all right welcome to the February Board of Health public meeting City R please stand for the pledge of allegiance to the flag United States of America to the Republic for which it stands one nation God indivisible
liberty and justice for all all right again welcome and uh my name is Dr Drew bunker I'm the chairperson of the Board of Health with me tonight is to my left Kathleen Savage board member and uh vivana katano also board member invited Municipal staff is Lauren
Buck who's director of Public Health Michael Wells who's Health agent and director of inspectional services and Paula SUV who is Board of Health clerk today we will um discuss some topics first being uh review and approve the minutes from the January 23rd 2025
meeting so just ask the other board members if they approve of those minutes yes I approve the minutes I approve of minutes excellent great so next is going to be the public health communicable I also approv the minute sorry next is the
public health communal monthly report with Lauren buck oh thank you um okay so for the February uh communicable monthly report uh we've had a significant increase in influenza cases we had 528 over the last month which is a significant amount um just a
reminder that it is still up a respiratory um infection season and you know flu vaccines are out there staying home if you're sick all you know going to a doctor if you're sick are all super important um because that is an extremely high number for one month
again 528 cases of influenza this month for the city of Rivier um second the public health update so the Massachusetts Department of Public Health has issued guidance regarding priorities for surveillance of the h5n1 that's the Aven flu that's been in the news lot recently for residents
h5n1 human cases have been rare in the US and primarily associated with direct contact with infected commercial chicken and turkey flocks or infected dairy cattle no human cases have been identified in in Massachusetts most confirmed uh human cases have been mild
however severe disease is possible and there has been one fatality in the US reported in an individual with pre-existing health conditions there have been no human cases of h5n1 in Massachusetts and surveillance from milk sorry surveillance of milk from dairy Cal hards in Massachusetts has remained
negative h5n1 is widespread in waterf in wild waterf in the Commonwealth uh next new provisional data from the cdc's national Vital Statistics system predict a nearly 24% decline in drug overdose death in the
United States for the 12 months ending in September 2024 compared with the previous year this is the most recent National Data available and shows a continued steep decline in overdo deaths um this is National Data and I just want to say data specific to Riv and Massachusetts is not available for 2024
yet it usually comes out sometime in the spring in which we will update um the members at that time all right right thank you next is the inspectional services monthly report with Michael Wells thank you Dr bunker inspectional Services report for the month of
February is as follows in two area housing division We performed 136 Certificate of Fitness inspections We performed 15 Certificate of Fitness reinspection two interior complaint re-inspections and one uh pool inspection on the food
inspection Vision We performed 32 routine inspections five reinspection two complaint inspections one pre-opening inspection and six temporary Food Service inspections on the XT area sanitation division uh violations issued
accumulation of litter garbage trash and debris was 28 carts outed improper times was five dumpster overflowing violations were 46 improper placement of garbage trash and bulky items was 499
one violation for um junk keep um illegally parked Vehicles one violation for Road and hridge one violation for unclean unsanitary land and um 208 violations for snow and ice
um I just want to repeat as I have in the past couple meetings um during storms it is the responsibility of the uh property owner residential and businesses uh to remove the snow in front of their property on the corner of their property to clear um so we can
ensure we have clear Pathways for all of our citizens and residents that are um walking on foot throughout our city thank you thank you Michael next is going to be the um Regional epidemiologist presentation from
Vanessa g menar hi are you able to hear me yes we can perfect so I'm going to go ahead and share my screen give me one second as I set up perfect so thank you for inviting me today I will be sharing some findings
that I have from the community health assessment part of my work has been completing this health assessment for the cities of reier Chelsea and winol and the main purpose of this assessment as a reminder for everyone is really to
identify and prioritize the needs of those living in these areas with an emphasis on diverse population and those experience and equities we are doing this through a survey focus groups and interviews and the goal is that
afterwards we will come up with a community health Improvement plan with this plan we will strategize with different cbos municipalities and residents to come up with goals for the next three to five years we have been
conducting the health assessment for about four Cycles now we work alongside with the hospitals and that includes Beth Israel Cambridge Health Alliance and MGB and we work together to share the data to make sure that we're not having any duplication and to prevent
suring fatigue among residents so really guiding this assessment are these four principles that I have here the first one being Equity the entire purpose of this health assessment is to work towards the systematic Fair treatments
of all people and the way we do this is through collaboration we have concluded with a steering committee and the steering committee is helping with the Outreach in order to Target vulnerable populations and get the survey in focus group group out we are intentionally
engaging with people to make sure that those who are not often heard are being reached out this time and of course always being very intentional with what questions are asked and what the purpose of those questions are so what I'm showing next is a timeline and this is a
timeline we're working for for the health assessment the kicked off was around August that is when at MPC we reached out to various members from all three municipalities to form the steering committee it consists of 20
active members and we meet every 3 to four months to go over material since of August we have been working on data collection both secondary and primary data collection for secondary data collection they just
