Cambridge, Massachutts
2013 RWJF Culture of Health Prize Winner
A Tale of Two Cities
Go to the city of Cambridge, Massachusetts, and stand outside the city’s health department. Look in one direction and you’ll see housing developments and a school serving the low-income families who call the area home. Turn your head 90 degrees and you’re looking down to Kendall Square—one of the most dense hubs of education and innovation in the country.
The city is famous for the elite institutions of Harvard University and the Massachusetts Institute of Technology, for its information technology and biotech scenes—yet parts of Cambridge struggle with immense poverty and public health challenges.
Cambridge is really a two-city city,” in the words of Ellen Semonoff, assistant city manager for Human Service Programs for the City of Cambridge.
"The demographics of Cambridge are a little bit unusual,” she says. “We’re really a city of the rich and the poor. We are in the midst of Harvard and MIT, and yet more than half of the children in our school system grew up and live in subsidized housing. We have a very large population of immigrants in this community. More than 50 percent of our children are children of color—and yet about two-thirds of the adult population is white.”
Effectively serving the public health needs of such a diverse community requires a “culture of collaboration” where government agencies, businesses and non-profit organizations come together to identify and address needs. The health department has been a major force in forging these alliances.
The Let’s Talk campaign brings knowledgeable ambassadors right to a family’s home so that the opportunity to learn happens right where the family lives. The goal of the program is to help the parent do the best job possible in helping their child succeed in school.
Semonoff’s ultimate goal for a healthier Cambridge is that a child born in one of the city’s housing developments has access to the same opportunities to lead a healthy and successful life as a child born in of the city’s more affluent homes—especially in a city of so many resources.
There are many opportunities in the city to engage with families,” she says. “The consensus in the city is that if we can start early, if we can reach parents in the maternity wards, we can help parents understand that they’re their children’s most important teacher and the rest of us are trying to surround them and help support them in their most important job.”
With a community so focused on the health and well-being of children, many of whom are from immigrant families, literacy is especially important. The Let’s Talk literacy ambassador campaign brings knowledgeable ambassadors right to a family’s home so that the opportunity to learn happens right where the family lives.
“When a literacy ambassador goes to visit a family, the goal of that visit is really to help the parent do the best job the parent can do in helping their child succeed in school. The literacy ambassador’s job is to bring books, and to explain to parents what’s the best way to talk and read to your child,” says Semonoff. “Parents know many things and the opportunity for the literacy ambassador—someone who already has a connection with that parent—to be the voice of support, makes a huge difference.”
The city has also seen great success with its Men’s Health League, a program that reaches out to men in the community who, while they’re making sure their families are taken care of, might not seek out health care for themselves. The initiative is especially focused on men of color and those that have been impacted by the burden of chronic disease.
This initiative reaches out to men in the community who, while they’re making sure their families are taken care of, might not seek out health care for themselves. The Men's Health League addresses heart disease, type 2 diabetes and other chronic disease among men of color.
Cambridge is home to the second-largest local health department in Massachusetts, but creating a healthier community… takes a village. The health department is a part of Cambridge Health Alliance, a healthcare system with three hospital campuses and an extensive primary care network, giving it the unique ability to fully integrate the provision of public health with related community health efforts, according to Claude-Alix Jacob, the Chief Public Health Officer for the city. Jacob oversees the operations of the Cambridge Public Health Department.
"Our core functions—gathering data, leveraging services, designing policies that work—allow us to not only be a part of the architecture of the Cambridge Health Alliance, but also to leverage resources with some of our partners, say with public safety, or emergency preparedness. So a lot of our planning efforts are tied into partnerships with the fire department and the police department. A lot of our activities on the wellness promotion side tie in with human services and community development.”
Semonoff says the Cambridge Health Alliance allows a level of collaboration and knowledge that would otherwise be very difficult to provide the residents of Cambridge.
“That means that as a health department and as a community we’re able to draw on resources that are way beyond the capacity of any one health department. When we’ve faced issues in the city—whether it’s trauma or flu, whatever the situation is—we’re able to draw on the rich opportunities and resources of the Cambridge Health Alliance.”
And, as with many of the other public health efforts in Cambridge, it’s built on a foundation of partnership.
"If there’s one thing we’ve learned in the City of Cambridge it’s that there is no one entity that can solve any particular problem,” says Semonoff.
When you take the expertise of the health department and you join that expertise with the community agencies and the human services department and the police department—if we join these efforts together, we have a much greater opportunity to actually have impact.
Ellen Semonoff, assistant city manager for Human Service Programs for the City of Cambridge