convened
a
health
equity.
Advisory
Committee
communities
from
across
the
city
apply
to
be
part
of
this
cross-cutting
committee
that
advises
our
nearly
50
different
programs.
The
residents
come
from
different
cultures,
backgrounds,
lived
experiences
and
neighborhoods
and
planning
development
and
implementation
of
our
work
at
the
Health
Department.
F
Just
this
summer
we
received
66
applications
and
we
for
only
12
seats,
we're
actually
introducing
the
new
health
equity
advisory
committee
members
at
our
November
20th
board
meeting
through
our
consortium
of
professional
development.
We've
developed
a
nationally
recognized
training,
curriculum
called
the
racial
justice
and
health
equity,
professional
development
series
or
the
PBS
Cirie's.
So
this
is
a
mandatory
training
that
all
new
employees
at
the
Boston
Public
Health
Commission
are
required
to
attend.
F
This
group
was
really
designed
to
complement
and
support
Mayor
Walsh's
imagined
bust
in
2030
and
other
plans,
including
his
resilience
plans,
which
really
do
focus
on
the
needs
of
marginalized
populations
by
advancing
racial
justice
and
social
justice
with
our
Board
of
Health.
We're
currently
considering
proposed
amendments
to
our
tobacco
control
regulations
that
would
close
the
mint
and
menthol
loophole
a
long
legacy
of
targeted
industry
marketing,
along
with
the
density
of
retail
outlets
that
sell
an
advertisement.
F
All
products
have
led
to
disproportionate
use
of
these
products
in
our
communities
of
colors,
and
so
through
these
regulatory
changes.
The
board
is
aiming
to
strengthen
our
efforts
to
prevent
our
youth
of
color,
in
particular,
from
becoming
the
next
generation
of
smokers
and
also
to
address
other
health
disparities.
That
result
from
smoking
also
wanted
to
highlight
in
the
work
that
we're
doing
around
opioid
use
disorders
that
we
recently
published
a
data
brief
entitled.
F
Racial
and
ethnic
differences
in
accessing
substance
use
disorder
treatment
following
an
opioid
overdose
in
Massachusetts
in
Boston,
and
through
this
report
we
were
able
to
show
that
for
black
and
Latin
X
residents
in
Massachusetts
they
were
twenty
four
percent
and
twenty-two
percent
respectively,
less
likely
to
receive
substance,
use
mistreatment
after
thirty
days
afterwards
being
admitted
for
opioid
overdoses
as
compared
to
whites.
I
also
wanted
to
make
sure
that
we've
seen
progress
in
the
city
and
you've
each
highlighted
that
there
have
been
persistent
racial
health
inequities,
but
I
don't
want
to
dismiss
that.
F
We
actually
have
made
progress
over
the
years
between
2006
and
2007
teen.
The
mortality
rate
for
black
infants
in
Boston
decreased
by
nearly
36
percent
between
2011
and
2017.
The
teen
birth
rate
decreased
by
61
percent
overall,
and
we
saw
an
even
greater
rate
of
decline
for
teens
of
color,
so
for
our
black
teens,
the
teen
birth
rate
decreased
by
66%
and
for
Latin
X
residence
for
the
Latinas
it
decreased
by
74
percent.
F
Counselor
Finn
in
terms
of
how
do
we
better
coordinate
services
and
invest
resources
in
the
communities
that
need
it
the
most,
especially
when
their
needs
that
have
been
identified,
and
there
are
solutions
that
have
been
identified
by
collaborating
with
community
partners
in
community
residents.
So
in
closing
again
want
to
thank
you
on
behalf
of
a
team
at
the
Public
Health
Commission,
for
allowing
us
to
be
part
of
the
testimony
this
morning
and
really
looking
forward
to
continuing
to
work
with
all
of
our
city.
Counselors.
Moving
forward.
G
Good
morning,
everybody,
my
name
is
dr.
Carolyn,
Rubin
and
I
also
want
to
thank
the
committee
for
holding
this
hearing
today
to
thank
councilor,
O'malley,
councilor,
Flynn
and
JC
and
Jamie,
and
also
councillor
Campbell
for
being
here
today.
So
I
am
a
assistant
professor
at
the
TUF
University
School
of
Medicine
and
I
also
direct
an
academic
community
research
partnership
called
adapt.
G
Adapt
is
a
partnership
between
Tufts
and
six
Chinatown
agencies
and
it's
a
space
for
us
to
collaborate,
:
and
work
on
research
projects
together
and
to
create
an
environment
such
that
it's
not
just
the
researchers
dictating
what
are
their
health
issues
of
the
concern.
But
it's
also
the
community
saying
these
are
the
health
issues
that
are
important
to
us.
So
as
a
public
health
researcher
and
teacher
I
think
about
health
as
overall
health
and
well-being,
and
my
work
in
Chinatown
over
the
last
10
years
has
has
focused
on
Chinatown
and
oftentimes.
G
So
the
way
that
I
know
about
Public
Health
in
Chinatown
is
through
a
series
of
you
know
smaller,
discreet
studies
that
adapt
has
been
able
to
support,
as
well
as
some
studies.
Some
other
researchers
in
the
area
have
been
able
to
do,
and
also
what
I
know
comes
from
just
listening
to
community
residents
and
spending
time
in
the
community
and
so
for
Public
Health.
What
do
what
do
I
see
in
Chinatown
so
I
see
that
residents
struggle
with
some
really
basic
needs
things
that
we
take
for
granted.
G
I've
had
residents
tell
me
over
and
over
and
over
again
about
public
about
public
defecation.
You
know
right
on
their
doorsteps
right,
so
people
are
struggling
with
just
basic
needs.
You
know.
We
know
that
the
diabetes
rate
for
Chinese
is
higher
than
the
white
population
in
Boston.
We
know
that
in
Chinatown,
45%
have
high
blood
pressure,
83%
of
the
Chinese
residents
live
in
public
housing
or
on
subsidies,
and
53%
are
on
WIC
or
food
stamps.
Now
we
also
know
that
air
quality
is
an
issue.
G
We
know
that
open
space
is
an
issue,
an
issue
that
the
community
has
brought
to
us
recently.
It
has
been
a
concern
around
problem
gambling.
It's
been
a
concern
that
many
have
known
about
for
a
you
know
many
years
and
of
course,
people
are
particularly
concerned
now
with
the
opening
of
encore
and
the
type
of
you
know
targeting
that
casinos
do
to
the
Chinese
community.
G
Now.
I
also
want
to
say
that
you
know-
and
this
goes
against
my
training,
but
you
know
date.
Data
is
important,
but
data
is
a
tool
and
it's
also
an
imperfect
tool.
So
you
know
we
we
did
the
study.
We
did.
This
community
needs
assessment
in
Chinatown
and
we
were
very
interested
in
learning
more
about
mental
health
and
the
instruments
we
use
didn't
necessarily
detect.
G
G
You
know
we
have
to
look
at
data,
but
but
also
you
know,
listen
to
what
residents
and
leaders
are
saying
and
another
issue
that
I
have
seen
come
forth
in
Chinatown
is
I
really
think
that
displacement
has
become
a
public
health
issue,
so
displacement
is
causing
chronic
stress.
It's
causing
people
to
feel
more
socially
isolated,
have
less
social
connectedness.
There
is
a
really
you
know
we're
looking
at
the
link
between
affordable
housing
and
health
outcomes
and
the
other
issue
around
displacement.
G
If
C
mark
goes
away,
we
could
have
a
you
know,
a
food
security
issue
in
our
neighborhood,
so
things
are
changing
really
fast
in
the
city
in
general,
so
I
wanna
I,
want
to
affirm
what
you
know
Monica
has
talked
about.
In
terms
of
you
know,
we
need
to
focus
on
the
determinants.
You
know
around
addressing
poverty
around
addressing
language
access
and
I
also
think
that
there
are
other
strategies
that
we
can
employ.
G
You
know,
I
I
am
a
transplant
from
California
I
live
in
Boston
now,
I
live
in
Jamaica,
Plain
and
I.
Think
that
we
have
this
really
amazing
city
and
I.
Think
we
have
you
know
from
my
work
in
Chinatown.
We
have
amazing
community
partners
and
I
think
what
we
need
to
do
is
I
think
we
need
to
invest
in
the
community
infrastructure
that
already
exists.
You
know,
especially
in
immigrant
communities
right.
These
are.
G
This:
is
the
infrastructure,
that's
the
safety
net
and
they're
doing
a
lot
of
work
like
we
call
it
cultural
brokering
that
doesn't
get.
You
know
it
doesn't
get
compensated,
it
doesn't
get
paid,
for
you
know
people
in
Chinatown
we're
working
on
problem
gambling
before
you
know,
and
you
know
people
not
being
compensated
for
working
on
problem
gambling
right,
because
these
are
you
know,
people
committed
to
the
community
and
I
think
we
also
have
strategies
that
are
being
used.
G
I
think
I
also
want
to
put
a
plug
in
for
more
local
studies
and
more
community
engaged
research.
So,
like
I
said
you
know,
Chinatown
is
a
unique
community.
I'm
sure
that
if
we
did
studies
in
different
neighborhoods
within
like
Dorchester
or
Roxbury,
you
know
and
gave
the
community
resources
and
the
ability
to
articulate
what
they
see
as
the
community
health
priorities.
You
know
we
would.
That
would
help
us
get
a
bigger
picture
of.
What's
going
on
in
different
neighborhoods
I
think
we
need
to
innovate.
G
I
think
that
you
know
we
need
to
work
across
sectors.
I
really
always
appreciate
the
Boston
Public
Health
Commission
focus
on
health
in
all
policies,
so
I
really
support
that
and
then
the
last
one
is
you
know
this.
This
comes
I,
you
know
my
backgrounds
in
education
is,
is
the
sense
that
you
know
I
know
in
Boston,
so
much
of
our
attention
has
been
put
on.
G
You
know
trying
to
maintain
the
the
people
who
come
in
for
school,
and
you
know
maintain
that
talent,
but
I
want
to
ask
you
know
what
about
investing
in
the
talent
of
the
kids,
who
are
growing
up
here
in
Boston?
Who
can
be
these
cultural
brokers
who
care
about
their
communities
and
I?
Think
there
needs
to
be
an
investment
and
a
building
of
a
pipeline
around.
You
know
the
public
health
you
know
pipeline
from
you
know
from
the
residents
of
Boston.
Thank
you
thank.
H
I
Good
morning
and
thank
you
so
much
for
inviting
me
here,
it's
an
honor
and
a
pleasure
and
I
appreciate
the
opportunity
to
tackle
this
issue.
This
is
my
life's
work
and
I
want
to
thank
all
the
councillors
and
everybody
in
the
room
for
giving
us
a
chance
to
bring
voice
to
many
communities
who
often
or
I'd,
say
a
rarely
at
tables
like
this.
So
I
appreciate
this
opportunity,
I'd
like
to
break
my
comments
into
three
different
areas.
First,
a
bit
of
background
about
what
I
do,
and
why
do
it?
So
you
understand
the
lens
I.
