SPRINGFIELD – The bottom line to a report about health concerns in Springfield is if you’re a person of color and living in or near the poverty line, you are facing health challenges that people who are white and/or making more money may not have to face.

While there has been progress made in the city of Springfield in addressing health concerns, however the concerns about infant mortality, lifespan, prenatal care, diabetes and asthma rates still remains.

The latest report from The Public Health Institute of Western Massachusetts shows that “Gateway Cities” in Massachusetts struggle with healthcare problems that are linked to poverty.

Jessica Collins, executive director of the organization explained to Reminder Publishing that Springfield is not alone with these problems and cities such as Holyoke, Brockton and Lynn – other Gateway Cities – have them as well.

“There is excellent work going on, but it takes a long time,” she said of addressing the health problems. She added seeing considerable progress, though, can take decades.

Collins believes with the increase of the minimum wage in the state, the health indicators will improve over time. Increasing a person’s work skills enabling a person to advance in his or her career is another way health outcomes are changed for the better, she added.

“We are moving in the right direction and are seeing change,” she added.

The last such report from the organization was in 2015. As noted in the introduction of the new report, “As discussed in the 2014 Health Equity report and continuing today, many Springfield residents, particularly those of color, experience numerous socioeconomic challenges which impact their health (e.g. limited economic resources, housing instability, food insecurity, poor housing conditions.) Systemic oppression and structural racism, such as racial residential segregation, limit opportunities for many people of color in Springfield to access the resources they need to achieve their full health potential. For example, Springfield residents have a median family income of $41,485, less than half the statewide median family income of ($94,110), and almost 30 percent of all Springfield residents live below the Federal Poverty Line (US Census, ACS, 2013-2017). Springfield residents of color continue to disproportionately experience inequities in these social determinants.”

Highlights from the report include:

• Life expectancy: “Although Massachusetts has one of the highest life expectancy rates in the nation (80.7 years), average life expectancy in most of Springfield’s census tracts falls below state rates. Estimates vary substantially across Springfield, with the lowest life expectancy of 70.3 years found in an area the Metro Center neighborhood and the highest life expectancy of 81.2 years found in an area of the Forest Park.”

• Premature births: “Springfield infants were born preterm (11.0 percent) and with low birth weights (9.6 percent) at rates higher than that of the state as a whole in 2016 (MA: Preterm – 8.7 percent, Low Birth Weight – 7.5 percent)(MDPH, Birth Dataset, 2016). In Springfield, noticeable differences in these rates continued to exist by race and ethnicity, with Black women experiencing the highest rates of preterm birth (12.6 percent) and Black and Latina women both experiencing higher rates of low birth weight (Black – 12.9 percent; Latina – 9.5 percent) than White women in 2016 (Preterm Birth-9.5 percent; Low Birth Weight – 7.6 percent).

• Infant mortality: “Springfield also continued to experience high infant mortality rates when compared to the statewide rate in 2014 (6.5 per 1,000 live births in Springfield vs. 4.5 per 1,000 live births statewide)(MDPH, 2014), with large disparities existing among communities of color. Blacks continued to have the highest rates of infant mortality (12.1 per 1,000), with rates over double that of Whites (4.6 per 1,000) from 2012-2014 (MDPH, 2012-2014). The infant mortality rate among those who are Latina was comparable to that of Whites (4.4 per 1,000).”

• Teen birth rate: “Springfield continues to have a teen birth rate that is substantially higher than Massachusetts as a whole. In 2016, the teen birth rate in Springfield (25.2 births per 1,000 female teens aged 15-19) was nearly three times the Massachusetts teen birth rate of (8.5 births per 1,000 female teens aged 15-19) (MDPH, Birth Dataset, 2016). When compared to all babies born in Springfield in 2016, babies born to teen mothers were more likely to be at risk of being born preterm (12.2 percent) and at a low birthweight (14.6 percent). In 2016, Latina teens continued to have the highest teen birth rate in Springfield (43 births per 1,000) at rates almost 6 times that of White teens (7.3 per 1,000) followed by Black teens (10.6 births per 1,000).” The report added, “Despite these inequities, significant gains have been made to lower the teen birth rate among all Springfield teens and to close the gap between the rate in Springfield and Massachusetts as a whole … The overall teen birth rate in Springfield has declined by 69 percent between 2006 and 2016.”

• Prenatal Care: “In Springfield, just under 80 percent of women received adequate prenatal care in 2016, which was slightly lower than that of the state as a whole (82.1 percent). Rates vary across racial and ethnic groups. Studies suggest that racial and ethnic disparities in receiving adequate prenatal care is linked to systemic injustices facing many individuals of color, including practitioners stereotyping women of color when providing care, and unequal education opportunities.”

•Chronic health concerns: “Latino/a and Black Springfield residents continued to be at substantially greater risk of experiencing complications from asthma than White Springfield residents … Springfield residents experienced higher rates of cardiovascular disease hospitalization compared to the state as a whole from 2012-2015 (1,672 vs. 1,248 per 100,000)(MDPH Acute Care Dataset, 2012-2015). People of color in Springfield were at disproportionate risk of being admitted to the hospital for cardiovascular disease. Latino/a Springfield residents were admitted at a rate 70 percent greater than that of White residents, while Black Springfield residents were admitted at a rate 40 percent greater than that of Whites... Springfield residents experienced high rates of morbidity from diabetes compared to the state as a whole with rates double that of the state (270 vs. 138 per 100,000) (MDPH, Acute Care Dataset, 2012-2015). Latino/a and Black Springfield residents were hospitalized for diabetes at a rate more than twice that of White Springfield residents.”

Collins said the air quality in the city has improved and added, “We’re seeing some headway in asthma.”

She added, “I’m not so confident about [progress in] diabetes and obesity.” Collins explained those two health concerns are a national concern and said, “That’s everywhere it’s not just a Springfield problem.”

Obesity can be addressed by steps the city has taken such as the installation of bike routes on city streets and significant changes in the food served by the city’s schools, Collins said.

The report came to several conclusions about the future. “Through continued collaboration, we can build on our prior successes and work together to advance a culture of health and create a healthier Springfield. Here are prioritized recommendations for how to strengthen our collective work to eliminate health inequities:

• Involve residents in interpreting data, identifying community based challenges and opportunities, and creating and testing solutions to address challenges.

• Ensure health is a shared community value by prioritizing well being and health in policy-making and community engagement – called Health in All Policies.

• Increase private/ business sector involvement in existing multi-sector collaborations to advance economic solutions that foster well being and create a healthier community for all Springfield residents.

• Encourage policies that decrease racial and socioeconomic segregation and increase opportunities for equitable access to high quality schools, grocery stores, and community resources.

• Prioritize action that will build economic prosperity for residents of Springfield.”