Massachusetts General Hospital

About the Center for Community Health Improvement

Good health begins with healthy communities that have access to healthy foods, safe places for children to play, and positive activities for teens. Communities must also have access to a health care system with programs to prevent, screen for, and treat conditions such as asthma, obesity, cancer, domestic violence, and substance abuse. MGH is committed to creating healthy communities in the towns and neighborhoods it serves.

Achieving healthy communities requires a collaborative approach. The MGH Center for Community Health Improvement (CCHI) builds relationships and works with community partners to make measurable, sustainable improvement on some of the toughest health problems – like violence, obesity, and teen substance abuse.

A collaborative process

The process starts with assessing the needs of the community through a participatory approach, identifying priority health challenges, then determining which evidence-based approaches will most effectively meet the community’s needs.

Working together with the community, CCHI uses three approaches to address community health priorities. “Environmental” strategies help to improve the conditions in communities, such as enacting a city ordinance banning smoking in public places in order to reduce exposure to secondhand smoke. Health care “navigation” and the support of community health workers increase access to health care and guide people through the health care system. Finally, youth programs serve to generate interest in science and health to expand horizons and create educational and economic opportunities for the future.

CCHI carries out its work in Chelsea, Revere, and Charlestown, where MGH has maintained healthcare centers for more than 40 years. CCHI programs also work with Boston youth and special populations such as the elderly, homeless, immigrants, and refugees to improve their health status. For 15 years, CCHI has partnered with the communities it serves to assess needs and create more than 35 programs that:

• Reduce and prevent substance abuse and violence
• Tackle the obesity epidemic by increasing access to healthy food and physical activity
• Increase access to care for vulnerable populations such as immigrants and refugees, seniors, and homeless people
• Prevent and detect cancers early in order to improve health outcomes
• Generate interest in science and health careers among youth

Our approach

CCHI is committed to its values that foster collaboration, community-based approaches, long-term systems change, and improve access to underserved and vulnerable populations. CCHI’s work is guided by the following principals:

• Commitment to the underserved and to reducing health care disparities
• A broad definition of health, inclusive of social determinants
• Building on community strengths and assets
• Prevention, early intervention, and health promotion, as well as equal access to care
• Mutual learning: MGH and communities listen to, collaborate with, and learn from each other
• Sustainability through systematic changes
• Evidence-based and culturally appropriate initiatives
• Community-based participatory research evaluation

2011 Outcomes

• A grant from the Susan G. Komen Foundation funded a culturally-tailored navigator program for breast cancer screening for Serbo-Croatian-speaking women immigrants. During only one year with this program, MGH Chelsea clinicians were able to increase screening rates from 44% to 67%, and were able to eliminate the disparity that existed between these women and English- and Spanish-speaking patients at the health center.

• Substance abuse prevention efforts are working. In Charlestown there was a 62% reduction in the rate of calls to Emergency Medical Services for Heroin Overdoses from 2003 to 2010. According to a City of Revere's review of its death certificate data, the number of deaths involving one or more opioids declined from 15 deaths in 2009 to 10 deaths in 2010, a 33 percent decrease.

• The Massachusetts Department of Public Health has awarded two $305,000 grants-- one to MGH Chelsea and one to MGH Revere-- to expand home visiting services to vulnerable and isolated new mothers and families. In Revere, the funds will be used to expand the Healthy Steps, a Pediatric program supporting the needs of parents and newborns. In Chelsea, this grant will be used to create the Healthy Beginnings - Healthy Futures Program which builds on the Visiting Moms program that the MGH Chelsea Community Health Improvement Team has operated for 10 years. The new program will pair home visitors with high risk mothers, provide child development specialists to all babies born into the Pediatric practice, and offer parenting support for their caretakers. The grants may be renewed for up to five years.

• Twenty-six high school juniors from Boston, Chelsea and Revere became MGH Bicentennial Scholars, a gift to the community to celebrate the hospital's bicentennial in 2011. These students receive comprehensive support to gain admission to, prepare for and graduate from college. The program includes SAT prep, college tours, parental support, mentoring, connections to an array of supportive services, coaching, financial aid counseling, jobs during the school year and summers and scholarships of $5,000 per year.

• The Chelsea Board of Health approved a ban on trans fat in food establishments, considered a first-in-the-nation ban because the regulation prohibits the use of any partially hydrogenated ingredients.  Other trans fat bans allow for 0.05. The work on this initiative took place over 18 months through a close collaboration between the Board of Health and the Healthy Chelsea Coalition.