I
Bring
to
this
topic.
Number
two
I'd
like
to
talk
about
what
we
know
both
from
the
national
and
local
landscape
and
I'd
like
to
humbly
share
three
possible
recommendations.
That
would
be
quite
concrete
that
I
believe
could
help
in
these
efforts.
So
my
name
is
Joseph
Betancourt
I'm
founding
director
of
the
disparity
solution
center
of
mass
general
hospital.
I
That
might
add
to
the
already
fantastic
work
we
do
personally
I'm
originally
from
Rico
I
grew
up
in
a
bilingual
bicultural
home.
A
lot
of
the
issues
that
we
are
discussing
today,
I've
lived,
and
so
this
work
is
certainly
personal
to
me.
I'll
begin
just
a
bit
by
talking
about
what
we
know
in
the
space
from
from
the
national
and
local
landscape.
I
I'd
start
by
saying
this
is
not
a
new
issue.
This
is
long-standing.
This
is
persistent.
We
see
improvements,
but
we
still
have
a
long
way
to
go.
I
had
the
good
pleasure
in
1999
now,
20
years
ago,
of
being
asked
to
serve
on
an
Institute
of
Medicine
committee
that
was
asked
by
Congress
to
better
tackle
better
understand
these
issues
of
disparities
and
20
years
later.
We
still
understand
that
today,
if
you
are
a
person
of
color,
you
are
more
likely
died
of
diabetes.
I
Heart
disease
have
higher
rates
of
infant
mortality,
higher
rates
of
cancer,
higher
rates
of
asthma,
higher
rates
of
oral
health
challenges,
asthma
than
your
white
counterparts,
no
matter
where
you
live
and
no
matter
what
your
socioeconomic
status
is.
So
this
isn't
just
about
socioeconomic
status
variations
and
that's
real.
We
also
understand,
as
was
mentioned
by
my
colleagues,
that
as
we
think
about
people
of
color,
we
shouldn't
necessarily
think
about
monolithic
groups.
We're
talking
here
today
about
Asian
Americans,
there's
an
incredible
diversity
within
those
groups.
I
So,
as
we
think
about
data
among
all
of
these
groups
of
peoples
of
color,
we
need
to
understand
who
is
in
our
neighborhoods,
who
is
our
population
and
how
we
tailor
our
approaches
to
meet
their
needs.
I
think
that's
critical,
a
critical
part
of
this
data.
If
we
think
about
the
contributors
to
these
disparities
and
health
outcomes,
we
lead
with
the
social
determinants
of
health.
These
are
things
that
we've
known
about
for
a
long
time.
We've
called
them
public
health
challenges.
I
They've
now
gotten
a
you
know,
a
more
attention
with
the
term
social
determinants,
but
in
essence,
it
is
shouldn't,
be
surprising
to
anyone
that
individuals
who
don't
have
a
living
wage
who
have
food
insecurity,
have
housing
insecurity
who
can't
pay
their
utilities,
who
don't
have
access
to
education,
are
going
to
do
less
well
as
it
relates
to
their
health,
and
so,
as
we
attempt
to
address
all
of
those
areas,
certainly
we
believe
we
will
move
the
needle
on
health
disparities,
and
so
social
determinants
play
a
very
large
role.
The
challenges.
I
These
are
very
big
issues
and,
in
the
absence
of
a
concerted
effort
that
ties
this
to
health,
we
move
these
occurs,
but
it
might
take
decades
before
we
move
is
around
disparities
in
health
and
health
outcomes.
The
second
largest
contributors
access
to
care,
the
state
and
the
city
have
done
incredible.
Work
around
getting
people
insured,
certainly
wonderful,
but
an
insurance
card
does
not
meaningful
access
make.
If
individuals
can't
get
to
a
health
care
provider
if
they
see
a
health
care
provider
who
doesn't
understand
culturally
or
speak
their
language,
that
access
is
very,
very
limited.
I
We
see
this,
we
have
evidence
of
these
challenges
and
so
creating
not
only
insurance
vehicles
but
appropriate
benefits
and
also
meaningful
access,
because
it's
going
to
be
critical
and
another
area
that
we've
tackled
a
third
area
to
contribute
to
these
disparities
is
we
know
today
if
two
patients
present
to
an
emergency
room
around
this
country
and
they
both
have
chest
pain
and
the
only
difference
between
them
is
a
color.
Their
skin
minority
patients
are
significantly
less
likely
to
be
referred
for.
Cardiac
catheterization,
angioplasty,
bypass
surgery,
cardiology,
specialist
care.
I
We
see
this
in
pain,
management
for
long
bone,
fractures,
referral
for
renal
transplantation
and
end-stage
renal
disease.
These
disparities
are
legitimate,
they're,
long-standing
and
many
in
the
healthcare
community
will
say
we're
trying
to
do
our
best
and
we
try
to
care
our
best
for
everyone.
But
ultimately
we
still
see
these
differences.
I'll
say
that
our
city
has
had
the
great
courage
of
asking
our
hospitals
to
monitor
their
quality
by
race,
ethnicity,
and
so
we've
come
a
long
way
in
tackling
that
area,
but
certainly
there's
more.
That
can
be
done.
I
Now
the
second
point
I'd
make
is
I
arrived
here
in
Boston,
2001
and
shortly
thereafter,
Mayor
Menino
and
had
a
chance
to
work
with
Monica
Valdes
Lupi
back
then
commissioned
a
major
initiative
on
disparities.
The
first
report
on
disparities
brought
together
leaders
from
private
industry
in
the
public
health
sector,
hospital
leaders
to
really
I
think
launched
an
initiative
in
this
area
and
Mayor
Walsh
has
been
equally
supportive,
but
that
initiative
was
very
exciting.
I
So
I
guess
I'd
like
to
say
that
we've
been
here
before
I
think
we've
taken
our
foot
off
the
gas
a
bit
to
some
degree
as
it
relates
to
a
concerted
campaign.
But
our
Boston
Public,
Health,
Commission
I,
would
argue,
is
one
of
the
best
in
the
nation
and
their
attention
to
health
equity
has
been
outstanding
and
it
now
span's.
I
You
know
well
more
than
15
years,
so
that
energy
is
real
and
I
went
in
by
saying
that
there
is
a
national
movement
afoot
on
this
area,
but
there
is
an
opportunity
for
us
to
lead
and
lead
more
significantly
as
a
city.
So
I'll
end
by
saying
a
couple
of
points
about
what
I
believe
we
can
do
number
one.
The
I
had
the
good
pleasure
of
serving
on
the
Boston
Public
Health
Commission
x'
board
on
the
board
of
health
for
nine
years.
I
I
have
seen
the
incredible
work
that
they
do
under
the
leadership
of
multiple,
very,
very
talented
directors,
including
now
Monica
Valdes
Lupi,
who
were
very
fortunate
to
have.
We
have
a
dedicated
team
there,
but,
as
is
always
the
case,
resources
are
a
challenge.
We
have
a
fantastic
office
of
health
equity.
We
have
within
the
Boston
Public
Health
Commission
I
think
an
incredible
foundation
to
build
on
this
work.
I
So
of
course,
you're
gonna
hear
many
of
my
comments
are
about
resources
and
certainly
giving
the
Boston
Public
Health
Commission
the
resources
to
expand
their
work
on
health
equity
and
their
collaborations
I
think
could
be
a
real
essential
target
here.
Number
two:
the
social
determinants
of
health
again
are
a
great
target,
but
they
could
be
daunting.
These
are
issues
that
span
education.
They
span
all
the
things
that
we
talk
and
care
about.
I
At
the
end
of
the
day,
there
is
a
national
movement
on
encouraging
hospitals
to
be
anchors
in
their
community,
and
so
it's
important
to
this
movement
is
now
developing,
but
this
anchor
concept
says
that
healthcare
systems
businesses
come
and
go,
but
health
care
systems
sit
in
a
community.
They
are
large
employers,
they're
purchasers
of
services
and
there's
a
health
care
anchor
network.
That's
asking
healthcare
systems
across
the
country.
How
might
you
invest
your
dollars
in
communities
to
address
the
social
determinants?
I
I
think
that's
there's
an
exciting
opportunity
there
to
support
this
anchor
movement,
but,
more
importantly,
I've
always
felt
like,
as
the
healthcare
system
is
increasingly
tackling
the
social
determinants,
they
cannot
do
it
in
the
absence
of
partnerships
with
private
industry
and
city
and
local
government.
So
how
do
we
really
expand
that
anchor
work
and
take
our
community
health
needs
assessments
and
the
work
we're
doing
but
really
bring
in
a
new
set
of
players
and
I
guess?
I
We
can
move
the
needle
on
multiple
social
determinants,
but
in
the
absence
of
a
concerted
effort
and
some
real
targets,
we'll
be
back
here
in
ten
years
talking
about
the
same
thing
so
I.
Thank
you
for
your
attention.
I
look
forward
to
taking
questions
and
I'm
excited
about
this
opportunity
again.
Thank
you.
Thank.
J
J
A
B
We
can
continue
to
provide
great
services
at
the
neighborhood
level
through
programs
through
our
community
health
centers,
and
that's
all
wonderful,
but
if
we're
not
also
tackling
the
reason
why
we
find
ourselves
in
this
situation,
then
we're
just
going
to
continue
to
chase
our
tails.
So
I
appreciate
that
I
also
appreciate
the
comments.
I
think
it
was
you
doctor
who
talked
about
that.
This
goes
beyond
race,
culture,
language,
ethnicity,
and
even
when
the
the
income
is
the
same
for
communities
of
color
compared
to
their
white
counterparts.
We
still
see
this
and
you
know
my
question.
B
My
first
question
would
be:
why
is
that
and
I'm
wondering
what
what
you
have
seen
as
health
care
professionals
in
terms
of
implicit
and
explicit
bias
and
how
that
is
impacting
care
access
to
care
referrals
to
specialists
that
you
mentioned.
If
you
could
talk
a
little
bit
more
about
implicit
and
explicit
bias
and
how
that
is
playing
out
and
that's.
I
So
first
I
want
to
just
second
this
idea
that
you
raised
and
just
put
a
you
know.
Second
point
on
this:
the
social
determinance
have
become
a
very
you
know
in
in
health
care
circle,
a
very
sexy.
You
know
thing
that
again,
we've
known
about
for
a
long
time
and
I
think
what
it
really
requires,
and
what
we're
asking
people
to
do
is
take
a
look
at
history.
I
Councillor
Flynn,
you
mentioned
you
know,
particularly
Chinatown,
and
and
all
these
different
factors
I
would
argue.
If
we
look
back
historically,
there
were
very
deliberate
policies
that
disempowered
communities
there
and
elsewhere,
and
those
range
from
redlining
and
mortgage
lending
to
where
you
know
where
highways
were
put
and
the
like
I
say
that,
because
not
only
should
we
learn
about
our
past,
because
people
today
say
well
that
wasn't
me
or
you
know
they
have
this
notion
that
that
there's
been
equity
and
that
you
know
the
things
just
happened.