pre-existing information that we're getting from online public sources and then the primary data collection has consisted of the survey that we worked alongside with hospitals and steing committee members to get input and then the focus groups with the one1
interviews this is still open at the moment so the information I will be sharing in a bit are all preliminary data that has not been finalized but the survey and interviews will stay open until the end of April and by then we
will be able to start working on areas to prioritize to come up with our Health assessment but also our Improvement strategies and Target specifically Vanessa do you mind putting it in presentation mode the um the
PowerPoint yes of course give me one second if it can't or you don't want to that's fine I just it just be a little bit easier to see yeah yeah of course let me just stop sharing my screen for a second and just reshare it
okay is it full on your end yes great that looks great thank you oh amazing um thank you for letting me know so the remaining information will be focused on just rever data let me just go back one yes it will just be all rever data so
what I have here is a list of secondary data that I have pulled we have been pulling data from the US and Bureau the behavioral risk fa Factor surveillance survey the youth risk behavior survey um data from the CDC and National bio
statistics the Massachusetts Community Health Equity survey and then other local sources of data in revie specifically working with Cambridge Health Alliance we have conducted six plus interviews we have conducted an interview with a clinical social worker
from Cambridge Health Alliance with uh educator who was focused in environmental justice the director from rier Community School someone from the disability commission someone from Myra and then a few residents from R itself
from the survey we are currently at 42 respondents and then we have conducted seven focus groups one was arabic speaking group from the rier Arabic community two of them have been from health workers one group was from the
Cambridge Health Alliance um Health worker and the other one was from MPC community health workers we have done one focus groups with the housing family one focus group with the woman encouraging empowerment and then two focus groups with the Regional Mental
Health Team and looking at these surveys itself from the 402 which is a combination from North suffk but also Cambridge Health Alliance I have here some of the
demographic datas that we have gotten so far so about 38% of respondents report a language other than English as their primary language spoken 68% of respondents have been women so far 133%
identify as having a disability and then 10% identify as any of the following gay lesbian asexual bisexual pansexual quear or questioning I also have the breakdown from race
ethnicity and also age so looking at race we're looking at about 39% identify as Hispanic following with about 20% identify as white 18% as
black/ africanamerican and 9% as Asian this does not include the full breakdown I just selected the top four as an overview for day and then for age I have the following breakdowns under 18 18 to
24 24 to 44 45 to 64 and 65 plus with the percentage for rever given that the survey and focus groups are still ongoing we have not decided what the priorities are for this health
assessment the steering committee is meeting next month with the goal to start the beginning conversations of this that being said the survey was Guided by the previous Health assessment conducted in
2022 so as a result from the basic findings I have looked at we are pretty confident that the priorities will remain pretty much the same or at least big pictures will so for the purpose of this meeting I have kept the four
priorities that were identifi in 2022 to provide some of the breakdowns for the following data so in 2022 it was identified the housing behavioral and mental health economic stability and mobility and environmental
health were the four priorities that emerge so using those categories I have P data from the current health assessment and looking at the first category of housing what we have here as primary
concerns these concerns are from the focus groups and interviews there have been mentions about um issues with affordability there's an increased High Cost of Living there have been mentions of displacement and also
gentrification and there have been mentions of overcrowding due to cost and limited housing availability from the survey end about 48% of review respondents when ask what they would like to improve in their
Community selected more affordable housing this was the number one response for this question and this was also the number one response for rier residents in 2022 for that Health assessment 32% would also let you see better access to
housing support services and about 16% um either selected disagree or strongly disagree agree with the statement about feeling secure about their current housing
situation and then one of the questions was asking if they had any issues paying for the following blink items in the past 12 months and about 31% stated they had trouble paying for either rent mortgage house taxes or house insurance
and these themes are pretty similar to the previous findings from 2022 the next theme that was identified previously was behavioral and mental health and again similar pattern from the concerns from the focus groups there
have been mentions of social isolation concerns among older adults and this has been connected to the increase of Casino usage there have been mentions about concerns about navigating the behavioral health system and a generalized concern
among youth Mental Health in the bottom there is a bar graph this bar graph comes from the survey itself it was a question asking if there were any barriers with access in mental health care and what those barriers are
about 21% of people did say they did not face any barriers but among those that did select something 19% stated that cost was the main concern followed by fear of discrimination SL and then lack of information on
available service continuing on from the survey about 28% a reviewer respondents selected mental health as one of their top five mental oh top five health problems that latter the most in the community and then overall one of the
questions was asking about the mental health of people in their community and about 54% described it as either fake or poor that being said 73% do believe that the healthc care in R does meet the
mental health needs of people um like them and that's based on their demographic features the third theme identify was economic stability and Mobility this from the focus group and the surveys were pretty similar with the
