Regional Health Status Indicators

Regional Health Status Indicators

Western Massachusetts

Deval L. Patrick, Governor Timothy P. Murray, Lieutenant Governor

Judyann Bigby, MD, Secretary of Health and Human Services John Auerbach, Commissioner, Department of Public Health

Jerry O’Keefe, Associate Commissioner Health Information, Statistics, Research, and Evaluation Bureau

Bruce Cohen, Director Division of Research and Epidemiology

Massachusetts Department of Public Health

June 2007

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ACKNOWLEDGEMENTS

This report was prepared by Isabel Caceres, MS, Malena Orejuela-Hood, MPH, and James West, PhD of the Division of Research and Epidemiology and by Lauren Wooley, MPH, of the Health Survey Program, Center for Health Information, Statistics, Research, and Evaluation. Special thanks go to Bruce Cohen, PhD, Director of the Division or Research and Epidemiology, and to all of the DPH Bureaus who have contributed to this report.

To obtain additional copies of this report, contact:

Massachusetts Department of Public Health Health Information, Statistics, Research and Evaluation Bureau

250 Washington Street, 6th Floor Boston, MA 02108

This and other Department of Public Health publications can be downloaded

from the following website:

http://www.mass.gov/dph/resep

To obtain more information on the health of Massachusetts and other Department of Public Health data:

Register for the Department’s free, Internet-based public health information service,

MassCHIP, via the website at:

http://masschip.state.ma.us

Or call 888-MAS-CHIP (toll free in MA) or 617-624-5629

http://www.mass.gov/dph/resep

http://masschip.state.ma.us/

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TABLE OF CONTENTS

NOTE TO READERS.................................................................................................... 15 INTRODUCTION........................................................................................................... 17

Goals for holding Regional Dialogues ....................................................................... 19 Goals of New DPH Leadership ................................................................................. 19 Timetable .................................................................................................................. 20

SOCIODEMOGRAPHIC INDICATORS ........................................................................ 21 Executive Office of health and Human Services Regions ......................................... 23 Massachusetts Counties & EOHHS Region.............................................................. 23 Comments about the Limitations of this presentation................................................ 24 2005 Population in Communities, Western Region: 2005 ......................................... 24 Race and Ethnic Breakdown of Population, Western Region and Massachusetts: 2005 .......................................................................................................................... 25 Race and Ethnic Breakdown of Population, Western Region and Massachusetts: 2005 ....................................................................................................................................................................25 Population by Age Group, Western Region and Massachusetts: 2005..................... 26 Population by Age Group, Western Region and Massachusetts: 2005..................... 26 Population by Age Group, Western Region and Massachusetts: 2005..................... 27 Language Spoken at Home, Western Region and Massachusetts: 2000 ................. 27 Language Spoken at Home, Largest Cities, Western Region and Massachusetts: 2000 .......................................................................................................................... 28 Language Spoken at Home, Western Region and Massachusetts: 2000 ................. 28 Highest and Lowest per Capita Income by Communities, Berkshires: 2000 ............. 29 Spanish Spoken at Home, Western Region: 2000 .................................................... 29 Socio-Demographic Indicators Western Region and Massachusetts: 2000.............. 30 Socio-Demographic Indicators Largest Cities, Western Region and Massachusetts 30 Highest and Lowest per Capita Income by Communities, Western Region: 2000 .... 31

HEALTH CARE ACCESS............................................................................................. 33

Adults who Have No Health Insurance by EOHHS Region, Massachusetts: 2005 ... 35 Adults who Have No Health Insurance by Race and Ethnicity, Western Region and Massachusetts: 2005 ................................................................................................ 35 Health Insurance Access, Western Region and Massachusetts: 2005 ..................... 36 Summary Indicators for Health Insurance by EOHHS Regions, Massachusetts: 2005 .......................................................................................................................... 36

BIRTH INDICATORS.................................................................................................... 37

Infant Mortality Rate (IMR) Western Region and Massachusetts: 1990-2005........... 39 Infant Mortality Rate by EOHHS Region and Massachusetts: 2002-2005 .......................39 Infant Mortality Rates by Race/Ethnicity, Western Region and Massachusetts: 2002-2005 ....................................................................................................................................................................40 Highest Infant Mortality Rates Among the 30 Largest Communities, Massachusetts: 2005 .......................................................................................................................... 40

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Infant Mortality Rate (IMR) Springfield: 1990-2005......................................................................41 Highest Infant Mortality Rate Among the 30 Largest Communities, Massachusetts 2003-2005 ................................................................................................................. 41 Infant Mortality Rates by Race/Ethnicity, Largest Cities in Western Region and Massachusetts: 2002-2005 .....................................................................................................................42 Low Birthweight, Western Region and Massachusetts: 1990-2005 .......................... 42 Low Birthweight by EOHHS Region, Massachusetts: 2005 ...................................... 43 Low Birthweight by Race and Ethnicity, Western Region and Massachusetts: 2005 43 Percent of Mothers Breastfeeding Western Region, Massachusetts: 1990-2005 ..... 44 Breastfeeding by EOHHS Region, Massachusetts: 2005.......................................... 44 Breastfeeding by EOHHS Region Largest Cities in Western Region, Massachusetts: 2005 .......................................................................................................................... 45 Breastfeeding by EOHHS Region Largest Cities in Western Region, Massachusetts: 2005 .......................................................................................................................... 45 Breastfeeding by Race and Ethnicity, Western Region and Massachusetts: 2005 ... 46 Teen Birth Rates, Western Region and Massachusetts: 1990-2005......................... 46 Teen Birth Rates by EOHHS Region, Massachusetts: 2005..................................... 47 Teen Birth Rates by EOHHS Region, Massachusetts: 2005..................................... 47 Teen Birth Rates by City/Town, Western Region: 2005 ............................................ 48 Teen Birth Rates by Race/Ethnicity, Western Region and Massachusetts: 2005 ..... 48 Teen Birth Rates by Race/Ethnicity, Berkshires and Massachusetts: 2005 .............. 49 Adequate Prenatal Care Western Region, Massachusetts: 1990-2005 .................... 49 Adequate Prenatal Care by EOHHS Regions, Massachusetts: 2005 ....................... 50 Public Source of Payment for Prenatal Care, Western Region and Massachusetts: 1990- 2005 ................................................................................................................ 50 Public Source of Payment for Prenatal Care, Western and Massachusetts: 2005.... 51 Infants Delivered by C-Section, Western Region and Massachusetts: 1990-2005 ... 51 Infants Delivered by C-Section by EOHHS Regions, Massachusetts: 2005.............. 52 Infants Delivered by C-Section by EOHHS Regions, Massachusetts: 2005.............. 52 Summary of Birth Indicators by EOHHS Regions, Massachusetts: 2005.................. 53 Summary of Birth Indicators by Community, in Western Region, Massachusetts: 2005 .......................................................................................................................... 53 Summary of Birth Indicators by EOHHS Regions ..................................................... 54 Summary of Birth Indicators by EOHHS Regions ..................................................... 54

LEADING CAUSES OF DEATH................................................................................... 55

Leading Causes of Death, Western Region and Massachusetts: 2005 .................... 57 Leading Causes of Death, Berkshires and Massachusetts: 2005 ............................. 57

CHRONIC DISEASE OUTCOMES AND OVERWEIGHT/OBESITY ............................ 59

Thresholds for Defining Overweight and Obesity ...................................................... 61 Adults who are Overweight by EOHHS Region, Massachusetts: 1995 & 2005......... 61 Adults who are Obese by EOHHS Region, Massachusetts: 1995 & 2005 ................ 62 Adults who are Obese by EOHHS Region, Massachusetts : 2005 ........................... 62 Adult Obesity by Race and Ethnicity, Western Region and Massachusetts: 2005 .... 63

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Adults who Participate in Regular Physical Activity by EOHHS Region, Massachusetts: 2005 ................................................................................................ 63 Adults who have 5+ Servings of Fruit or Vegetables by EOHHS Region, Massachusetts: 2005 ................................................................................................ 64 Adults who had their Cholesterol Checked in Past 5 Years by EOHHS Region, Massachusetts: 2005 ................................................................................................ 64 Adults who were Told by Health Care Provider that they had High Cholesterol, by EOHHS Region, Massachusetts: 2005 ..................................................................... 65 Adults who were Told by a Health Care Provider they have High Blood Pressure, by EOHHS Region, Massachusetts: 2005 ..................................................................... 65 Adults who take Medicine for High Blood Pressure, by EOHHS Region, Massachusetts : 2005 ............................................................................................... 66 Hypertension Hospital Discharges by EOHHS Region, Massachusetts: 2003-3005. 66 Hypertension Hospital Discharge Rates by Race/Ethnicity, Western Region, Massachusetts: 2003-2005 ....................................................................................... 67 Heart Disease Mortality Rates by EOHHS Region, Massachusetts: 2003-2005 ....... 67 Heart Disease Death Rates by Race/Ethnicity, Western Region and Massachusetts : 2003-2005 ................................................................................................................. 68 Diabetes Hospital Discharge Rates by EOHHS Region, Massachusetts: 2003-200568 Diabetes Hospital Discharge Rates by EOHHS and Berkshires, and Pittsfield Massachusetts: 2003-2005 ....................................................................................... 69 Diabetes Hospital Discharge Rates Largest Cities, Western Region: 2003-2005 ..... 69 Diabetes Hospital Discharge Rates by Race/Ethnicity, Western Region, Massachusetts: 2003-2005 ..................................................................................... 70 Diabetes Hospital Discharge Rates by Race/Ethnicity, Berkshires, Pittsfield, & Massachusetts: 2003-2005 ....................................................................................... 70 Diabetes Mortality Rates by EOHHS Region, Massachusetts: 2003-2005................ 71 Diabetes Death Rates by Race/Ethnicity, Western Region and Massachusetts : 2003- 2005 .......................................................................................................................... 71 Summary Indicators for Overweight/Obesity, by EOHHS Regions, Massachusetts : 2005 .......................................................................................................................... 72 Summary Indicators for Chronic Disease Outcomes for Overweight/Obesity by EOHHS Regions ....................................................................................................... 72 Summary Indicators for Chronic Disease Outcomes for Overweight/Obesity, Communities in Western Region: 2003-2005............................................................ 73 Summary Indicators for Chronic Disease Outcomes for Overweight/Obesity For Berkshires, Western Region, Massachusetts 2003-2005.......................................... 73

CANCER....................................................................................................................... 75

Adults Ages 50+ who have had a Sigmoidoscopy or Colonoscopy in Past 5 Years by EOHHS Regions, Massachusetts: 2005.................................................................... 77 Incidence Rates for Invasive Colorectal Cancer by EOHHS Region, Massachusetts: 1990-2003 ................................................................................................................. 77 Incidence Rates for Early Stage Colorectal Cancer, Males, by EOHHS Region, Massachusetts: 1999-2003 ....................................................................................... 78

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Incidence Rates for Early Stage Colorectal Cancer, Females, by EOHHS Region, Massachusetts: 1999-2003 ....................................................................................... 78 Colorectal Cancer Mortality Rates by EOHHS Region, Massachusetts: 2005 .......... 79 Men Ages 50+ who had a Prostate-Specific Antigen Test in the Past 2 years by EOHHS Region, Massachusetts: 2004 ..................................................................... 79 Men Ages 50+ who had a Digital Rectal Exam in the Past Two Years by EOHHS Region, Massachusetts: 2004 ................................................................................... 80 Adults Ages 50+ who had a Blood Stool Test in the Past Two Years by EOHHS Region, Massachusetts: 2005 ................................................................................... 80 Incidence Rates for Invasive Prostate Cancer by EOHHS Region, Massachusetts: 1999- 2003 ................................................................................................................ 81 Incidence Rates for Early Stage Prostate Cancer by EOHHS Region, Massachusetts: 1999-2003 ................................................................................................................. 81 Prostate Cancer Mortality Rates by EOHHS Region, Massachusetts: 2005............. 82 Women Ages 40+ who had a Clinical Breast Exam in the Past Two Years by EOHHS Region, Massachusetts: 2004 ................................................................................... 82 Women who had a Clinical Breast Exam in the Past Two Years by Race and Ethnicity, Western Region and Massachusetts : 2004 .............................................. 83 Women Ages 40+ who have had a Mammography in Past 2 Years by EOHHS Region, Massachusetts: 2005 ................................................................................... 83 Incidence Rates for Invasive Female Breast Cancer by EOHHS Region, Massachusetts: 1999-2003 ....................................................................................... 84 Incidence Rates for Early Stage Female Breast Cancer by EOHHS Region, Massachusetts : 1999-2003 ...................................................................................... 84 Female Breast Cancer Mortality Rates by EOHHS Region, Massachusetts : 2005 .. 85 Adults who Currently Smoke by EOHHS Regions and Massachusetts: 2005........... 85 Adults who Currently Smoke by EOHHS Regions and Berkshires, Massachusetts: 2005 .......................................................................................................................... 86 Current Smoker by Race and Ethnicity, Western Region and Massachusetts: 2005 86 Percent of Mothers Smoking During Pregnancy for Largest Communities, Western Region: 2005............................................................................................................. 87 Smoking During Pregnancy, Western Region and Massachusetts: 1990-2005 ........ 87 Smoking During Pregnancy by Race and Ethnicity, Berkshires, Western Region and Massachusetts: 2005 ............................................................................................... 88 Incidence Rates for Early Stage Lung Cancer, Males, by EOHHS Region, Massachusetts : 1999-2003 ...................................................................................... 88 Incidence Rates for Early Stage Lung Cancer, Females, by EOHHS Region, Massachusetts: 1999-2003 ....................................................................................... 89 Lung Cancer Mortality Rates by EOHHS Region, Massachusetts : 2005 ................. 89 Incidence Rates for Invasive Lung Cancer by EOHHS Region, Massachusetts: 1999-2003 .......................................................................................................................... 90 Summary Indicators for Cancer Screening by EOHHS Regions, Massachusetts: 2005 .......................................................................................................................... 90 Summary Cancer Indicators (Early Stage) by EOHHS Regions, Massachusetts: 1999- 2003 ................................................................................................................ 91

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Summary Cancer Indicators (Late Stage) by EOHHS Regions, Massachusetts: 1999- 2003 .......................................................................................................................... 91 Summary Invasive Cancer Incidence Rates by EOHHS Regions, Massachusetts: 1999 - 2003 ............................................................................................................... 92 Summary Invasive Cancer Incidence Rates, Communities In Western Region: 1999 - 2003 .......................................................................................................................... 92 Summary Invasive Cancer Incidence Rates, Western Region, Massachusetts: 1999 - 2003 ....................................................................................................................................................................93 Summary Cancer Mortality Indicators by EOHHS Regions, Massachusetts: 2005 ... 93 Summary Cancer Mortality Rates, Communities in the Western Region .................. 94 Summary Cancer Mortality Rates, Berkshires, Western Region, Massachusetts: 1999 - 2003 .....................................................................................................................................................94

SUBSTANCE ABUSE .................................................................................................. 95 Alcohol Use in Past Month, Persons Aged 12 to 20 Years, by EOHHS Region, Massachusetts : 2002-2004 ...................................................................................... 97 Binge Drinking in Past Month, Persons Aged 12 to 20 Years, by EOHHS Region, Massachusetts : 2002-2004 ...................................................................................... 97 Any Illicit Drug Use in Past Month, Persons Aged 12+ Years, by EOHHS Region, Massachusetts: 2002-2004 ....................................................................................... 98 Any Illicit Drug Use Other Than Marijuana use in Past Month, Persons Aged 12+ Years, by EOHHS Region, Massachusetts: 2002-2004 ............................................ 98 Alcohol Dependence or Abuse in Past Year, Persons Aged 12+ Years, by EOHHS Region, Massachusetts : 2002-2004......................................................................... 99 Dependence or Abuse of Any Illicit Drug or Alcohol in Past Year, Persons Aged 12+ Years by EOHHS Region, Massachusetts : 2002-2004 ........................................... 99 Adults who Binge Drink, by EOHHS Region, Massachusetts : 2005....................... 100 Adults who Used Illicit Drugs in Past Month by EOHHS Region, Massachusetts : 2005 ........................................................................................................................ 100 Substance Abuse Treatment Program Admissions by EOHHS Region, Massachusetts : 2005 ............................................................................................ 101 Substance Abuse Treatment Program Admissions, Alcohol Primary Substance, by Largest Cities, Western Region : 2005.................................................................... 101 Substance Abuse Treatment Program Admissions, Alcohol Primary Substance, by EOHHS Region, Massachusetts : 2005 .................................................................. 102 Substance Abuse Treatment Program Admissions, Alcohol Primary Substance, by Race and Ethnicity, Berkshires and Massachusetts : 2005..................................... 102 Substance Abuse Treatment Program Admissions, Cocaine Primary Substance, by EOHHS Region, Massachusetts : 2005 .................................................................. 103 Substance Abuse Treatment Program Admissions, Heroin Primary Substance, by EOHHS Region, Massachusetts : 2005 .................................................................. 103 Substance Abuse Treatment Program Admissions, Heroin Primary Substance, by EOHHS Region and Berkshires, Massachusetts : 2005 ........................................................104 Opioid-related Emergency Visit Rates by EOHHS Region, Massachusetts : 2003-2005 ........................................................................................................................ 104

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Opioid-related Emergency Visit Rates by Largest Cities in Western Region, Massachusetts : 2003-2005 .................................................................................... 105 Opioid-related Emergency Visit Rates by Race and Ethnicity Western Region, Massachusetts : 2003-2005 .................................................................................... 105 Massachusetts City and Town FY03-05, Total Number of Opioid Overdose Related Deaths..................................................................................................................... 106 Massachusetts City and Town FY03-05, Total Number of Opioid Overdose Related Deaths..................................................................................................................... 106 Opioid-Related Fatal Overdoses by EOHHS Region, Massachusetts : 2003-2005 107 Opioid-Related Fatal Overdoses by Race/Ethnicity, Western Region and Massachusetts : 2003-2005 .................................................................................... 107 Massachusetts City and Town FY03-05, Total Number of Poly-Drug Overdose related Deaths..................................................................................................................... 108 Massachusetts City and Town FY03-05, Total Number of Poly-Drug Overdose related Deaths..................................................................................................................... 108 Summary Substance Abuse Indicators Percentages by EOHHS Regions.............. 109 Summary Substance Abuse Indicators by EOHHS Region, Massachusetts: 2005. 109 Summary Substance Abuse Indicators Communities in the Western Region:2005 110 Summary Substance Abuse Indicators Berkshires, Western Region, and Massachusetts: 2005 .............................................................................................. 110 Summary Opioid Indicators by EOHHS Regions, Massachusetts: 2003-2005........ 111 Summary Opioid Indicators, Communities in Western Region, Massachusetts: 2003-2005 ........................................................................................................................ 111