I
You
know
kind
of
in
in
some
way
and
you're
absolutely
correct.
Unless
we
expand
from
health
and
all
policies
to
equity
and
all
policies,
we
will
continue
to
repeat
these
same.
We
need
to
be
careful
watchdogs
around
how
our
policies
might
impact
honorable
populations
and
make
sure
they
have
voice
so
I.
Thank
you
for
raising
that
on
the
this
bias
piece,
I'd
say
two
things.
When
we
looked
at
healthcare,
we
saw
that
there
were
probably
four
major
root
causes
that
led
to
disparities.
I
Number
one
navigation,
it's
hard
to
navigate
the
system,
no
matter
who
you
are,
where
your
it's
certainly
more
difficult
to
navigate
it.
If
you
have
any
vulnerabilities
and
that
crosses
race
I
mean
this
could
be
low
health
literacy
in
a
white
community.
But
certainly
we
see
that
that
disproportionate
impacts
from
use
of
color
communications,
another
one,
and
certainly
when
surveyed
minority
patients
that
might
feel
that
much
greater
rates
that
they
are
now
unable
to
understand
their
doctor
feel,
like
their
doctor,
understands
them
or
able
to
communicate
effectively.
So
improving
communication
is
important.
I
Mistrust
is
a
very
legitimate
challenge.
We
have
many
people
who
mistrust
health
care
for
a
lot
of
different,
very
legitimate
historical
reasons
and
otherwise,
and
so
building
trust
becomes
an
essential
tool.
But
the
point
that
you
raised
is
implicit
bias,
explicit
bias
and
the
like,
and
at
the
end
of
the
day,
I
believe
that
we
know
our
health
care
system
is
built
on
a
model
of
structural
racism.
We're
still
many
of
these
policies
failed
in
in
a
variety
of
different
ways,
still
have
disproportionate
impacts
on
people,
whether
they're,
intentional
or
not.
I
So
looking
at
policies
are
gonna
be
critical,
but
on
the
individual
provider
level,
you
know
it's
really
interesting,
because
if
you
were
to
ask
any
doctor,
do
I
treat
people
differently?
That's
absolutely
not,
and
we
surveyed
people-
and
you
know
thousands
of
doctors
in
1999
and
the
Namie
phenomena
is
very
real
because
people
come
into
this
and
they
say
no.
I
So
you
have
good
intent,
well
intentioned
people
who
want
to
do
the
right
thing,
think
they're
doing
the
right
thing,
but
are
susceptible
to
stereotypes,
and
they
don't
believe
they
are,
and
the
good
news
is.
Is
we've
engaged
in
this
discussion
scientifically
about
how
our
minds
work,
not
good
or
bad
people,
but
how
our
minds
work?
Twenty.
Sixteen
sixteen
thousand
doctors
were
asked
about
bias.
Now
forty-three
percent
agree
that
they
have
biases
that
impact
their
clinical
decision
making.
I
So
a
long
way
of
saying
that
I
think
through
educating
caregivers
to
say
you
know,
doesn't
mean
you're,
good
or
bad.
Just
mean
hot,
you
know
how
your
mind
works
may
lead
to
these
very
different
decisions.
We
are
slowly
making
gains
in
in
normalizing,
something
which
has
very
abnormal
effects,
which
are
disparities
in
care,
so
I'm,
confident
I
feel
confident
that
these
discussions
now
are
bubbling
up.
There's
a
lot
more
going
on
around
implicit
bias,
training,
stereotyping
and
alike,
and
it's
not
just
healthcare.
I
We
see
it
in
criminal
justice,
we
see
it
in
the
legal
system.
We
see
it
in
many
areas,
but
I
believe
there's
positive
energy
here.
Councillor,
Jane,
Ian
and
I
would
say
that
those
are
the
factors
that
lead
to
still
these
disparities,
no
matter
your
race,
even
if
your
socioeconomic
status
is
the
same,
could.
B
Any
of
you
speak
to
the
cross-section,
so
the
intersection
between,
let's
say,
being
a
woman
and
being
black
and
how
that
impacts.
Our
our
health
care
and
and
I
say
this,
because
I
recently
saw
a
clip
on
one
of
the
television
talk
shows
the
morning
shows
that
are
all
light
and
fluffy,
and
they
were
talking
about
breast
cancer.
This
is
Breast
Cancer
Awareness
and
it
was
a
black
woman
on
the
show
who
was
sharing
her
purse.
B
B
If
you
were
a
white
woman,
particularly
if
you
were
a
white
woman
who
had
more
opportunities
around
income,
etc,
that
you
could
wait
till
50,
but
the
grave
consequences
of
for
black
woman
to
wait
until
50
could
mean
me
missing
something
in
a
mammogram
and
when
black
women
do
end
up
with
a
diagnosis
around
breast
cancer,
it
tends
to
be
a
more
invasive
or
aggressive
cancer.
The
life
expectancy
is
shorter,
for
black
women,
etc,
etc.
B
And
you
know
I
was
frustrated
watching
this
play
out,
because
what
it
didn't
communicate
to
me
is
that
what
you
may
advise
one
particular
group:
that's
fine,
but
you
have
to
acknowledge
that
for
this
other
group
there
are
different
outcomes
and
it
didn't
it
didn't
kind
of
do
that
and
so
I
wonder
if
you
could
speak
to
the
intersection
when
it
comes
to
gender
and
race
in
class
and
how
that
plays
out
in
the
healthcare
field
and
that
could
be
for
anyone.
And
what
are
we
doing
to
to
combat
that
like?
F
I
can
start
the.
There
was
a
group
that
started
actually
under
Mayor
Menino,
but
mayor
Walsh
just
recently
had
them
in
earlier.
This
week
are
pink
and
black
group,
and
this
was
really
to
your
point
in
terms
of
black
women
in
particular,
who
have
some
of
the
highest
screening
rates,
local
locally
in
the
city
and
statewide,
in
terms
of
getting
screened
and
getting
their
mammograms
and
yet
dying.
Their
mortality
rates
from
breast
cancer.
F
Colorectal
cancer
are
much
higher
than
whites,
despite
the
fact
that
they're
screened
some
of
the
things
that
doctor
competin
court
mentioned
in
terms
of
care
when
you
are
diagnosed
and
it's
at
a
later
stage,
you
have
to
have
all
of
these
wraparound
supports
and
I
think.
This
is
why
social
determinants
has
gotten
to
be
a
really
sexy
label
now,
because
hospitals
and
insurers
and
the
way
that
payment
reform
is
changing
the
landscape
of
how
our
providers
are
being
paid.
Is
that
these
these
these
community
health
workers
coordinated
care?
F
The
patient
navigators
that's
essential
to
have
when
you
have
a
diagnosis
and
to
have
someone
who
has
the
same
lived
experience
who
reflects?
Who
is
reflective
of
the
population
that
you're
serving?
We
just
recently
met
two
weeks
ago
with
American
Cancer
Society.
The
topic
was
on
colorectal
guidelines,
colorectal
screening
guidelines,
and
they
have
a
campaign
where
they're
trying
to
get
80
percent
of
blacks
screened
by
the
age
of
45,
because
they
have
higher
risk
factors,
and
so
a
lot
of
it
is.
F
We
are
having
a
lot
of
positive
trends
in
terms
of
screening,
but
there's
so
many
other
things
that
we
have.
We
have
to
be
vigilant
about
in
terms
of
making
sure
that,
once
you
do
get
that
screening
and
there's
something
that
comes
out
whether
it's
a
mammogram,
a
pap
smear
for
asian-americans,
there
Riaan
Singh
cervical
cancer
at
higher
rates
than
been
Latinos
and
blacks.
F
So
when
you
get
that
positive
test
result,
you
need
to
be
able
to
get
care
given
in
a
language
that
you
can
understand
and
with
providers
that
look
like
you
and
I
know
that
dr.
Benton
Court
through
the
disparities
solution,
Center
did
a
lot
of
work
in
this
space,
both
locally
and
nationally
and
I.
Don't
know
Carolyn
if
you
have
information
from
the
research
that
you've
done
at
Tufts
specific
to
Asians
I.
B
Let
me
ask
this
too
so
also
in
the
presentation
someone
mentioned
displacement
and
gentrification
and
I
think
that's
huge
in
terms
of
the
public
health
risk.
We
know
from
listening
to
the
news
just
every
morning
you
hear
about
electronic
cigarettes
and
the
health
risks
there.
We
we
think
you
mentioned
gambling
and
casinos
the
opioid
crisis.
B
What
more
can
we
do
particularly
like
with
our
young,
our
students,
our
children,
around
making
sure
that
they
understand
the
risks?
What
are
their
programs
in
schools
at
the
community
health
centers
around,
like
opioid
use
electronic
cigarettes
and
how
that's
impacting
I,
think
one
of
the
panelists
mentioned
mint
and
menthol
campaign
and
how
they're
targeting
you
know
historically
have
targeted
communities
of
color,
particularly
black
people,
around
menthol
cigarettes,
but
we
see
the
same
thing
with
the
electric
electronic
cigarettes
for
our
young
people,
flavored
cigarettes,
etc,
etc.
B
How
do
we
seeing
we
know
what
will
happen
if
we
do
nothing
right?
That
will
see
a
new
generation
that
will
be
subjected
to
cancers,
etc,
respiratory
illnesses?
What
can
we
do
that
really
looks
at
this
issue,
and
if
do
we
need
more
programs
in
our
schools?
If
we're
trying
to
combat
this
in
terms
of
young
people
same
thing
with
our
STDs
and
making
sure
we're
doing
more
screenings
there,
or
are
we
in
the
schools
in
a
substantial,
significant
way?
B
F
I
think
there's
always
we
can
always
be
doing
more
I'm
happy
to
share
that.
We
are
working
closely
with
superintendents
cassellius
and
her
team
post
I
think
release
of
the
governor's
executive
order
around
vaping,
but
we've
been
doing
work
with
bps
for
many
years
through
our
school-based
health
centers
and
through
our
peer
leaders
in
terms
of
raising
awareness
and
promoting
prevention
messages
using
the
high
school
students
themselves
so
and
with
the
mint
and
the
menthol
it
we
relied
and
worked
with
our
community
partners.
F
When
we
held
a
community
forum
this
summer
we
held
it
in
July
at
Codman
square
at
the
Great
Hall,
and
that
was
Cynthia
leche.
Who
was
one
of
our
original
I?
Don't
know
Joe.
If
you
remember
her,
she
was
one
of
our
original,
bold
teens
and
now
she's.
You
know
an
adult,
a
mom
and
she
had
this
next
generation
of
bold
teens
with
her
talking
about
the
impact
of
minth
and
menthols
any
cigarettes
and
vaping
in
communities
of
color.
F
So
I
know
that
china
town
also
has
teens
who
are
working
around
raising
awareness
and
prevention
around
east
cigarettes,
and
so
I
think
that
the
youth
and
the
young
adults
in
the
cities
are
activated
and
we
can
always
do
better
in
terms
of
mobilizing
them
they're
the
best
champions
in
terms
of
working
with
their
peers
around
whether
it's
opioid
use
marijuana
menthols.
