Dorchester Health Initiative

Dorchester, with a population of 143,000 people, is home to over one-fifth of all Boston residents. The population has grown as local Bostonians seeking affordable housing in an ethnically diverse neighborhood have moved into its six communities. Dorchester has also become a destination for immigrants seeking communities similar to home. The high proportion of residents of color (73% compared to 47% for Boston overall) reflects this cultural and ethnic diversity; however, because of language and cultural barriers, healthcare disparities, and other socioeconomic factors, Dorchester experiences a disproportionate burden of health challenges.

Tufts Medical Center established the Dorchester Health Initiative (DHI) in 2004 to address health issues disproportionately affecting residents of the various Dorchester neighborhoods. Through the DHI, Tufts MC provides grant funding to innovative programs addressing the priority health needs of the Dorchester community identified with the assistance of the DHI Advisory Committee, comprised of community stakeholders with experience in serving the needs of Dorchester residents.

Since its inception, program topics funded by DHI have included asthma, infant mortality, violence, substance use, cardiovascular disease, healthy lifestyles/habits, and nutrition.
The need for health care support in Dorchester

Violence – particularly among youth – has been a consistent priority for Dorchester community members since DHI began in 2004. For the period of 2011-2015, North Dorchester experienced an average incidence of 16.0 homicides per 100,000 residents, compared to Boston’s overall average of 5.8 per 100,000 residents for the same period, according to the 2016-2017 Health of Boston report. For the same period, South Dorchester experienced 13.2 homicides per 100,000 residents.

Gathering primary and secondary data for its 2019 Community Health Needs Assessment (CHNA), Tufts MC found that “community violence” was the leading concern among 470 survey respondents in Dorchester, and mental health was third. Violence was also among the priorities identified by community health centers in 2017 and 2018, along with substance use and mental health.

Key informants and focus group participants providing input for Tufts MC’s CHNA discuss these three issues as inter-related, each potentially causing or exacerbating the others and all being influenced by financial stability and access to economic opportunity. For this reason, we approach these topics cohesively and believe that they will be most successfully addressed holistically.
DHI-funded programs

Boys & Girls Clubs of Dorchester (BGCD) with facilities in Savin Hill and Harbor Point, provides youth ages 5-18 with after-school programming, each including social-emotional learning components to help them forge a solid foundation that will serve them in all aspects of their lives. Youth and families in these programs experience numerous socio-economic challenges that affect a young person’s path to becoming a caring, responsible citizen. With the help of social work personnel, BGCD will take a proactive, preventive approach by offering in-house counseling, support groups, referrals to outside agencies when necessary, and help navigating the complex web of supports that are available in the community. Staff will also learn to use the MindUp curriculum, which supports youth in focusing their attention, improving self-regulation skills, building resilience to stress, and developing a positive mind-set.

DotHouse Health (DHH) will serve youth ages 12 to 18 through their Generation Next Academy programs at the DHH Teen Center in Fields Corner by adding a full-time Case Manager to address the changing needs of Dorchester youth and their families. The Case Manager will facilitate group discussions on overall social-emotional wellness, provide referrals to behavioral health care both inside and outside of DHH, and train Teen Center staff on responding to anger and depression in the population. The Case Manager will also help provide linkages to primary care, financial assistance, substance use services, and other social supports for youth and their families in order to foster safe, supportive conditions for youth to thrive as they enter adulthood. 

Family Nurturing Center (FNC) will promote social-emotional wellness in Dorchester through a continuum of neighborhood-based parenting education and family support programs that engage young children and their parents together – building the knowledge, skills, and connections needed for children to develop in a healthy way. FNC will place increased emphasis on supporting fathers and helping them play a critical role in their children’s live and development. FNC will also introduce versions of its family nurturing programs tailored to support the large Cape Verdean community in the neighborhood of Bowdoin-Geneva, where FNC’s new facility is based.

Father's UpLift (FUL), located in the Codman Square neighborhood, supports fathers who are facing challenges that have kept them away from their families by providing mental health and substance use treatment to help these fathers become and remain emotionally stable for their children. FUL will use peer coaching, clinical therapy, and capacity-building training to honor and rehabilitate the relationship between fathers and their families. FUL also engages boys growing up in households without their father present, helping these young men practice etiquette; develop self-confidence; and improve decision-making, communication, and leadership skills. Social workers – who are part of each family’s care team – help connect families with services in their communities to meet a range of social needs.

Smart from the Start (Smart) will promote the healthy development of young children and their families by helping families identify and address the root causes of chronic stress. The Address the Stress (ATS) program will help to break down stigma and increase access to behavioral health treatment while combating toxic stress among low-income families. Through weekly classes and sessions with clinical social workers and a family summer day camp, ATS will create spaces for families to safely process and address the stresses in their lives through accessible, culturally-reflective therapeutic services. ATS will help to normalize behavioral health care and equip families – primarily in the Franklin Field neighborhood – with the strategies they need to help express and process their emotions and combat the effects of toxic stress.

Sportsmen’s Tennis & Enrichment Center’s Generating Excellent Mentors (GEM) program includes two complementary components: (1) Volley Against Violence is a partnership with the Boston Police Department focused on preventing youth violence by providing intentional mentoring, life skills training, and educational experiences; (2) HEY Sister and DEUCE are gender-specific weekend leadership development and social-emotional wellness programs which provide a much-needed safe space for youth to explore the many challenges they face, to build their self-advocacy skills, and develop positive relationships with peers and adult mentors. Sportsmen’s, based in the Franklin Field neighborhood, will enhance their GEM programs by integrating social work personnel to provide on-the-spot support to youth in need during practice and engaging with youth and families off the court to assess longer-term needs and connect them with community resources to support their continued positive development.
Contact DHI

For more information contact:

Sherry Dong, Senior Director
Community Benefits and Community Health Initiatives
Tufts Medical Center
800 Washington Street, Box 116
Boston, MA 02111
617.636.1628
sherry.dong@tuftsmedicine.org