A clinic staffed by Mass General Brigham doctors will open inside La Colaborativa later this month.
"We envision this clinic as more than a healthcare facility," said Gladys Vega, president and chief executive officer of La Colaborativa, at a Wednesday press conference in Chelsea. "This will be a hub of wellness, a place where residents feel safe, seen and valued. Our goal is just not to treat the illness, but to foster a culture of health and wellbeing, and empowering the residents."
Dr. Elsie Taveras, a pediatrician who is also chief community health and health equity officer at Mass General Brigham, said the effort's location will allow its doctors to have maximum impact.
"At Mass General Brigham, we have a deep commitment to health equity," she said. "We focus on the conditions that lead to the most people dying and where there are the greatest inequities."
In Chelsea the conditions that contribute the most to disparities and premature deaths are cardiovascular disease, hypertension, diabetes, substance use disorder, maternal health, and cancer, she said.
Since 1971, Mass General Hospital has provided primary and urgent care to Chelsea residents through a community health center just a couple blocks away. But the COVID-19 pandemic showed that many people need alternative ways to access care. Nearly half of Chelsea's residents are immigrants and many are undocumented. Some are reluctant to seek out medical care because they lack health insurance, fear being turned away, do not speak English, are too busy working, or are afraid hospital visits might result in deportation, Vega said.
"These barriers mean that treatable conditions go unchecked [and] chronic illness worsens," Vega said. "And this amplifies the poverty that we have in our community"
La Colaborativa, originally founded 1988, has focused on addressing social justice issues by lobbying the state house, helping connect locals with ESL classes, providing citizenship classes, or fighting evictions.
But that all changed when COVID hit. The day after former governor Charlie Baker declared a state of emergency in Massachusetts on March 10, 2020, Vega received a call from a local food bank. They had a truck full of food and nowhere to send it. Vega decided to hand it out from her home, posting a message to Facebook inviting locals to come get food. More than 250 people showed up, and within the first hour all the food was gone.
Later that spring, the organization opened a food pantry to feed out of work residents in its headquarters -- and demand was so great, the floors caved in. By then, Chelsea, with its population of roughly 40,000 people, had become the regional epicenter of the pandemic, with a rate of COVID-19 infections much higher than that in Boston.
When a vaccine was finally developed and rolled out, largely through mass vaccination sites in cities and neighborhoods far from hard-hit communities, Vega led the effort to call attention to the vast disparities in vaccine access. The state eventually opened a mass vaccination site in La Colaborativa's headquarters.
But many locals balked even then, because vaccination required them to go through a portal, and many residents didn't speak English, or even have access to a computer. So Vega's team began knocking on doors. When some still balked, after hearing rumors that shots weren't safe, Vega lobbied Mass General for doctors in white coats to join them knocking on doors. That evolved into a mobile vaccination vehicle, which drove around neighborhoods delivering the shots to people where they lived.
The unit has continued to this day, offering not just vaccinations, but blood pressure screening and other services.
The initial phase of the program will include adult vaccinations for COVID-19 and the flu, along with multilingual educational efforts to help overcome vaccine skepticism, regular screening for hypertension and diabetes, prescribed interventions for both, as well as educational resources around disease management.
The initiative will also offer nutrition counseling, including culinary classes in a teaching kitchen. All of this will be paired with programs aimed at mitigating "social risk," by addressing broader social determinants of heath, including housing stability, economic mobility, and youth empowerment programs.
In the future, new services are planned, including community-based cancer screening, substance use disorder services, and maternal health services.