They
really
are.
The
partners
who
we
bring
to
the
table.
F
I
was
just
with
a
group
last
night
of
our
youth
advisory
board
at
our
Boston
area,
Health
Education
Center,
and
we
have
a
curriculum
on.
It's
called
a
porn
literacy
curriculum
which
we
do
in
partnership
with
Emily
Rothman
at
BU,
School
of
Public
Health,
and
they
were
talking
about
healthy
relationships
and
I.
G
Because
I
want
I,
wanted
to
respond
to
the
question
around
implicit
bias
and
actually
give
an
example
in
the
Chinatown
community.
I
think
the
way
that,
because,
as
we've
discussed,
you
know,
all
communities
of
color
are
different,
there's
heterogeneity,
you
know
even
within
asian-americans,
but
what
I
see
happening
a
lot
in
Chinatown
is
that
some
is
that
some
is
that
we
get
that
Chinese
get
blamed
and
say
it's
well,
it's
your
culture.
So
why
do
Chinese
gamble?
Oh
it's
in
your
culture.
How
come
you
know
you're
around
accessing
services?
G
Well,
because
the
parents
are
passive
and
they're
not
seeking
services
and
I
think
that
it
you
know
it's
victim
blaming
and
it
puts
the
onus
you
know
on
the
person
versus
putting
the
onus
on
the
system.
You
know
I
know
that
my
colleague
Don
Salma
from
the
engine
task
force
against
domestic
violence.
You
know
contestant
will
be
testifying
and
can
testify
to
this
as
well.
You
know
I
had
a
student
who
did
a
small
research
project
with
a
test.
G
B
C
You,
mr.
chairman,
and
thank
you
to
counsel
Janie
for
her
excellent
questions.
It
was
very
informative.
The
discussion
going
back
and
forth
and
he
ended
it
and
educational
I
just
wanted
to
focus
on
a
couple
comments
that
that
were
made.
I
am
working
with
council
president
Campbell
on
an
upcoming
hearing
on
domestic
violence
and
sexual
assaults
and
I've
been
focused.
We've
been
meeting
a
lot
of
providers
across
the
city
in
the
state
I've
been
focused
on
what
impact
language
access
has
on
this.
What
what
is
the
impact
of
being
an
immigrant
on
this
particular
issue?
C
But
but
my
question
really
focuses
on
language
access
in
general,
in
public
health,
I.
Think
I
think
you
mentioned
doctor
that
you
know
there
are
so
many
different
Asian
American
communities
across
across
Boston
across
Massachusetts.
So
what
happens
in
Chinatown
with
the
Chinese
community
is
very
different
than
what
happens
in
Dorchester
with
the
Vietnamese
community.
I
also
do
a
lot
of
work
with
what
the
Vietnamese
community
as
well,
although
they're,
not
in
my
in
my
district,
but
do
we
have
I,
don't
think
we
have
enough
data
I,
don't
think
we
focus.
C
We
concentrate
enough
on
really
diving
into
the
Chinatown
community
itself.
Looking
at
the
unique
problems,
social
problems,
health
problems
of
the
Chinese
community
in
Chinatown,
I
think
it's
oftentimes
lumped
in
with
all
Asian
communities
across
Boston,
including
Brighton,
that
has
a
high
in
Ulsan.
That
has
has
a
high
aging
community,
but
if
we're
doing
that,
are
we
not
getting
an
accurate
picture
at
times,
because
the
data
is
is
not
accurate?
C
I
had
the
opportunity
to
testify
in
favor
of
representative
Jackie
Chan's
proposed
legislation
last
week
in
favor
of
it,
I
want
to
see
us
break
down.
I
want
to
see
government
break
down
ethnic
groups
so
that
we
can
really
get
a
fear
and
accurate
portrayal
of
exactly
what
has
happened,
but
I
think,
because
we're
not
doing
that
at
times.
We
don't
have
all
the
we
don't
have
all
the
we
don't
have
the
accurate
story.
I.
G
G
You
know
work
on
that
data
and
and
to
be
able
to
compare
it
to
to
the
grader
or
to
the
city
of
Boston
and
I
believe
you've
seen
some
of
that
data.
But,
as
I
mentioned,
you
know
in
my
remarks
you
know
date.
We
need
more
data,
but
also
data
isn't
perfect.
You
know
it's
also
that
very
survey
from
which
we
couldn't
detect.
G
You
know
depression
and
mental
health
concerns
in
the
community,
but,
like
I
said
everyone
that
I
ever
talked
to
in
Chinatown
will
say
that
one
of
the
top
concerns
in
Chinatown
is
mental
health.
So
I'm
not
sure
if
it's
a
measurement
issue
or
if
it
I'm,
not
sure,
but
it's
you
know
there
are.
You
know
we
are
still
working
on
trying
to
find
out
ways
to
get
reliable
data.
You
know
from
from
the
community.
C
C
Know
I
spoke
on
and
off
for
the
last
two
years
with
with
Public
Health
on
that
particular
issue.
It
was
always
my
goal
to
continue
working
with
the
city
of
Boston
with
Public
Health,
but
really
to
dig
deep
into
Chinatown
into
a
specific,
in-depth
study
about
the
public
health
concerns
in
that
community,
and
that's
something.
I
would
really
like
to
see
happen
and
I
know.
I
spoke
to
many
people
at
the
mayor's
office
and
in
with
director
of
director
Luffy
as
well
about
that
issue.
F
Probably
share
some
of
the
the
details,
but
I
know
that
we
were
able
to
because
they
used,
and
this
might
be
a
little
in
the
weeds,
but
they
used.
The
good
thing
is
that
the
the
survey
that
they
did
actually
used
questions
that
are
the
same
questions
that
we
use
in
the
behavioral
risk
factor
the
BRFSS
survey,
and
so
we
were
able
to
do
some
additional
analysis
and
weighting
that
allowed
them
to
tease
out
some
of
the
data
that
we
we
weren't,
that
we
didn't
do
in
health
of
Boston.
F
So
I
understand
that
in
that
initial,
a
deeper
dive
that
they
were
able
to
see
that
Chinese
adults
in
Chinatown
experienced
lower
rates
of
asthma
and
then
they,
but
they
also
experienced
higher
rates
of
diabetes
and
hypertension
when
compared
to
Boston
residents
as
a
whole.
I
think
we
have
to
continue
to
work
on
how
to
collect
the
data
and
BRFSS.
As
you
said,
it's
not
a
perfect
tool
and
some
of
the
more
qualitative
data
I
think
that
Carolyn
talked
about
might
be
a
different
way
of
gathering
information.
We
we
saw
this
when
we
did.
F
The
community
health
needs
assessments
with
the
hospitals,
so
that
was
a
online
survey
very
long
about
forty
five.
It
was
forty
five
fifty
questions,
I
think
and
what
we
were
able
to
do.
I
think
in
partnership
with
Tufts
and
Sherry's
team
was
do
smaller
focus
groups
and
I
think
when
you
are
working
with
different
populations,
particularly
populations.
That
might
not
be
the
first
to
do
that
online
survey
or
to
take
a
telephone
survey
because
of
language
barriers.
We
have
to
think
creatively
about
we
how
we
collect
the
information
I.
G
Wanted
to
also
add
you
know
so
this
survey
that
we
that
we
did
you
know
we
it
wasn't
online,
it
wasn't
by
phone,
we
actually
hired
bilingual
bicultural
survey.
You
know
community
field
researchers
who
went
out
into
the
community,
you
know
knocking
on
to
recruit
people
and
then
administered
the
survey
verbally
and
I.
G
Think
because
of
that
we
were
able
to
get
a
high
response
rate
because
and
I
think
this
predates
you
Monica,
because
we
think
years
ago,
when
we
asked
when
we
asked
the
Boston
Public
Health
Commission
about
you,
know
doing
the
BRFSS
in
in
Chinese
over
the
phone.
They
actually
said
that
even
when
they've
done
it
over
the
phone,
they
don't
get
a
good
sample
size.
So
that's
why
we
went
door-to-door
and
so,
but
it's
important
to
note
these-
are
you
know
these
are
resource
intensive?
You
know
these
are
more
resource.
G
F
C
That
would
be
excellent.
Thank
you.
I
know
both
all
three
panelists
mentioned
the
breast
cancer
issue
and
in
the
Chinese
community
as
well.
Asian
women
have
longer
wait
time
after
an
abnormal
screening
and
lowest
screening
rates
on
breast
cancer,
as
well
I,
often
think
about
in
my
community
in
Chinatown,
where
we're
practically
surrounded
by
hospitals.
C
G
I,
you
know
I
know
my
colleague,
Qin
Shihuang
is
also
in
the
audience
I'm
sure
she
can
speak
to
this
as
well,
but
I
think
that
you
know
for
a
lot,
for
you
know
an
immigrant
community
where
there
may
be
either
a
lack
of
awareness
or,
but
probably
also
maybe
more
distrust
or
fear
of
the
medical
system.
I
think
that
you
know
these
cultural
brokers,
that
I
was
talking
about
that.
Sometimes
we
call
them
patient
navigators.
Sometimes
we
call
them
community
health
workers.
G
You
know
these
are
these
are
people
from
the
community
who
are
seen
as
trusted?
You
know
allies,
interpreters
and
bridges.
You
know
between
you
know
more
mainstream
institutions.
You
know
these
big,
these
big
hospitals
and
local
communities
and
and
I
think
that
these
are
assets
that
we
have
in
our
city
and
I.
G
Think
that
you
know
that
that
we
need
to
you,
know
del
allocate
resources
for
them
as
well,
and
and
also
for
them
to
happen
in
community
settings,
and
you
know,
and
and
and
I
don't
mean
just
community-based
organizations
right
I
mean
I
think,
depending
on
what
community
setting
makes
sense
like,
for
example,
is
it
the
faith-based
organizations
but
to
you
know,
meet
people
where
they
are
at
and
to
do
it
with
people
that
are
sensitive?
You
know
to
their
needs
and
to
their
cultural
concerns.
I
There's
countless
examples
of
how
community
health
workers,
health
care,
coaches
navigators
have
significantly
narrowed
disparities
in
breast
cancer
in
colorectal
cancer
in
cervical
cancer
and
the
challenges
that
our
current
payment
model,
which
is
fee-for-service,
does
not
support
the
sustainability
of
those
programs.
Those
programs
are
often
grant
programs
community-based
programs
that
you
know
receive
some
funding.
I
They
show
great
results,
but
the
other
day
within
the
current
healthcare
financing
system,
they're
not
supported,
and
so
you
know,
there's
a
graveyard
full
of
incredible
interventions
like
that
that
leverage
the
strength
the
community
and
that
Eero
disparities
in
these
areas.
Now
our
push
as
Monica
was
mentioning
towards
value-based
contracting
I
think
gives
us
an
opportunity
to
invest
there,
but
I
always
felt
like
partnerships,
City
private-public,
that
would
support
in
community
community
health
workers
navigators
coaches.