INJURY, VIOLENCE AND OCCUPATIONAL HEALTH............................................. 113

Causes of Injury Deaths, Western Region and Massachusetts: 2005..................... 115 Injury-Related Hospital Discharge Rates by EOHHS Region, Massachusetts: 2003-2005 ........................................................................................................................ 115 Injury-Related Hospital Discharge Rates by Race and Ethnicity, Western Region and Massachusetts: 2003-2005 ..................................................................................... 116 Emergency Department Visit Rates for Injuries and Poisonings by EOHHS Region, Massachusetts : 2003-2005 .................................................................................... 116 Emergency Department Visit Rates for Injuries & Poisonings by Race/Ethnicity, Western Region and Massachusetts : 2003-2005................................................... 117 Hospital Discharge Rates for Traumatic Brain Injuries by EOHHS Region, Massachusetts : 2003-2005 .................................................................................... 117 Hospital Discharge Rates for Traumatic Brain Injury by Race/Ethnicity, Western Region and Massachusetts : 2003-2005................................................................. 118 Emergency Department Visit Rates for Traumatic Brain Injury, by EOHHS Region, Massachusetts : 2003-2005 .................................................................................... 118 Emergency Department Visit Rates for Traumatic Brain Injury by Race/Ethnicity, Western Region and Massachusetts : 2003-2005................................................... 119 Injury Death Rates by EOHHS Region, Massachusetts: 2003-2005....................... 119 Injury Death Rates by Race/Ethnicity, Western Region and Massachusetts: 2003-2005 ........................................................................................................................ 120 Homicide Rates by EOHHS Region, Massachusetts : 2003-2005 .......................... 120

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Homicide Rates by Race and Ethnicity, Western Region and Massachusetts: 2003-2005 ........................................................................................................................ 121 Hospital Discharge Rates for Self-Inflicted Injury, by EOHHS Region, Massachusetts : 2003-2005 .................................................................................... 121 Hospital Discharge Rates for Self-Inflicted Injury, by EOHHS Region, Massachusetts : 2003-2005 .................................................................................................................122 Hospital Discharge Rates for Self-Inflicted Injuries by Race/Ethnicity, Western Region and Massachusetts: 2003-2005 .............................................................................. 122 Suicide by EOHHS Region, Massachusetts: 2003-2005......................................... 123 Suicide Rates by Race and Ethnicity, Western Region and Massachusetts: 2003-2005 ........................................................................................................................ 123 Hospital Discharge Rates for Motor Vehicle-Related Injuries by EOHHS Region and Massachusetts : 2003-2005 .................................................................................... 124 Hospital Discharge Rates for Motor Vehicle-Related Injuries by EOHHS Region, Berkshires, and Pittsfield, Massachusetts : 2003-2005........................................... 124 Hospital Discharge Rates for Motor Vehicle-Related Injuries by Largest Cities in Western Region, Massachusetts : 2003-2005......................................................... 125 Hospital Discharge Rates for Motor Vehicle-Related Injuries by Race/Ethnicity, Western Region and Massachusetts: 2003-2005.................................................... 125 Motor Vehicle-Related Mortality Rates by EOHHS Region, Massachusetts : 2003-2005 ........................................................................................................................ 126 Hospital Discharge Rates for Motor Vehicle-Related Injuries by Race/Ethnicity, Western Region, Berkshires and Massachusetts: 2003-2005................................. 126 Emergency Department Visit Rates for Firearm Injuries, by EOHHS Region, Massachusetts: 2003-2005 ..................................................................................... 127 Emergency Department Visit Rates for Firearm Injuries, Largest Cities in Western Region, Massachusetts: 2003-2005........................................................................ 127 Emergency Department Visit Rates for Firearm Injuries by Race/Ethnicity, Western Region and Massachusetts: 2003-2005.................................................................. 128 Firearm Death Rates by EOHHS Region, Massachusetts: 2003-2005 ................... 128 Firearm Death Rates by Race/Ethnicity, Western Region and Massachusetts: 2003-2005 ........................................................................................................................ 129 Hospital Discharge Rates for Fall-Related Injuries, by EOHHS Region, Massachusetts : 2003-2005 .................................................................................... 129 Hospital Discharge Rates for Fall-Related Injuries by Race/Ethnicity, Western Region and Massachusetts : 2005 ...................................................................................... 130 Emergency Department Visit Rates for Fall-Related Injuries, by EOHHS Region, Massachusetts : 2003-2005 .................................................................................... 130 Emergency Department Visit Rates for Fall-Related Injuries by Race/Ethnicity, Western Region and Massachusetts : 2003-2005................................................... 131 Fall-Related Injury Death Rates by EOHHS Region, Massachusetts : 2003-2005.. 131 Fall-Related Injury Death Rates by Race/Ethnicity, Western Region and Massachusetts : 2003-2005 .................................................................................... 132 Fall-related Injury Death Rates, Persons 65+ years, by EOHHS Region, Massachusetts : 2003-2005 .................................................................................... 132

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Hospital Discharge Rates for Assaults, by EOHHS Region, Massachusetts: 2003-2005 ........................................................................................................................ 133 Hospital Discharge Rates for Assaults by Race/Ethnicity, Western Region and Massachusetts: 2003-2005 ..................................................................................... 133 Work-related Injuries, Emergency Department Visits per 100 Full Time Equivalents, Massachusetts Counties: 2004-2005 ...................................................................... 134 Work-related Injuries among Teens, Emergency Department Visits per 100 Full Time Equivalents, Massachusetts Counties: 2004-2005.................................................. 134 Work-related Burn Injuries, Emergency Department Visits per 10,000 Full Time Equivalents, Massachusetts Counties: 2004-2005.................................................. 135 Work-related Amputations, Emergency Department Visits per 10,000 Full Time Equivalents, Massachusetts: 2004-2005................................................................. 135 Work-related Injuries, Hospitalizations per 10,000 Full Time Equivalents, Massachusetts Counties: 2004-2005 ...................................................................... 136 Number and Rate of Fatal Occupational Injuries by year, Massachusetts: 1991- 2005 ........................................................................................................................ 136 Summary Injury/Violence Hospitalization Indicators by EOHHS Regions, Massachusetts : 2003-2005 .................................................................................... 137 Summary Injury/Violence Hospitalization Indicators, Communities in Western Region: 2003-2005 ............................................................................................................... 137 Summary Injury/Violence Hospitalization Indicators Berkshires, Western Region and Massachusetts : 2003-2005 .................................................................................... 138 Summary Injury/Violence Emergency Department Indicators by Communities in Western Region: 2003-2005 ................................................................................... 138 Summary Injury/Violence Emergency Department Indicators Communities in Western Region: 2003-2005.................................................................................................. 139 Summary Injury/Violence Emergency Department Indicators Berkshires, Western Region and Massachusetts : 2003-2005................................................................. 139 Summary Injury/Violence Mortality Rates by EOHHS Regions, Massachusetts : 2003-2005 ........................................................................................................................ 140 Summary Injury/Violence Mortality Indicators Communities in Western Region: 2003-2005 ........................................................................................................................ 140 Summary Injury/Violence Mortality Indicators Berkshires, Western Region and Massachusetts : 2003-2005 .................................................................................... 141

HIV/AIDS..................................................................................................................... 143

Persons Living with HIV, by EOHHS Region, Massachusetts: 2005....................... 145 HIV Incidence, by EOHHS Region, Massachusetts: 2005 ...................................... 145 AIDS Incidence, by EOHHS Region, Massachusetts: 2005 .................................... 146 Persons Living with AIDS, by EOHHS Region, Massachusetts : 2005 ................... 146 HIV/AIDS Death Rates, by EOHHS Region, Massachusetts : 2003-2005 .............. 147 HIV/AIDS Death Rates by Largest Communities Western Region: 2003 - 2005..... 147 HIV/AIDS Death Rates by Race and Ethnicity, Western Region and Massachusetts: 2003 - 2005 ............................................................................................................. 148 Summary HIV/AIDS Indicators by EOHHS Regions ............................................... 148 Summary HIV/AIDS Indicators Communities in Western Region............................ 149

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Summary HIV/AIDS Indicators Communities in Western Region............................ 149 INFECTIOUS DISEASES ........................................................................................... 151

Chlamydia Incidence, Western Region and Massachusetts : 1989-2005................ 153 Chlamydia Incidence by EOHHS Region, Massachusetts: 2005 ............................ 153 Chlamydia Incidence Rate by Emergency Preparation Region, 2006..................... 154 Gonorrhea Incidence by EOHHS Region, Massachusetts : 2005 ........................... 154 Syphilis Incidence, Western Region and Massachusetts : 1989-2005 .................... 155 Syphilis Incidence, by EOHHS Region, Massachusetts : 2005 ............................... 155 Tuberculosis Incidence, by EOHHS Region, Massachusetts : 2004 ....................... 156 Tuberculosis Incidence, by EOHHS Region, Massachusetts : 2006 ....................... 156 Confirmed Tuberculosis Cases by Race/Ethnicity and EOHHS Region, Massachusetts: 2006 .............................................................................................. 157 Percent Confirmed Tuberculosis Cases by EOHHS Region, Massachusetts : 2006157 Percent of Confirmed Tuberculosis Cases by Race/Ethnicity and EOHHS Region, Massachusetts : 2006 ............................................................................................. 158 Tuberculosis Cases by EOHHS Region, Massachusetts : 1993-2006 .................... 158 Percent of Confirmed Tuberculosis Cases by Race/Ethnicity and EOHHS Region, Massachusetts : 2006 ............................................................................................. 159 Hepatitis C Average Incidence Rates, by EOHHS Region, Massachusetts: 1992- 2006 ........................................................................................................................ 159 Massachusetts Hepatitis C Infection Average per Year, by Town, 1992-2006........ 160 Hepatitis C Incidence Rates, by EOHHS Region, Massachusetts : 2006................ 160 Massachusetts Hepatitis C Infection Average per Year, by Town, 2006................. 161 Lyme Disease Incidence by EOHHS Region and Massachusetts: 2004................. 161 Massachusetts Lyme Disease Case Rates, by Town, 2005.................................... 162 Pneumonia and Influenza Hospital Discharges by EOHHS Region, Massachusetts: 2005 ........................................................................................................................ 162 Summary Infectious Disease Indicators, by EOHHS Regions................................. 163 Summary Infectious Disease Indicators Communities in Western Region .............. 163 Summary Infectious Disease Indicators Communities in Western Region .............. 164

ASTHMA..................................................................................................................... 165

Asthma Hospital Discharges by EOHHS Region, Massachusetts: 2005................. 167 Asthma Emergency Department Visits, by EOHHS Region, Massachusetts: 2005 167 Emergency Department Visit Rates for Asthma by Race/Ethnicity, Western Region and Massachusetts: 2005 ....................................................................................... 168 Adults who Currently have Asthma by EOHHS Region, Massachusetts: 2005....... 168 Asthma ER Visits, Children Ages 0-4, by EOHHS Region, Massachusetts : 2005 . 169 Asthma ER Visits, Children Ages 5-9, by EOHHS Region, Massachusetts : 2005 . 169 Asthma ER Visits, Children Ages 10-14, by EOHHS Region, Massachusetts : 2005 ........................................................................................................................ 170 Asthma ER Visits, Children Ages 0-14, by EOHHS Region, Massachusetts : 2005 170 Asthma ER Visits, Children Ages 0-14, by EOHHS Region, Massachusetts : 2005 171 Asthma ER Visits, Children Ages 0-14, Largest Cities, Western Region: 2005....... 171

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Asthma Emergency Department Visit Rates, Children ages 0-14, Western Region and Massachusetts : 2005 ...................................................................................... 172 Asthma Emergency Department Visit Rates, Children ages 0-14, Berkshires and Massachusetts : 2005 .............................................................................................................................173 Pediatric Asthma Prevalence by EOHHS Region, Massachusetts : 2005-2006...... 173 Pediatric (Ages <5) Asthma ER Visit Rates by Community, Massachusetts : 2005-2006 ........................................................................................................................ 174 Pediatric (Ages <5) Asthma ER Visit Rates by Community, Western Region, Massachusetts : 2005-2006 .................................................................................... 174 Pediatric (Ages <5) Asthma Hospitalization Rates by Community, Western Region, Massachusetts : 2005-2006 .................................................................................................................175 Summary Asthma Indicators, by EOHHS Regions, Massachusetts : 2005............. 175 Summary Asthma Indicators, Communities in Western Region : 2005 ................... 176 Summary Asthma Indicators, Communities in Western Region : 2005 ................... 176 Summary Asthma Indicators, by EOHHS Regions, Massachusetts : 2005............. 177

OTHER HEALTH INDICATORS................................................................................. 179 Total Cases of Elevated Blood Lead Levels (>=15 µG/DL), by EOHHS Region, Massachusetts: 2005 .............................................................................................. 181 Lead Poisoning Prevalence Rates (BLL≥ 25 µG/DL), Children 9-48 Months, by EOHHS Region, Massachusetts: 2006 ................................................................................. 181 Adults who Report Experiencing Intimate Partner Violence by Gender and EOHHS Region, Massachusetts: 2005 ................................................................................. 182 Adults who Report Having a Disability by EOHHS Region, Massachusetts : 2005 . 182 Adults who Report Having a Disability and needing help with activities, by EOHHS Region, Massachusetts : 2005 ................................................................................ 183 Adults with Fair or Poor Health, by EOHHS Region, Massachusetts : 2005 ........... 183 Adults who Reported Fair or Poor Health by Race and Ethnicity, Western Region and Massachusetts : 2005 ............................................................................................. 184 Adults who Reported Fair or Poor Health by Race and Ethnicity, Western Region and Massachusetts : 1999-2005 .................................................................................................................184 Adults who Visited a Dentist in Past Year, by EOHHS Region, Massachusetts : 2004 ........................................................................................................................ 185 Adults who have lost 6 or More Teeth to Decay or Disease, by EOHHS Region, Massachusetts : 2004 ............................................................................................. 185 Adults with Poor Mental Health for 15+ Days in Past Month, by EOHHS Region, Massachusetts : 2005 ............................................................................................. 186 Summary Other Health Indicators, by EOHHS Regions.......................................... 186 Summary Other Health Indicators, by EOHHS Regions.......................................... 187 Refugee Arrivals Western Region, Massachusetts: 2002-2006 .............................. 187 Refugee Health Concern Western Region, Massachusetts: 2002-2006 ................. 188 Summary Refugees by EOHHS Regions, Massachusetts : 2002-2006 .................. 188 Premature Mortality Rate (PMR) ............................................................................. 189 Premature Mortality Rates (PMR) by Region, Massachusetts : 2005 ..................... 189 PMR –Western Region by City/Town, Massachusetts : 2005 ................................. 190 Median Household Income and PMR by EOHHS Region, Massachusetts: 2005 ... 190

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Premature Mortality Rate (PMR) by EOHHS Regions: 2005................................... 191

SUMMARY.................................................................................................................. 193 Summary – Berkshires ............................................................................................ 195 Summary – Berkshires (Continued) ........................................................................ 195 Selected Health Disparities by Race/Ethnicity, Berkshires...................................... 196 Summary – Western Region ................................................................................... 196 Summary – Western Region (Continued)................................................................ 197 Selected Health Disparities by Race/Ethnicity, Western Region........................................197

APPENDIX.................................................................................................................. 199 Regions and Towns ................................................................................................ 201 Data Sources .......................................................................................................... 207

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NOTE TO READERS

Background This report presents important health indicators for your region, which were developed as background material for the Regional Health Dialogues being held across the Commonwealth in May and June 2007. These dialogues offer an opportunity for you to have a conversation with the Commissioner of Public Health, learn the latest health information for your region, identify your resources and areas of need, and together, with the Massachusetts Department of Public Health, shape a public health partnership. Contents This report provides information about the socio-demographics, health care access, births, deaths, major chronic and infectious disease rates, substance abuse, and injury and violence for your region. Your region’s indicators are compared with those of other regions and to the state as a whole in order to provide you with a sense of the relative health of your region. Many indicators for your region are stratified by race, Hispanic ethnicity, and age in order help determine specific population groups that may require targeted health interventions. We have also provided information about the health status of one or more large communities in your region, which may be influencing your regional outcomes. We hope that this collection of important and diverse health indicators will stimulate discussions of local health priorities, as well as serving as a resource for health information and a reference for data that are available from the Massachusetts Department of Public Health. Please contact us with your comments and suggestions.

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INTRODUCTION

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Goals for holding Regional Dialogues

• Introduce new DPH leadership

• Present latest health data on your particular region

• Talk with residents and providers about data and identify areas of need

• Gather feedback to inform process of setting DPH priorities

Goals of New DPH leadership

• Use data and community input to set new priorities & reshape the Department

• Rely on science and evidence-based process to guide the work

• Strengthen ties with and support for local health and local agencies

• Increase resources to and visibility of public health in Massachusetts

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Timetable

• Hold 8 regional dialogues with comprehensive data review and identification of key health concerns (by July)

• Identify short list of top priorities by end of August

• Hold second round of community dialogues to discuss action plans/results by end of calendar year

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SOCIODEMOGRAPHIC INDICATORS

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WesternRegion Central

Region

SoutheastRegion

Metro WestRegion

NortheastRegion

BostonRegion

Executive Office of Healthand Human Services Regions

Western RegionCentral RegionNorth East RegionMetro West RegionSouth East RegionBoston Region

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology Program

Executive Office of Health and Human Services Regions (EOHHS)

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Massachusetts Counties& EOHHS Western Region

EOHHS Western Region

Berkshires

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A few comments about the limitations of this presentation

• A regional analysis has its drawbacks

• Variability within a region – urban vs. rural/suburban (i.e. Berkshires vs. the rest of the region)

• Variability by sub-population – race matters, poverty matters

• Our data don’t reflect all the important health indicators

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OTIS

LEE

WAREBECKET

PETERSHAM

SAVOY

MONSON

COLRAIN

PERU

SHEFFIELD

BLANDFORD

CONWAY

ORANGE

ASHFIELD

SANDISFIELD

CHESTER

ROWE

WARWICK

GRANVILLE

HEATH

HAWLEY

WINDSOR

TOLLAND

ROYALSTON

GILL

WENDELL

GRANBY

PELHAM

ADAMS

LENOX

HADLEY

FLORIDA

WASHINGTON

MONTAGUE

CHESHIRE

SOUTHWICK

MONTEREY

LEYDEN

WHATELYGOSHEN

HAMPDEN

ERVING

PLAINFIELD

BUCKLAND

CUMMINGTON

MONROE

NEW SALEM

HANCOCK

WILLIAMSTOWN

DEERFIELD

NORTHFIELD

DALTON

NEW MARLBOROUGH

LEVERETT

GREAT BARRINGTON

HINSDALE

WORTHINGTONCHESTERFIELD

HUNTINGTON

SHUTESBURY

RUSSELL

SHELBURNE

PHILLIPSTON

CHARLEMONT

SOUTHAMPTON

MIDDLEFIELD

HATFIELD

LANESBOROUGH

WESTHAMPTON

RICHMOND WILLIAMSBURG

EGREMONT

STOCKBRIDGE

TYRINGHAM

BERNARDSTON

ALFORD

SUNDERLAND

MOUNT WASHINGTON

MONTGOMERY

CLARKSBURG

NEW ASHFORD

WEST STOCKBRIDGE

!.ATHOL

!.WESTFIELD

!.PALMER

!.PITTSFIELD

!.LUDLOW

!.AGAWAM

!.SPRINGFIELD

!.HOLYOKE

!.CHICOPEE

!.BELCHERTOWN

!.AMHERST

!.NORTHAMPTON

!.WILBRAHAM

!.GREENFIELD

!.NORTH ADAMS

!.SOUTH HADLEY!.

