The health of every Bostonian is shaped by where we live: the daily conditions in our zip code deeply influence our social, behavioral, and physical health. Our neighborhood environment shapes how we feel and whether we have access to fresh, healthy food. Affordable and accessible public transportation, a clean climate, and available safe and affordable housing directly influence our health.
Boston is made up of 23 neighborhoods, and the health of residents living in them can differ dramatically — life expectancy for a Bostonian in the Back Bay has been estimated at 92 years, over 30 years higher than in Roxbury at 59 years. The Boston Public Health Commission reported that in 2015, the rate of premature death (before age 65) for Black residents was 31% higher than for white residents of Boston. Between 2015 and 2019, over 900 Bostonians died of opioid-related overdose. The daily tragedy at the intersection of Mass. Ave and Melnea Cass Blvd — which has become Boston’s epicenter of the converging homelessness, substance use disorder, and behavioral health crises — is unfathomable right in the middle of such a wealthy, asset-rich city.
Boston’s deep inequities in wealth and health are rooted in systemic racism. Racist policies and systems have and continue to determine where we live, reinforcing racial health disparities. In turn, these inequities hold us all back from reaching our collective potential across this city. Yet Boston is a world-class medical center as the home to leading hospitals, research institutions, and community health centers. Having lived these inequities in her own life and worked to address them for her district as a Councilor, Andrea has the vision required to dismantle this long-standing disconnect across the entire City. Andrea will drive health in every zip code, prioritize racial equity across all public health domains, and create innovative partnerships, programs, and initiatives that harness our unique assets. She will ensure that in Boston, health includes complete physical, mental, and social well-being.
As Mayor, Andrea Will:
Drive Health and Wellness In Every Zip Code
COVID-19 exposed deep racial inequities and painfully demonstrated how central our health is to every aspect of our lives — both as individuals, and as a community. Andrea will build a culture at City Hall centered on delivering cohesive health solutions in its core capacity as a local service provider. This approach will be more in sync with how residents live our lives — not in silos of individual service areas, but comprehensively throughout each neighborhood.
- Connect residents to health solutions. There are many programs, services, and systems available to Bostonians, but it can be difficult and demoralizing to navigate them. This dynamic reinforces stigma, exacerbates inequities between our neighborhoods, and wastes precious resources. Andrea will work to redesign service access so her administration can seamlessly connect residents to health solutions. Andrea will pilot dedicated staff positions to streamline, communicate, and connect the dots of the available programs and services across Boston’s communities. Their core mandate will be to ease the burden on residents by developing a single point of access to social and health services, using technology and innovative design.
- Leverage community health centers and schools. The infrastructure to take this neighborhood approach already exists in our robust network of Community Health Centers (CHCs) and Boston Public Schools (BPS). By necessity and by design, CHCs already work tirelessly to serve neighborhoods as centers of physical and behavioral health services and as social service agencies. As Boston recovers from COVID-19, kids will be in BPS every day to learn, eat breakfast and lunch, and access services. Andrea will ensure greater collaboration between CHCs, BPS, and City Hall to streamline services, deliver information, and efficiently utilize existing resources.
- Ensure every Bostonian has a primary health care provider. Evidence shows that having a primary care provider improves health, prevents visits to the Emergency Room, and helps mitigate and manage chronic disease. Working to connect every Bostonian to primary care services — that integrate behavioral health — is critical to eradicating health inequities and improving our City’s public health. To make this a reality, Andrea will prioritize and implement outreach campaigns for annual physicals and supporting residents in enrolling in MassHealth and other coverage options, in partnership with community health workers. Andrea will also prioritize dental health and equitable access to care.
Expand Our Definition of Health
Because health is undeniably shaped by where we live and how we identify, eradicating health inequities in Boston demands that we prioritize critical social, economic, and environmental factors beyond the health care system itself. Andrea will lead a cross-agency team to implement strategy that includes health in all policies and invests in structural aspects of communities to drive lasting improvements in health across neighborhoods.
- Provide pathways to economic mobility. Financial stability underpins health. To improve long-term health for Bostonians, Andrea will systemically invest in economic opportunity by increasing access to financial coaching, banking and savings, and high quality jobs, including in the healthcare sector itself, which is core to Boston’s economy.