I
To
do
this
incredible
proven
efficient
work
as
we
continue
to
build
out
our
value-based
contracting
is
where
the
money
is
out.
I,
don't
necessarily
believe,
especially
in
Boston,
that
we
need
more
doctors
or
more
nurses.
I
mean
we
have
plenty
of
those.
This
is
where
the
leverage
is,
and,
quite
frankly,
this
is
an
opportunity
for
empowerment
for
those
individuals
in
the
community
and
getting
them
on
a
career
ladder
as
well.
So
I
think
you
do
multiple
things
at
once.
I
C
You
I
referenced
it
in
my
opening
statement,
but
I
also
represent
a
large
Puerto
Rican
community
in
the
south.
End
I
also
represent
a
large
african-american
community
in
in
the
south
end
and
in
South
Boston
in
South
Boston,
particularly
in
many
of
the
public
housing
developments,
so
I'm
proud
to
represent
both
of
those
communities
as
well.
F
C
F
Partnerships
that
we
have
around
maternal
health
with
the
Boston
Housing
Authority,
and
this
really
happened
councillors
with
the
leadership
of
director,
McGonagall
and
I-
know.
I
saw
many
of
you.
A
couple
I
think
was
just
last
week
at
his
funeral
Mass
and
he
had
that
lived
experience
of
growing
up
in
in
the
in
South
Boston
there,
and
so
he
was
a
big
champion
of
ours
in
public
health.
F
So
everything
from
our
the
work
that
the
environmental
health
team
does
at
the
Boston
Public
Health
Commission
around
healthy
homes
and
integrated
pest
management
address
higher
asthma
rates
in
DHA
properties,
to
looking
at
food
insecurity
and
healthy
eating
and
increasing
physical
activity.
Those
are
the
things
that
we've
been
working
on
over
the
years
with
partners
in
bhj.
We
we
also
had
done
now,
I
think
it's
three
years
ago
we
do
summer
community
dialogues
and
we
looked.
F
We
worked
with
PHA
and
they
ndnd
in
convening
a
series
of
conversations
on
the
impact
of
housing
on
health
and
so
issues
of
displacement
issues
around
lack
of
transportation.
Those
are
the
sorts
of
things
that
we've
worked
on
with
our
other
city
partners
and
other
community
partners,
but
all
of
the
issues
I
think
the
health
issues
that
we've
talked
about
you
see
are
exacerbated
among
people
who
are
already
living.
F
We
looked
at
housing
status
in
among
individuals
who
responded,
who
were
in
public
housing,
people,
respondents
who
had
Genet
housing
and
compared
it
with
renters,
and
also
people
who
own
their
homes
and
not
surprising,
to
see
higher
reported
experiences
around
the
chronic
diseases
and
also
experiencing
mental
health
and
behavioral
health
challenges
that
that
is
actually
broken
out
in
the
health
of
Boston
report,
and
we
can
provide
that
offline.
Thank.
C
Thank
you
very
much
and
in
the
interest
of
time
I'm
not
going
to
ask
any
more
questions.
Although
I
could
ask
more
questions
for
at
least
another
hour,
you
guys
have
been
very
informative
in
providing
great
information,
but
I
know
my
council.
The
council
president
wants
to
is
next
so
I'm
not
going
to
ask
you
more
questions.
Thank
you.
Thank
you.
Thank.
E
You
councillor
O'malley
and
thank
you
guys
for
the
thoughtful
and
very
frank
you
know
points
that
you've
made
and
thank
you
for
the
work
you
do
in
your
respective
spaces,
I'm
sure
it
is
challenging
and
difficult
every
day.
I
think
I.
Just
you
know
I'm
telling
myself
not
to
be
depressed
over
here
frankly,
and
what
I
mean
by
that
is
I,
think
you
said
this
dr.
E
Bethencourt
that
it
you
know
these
are
long-standing
persistent
issues,
they're
big
issues
and
when
you
look
at
the
social
determinants
in
particular
they're
big
issues,
and
so
it
will
take
us
some
time
to
address
them.
But
then,
on
the
other
hand,
our
residents
don't
have
time
right.
So
I
just
really
appreciate
the
work
you're
doing
and
for
sort
of
naming
some
of
that.
E
Where
do
I
begin
so
I
have
a
lot
of
questions,
but
I'll
try
to
start
with
just
a
few
and
for
the
sake
of
time
one
of
the
things
I
thought
was
really
powerful.
Was
this
conversation
around
data
and
in
really
naming
the
fact
that
it's
not
data
is
not
perfect?
The
importance
of
both
quantitative
and
qualitative
data
community
assessments,
conversations
with
real
people
to
see
if
the
data
that
we
have
actually
is
accurate
or
complete,
and
it's
one
thing
that
we
talked
about
I,
think
with
respect
to
every
issue.
E
Education
is
a
big
one
for
me
and
you
think
about
disparities
in
education,
particularly
within
the
Asian
community,
and
if
you
do
not
dissipate
that
data,
you
missed
the
picture,
particularly
you
think
about
my
district
I
have
a
large
Vietnamese
population
and
by
some
metrics
they
are
doing
worse
than
black
and
Latino
students.
You
would
never
know
that
experiencing
very
significant
mental
health
issues
in
the
education
space
that
often
don't
get
talked
about
so
I'm
just
curious.
E
It
sounds
like
we
still
have
work
to
do
and
investments
need
to
be
made
to
really
come
at
this
from
different
angles.
To
really
get
data
from
the
community
in
different
innovative
ways,
but
I'm
curious,
who
is
doing
it
maybe
really
well.
It
sounds
like
there
has
been
some
folks
in
the
community
already
who
have
already
done
this
in
Chinatown
but
who's.
I
With
an
approach
that
we've
taken
going
back
to
2004,
so
this
is
a
you
know.
The
bottom
line
is
that
you
can't
manage
what
you
don't
measure
pushing
our
capacities
to
better
stratify
by
not
just
race
and
ethnicity.
But
you
know
this
state
and
the
city
have
the
courage
to
require
hospitals
to
collect.
You
know,
race,
ethnicity,
language,
proficiency
and
highest
level
of
education
and
I
believe
that
this
move
towards
Big
Data
really
can
be
applied
to
to
healthcare,
and
so
that's
one
but
number
two
looking
under
the
hood
is
really
really
critical.
I
We
measure
patient
satisfaction
because
of
requirements.
You
know
for
many
many
years
and
what's
lost
in
that
measurement.
Is
that
the
people
who
reply
to
those
patient
experience,
surveys
and
patient
satisfaction
surveys,
the
you
know
rarely
represents
the
catchment
area
and
the
entire
community
who
receives
care
in
our
institution,
for
example,
and
so
in
2004
we
set
up
a
series
of
resources
to
do
exactly
that.
I
How
can
we
make
sure
we
are
going
using
different
techniques
to
hear
from
our
communities
of
color
who
we
know
good
care
from
us,
but
who
we
don't
see
in
our
patient
experience
survey
results
and
asking
them
questions
about
their
experience,
but
also
about
racism,
about
trust
about
disparities,
related
issues.
We
did
that
in
2004
and,
as
you
might
imagine,
we
learned
a
lot
of
interesting
things
that
our
basic
survey
tools
didn't
tell
us,
but
it
took,
as
was
mentioned,
that
a
kated
resources,
specific
efforts,
but
they
shouldn't
be
one
offs.
I
They
shouldn't
be
ad
hocs.
They
shouldn't
depend
on
on
some
institutions,
goodwill.
We
now
have
done
a
2004
2012-2017,
we're
gonna,
do
it
probably
every
couple
of
every
two
years
or
so,
where
we
take
specific
efforts
to
make
sure
we're
hearing
from
everybody
and
I
think
that
approach
needs
to
take
root
not
only
in
our
health
care
institutions
but
also
in
our
in
our
communities
and
I.
Would
second
this
idea
that
you
know
too
much
data.
Can
you
know?
I
E
That
sort
of
connects
to
the
other
point
around
sort
of
the
investing
in
community
infrastructure.
The
assets
are
the
people
on
the
ground
willing
to
volunteer
their
time
to
be
a
part
of
the
solution.
The
organizations
that
are
community
based
one
thing:
I
love
about
my
district
and
it's
largely
Mattapan
and
Jamaica
Mattapan
and
Dorchester-
that
I
represent
from
lower
Mills
all
the
way
through
Grove
Hall
I've
a
little
bit
of
Jamaica
Plain
in
Roslindale,
I,
say
it's
where
all
the
inequities
live.
E
So
you,
you
think
about
data
collection,
the
people
who
are
on
the
ground.
If
you
invest
in
them.
What
might
you
learn
in
terms
of
the
data
piece?
But
how
might
you
utilize?
The
fact
that
they
have
built
trust
with
populations
that
often
distrust
systems
and
a
whole
bunch
of
systems
and
so
I'd
love
to
hear
a
little
bit
more
on
what
the
city
could
be
doing
or
thinking
about
doing
in
terms
of
and
through.
The
leadership
of
you
know,
Monica
and
the
work
you're
doing
at
your
agency
to
better
and
expand.
K
E
F
As
you're
talking
through
that
exam
counselor
the
the
example,
there
are
two
things
that
come
to
mind.
So
the
one
example
that
I
know
you're
very
familiar
with
and
have
been
a
good
advocate
for
us,
is
around
our
neighborhood
trauma
team
that
works,
and
that
really
was
you
know,
mayor
Walsh,
who
asked
us
to
think
about.
F
That
then
provides
resources
to
community
members
who
are
volunteering
or
who
are
civically,
engaged
and
going
out
and
doing
that
first
response
at
the
scene,
and
how
do
you
compensate
and
provide
resources
to
build
agency
and
capacity
at
the
neighborhood
level?
So,
as
you're
talking
that's
one
example,
I
can
think
of.
Where
could
there
be
opportunities
to
look
at
that
and
how
could
you
expand
or
build
from
that?
F
The
other
exam
that
I
would
share
with
you
is
in
working
with
our
colleagues
here
at
City,
Hall
and
chief
barrows,
and
the
work
that
he
oversees
in
economic
development.
We
just
rolled
out
this
summer,
a
policy
at
the
Public
Health
Commission,
that's
focused
on
equitable
procurement,
and
how
do
we
build?
How
do
we
increase
the
number
of
grants?
F
We
have
over
a
thousand
contracts,
millions
of
dollars
in
city
and
state
and
federal
funding
that
we
receive
that
we
push
out
through
request
for
proposals
into
communities,
but
even
in
terms
of
the
vendors
that
we
work
with,
we
can
do
better,
and
so
we
developed
a
new
policy
that
I
know.
The
staff
have
been
here
at
City,
Hall,
sharing
that
policy
and
providing
some
technical
assistance
to
other
departments
who
want
to
look
at
the
data
that
they
have
on
their
contracts.
F
And
how
do
you
better
invest
in
what
we're
describing
is
cubes
certified
under
represented
business
enterprises?
I
think
it's
it's
a
long
word,
but
the
acronym
is
cubes,
and
so
that's
another
example.