EASTHAMPTON

!.WEST SPRINGFIELD

!.LONGMEADOW

!.EAST LONGMEADOW

!.Cities with at least 10,000 Population

2005 Population by Communities Western Region

LargestSpringfield:

156,358

SmallestMonroe: 100


25

5Race and Ethnic Breakdown of PopulationWestern Region and Massachusetts: 2005

Western Region Massachusetts

White* 81.3%

Black* 5.5%

Hispanic 11.0%

Asian* 2.0%

* Non-Hispanics

White* 81.0%

Black* 6.0%

Hispanic 7.9%

Asian* 4.9%


American Indian* 0.2%


Berkshires

White* 93.8%

Black* 2.5%

Hispanic 2.3%

Asian* 1.3%


6Race and Ethnic Breakdown of PopulationWestern Region and Massachusetts: 2005

0.3 %

2.4 %

31.0 %

21.3 %

45.0 %

Springfield

0.1%

1.6%

2.8%

4.7%

90.8%

Pittsfield

0.2%0.2 %0.2 %0.2%American Indian

4.9%1.0 %1.2 %2.0%Asian non-Hispanic

7.9%46.7 %10.1%11.0%Hispanic

6.0%2.7 %2.2%5.5%Black non-Hispanic

81.0%49.3 %86.3%81.3%White non-Hispanic

MA Total

HolyokeChicopeeWestern Region


26

7


0-19 years 25.5%


Population by Age Group Western Region and Massachusetts: 2005

20-24 years 8.1%

25-44 years 26.5%

45-64 years 25.7%

65+ years 14.2%

0-19 years 25.5%

20-24 years 6.7%

25-44 years 29.4%

45-64 years 25.3%

65+ years 13.3%

8Population by Age Group

Western Region and Massachusetts: 2005

18.4%

25.6%

26.9%

5.7%

23.3%

Pittsfield

17.3%

27.8%

24.7%

6.6%

23.2%

Berkshires

13.3%14.2%65+ years

25.3%25.7%45-64 years

29.4%26.5%25-44 years

6.7%8.1%20-24 years

25.5%25.5%0-19 years

MA TotalWestern Region

Ages


27

9Population by Age Group


11.7%

20.9%

28.3%

8.6%

30.6%

Springfield

13.3%14.4%16.8%14.2%65+ years

25.3%21.2%25.6%25.7%45-64 years

29.4%27.1%27.2%26.5%25-44 years

6.7%6.7%6.7%8.1%20-24 years

25.5%30.5%23.7%25.5%0-19 years

MA Total

HolyokeChicopeeWestern Region

Ages


10Language Spoken at Home,Western Region and Massachusetts: 2000

Western Region

Massachusetts Overall

Only English 83.9 81.3

Spanish or Spanish Creole 8.2 6.2 Portuguese or Portuguese Creole 0.9 2.7

French 1.5 1.4 Chinese 0.4 1.2 Italian 0.7 1.0 French Creole 0.04 0.7 Russian 0.7 0.6 Vietnamese 0.3 0.5 Polish 1.4 0.5


28

11Language Spoken at Home,Largest Cities, Western Region: 2000

Western Region Chicopee Holyoke Springfield

Only English 83.9 79.2 57.2 68.4

Spanish/Spanish Creole 8.2 7.1 35.8 23.5

Portuguese/Portuguese Creole

0.9 1.8 0.3 0.7

French 1.5 3.7 1.9 1.3 Italian 0.7 0.3 0.2 1.1

French Creole 0.04 0.07 0.03 0.06

Russian 0.7 0.9 0.1 0.7

Other languages 4.1 6.9 4.5 4.2


12Language Spoken at Home,Western Region and Massachusetts: 2000

Pittsfield Berkshires Western

Region Massachusetts

Overall

Only English 93.0 93.6 83.9 81.3

Spanish or Spanish Creole 1.7 1.6 8.2 6.2 Portuguese or Portuguese Creole

0.2 0.1 0.9 2.7

French 0.9 1.1 1.5 1.4 Chinese 0.2 0.2 0.4 1.2 Italian 1.4 0.8 0.7 1.0 French Creole 0.0 0.01 0.04 0.7 Russian 0.2 0.09 0.7 0.6 Vietnamese 0.1 0.1 0.3 0.5 Polish 0.9 0.9 1.4 0.5


29

13

$13,815

$16,979

$18,572

$25,952

$20,347

$40,412

$41,702

$50,149

$0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000

North Adams

Florida

Adams

Massachusetts

Western

Alford

Egremont

Mount Washington

Highest and Lowest Per Capita Income by Community1, Berkshires: 2000

High

Low

1 Selected among communities with at least 10,000 population


14

SPRINGFIELD 24%

HOLYOKE 36%LUDLOW 6%

AMHERST 6%

CHICOPEE 7%Spanish Language Spoken at Home (%)Cities/Towns in Western Region

10.0% - 55.3%

5.0% - 9.9%

0.2% - 4.9%

Western Region

9

Miles

Spanish Spoken at HomeWestern Region: 2000


30

15Socio-Demographic IndicatorsWestern Region and Massachusetts: 2000

Western Region

Massachusetts Overall

US Overall

Per Capita Income $20,347 $25,952 $21,587

Persons living below 100% poverty

12.5% 9.3% 12.4%

Children < 18 living below 100% poverty

17.8% 11.6% 16.1%

Less than a High School Education

17.2% 15.2% 19.6%

Foreign born 6.2% 12.2% 11.1%

Unemployed 5.2% 5.1% 5.5%


16

Socio-Demographic IndicatorsLargest Cities, Western Region and Massachusetts

Massachusetts Chicopee Holyoke Springfield Pittsfield

Per Capita Income (2000) $25,952 $18,646 $15,913 $15,232 $20,549

Persons living below 100% poverty (2000)

9.3% 12.3% 26.4% 23.1% 11.4%

Children < 18 living below 100% poverty (2000)

11.6% 19.5% 41.7% 33.9% 16.7%

Less than a High School Education (2000)

15.2% 25.1% 30.0% 26.6% 15.6%

Foreign born (2000)

12.2% 8.2% 5.4% 8.0% 3.9%

Speak language other than English at home (2000) 18.7% 20.8% 42.8% 31.6% 7.0%

Unemployed (2004) 5.1% 6.2% 7.3% 7.7% 4.8%


31

17

$15,232

$15,913

$16,845

$25,952

$20,347

$27,659

$38,949

$29,854

$0 $10,000 $20,000 $30,000 $40,000 $50,000

Springfield

Holyoke

Athol

Massachusetts

Western

East Longmeadow

Wilbraham

Longmeadow

Highest and Lowest Per Capita Income by Community1, Western Region: 2000

High

Low

1 Selected among communities with at least 10,000 population


32

33

HEALTH CARE ACCESS

34

35

18

Adults who Have No Health Insurance by EOHHS Region, Massachusetts: 2005

11.3 11.4

6.8

12.3

9.4

4.6

8.9

0

5

10

15

20

Western Central Northeast MetroWest

Southeast Boston MA

Perc

ent

**

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state

Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), Health Survey Program

19Adults who Have No Health Insurance by Race and Ethnicity


11.5

7.0

11.2

17.7

22.7 23.8

0

5

10

15

20

25


Perc

ent

White non-Hispanic Black non-Hispanic Hispanic



36

20Health Insurance Access


85%

10%

87%

9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Have personal health care provider Could not see doctor due to cost

Western RegionMassachusetts



21

10.4

85.3

12.3

Western

9.2

88.2

11.3

South East

9.47.07.810.48.8% Adults who were unable to see a doctor due to cost

78.390.385.890.087.1

% Adults who have a

personal health care

provider

11.44.69.46.88.9% Adults with

no health insurance

BostonMetro West

North East

CentralMATotal

Indicator

Summary Indicators for Health Insurance by EOHHS Region, Massachusetts: 2005

Better Outcome (significantly different from state) Worse Outcome (significantly different from state)


37

BIRTH INDICATORS

38

39

22

5.1

7.0

6.6 5.7

0

1

2

3

4

5

6

7

8

9

10

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Year

IMR

(# d

eath

s/1,

000

live

birt

hs)

Infant Mortality Rate (IMR) Western Region and Massachusetts: 1990-2005

Massachusetts

Western Region

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology ProgramInfant Mortality Rate: deaths of infants less than one year of age per 1000 live births

23Infant Mortality Rates by EOHHS Region Massachusetts: 2002-2005

4.8 4.94.0**

4.75.6 5.4 5.7

0

1

2

3

4

5

6

7

8

9

10


Southeast Boston MA

Infa

nt D

eath

s pe

r 1,0

00 L

ive

Birt

hs

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology ProgramInfant Mortality Rate: deaths of infants less than one year of age per 1000 live births


40

24Infant Mortality Rates by Race/Ethnicity Western Region and Massachusetts: 2002-2005

NA= Calculations based on less than 5 events are excluded


11.2

4.14.5

13.8

7.1 7.0

3.0

0

2

4

6

8

10

12

14

16


Dea

ths

per

1000

live

bir

ths

White non-Hispanic Black non-HispanicHispanic Asian non-Hispanic

NA


25Highest Infant Mortality RatesAmong the 30 Largest Communities1

Massachusetts: 2005

1Selected among the 30 Massachusetts communities with the largest populations. IMR = infant deaths per 1,000 live births. 2A Confidence Interval for a population parameter is a range in which you are 95% certain that the true population estimate is within. It is a function of variability and the number of events.

391[4.6, 5.6]5.1State

12[3.8, 13.5]8.6New Bedford

25[6.4, 14.7]10.6*Springfield

7[2.9, 18.9]10.9Revere

9[4.0, 18.7]11.4Malden

36[9.4,18.4]13.9*Worcester

Number of Deaths

95% CI2IMR

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology ProgramStatistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state

41

26Infant Mortality Rates (IMR)

Springfield: 1990-2005

11.0

4.6

10.610.2

0

2

4

6

8

10

12

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Infa

nt D

eath

s pe

r 10

00 in

fant

bir

ths


27

2003-2005 Rate

Massachusetts 4.9 (n = 1,150)

Worcester 8.3 (n = 64) *Lowell 7.8 (n = 39) *Brockton 7.6 (n = 35)Lawrence 7.5 (n = 32)Weymouth 7.5 (n = 16)Springfield 7.1 (n = 51)

Highest Infant Mortality Rates Among the 30 Largest Communities1

Massachusetts: 2003-2005

1 Selected among the 30 Massachusetts communities with the largest populations. Rate = infant deaths per 1,000 live births



42

28Infant Mortality Rates by Race/EthnicityLargest Cities in Western Region and



5.54.1

15.4

11.3

6.27.0

3.0

5.2

11.8

0

2

4

6

8

10

12

14

16

18

Chicopee Holyoke Springfield Massachusetts

Dea

ths

per 1

000

live

birt

hs


NA NA NA NA

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better

29

7.8

5.8

8.3

5.7

4

5

6

7

8

9

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Perc

ent o

f LB

W B

irths

(%)

Low Birthweight Western Region and Massachusetts: 1990-2005

Western Region

Massachusetts

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology ProgramLow birthweight: less than 2,500 grams or 5.5 pounds

43

30

Low Birthweight byEOHHS Region, Massachusetts: 2005

8.3 7.97.1

7.68.2

7.5

9.4

0

1

2

3

4

5

6

7

8

9

10

WesternMass

Central Mass Northeast Metro West Southeast BostonRegion

MA

Perc

ent o

f LB

W B

irths

(%)


**

*

Low birthweight: less than 2,500 grams or 5.5 pounds


31Low Birthweight by Race and Ethnicity


12.0

7.37.4

12.2

9.28.2 7.8

10.6

0

2

4

6

8

10

12

14


Perc

ent




44

32

68.7

55.4

79.3

56.6

0

10

20

30

40

50

60

70

80

90

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Perc

ent o

f Bre

astfe

edin

g (%

)

Percent of Mothers Breastfeeding Western Region and Massachusetts: 1990-2005

Massachusetts

Western Region

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology ProgramMother was breastfeeding or intending to breastfeed at the time the birth certificate was completed.

33

Breastfeeding by EOHHS Region Massachusetts: 2005

79.371.5

88.477.6

68.779.5

86.9

0

10

20

30

40

50

60

70

80

90

100

WesternMass

Central Mass Northeast Metro West Southeast BostonRegion

MA

Perc

ent


*

**

*

**

Mother was breastfeeding or intending to breastfeed at the time the birth certificate was completed.Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better

45

34

Breastfeeding by EOHHS Region Largest Cities in Western Region, Massachusetts: 2005

79.3

68.768.7 66.8

0

10

20

30

40

50

60

70

80

90

Pittsfield Berkshires Western Mass MA

Perc

ent


*


**

35

Breastfeeding by EOHHS Region Largest Cities in Western Region, Massachusetts: 2005

79.3

56.265.6

70.968.7 65.975.3

0

10

20

30

40

50

60

70

80

90

WesternMass

Chicopee Holyoke Pittsfield Springfield Western w/olargest cities

MA

Perc

ent


*

*


***

*

46

36Breastfeeding in Western Region and Massachusetts by Race/Ethnicity: 2005

7770*

80

53*60*

8085

76*

0

10

20

30

40

50

60

70

80

90


Perc

ent




37

21.7

35.1

40.4

31.0

0

5

10

15

20

25

30

35

40

45

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Birt

hs p

er 1

,000

w

omen

age

s 15

-19

Teen Birth RateWestern Region and Massachusetts: 1990-2005

Massachusetts

Western Region

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology ProgramTeen birth rates are number of births to women ages 15-19 per 1000 females ages 15-19.

47

38

Teen Birth Rates1 by EOHHS Region Massachusetts: 2005

21.7

8.3

29.4

23.022.6

31.029.0

23.1

0

5

10

15

20

25

30

35

Western Berkshires Central Northeast Metro West Southeast Boston MA

Birt

hs p

er 1

,000

w

omen

age

s 15

-19


*

**

*

1Teen birth rates are number of births to women ages 15-19 per 1000 females ages 15-19.Statistically different from State (p ≤.05) Red (*) = Statistically higher; Green (**) = Statistically lower

*

39

Highest

Central22.6

Southeast23.1

Northeast22.9

Western31.0

Boston29.4Metro

West8.3

Teen Birth Rates by Executive Office of Health and Human Service(EOHHS) Regions, Massachusetts Births 2005

EOHHS Teen Birth Rateper 1,000 15-19 Female Population

Significantly higher than state rateNot different from state rateSignificantly lower than state rate


Teen Birth Rates by EOHHS Region Massachusetts: 2005

Teen birth rates are number of births to women ages 15-19 per 1000 females ages 15-19.

48

40

PITTSFIELD52.7

MONTAGUE52.3

SPRINGFIELD71.6

HOLYOKE96.8

CHICOPEE41.4

NORTH ADAMS49.5

Teen Birth Rates by Towns*West Region Births 2005

Town Teen Birth Rateper 1000 15-19 Female Population


*Towns with less than 100 births were excluded.


Teen Birth Rates by City/Town* Western Region: 2005

Teen birth rates are number of births to women ages 15-19 per 1000 females ages 15-19.

Highest Holyoke: 96.8

41Teen Birth Rates by Race and Ethnicity


36.4

12.916.0

46.6

107.7

73.2

15.312.1

0

20

40

60

80

100

120


Birt

hs p

er 1

,000

w

omen

age

s 15

-19



*

*

Teen birth rates are number of births to women ages 15-19 per 1000 females ages 15-19.Statistically different from State (p ≤.05) Red (*) = Statistically higher; Green (**) = Statistically lower

49

42Teen Birth Rates by Race and Ethnicity

Berkshires Region and Massachusetts: 2005

36.4

12.9

26.3

43.2

82.773.2

15.3

0

10

20

30

40

50

60

70

80

90

Berkshires Massachusetts

Birt

hs p

er 1

,000

w

omen

age

s 15

-19



*

Teen birth rates are number of births to women ages 15-19 per 1000 females ages 15-19.Statistically different from State (p ≤.05) Red (*) = Statistically higher; Green (**) = Statistically lower

43

79.5

74.4

84.079.5

45

50

55

60

65

70

75

80

85

90

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Perc

ent o

f Ade

quat

e Pr

enat

al C

are

(%)

Adequate Prenatal Care Western Region and Massachusetts: 1990-2005

Massachusetts

Western Region

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology ProgramBased on Adequacy of Prenatal Care Utilization (APNCU) Index.

50

44

Adequate Prenatal Care by EOHHS Region Massachusetts: 2005

83.6 84.087.582.079.5

85.4 84.3

0

20

40

60

80

100


Southeast Boston MA

Perc

ent


***

***

Based on Adequacy of Prenatal Care Utilization (APNCU) Index.


45

47.4

34.1

32.6

25.7

0

5

10

15

20

25

30

35

40

45

50

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Perc

ent

Public Source1 of Payment for Prenatal CareWestern Region and Massachusetts: 1990-2005

Western Region

Massachusetts


1Public: Government programs including Commonhealth, Healthy Start, Medicaid/MassHealth, or free care. Private: Commercial indemnity plan, commercial Managed care (HMO, PPO, IPP, IPA and other) or other private insurance.

51

46

Public Source of Payment for Prenatal Care1

Western and Massachusetts: 2005

Private 50%Public 47%


Public 33%Private 67%


**

* Statistically Significantly different from state (p ≤.05)

1Public: Government programs including Commonhealth, Healthy Start, Medicaid/MassHealth, or free care. Private: Commercial indemnity plan, commercial Managed care (HMO, PPO, IPP, IPA and other) or other private insurance.