- Address the housing crisis. We must ensure adequate affordable housing to set families up for healthier eating, better sleep, and more stability and security. Evidence shows that this is one of the most important and impactful ways to improve urban health. Boston’s hospital systems have demonstrated leadership in investing in housing as a core social determinant of health, and Andrea will expand these efforts to provide greater access to stable housing while leveraging innovative approaches to spur affordable housing growth across the City. Expanded efforts to address the housing crisis will also ensure residents who often struggle to find safe, affordable housing, including LGBTQ+ elders and veterans, have access to safe housing.
- Build a resilient food system. Access to fresh, healthy and culturally appropriate food is critical to achieving good health. In a City as service-rich as Boston, no one should be going hungry. Andrea will strengthen the City’s Office of Food Access and tap into Boston’s unparalleled expertise in food policy and entrepreneurship to tackle the complex challenge of food insecurity as a health, economic, and environmental priority. Under Andrea’s leadership, City leaders will drive coordinated efforts to ensure all Bostonians can access the nutrition they need to be at their best. These leaders will partner with health care providers who are investing in food as medicine, increase Bostonian’s utilization of proven, economically responsive federal nutrition programs like SNAP, WIC, and School Meals, and make healthier food less expensive and easier to access through incentive programs, innovative mobile and delivery programs, and encouraging greater urban agriculture.
- Treat the climate crisis as a health justice priority. We know that access to walkable pedestrian areas, safe crosswalks, traffic calming measures, clean air and water, and parks enables Bostonians to get outside, exercise, and maintain well-being. Andrea will expand bike lane networks, pedestrian paths, and active alternatives to driving, invest in resilient infrastructure to mitigate the risks posed by the climate crisis especially for our low-income communities and communities of color, and grow the city’s tree canopy to reverse the long-term decline in tree cover in our low-income neighborhoods in particular. With city-led investments and intentional zoning, Andrea believes Boston can adopt the globally renowned gold standard of sustainability of a 15-minute city, where residents have the amenities they need within 15 minutes of their doorsteps, that cuts commutes, reduces reliance on fossil fuels, and improves the health of residents and the environment alike. She will charge BPHC with rigorously tracking the disproportionate levels of exposure to lead, airborne particulates, and pollution in low-income communities in Boston, report the data regularly, and respond with programs that invest in both environmental treatment and prevention.
Activate City Health Leaders To Reduce Health Inequities
In a city with the best healthcare in the country, communities of color in Boston are disproportionately dying — not only from COVID-19, but also from preventable chronic illnesses, tragic gun violence, and treatable behavioral health conditions. Because we lack quality data, not enough residents — or even healthcare professionals — can understand these stark inequities. And we can only solve problems that we measure, discuss clearly, and prioritize.
- Build the #1 city health department in the United States. The pandemic demonstrated how vital a modern, 21st Century health commission is to Boston’s future. As we recover from COVID-19, Andrea will lead in transforming our local public health department to be at the forefront of public health innovation, build community and academic partnerships, and leverage best practices from local experts to inform action for citywide health with targeted strategies that address racial and economic inequities. She will elevate and refocus the mission and leadership of the BPHC, ensure Mayoral oversight, modernize the tools and resources at the Commission’s disposal, and build stronger partnerships with the healthcare community, nonprofits, and the private sector.
- Use data to inform the work. Without a clear plan, the data to make decisions, and capacity to execute bold plans, progress toward ending inequity will continue to stall. Holding BPHC accountable to specific measurable results will allow us to change the narrative on inequities, ensure everyone in our City understands the challenges of their neighbors, and take action to eradicate them. A public-facing dashboard will include key health system metrics such as disparities in poverty, employment, housing and other social determinants of health by neighborhood; gaps in access to care, including utilization of a primary care provider; mortality rates; sexual orientation and gender identity (SOGI) data; and key health behaviors.