When
I
hear
you
talking
about
so
agency
and
building
capacity
at
the
neighborhood
level
that
we're
thinking
a
bit
differently
at
the
Commission
about
the
work
that
we
do
and
I
know,
the
hospitals
are
doing
this
in
terms
of
their
chinna,
their
needs
assessment
and
the
health
improvement
plans
and
thinking
really
outside
healthcare.
How
are
they
hiring
people
from
the
communities?
F
E
G
Also
think
you
know
there
is
an
opportunity
for
working
more
with
the
hospitals.
Someone
was
mentioning
that
you
know
people
are
beginning
to
think
about
hospitals
as
anchor
institutions
in
neighborhoods,
and
one
thing
I
know
that's
happening
in
hospital
now
is
that
hospitals
are
being
asked
to
screen
for
social
determinants
of
health,
but
my
question
is,
but
what
are
they
doing
with
that
data?
And
it's
good
to
know
you
know
if
people
are
food
insecure,
but
then
how
do
we
address?
G
That
and
I
know
there
are
hospitals
around
the
city
that
are,
you
know,
doing
different
things,
but
I
think
that
there
needs
to
be
a
more
intentionality
and
then
this
is
where
we
come.
I
think
the
the
pathway
of
partnering
with
different.
You
know,
community
level
partners
can
help.
You
know,
fill
those
gaps
and
in
ways
where
they
do
get.
You
know
do
get
compensated.
You
know,
I
know
that
at
Tufts
there
was
an
interest.
G
There's
there's
been
an
interesting
example
of
a
of
using
patient
navigators
in
the
Tufts
Cancer
Center,
and
it
started
with
a
grant.
You
know
from
the
susan
komen
foundation
and
I
think
and
because
the
program
was
very
successful
and
was
able
to
show
positive
outcomes
with
a
lot
of
work.
You
know
Tufts
actually
has
put
those
patient
navigators
in
their
operating
budget
right
now
so
I.
You
know
you
know
similar
to
what
dr.
Benton
court
was
saying.
I
think
we
need
to
find
a
way
to
institutionalize
these
resources
that
we
know
do
work.
E
And
another
thing
that
came
up
was
just
you
know.
First
of
all,
thank
you
for
mentioning
Cynthia
lash,
who
is
District
for
residential,
was
in
my
district,
so
I
was
very
happy
to
hear
her
name
mentioned,
but
I,
nothing
that
came
up
was
just
the
resources
that
your
agency
needs
to
be
able
to
do
this
work
in
terms
of
the
Health
Commission
and
obviously
we
worry
every
year
we're
in
budget
season,
and
my
new
question
has
been
at
least
in
the
last
budget
cycle
to
various
departments.
E
Is
you
know
what
was
the
proposed
budget
you
sent
to
the
administration?
Then
what
did
you
actually
get,
but
I
love
to
hear
a
little
bit
more
from
you,
Monica
or
even
dr.
Bethencourt,
who
brought
this
up
around
what
what
those
resources
look
like
is
it
you
know,
increase
in
monetary
dollars?
Is
it
more
human
capital?
Is
it
something
else,
but
what
does
a
Health
Commission?
F
Fy
21
budget
planning
process,
something
that
we
implemented
when
I
came
back
to
the
Commission
was
integrating
and
I
had
learned
this
from
other
colleagues.
Frankly,
who
are
from
Minnesota
in
Washington
State
who,
at
the
state
health
department's,
were
integrating
an
equity
assessment,
as
they
were
looking
at
bills
that
were
being
filed,
budget
proposals
that
they
were
submitting
so
that
there
could
be
some
objective
criteria
for
the
programs
in
addressing
health
equity.
F
Again,
how
do
you
integrate
equity
into
the
day
to
day
work
happy
to
talk
more
with
you
about
that
that
process,
but
we're
just
beginning
that
and
I.
So
there
isn't
a
simple
answer
to:
what
exactly
would
we
we
need?
Is
it
more
people
or
more
or
resources,
because
I
think
it's
a
combination
of
the
two
there
isn't
I,
don't
think,
there's
a
gold
standard
or
a
benchmark
in
terms
of
what
a
health
department
should
have
in
terms
of
whether
it's
staffing
models
or
resources.
F
We
actually
do
have
diverse
resources
that
we've
been
able
to
braid
at
the
Public
Health
Commission,
and
this
is
just
over
the
years
in
terms
of
the
grants
that
we
submit.
So
every
grant
that
we
have
submitted
since
I've
been
back
and
I'm
sure
under
Barbara
Ferreira
and
John
Auerbach
had
racial
justice
and
equity
as
a
central
focus
in
our
grant
applications.
F
If
we,
which
I'm
happy
to
provide
you
with
the
recent
grant,
applicated
the
grants
that
we've
received
from
Samsa
actually
from
Department
of
Justice,
the
rise
grant
that
I
mentioned
to
work
on
the
substance
use
disorders.
All
of
those
grants
that
have
come
back
to
us
have
a
racial
and
racial
justice.
Health
equity
lens-
that's
been
built
in
so
we
are
proactively
building
that
in
to
our
grant
applications
in
our
city
and
state
budget
requests
and
I'm
happy
to
talk
more
with
you
about
how
we
do
that.
E
Just
to
be
mindful
of
time
and
in
public
testimony,
you
know
thank
you
for
the
work
you're
doing.
I
I'll
have
more
questions,
but
I
can
follow
up
with
folks
separately,
but
I
did
want
to
echo
just
what
councillor
Jani
was
saying
when
she
was
asking
questions
of
the
panel
is
in
the
importance
of
racial
equity
and
equity.
E
H
I
want
to
thank
a
lot
of
the
folks.
First
I
want
to
acknowledge
the
incredible
work
and,
if
I'm,
between
public
testimony-
and
if
my
comments
are
then
I
will
just
make
some
broad
comments.
Some
suggestions,
so
I
can
hear
from
the
experts
in
the
audience.
Many
of
who
might
know
personally
and
I
want
to
thank
you
already
for
the
work
that
you've
done
on
the
ground.
H
Healthcare
facilities
such
as
BMC
now
prescribing
housing
in
their
new
housing
grant
I
think
that's
an
innovative
way
of
looking
at
how
health
care
facilities,
health
care,
hospitals
can
step
in
and
prescribe
social
I.
Don't
know,
programs
or
social,
a
social,
better,
no
benefits
as
part
of
the
healthcare
dialogue
and
I
think
that's
an
innovative
way
of
looking
at
it.
H
So
I
would
love
to
further
the
conversation
about
prescribing
HEPA
filters
when
dealing
with
the
ultrafine
particulates
and
that's
based
off
of
what
we
did
with
Massport,
where
they
literally
gave
us
windows
for
all
of
our
homes
because
of
noise
pollution,
which
I
don't
know
that
we
discussed
today
and
the
impact
on
the
hearts
and
on
the
pair
I
think
it
was
learned,
impacts
your
heart.
It
impacts
your
anxiety
and
there
was
a
third
one
and
I
apologize.
I
just
met
with
some
folks
about
noise
pollution.
H
So
the
looking
at
infrastructure
prescriptions
that
health
health
care
facilities
could
start
to
push
out
as
part
of
narrative
of
benefits.
I'd
love
to
have
that
conversation
also
I
wanted
to
make
sure
that
we
kept
in
on
the
public
housing
and
the
disparity
conversation.
I
do
appreciate
and
I
have
seen
with
East
Boston
Health
Center,
especially
coming
out
door-to-door
doing
that
kind
of
outreach,
but
because
we're
in
such
a
unique
and
I
think
moral
position,
because
it's
our
housing,
we
should
be
leading
actually
in
destroying
disparities
in
the
housing
that
we're
providing
for
individuals.
H
So
I'd
love
to
see
it
a
prescription
based
understanding
of
how
public
housing
can
immediately
right
now
in
its
infrastructure,
address
the
disparities,
racial
disparities
of
the
folks
who
we
have
decided
as
a
moral
obligation
to
private
housing.
For
that
so
I
know
that
that's
a
lot
but
again,
if
it's
just
between
me
and
hearing
from
actual
experts,
I'm
gonna
close
out
my
comments.
I
look
forward
to
talking
with
you
individually
and
I'm,
really
excited
to
hear
from
the
folks
in
the
audience.
A
Thank
You
councillor
Edwards,
so
just
briefly
before
we
get
to
public
testimony,
I
wanted
three
very
brief
follow-ups.
One
appreciate
all
the
thoughtful
questionings
from
my
colleagues
and
the
terrific
answers
for
you.
Country
Janie,
brought
up
the
intersection
of
class
and
race
and
use
the
example
of
breast
cancer,
which
was
a
terrific
one.
I'd
also
add
to
that,
as
we
sort
of
look
at
this
and
going
forward
the
incredibly
higher
rates
of
breast
cancer
and
lesbians,
as
opposed
to
straight
there
straight
counterparts.
So
that's
something
we
should
be
mindful
of.
A
Secondly,
as
it
relates
to
the
vaping
ban,
which
I
wholeheartedly
support
and
I
know,
we
talked
about
menthol
mints.
I'd
also
had
wintergreen
for
that
three
of
the
non
flavored
categories.
That
I
think
the
vaping
industry
in
the
e-cigarette
industry
has
gotten
around
to
again
go
after
young
people
ended
communities
of
color.
There
have
been
sort
of
this
anecdotal
evidence
and
it
may
be
too
early
to
actually
know,
but
I'd
ask
any
of
you
that
the
vaping
ban
has
actually
caused
folks
to
go
back
to
combustible
cigarettes.
F
Think
that
I
think
it's
too
early
I,
think
that
was
a
concern
yeah,
that
even
our
public
health
colleagues
said
raised
in
terms
of
harm
reduction,
that
it
would
push
people
to
go
back
to
cigarettes,
but
I
I'm
not
aware
of
hard
data.
At
this
point
in
time,
I
forgot
I
should
put
a
plug
in
for
our
public
hearing,
which
will
be
on
November
7th,
so
I
hope
that
and
we're
doing
a
lot
of
outreach
to
promote
that
terrific.
A
F
D
A
B
That's
okay,
just
a
quick
follow-up
since
you
brought
up
the
e-cigarettes
and
whether
or
not
people
are
going
back
to
traditional
cigarettes,
I
think
another
concern
that
people
had
regarding
the
ban
was
that
it
would
force
people
to
go
back
into
the
illegal
market,
so
people
who
may
have
been
buying
their
cigarettes
from
stores
that
have
you
know,
regulations
in
place,
etc,
are
now
kind
of
going
underground.
Is
there
any
evidence
of
that?
You.
F
Know
again,
I
think
that
is
something
that
we
have
read
about
and
heard
about
anecdotally
and
we're
all
sort
of
in
a
holding
pattern
watching
and
waiting
to
see
what
happens
with
the
state's
ban.
Okay
have
until
Monday
from
what
I
understand
to
do
something.
There
are
various
court
proceedings
going
on,
but
that
is
actually
anecdotal.
The
concern
that
was
raised
to.
I
Mass
General,
we
have
two
people
who
have
been
real
leaders
on
this
doctors
Winnick
often
doctors
Regardie.
