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BOSTON — Bob Thompson learned he had prostate cancer after routine screening at the Whittier Street Health Center, a community-based facility that has long served serving thousands of residents of the inner-city Roxbury neighborhood.
The screening probably saved his life, said Thompson, 60, a long-time Roxbury resident who had surgery for the cancer last May.
"Without it I probably would not have discovered that I had cancer, it would have gone on for a number of years and the cancer would have gotten worse," he said.
On Monday, Gov. Deval Patrick and others will attend a ceremony dedicating Whittier's new, $35 million state-of-the-art facility viewed by many as a model for efficient health care delivery to traditionally underserved urban residents. The six-story, 79,000-square-foot building has been described as a "one-stop" center for health care and social services, offering 19,000 residents everything from cancer screening to dental care to violence prevention programs.
Patrick said community health centers like Whittier are critical to the state's twin goals of providing universal care while reducing costs.
"Part of the way to assure access and also part of the way to assure cost-containment is encouraging as many people as possible to get their care in lower-cost community centers," he said in an interview last week. Patrick has been pushing lawmakers to approve a payment reform bill that would shift the health care industry away from a fee-for-service system based on individual tests and procedures and toward a so-called global payment system that stresses a team-oriented approach to patient care.
Construction of the new facility was largely enabled by a portion of the $80 million in federal stimulus funds the state received for eight community-based health centers, four in Boston and one each in New Bedford, Fall River, Fitchburg and Lowell.
Nationally, community-based health centers received about $2 billion in federal stimulus grants over the past two years, according to the U.S. Health Resources and Services Administration.
Whittier first opened in 1933 to help care for newborn babies in a public housing development. The new building keeps the center's original name though it is now located on a former vacant lot on nearby Tremont Street, with more than twice the size and capacity of the previous facility.
Situated just a few miles from, but in many ways a world removed from, Boston's renowned Longwood medical district, it has faced enormous challenges serving the diverse and largely low-income neighborhood.
"When you look at our mission statement it is about eliminating health and social disparities," said Frederica Williams, Whittier's president and chief executive. "You cannot cure someone's illness and make them engaged if they are dealing with poverty or not making sustainable wages."
Center officials say 60 percent of their patients live below the poverty level and 85 percent live in public housing.
Fewer than one in four patients have private insurance and about half receive Medicaid. And 23 percent have no health insurance at all — a startling figure in Massachusetts, where 98 percent of all residents have health insurance because of the state's landmark 2006 health care law.
The socio-economic disparities appear to translate directly to health disparities. About 70 percent of Whittier's patients have been diagnosed with at least one chronic medical condition such as diabetes, cancer, hypertension , asthma or obesity. Many live with more than one such disease.
The neighborhood's 1-in-10 infant mortality rate also far exceeds state and national averages.
Four in five patients also have "psycho-social" issues, center officials say, often stemming from violence or substance abuse prevalent in their lives or families.
"If other stressors in your life are preventing you from addressing care or seeing your doctors on a regular basis, then it's hard to stay connected," said Dr. Christopher Lathan, director of the cancer care equity program at Dana-Farber Cancer Institute. Lathan is one of five oncologists assigned on a rotating basis to a cancer clinic at Whittier that is run by Dana-Farber, one of the nation's most prestigious cancer research and treatment centers.
Lathan pointed to statistics showing that African-American men have the highest rates of prostate cancer in the world, and African-American women in the U.S. have higher breast cancer mortality rates. He said Dana-Farber tries to provide Roxbury residents with access to similar care that patients would receive at the institute's main campus in the Longwood medical area.
The clinic, originally funded by a 2008 gift from New England Patriots owner Robert Kraft and his late wife, Myra, may be the first example of a major U.S. cancer center operating in a community-based setting, Williams said.
Monday's dedication culminates a nearly decade-long quest by Williams to find a permanent home for Whittier, yet she understands the building itself doesn't guarantee that all in the community will take advantage of its offerings.
That's why, she said, the center employs roving "health ambassadors" in the neighborhood to seek out residents — particularly men — who might otherwise have no contact with doctors until a crisis lands them in a hospital emergency room.
"We are relentless in getting you in here," said Williams. "Once we screen you for the first time, if there is an abnormal result, our patient navigators will follow you and call you until you have no choice but to come in."