themes that emerged that being limited opportunities for career advancement economic insecurity and then High Cost of child care when it comes to main barriers for finding slash maintaining employment 30% dis select limited
opportunities for career advancement followed by just lack of job openings in their field um and language barrier 10% did select that they did not face any barriers in rev specifically when they
asked about if they're satisfied with the economic opportunities in um R about 32% dis disagree or strongly disagree when it came to selecting top
five concerns for them 45% did report wanting better access to a good job and about 21 responded wanted more affordable child care in their City the last theme that was identified
previously was environmental health and from the focus groups conversations that came up was regarding water safety and that included both drinking water at home but also water from the beach there was concerns about lead and housing and
water pipes and then the concept of this lack of physical open space for people to attend in general most people dis select that they wanted to see less environmental health
issues and that included less trash and litter less air pollution and less noise pollution and it was about 25% across and one of the questions was asking about their housing environment
and about 11% strongly believe or believe their house is not safe from pest and mold and of good quality that being said this survey and this health health assessment is still going on it is in the process of being
wrapped up in the next month or two so we are hoping to see more respondents in 2022 there are about 700 for review so we are aiming for about the same sample size this round next month we'll be having conversations about what the
priorities are they may change and they may not be the same to the ones I just mentioned but those conversations will be going and once we determine these priorities we will able to really do exploratory data analysis to really
understand how socioeconomic factors impact the priorities what I provided for today is just overall descriptive stats it is not stratified by age it is not stratified by race ethnicity or other factors but it will be by the
final report and then Cambridge Health Alliance has started listening sessions for re rev residents going over their findings we are hoping to follow and doing our listening sessions around June for residents and cbos that were part of
it and that is what I have for today if anybody has any questions that I can help clarify but I can stop sharing my screen thank you thank you Vanessa uh any questions from the board or yep go ahead um I have a couple of
questions Vanessa what specific day doeses the survey close yes so the survey will be closing early April there's no end date at the moment given that we are working with Chelsea and Winthrop and we're coordinating with other hospitals and
communities it is going to be a flexible end date but early April at the moment um and have you has the survey been posted on like the city of Rivier social media Pages another and then another question Lauren that occurs to me is I I
know Maddie and I forget the official name of their department now they used to be known like the ambassadors the health ambassadors and I know they're incredible at getting survey respondents I know for that um walk bike enroll
survey they were a huge player in helping us get some of that data they got like 800 responses because they helped a lot with that so um my question is can we can we ask them to help really push this because I think if we get a
lot more people to participate our data will be even better so like if we could double this number to 800 that would be amazing yeah we can definitely have the community asson help thank you thank you for that suggestion I will
reach out shout to Lauren afterwards and Viana maybe so I can follow up with the contact information thank you uh actually Vanessa um do you have any plans so I noticed uh that your numbers for the 18 to 24 year olds are
the lowest those are tough people to get do you have any particular strategy or plan to reach them for r i don't have I don't have a solution for you but I'm curious if you have something you have thought of yes so they are the lowest demographic feature
at the moment we are planning on holding some events at the library and hoping that we can possibly advertise there but it has been hard to get that group to take the survey okay I think for because I think for the community health needs
assessment um what what I did for the walk bike and roll and I believe I did it for this as well is we send it to the high school libarian and offer the kids community service hours for taking it so I send them back an email saying you
know show this to your uh vice principal showing that you did take the survey and and so I think we got at least some responses from the high school but I think this 18 to 24 year olds are a little bit tougher to get because where are they right they're in college um are
there any incentives for residents to take this survey like um are there gift cards or is there some incentives tied to this that we can promotee there are incentives for the focus groups and interviews if needed we
can discuss doing an incentive for the survey there isn't at the moment but having the incentive at the high school for seniors was a really big help for getting the under 18 so we're definitely willing to have those conversations if it comes down to
it um and then another Vanessa another place where like if you could get a team um I know like the First Congregational Church is serving a lot of people um like 80% of their clients are from RE um
and that might be like a good group to go visit I know they they service Folks by alphabetical I think is their last name so they don't see everybody the same week but I think they get a good amount of people that might be like a good location for you to collect some
surveys another place again if you had boots on the ground this is what I would do another place um where you can get like a lot of people uh if you had a team collecting surveys would be uh like the faith based organization so again First Congregational Church Immaculate
Conception um the 12:00 mask gets packed with like 500 people so if you had I don't know if you had a team and some incentives for folks to pause a moment or or promote like QR code for people to take the survey um thank you
thank you that's a great idea I will reach out I am doing iners Outreach so an iners survey so I will definitely contact them and see if I can set something up great thank you so much that will conclude this month's meeting thank you
everyone for being here for