They
probably
would
have
data
on
this
they're
tracking
this
doctor,
when
it
costs
been
in
the
news,
a
lot
around
what's
happening,
but
just
as
a
resource,
I'm
sure,
there's
many,
but
these
people
are
probably
could
provide
some
real
cutting
edge
perspectives
on
this.
Thank.
C
Thank
You
councillor
O'malley
and
again
thank
you
to
the
panelists
for
your
excellent
testimony.
I
just
wanted
to
follow
up
on
one
brief
comment:
Monica
you
mentioned
and
I
certainly
agree
with
you,
but
pest
management
is,
is
an
issue
throughout
public
housing
developments.
It's
really
an
issue
throughout
the
city
as
well.
I
also
think
it's
a
public
health
related
concern
and
that's
something
I've
been
doing.
C
Some
research
on
and
I
do
hope
to
have
a
hearing,
probably
sometime
next
year,
on
what
impact
does
pest
management
have
on
communities
of
color,
especially
and
my
my
neighborhood
of
Chinatown
and
some
of
the
public
housing
developments.
So
if
we
have
an
opportunity
to
continue
to
work
together
going
forward
on
pest
management,
I
think
that
would
be.
That
would
be
very
important.
A
You
thank
you
counselor.
Thank
you
all
to
the
panel
again
you're
welcome
to
stay
in
those
seats
or
stick
around.
If
you
want
to
listen
to
some
public
testimony,
we
have
a
number
of
individuals
who
are
looking
to
testify.
We
do
have
an
up.
This
committee
will
be
at
the
conclusion
of
this
hearing,
taking
a
break
and
then
reconvene
at
1:00
o'clock
on
the
black
maternal
health
hearing
order
authored
by
councillor
Jani
and
myself.
Thank
you
all
for
your
great
work
in
partnership
and
I've
got
I.
A
Think
five
or
six
folks
have
indicated
they'd
like
to
testify.
If
you
have
circled
no
but
would
like
to
now
testify
we'll
take
you
at
the
end
or
if
you
have
not
signed
in
and
decide
you'd
like
to
testify.
We
will
of
course
take
you
after
these
folks,
so
the
first
person
I
have
indicating
they
would
like
to
testify
as
Chen
Qi
Huang,
followed
by
Don
Salma,
and
you
could
just
grab
either
of
these
two.
A
If
you
had
a
line
up
at
the
respective
microphones
on
the
left
and
right,
whichever
you
prefer
and
again
we'd
like
to
keep
it
to
two
to
three
minutes
but
I'm,
not
as
hard
and
fast
on
time
limits
as
some
of
my
colleagues
that
wield
the
gavel
you
can,
you
can
see,
you
can
take
the
standing
ones,
probably
easier.
If
you
don't
mind,
sorry.
L
So
my
name
is
Qin
Shihuang
I'm,
an
immigrant
from
Taiwan
I'm,
also
a
breast
cancer
survivor
and
before
I
started
the
nonprofit
organization
Asian
women
for
health
I
was
the
Asian
community
program
manager
working
for
the
Massachusetts
Council
in
compulsive
gambling,
so
I
have
both
personal
and
professional
experience
working
in
the
aging
community,
and
today,
I
would
like
to
focus
on
the
number
one
health
disparity
in
the
Asian
community,
which
is
cancer.
So,
as
you
heard
from
the
previous
panel
I'm,
not
gonna,
repeat
some
of
the
data
because
you
have
it
there.
L
But
then
one
thing
I
want
to
bring
to
your
attention
is
that
the
Boston
Public
Health
Commission
has
the
most
recent
cancer
data
and
in
it
it
says
that
there's
a
89
percent
of
increase
of
breast
cancer
of
Asian
women
in
Massachusetts
and
I
was
one
of
those
number.
The
data
was
from
1999
to
2013
and
also
I
have
noticed
that
there's
a
increasing.
L
Number
of
Asian
women
who
are
being
diagnosed
at
a
younger
age
so
and
Dana
Farber
also
recently
have
their
own
cancer
report
and
I
am
on
their
Advisory
Committee.
So
I
got
to
see
the
report
and
it
says
that
all
cancers
are
up
for
Asian
women
and
Asian.
Men
has
a
higher
rate
for
lung
cancer
and
liver
cancer
and
I
also
wanted
to
point
it
out
that
in
Massachusetts
we
have
efforts
to
looking
at
Hep
C.
L
L
So
they
just
thought
that
she
needs
to
have
physical
therapy
for
the
back
pain,
but
they
they
delay
the
diagnosis
and
it
turned
out
that
the
cancer
was
spread
to
her
other
into
her
bone.
So
this
kind
of
things
happen
a
lot
and
it's
not
being
captured
and
so
I'm
very
lucky
I'm.
The
one
who
live
here-
and
you
know
to
tell
to
tell
the
story
but
I
just
wanted
to
raise
your
your
your
to
alert
you
about
things
that
happen
so
number.
One
I
think
that
it's
it's
crucial
for
us
to
do.
L
Training
for
providers
and,
like
the
previous
panelists
said
that
you
know,
providers
tend
to
treat
patients
differently
based
on
their.
You
know
skin
color,
and
so
we
need
to
make
sure
that
you
know
the
providers
not
only
have
culturally
like
have
materials
translated
in
the
appropriate
languages,
but
also
they
are
trained
to
to
treat
the
patients
as
a
whole
person
not
just
to
treat
the
disease
and.
L
Number
two
I
think
that
we
need
to
look
at
and
also
to
give
funding
to
place
based
program.
I
know
that
you
know
there's
a
talk
about
incre
based
program,
but
I
think
that
we
have
to
realize
that
most
people
live
and
work
and
study
in
the
community.
We
don't
do
this
kind
of
living
in
the
hospital
so
to
have
this
kind
of
outreach.
Education
work
to
be
really
effective.
We
need
to
do
this.
We
need
to
keep
me
people
where
they
are
and
we
have
been
very
successful
in
partnering
with
coming.
L
You
know,
residents
Association
to
do
screening
and
education
outreach
program
like
at
the
castle
square,
attendants,
association
or
Roxbury
tenants
at
Harvard.
We
also
in
the
past
when
I
was
working
for
the
mask
on.
So
we
we
have
done
outreach
education
in
the
night
time
like
after
the
restaurant
worker,
get
off
work
at
the
at
the
church,
and
so
we
need
to
be
more
creative
and
more
innovative
and
think
about
how
we
can
reach
out
to
those
underserved
and
under
on
the
rivers
and
the
population.
A
L
Ok,
so
to
to
other
things
that
so
yeah
so
I
I
will
advocate
for
the
workforce
development
and
to
yeah
to
train
community
members
to
be
a
community
health
worker
interpreters
and
peer
specialist
Peschel
II
people
with
live
experience
that
we
can
share
our
stories
and
we
we
know
the
community.
We
can
help
them
navigate
better.
L
The
health
care
system
and
the
last
point
I
wanted
to
make
is
that
I
think
that,
yes,
we
do
need
more
research,
but
we
also
need
to
allocate
resources
for
the
community
to
capture
and
document
the
data
and
to
be
mindful
that
the
result
should
be
that
that
whatever
effort
is
that
it
should
be
data
informed,
not
just
data-driven.
So,
for
example,
the
BRFSS,
the
regular
Health
Survey,
it's
done
in
only
Spanish
English
and
Portuguese,
and
it
doesn't
include
the
Asian
languages
and
also
it's
self
reporting.
L
So
when
you
have
that
kind
of
research
method,
the
data
in
is
already
skewed
or
not
include
a
lot
of
the
population
who
don't
use
landline.
So
I
just
want
the
councillors
to
be
aware
that
you
know
when
we're
talking
about
data
when
we
use
data
as
a
measurement,
it
should
be
data,
inform
and
not
data
driven.
That's
it.
Thank.
A
M
Thank
You
councillor
O'malley,
Flynn
and
zany
for
raising
the
issue
of
health
disparities
and
people
of
color.
My
name
is
Don
Salma
I'm,
the
co-executive
director
and
clinical
director
of
the
Asian
task
force
against
domestic
violence,
otherwise
known
always
as
a
task
we're
a
statewide
nonprofit
organization,
that's
been
serving
the
Asian
victims
of
violence
in
Massachusetts
for
over
26
years
as
a
direct
service
community-based
organization.
My
goal
is
to
bring
the
perspective
of
a
highly
marginalized
population
annually
we
serve
over
600
households
across
the
state.
M
98%
are
Asian
and
immigrated
from
over
30
different
countries
and
territories.
In
Asia
they
speak
over
35,
different
Asian
languages
and
dialects.
The
majority
of
the
600
households
are
first-generation
new
immigrant
and
refugee
low-income
without
social
and
familial
resources
and
are
in
the
brink
of
crisis.
You
want
me
to
slow
down
and
believe
me.
I
was
winding
that
I
was
slowing,
that
down.
M
Anyway,
linguistic
and
circumstantial
barriers
are
compounded
by
cultural
barriers.
Abuse
and
Asian
communities
is
considered
a
private
family
issue
and
customarily
does
not
escape
those
confines
in
any
circumstance.
Additionally,
many
deeply
ingrained
cultural
values
such
as
prioritizing
family
over
self,
and
not
bringing
shame
in
disruption
to
the
family
balance,
discourage
Asian,
victims
of
violence
from
disclosing
abuse
or
seeking
help
racial
comparison.
So
the
Asians
did
experience
domestic
violence
twice
as
mine
is
white,
latina
acts
and
flattened
black
and
african-american
survivors.
M
Immigrants
are
two
times
as
likely
to
be
killed
due
to
IPV
than
non
immigrants
and
19
percent
of
Asian
women
report
being
pressured
to
have
non-consensual
sex
with
their
partners
and
severe
underreporting
suggests
that
these
statistics
are
a
lot
higher.
These
combined
circumstances
plays
Asian
victims
of
violence
at
high
risk
for
being
dis,
served
under
served
or
not
served
at
all.
M
Due
to
these,
such
due
to
systemic
barriers
and
in
general,
most
consumers
who
speak
English
manage
their
own
life
needs
their
communicate
with
their
health
workers
attorneys
if
they
have
legal
issues
with
their
children's
teachers
and
police
for
emergencies,
etc.
As
the
consumer
is
their
own
managed
care
provider
for
their
own
personal
needs
and
navigate
multiple
systems,
this
is
a
natural
function
that
becomes
very
challenging
for
a
sumer
that
does
not
speak,
read
or
write
English,
particularly
when
they
don't
know
that
resources
exist
and
providers
don't
speak
their
language.
M
Currently,
our
language
access
solutions
are
inadequate
number
one.
Domestic
violence,
victims
interact
with
multiple
government
and
community
based
systems
whom
have
limited
cultural
and
linguistic
capacity
to
competently
and
comprehensively
address
the
needs
of
Asian
victims
of
violence.
