>>> SOMETHING THAT MANY PEOPLE WORKING THE SOCIAL SERVICE
INDUSTRY KNOW WAS RECENTLY CONFIRMED BY DATA FOR THE
NATIONAL CENTER FOR HEALTH STATISTICS.
PEOPLE WHO LIVE IN POORER NEIGHBORHOODS IN SPRINGFIELD
GENERALLY HAVE A LOWER LIFE EXPECTANCY THAN PEOPLE IN MORE
AFFLUENT AREAS.
I ASKED KATHARINE COOK, VICE PRESIDENT OF CLINICAL SERVICES
AT THE CENTER FOR HUMAN DEVELOPMENT, FOR HER REACTIONS
TO THE FINDINGS.
>> THIS IS NOT ACTUALLY NEW INFORMATION.
STUDIES HAVE BEEN CONDUCTED THROUGHOUT THE YEARS THAT
INDICATE THAT PEOPLE WITH LOWER SOCIO-ECONOMIC STATUS ARE
STRUGGLING WITH HEALTH INDICATORS.
MOST IMPORTANTLY, I THINK THERE'S A NUMBER OF BARRIERS
THAT PEOPLE ENCOUNTER WHEN THEY'RE TRYING TO GET THE CARE
THEY NEED.
AND SO THIS WASN'T NEW INFORMATION.
>> SO LET'S TALK ABOUT MAYBE THE BARRIER THAT YOU THINK IS MOST
PREDOMINANT OR THE LARGEST CHALLENGE WE'RE FACING HERE IN
THIS REGION.
AND I KNOW IT'S A BROAD TOPIC AND WE'LL BREAK IT DOWN, BUT
JUST BROADLY.
>> WERL, CERTAINLY I THINK THE WORK WE DO AT C.H.D.
LEADS US INTO AREAS WHERE WE FIND THAT
PEOPLE ARE STRUGGLING WITH FOOD INSECURITY, WITH ECONOMIC
INSECURITY, WITH HIGH HOUSING COSTS, WITH PERHAPS LANGUAGE
BARRIERS AND EDUCATIONAL OPPORTUNITIES THAT ARE MAYBE
LACKING FOR THEM BECAUSE OF SOME OF THOSE BARRIERS.
SO I THINK ALL OF THOSE THINGS COMBINED REALLY IMPACT ONE'S
ABILITY TO ADDRESS THEIR HEALTH CARE NEEDS PRO-ACTIVELY.
>> SO IT'S A REALLY INTERTWINED ISSUE.
WE'RE GOING TO LOOK AT SOME OF THE SPECIFIC DATA TO PULL APART
SOME OF THOSE THREADS.
WHAT THE DATA TOLD US IS THAT THE DOWNTOWN AREA OF SPRINGFIELD
REALLY SHOWS THE CITY'S SHORTEST LIFE EXPECTANCY, SO ABOUT 70
YEARS OF AGE. AND A MEDIAN INCOME OF ABOUT
$12,300.
AND THOSE TWO ARE CONNECTED.
AND I THINK YOU COULD MAKE THE CASE, OKAY, SO IF YOU HAVE A
LOWER MEDIAN INCOME, YOU'RE PROBABLY NOT ABLE TO SPEND VERY
MUCH MONEY ON HEALTH CARE.
BUT IS IT AS SIMPLE AS THAT?
>> I DON'T THINK IT'S AS SIMPLE AS THAT, BECAUSE WE KNOW THAT
MASSACHUSETTS HAS ABOUT 97% OF ITS INDIVIDUALS HAVE HEALTH
INSURANCE.
SO COVERAGE IS AVAILABLE FOR PEOPLE TO GET THE CARE THEY
NEED.
BUT PERHAPS THERE'S LESS OPPORTUNITY TO GET CUTTING EDGE
TREATMENT FOR SOME INDIVIDUALS DUE TO TRANSPORTATION BARRIERS
OR UNDERSTANDING OF THE TECHNOLOGY AND THE METHODS IN
WHICH THE DIAGNOSTICS ARE COMMUNICATED TO SOMEBODY BECAUSE
OF LANGUAGE BARRIERS.
SO I THINK THAT THERE ARE MANY FACTORS THAT MAKE IT DIFFICULT.
ONE OF THE OTHER THINGS WE'RE SEEING IS A HIGHER OPIATE
OVERDOSE RATE, WHICH IS ALSO LEADING SOME OF THOSE MORTALITY
STATISTICS.
>> AND YOU MENTIONED FOOD INSECURITY, SO SOMETHING WE KNOW
ABOUT THE DOWNTOWN AREA.
