‘There are these persistent and pervasive health inequities across the city of Boston’: A Q&A with Boston’s Public Health Commissioner

Boston Public Health Commissioner Executive Director Dr. Bisola Ojikutu during a roundtable discussion in November 2022 on anti-racism, at the Boston Public Health Commission headquarters.Jonathan Wiggs/Globe Staff

From 2017 to 2021, overall deaths in Boston increased by 11 percent, rising more sharply in Black and Latino communities. The leading cause of deaths through those years was cancer — with the exception of 2020, when COVID-19 was the most common cause.

These are among the findings of the Boston Public Health Commission’s “Health of Boston” reports, a series of five reports released Friday each examining how a particular health issue is affecting Boston’s residents. Researchers analyzed data from 2017-2021 to track how rates of diabetes, asthma, cancer, heart disease, and premature deaths are trending in the city.

Here’s what Dr. Bisola Ojikutu, executive director of the Boston Public Health Commission, had to say in an interview with the Globe about the reports and what’s needed to tackle the racial disparities the research shows.

This interview has been edited for length and clarity.

What are the most important takeaways from the report?

“There are these persistent and pervasive health inequities across the city of Boston, which are disturbing, but not really surprising. One piece [of data] we wanted to focus on was the differences in life expectancy between different parts of the city. About 10 years ago, there was a report, which noted a 33-year life expectancy gap between a census tract in Roxbury and a census tract in Back Bay. We redid that analysis and found…some things haven’t changed. In Back Bay, life expectancy is still 92, which is what it was before. And that area still has one of the highest life expectancies in Boston. The lowest life expectancy is also still in [an area in] Roxbury where the life expectancy is 69 years. So now there’s a difference of 23 years, which is still very concerning.

The second thing is the impact of COVID on life expectancy, which is an issue that a lot of people across the country are trying to understand and grasp. We noted an overall loss of 2.4 years of life expectancy before and after COVID. Life expectancy decreases were greatest amongst Latinx residents, who lost four years, Black residents lost 3.3 years, Asian residents lost three years and white residents had the smallest decrease in life expectancy of 1.1 years. The question remains: Will those years of life expectancy be regained?”

The pandemic created a lot of momentum and funding to address health equity issues. How important is it to preserve that infrastructure?

“We all lived through this horrific tragedy. Yet, there are wonderful lessons we learned that we need to carry forward. One of which is community empowerment and mobilization. During COVID, there were many coalitions that really rose to the occasion. They took minimal resources, put boots on the ground and learned how to do the work. They are the primary reason we were able to close racial vaccination gaps in April of 2022. We would like to continue building capacity and resources to these community coalitions so they can continue their work and apply it to some of these other areas. If it worked [during the pandemic], there’s no reason why it wouldn’t work for these other areas as long as there’s momentum and resources.”

And how can we create that momentum?

“What needs to happen is that we need to identify this as an area of [collective] concern. We saw COVID as a threat to all of us, but we also have to care about what might not be an immediate threat to us, as individuals. We can either choose to do something differently, or we can accept the status quo and I suggest that we choose wisely and choose to do things differently.”

During the pandemic, there was an elevation of public health experts and leaders in the public eye. Now that the pandemic is subsiding, is there any concern that might change?

“Of course, it’s something we worry about. Oftentimes, people don’t really pay much attention to us unless we’re in the setting of crisis and emergency. Otherwise, we’re not in the spotlight. And I wonder, what will it take for us to value the work that we’re doing? I can’t say that I have an answer. But, it certainly shouldn’t be when we have another crisis or another emergency. This has to be when we value the work because it is work that is keeping us all safe. It’s not just for one community or for one population who’s been made vulnerable. Public health is really for everybody.”