47

27.1

21.2

32.3

22.5

14

18

22

26

30

34

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Perc

ent

Infants Delivered by C-Section Western Region and Massachusetts: 1990-2005

Massachusetts


Western Region

52

48

Central29.5%

Southeast34.6%

Northeast34.4%

Western27.1%

Boston29.9%Metro

West34.2%

Percentage of Cesarean Births by Executive Office of Health and Human Service(EOHHS) Regions, Massachusetts Births 2005

EOHHS Region's % Cesarean BirthsSignificantly higher than state rateNo different from state rateSignificantly lower than state rate

Highest in South East

Region


Infants Delivered by C-Section by EOHHS Regions, Massachusetts: 2005

49

Infants Delivered by C-Section by EOHHS Region Massachusetts: 2005

34.6 32.334.234.427.1 29.5 29.9

0

20

40

60

80

100


Southeast Boston MA

Perc

ent


***** * ***

Statistically different from State (p ≤.05) Red (*) = Statistically higher; Green (**) = Statistically lower

53

50

13.5

47.4

68.7

8.2

27.1

79.5

Western

(n=8,935)

10.2

34.7

71.5

8.3

34.6

83.6

South East

(n=14,681)

3.93.27.27.67.1Smoking during

pregnancy

46.417.233.727.932.6Public Pay for Prenatal Care

86.988.477.679.579.3Breastfeeding

9.47.17.67.57.9Low Birth weight (<5.5 lb)

29.934.234.429.532.3C-section deliveries

84.387.582.085.484.0Adequate

Prenatal Care (Kotelchuck index)

Boston (n=9,644)

Metro West

(n=17,093)

North East

(n=15,939)

Central

(n=10,532)

MATotal

(n=76,824)

Indicator (as % of births)

Summary Birth Indicators by EOHHS Region, Massachusetts:2005



51

20.7

45.7

68.3

8.6

29.3

72.5

Berkshires(n=1,277)

13.5

47.4

68.7

8.2

27.1

79.5

Western(n=8,935)

14.8

70.9

56.2

9.8

24.8

71.6

Springfield (n=2,369)

24.57.314.17.1Smoking during pregnancy

53.074.451.132.6Public Pay for Prenatal Care

65.670.965.979.3Breastfeeding

8.48.86.97.9Low Birth weight (<5.5 lb)

30.520.528.232.3C-section deliveries

61.078.482.984.0Adequate

Prenatal Care (Kotelchuck index)

Pittsfield (n=526)

Holyoke (n=642)

Chicopee (n=608)

MATotal

(n=76,824)

Indicator (as % of births)

Summary Birth Indicators by Community in Western Region Massachusetts: 2005



54

52Summary Birth Indicators

by EOHHS Region



31.0

5.6

Western

23.1

4.8

South East

29.48.323.022.921.7

Teen birth rate

(2005)(births to

women ages 15-19 per 1000 women ages

15-19)

5.74.04.75.44.9

Infant Mortality

Rate (2002-2005)

(infant deaths per 1000 live

births)

BostonMetro West

North East

CentralMA

Total Indicator

53Summary Birth Indicators

by EOHHS Region



29.0

5.5

Berkshires

31.0

5.6

Western

71.6

7.8

Springfield

52.796.841.421.7

Teen birth rate (2005)

(births to women ages 15-19 per 1000 women ages 15-19)

4.78.46.14.9

Infant Mortality Rate

(2002-2005)(infant deaths per 1000 live births)

PittsfieldHolyokeChicopeeMA

Total Indicator

55

LEADING CAUSES OF DEATH

56

57

54Leading Causes of DeathWestern Region and Massachusetts: 2005


MassachusettsN=53,776

1.8%982 Septicemia

2.4%1,271 Diabetes

2.6%1,403 Nephritis

3.0%1,635 Alzheimer's

3.6%1,932 Influenza and pneumonia

4.9%2,643

Chronic Lower Respiratory Disease (formerly COPD)

4.9%2,657All Injuries

5.5%2,979 Stroke

24.5%13,159 Cancer

24.6%13,248 Heart Disease

5.0%394


Western RegionN=7,833

1.8%141Septicemia

2.6%201Diabetes

2.9%228Nephritis

3.1%242Influenza & pneumonia

3.2%251Alzheimer's

5.0%395All Injuries

5.6%437Stroke

23.9%1,874Cancer

24.6%1,929Heart Disease

Statistically different from State (p ≤.05) Red (*) = Statistically higher; Green (**) = Statistically lower than state

55Leading Causes of DeathBerkshires and Massachusetts:2005

Source: MDPH, Center for Health Information, Statistics, Research & Evaluation, Research & Epidemiology Program

BerkshiresN=1,487

1.6%24 Septicemia

2.6%39 Nephritis

3.0%45 Diabetes

3.3%49 Influenza & pneumonia

3.6%54 Alzheimer's

4.6%68 All Injuries

6.0%89Stroke

6.5%*96


23.3%347 Cancer

26.2%389 Heart Disease


MassachusettsN=53,776

1.8%982 Septicemia

2.4%1,271 Diabetes

2.6%1,403 Nephritis

3.0%1,635 Alzheimer's

3.6%1,932 Influenza and pneumonia

4.9%2,643


4.9%2,657All Injuries

5.5%2,979 Stroke

24.5%13,159 Cancer

24.6%13,248 Heart Disease

58

59

CHRONIC DISEASE OUTCOMES AND OVERWEIGHT/OBESITY

60

61

56

Overweight ObesityHeight BMI 25.0-29.9 BMI > 30

5’ 128 lbs. 153 lbs.

5’2’’ 136 164

5’4’’ 145 1745’6’’ 155 186

5’8’’ 164 197

6’ 184 221

6’2” 195 234


Thresholds for DefiningOverweight and Obesity

57

Adults who are Overweight1

by EOHHS Region, Massachusetts: 1995 and 2005

5045

6158 56

5358

5256

5054

46 44 45

36

66*

0

10

20

30

40

50

60

70

Western Springfield Central Northeast Metro West Southeast Boston MA

Perc

ent

1995 2005


1 Overweight: BMI greater than or equal to 25Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better

62

58Adults who are Obese1

by EOHHS Region, Massachusetts: 1995 and 2005

23.6

11.7

8.1

16.8

9.610.211.6

14.3

20.7

16.819.2

23.321.7 20.9

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent

1995 2005

**

1 Obesity: BMI greater than or equal to 30Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), Health Survey Program


59Adults who are Obese by EOHHS Region, Massachusetts: 2005

23.620.7

16.819.2

23.321.7 20.9

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent **

Obesity: BMI greater than or equal to 30



63

60Obesity by Race and Ethnicity Western Region and Massachusetts: 2005

32.7

19.921.6

47.7

33.727.4

0

10

20

30

40

50

60


Perc

ent




61Adults who Participate in Regular Physical Activity by EOHHS Region, Massachusetts: 2005

51.8 52.654.750.656.4 51.5 49.5

0

10

20

30

40

50

60

70

80

90

100


Southeast Boston MA

Perc

ent



64

62Adults who have 5+ Servings of Fruit or Vegetables by EOHHS Region, Massachusetts: 2005

26.4 28.633.0

26.428.4 29.3

26.4

0

5

10

15

20

25

30

35

40

45

50


Southeast Boston MA

Perc

ent



63Adults who had their cholesterol checked in Past 5 Years by EOHHS Region, Massachusetts: 2005

82.0 79.384.879.2

74.0 76.6 73.3

0

10

20

30

40

50

60

70

80

90

100


Southeast Boston MA

Perc

ent

**

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than stateSource: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), Health Survey Program

65

64Adults who were told by a health care provider that they have high cholesterol1 by EOHHS Region

Massachusetts: 2005

36.5 35.738.434.534.2 35.9

31.2

0

5

10

15

20

25

30

35

40

45

50


Southeast Boston MA

Perc

ent

1 Among those who reported having their cholesterol checkedStatistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state


65Adults who were told by a health care provider to have high blood pressure by EOHHS Region

Massachusetts: 2005

28.925.325.122.8

26.3 25.321.9

0

5

10

15

20

25

30

35

40

45

50


Southeast Boston MA

Perc

ent



66

66

Adults who take Medicine for High Blood Pressure1

by EOHHS Region, Massachusetts: 2005

76.5 75.373.578.676.0 74.0 71.3

0

10

20

30

40

50

60

70

80

90

100


Southeast Boston MA

Perc

ent

1 Among those who reported having high blood pressureStatistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state


67Hypertension Hospital Discharges by EOHHS Region, Massachusetts: 2003-2005

38.738.731.033.035.0 30.9

84.6

0

10

20

30

40

50

60

70

80

90


Southeast Boston MA

Dis

char

ges

per1

00,0

00

Age-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database

*

** ** ****


67

68Hypertension Hospital Discharge Rate by Race/Ethnicity

Western Region Massachusetts: 2003-2005

176

2824

162

10689

3339

0

20

40

60

80

100

120

140

160

180

200


Dis

char

ges

per 1

00,0

00



**


69Heart Disease Mortality Ratesby EOHHS Region


182.5195.1

159.8186.3188.8 196.8

177.9

0

100

200

300


Southeast Boston MA

Dea

ths

per 1

00,0

00

Age-adjusted to the 2000 US standard population. Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology Program

*

**

*


68

70Heart Disease Death Rate by Race/EthnicityWestern Region and Massachusetts: 2003-2005

188 185

226209

104

70 68

160

0

50

100

150

200

250


Dea

ths

per 1

00,0

00



*


71Diabetes Hospital Discharges by EOHHS Region, Massachusetts: 2003-2005

130.7 132.5110.8

124.3

151.4

114.3

208.1

0

50

100

150

200

250


Southeast Boston MA

Age

-adj

uste

d ra

tepe

r100

,000

Age-adjusted to the 2000 US standard population.Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database

*

** ** **

*


69

72Diabetes Hospital Discharges by EOHHS Region, Berkshires, and Pittsfield


132.5

208.1

124.3 130.7114.3

240.9

151.4 141.9

110.8

0

50

100

150

200

250

300

Western Berkshires Pittsfield Central Northeast MetroWest

Southeast Boston MA

Age

-adj

uste

d ra

tepe

r100

,000


*

****

**

*


*

73Diabetes Hospital Discharges Largest Cities, Western Region: 2003-2005

118.5

274.2

201.6

151.4 155.6132.5

0

50

100

150

200

250

300

Western Chicopee Holyoke Springfield Western w/oChicopee,Holyoke,

Springfield

MA

Age

-adj

uste

d ra

tepe

r100

,000


*


***

*

*

70

74Diabetes Hospital Discharge Rate by Race/Ethnicity

Western Region and Massachusetts: 2003-2005

368

114118

452

396

242

4536

0

50100150200250

300350400450500


Dis

char

ges

per 1

00,0

00



**


75Diabetes Hospital Discharge Rate by Race/Ethnicity

Berkshires, Pittsfield & Massachusetts: 2003-2005

114

368242

45181122

1,584

975

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

Berkshires Pittsfield Massachusetts

Dis

char

ges

per 1

00,0

00



*


*

NA NA NA NA

71

76Diabetes Mortality Rates by EOHHS Region Massachusetts: 2003-2005

18.2 18.415.1

17.420.3

22.6 21.9

0

10

20

30

40

50


Southeast Boston MA

Dea

ths

per 1

00,0

00


*

**

*


77Diabetes Death Rate by Race/EthnicityWestern Region and Massachusetts: 2003-2005

19 17

47

3937

29

14

0

5

10

15

20

25

30

35

40

45

50


Dea

ths

per 1

00,0

00


NA



72

78

34.2

74.0

28.4

56.4

23.3

Western

36.5

82.0

26.4

51.8

23.6

South East

31.238.434.535.935.7% Adults with

high cholesterol

73.384.879.276.679.3% Adults who

had cholesterol

checked

26.433.026.429.328.6% Adults with 5+ servings

fruits/ vegetables

49.554.750.651.552.6% Adults

Participation in regular PA

20.916.819.221.720.7% Obese Adults

BostonMetro West

North East

CentralMATotal

Indicator

Summary Indicators for Overweight/Obesity by EOHHS Region, Massachusetts: 2005


Source: MDPH, Center for Health Information, Statistics, Research & Evaluation, Health Survey Program

79

208.1130.7110.8124.3114.3151.4132.5Diabetes Hospital

Discharges (2003-2005)

20.3

188.8

35.0

76.0

26.3

Western

18.2

195.1

38.7

76.5

28.9

South East

21.915.117.322.618.4Diabetes Death Rate (2003-2005)

177.9159.8186.3196.8182.5Heart Disease

Death Rate (2003-2005)

84.631.032.930.938.7Hypertension

Hospital Discharges(2003-2005)

71.373.578.674.075.3% Adults take HBP medications

21.925.122.825.325.3% Adults with HBP

BostonMetro West

North East

CentralMATotal

Indicator

Summary Indicators for Chronic Disease Outcomes for Overweight/Obesity by EOHHS Region


73

80

21.1

155.6

216. 7

43.3

Chicopee

20.3

151.4

188.8

35.0

Western

18.4

132.5

182.5

38.7

MATotal

274.2201.6Diabetes Hospital

Discharges (2003-2005)

27.130.6Diabetes Death Rate (2003-2005)

206.8213.3Heart Disease

Death Rate (2003-2005)

75.745.6Hypertension

Hospital Discharges(2003-2005)

SpringfieldHolyokeIndicator

(age adjusted per 100,000)

Summary Indicators for Chronic Disease Outcomes for Overweight/Obesity

Communities in Western Region: 2003-2005



81

26.2

240.9

187.7

30.5

Pittsfield

141.9

22.6

Berkshires

151.4132.5Diabetes Hospital Discharges (2003-2005)

20.3

188.8

35.0

Western

18.4Diabetes Death Rate (2003-2005)

182.5Heart Disease Death Rate (2003-2005)

38.7Hypertension Hospital

Discharges(2003-2005)

MATotal

Indicator

Summary Indicators for Chronic Disease Outcomes for Overweight/Obesity

Berkshires, Western Region, Massachusetts: 2003-2005



74

75

CANCER

76

77

82Adults Ages 50+ who have had a Sigmoidoscopy or Colonoscopy in Past 5 Years by EOHHS Region

Massachusetts: 2005

55.0 58.868.5

53.253.960.2 58.9

0

20

40

60

80

100


Southeast Boston MA

Perc

ent

**

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than stateSource: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), Health Survey Program

83Incidence Rates for Invasive Colorectal Cancer by EOHHS Region, Massachusetts: 1999-2003

56.2 58.961.855.2 57.2

63.659.7

0

10

20

30

40

50

60

70


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n

Age-adjusted to the 2000 US standard population. Source: MDPH, Center for Health Information, Statistics, Research & Evaluation, Cancer Registry

**

*


*

78

84Incidence Rates for Early Stage Colorectal Cancer MALES

by EOHHS Region, Massachusetts: 1999-2003

27.931.0

29.0

22.1

26.3

33.132.8

0

5

10

15

20

25

30

35


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


**

**

* *


85Incidence Rates for Early Stage Colorectal Cancer FEMALES


17.6 18.4 18.4

15.3 16.4

22.920.8

0

5

10

15

20

25


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n

****

**



79

86Colorectal Cancer Mortality Rates by EOHHS Region, Massachusetts: 2005

17.2 17.416.5

17.518.2 18.3 18.4

0

10

20

30


Southeast Boston MA

Dea

ths

per 1

00,0

00 p

opul

atio

n



87Men Ages 50 and Older who had a Prostate-Specific

Antigen Test in the Past Two Years by EOHHS Region, Massachusetts: 2004

56.3 56.162.5

52.349.152.3

66.2

05

1015202530354045505560657075


Southeast Boston MA

Perc

ent



80

88Men Ages 50 and Older who had a Digital Rectal Exam in the Past Two Years by EOHHS Region

Massachusetts: 2004

62.6 62.764.563.059.5 60.069.0

0

10

20

30

40

50

60

70

80

90

100


Southeast Boston MA

Perc

ent

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than stateSource: MDPH, Center for Health Information, Statistics, Research & Evaluation, Health Survey Program

89Adults Ages 50 and Older who had a Blood Stool Test in the Past Two Years by EOHHS Region

Massachusetts: 2005

26.430.030.9

33.534.229.9

20.7

0

5

10

15

20

25

30

35

40

45

50


Southeast Boston MA

Perc

ent

*



81

90Incidence Rates for Invasive Prostate Cancer by EOHHS Region, Massachusetts: 1999-2003

180.5 181.9170.3 159.7

178.4191.3202.5

0

50

100

150

200

250


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


**

*


**

91Incidence Rates for Early Stage Prostate Cancer by EOHHS Region, Massachusetts: 1999-2003

140.1 140.5129.7 122.4 128.5

174.6156.6

0

20

40

60

80

100

120

140

160

180

200


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n

** ** **

**



82

92Prostate Cancer Mortality Rates by EOHHS Region, Massachusetts: 2005

17.921.8

18.722.9

25.027.7

24.0

0

10

20

30

40

50


Southeast Boston MA

Dea

ths

per 1

00,0

00 p

opul

atio

n



93Women Ages 40 and Older who had a Clinical Breast Exam in the Past Two Years


85.6 86.687.190.085.0 85.5 85.7

0

10

20

30

40

50

60

70

80

90

100


Southeast Boston MA

Perc

ent


83

94Women who had a Clinical Breast Exam in Past Two Years by Race and Ethnicity


80.887.986.3

75.8 73.8 78.4

0

10

20

30

40

50

60

70

80

90

100


Perc

ent



95Women Ages 40+ who have had a mammography in Past 2 Years by EOHHS Region

Massachusetts: 2005

82.0 84.187.183.486.9 83.0 80.1

0

20

40

60

80

100


Southeast Boston MA

Perc

ent

Source: MDPH, Center for Health Information, Statistics, Research & Evaluation, Health Survey ProgramStatistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state

84

96Incidence Rates for Invasive Female Breast Cancer


139.8 138.9135.3 127.8146.7

134.9139.6

0

50

100

150

200


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


***


97Incidence Rates for Early Stage Female Breast Cancer


119.8 118.6105.3

113.1112.9124.9

137.6

0

20

40

60

80

100

120

140

160


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


** ***

**

*


85

98Female Breast Cancer Mortality Rates by EOHHS Region, Massachusetts: 2005

22.5 23.020.9

23.125.5

23.2 24.6

0

10

20

30

40

50

Western Central Northeast Metro West Southeast Boston MA

Dea

ths

per

100

,000

pop

ulat

ion



99

Adults who Currently Smoke by EOHHS Region, Massachusetts: 2005

18.119.520.421.218.8

25.6

12.4

18.3

0

10

20

30

40

50

Western Springfield Central Northeast Metro West Southeast Boston MA

Perc

ent

**

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically betterSource: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), Health Survey Program

*

86

100

Adults who Currently Smoke by EOHHS Region and Berkshires, Massachusetts: 2005

18.1

12.4

19.518.3

21.218.8

22.620.4

0

5

10

15

20

25

30

Western Berkshires Central Northeast MetroWest

Southeast Boston MA

Perc

ent


**


101

Current Smoker by Race and Ethnicity Western Region and Massachusetts: 2005

16.2

18.4

19.1

16.9

17.7 17.9

15

1516

1617

17

1818

1919

20


Perc

ent



87

102

Percent of Mothers Smoking During Pregnancy for Largest Communities in Western Region: 2005

% Smokers BirthsMassachusetts 7.2% 5,555 76,653Western Region 13.5%* 1,203 8,935

LowestAmherst 2.0%** 9 166Holyoke 5.3%** 47 642Northampton 3.7%** 14 191

HighestNorth Adams 37.7%* 58 155Pittsfield 24.5%* 128 526Palmer 23.1%* 33 138Springfield 14.8% 349 2,369



103

7.2

19.3 13.5

24.3

0

5

10

15

20

25

30

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Perc

ent

Smoking During PregnancyWestern Region and Massachusetts: 1990-2005

Massachusetts

Western Region


88

104Smoking During Pregnancy by Race and Ethnicity

Western Region, Berkshires, and Massachusetts: 2005

8.4

14.9

6.1 5.2

1.4

21.8

14.9 15.4

10.3

2.8

0

5

10

15

20

25

Western Region Berkshires Massachusetts

Perc

ent



* *

*


*

105Incidence Rates for Early Stage Lung Cancer

MALESby EOHHS Region, Massachusetts: 1999-2003

13.915.9

19.2

15.6

11.3 11.9 11.4

0

5

10

15

20

25


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


**

*

*

** **


89

106Incidence Rates for Early Stage Lung Cancer FEMALES


10.0

12.411.2

15.0

11.49.6 10.0

0

2

4

6

8

10

12

14

16


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


**

*

***


107Lung Cancer Mortality Ratesby EOHHS Region, Massachusetts: 2005

52.1 52.444.6

57.356.0 55.4 54.2

0

10

20

30

40

50

60

70

80

90


Dea

ths

per 1

00,0

00 p

opul

atio

n


**


90

108Incidence Rates for Invasive Lung Cancer by EOHHS Region, Massachusetts: 1999-2003

72.076.7

67.2 69.965.1

77.777.5

0

25

50

75

100


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


*


** *

*

109

20.726.430.933.529.934.230.0% Blood Stool Test †

86.9

85.0

53.9

59.5

49.1

Western

82.0

85.6

55

62.6

56.3

South East

80.187.183.483.084.1% Women* Mammography

85.787.190.085.586.6% Women Clinical Breast Exam (2004)

58.968.553.260.258.8% Adults

Sigmoidoscopy or Colonoscopy†

69.064.563.060.062.7% Men†

DRE (2004)

66.262.552.352.356.1% Men†

PSA (2004)

