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Back Bay to Nubian Square: 2 miles and a 23-year life expectancy gap

The corners of Dudley, Mt.Pleasant and Dearborn Streets in Roxbury. (Jesse Costa/WBUR)
The corners of Dudley, Mt.Pleasant and Dearborn Streets in Roxbury. (Jesse Costa/WBUR)

In Boston, a two-mile difference in where you live may mean a 23-year difference in life expectancy.

That startling analysis from the Boston Public Health Commission shows the longest average life expectancy is nearly 92 years, for residents in a section of the Back Bay. Residents near Nubian Square in Roxbury have the shortest expected life span, just under 69 years.

“It’s really disturbing,” said Boston’s Public Health Commissioner Dr. Bisola Ojikutu. “So much work has gone into improving life expectancy for individuals. It feels discouraging.”

The two neighborhoods, highlighted in a report released Friday, are vastly different in many ways. The median household income of the census tract within Roxbury is $42,211, versus $141,250 in the Back Bay tract. Rates of homeownership in the Back Bay are more than double those in Roxbury.

A vast majority, some 91%, of Back Bay residents over the age of 25 have a college degree, compared to 44% in Roxbury. And 82% of residents in the Back Bay tract are white, while 87% in the Roxbury tract are people of color, predominantly Black or Latinx, the report said.

Many factors play a role in life expectancy. Ojikutu said the stress of trying to live on low wages and combat racism, sometimes in substandard housing while not feeling safe, erodes health.

“Chronic stress leads to higher blood pressure and an increased risk for cardiovascular disease,” said Ojikutu. Chronic stress can also increase levels of the hormone cortisol, which can “increase your risk of weight gain, obesity, and diabetes.

"I think all of these things are interconnected,” she said.

Dr. Bisola Ojikutu, Executive Director of the Boston Public Health Commission, on Dudley St. (Jesse Costa/WBUR)
Dr. Bisola Ojikutu, Executive Director of the Boston Public Health Commission, on Dudley St. (Jesse Costa/WBUR)

Some researchers call the impact of chronic stress “weathering,” an analogy to the wear and tear of steady storms to describe how stress can age a body.

The report showed a much smaller gap, five years, between Roxbury and the Back Bay when all of the census tracts in each neighborhood were combined. Ojikutu said the report pulls out gaps by census tract to make sure areas with the greatest need get more attention.

COVID-19 contributed to a decrease in life expectancy for all Boston residents, but the impact varied by race. Life expectancy dropped by about one year for white residents, compared to three years for Asian and Black residents, and four years for Latinx residents, the report said.

The commission’s finding of a gap in average life expectancy as large as 23 years was unsurprising to those who live or work near Nubian Square.

“Just hearing the number is weathering for me. I’ve heard about these health gaps for years,” said Rev. Jeffrey Brown, associate pastor at the Twelfth Baptist Church in Roxbury. “The struggle to find ways to make it better is wearying.”

Brown said he can offer church members spiritual relief, but government must deal with the underlying problems: poor schools, unemployment or underemployment and failed housing policies.

With housing, Brown described a paradox. Roxbury residents have few opportunities for home ownership and the upward mobility it offers because so much of the area's housing is designated affordable and not available for sale. Boston City Councilor Tania Fernandes Anderson, who represents residents near Nubian Square, echoed Brown’s concern. She’s investigating rent-to-own housing options.

“In this incredibly resource-rich city, we still have these persistent challenges. We have people dying before they should. We should all care about this.”

Dr. Bisola Ojikutu

Anderson often cites a 2012 report from the Center on Human Needs at Virginia Commonwealth University that showed a 33-year life expectancy gap between similar census tracts in Boston. Anderson said she wonders if another report will make any difference.

“How many people will pay attention to it I don’t know,” she said. “I just want us to be sincere and actually prioritize the most vulnerable in our society.”

The new report shows an improvement in the estimate for lowest average expected life span, from 59 years in 2003-2007, to 69 years in 2015-2021. The estimate for the highest life expectancy remained nearly unchanged.

Ojikutu said the earlier report did spur action. She’s not sure if the gap has narrowed because of those actions, demographic shifts or other complex factors. But Ojikutu said one program launched by Whittier Street Health Center in Roxbury has helped.

Whittier’s Boston Health Equity Program includes outreach to residents who are reluctant to seek care. Patients are screened and prioritized based on their health risks. Case managers link patients to housing, food assistance and other social needs. The health center has a food pantry, a teaching kitchen, and a gym for patients who don’t feel safe exercising outdoors.

“It started with the tale of two cities and seeing how unfair policies and systemic issues have been,” said Frederica Williams, president and CEO of Whittier Street Health Center, referring to the disparities between Roxbury and the Back Bay. “We all have to change that if we have the will and interest.”

Members of the Neighborhood Association of the Back Bay call the 23-year life span difference distressing and shocking.

“It’s too big a difference,” said the association's board chair Elliott Laffer. “That’s why you want to make the whole city grow and prosper and not just chunks of it.”

A woman walks her dog along the Commoweath Avenue Mall in Back Bay. (Jesse Costa/WBUR)
A woman walks her dog along the Commonweath Avenue Mall in Back Bay. (Jesse Costa/WBUR)

Laffer said it’s time to bring neighborhood groups together and end the perception that Nubian Square and Copley Square are miles apart.

“It’s a half hour walk for this 74-year-old guy,” Laffer said.

Laffer and some neighborhood residents said they want the Back Bay to be more economically diverse.

Elisabeth Morris, a board member at the neighborhood association, said the group recently helped ensure that a major building renovation project on Clarendon St. included affordable and supportive housing. Morris said she is hopeful that Boston Mayor Michelle Wu’s plan to increase the portion of developments reserved for lower income renters will add more options in the Back Bay and across the city.

“It’s our responsibility to work as hard as we can to make housing affordable,” Morris said.

David Williams, a leading researcher on health disparities at Harvard’s T.H. Chan School of Public Health, said the life expectancy gap in Boston is the result of limited chances to learn, work and thrive.

“It really begins with educational opportunity,” said Williams.

“What’s the quality of education that kids going to those local schools are getting? What prep are they getting to be competitive in today’s contemporary labor market?” Williams asked. “We also need apprenticeship programs for those who’ve been through the schools and are not prepared to be competitive.”

Ojikutu said the Boston Public Health Commission is doing more research into the variables that affect life expectancy. She envisions major investments in the Nubian Square area and other parts of the city, beyond development plans already in the works. She said city officials could pool funds from hospitals, other non-profits, employers and the government to fund these projects.

“In this incredibly resource-rich city, we still have these persistent challenges. We have people dying before they should. We should all care about this,” Ojikutu said. “The only way that we will make a difference is if we do something that really is radically different and we work together to change these dynamics.”

This article was originally published on May 11, 2023.

This segment aired on May 12, 2023.

Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.



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