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Framework for Safe Neighborhoods and Innovative Partnerships

Boston’s framework to boost public safety and reduce violence recognizes that violence is a complex social problem that requires a multifaceted response. The plan outlines a continuum of care to address the fundamental causes of violence—not just the symptoms. A multidisciplinary approach to violence prevention emphasizes opportunities and pathways away from violence via intervention, enforcement and reentry.

Health & Safety

The conditions in which Bostonians live, work, play, commute, and go to school have an enormous impact on our health, long before we ever see a doctor.

Boston has a long history of integrating public-health considerations into City policies and understands the role that the built environment and community infrastructure play in determining individual health outcomes. Our compact size and forward-looking policies make us well positioned to create a built environment and implement policies that reduce health disparities between races and neighborhoods. The following initiatives strive to address persistent health inequities and set higher goals for improving health outcomes for all residents and neighborhoods.

This is what inspires us to act.

Premature mortality rates vary significantly by neighborhood. They are higher for Dorchester (249 per 100,000 residents under 65), Roxbury (281), and South Boston (251), and lower for Back Bay (145), Roslindale (174), and West Roxbury (136) compared to the Boston average (202).¹ South Boston has significantly more substance abuse deaths compared to the city average, and Roxbury has a homicide rate more than double the city average.²

Some residents do not consume healthy food. Approximately 17 percent of Boston public high-school students report consuming less than one serving of fruits and vegetables per day.³

Urban surroundings are closely connected to health. Bostonians are eager to live in safe, walkable neighborhoods. Today, many areas that are less walkable have higher rates of obesity. Residents also discussed the importance of air quality in neighborhoods and access to healthy food. They are interested in strategies to improve air quality, such as encouraging mode shift toward walking and biking, planting trees, and improving green spaces. See graph on facing page $\rightarrow$ Boston Neighborhoods, Obesity Rate vs. Walk Score

Many caregivers worry about safety. 26 percent of Boston children ages 0-17 live in households where their parent or caregiver felt the child was unsafe in his or her neighborhood.⁴

Low-income residents have higher incidence of diseases. In 2015, Bostonians with incomes below $25,000 had higher rates of diabetes (13 vs. 5 percent), hypertension (30 vs. 5. percent), obesity (28 vs. 20 percent), persistent anxiety (28 vs. 17 percent), and persistent sadness (20 vs. 5 percent) than those with incomes above $50,000.⁵

Boston’s collaborative efforts to prevent violence are working. Boston is reducing crime without locking people up. Violent and property crimes in Boston have decreased 38 percent over the last 10 years. Over the same period, arrests have fallen by half.⁶ Today, Boston is one of the safest cities in the United States, and has been identified as a national model in Community Policing.

"Our neighborhood needs more than bodegas, check cashing, and fast food. Rebuild, rezone, and revitalize to support healthy places to shop, eat, and work." Roxbury resident via online mapping comments

26%

of Boston children live in households where their parent or caregiver felt the child was unsafe in his or her neighborhood.

Source: Boston Public Health Commission

Boston Neighborhoods, Obesity Rate vs. Walk Score

Boston neighborhoods that are more walkable tend to have lower obesity rates.

"Bringing jobs closer to where people live will promote a healthier lifestyle with more people biking or walking to work." Mattapan resident via online mapping comments

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Source: “Go Boston 2030,” Boston Transportation Department

Multiple factors influence obesity rate including access to healthy foods and health care. This graphic shows the relationship between obesity and Walk Score.

Walk Score® is an online tool that measures walkability on a scale of 0-100 based on walking routes to nearby amenities, such as schools, parks, and retail.

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We will:

Prevent violence, human trafficking, and trauma

We will work together to achieve sustained reductions in youth violence, victimization, trauma and exposure to violence as well as human trafficking. We will proactively prevent these by boosting employability, strengthening community connections, and supporting stronger families and community networks. We will increase our capacity and the capacity of partners to identify, intervene, and serve at-risk individuals earlier, including via program such as YouthConnect and Operation Homefront.