- Invest in Boston’s healthcare workforce. The COVID-19 pandemic has disproportionately impacted those on the frontlines of healthcare, particularly in Boston as a medical center. As the backbone of our City’s health, Andrea will support healthcare workers and create innovative pathways to join the sector. 1 in 5 jobs in Boston are in healthcare — yet LGBTQ+ people and people of color are underrepresented in well-paid jobs and over-represented in lower-paid jobs — reinforcing both health and economic inequities. Andrea will establish an innovative healthcare workforce program that intentionally connects underrepresented groups to a range of healthcare careers. The program will increase access to quality jobs and build a pipeline of professionals who can provide patients with culturally competent care from someone who looks and identifies like them, which research shows improves health outcomes. To build this pipeline, Andrea will enhance public school curriculum to encourage students toward careers in health, particularly for LGBTQ+ students and students of color. To improve access to both jobs and ladders for professional growth in a healthcare career, she will strengthen, streamline and coordinate partnerships between institutions of higher education and major employers — including community colleges and community health centers –and fill employment and health care delivery gaps in social work, behavioral health, nursing, biotech, research, and beyond.
- Ensure equitable access to care and coverage. Quality medical services remain critical to prevention and intervention, and they must be available and affordable to all, regardless of one’s zip code, language, economic or immigration status, or sexual or gender identity. LGBTQ+ residents, particularly LGBTQ+ people of color, lack equitable access to culturally competent care at affordable prices. Andrea will work to ensure that Bostonians who often fall through the cracks in our health insurance system because they earn just too much to receive MassHealth but not enough to afford quality health care for their families have access to care and coverage. We must also use the lessons from COVID-19 to scale creative delivery models like telehealth and mobile solutions, which will require closing the digital divide, coverage for telehealth by all insurers, and use of standardized procedures and accommodation services for individuals with disabilities and limited English proficiency.
Support Youth, Working Parents, and Families
There is abundant evidence that we can disrupt cycles of poverty and inequity by supporting our children — in school, at home, and in our communities. Andrea will focus on our youth, including expanded healthcare screening and services for mental health and wellbeing, physical health, and contraceptive and sexual health for adolescents, especially our LGBTQ+ youth, which are too often overlooked. She knows that to support our kids, their parents and caregivers must be set up for success too.
- Fight for reproductive justice. Andrea will fight for reproductive justice and access to reproductive health care for Bostonians. She will advocate for the state to protect and enforce the provisions of the ROE Act to make abortion care and family planning services accessible and make reproductive healthcare, including contraceptive care, affordable and equitable for all Boston residents. Andrea will work to expose fake anti-choice health centers, known as “Crisis Pregnancy Centers,” that intentionally provide medically inaccurate and dangerous information to those experiencing pregnancy.
- Champion state efforts to expand MassHealth maternity coverage. Andrea believes we must work with leaders at the state level to ensure all eligible women and people who menstruate have continuous MassHealth coverage to include the entire 21-month period from the beginning of pregnancy to a year after delivery, or are seamlessly enrolled in Health Connector plans. Coverage should include doula services for prenatal care, labor and delivery, and postpartum care; in-home postpartum visits with newborn care services; postpartum depression screening and treatment, and infant feeding support. She will advocate for screening and support for preventable high-risk pregnancies and payment for increased postpartum care visits to manage gestational diabetes, hypertension, postpartum cardiovascular and other conditions that disproportionately affect women of color.
- Eradicate maternal and infant mortality. While there have been improvements, the United States continues to meaningfully underperform our high-income country counterparts with regard to maternal and infant health. These devastating outcomes are markedly worse for communities of color, with mothers experiencing severe maternal morbidity during labor and delivery, resulting in acute medical conditions with lasting consequences. In 2015, BPHC reported that the rate of infant mortality was 8.1 per 1,000 live births for Black infants and 9.8 for Latino infants as compared to 1.7 for white infants. Andrea is committed to measuring inequities in maternal and infant outcomes, understanding the strategies that have worked to improve them, and addressing systemic racism and racial bias underlying them and leading to differences in access to and quality of care. She supports the new law mandating a commission study on maternal health and the underlying drivers of racial disparities of maternal mortality. As Mayor, Andrea will push the legislature to adopt the recommendations of the commission to address systemic racism and racial bias in maternity care.
- Invest in early education and childcare infrastructure. Andrea will continue to champion efforts to build a robust childcare system throughout the City in partnership with state leadership, local employers, and providers working together to close gaps in funding and capacity. With the right infrastructure, childcare centers and family childcare providers can offer more families high quality care, serve as access points to other services, and recruit and retain talented staff. High quality and affordable childcare means parents and guardians are not prevented from being employed nor must they spend a disproportionate percentage of earnings on childcare.
