Obesity and Tobacco Use Prevention
“INCREASING ACCESS TO HEALTHY, AFFORDABLE FOODS THROUGH FARMERS' MARKETS AND URBAN GARDENING OPPORTUNITIES IS A CRITICAL PART OF OUR OBESITY PREVENTION STRATEGY. THE NEIGHBORHOODS WHERE OBESITY RATES ARE HIGHER ARE THE SAME NEIGHBORHOODS WHERE WE HAVE MADE PROGRESS ON INCREASING ACCESS TO AND LOWERING THE COST OF FRESH, HEALTHY FOOD. BUT WE STILL HAVE MORE WORK TO DO.”
— Thomas Menino, Mayor, City of Boston
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“I WAS A THREE-PACK-A-DAY SMOKER FOR ABOUT 20 YEARS. WHEN I WENT TO GET A FLU SHOT, A LADY GAVE ME A PAMPHLET AND EXPLAINED THE PROGRAM AND FREE PATCHES ... I'VE GAINED MY HEALTH BACK. IT'S BEEN A FABULOUS PROGRAM.”
— Michael, Boston resident and smoking cessation participant
Communities Putting Prevention to Work (CPPW) is an initiative designed to make healthy living easier by promoting environmental changes at the local level. Through funding awarded by the Centers for Disease Control and Prevention in 2010, a total of 50 communities are working to prevent obesity and tobacco use—the two leading preventable causes of death and disability.
Boston, Massachusetts, is tackling obesity and tobacco use throughout the community. Obesity in Massachusetts is a concern, as the overall adult obesity rate in the Boston metropolitan area is 22%. Among Boston high school students, the obesity rate is 15%, which is comparable to the national rate. Obesity is disproportionately prevalent among certain racial and ethnic groups. The obesity rates among black adults (32%) and Hispanic adults (30%) are almost twice the obesity rate among white adults (17%). Further, nearly 40% of Boston's 617,594 residents are black or Hispanic.
Tobacco use prevention also is a priority health focus. In the Boston metropolitan area, the adult smoking rate is 14.4%, which is comparable to the state adult smoking rate of 14.1%. Tobacco use is a particularly serious problem among Boston youth. Approximately 10% of Boston high school students reported smoking a cigarette in the past 30 days.
If healthy options are not available, then healthy living is not possible. With the support of the CPPW initiative, Boston has implemented a variety of changes throughout the community to make healthy living easier.
To decrease the prevalence of obesity, Boston:
- Launched Hubway, a bike-share program that encourages active transportation by offering residents access to 600 bicycles at 61 bike stations. Local officials and planners estimate that Hubway will generate 100,000 trips in its first year.
- Trained 82 Wellness Champions to increase quality physical activity across 59 Boston elementary, middle, and high schools representing nearly 22,000 students.
- Developed point-of-purchase signage to encourage Bostonians to choose healthy drink options in lieu of sugary drinks. On April 7, 2011, Boston implemented a policy requiring city departments to take steps to phase out the sale, advertising, and promotion of sugar-sweetened drinks on city-owned property over the subsequent six months.
To decrease tobacco use, Boston:
- Launched the city's first-ever nicotine-replacement patch giveaway to help drive smokers to the Massachusetts Smokers' Helpline. Since the launch, more than 2,400 smokers have called the quitline to access free quit assistance and free nicotine-replacement therapy.
- Worked with the Boston Housing Authority to amend their occupancy guidelines to accommodate the transition to smoke-free housing. The shift to smoke-free buildings currently is in progress. Once complete, it will enable more than 27,000 residents to be protected from secondhand smoke exposure in their homes.
- Funded and provided technical assistance to five nonprofit community development corporations to offer new smoke-free housing. This effort will protect an additional 4,199 residents from secondhand smoke exposure.
(The list above is a sample of all activities completed by the community.)
Boston is increasing access to fresh fruits and vegetables through community gardens that enable low-income residents to grow produce in their own neighborhoods. To date, approximately 200 youth and adult volunteers have helped to plant 250 raised garden beds, which are making fresh produce available to more than 2,000 low-income residents. Additionally, through the opening of the Roxbury Greenhouse, affordable produce now is available to a neighborhood with one of the highest obesity rates in Boston.
Health Care Providers Increase Tobacco Cessation
Boston is working closely with health care providers to decrease tobacco use throughout the city by incorporating tobacco assessment, counseling, and referral practices into overall wellness and treatment plans. Participating providers include eight pediatric departments, serving approximately 30,000 patients; and nine oral health clinics, serving an estimated 28,000 patients. During the three months of implementation, the oral-health clinics assessed more than 4,127 dental patients for smoking, and 316 of 682 self-identified smokers accepted referrals to a smoking cessation treatment service. By changing current operational procedures, the health centers have increased the volume of tobacco screening and referrals.
The leadership team includes high-level community leaders from multiple sectors, who have the combined resources and capacity to make healthy living easier. Members of Boston's leadership team are key agents for change in their community. The leadership team includes representatives from the following organizations:
- City of Boston Mayor's Office
- Black Ministerial Alliance
- Boston Alliance for Community Health
- Boston Collaborative for Food and Fitness
- Boston Conference of Community Health Centers
- Boston Fire Department
- The Boston Foundation
- Boston Housing Authority
- Boston Public Health Commission
- Boston Public Schools
- Boston Redevelopment Authority
- Boston Transportation Department
- Brigham and Women's Hospital
- Carney Hospital
- DentaQuest Foundation
- Harvard School of Public Health
- John Hancock Financial Services
- Massachusetts Department of Public Health
- Northeastern University
- Partners HealthCare
- Strategic Alliance for Health
- Trinity Financial
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