‘Striking’ health disparities exist among Boston’s neighborhoods, public health report says

BOSTON — Striking health disparities remain among Boston’s demographic groups and neighborhoods, with premature mortality notably higher among city residents with a lower median income, and a “significant” impact of Covid-19 on life expectancy for city residents, public health officials said.

In reviewing several key public health indicators and chronic conditions -- asthma, cancer, diabetes, heart disease, and life expectancy and mortality -- public health officials said “persistent health inequities” continue to exist for Boston residents, according to the Health of Boston Report released by the Boston Public Health Commission on Friday.

The report shows “concerning disparities in life expectancy along neighborhood and census tracts (subdivisions of neighborhoods),” public health officials said.

Most notable is the nearly 23-year gap between a census tract in Back Bay where the life expectancy is 91.6 years and a census tract in Roxbury where life expectancy is 68.8 years, the report found. While this difference is lower than previous estimates that noted a 33-year disparity between census tracts (2003-2007), these findings “indicate that significant challenges remain to advance health equity across the city of Boston.”

The “persistent health inequities” in Boston were also pronounced in premature mortality (death before the age of 65 years), the report found. From 2017 to 2021, Black residents in Boston experienced the greatest increase in premature mortality rate (37.3%). Also, in 2021, premature mortality was more than twice as high in Dorchester (293.9) and Roxbury (282.9), neighborhoods with higher concentrations of Black and Latinx residents and lower median income, than it was in Back Bay, Downtown, and Beacon Hill (140.3).

As a result of the COVID-19 pandemic, average life expectancy decreased by 2.4 years for Boston residents, the report found. The pandemic also exacerbated racial and ethnic health inequities. Latinx residents experienced the greatest decrease in life expectancy (-4 years), followed by Black residents (-3.3 years), and Asian residents (-3 years). White residents had the smallest decrease in life expectancy (-1.1 years).

The report examines “the city’s health trends and the health status of residents,” with data used to address urgent public health issues, public health officials said.

The Health of Boston report also highlight persistent health inequity in chronic disease outcomes by race and ethnicity. Boston experienced some positive trends in health over the past several years, but striking disparities remain between demographic groups and neighborhoods:

• From 2015 to 2021, the cancer mortality rate decreased overall and specifically for breast cancer, colorectal cancer, liver cancer, and lung cancer, but the cancer mortality rate was highest among Black males and females. In 2021, the overall cancer mortality rate was highest among Black men (218.9) compared to Latinx men who had the lowest rate (117.9).
• From 2017 to 2021, there were no significant changes in heart disease mortality rates in Boston. However, in 2021, heart disease mortality was 37% higher for Black residents (158.55) compared with White residents (115.6).
• From 2017 to 2021, there were no significant changes in diabetes mortality rates. However, for Black female residents in 2020 and 2021 combined, the age-adjusted diabetes mortality rate per 100,000 was 3.3 times the rate for White female residents (38.1 vs. 11.5). Similarly, the diabetes mortality rate for Black male residents was almost 3 times that of White male residents (58.2 vs. 20.6).
• From 2017 to 2021, the age-adjusted asthma emergency department rate per 10,000 residents decreased by 52.0% overall for Boston residents, but the rate of asthma emergency department visits for Black residents (112.6) and for Latinx residents (55.7) were 9.0 and 4.4 times, respectively, higher than the rate for White residents (12.5).

“These data offer sobering evidence of health inequities that pre-dated COVID-19, and they provide insight into the tragic impact of COVID-19 on life expectancy in Boston,” Dr. Bisola Ojikutu, Commissioner of Public Health and Executive Director of the Boston Public Health Commission, said in a statement. “We can address these challenges by using lessons learned during the pandemic. During the height of COVID-19, we successfully broke down silos and collaborated. We worked with empowered communities to achieve collective goals. Working together, Boston can be a healthier and more equitable city.”

In a statement, Mayor Michelle Wu said her priorities, including environmental justice, transportation access, and affordable housing and ending chronic homelessness, address the social determinants of health and are therefore critical for improving the health and wellbeing of Boston residents.

“The Boston Public Health Commission’s Health of Boston report is a critical resource informing the priorities and investments of the City,” said Wu. “We have a lot of work to do in Boston, but we have the tools and community to make this a truly equitable city for all families.”

Boston officials said programs are in place to improve the overall health and wellbeing of the city, including residents experiencing chronic illnesses.

Boston public health officials said they will host a series of community meetings in the coming weeks “to identify ways it can partner with neighbors and advocates to advance health equity throughout Boston.”

Anyone experiencing difficulties with health issues or who needs help accessing health care or other health services may visit boston.gov/bphc for more information or call the Mayor’s Health Line at 617-534-5050.

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