A main artery through downtown Chelsea, Mass.
City of Chelsea

2017 RWJF Culture of Health Prize Winner

With Grit and Determination, a City Comes Together For Health 

To begin to understand Chelsea, Massachusetts, take a drive from the McArdle Bridge down Marginal Street, past major industries that block views and access to the Chelsea River, known locally as the Chelsea Creek.

Along the water’s edge, you’ll find remnants of industries past transformed into urban beauty. In a swath of green, children are playing in view of tugboats coming up the river. The kids are darting about beneath a metal canopy made from material reclaimed from the oil tanks that used to sit here.

Beauty in the midst of industrial grit. It’s an apt metaphor for a city that was bankrupt two decades ago and nearly annexed by nearby Boston, yet now is tackling urban challenges with innovation and heart. Grassroots activists and policymakers, police officers and business owners, health care officials, and high school students—all are working together to make inroads against substance abuse, pollution, obesity, homelessness, and violence.

Chelsea, Massachusetts

This tiny city near Boston is tackling big urban challenges with innovation and heart.           

To address such a wide gamut of issues, they’re changing policy through activism, forward-thinking policies like an aggressive trans-fat ban, sanctuary city protections for undocumented immigrants, and the inclusion of affordable housing in new developments. Though everyone may not agree on everything, there is strong coordination here between city government, health providers, nonprofits, and businesses.

Pocket-sized Chelsea—just 1.8 square miles—is one of the nation’s most densely populated places, with about 39,000 people squeezed into the one-third of the city that is zoned for housing. Sixty-three percent of people who live here are Hispanic and 44 percent are foreign-born, with 35 languages spoken.

Residents share their city and waterway with the largest privately owned wholesale produce market in the nation, road salt piles, and terminals storing the majority of New England’s heating fuel and all of Logan International Airport’s jet fuel.

That proximity means everybody has to pull their weight over the long haul to make health better for all. “There’s a lot of hardworking people who love the city who want to make it better,” City Councilor Enio Lopez says.

There’s a lot of hardworking people who love the city who want to make it better.

Enio Lopez, city councilor

A Fight for Environmental Justice Along the Waterfront

A Fight for Environmental Justice Along the Waterfront

Lifelong Chelsea, Massachusetts, resident Roseann Bongiovanni, the daughter and granddaughter of Italian immigrants, envisions an “emerald necklace” of parks, trails and salt marshes one day adorning the coastline of this city bounded on three sides by water.

She challenges the perception that Chelsea is just a gritty, densely populated, urban locale being choked by its industry and traffic and the health effects that go along with them.

To be sure, two busy thoroughfares cut through the city, which sits just across the Tobin Bridge from Boston. The Chelsea Creek waterfront is home to seven bulk petroleum storage terminals as well as salt waiting to be trucked to 300-plus municipalities in the region. And straddling the border of Chelsea and Everett, Massachusetts, is the New England Produce Center, whose 35 tenants sell fruits and vegetables that are distributed to stores throughout New England and beyond.

All of this activity means pollutants in Chelsea’s air exceed by 20 percent levels the EPA deems safe. The city has the highest asthma hospitalization rates in Massachusetts, and among the highest hospitalization rates for heart attacks and stroke.

But Bongiovanni, executive director of the environmental justice group GreenRoots, and others in the city are tackling these challenges collaboratively and aggressively, working to make Chelsea a greener place, and, therefore, a healthier one. Among the successes to date:

  • Reducing diesel emissions: Efforts involving the New England Produce Center, Eastern Salt Company, Shapiro Produce, the City of Chelsea, Global Petroleum and Alliance Express have replaced dozens of diesel engines with cleaner electric engines to power trucks and refrigerated trailer units. The result has been 2,000 tons fewer of harmful pollutants released into Chelsea’s air each year and 400,000 fewer gallons of fuel burned. The facility is “becoming very green,” says Peter D’Arrigo Jr., produce center president and CEO of produce distributor D’Arrigo Brothers Company of Massachusetts.


2015 Culture of Health Prize Winner

A New Chapter For an Old City

Bridgeport, Connecticut has improved the health and the economy of the city by "going green." 

Roseann Bongiovanni, executive director of GreenRoots. Roseann Bongiovanni, executive director of the environmental justice organization GreenRoots, meets with staff and youth volunteers.

  • Collaborating to open up the waterfront: What was once an adversarial relationship between GreenRoots and Kevin Saba, a developer and marina owner in the Admiral’s Hill neighborhood, has become an alliance built on mutual interest in creating public spaces, boosting the city’s ability to withstand the effects of climate change and preserving and accessing salt marshes. Along a small stretch of Island End River, which Saba’s property overlooks, he developed trellised walkways and new raised boardwalks, provided a public access easement across his property to a once-vacant city-owned parcel that is now a park. Saba also contributed to the city’s affordable housing trust fund, which serves all of Chelsea. This was made possible through a settlement agreement between Saba and GreenRoots.
  • Engaging future leaders: Youth on GreenRoots’ Environmental Chelsea Organizers (ECO) team have surveyed community members about environmental health concerns, developed an environmental justice curriculum for Chelsea schools, and joined a successful effort to create reduced fare public transit passes for Boston-area youth.