The
problem
is
that
every
one
of
these
touchpoints
Asian
victims
are
risk
being
misinterpreted
and
mistreated
due
to
inadequate
linguistic
and
cultural
services
resulting
in
the
client,
not
returning
and
further
rejecting
services
due
to
cumulative
negative
experiences.
M
Government
and
social
agencies
translate
information
and
documents
for
only
the
largest
minority
groups,
which
are
Spanish,
Mandarin,
Vietnamese,
Haitian,
Creole,
kamae
and
Portuguese.
However,
all
that
Spanish
are
typically
geographically
specific.
Thus
Mandarin
Cantonese
may
be
available
in
the
Chinatown
Boston
area,
but
they
may
not
be
in
Framingham
in
I
may
be
available
in
Lowell,
but
may
not
be
in
Fall
River,
and
all
these
are
places
where
the
these
subpopulations
live,
with
only
three
Asian
languages
translated
in
an
extensive
number
of
LEP
Asian
victims
are
left
without
access
to
basic
information
on
services
and
rights.
M
English
only
websites
are
impossible
to
navigate
without
a
translator
and
web
sites
are
translated
with
versions
that
are
grossly
inadequate
agency
is
hiring
fee
for
service
translation
interpreters
on
phone
services
are
often
often
hiring
translation
interpreter
phone
services
on
a
case-by-case
basis.
The
problem
is
the
asian
LEP.
Victims
of
violence
have
ongoing
case
management
needs
and
multidisciplinary
services.
These
require
long-term
care
and
support
provider,
engagement,
education
and
coaching
on
the
system
and
off-site
accompaniment.
M
The
problem
is
that
is
not
cost-effective
and
can
be
budget
budget
breaking
from
mainstream
providers.
Consequently,
providers
may
forego
linguistic
services
to
save
costs
and
utilize
services,
which
are
subpar
not
trauma-informed
or
inappropriate,
resulting
in
clients
being
denied
restraining
orders
misinterpreted
as
perpetrators
arrested,
losing
custody
of
their
children,
less
able
to
successfully
assert
legal
claims
and
defend
against
legal
accusation
and
being
denied
or
terminated
from
shelters.
These
are
all
very
common
and
we
see
it
all.
The
time
Asian
interpreter
pools
are
small
and
untrained.
M
Lastly,
unqualified
employers
are
hiring
linguistically
and
culturally
specific
staff.
The
problem
is,
is
that
employers
without
expertise
to
vet,
qualified,
linguistically
and
culturally
competent
employees
are
unbeknownst
hiring
unqualified
staff
of
all
here's
who
are
then
providing
inadequate
or
sometimes
determine
detrimental
services
interventions
and
intervene
and
information
to
LEP
consumers.
M
So
Boston
is
a
home
in
part
of
life
for
many
asian-americans,
a
significant
Asian
population
lives
in
the
Boston
area
in
neighborhoods,
even
more
receive
services
in
Boston
in
Boston,
even
though
they've
been
displaced
due
to
gentrification
and
many
Asians
identify
with
the
neighbors
and
the
neighborhoods
in
Boston,
such
as
China
houn,
Chinatown
and
Dorchester
as
cultural
hubs.
Thank.
M
A
M
Okay,
so
we
need
to
develop
culturally
and
linguistically
competent
services
for
a
highly
diverse
population
in
Boston.
This
requires
government
agency
in
mainstream
organizations
to
closely
collaborate
with
culturally
specific
organizations
and
communities
to
best
identify
practice
and
policy.
Thank.
A
You
very
much
appreciate
it.
A
Rachel
Miller
is
next
followed
by
anna
leslie
and
for
all
of
those
who
have
prepared
testimony.
If
you
want
to
email
me
or
email,
the
committee
I'll
make
sure
that
all
of
our
colleagues
get
copies
or
you
could
give
it
to
corps
so
a
rachel
is
next
followed
by
anna.
Thank
you
for
waiting
good.
N
Morning,
how
are
you?
My
name
is
Aisha
Miller.
My
work
at
Berklee
College
of
Music
is
a
shell,
but
I
came
with
chin
chin
Chi
for
healthcare
disparities
I'm
here
to
seek
assistance
from
for
a
family
member
who's
been
terrorized
by
sexual
assualt
and
on
violence
towards
her
children
on
the
first
assault
was
on
a
four-year-old
child
who
was
something
to
the
bathroom
at
her
school
by
herself
and
was
sexually
molested,
and
that
had
happened
even
though
it
happened.
A
A
O
Thank
you
for
having
me
I'm
Anna,
Leslie
I'm,
the
director
of
Boston,
Brighton,
health,
collaborative
and
and
I
just
wanted
to
reflect
on
the
panel
and
I
think.
The
discussion
generally
has
been
majority
about
downstream
approaches
and
kind
of
reactive
and
and
less
preventative
work
around
the
full
spectrum
of
the
social
determinants,
and
so,
when
you
think
about
sort
of
determines
I'm
thinking,
transportation
and
housing,
infrastructure
and
education,
and
so
I'd
really
love
to
see.
O
These
future
conversations
include
the
Transportation
Department
MB,
PDA
and
bps,
and
the
Zoning
Board,
because
those
are
the
things
that
really
initially
impact
who
is
able
to
survive
in
our
communities
and
thrive
in
our
communities.
Many
of
the
things
that
we're
talking
about
are
in
reaction
to
not
having
equitable
access
to
services
and
those
things
begin
with
transportation
and
housing
and
infrastructure
and
education.
So
I
really
think
those
departments
really
need
to
be
integral
to
these
conversations
and
to
understand
that
that
is
a
part
of
their
work.
O
I
think
they
at
this
point
see
that
work
is
very
siloed
and
disconnected
to
their
focus,
and
so
a
lot
falls
on
to
the
public
health
department
and
public
health
sector
to
do
reactive
work
to
what
is
very
much
within
their
control
and
and
they
have
abundant
resources
in
a
lot
of
cases,
to
address
these
upstream
strategies.
So
I'd
really
love
to
see
that
conversation
expand
and
to
put
more
of
the
onus
on
on
those
departments
with
those
resources.
Thank
you.
Thank.
P
P
So,
as
many
of
you
might
know,
because
African
immigrants
live
in
you,
all's
neighborhoods,
African
immigrants,
I'm
one
of
the
most
fastest-growing
immigrant
populations
on
a
rapidly
growing
segment
of
the
black
community
in
Boston
they
migrate
for
work,
educational
opportunities.
We
write
we
reunite
with
family
families
and
as
asylees
and
refugees.
These
communities
have
historical
ties
to
Boston's
similar
to
such
as
Cape
Verdean
who
live
in
the
upland
corner.
P
They
are
long-standing
refugee
refugee
communities
such
as
Somalis
and
Sudanese
living
in
Roxbury
and
Jamaica
Plain,
and
there
are
newer
groups
seeking
asylum
from
countries
such
as
the
the
dr
in
rwanda,
living
in
various
on
boston
cities,
with
owning
venice
businesses
being
part
of
the
labor
force
and
hosting
local
cultural
activities.
African
immigrants
bring
strengths
of
resiliency
economic
growth
in
cultural
diversity.
This
community
also
faces
multiple
challenges
when
accessing
utilizing
and
retaining
in
care
due
to
barriers
such
as
low
health,
literacy,
lack
of
health
insurance,
limited
english
proficiency,
barriers
related
to
patient,
dr.
P
communication,
risk
of
Disco's,
disclosing
immigration
status
and
a
host
of
others
related
to
navigating
the
healthcare
system.
As
a
result,
African
immigrants
tend
to
be
slow
to
seek
health
care
and
may
present
with
relatively
advanced
health
problems
that
need
critical
clinical
interventions.
Increasing
healthcare
cost
health
care
providers,
as
systems
are
not
culturally
and
linguistically
competent
reinforced
these
challenges.
P
Public
Safety
in
health
policies
that
lead
to
housing,
displacement,
anti-immigration
policies
such
as
public
charge,
institutional
racism,
food
insecurity
and
other
determinants
of
health
proved
to
compound
our
public
health
disparities
addressing
African
immigrants
as
such
I
want
to
talk
about
three
recommendations
that
I
would
like
to
respectfully
offer
to
the
council.
Greater
attention
must
be
paid
to
address
public
health
disparities
and
we
can
learn
a
lot
from
a
lot
of
the
other
immigrant
populations
and
communities
in
terms
of
what
they
have
done.
P
So
my
first
recommendation
to
the
Kemp
committee
and
the
council
is
one
that
we
sub
to
support
support
efforts
such
as
the
bill
h26,
a
one
that
notes
data
disaggregation
as
critical
to
identifying
the
public
health
disparities
experienced
by
populations
similar
to
asian-americans
african-americans
are
grouped
under
the
racial
category
as
black
/,
African
and
African
African
American,
and
because
of
this
we
often
miss
the
unique
issues
that
African
Americans
are
dealing
with,
and
also
the
unique
opportunities
to
reduce
health
disparities.
In
that
community
number.
P
Two
I
want
to
recommend
that
a
body
is
dedicated
to
represent
African
immigrants,
a
body
that
is
a
part
of
the
city's
efforts
through
African,
car
or
Commission.
This
permanent
body
would
support
understanding,
emerging
issues,
creating
pathways
to
civic
engagement
and
making
recommendations
on
how
to
improve
the
quality
of
life
for
this
growing
population.
P
This
has
been
proven
effective
in
other
immigrant
communities
here
in
Boston
and
has
also
be
seen
seen
in
other
metropolitan
areas
such
as
Washington
DC
has
a
mayor
mayor's
office
of
African
affairs
and
the
Bronx
has
an
African
Advisory
Council,
and
my
life's
last
recommendation
is
that
we
need
to
provide
quality
and
culturally
appropriate
language
access.
It's
critical
to
ensuring
our
most
vulnerable
communities,
such
as
African
immigrants,
are
able
to
receive,
understand
and
act
on
public
health
information.
P
There's
a
need
I'm
requesting
to
conduct
a
language
access
assessment
in
planning
process
for
critical
health,
related
programs
under
the
city
of
Boston,
such
as
youth
and
families,
food
access,
fair
housing
in
emergency
preparedness.
This
will
provide
an
opportunity
to
expand
language
access
to
includes
languages
most
spoken
by
the
African
immigrant
communities
in
Boston
I
offer
myself
as
a
resource
to
each
and
every
one
of
you,
as
we
continue
to
think
about
how
we
can
better
adjust
public
health
disparities
and
particularly
look
at
what
is
happening
within
African
immigrant
communities.
Thank
you.
Thank.
A
You
very
much
appreciate
your
time
in
your
testimony,
that
is
all
I
have
for
public
testimony
unless
there
is
any
individual
that
didn't
sign
up
and
would
now
like
to
speak
going
once
going
twice
well.
This
concludes
the
hearing.
Thank
you
again
to
the
makers,
counselor
Edie
Flynn
and
councillor
Kim
Janie,
the
council
president
Andre
Campbell
and
councilor
Lydia
Edwards
for
their
joining
us
in
support
of
this
initiative.
Today
we
now
conclude
docket
number
one:
zero,
five,
four
and
again
miss
Miller.