Boston Public: Transforming a city department to eradicate racial disparities in health outcomes

Barbara Ferrer, executive director of the Boston Public Health Commission, is leading one of the forward-thinking health departments of any jurisdiction in America.

"Right now in Boston black babies are dying at the rate of four times that of white babies, a rate that white babies didn't die of 25 years ago," Ferrer says. "The problem is profound and has been long standing and I think that's why it's a particular challenge for us as a health department to figure out exactly what we could do around problems of inequity and infant mortality rates and obesity rates. For so long we've lived with those disparities and accepted them. I think that's wrong because it's unfair that because of the color of their skin some people die earlier than others."

Ferrer has initiated a racial and social justice initiative that aims to reduce the gap between black and white residents in several key areas, such as infant mortality, obesity and sexually transmitted diseases.

To support the initiative, she says there should be no place in the offices, clinics and hospitals under the Boston Health Department, where patients receive unhealthy foods. "There should be no place where people have access to sugar sweetened beverages because we know that that hurts them, especially people of color. We should ensure that all of our children who go to Boston Public high schools have good access to health information around sexually transmitted infections and that means shifting up some resources and moving to combat those issues."

Moreover, she says that each of the 1,200 employees of the Boston Health Department will undergo extensive training to help them understand how racism impacts health. More than 50 people, working for the past year, designed the professional development training. "We want them to know the social determinants of health and what we can you can do about it as a health department," she says. "Our obligation is to ensure that people become healthy, stay healthy and that we prevent disease. Right now in America you just can't do it without tackling the racial and social injustice issues."

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