A welcoming community parks and recreation area lined with trees. "Port Park, which sits next to the salt piles along Marginal Street in Chelsea, came about because of community efforts to mitigate the effects of industry along the waterfront."
Miguel Ferreira plays in Creekside Common Park. Miguel Ferreira plays in Creekside Common Park, which includes an all-weather skating rink, a motor and sensory skill park, and water fountains for play.

Today, this city with considerable and long-standing environmental challenges is seeing all such issues as pressing. Now, government, nonprofit and private partners in Chelsea are looking into green infrastructure projects, such as rain gardens and permeable streets that would reduce rainwater runoff into its waterways.

They’re also studying the feasibility of a green-energy powered micro-grid that could give the city energy independence and protect the produce center from a large-scale power outage, Bongiovanni says.

And ECO youth are working with members of the Board of Health and Boston University’s School of Public Health to map the city’s methane leaks and study the effects on tree health.

“I would like to see a better future for this community,” says Cristian Garcia, a 17-year-old ECO member. “More parks, more places for people to go outdoors and enjoy and be a community.”

I would like to see a better future for this community.

Cristian Garcia, 17, GreenRoots' Environmental Chelsea Organizers team

Community members gathering for a meeting.

How to Keep People From Falling Through the Cracks

Healthcare workers at a hospital. Ali Abdullahi, Kaftun Ahmed, Franka Miletic, and Anjana Chakkour are community health workers and interpreters at Massachusetts General Hospital's Chelsea HealthCare Center. They help immigrants and refugees, many of whom have had traumatic experiences, navigate the health system.

There’s a box of hot coffee in the back of the community room at the Chelsea Police Department on this Thursday morning.

About 20 people are gathered around the conference table for a meeting convened by the police department and The Neighborhood Developers, a community development nonprofit.

Police officers, child protective services and city code enforcement agents, substance abuse counselors, social workers, substance-use recovery coaches, and medical center staff all fuel up on coffee and mingle.

They talk through the city’s most difficult cases of people who have come in contact with the police and whose lives have been influenced—and too often upended—by drugs, violence, and homelessness.

This is the Hub, established in Chelsea, Massachusetts, just outside Boston, in 2015 to help the community’s most vulnerable people. The group emulates a successful approach developed by the government of Saskatchewan, Canada, to cut crime and boost well-being by using data to pinpoint who most needs help. Social services resources are then mobilized to provide assistance. The group has coordinated 250 cases among them since January 2015.

Participants in Chelsea’s Hub say the weekly meetings—and many phone calls and texts in between—enable them to keep parolees out of jail, protect children from violence, and get people dealing with drug addiction into treatment. The meetings also exemplify how Chelsea works: All together.

“What makes Chelsea most unique is the level of collaboration that exists among the city and its community-based organizations,” says City Manager Tom Ambrosino. “It’s unmatched. It makes getting things accomplished here so much easier.”

Michael Caine, a recovery coach for North Suffolk Mental Health Services, is one of two community health navigators contracted by the City of Chelsea to connect teens and adults at risk of overdose and other health issues to a range of resources.

The city also contracts with CAPIC, a local social services nonprofit, to provide wrap-around services such as housing, food, and transportation. Clients’ outcomes are tracked, and Ambrosino reviews data quarterly to assess progress and recalibrate resources. The Hub is integral in coordinating these efforts.

Cain estimates he’s gotten 20 cases this year because of the Hub meetings. “I’m honored to work with this team,” says Cain, who is in recovery himself and lost his 24-year-old son to an opioid overdose in 2015. “It’s remarkable.”

The Hub is just one part of Chelsea Thrives, a cross-sector coalition launched in 2014 to reduce crime by 30 percent over 10 years. The Neighborhood Developers leads the coalition and involves two dozen partners, including Chelsea’s schools, its housing authority, and the Chamber of Commerce. The total number of crimes in Chelsea dropped 12.5% from 2014 to 2016, according to police department data.

2016 Culture of Health Prize Winner
An aerial view of an ocean pier and palm trees.

Using Data to Help Lift All Boats

Santa Monica, California, has tackled problems similar to Chelsea's while building an inclusive, equitable, and diverse community for more than 40 years.   

Chelsea’s city government and the police department have good avenues for building trust with residents because of the existence of deeply rooted organizations that have developed strong ties to the community over decades.

The social justice nonprofit Chelsea Collaborative, for example, partners with the police to publicize Chelsea’s sanctuary city policy, understand the needs and experiences of immigrant residents, and help them acclimate. The department also collaborates closely with Roca, a nonprofit that works with young men at risk for incarceration and with young mothers.

“We knock on doors together,” says Roca founder and CEO Molly Baldwin of her organization’s partnership with police.