BostonMetro West

North East

CentralMATotal

Indicator

Summary Indicators for Cancer Screening by EOHHS Regions, Massachusetts: 2005


*40 years and older, † 50 years and older

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Health Survey Program

91

110

12.0

25.9

112.9

129.7

Western

16.1

28.7

113.1

156.6

South East

19.612.415.312.714.4Lung Cancer Incidence

32.024.329.521.326.9Colorectal

Cancer Incidence

137.6119.8124.9105.3118.6Female Breast Cancer

Incidence

174.6128.5140.1122.4140.5Prostate Cancer

Incidence

BostonMetro West

North East Central

MATotal Indicator

Summary Cancer Indicators (Early Stage)by EOHHS Region, Massachusetts: 1999-2003

Source: MDPH, Center for Health Information, Statistics, Research & Evaluation, Cancer Registry


111

45.8

30.6

37.9

4.9

Western

55.1

34.4

38.4

6.2

South East


42.730.635.232.933.8Colorectal

Cancer Incidence


Incidence

8.73.95.95.25.5Prostate Cancer

Incidence

BostonMetro West

North East Central

MATotal Indicator

Summary Cancer Indicators (Late Stage)by EOHHS Region, Massachusetts: 1999-2003



92

112Summary Invasive Cancer Incidence Ratesby EOHHS Region, Massachusetts: 1999-2003



77.777.565.176.769.967.272.0Lung Cancer

545.1543.1509.9529.4478.2485.6517.0Total Cancer

56.2

135.3

170.3

Western

59.7

139.6

202.5

Southeast

63.657.261.855.258.9Colorectal Cancer


191.3178.4180.5159.7181.9Prostate Cancer

BostonMetro West

North East Central

MATotal

Indicator(age-adjusted per

100,000)

113


485.6

56.2

135.3

170.3

Western

474.9

55.9

130.1

166.0

Springfield

482.7507.8517.0Total Cancer

61.758.758.9Colorectal Cancer Incidence

115.0137.6138.9Female Breast Cancer Incidence

149.4186.9181.9Prostate Cancer Incidence

HolyokeChicopeeMA

Total Indicator

Summary Invasive Cancer Incidence RatesCommunities in Western Region: 1999-2003



93

114

74.57

62.64

129.74

182.3

Berkshires

67.2

56.2

135.3

170.3

Western

81.972.0Lung Cancer Incidence

63.758.9Colorectal

Cancer Incidence

135.9138.9Female Breast

Cancer Incidence

178.1181.9Prostate Cancer Incidence

PittsfieldMA

Total Indicator

Summary Invasive Cancer Incidence Ratesby Western Region, Massachusetts: 1999-2003



115

56.0

25.5

18.2

25.0

Western

52.1

22.5

17.2

17.9

South East

54.244.657.355.452.4Lung Cancer Death Rate

24.620.923.123.123.0Female Breast

Cancer Death Rate

18.416.417.518.317.4Colorectal

Cancer Death Rate

24.018.722.927.721.8Prostate

Cancer Death Rate

BostonMetro West

North East Central

MATotal Indicator

Summary Cancer Mortality Indicators by EOHHS Region, Massachusetts: 2005



94

116

56.0

25.5

18.2

25.0

Western

58.9

28.1

12.9

19.4

Pittsfield

65.545.267.352.4Lung Cancer Death Rate

25.925.412.823.0Female Breast Cancer Death

Rate

11.626.224.017.4Colorectal

Cancer Death Rate

14.125.642.021.8Prostate

Cancer Death Rate

SpringfieldHolyokeChicopeeMA

Total Indicator

Summary Cancer Mortality Indicators Communities in Western Region: 2005



117

56.0

25.5

18.2

25.0

Western

56.352.4Lung Cancer Death Rate

20.523.0Female Breast Cancer Death Rate

16.117.4Colorectal Cancer Death Rate

24.921.8Prostate Cancer Death Rate

BerkshiresMATotal Indicator

Summary Cancer Mortality Indicators Berkshires, Western Region, Massachusetts: 2005



95

SUBSTANCE ABUSE

96

97

118Alcohol Use in Past Month Persons Aged 12 to 20by EOHHS Region, Massachusetts: 2002, 2003, 2004

34.0 34.135.333.536.7

31.233.6

0

10

20

30

40

50


Southeast Boston MA

Perc

ent

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, and 2004.Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state

119Binge Drinking1 in Past Month Persons Aged 12 to 20by EOHHS Region, Massachusetts: 2002, 2003, 2004

24.1 24.124.722.627.2

24.621.0

0

10

20

30

40

50


Southeast Boston MA

Perc

ent

1 Binge Alcohol use is defined as drinking 5+ drinks on the same occasion on at least 1 day in the past 30 days

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, and 2004.


98

120Any Illicit Drug Use in Past Month Persons Aged 12+by EOHHS Region, Massachusetts: 2002, 2003, 2004

9.4 9.48.78.410.4

8.5

12.2

0

5

10

15

20

25


Southeast Boston MA

Perc

ent


121Any Illicit Drug Use Other than Marijuana in Past Month Persons Aged 12+ by EOHHS Region

Massachusetts: 2002, 2003, 2004

3.6 3.73.63.33.8 3.44.5

0

5

10

15

20

25


Southeast Boston MA

Perc

ent


99

122Alcohol Dependence or Abuse in Past Year Persons Aged 12+ by EOHHS Region


7.9 8.38.77.68.6 8.09.7

0

5

10

15

20

25


Southeast Boston MA

Perc

ent


123Dependence or Abuse of Any Illicit Drug or Alcohol in Past Year Persons Aged 12+ by EOHHS Region


9.7 10.310.29.710.6 10.012.1

0

5

10

15

20

25


Southeast Boston MA

Perc

ent


100

124Adults who Binge Drink by EOHHS Region, Massachusetts: 2005

15.3 15.714.5

16.016.4 15.818.1

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent


125

Adults who Used Illicit Drugs in Past Month by EOHHS Region, Massachusetts: 2005

8.1 8.17.07.2

13.9

7.25.3

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent


101

126

Substance Abuse Treatment Program Admissions by EOHHS Region, Massachusetts: 2005

1,724 1,601

871

1,379

2,044

1,441

2,978

0

500

1000

1500

2000

2500

3000

3500


Southeast Boston MA

Cru

de ra

te

per 1

00,0

00 *

** **

**

*

*

Source: Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2005.


127Substance Abuse Treatment Program Admissions-Alcohol Primary Substance

Largest Cities, Western Region: 2005

8151,081

2,612

9211,159

661

0

500

1,000

1,500

2,000

2,500

3,000

Western Chicopee Holyoke Pittsfield Springfield MA

Cru

de ra

te

per 1

00,0

00


**

*

**


102

128Substance Abuse Treatment Program Admissions-Alcohol Primary Substance


661571**

2,612*

1,010*

1,403 *

821*921*

498** 404**

0

500

1,000

1,500

2,000

2,500

3,000

Western Berkshires Pittsfield Central Northeast MetroWest

Southeast Boston MA

Cru

de ra

te/1

00,0

00



129Substance Abuse Treatment Program Admissions-Alcohol Primary Substance by Race/Ethnicity

Berkshires and Massachusetts: 2005

1,1791,344*

633

2,842*

1,317*

671

850

500

1,000

1,500

2,000

2,500

3,000


Visi

ts p

er 1

00,0

00


NA

Age-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Emergency Department Visits


103

130Substance Abuse Treatment Program Admissions-Cocaine Primary Substance


6558 62

4434

8899

0

20

40

60

80

100

120


Southeast Boston MA

Cru

de ra

te/1

00,0

00


****

**


131Substance Abuse Treatment Program Admissions-Heroin Primary Substance


609504

583

286

636635

1,453

0

200

400

600

800

1,000

1,200

1,400

1,600


Southeast Boston MA

Cru

de ra

te/1

00,0

00


*

**

**

*

* **


104

132Substance Abuse Treatment Program Admissions-

Heroin Primary Substance by EOHHS Region and Berkshires, Massachusetts: 2005

609

1,453

286

636 583475

635504

0

200

400

600

800

1,000

1,200

1,400

1,600


Cru

de ra

te/1

00,0

00


*

**

**

*

* **


**

133Opioid-related Emergency Department Visit Rates by EOHHS Region


181196

126

223

114

169

309

0

50

100

150

200

250

300

350


Southeast Boston MA

Visi

ts p

er 1

00,0

00

**

**

*

*

*

**

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than stateAge-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Emergency Department Visits

105

134Opioid-related Emergency Department Visit Rates Largest Cities in Western Region


84

151

310

114148

181

0

50

100

150

200

250

300

350


Springfield

MA

Visi

ts p

er 1

00,0

00

**

*

**


**

**

135Opioid-related Emergency Department Visit Ratesby Race/Ethnicity


188

95

187

89

286

237

100

50

100

150

200

250

300

350


Visi

ts p

er 1

00,0

00


** **

*

NA


106

136

137

107

138Opioid-related Fatal Overdosesby EOHHS Region, Massachusetts: 2003-2005

8.110.1

6.0

9.56.7 6.5

10.8

0

10

20

30


Dea

ths

per 1

00,0

00 p

opul

atio

n

** **

* **



139

97

13

9

1

7

0

2

4

6

8

10

12

14


Dea

ths

per 1

00,0

00


Opioid-related Fatal Overdoses by Race/EthnicityWestern Region and Massachusetts: 2003-2005


NANA

**


108

140

141

109

142

9.77.98.77.68.08.68.3Alcohol Dependence or Abuse past Year,

Ages 12+

10.6

3.8

10.4

27.2

36.7

Western

9.7

3.6

9.4

24.1

34.0

South East

12.110.29.710.010.3Dependence or Abuse

of Alcohol or Any Illicit Drug, Ages 12+

4.53.63.33.43.7Any Illicit Drug Use

Other than Marijuana Past Month, Ages 12+

12.28.78.48.59.4Any Illicit Drug Use Past Month, Ages 12+

21.024.722.624.624.1Past Month Binge Drinking- 12-20 years

33.635.333.531.234.1Past Month Alcohol 12-20 years

BostonMetro West

North East

CentralMATotal

Indicator

Summary Substance Abuse Indicators Percentages by EOHHS Region


Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, and 2004.

143

99883458446562Substance Abuse Treatment Program Admissions Rate—

Cocaine

1,010821404498571921661Substance Abuse Treatment Program Admissions Rate--

Alcohol

635

2,044

13.9

18.8

16.4

Western

504

1,724

8.1

20.4

15.3

South East

1,453286583636609Substance Abuse Treatment Program Admissions Rate—

Heroin

2,9788711,3791,4411,601Substance Abuse Treatment Program Admissions Rate

5.37.07.27.28.1% Adults using illicit drugs

19.512.418.321.218.1% Adults Smoking

18.114.516.015.815.7% Adults Binge Drinking

BostonMetro West

North East

CentralMATotal

Indicator

Summary Substance Abuse Indicators by EOHHS Region, Massachusetts: 2005


110

144

646.5

54.9

815.0

1,807.7

Chicopee

635

65

921

2,044

Western

1,618.4

138.7

1,080.6

3,353.7

Holyoke

95.962Substance Abuse

Treatment Program Admissions Rate—

Cocaine

1,158.9661Substance Abuse

Treatment Program Admissions Rate--

Alcohol

1,359.7

3,153.0

Springfield

609Substance Abuse

Treatment Program Admissions Rate—

Heroin

1,601Substance Abuse

Treatment Program Admissions Rate

MATotal

Indicator (crude rates, per 100,000)

Summary Substance Abuse Indicators Communities in Western Region: 2005


Lower Outcome (significantly different from state) Higher Outcome (significantly different from state)

145

880.6

166.1

2,612.1

5,592.8

Pittsfield

82.66562Substance Abuse Treatment Program Admissions Rate—

Cocaine

1,402.6921661Substance Abuse Treatment Program Admissions Rate--

Alcohol

635

2,044

Western

475.1609Substance Abuse Treatment Program Admissions Rate—

Heroin

2,894.01,601Substance Abuse Treatment Program Admissions Rate

BerkshiresMA

Total Indicator

Summary Substance Abuse Indicators Western Region, Massachusetts: 2005

Lower Outcome (significantly different from state) Higher Outcome (significantly different from state)


111

146

309196126223169114181

Opioid-related

Emergency Department Visit Rate

6.7

Western

10.1

South East

10.86.09.56.58.1

Opioid-related fatal

overdose rate

BostonMetro West

North East Central

MATotal Indicator

Summary Opioid Indicators by EOHHS RegionMassachusetts: 2003-2005


147

157122332153114181

Opioid-related

Emergency Department Visit Rate

6.7

Western

9.3

Springfield

5.45.18.78.1

Opioid-related fatal

overdose rate


Total Indicator

Summary Opioid Indicators Communities in Western Region: 2003-2005


112

113

INJURY, VIOLENCE, & OCCUPATIONAL HEALTH

114

115

148Causes of Injury Deaths


Western Region Total Injuries = 395

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

Massachusetts Total Injuries = 2,657

Poisonings 30%Firearm

8%

Falls 11%

Suffocation, Hanging, or Strangulation

13%

Motor Vehicle-related

18%

Other20%Poisonings

24%

Firearm 11%

Suffocation, Hanging, or Strangulation

13%

Motor Vehicle-related

19%

Falls 9%

Other24%

149Injury-Related Hospital Discharge Rates by EOHHS Region, Massachusetts: 2003-2005

830.4 836.3

965.9*

858.9 *

753.2 **

872.4 * 835.9

0

200

400

600

800

1,000


Southeast Boston MA

Dis

char

ges

per 1

00,0

00

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than stateAge-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database

116

150

812 831704

267 301

832*934 * 939 *

0

200

400

600

800

1,000

1,200


Dis

char

ges

per 1

00,0

00White non-Hispanic Black non-HispanicHispanic Asian non-Hispanic

Injury-Related Hospital Discharge Rates by Race/Ethnicity, Western Region and



151Emergency Department Visit Rates for Injuries & Poisonings by EOHHS Region


13,996

11,298

9,112

11,19512,323

11,37910,539

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000


Southeast Boston MA

Visi

ts p

er 1

00,0

00 *

**

*

*****


117

152Emergency Department Visit Rates for Injuries & Poisonings by Race/Ethnicity


14,158

3,344

11,586 10,930

15,63416,225

11,930

3,277

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000


Visi

ts p

er 1

00,0


*

**


153Hospital Discharge Rates for Traumatic Brain Injuries by EOHHS Region Massachusetts: 2003-2005

82 80

94 *

73 **65 **

97 *93 *

0

20

40

60

80

100


Dis

char

ges

per 1

00,0

00


118

154Hospital Discharge Rates for Traumatic Brain Injury

by Race/Ethnicity, Western Region and Massachusetts: 2003-2005

76

102

82 85

22

39

86*

112*

0

20

40

60

80

100

120


Visi

ts p

er 1

00,0




155Emergency Department Visit Rates for Traumatic Brain Injury by EOHHS Region


604563

662

461

646 641

0

100

200

300

400

500

600

700


Southeast Boston MA

Visi

ts p

er 1

00,0

00 **

**

**

Age-adjusted to the 2000 US standard population.Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Emergency Department Visits

**


119

156Emergency Department Visit Rates for Traumatic Brain Injury by Race/Ethnicity


663

456

595516 497

588

159215

0

100

200

300

400

500

600

700


Visi

ts p

er 1

00,0


**** **


**


157Injury Death Rates by EOHHS Region


38.5 38.9 39.1

45.1 *46.3 *

29.1 **

43.7 *

0

5

10

15

20

25

30

35

40

45

50


Deat

hs

per

100,

000

popu

latio

n



120

158

41.5 39.044.2

47.4

35.229.9

19.4

50.6 *

0

10

20

30

40

50

60

70


Dea

ths

per 1

00,0

00 P

opul

atio

n


Injury Death Rates by Race/EthnicityWestern Region and Massachusetts: 2003-2005



159Homicides by EOHHS RegionMassachusetts: 2003-2005

2.6 2.6

0.7

1.8

3.3

1.7

7.3

0

5

10


Dea

ths

per 1

00,0

00 p

opul

atio

n

**

**

*

**



121

160Homicide Rates by Race/Ethnicity


1 1

1615

8

6

2

0

2

4

6

8

10

12

14

16

18


Dea

ths

per 1

00,0

00



NA


161

Hospital Discharge Rates for Self-Inflicted Injury by EOHHS Region


68 66 65 6563

48**

92*

0

20

40

60

80

100


Southeast Boston MA

Dis

char

ges

per 1

00,0

00


122

162

Hospital Discharge Rates for Self-Inflicted Injury by EOHHS Region


68 66 65 65

48**

138*

101*

63

92*

0

20

40

60

80

100

120

140

160

Western Berkshires Pittsfield Central Northeast Metro West Southeast Boston MA

Dis

char

ges

per 1

00,0

00


163

64 6273

17 17

85* 88*

137*

0

20

40

60

80

100

120

140


Dis

char

ges

per

100,

000


Hospital Discharge Rates for Self-Inflicted Injuries by Race/Ethnicity, Western Region and



123

164

Suicides by EOHHS RegionMassachusetts: 2003-2005

6.9 6.65.3

7.47.9 7.25.5

0

5

10

15

20


Dea

ths

per 1

00,0

00 p

opul

atio

n

**



165Suicide Rates by Race/Ethnicity


8

7

4

7

4

5

0

1

2

3

4

5

6

7

8

9


Dea

ths

per 1

00,0

00



NANA


124

166

Hospital Discharge Rates for Motor Vehicle-related Injuries by EOHHS RegionMassachusetts: 2003-2005

73 74 7788 *

57 **

91 *93 *

0

20

40

60

80

100


Southeast Boston MA

Dis

char

ges

per 1

00,0

00


167

Hospital Discharge Rates for Motor Vehicle-Related Injuries by EOHHS Region, Berkshires, and Pittsfield


74 77

57**

88*

151*

73

91*

110 *

93 *

0

20

40

60

80

100

120

140

160


Dis

char

ges

per 1

00,0

00


125

168

Hospital Discharge Rates for Motor Vehicle-related Injuries, Largest Cities in Western Region


77

99*88*

113*

9393 *

0

20

40

60

80

100

120


Springfield

MA

Dis

char

ges

per 1

00,0

00


169

72

9081

28 33

89*

116*108*

0

20

40

60

80

100

120


Dis

char

ges

per 1

00,0

00


Hospital Discharge Rates for Motor Vehicle-related Injuries by Race/Ethnicity, Western

Region and Massachusetts: 2003-2005


126

170Motor Vehicle-related Death Rates by EOHHS Region


10.7

7.7

5.46.4

10.2 9.8

4.6

0

5

10

15

20


Dea

ths

per 1

00,0

00 p

opul

atio

n

**


* *

**

*

**


171

72

185

90 81

28 33

112*89*

116*108*

020406080

100120140160180200

Western Region Berkshires Massachusetts

Dis

char

ges

per 1

00,0

00


Hospital Discharge Rates for Motor Vehicle-Related Injuries by Race/Ethnicity, Western

Region, Berkshires, and Massachusetts: 2003-2005


NANA NA

127

172Emergency Department Visit Rates for Firearm Injuries by EOHHS Region Massachusetts: 2003-2005

87

2

6

13

5

13

0

2

4

6

8

10

12

14

16


Southeast Boston MA

Visi

ts p

er 1

00,0

00

**

*

**

*


**


173

7

39

7

41

138

3

0

5

10

15

20

25

30

35

40

45

Western Chicopee Holyoke Pittsfield Springfield Western w/oChicopee,Holyoke,

Springfield

MA

Visi

ts p

er 1

00,0

00

Emergency Department Visit Rates for Firearm Injuries, Largest Cities in Western Region