PEOPLE DON'T HAVE EASY ACCESS, DESPITE FARMERS MARKETS AND SOME
OTHER EFFORTS THAT HAVE COME UP IN RECENT YEARS, TO FRESH FOOD.
SO HOW ARE WE OR IS THIS COMMUNITY HELPING PEOPLE MEET
THAT CHALLENGE?
>> WELL, I THINK THAT'S A REALLY GOOD QUESTION, IN THAT WE'RE
CONTINUING TO LOOK AT WAYS TO BRING FRESH PRODUCE TO
POPULATIONS THAT DON'T TYPICALLY HAVE THEM.
BUT CERTAINLY I THINK ONE OF THE THINGS WE'RE DOING IS CREATING
CLINICS THAT ACTUALLY WORK IN THE COMMUNITY.
SO BRINGING STAFF OUT TO THE COMMUNITY TO SUPPORT PEOPLE TO
GET THOSE RESOURCES THAT THEY NEED, WHETHER IT BE FOOD,
WHETHER IT BE TRANSPORTATION, TO HELP THEM NAVIGATE THAT FOOD
DESERT IF YOU WILL.
>> AND THAT'S WHAT IT'S COMMONLY CALLED IN THE DOWNTOWN AREA IS A
FOOD DESERT BECAUSE YOU DON HAVE ACCESS THOUGH THOSE FRESH FOODS.
AND ALSO AGAIN HERE WE ARE WITH LOOKING AT THE WAYS IN WHICH
THESE THINGS ARE INTERWOVEN.
SO IF YOU'RE IN A FOOD DESERT, ONE OF THE THINGS THAT'S EXAWLS
EXACERBATING THAT IS THE FACT THAT TRANSPORTATION IS A
CHALLENGE.
YOU MIGHT HAVE ACCESS TO THE BUS, BUT HOW CAN YOU OR IT'S
PROBABLY HARD TO BRING HOME A WEEK'S WORTH OF GROCERIES ON A
BUS LIKE YOU WOULD IF YOU HAD A CAR.
>> EXACTLY.
>> SO IS THERE AN ANSWER TO THAT CHALLENGE AT THIS POINT?
>> WELL, I THINK THAT THERE'S SOME CREATIVE IDEAS OUT THERE TO
LOOK AT BRINGING MOBILE FOOD PANTRIES AND MOBILE PRODUCE
VENDORS INTO THOSE NEIGHBORHOODS AND BEING ABLE TO PROVIDE THAT
RESOURCE FOR FOLKS.
>> IN A CENTRAL PLACE.
>> YES.
>> SO, I SAID THAT IN THE METRO CENTER LIFE EXPECTANCY ACCORDING
TO THIS DATA IS ABOUT 70 YEARS OF AGE, SO THAT'S MORE THAN 10
YEARS BELOW THE STATEWIDE AVERAGE, AND 8.4 YEARS BELOW THE
NATIONAL AVERAGE.
WHEN YOU LOOK BROADER ON THE OTHER END OF THE SPECTRUM, THE
HIGHEST LIFE EXPECTANCY IS IN THE FOREST PARK AREA, ABUTTING
LONGMEADOW AND EAST LONGMEADOW WHICH TEND TO BE AFFLUENT AREAS
OF THIS REGION AND YOU'RE LOOKING AT A LIFE EXPECTANCY OF
OVER 81 YEARS.
81.2 YEARS TO BE SPECIFIC.
MEDIAN INCOME OF MORE THAN $57,000 A YEAR.
BUT WE ALSO KNOW AS A SOCIETY THROWING MONEY, HAVING MONEY AND
JUST SAYING OKAY IT'S AS SIMPLE AS MORE MONEY FOR THESE LOWER
INCOME FOLKS, IS IT THAT SIMPLE?
>> NO, I DON'T BELIEVE IT'S THAT SIMPLE.
WE CAN LOOK AT WORK THAT WAS DONE BY RUBY PAYNE AND THE
BRIDGE OUT OF POVERTY AND WE CAN SEE WHERE SOME OF THAT RESEARCH
MAY HAVE LOOKED AT A GROUP RATHER THAN THE INDIVIDUAL.
AND WHEN WE AT C.H.D.
WORK WITH INDIVIDUALS, WE'RE LOOKING AT
WHAT ARE THEIR SPECIFIC BARRIERS FOR THAT INDIVIDUAL THAT MAKE IT
DIFFICULT FOR THEM TO GET THEIR NEEDS MET.