“Law enforcement is 10 percent of what we do,” says Chief of Police Brian Kyes, who grew up in Chelsea and has been with the department for 30 years. “The community sets the agenda for us to do our jobs. We listen to their concerns and work together.”

Courtney Evans demonstrates a healthy squash recipe at the Chelsea Lunch Marketplace. Courtney Evans demonstrates a healthy squash recipe at the Chelsea Lunch Marketplace.
Tom Ambrosino, Chelsea City Manager Tom Ambrosino, Chelsea City Manager, stops by GreenRoots' kayak and canoe event on the Chelsea Creek waterfront.
Young researchers on a pier gathering water for environmental testing. Cristian Garcia, a youth member of GreenRoots, and researcher Sara Wylie, with Public Lab, prepare a water testing kit for placement in Chelsea Creek.
Rock salt piles line Chelsea Creek. Rock salt piles line Chelsea Creek.
A mother and her son enjoy ice cream while sitting on a park bench.

Building an Understanding that Health is Everything

2017 Culture of Health Prize Winner
A nurse testing blood pressure at an outdoor health fair.

Live Healthy, Live Well, ‘Live Algoma’

Algoma, Wisconsin–Making Health Improvement Everyone’s Business

Chelsea, Massachusetts’ Wednesday Lunch Marketplace is a small, yet lively affair.

On a recent August afternoon just outside City Hall, there’s something for everyone: a sandwich vendor, a chocolatier, a cooking demo, a booth with information about free summer lunches for kids and other social services, and an impressive guitarist covering The Rolling Stones and X Ambassadors.

Energizing the downtown and boosting public safety is the mission of Chelsea Prospers, an initiative launched by the city manager this spring. This city just outside Boston also has plans to make Broadway, its main thoroughfare, more pedestrian and bike-friendly and revitalize business.

The city’s new Downtown Task Force includes four police officers tasked with building relationships with businesses, reducing loitering and public drug use by connecting people to services and treatment, and making the area feel safer.

“Though [Chelsea Prospers] has a goal of economic development, we’re using public health strategies,” says Mimi Graney, who coordinates the city’s efforts. For example, she says, “If you have a more walkable downtown, it fosters both economic development and health.”

There’s a strong understanding here that health touches every aspect of people’s lives and that citywide policies can have a big impact.

A few ways Chelsea is working to become healthier:

  • Making healthy food choices easier: Chelsea’s 2015 ban on the use of artificial trans-fats—which can increase risk of heart disease, stroke, and Type 2 diabetes—in its restaurants and corner and grocery stores made it the first U.S. community to be 100 percent trans-fat free. Before enacting the ban, the Chelsea Board of Health worked with food suppliers to make trans-fat-free alternatives easily available to restaurants, and the Healthy Chelsea Coalition, supported by Massachusetts General Hospital, went door-to-door showing owners how to comply. In addition, middle and high school students interning with Healthy Chelsea’s Youth Food Movement team, worked to give their peers more healthy lunch choices in Chelsea schools. For example, they’ve helped the school district’s food-service provider develop healthier recipes, tested them with students, and marketed new menu choices on social media.
  • Working toward secure and affordable housing for all: The Health Starts at Home Initiative at MGH Chelsea HealthCare Center screens patients for housing instability. Those at risk of homelessness are referred to CONNECT, a multi-agency program that helps people find jobs, manage finances and secure stable housing.
  • Tackling substance use: City government and its partners work together to offer wrap-around services as alternatives to incarceration. The city has also trained citizens how to respond in the event a family member or friend overdoses on opioids. They learn how to administer NARCAN (naloxone), the emergency medicine used to reverse overdoses.
  • Bolstering immigrant and refugee health: Chelsea’s city council declared it a “sanctuary city” in 2007, essentially preventing law enforcement from asking about immigration status and ensuring everyone in Chelsea feels welcome and able to become civically involved. At MGH Chelsea HealthCare Center, bilingual community health workers help patients who have come from countries such as Somalia, Bosnia and Nepal navigate the U.S. health care system and overcome barriers to receiving care.
  • Addressing trauma: Because so many residents have lived in poverty or faced violence either here or in their countries of origin, Healthy Chelsea is leading an effort to become a trauma-sensitive city with a culture of understanding the long- and short-term effects of trauma on mental and physical health. The first step, says Jennifer Kelly, director of Healthy Chelsea, is training teachers, students, first responders, and staff and tenants of public housing on the effects of trauma and how to help those who have been traumatized. Next on the agenda will be updating city policies and procedures.
naluis Sosa (center), a supervisor with the youth-serving organization Roca. Inaluis Sosa (center), a supervisor with the youth-serving organization Roca, assists a work crew cleaning up Chestnut Street. Roca helps young mothers and youth who have been incarcerated or involved with gangs.


A fruit and vegetable display inside a Chelsea corner store. A Chelsea corner store displays fruits and vegetables as part of the community's effort to increase access to healthy foods.

We’re trying to look at the whole person. It’s all about increasing resilience and reducing risk factors.

Jennifer Kelly, director, Healthy Chelsea