**

**



*

128

174Emergency Department Visit Rates for Firearm

Injuries by Race/EthnicityWestern Region and Massachusetts: 2003-2005

38

3 2

84

36

19

30

10

20

30

40

50

60

70

80

90


Visi

ts p

er 1

00,0

00


*

*


NA


175Firearm Death Rates by EOHHS Region


3.4 3.2

1.32.9

4.13.1

5.9

0

5

10

15

20


Dea

ths

per 1

00,0

00 p

opul

atio

n


*

**


129

176Firearm Death Rates by Race/Ethnicity


32

11

13

6

4

1

0

2

4

6

8

10

12

14

16

18

20


Dea

ths

per 1

00,0

00



NA


177

Hospital Discharge Rates for Fall-related Injuries by EOHHS Region


380 379 375 374338 ** 357 **

419 *

0

100

200

300

400

500


Dis

char

ges

per 1

00,0

00



130

178

375

232 234240 216

132 144

339 **

0

100

200

300

400

500


Dis

char

ges

per 1

00,0


Hospital Discharge Rates for Fall-related Injuries by Race/Ethnicity, Western Region and



179Emergency Department Visit Rates for Fall-Related Injuries by EOHHS Region Massachusetts: 2003-2005

2,7502,5112,713

3,1912,860

5,027

2,913

3,992

2,410

0

1,000

2,000

3,000

4,000

5,000

6,000


Visi

ts p

er 1

00,0

00

*** ***


*

**


*

*

131

180Emergency Department Visit Rates for Fall-related Injuries by Race/Ethnicity


2,504

758

2,849 2,7832,898

3,443

2,502

784

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000


Visi

ts p

er 1

00,0

00


* *

*



181Fall-related Injury Death Rates by EOHHS Region


4.3 3.83.63.83.2 3.54.3

0

5

10

15

20


Dea

ths

per 1

00,0

00 p

opul

atio

n



132

182Fall-related Injury Death Rates by Race/EthnicityWestern Region and Massachusetts: 2003-2005

3 43 2

3

0

2

4

6

8

10

12

14

16

18

20


Dea

ths

per 1

00,0



NANA NA


183Falls-related Injury Death Rates Persons 65+ Years by EOHHS Region


26.8

23.523.622.521.4 20.1

24.7

0

5

10

15

20

25

30


Dea

ths

per 1

00,0

00 p

opul

atio

n



133

184Hospital Discharge Rates for Assaults by EOHHS Region


2821 **

14 **

23 **24 **

72 *

34 *

0

10

20

30

40

50

60

70

80


Southeast Boston MA

Dis

char

ges

per 1

00,0

00

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically betterAge-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database

185

17.4 16.1

118.4

69.2

11.8

150.0 *

98.1 *

0

50

100

150


Dis

char

ges

per 1

00,0

00


Hospital Discharge Rates for Assaults by Race/Ethnicity, Western Region and



134

186

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Occupational Health Surveillance Program

187


135

188


189


136

190


191

70

54

46

7872

7883

44

69

6266

74

86

67

82

2.2

1.61.4

2.42.2

2.4

3.0

1.4

2.72.5

2.22.0

2.2

2.62.3

0

10

20

30

40

50

60

70

80

90

100

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Years

Num

ber o

f Fat

al In

jurie

s

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0Fa

talit

y ra

te p

er 1

00,0

00 w

orke

rs

Number of fatalities Fatality Rates

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Occupational Health Surveillance Program-Census of Fatal Occupational Injuries (CFOI) 1991-2005. MA employment data from BLS Current Population Survey (1991 -2005) was used to calculate rates.

Number and Rate of Fatal Occupational Injuries by year, Massachusetts: 1991- 2005

137

192

65664868639265Self-Inflicted

74885773919377Motor vehicle-related

72211423243428Assault

419375379380357338374Fall-related

injury hospitalizations

93

872

Western

73

859

South East

9465829780Traumatic Brain Injuries

966753836830836All Injuries

BostonMetro West

North East Central

MATotal

Hospital Discharge

Indicator Rates (age-adjusted)

Summary Injury/Violence Hospitalization Indicators by EOHHS Regions, Massachusetts: 2003-2005



193


346455378320338374Fall-related injury hospitalizations

93

872

Western

137

1,033

Springfield


1,4291,054856836All Injuries

PittsfieldHolyokeChicopeeMATotal

Hospital Discharge

Indicator Rates (age-adjusted, per

100,000)

Summary Injury/Violence Hospitalization Indicators Communities in Western Region: 2003-2005



138

194

31

101

110

99

380

1059

Berkshires

1389265Self-Inflicted


653428Assault

455338374Fall-related Injury hospitalizations

93

872

Western


1,429836All Injuries

PittsfieldMA

Total Hospital Discharge

Indicator Rates (age-adjusted)

Summary Injury/Violence Hospitalization Indicators Berkshires, Western Region, Massachusetts: 2003-2005



195

3,1635,0273,3842,9292,9132,750ER Visit Rate for

Fall-related injuries

397418137ER Visit Rate for Firearm

524568444434461604ER Visit Rate for Traumatic Brain

Injury

12,323

Western

14,319

Springfield

20,74715,01211,73911,298ER Visit Rate for all Injuries


Total Indicator Age-adjusted Rate per

100,000

Summary Injury/Violence Emergency Department Indicators



Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Emergency Department Visits

139

196

3,1633,3842,9292,9132,750ER Visit Rate for

Fall-related injuries


524444434461604ER Visit Rate for Traumatic Brain

Injury

12,323

Western

14,319

Springfield

15,01211,73911,298ER Visit Rate for all Injuries

HolyokeChicopeeMA

Total Indicator Age-adjusted Rate per

100,00





197

5,027

7

568

20,747

Pittsfield

3,992

4

512

16,379

Berkshires

2,9132,750ER Visit Rate for Fall-related injuries


461604ER Visit Rate for Traumatic Brain Injury

12,323

Western

11,298ER Visit Rate for all Injuries

MATotal Indicator

Age-adjusted Rate per 100,00


Berkshires, Western Region, Massachusetts: 2003-2005



140

198

5.56.95.37.47.27.96.6Suicide Death Rate

4.610.75.46.49.810.27.7Motor Vehicle-related Death

Rate

7.32.60.71.81.73.32.6Homicide Death Rate

5.93.41.32.93.14.13.2Firearm Death Rate

3.2

Western

4.3

South East

4.33.63.83.53.8Fall-related Injury Death

Rate

BostonMetro West

North East Central

MATotal

Mortality Indicator


Summary Injury/Violence Mortality Indicators by EOHHS Region, Massachusetts: 2003-2005



199

8.37.38.97.37.96.6Suicide Death Rate

10.412.810.36.710.27.7Motor Vehicle-related Death

Rate

8.95.16.53.93.32.6Homicide Death Rate

6.76.46.4NA4.13.2Firearm Death Rate

3.2

Western

2.1

Springfield

4.26.0NA3.8Fall-related Injury Death

Rate


Total Mortality Indicator


Summary Injury/Violence Mortality Indicators Communities in Western Region: 2003-2005



141

200

3.7

3.6

12.9

7.1

1.8

Berkshires

7.37.96.6Suicide Death Rate

12.810.27.7Motor Vehicle-related Death Rate

5.13.32.6Homicide Death Rate

6.44.13.2Firearm Death Rate

3.2

Western

4.23.8Fall-related Injury Death Rate

PittsfieldMA

Total Mortality IndicatorAge-adjusted Rate per 100,000

Summary Injury/Violence Mortality Indicators Berkshires, Western Region, Massachusetts: 2003-2005



142

143

HIV/AIDS

144

145

201

170.9247.1

133.2179.4

221.4167.5

729.2

0

100

200

300

400

500

600

700

800


Pers

ons

per 1

00,0

00

Persons Living with HIV by EOHHS Region Massachusetts: 2005

Source: MDPH, BCDC HIV/AIDS Files as of 09/01/06

****

*

**** **


N=15,907N=5,189N=2,185N=1,982N=2,297N=1,415N=1,845

202

HIV Incidence by EOHHS Region Massachusetts: 2005

12.7

7.78.510.311.2

8.3

38.8

0

5

10

15

20

25

30

35

40

45


Pers

ons

per 1

00,0

00

** ** **

*


N= 814N=276N=99N=126N=132N=70N=93


146

203

AIDS Incidence by EOHHS Region Massachusetts: 2005

6.38.0

5.06.1

7.3 6.4

21.1

0

5

10

15

20

25


Pers

ons

per 1

00,0

00

**

*


N=516N=150N=81N=75N=78N=54N=61


204

Persons Living with AIDS by EOHHS Region Massachusetts: 2005

95.2133.3

71.8100.0107.7 93.5

395.7

0

50

100

150

200

250

300

350

400

450


Pers

ons

per 1

00,0

00

**

*

********


N=8,577N=2,816N=1,217N=1,069N=1,281N=790N=897


147

205

HIV/AIDS Death Rates by EOHHS Region Massachusetts: 2003-2005

3.1

1.4

8.5

2.42.9

4.4

1.5

2.5

0

1

2

3

4

5

6

7

8

9


Dea

ths

per 1

00,0

00 p

opul

atio

n


*

**

*


**

206

HIV/AIDS Death Rates Largest Communities Western Region: 2003-2005

3.1

15.914.1

4.4

1.2

0

2

4

6

8

10

12

14

16

18

Western Chicopee Holyoke Pittsfield Springfield Westernw/o Largest

Cities

MA

Dea

ths

per 1

00,0

00 p

opul

atio

n


*

**

*


N=617N=20 N=67N=4N=15N=4N=110

*

NA NA

148

207HIV/AIDS Death Rate by Race/EthnicityWestern Region and Massachusetts: 2003-2005

1 2

1916

13

1

29

0

5

10

15

20

25

30

35


Dea

ths

per 1

00,0

00


NA

*

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than stateAge-adjusted to the 2000 US standard population. Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology Program

208

38.87.78.510.38.311.212.6HIV Incidence(2005)

729.2170.9133.1179.4167.5221.4247.1Persons living with HIV (2005)

4.4

7.3

107.7

Western

2.5

6.3

95.2

South East

8.51.42.42.93.1HIV/AIDS Mortality (2003-2005)

21.15.06.16.48.0AIDS Incidence (2005)

395.771.8100.093.5133.2Persons living with AIDS (2005)

BostonMetro West

North East Central

MATotal

Indicator Crude rate, per

100,000

Summary HIV/AIDS Indicators by EOHHS Region


149

209

33.9NA39.012.811.212.6HIV Incidence (crude rate per 100,000) (2005)

634.495. 6800.7225.3221.4247.1Persons living with

HIV (crude rate per 100,000) (2005)

4.4

7.3

107.7

Western

NA

21.7

307.6

Springfield

NA14.1NA3.1HIV/AIDS Mortality

(age-adjusted per 100,000) (2003-2005)

NA31.6NA8.0AIDS Incidence

(crude rate per 100,000) (2005)

43.2372.4108.1133.2Persons living with AIDS (crude rate per

100,000) (2005)


Total Indicator

Summary HIV/AIDS Indicators Communities in Western Region


210

NANA11.212.6HIV Incidence (crude rate per 100,000) (2005)

64.495. 6221.4247.1Persons living with HIV

(crude rate per 100,000) (2005)

4.4

7.3

107.7

Western

1.5

3.8

30.3

Berkshires

NA3.1HIV/AIDS Mortality (age-adjusted per 100,000) (2003-

2005)

NA8.0AIDS Incidence (crude rate per 100,000) (2005)

43.2133.2Persons living with AIDS

(crude rate per 100,000) (2005)

PittsfieldMA

Total Indicator

Summary HIV/AIDS Indicators Communities in Western Region


150

151

INFECTIOUS DISEASES

152

153

211Chlamydia Incidence


225.7

169.0

369.4

216.0

0

50

100

150

200

250

300

350

400

1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Cas

es p

er 1

00,0

00 p

opul

atio

n

Massachusetts

Western Region

Source: MDPH, BCDC STD Files

212

Chlamydia Incidence by EOHHS Region Massachusetts: 2005

169.7225.7

106.1

178.0

369.4

145.4

588.5

0

100

200

300

400

500

600

700


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


*

*

**

**

****


154

213


214

Gonorrhea Incidence by EOHHS Region Massachusetts: 2005

35.4 39.6

20.322.4

55.9

16.6

126.2

0

20

40

60

80

100

120

140


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


*

*

******


155

215

Syphilis IncidenceWestern Region and Massachusetts: 1989-2005

6.3

17.9

3.1

10.8

0

5

10

15

20

25

30

35

1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Cas

es p

er 1

00,0

00 p

opul

atio

n

Massachusetts

Western Region


216

Syphilis Incidence by EOHHS Region Massachusetts: 2005

6.3

2.74.74.9

3.11.7

27.7

0

5

10

15

20

25

30


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n


**

*

****


156

217

Tuberculosis Incidence by EOHHS Region Massachusetts: 2004

4.4

2.0

4.34.8

1.9

4.2

27.7

0

2

4

6

8

10

12


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n

**

*

**


Source: MDPH Bureau of Communicable Disease Control, ISIS

218

Tuberculosis Incidence by EOHHS Region Massachusetts: 2006

2.5

4.03.0

4.3

2.7

9.6

4.1

0

2

4

6

8

10

12


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

opul

atio

n



157

219Confirmed Tuberculosis Cases by Race/Ethnicity and EOHHS Region

Massachusetts: 2006

8<5914Southeast

819268Boston

13212021Metro Boston

61965Northeast

10146<5Central

<58<5<5West

HispanicAsian/Pacific

IslanderBlack non-Hispanic

White non-Hispanic

EOHHS Region


Percent of Confirmed Tuberculosis Cases by EOHHS Region

Massachusetts: 2006 (N = 259)

Metro WestN=63, 24%

BostonN=72, 28%

WesternN=21, 8%

CentralN=32, 12%

SoutheastN=33, 13%

NortheastN=38, 15%


220

158

221

Percent of Confirmed Tuberculosis Cases by Race/Ethnicity and EOHHS Region

Massachusetts: 2006

0%10%20%30%40%50%60%70%80%90%

100%

White/NH (N=55) Black /NH (N=71) Asian/PacificIslander (N=84)

Hispanic (N=49)

SoutheastBostonMetro BostonNortheastCentralWest


Tuberculosis Cases by EOHHS RegionMassachusetts: 1993-2006

0

20

40

60

80

100

120

140

93 94 95 96 97 98 99 2000 01 02 03 04 05 06

West Central NortheastMetro Boston Boston Southeast

YEAR


222

159

223

Percent of Confirmed Tuberculosis Cases by Race/Ethnicity and EOHHS Region

Massachusetts: 2006

0%10%20%

30%40%50%60%70%

80%90%

100%

West Central Northeast Metro Boston Boston Southeast

White/NH (N=55) Black/NH (N=71)Asian/Pacific Islander (N=84) Hispanic (N=49)


224Hepatitis C Average Incidence Rates by EOHHS Region, Massachusetts: 1992-20061

41.0

51.0

30.0

49.056.0

50.0

75.0

0

10

20

30

40

50

60

70

80

Western Central Northeast Outer MetroBoston

Inner MetroBoston

Boston Southeast

Cas

es p

er 1

00,0

00 p

opul

atio

n


1 Data as of March 17, 2007


160

225


226Hepatitis C Incidence Infection Rates by EOHHS Region, Massachusetts: 2006

82.0

114.0

49.0

92.095.0

123.0

150.0

0

20

40

60

80

100

120

140

160

Western Central Northeast Outer MetroBoston

Inner MetroBoston

Boston Southeast

Cas

es p

er 1

00,0

00 p

opul

atio

n



161

227


228

Lyme Disease Incidence by EOHHS Region Massachusetts: 2004

24.7

4.0

21.218.419.7

27.3

66.4

48.5

0

10

20

30

40

50

60

70


Cas

es p

er 1

00,0

00 p

opul

atio

n

*

**


****


*

162

229


230Pneumonia/Influenza Hospital Discharges by

EOHHS Region, Massachusetts: 2005

377.0406.7

341.6384.4

346.0392.7

415.8

0

50

100

150

200

250

300

350

400

450


Southeast Boston MA

Age

-adj

uste

d ra

te

per 1

00,0

00

Source: Division of Health Care Finance and Policy. Calendar Year 2005. Inpatient Hospital Discharge Database

** **

* *


163

231

150.082.049.092.0123.095.0114.0Average Hep C

Incidence Infection(crude rates, 2006)

4.048.421.218.419.727.324.7Lyme Disease Incidence(crude rates, 2004)

9.62.74.33.04.02.54.1Tuberculosis Incidence(crude rates, 2006)

126.235.420.322.416.655.939.6Gonorrhea Incidence (crude rates, 2005)

346.0

3.1

369.4

Western

406.7

2.7

169.7

Southeast

415.8341.5384.4392.7377.0Pneumonia/ Influenza Hospital Discharges

(age-adjusted, 2005)

22.74.74.91.76.3Syphilis Incidence (crude rates, 2005)

588.5106.1178.0145.4225.7Chlamydia Incidence (crude rates, 2005)

BostonMetro West

North East Central

MATotal Indicator

Summary Infectious Disease Indicators by EOHHS Region


232

NANANA27.324.7Lyme Disease Incidence(crude rates, 2004)

NANANA1.94.4Tuberculosis Incidence(crude rates, 2004)

190.0104.631.155.939.6Gonorrhea Incidence (crude rates, 2005)

346.0

3.1

369.4

Western

383.1

11.5

1,018.2

Springfield

466.5315.4377.0Pneumonia/ Influenza

Hospital Discharges (age-adjusted, 2005)

NANA6.3Syphilis Incidence (crude rates, 2005)

810.4245.4225.7Chlamydia Incidence (crude rates, 2005)

HolyokeChicopeeMA

Total Indicator

Summary Infectious Disease Indicators Communities in Western Region


164

233

290.0

66.4

NA

NA

34.9

233.4

Berkshires

NA27.324.7Lyme Disease Incidence(crude rates, 2004)

NA1.94.4Tuberculosis Incidence(crude rates, 2004)

70.555.939.6Gonorrhea Incidence (crude rates, 2005)

346.0

3.1

369.4

Western

310.0377.0Pneumonia/ Influenza

Hospital Discharges (age-adjusted, 2005)

NA6.3Syphilis Incidence (crude rates, 2005)

395.9225.7Chlamydia Incidence (crude rates, 2005)

PittsfieldMA

Total Indicator

Summary Infectious Disease Indicators Communities in Western Region


165

ASTHMA

166

167

234Asthma Hospital Discharges


140161

101

133125 131

242

0

50

100

150

200

250

300


Southeast Boston MA

Age

-adj

uste

d ra

te

per1

00,0

00

Source: Division of Health Care Finance and Policy. Calendar Year 2005. Inpatient Hospital Discharge Database

****

*

*


235Asthma Emergency Department Visit Ratesby EOHHS Region, Massachusetts: 2005

655577

363

491

761

566

897

0

100

200

300

400

500

600

700

800

900

1000


Southeast Boston MA

Visi

tspe

r100

,000

Age-adjusted to the 2000 US standard population.Source: Division of Health Care Finance and Policy. Calendar Year 2005. Emergency Department Visits