AND SO WHEN WE LOOK AT THE INCOME DISPARITY, THE INCOME IS
THE DRIVING FACTOR, BUT UNDERNEATH THAT ARE GOING TO BE
THINGS LIKE CARDIOVASCULAR DISEASE AND OBESITY AND SMOKING.
AND MANY OF THOSE THINGS ARE MUCH MORE VISIBLE IN SOME OF THE
LOWER SOCIO-ECONOMICALLY BASED COMMUNITIES.
PARTICULARLY THE OTHER IMPORTANT FACTOR IS THE EDUCATIONAL
ATTAINMENT WITHIN THESE NEIGHBORHOODS THAT WE'RE
SPEAKING OF TODAY.
SO THAT REALLY LIMITS SOMEBODY'S OPPORTUNITY TO GET OUT OF THAT
INCOME BRACKET, IF YOU WILL.
STUDIES SHOW THAT THE ONE PERCENT OF THE POPULATION WITH
THE HIGHEST INCOME, MEN AND WOMEN RESPECTIVELY, MEN LIVE 15
YEARS LONGER AND WOMEN 10 YEARS LONGER THAN THE LOWEST ONE
PERCENT OF THE INCOME.
SO THAT'S REALLY TELLING.
>> ALSO, RACE PLAYS A BIG FACTOR HERE, AND I THINK I WOULD BE
REMISS IF I DIDN'T BRING THAT UP BECAUSE ANOTHER PIECE OF THE
DATA SET, IN THAT LOWEST LIFE EXPECTANCY REGION, THE DOWNTOWN
AREA, WE HAVE A HIGH MINORITY POPULATION, SPECIFICALLY
HISPANIC POPULATION.
ON THE OTHER END OF THE SPECTRUM, MOVING TOWARD THE
FORES PARK AREA, A HIGH PERCENTAGE OF WHIEFLT PEOPLE
LIVING IN THAT REGION.
HOW DO WE MEET THAT CHALLENGE?
>> WELL, I THINK THAT'S AGAIN A REALLY GOOD QUESTION.
WE NEED TO BE ABLE TO LOOK AT THE INSTITUTIONAL RACISM THAT
HAPPENS WITHIN OUR CULTURE AND BE ABLE TO ADDRESS SOME OF THE
THRESHOLDS THAT WE CREATE WITHIN SERVICE AGENCIES THAT MIGHT NOT
BE CULTURALLY SENSITIVE OR UNDERSTANDING OF THE BARRIERS
THAT PEOPLE ARE FACING IN THEIR LIVES.
>> FOR YOU OVERALL, WORKING IN THIS FIELD FOR SOME TIME NOW,
WHEN YOU HEAR DATA THAT COMES OUT, OH THIS IS A NEW REPORT,
NEW DATA, BUT AS YOU MENTIONED AT THE BEGINNING NOT REALLY NEW
INFORMATION HERE, RIGHT, WE KNEW A LOT OF THESE CHALLENGES
EXISTED.
WHAT'S THAT LIKE FOR YOU?
IS IT FRUSTRATING, DO YOU FEEL LIKE WE'RE NOT MAKING ENOUGH
PROGRESS?
OR DO YOU SEE, OKAY, WE ARE MAKING SLOW, PROGRAMS INCREMENT
AL PROGRESS, WHETHER IT'S THROUGH SMALL PROGRAMS LIKE THE
FOOD PROGRAMS YOU MENTIONED.
>> I THINK WE'RE MAKING STRIDES BECAUSE WE'RE NOW REALLY
FOCUSING ON THE SOCIAL DETERMINANTS OF HEALTH.
SO WE CAN LOOK AT MENTAL HEALTH AS A CONTRIBUTOR TO A SOCIAL
DETERM INABILITY -- DETERMINANT OF HEALTH,
PARTICULARLY AS IT RELATES TO VIOLENCE IN THE COMMUNITY, IF
THERE'S TRAUMA THAT A PERSON HAS EXPERIENCED, THAT THAT IMPACTS
SOMEONE'S OVERALL WELL-BEING, WHICH IMPACTS THEIR OVERALL
HEALTH.
SO WE'RE TAKING EFFORTS ACROSS OUR SERVICE SYSTEM TO BE ABLE TO
LOOK AT THAT BIGGER PICTURE, AND WE'RE WORKING CLOSELY WITH OUR
MEDICAL PROVIDERS AND OTHER MEDICAL SYSTEMS SO THAT WE'RE
JOINING OUR EFFORTS TO BOTH SUPPORT SOMEONE PSYCHOLOGICALLY
AND EMOTIONALLY AS WELL AS PHYSICALLY.