Address Violence and Trauma
The impacts of trauma – from poverty, violence, homophobia and transphobia, and racism – influence both our behavior and our health. Transgender people of color face violence at alarming rates, with over 40 individuals murdered nationwide in 2020. We must address racism and gun violence as the public health crises that they are, particularly for economically disadvantaged communities of color, and respond with programs and services that are built to eradicate the racial and systemic inequities that perpetuate cycles of violence, trauma, and poverty.
- Treat racism and gun violence as public health crises. According to the BPHC, the homicide rate for young Black males in Boston is 32 times that of young white males. Under Andrea’s leadership, the City will lead on a coordinated approach to violence prevention and violence response with greater communication between City departments, service providers, and the communities that are facing violence and trauma, deploying best practices such as the HUB model. To address gun violence, we need to rigorously collect and utilize data and take a coordinated, case management approach. Andrea will convene Boston’s public safety, criminal justice, faith-based, community leaders and researchers to understand best practices, build evidence-based approaches to addressing urban violence and trauma in Boston communities, and then implement what works. Our communities deserve a strategy that is targeted to where violence is, and is grounded in data and transparency.
- Scale trauma-informed programs. Andrea will work in partnership with the leading nonprofits, community organizers, and Boston’s public health and safety agencies to implement and scale best in class trauma-informed programs. This is critical to better support residents who are re-entering from prison and too often face significant gaps in healthcare services upon leaving the system, as well as people who are suffering the impacts of domestic violence and gun violence.
- Stand with survivors of domestic violence and sexual assault. Domestic violence and sexual assault are public health issues. Survivors frequently do not feel heard nor do they receive adequate services, protections, or justice. She will convene a city commission including advocates, survivors, law enforcement, and the DA’s office in a robust, consistent conversation about system improvements, loosely based on high risk team models, that will provide an opportunity to present cases, challenges and suggestions for reform. Andrea has and remains committed to elevating the voices of survivors and investing in prevention to reduce incidents of domestic violence and sexual assault in our communities. All sexual violence efforts will be inclusive of the LGBTQ+ community.
Invest In Mental and Behavioral Health
In addition to trauma-informed care, mental and behavioral health care and recovery services are foundational to Boston’s overall health. In response to the public health crises facing our city, including COVID-19, mental and behavioral health, substance use disorder, and chronic homelessness, Andrea will establish dedicated leadership over a coordinated public health response, fund innovative initiatives, and decentralize recovery services from the area around Mass & Cass so that they are accessible Citywide. Under her leadership, Bostonians will shift the mental health narrative away from stigma and toward understanding, acceptance and compassion.
- Redirect funds from police to mental health crisis responders. Andrea will reduce police overtime costs and reallocate funding from the police department to licensed mental health, substance use, and domestic violence counselors who can better serve residents in need, especially in non-violent situations. This approach reduces the trauma experienced by both police officers and residents alike and enables our first responders to bring the right resources to Bostonians in need.
- Integrate behavioral health into primary care. Bostonians need greater access to mental and behavioral health services, whether it is for short term, long term, or intensive care. Access to mental and behavioral health professionals should be as simple as a connection made during a primary care visit. Andrea’s health care workforce development program will help address this pervasive yet not openly discussed health challenge, and enable more accessible, diverse, and well-trained professionals to reach more patients. She will also invest in training and capacity development for community health workers to be able to address mental health needs, and refer to other providers as necessary — an evidence-based strategy that can reduce stigma around mental health, increase access to services, and provide culturally appropriate care.
- Tackle the public health crisis at Mass & Cass. To address the opioid crisis, and the underlying chronic conditions driving this epidemic, Boston must be creative, courageous, and community-driven in implementing solutions. Andrea has a plan to increase access to shelters, decentralize recovery services throughout our city, and dedicate the necessary resources and leadership.
Andrea’s public health agenda is grounded in her personal experience, fundamental to her vision for Boston, and driven by her belief in healing communities through thoughtful action. By being transparent about the deep inequities that drive health outcomes, connecting residents with comprehensive health solutions, and taking a holistic, neighborhood approach, Andrea will close these gaps and build a healthier, more equitable and resilient city for all Bostonians.