*

**

**

*

*


168

236Emergency Department Visit Rates for Asthma by Race/Ethnicity


434

1,4691,251

194 141

498

1,562

2,255

0

500

1,000

1,500

2,000

2,500


Visi

ts p

er 1

00,0

00


*

*



237

Adults who Currently have Asthmaby EOHHS Region, Massachusetts: 2005

10.7 9.68.17.8

10.9 11.99.2

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent



169

238Asthma Emergency Department Visit Rates Children Ages 0-4


1,130

854809815

1,618

1,241

2,148

0

500

1,000

1,500

2,000

2,500


Southeast Boston MA

Visi

ts p

er10

0,00

0

*

** ** **

*



239

Asthma ER Visits, Children Ages 5-9by EOHHS Region, Massachusetts: 2005

775687

582608

831 761

1,812

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000


Southeast Boston MA

Visi

ts p

er10

0,00

0

** ****

*



170

240


571 533

365363

632

470

1,236

0

200

400

600

800

1,000

1,200

1,400


Southeast Boston MA

Visi

ts p

er10

0,00

0

** **

*

*



241


808697

584594

995811

1,771

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000


Southeast Boston MA

Visi

ts p

er10

0,00

0

** **

*

*

**



171

242


808

1,771

584594

811

995

570697

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000


Visi

ts p

er10

0,00

0

** **

*

*

**



**

243

Asthma ER Visits, Children Ages 0-14Largest Cities, Western Region: 2005

808

1,839

919

1,768

995 964

579

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Western Chicopee Holyoke Pittsfield Springfield Westernw/o largest

cities

MA

Visi

ts p

er10

0,00

0

*

*

**



*

172



2,096

238569 516

1,683

2,196

1,573

356

0

500

1,000

1,500

2,000

2,500


Visi

ts p

er 1

00,0


**

*




Berkshires and Massachusetts: 2005

506.5 515.82

19272095.79

0

500

1,000

1,500

2,000

2,500


Visi

ts p

er 1

00,0

00




NA NA NA NA

173

246

Pediatric Asthma Prevalence by EOHHS Region Massachusetts: 2005-2006

10.5 10.69.410.1

12.7

9.8

13.0

0

5

10

15

20


Southeast Boston MA

Perc

ent

Source: MDPH, Center for Environmental Health, Pediatric Asthma Surveillance (2005-2006)

* *

** ** **


247

BOSTON2553.1

BOURNE1709.6

FALLRIVER1476.1

WORCESTER2350.5

SPRINGFIELD2930.9

HOLYOKE3168.7

CHICOPEE2239.8

FRAMINGHAM1639.3

BROCKTON1649

LYNN1570.8

GREENFIELD1934.1

SOUTHBRIDGE3614.8

STOUGHTON1646.5

NORWOOD1823.2

CLINTON1897.1

LAWRENCE1494.5

Pediatric Asthma Emergency Visit Rates by Towns*Among Chilldren Ages <5 Massachusetts 2004-2005

Emergency Visit Rates by Townsper 100,000


*Towns with less than 5 cases in the period were excluded.

Massachusetts State Total Rate: 1,136.2

Pediatric (Ages < 5) Asthma Emergency Department Visit Rates by Community



174

248

SPRINGFIELD2930.9

HOLYOKE3168.7

CHICOPEE2239.8

GREENFIELD1934.1

Pediatric Asthma Emergency Visit Rates by Towns*Among Chilldren Ages <5

West Region - Massachusetts 2004-2005

Emergency Visit Rates by Townsper 100,000



Massachusetts State Total Rate: 1,136.2

Pediatric (Ages < 5) Asthma Emergency Department Visit Rates by Community

Western Region: 2004-2005


249

ATHOL601.8

PITTSFIELD250.8

AMHERST476.5

AGAWAM233.4

NORTHAMPTON382.4

HOLYOKE248.8

NORTH ADAMS476.9

SOUTH HADLEY432

WEST SPRINGFIELD258.5

SPRINGFIELD244.6

CHICOPEE105.8

Pediatric Asthma Hospitalization Rates by Towns*Among Chilldren Ages <5

West Region - Massachusetts 2004-2005

Hospitalization Rates by Townsper 100,000



Massachusetts State Total Rate: 337.5

Source: Division of Health Care Finance and Policy. Calendar Year 2004-2005. Hospital Discharges

Pediatric (Ages < 5) Asthma Hospitalization Ratesby Community, Western Region: 2004-2005

175

250

9.210.78.17.811.910.99.6% Adults who currently have asthma (2005)

1,771697584594811995808Asthma ER Visits

Ages 0-14 (age-adjusted per100,000)

897.1654.5363.0491.4565.9760.9576.9Asthma ER Visits

(age-adjusted per100,000)

125.0

Western

160.9

South East

241.9100.9132.7131.5140.1Asthma Hospital Discharges (age-

adjusted per100,000)

BostonMetro West

North East Central

MATotal Indicator

Summary Asthma Indicators by EOHHS Region, Massachusetts: 2005

Statistically lower than state Statistically higher than state

251

NANANA10.99.6% Adults who currently have asthma (2005)

1,838.61,767.8963.5995808Asthma ER Visits


1,454.21,372.8645.6760.9576.9Asthma ER Visits (age-adjusted per100,000)

125.0

Western

260.5

Springfield

320.9118.8140.1Asthma Hospital

Discharges (age-adjusted per100,000)

HolyokeChicopeeMA

Total Indicator

Summary Asthma Indicators Communities in Western Region: 2005


176

252

NANA119.6% Adults who currently have asthma (2005)

919570995808Asthma ER Visits


1418824761576.9Asthma ER Visits (age-adjusted per100,000)

125

Western

16696140.1Asthma Hospital

Discharges (age-adjusted per100,000)

PittsfieldBerkshiresMA

Total Indicator

Summary Asthma Indicators Communities in Western Region: 2005


253

1,236571365363470632533Asthma ER Visits

Ages 10-14 (age adjusted per100,000)

1,812687582608761831775Asthma ER Visits


12.7

1,618

Western

10.5

854

South East

13.09.410.19.810.6Pediatric Asthma

Prevalence (2005-2006)

2,1488098151,2411,130Asthma ER Visits


BostonMetro West

North East Central

MATotal Indicator

Summary Asthma Indicators by EOHHS Region, Massachusetts: 2005


177

OTHER HEALTH INDICATORS

178

179

254Total Cases of Elevated Blood Lead Levels

(>=15 µg/dL) by EOHHS RegionMassachusetts: 2005

2.2 2.3

1.0

2.13.0 3.1 3.2

0

1

2

3

4

5

6

7

8

9

10


Southeast Boston MA

Prev

alen

ce R

ate

Per 1

000

Source: MDPH, Childhood Lead Poisoning Prevention Program (CLPPP)

**

* *


255Lead Poisoning Prevalence Rates

(BLL≥ 25 µg/dL) Children 9-48 Monthsby EOHHS Region, Massachusetts: 2006

0.4 0.4

0.6

0.3

0.5 0.5

0.2

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0


Southeast Boston MA

Prev

alen

ce R

ate

Per 1

000

Source: MDPH, Childhood Lead Poisoning Prevention Program (CLPPP)Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state

180

256Adults who Report Experiencing Intimate Partner Violence by EOHHS Region and Gender

Massachusetts: 2005

25.722.4

19.322.0

25.923.2

17.217.415.1 15.3

11.413.1

10.713.8

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent

Women Men


257

Adults who Report Having a Disability by EOHHS Region, Massachusetts: 2005

24.2

19.5

15.318.1

21.5 20.6

17.1

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent


181

258Adults who Report Having a Disability and needing help with activities

EOHHS Region, Massachusetts: 2005

9.06.7

4.75.57.3

8.5

5.1

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent



259

Adults with Fair or Poor Health by EOHHS Region, Massachusetts: 2005

14.3 13.2

9.3

13.414.6 15.2 14.7

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent

**



182

260Adults who Reported Fair or Poor Health by Race and Ethnicity


16.5

12.313.111.5

27.5

23.5

0

5

10

15

20

25

30


Perc

ent


* Statistically Significantly different from state (p ≤.05)Source: MDPH, Center for Health Information, Statistics, Research & Evaluation, Health Survey Program

261

13%

11%

17%16% 21%

15%

0%

5%

10%

15%

20%

25%

30%

35%

1999 2000 2001 2002 2003 2004 2005

Perc

ent


Adults who Reported Fair or Poor Health by Race and Ethnicity

Western Region: 1999-2005


183

262Adults who Visit a Dentist in Past Yearby EOHHS Region, Massachusetts: 2004

76.8 78.286.1

76.375.4 75.1 74.1

0102030405060708090

100


Southeast Boston MA

Perc

ent

**


263

Adults who have lost 6 or more teeth to decay or disease by EOHHS Region, Massachusetts: 2004

17.415.1

10.5

16.518.8

15.4 13.7

0

10

20

30

40

50


Southeast Boston MA

Perc

ent

**


184

264Adults with Poor Mental Health for 15 or more days

in Past Month by EOHHS Region Massachusetts: 2005

10.2 8.8

5.38.0

11.2 10.5 9.5

0

5

10

15

20

25

30


Southeast Boston MA

Perc

ent

**



265

3.22.21.02.13.12.92.3

Cases of Elevated Blood

Lead levels (Percent of All

Children Screened Per 1000, 2005)

13.717.410.516.515.418.815.1% 6+ Teeth Missing (2004)

74.176.886.176.375.175.478.2% Visited Dentist Past Year (2004)

14.714.39.313.415.214.613.2% Fair or Poor Health (2005)

11.2

Western

10.2

South East

9.55.38.010.58.8% Poor Mental Health for 15 or

more days in Past Month (2005)

BostonMetro West

North East Central

MATotal Indicator

Summary Other Health Indicators by EOHHS Region


185

266

5.19.04.75.58.57.36.7

% Adults reporting having a

disability and needing help with activities

(2005)

17.124.215.318.120.621.519.5% Adults reporting having a

disability (2005)

Western South East

BostonMetro West

North East Central

MATotal Indicator

Summary Other Health Indicators by EOHHS Region



267

Refugee Arrivals: Western Region Massachusetts: 2002-2006

• 2,204 refugees resettled over 5 years

• Increasing diversity in population

• 44% age <19 at arrival

• Cities/Towns with largest number of arrivals: Greenfield, Springfield, West Springfield, Westfield

050

100150200250300350400450

FY02 FY03 FY04 FY05 FY06

Africa Europe/CentAsia Other

Source: MDPH, Refugee and Immigrant Health Program and the Bureau of Communicable Disease Control Office of Integrated Surveillance and Informatics

186

268

Refugee Health Concerns: Western RegionMassachusetts: 2002-2006

• High rates of latent TB infection (LTBI)– 1,843 refugees tested: 41% positive– Intensive follow-up in partnership with TB clinics, local health and

DPH to assure testing, evaluation and treatment– Rapid assessment identifies active disease early to prevent

spread

• Risk of lead poisoning among refugee children– 25 refugee children identified with elevated blood lead levels at

arrival– Poor nutritional status puts children at risk of increased absorption

of lead post-resettlement

• Need for bilingual, bicultural services to promote access to care


269

AfricanAfrican and South East Asian

AfricanEuropean and Central AsianLargest Group

2,8431,3128582,204Refugee Arrivals

47%

Boston, Cambridge, Chelsea, Everett, Quincy, Revere, Somerville, Waltham

39%

Metro West and Boston

Regions

44%33%41%%TB Positive

Lowell, Lynn, MaldenWorcester

Greenfield, Springfield, West Springfield, Westfield

Largest Cities

44%

Western

45%51%% refugees 19 years or less

North East CentralIndicator

Summary Refugees by EOHHS Regions Massachusetts: 2002-2006


187

270

Premature Mortality Rate (PMR)1

• Definition– deaths before age 75

• Rationale– two-thirds of deaths to persons ages 75+– vast majority of deaths to persons age 75+ are due to chronic

conditions associated with aging – Focusing on deaths to persons less than 75 years may be more

preventable

• Summary health statistic– excellent measure to reflect the health status of a population– used as a health status indicator that can be used to focus

prevention initiatives and target programs

1 Rates are per 100,000 population. Age-adjusted to the 2000 US standard population under 75 years of age.


271

Western355 Central

340

Southeast332.3

Boston373.1

Northeast311.5

Metro West248.9

Map 2. Premature Mortality Rate (PMR) by RegionMassachusetts: 2005

Rates are per 100,000 persons under 75 years of age, age-adjusted to the 2000 US standard population under 75 years of age.

Massachusetts PMR= 317.0

25 Miles

PMR by RegionSignificantly higher than state rateNot different from state rateSignificantly lower than state rate

Premature Mortality Rates (PMR) by RegionMassachusetts: 2005


188

272

Rates are per 100,000 persons under 75 years of age, age-adjusted to the 2000 US standard population under 75 years of age.

Map 3. Premature Mortality Rates (PMR) Massachusetts Western Region by City/Town: 2005

Western Region PMR= 355.0

*R t 100 000 l ti

PMR by City/Town

Significantly higher than state rateNot different from state rateSignificantly lower than state rateLess than 5 premature deaths.

10Miles

Massachusetts PMR= 317.0

PMR- Western Region by City/Town Massachusetts: 2005

HighestSpringfield:466.0

LowestLenox: 178.9


273Median Household Income and PMR

by EOHHS Regions, Massachusetts: 2005

State Median Household Income: $66,365

0

50

100

150

200

250

300

350

400

Boston Region Western Mass Central Mass Southeast Northeast Metro West

PMR

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

$90,000

$100,000

Med

ian

Hou

seho

ld In

com

e ($

)

PMR Median Household Income


189

274Premature Mortality Rate (PMR)

by EOHHS Region: 2005



466.0Springfield336.9Berkshires

485.6Holyoke360.7Chicopee

332.3Southeast Region

317.0Massachusetts

373.1Boston Region

248.9Metro West Region311.5North East Region340.0Central Region

355.0Western Region

PMR

190

191

SUMMARY

192

193

275

Summary- Berkshires

• The Berkshires has only 2 larger cities: Pittsfield (43,949) and North Adams (14,031).

• The race/ethnicity and age distributions of the Berkshires differ from the Western Region as a whole:– The Berkshires are 94% White Non-Hispanic – Higher proportion of older persons (65+)

• Some indicators are better than the state:– Lower hypertension hospital discharge rates– Heroin abuse treatment program admission rates are lower in

Berkshires– HIV/AIDS deaths are lower in the Berkshires– Low firearm ER visit rate– Low HIV indicators (incidence and mortality)

276

Summary- Berkshires

Some indicators are worse than the State:– Birth indicators worse than state (low breastfeeding rate, high teen birth rate,

low adequacy of prenatal care, high public funding for prenatal care, high smoking during pregnancy)

– Higher proportion of Chronic Lower Respiratory Disease (formerly COPD) deaths

– Higher alcohol-related abuse treatment program admission rates in Berkshires

– Injuries such as motor vehicle-related and self-inflicted hospital discharge rates are higher in the Berkshires and especially in Pittsfield

– Higher emergency department visit rates for fall-related injuries in the Berkshires

– Higher incidence of Lyme disease in the Berkshires– Higher rates of Chlamydia and gonorrhea in Pittsfield

194

277

Selected Health Disparities by Race/Ethnicity, Berkshires

• Blacks– Higher diabetes hospital discharge rates– Higher ER rate for children 0-14

• Whites– High teen birth rates– Higher rate of smoking during pregnancy– Higher motor vehicle ER visit rates

278

Summary- Western Region• We need to examine local variation and subgroups in the population to get a

more complete picture of the health of the Western region:– Socio-demographic indicators very different for largest cities:

• Large Hispanic population in Holyoke and Springfield• Younger population in Holyoke and Springfield• SES lower in Chicopee, Holyoke and Springfield

• Some indicators are worse than the State :– Birth indicators poorer than state (low breastfeeding, high teen birth rate, low

adequate prenatal care, high public funding for prenatal care, high smoking during pregnancy)

– High diabetes hospitalizations– High Substance Abuse Treatment Program Admission rates Injuries such as TBI,

motor vehicle-related, self inflicted and assault hospitalization rates are higher – High Emergency Department Visit rates for all injuries, firearm and fall-related– High motor vehicle-related mortality rate– High ER visit rates for asthma

• Some indicators are better than the State :– Low C-section– Low Cancer Incidence– Low HIV/AIDS mortality in Western region outside Springfield area

195

279

Summary- Western Region

We need to examine local variation and subgroups in the population to get a more complete picture of the health of the Western region. Some indicators in largest cities are worse than the State:

• Higher homicide rate in Springfield• Higher opioid ER visit rates in Holyoke• Higher HIV/AIDS rates (incidence, persons living with disease and mortality)

in Holyoke• Higher HIV/AIDS rates (incidence and persons living with disease) in

Springfield• Higher rates of gonorrhea and Chlamydia incidence in Holyoke, Pittsfield and

Springfield• Higher pneumonia/influenza hospitalizations in Holyoke• High asthma hospitalizations and ER visits in Holyoke and Springfield

280

Selected Health Disparities by Race/Ethnicity, Western Region

• Hispanics– Teen birth rates– Smoking during pregnancy– High Heart disease and Diabetes– Opioids ER visits– High hospitalizations rates for: TBI, self-inflicted injuries, MVA, assaults– High ER visits for firearm injuries, fall-related injuries, and asthma overall and for ages

0-14– High HIV Mortality

• Blacks– Smoking during pregnancy– Diabetes– High hospitalizations rates for motor vehicle-related injuries (MVA) and assaults– High ER visits for firearm injuries, fall-related injuries and asthma for ages 0-14

• Whites– Smoking during pregnancy– High hospitalizations rates for: MVA, fall-related injuries– High ER visits for fall-related and asthma

196

197

APPENDIX

198

199

REGIONS AND TOWNS

REGION TOWN COUNTY CHNA BOSTON BOSTON

BROOKLINE CHELSEA REVERE WINTHROP

SUFFOLK NORFOLK SUFFOLK SUFFOLK SUFFOLK

Alliance for Community Health Alliance for Community Health Alliance for Community Health Alliance for Community Health Alliance for Community Health

CENTRAL ASHBURNHAM ASHBY AUBURN AYER BARRE BELLINGHAM BERLIN BLACKSTONE BOLTON BOYLSTON BRIMFIELD BROOKFIELD CHARLTON CLINTON DOUGLAS DUDLEY EAST BROOKFIELD FITCHBURG FRANKLIN GARDNER GRAFTON GROTON HARDWICK HARVARD HOLDEN HOLLAND HOPEDALE HUBBARDSTON LANCASTER LEICESTER LEOMINSTER LUNENBURG MEDWAY MENDON MILFORD MILLBURY MILLVILLE NEW BRAINTREE NORTH BROOKFIELD NORTHBRIDGE OAKHAM OXFORD

WORCESTER MIDDLESEX WORCESTER MIDDLESEX WORCESTER NORFOLK WORCESTER WORCESTER WORCESTER WORCESTER HAMPDEN WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER NORFOLK WORCESTER WORCESTER MIDDLESEX WORCESTER WORCESTER WORCESTER HAMPDEN WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER NORFOLK WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER