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Residents emphasized the multifaceted ways to improve health during workshops in summer 2016.

A Roxbury resident commented on the need for "healthy, safe ways to walk and bike without worrying about harm from cars or gun violence," while a Mattapan resident suggested that "urban neighborhoods are in desperate need of more healthy food options and restaurants."

Create a more integrated system of care, focused on population health

We will continue to improve access, quality, and responsiveness of prehospital EMS care, as well as primary and specialty care. We will work to ensure that emerging healthcare delivery entities created under the Affordable Care Act, including Accountable Care Organizations, more closely align health-care delivery with community health needs.

Work to understand the root causes of persistent disparities in health outcomes

These include birth outcomes, chronic health conditions, and other key outcomes. We will use this knowledge to address the physical and social determinants of health that are built into our urban fabric. We will proactively address racial equity, social cohesion, and economic mobility to improve health and wellness.

Prepare communities for the public health challenges associated with climate change

We will enhance community education and create a more climate-ready built environment by addressing risks associated with floods such as sewage and contaminants, and by providing community "cooling centers" on our increasing numbers of hot days.

Work to improve access to mental health and substance abuse health services

We will integrate preventative mental health care into adult care, primary pediatric care, and school-based health centers in collaboration with state and federal partners, as well as the region's provider community. We will strive to provide assistance to residents in recovery, including by providing a 24/7 311 line for recovery support.

Make neighborhoods healthier places to live

We will encourage mixed-use, compact communities where it is easy to bike and walk, improve access to healthy and affordable food, expedite response times for emergency services, and improve indoor and outdoor air quality. We will also utilize health centers and other community resources as community meeting places to further engage residents and strengthen community cohesion.

"Increasing access to education to substance abuse is key to healthier communities" Allston resident via handwritten comment

"Easier and more reliable transport to community health centers and mental health services" Allston resident via poster comment

"By investing in proactive good health, more organic gardens [and] grocery stores... citizens will live longer, spend less on healthcare or disease maintenance and be more productive" Resident via draft plan feedback

Support Boston's homeless population

We will provide a central system for coordinating access to supportive housing units, improve the Front Door Triage Program, expand housing placement efforts for all individuals experiencing homelessness through initiatives such as Housing First, improve the shelter system, and advocate for a statewide response to homelessness to allow for coordinated discharge from institutions where individuals are at risk of homelessness.

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Roosevelt School, Hyde Park. The BOKS program focuses on the link between exercise and academic performance and brings exercise programming into schools.

Strengthen our local public health and healthcare systems to rapidly respond to emerging infectious diseases

We will catalyze innovations in disease surveillance, enhance electronic data systems to track and tackle diseases spatially, develop emergency response protocols, and coordinate with partners to control the spread of disease.

Sustain and cultivate trust between immigrant communities and police

We will build a culture of trust between communities and police, regardless of immigration status, so that residents feel safe enough to come forward, report crimes, and help with investigations without fear of arrest, detainment, or deportation.

Ensure City employees are healthy

We will ensure that the health and safety of City employees are protected including reducing cancer risks from chronic exposure for our Fire Department and enabling all employees to get cancer screenings.

Prioritize community partnerships

We will place the community at the center of our public safety mission and strengthen relationships with the community and partners. We will support and coordinate with non governmental organizations as well as religious and community organizations that strengthen community fabrics and break the cycle of violence.

Effectively respond to violence to decrease future risk

Trauma Response Teams will provide immediate crisis response and ongoing care as well as prompt engagement and intervention after events such as homicides. We will provide training and career pathways for high-risk and previously incarcerated individuals through initiatives such as Operation Exit, Youth Options Unlimited, and a newly-created Mayor's Office of Returning Citizens. We will also spearhead policy to drive change such as stemming the flow of illegal guns by strengthening licence to carry laws and working with the community and local leaders to boost compliance, and responsible purchasing.