Fitchburg/Gardner CHN Fitchburg/Gardner CHN Community Wellness Coalition Fitchburg/Gardner CHN Fitchburg/Gardner CHN Community Partners for Health Fitchburg/Gardner CHN Community Partners for Health Fitchburg/Gardner CHN Community Wellness Coalition CHN of Southern Worcester County CHN of Southern Worcester County CHN of Southern Worcester County Fitchburg/Gardner CHN Community Partners for Health CHN of Southern Worcester County CHN of Southern Worcester County Fitchburg/Gardner CHN Community Partners for Health Fitchburg/Gardner CHN Community Wellness Coalition Fitchburg/Gardner CHN Fitchburg/Gardner CHN Fitchburg/Gardner CHN Community Wellness Coalition CHN of Southern Worcester County Community Partners for Health Fitchburg/Gardner CHN Fitchburg/Gardner CHN Community Wellness Coalition Fitchburg/Gardner CHN Fitchburg/Gardner CHN Community Partners for Health Community Partners for Health Community Partners for Health Community Wellness Coalition Community Partners for Health Fitchburg/Gardner CHN CHN of Southern Worcester County Community Partners for Health Fitchburg/Gardner CHN CHN of Southern Worcester County

200

PAXTON PEPPERELL PRINCETON RUTLAND SHIRLEY SHREWSBURY SOUTHBRIDGE SPENCER STERLING STURBRIDGE SUTTON TEMPLETON TOWNSEND UPTON UXBRIDGE WALES WARREN WEBSTER WEST BOYLSTON WEST BROOKFIELD WESTMINSTER WINCHENDON WORCESTER

WORCESTER MIDDLESEX WORCESTER WORCESTER MIDDLESEX WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER MIDDLESEX WORCESTER WORCESTER HAMPDEN WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER WORCESTER

Community Wellness Coalition Fitchburg/Gardner CHN Fitchburg/Gardner CHN Fitchburg/Gardner CHN Fitchburg/Gardner CHN Community Wellness Coalition CHN of Southern Worcester County CHN of Southern Worcester County Fitchburg/Gardner CHN CHN of Southern Worcester County Community Partners for Health Fitchburg/Gardner CHN Fitchburg/Gardner CHN Community Partners for Health Community Partners for Health CHN of Southern Worcester County CHN of Southern Worcester County CHN of Southern Worcester County Community Wellness Coalition CHN of Southern Worcester County Fitchburg/Gardner CHN Fitchburg/Gardner CHN Community Wellness Coalition

METRO WEST

ACTON ARLINGTON ASHLAND BEDFORD BELMONT BOXBOROUGH BRAINTREE BURLINGTON CAMBRIDGE CANTON CARLISLE COHASSET CONCORD DEDHAM DOVER FOXBOROUGH FRAMINGHAM HINGHAM HOLLISTON HOPKINTON HUDSON HULL LEXINGTON LINCOLN LITTLETON MARLBOROUGH MAYNARD

MIDDLESEX MIDDLESEX MIDDLESEX MIDDLESEX MIDDLESEX MIDDLESEX NORFOLK MIDDLESEX MIDDLESEX NORFOLK MIDDLESEX NORFOLK MIDDLESEX NORFOLK NORFOLK NORFOLK MIDDLESEX PLYMOUTH MIDDLESEX MIDDLESEX MIDDLESEX PLYMOUTH MIDDLESEX MIDDLESEX MIDDLESEX MIDDLESEX MIDDLESEX

Greater Woburn/Concord/Littleton CHN Greater Cambridge/Somerville CHN CHN of Greater Metro West Greater Woburn/Concord/Littleton CHN Greater Cambridge/Somerville CHN Greater Woburn/Concord/Littleton CHN Blue Hills Community Health Alliance Greater Woburn/Concord/Littleton CHN Greater Cambridge/Somerville CHN Blue Hills Community Health Alliance Greater Woburn/Concord/Littleton CHN Blue Hills Community Health Alliance Greater Woburn/Concord/Littleton CHN West Suburban Health Network West Suburban Health Network CHN of Greater Metro West CHN of Greater Metro West Blue Hills Community Health Alliance CHN of Greater Metro West CHN of Greater Metro West CHN of Greater Metro West Blue Hills Community Health Alliance Greater Woburn/Concord/Littleton CHN Greater Woburn/Concord/Littleton CHN Greater Woburn/Concord/Littleton CHN CHN of Greater Metro West CHN of Greater Metro West

201

MEDFIELD MILLIS MILTON NATICK NEEDHAM NEWTON NORFOLK NORTHBOROUGH NORWELL NORWOOD PLAINVILLE QUINCY RANDOLPH SCITUATE SHARON SHERBORN SOMERVILLE SOUTHBOROUGH STOW SUDBURY WALPOLE WALTHAM WATERTOWN WAYLAND WELLESLEY WESTBOROUGH WESTON WESTWOOD WEYMOUTH WILMINGTON WINCHESTER WOBURN WRENTHAM

NORFOLK NORFOLK NORFOLK MIDDLESEX NORFOLK MIDDLESEX NORFOLK WORCESTER PLYMOUTH NORFOLK NORFOLK NORFOLK NORFOLK PLYMOUTH NORFOLK MIDDLESEX MIDDLESEX WORCESTER MIDDLESEX MIDDLESEX NORFOLK MIDDLESEX MIDDLESEX MIDDLESEX NORFOLK WORCESTER MIDDLESEX NORFOLK NORFOLK MIDDLESEX MIDDLESEX MIDDLESEX NORFOLK

CHN of Greater Metro West CHN of Greater Metro West Blue Hills Community Health Alliance CHN of Greater Metro West West Suburban Health Network West Suburban Health Network CHN of Greater Metro West CHN of Greater Metro West Blue Hills Community Health Alliance Blue Hills Community Health Alliance CHN of Greater Metro West Blue Hills Community Health Alliance Blue Hills Community Health Alliance Blue Hills Community Health Alliance Blue Hills Community Health Alliance CHN of Greater Metro West Greater Cambridge/Somerville CHN CHN of Greater Metro West CHN of Greater Metro West CHN of Greater Metro West CHN of Greater Metro West West Suburban Health Network Greater Cambridge/Somerville CHN CHN of Greater Metro West West Suburban Health Network CHN of Greater Metro West West Suburban Health Network West Suburban Health Network Blue Hills Community Health Alliance Greater Woburn/Concord/Littleton CHN Greater Woburn/Concord/Littleton CHN Greater Woburn/Concord/Littleton CHN CHN of Greater Metro West

NORTHEAST AMESBURY ANDOVER BEVERLY BILLERICA BOXFORD CHELMSFORD DANVERS DRACUT DUNSTABLE ESSEX EVERETT GEORGETOWN GLOUCESTER GROVELAND HAMILTON HAVERHILL IPSWICH

ESSEX ESSEX ESSEX MIDDLESEX ESSEX MIDDLESEX ESSEX MIDDLESEX MIDDLESEX ESSEX MIDDLESEX ESSEX ESSEX ESSEX ESSEX ESSEX ESSEX

Greater Haverhill CHN Greater Lawrence CHN Community Health Network North Greater Lowell CHN Greater Haverhill CHN Greater Lowell CHN North Shore CHN Greater Lowell CHN Greater Lowell CHN Community Health Network North North Suburban Health Alliance Greater Haverhill CHN Community Health Network North Greater Haverhill CHN Community Health Network North Greater Haverhill CHN Community Health Network North

202

LAWRENCE LOWELL LYNN LYNNFIELD MALDEN MANCHESTER MARBLEHEAD MEDFORD MELROSE MERRIMAC METHUEN MIDDLETON NAHANT NEWBURY NEWBURYPORT NORTH ANDOVER NORTH READING PEABODY READING ROCKPORT ROWLEY SALEM SALISBURY SAUGUS STONEHAM SWAMPSCOTT TEWKSBURY TOPSFIELD TYNGSBOROUGH WAKEFIELD WENHAM WEST NEWBURY WESTFORD

ESSEX MIDDLESEX ESSEX ESSEX MIDDLESEX ESSEX ESSEX MIDDLESEX MIDDLESEX ESSEX ESSEX ESSEX ESSEX ESSEX ESSEX ESSEX MIDDLESEX ESSEX MIDDLESEX ESSEX ESSEX ESSEX ESSEX ESSEX MIDDLESEX ESSEX MIDDLESEX ESSEX MIDDLESEX MIDDLESEX ESSEX ESSEX MIDDLESEX

Greater Lawrence CHN Greater Lowell CHN North Shore CHN North Shore CHN North Suburban Health Alliance Community Health Network North North Shore CHN North Suburban Health Alliance North Suburban Health Alliance Greater Haverhill CHN Greater Lawrence CHN Greater Lawrence CHN North Shore CHN Greater Haverhill CHN Greater Haverhill CHN Greater Lawrence CHN North Suburban Health Alliance North Shore CHN North Suburban Health Alliance Community Health Network North Greater Haverhill CHN North Shore CHN Greater Haverhill CHN North Shore CHN North Suburban Health Alliance North Shore CHN Greater Lowell CHN Community Health Network North Greater Lowell CHN North Suburban Health Alliance Community Health Network North Greater Haverhill CHN Greater Lowell CHN

SOUTHEAST ABINGTON ACUSHNET ATTLEBORO AVON BARNSTABLE BERKLEY BOURNE BREWSTER BRIDGEWATER BROCKTON CARVER CHATHAM CHILMARK DARTMOUTH DENNIS DIGHTON DUXBURY

PLYMOUTH BRISTOL BRISTOL NORFOLK BARNSTABLE BRISTOL BARNSTABLE BARNSTABLE PLYMOUTH PLYMOUTH PLYMOUTH BARNSTABLE DUKES BRISTOL BARNSTABLE BRISTOL PLYMOUTH

Greater Brockton CHN Greater New Bedford CHN Health & Education Response Greater Brockton CHN Cape and Islands CHN Health & Education Response Cape and Islands CHN Cape and Islands CHN Greater Brockton CHN Greater Brockton CHN South Shore Community Partners in Prevention Cape and Islands CHN Cape and Islands CHN Greater New Bedford CHN Cape and Islands CHN Health & Education Response South Shore Community Partners in Prevention

203

EAST BRIDGEWATER EASTHAM EASTON EDGARTOWN FAIRHAVEN FALL RIVER FALMOUTH FREETOWN GAY HEAD GOSNOLD HALIFAX HANOVER HANSON HARWICH HOLBROOK KINGSTON LAKEVILLE MANSFIELD MARION MARSHFIELD MASHPEE MATTAPOISETT MIDDLEBOROUGH NANTUCKET NEW BEDFORD NORTH ATTLEBORO NORTON OAK BLUFFS ORLEANS PEMBROKE PLYMOUTH PLYMPTON PROVINCETOWN RAYNHAM REHOBOTH ROCHESTER ROCKLAND SANDWICH SEEKONK SOMERSET STOUGHTON SWANSEA TAUNTON TISBURY TRURO WAREHAM WELLFLEET WEST BRIDGEWATER WEST TISBURY WESTPORT

PLYMOUTH BARNSTABLE BRISTOL DUKES BRISTOL BRISTOL BARNSTABLE BRISTOL DUKES DUKES PLYMOUTH PLYMOUTH PLYMOUTH BARNSTABLE NORFOLK PLYMOUTH PLYMOUTH BRISTOL PLYMOUTH PLYMOUTH BARNSTABLE PLYMOUTH PLYMOUTH NANTUCKET BRISTOL BRISTOL BRISTOL DUKES BARNSTABLE PLYMOUTH PLYMOUTH PLYMOUTH BARNSTABLE BRISTOL BRISTOL PLYMOUTH PLYMOUTH BARNSTABLE BRISTOL BRISTOL NORFOLK BRISTOL BRISTOL DUKES BARNSTABLE PLYMOUTH BARNSTABLE PLYMOUTH DUKES BRISTOL

Greater Brockton CHN Cape and Islands CHN Greater Brockton CHN Cape and Islands CHN Greater New Bedford CHN Partners for a Healthier Community Cape and Islands CHN Greater New Bedford CHN Cape and Islands CHN Cape and Islands CHN South Shore Community Partners in Prevention South Shore Community Partners in Prevention South Shore Community Partners in Prevention Cape and Islands CHN Greater Brockton CHN South Shore Community Partners in Prevention Health & Education Response Health & Education Response Greater New Bedford CHN South Shore Community Partners in Prevention Cape and Islands CHN Greater New Bedford CHN Health & Education Response Cape and Islands CHN Greater New Bedford CHN Health & Education Response Health & Education Response Cape and Islands CHN Cape and Islands CHN South Shore Community Partners in Prevention South Shore Community Partners in Prevention South Shore Community Partners in Prevention Cape and Islands CHN Health & Education Response Health & Education Response Greater New Bedford CHN South Shore Community Partners in Prevention Cape and Islands CHN Health & Education Response Partners for a Healthier Community Greater Brockton CHN Partners for a Healthier Community Health & Education Response Cape and Islands CHN Cape and Islands CHN Greater New Bedford CHN Cape and Islands CHN Greater Brockton CHN Cape and Islands CHN Partners for a Healthier Community

204

WHITMAN YARMOUTH

PLYMOUTH BARNSTABLE

Greater Brockton CHN Cape and Islands CHN

WESTERN ADAMS AGAWAM ALFORD AMHERST ASHFIELD ATHOL BECKET BELCHERTOWN BERNARDSTON BLANDFORD BUCKLAND CHARLEMONT CHESHIRE CHESTER CHESTERFIELD CHICOPEE CLARKSBURG COLRAIN CONWAY CUMMINGTON DALTON DEERFIELD EAST LONGMEADOW EASTHAMPTON EGREMONT ERVING FLORIDA GILL GOSHEN GRANBY GRANVILLE GREAT BARRINGTON GREENFIELD HADLEY HAMPDEN HANCOCK HATFIELD HAWLEY HEATH HINSDALE HOLYOKE HUNTINGTON LANESBOROUGH LEE LENOX LEVERETT LEYDEN LONGMEADOW

BERKSHIRE HAMPDEN BERKSHIRE HAMPSHIRE FRANKLIN WORCESTER BERKSHIRE HAMPSHIRE FRANKLIN HAMPDEN FRANKLIN FRANKLIN BERKSHIRE HAMPDEN HAMPSHIRE HAMPDEN BERKSHIRE FRANKLIN FRANKLIN HAMPSHIRE BERKSHIRE FRANKLIN HAMPDEN HAMPSHIRE BERKSHIRE FRANKLIN BERKSHIRE FRANKLIN HAMPSHIRE HAMPSHIRE HAMPDEN BERKSHIRE FRANKLIN HAMPSHIRE HAMPDEN BERKSHIRE HAMPSHIRE FRANKLIN FRANKLIN BERKSHIRE HAMPDEN HAMPSHIRE BERKSHIRE BERKSHIRE BERKSHIRE FRANKLIN FRANKLIN HAMPDEN

CHN of Berkshire The Community Health Connection CHN of Berkshire Partnership for Health in Hampshire County Upper Valley Health Web Upper Valley Health Web CHN of Berkshire Partnership for Health in Hampshire County Upper Valley Health Web The Community Health Connection Upper Valley Health Web Upper Valley Health Web CHN of Berkshire Four (For) Communities Partnership for Health in Hampshire County Four (For) Communities CHN of Berkshire Upper Valley Health Web Upper Valley Health Web Partnership for Health in Hampshire County CHN of Berkshire Upper Valley Health Web The Community Health Connection Partnership for Health in Hampshire County CHN of Berkshire Upper Valley Health Web CHN of Berkshire Upper Valley Health Web Partnership for Health in Hampshire County Partnership for Health in Hampshire County The Community Health Connection CHN of Berkshire Upper Valley Health Web Partnership for Health in Hampshire County The Community Health Connection CHN of Berkshire Partnership for Health in Hampshire County Upper Valley Health Web Upper Valley Health Web CHN of Berkshire Four (For) Communities Four (For) Communities CHN of Berkshire CHN of Berkshire CHN of Berkshire Upper Valley Health Web Upper Valley Health Web The Community Health Connection

205

LUDLOW MIDDLEFIELD MONROE MONSON MONTAGUE MONTEREY MONTGOMERY MOUNT WASHINGTON NEW ASHFORD NEW MARLBOROUGH NEW SALEM NORTH ADAMS NORTHAMPTON NORTHFIELD ORANGE OTIS PALMER PELHAM PERU PETERSHAM PHILLIPSTON PITTSFIELD PLAINFIELD RICHMOND ROWE ROYALSTON RUSSELL SANDISFIELD SAVOY SHEFFIELD SHELBURNE SHUTESBURY SOUTH HADLEY SOUTHAMPTON SOUTHWICK SPRINGFIELD STOCKBRIDGE SUNDERLAND TOLLAND TYRINGHAM WARE WARWICK WASHINGTON WENDELL WEST SPRINGFIELD WEST STOCKBRIDGE WESTFIELD WESTHAMPTON WHATELY WILBRAHAM

HAMPDEN HAMPSHIRE FRANKLIN HAMPDEN FRANKLIN BERKSHIRE HAMPDEN BERKSHIRE BERKSHIRE BERKSHIRE FRANKLIN BERKSHIRE HAMPSHIRE FRANKLIN FRANKLIN BERKSHIRE HAMPDEN HAMPSHIRE BERKSHIRE WORCESTER WORCESTER BERKSHIRE HAMPSHIRE BERKSHIRE FRANKLIN WORCESTER HAMPDEN BERKSHIRE BERKSHIRE BERKSHIRE FRANKLIN FRANKLIN HAMPSHIRE HAMPSHIRE HAMPDEN HAMPDEN BERKSHIRE FRANKLIN HAMPDEN BERKSHIRE HAMPSHIRE FRANKLIN BERKSHIRE FRANKLIN HAMPDEN BERKSHIRE HAMPDEN HAMPSHIRE FRANKLIN HAMPDEN

Four (For) Communities Partnership for Health in Hampshire County Upper Valley Health Web The Community Health Connection Upper Valley Health Web CHN of Berkshire The Community Health Connection CHN of Berkshire CHN of Berkshire CHN of Berkshire Upper Valley Health Web CHN of Berkshire Partnership for Health in Hampshire County Upper Valley Health Web Upper Valley Health Web CHN of Berkshire The Community Health Connection Partnership for Health in Hampshire County CHN of Berkshire Upper Valley Health Web Upper Valley Health Web CHN of Berkshire Partnership for Health in Hampshire County CHN of Berkshire Upper Valley Health Web Upper Valley Health Web The Community Health Connection CHN of Berkshire CHN of Berkshire CHN of Berkshire Upper Valley Health Web Upper Valley Health Web Partnership for Health in Hampshire County Partnership for Health in Hampshire County The Community Health Connection The Community Health Connection CHN of Berkshire Upper Valley Health Web The Community Health Connection CHN of Berkshire Partnership for Health in Hampshire County Upper Valley Health Web CHN of Berkshire Upper Valley Health Web The Community Health Connection CHN of Berkshire Four (For) Communities Partnership for Health in Hampshire County Upper Valley Health Web The Community Health Connection

206

WILLIAMSBURG WILLIAMSTOWN WINDSOR WORTHINGTON

HAMPSHIRE BERKSHIRE BERKSHIRE HAMPSHIRE

Partnership for Health in Hampshire County CHN of Berkshire CHN of Berkshire Partnership for Health in Hampshire County

207

DATA SOURCES

Massachusetts Division of Health Care Finance and Policy MDPH, Bureau of Communicable Disease Control MDPH, Bureau of Substance Abuse Services MDPH, Environmental Health Bureau MDPH, Health Information, Statistics, Research & Evaluation Bureau SAMHSA, Office of Applied Studies

Documents

Regional Health Status Indicators