Session Schedule (with descriptions)

People who inject drugs (PWID) make up less than 10% of new HIV infections in the U.S. In 2016 and 2017, Lawrence MA experienced a significant increase, from 25% to over 60%, of new cases identifying IDU as their main risk factor. Greater Lawrence Family Health Center (GLFHC) is the primary provider of HIV care in this community and adopted a unique approach to provide HIV care for this community. First, GLFHC worked closely with the MDPH to alert each other of new cases, and notification to local and state officials of the response, including the promotion of syringe service program (SSP) as a key prevention tool. Second, the HIV team delivered care in alternative settings to improve access to medical and supportive services and arranged for virtual medical consultation to improve access to HIV medications. Providing HIV care and treatment to PWID is complicated by many barriers including insurance coverage, mental illness, housing instability, and active substance use. Our experience shows that early identification and treatment of individuals at high risk of transmission due to active IDU is possible; next steps include identifying strategies to improve retention and viral suppression rates.

• 10,000 GRIP CASES IN LYNN: The September to December 1918 Pandemic in Lynn, MA
  Presenter(s):Dr. Barbara Poremba, Professor Emeritus of Nursing, Salem State University

   
  One hundred years ago, the deadly influenza pandemic of 1918 killed at least 3 times more people than WWI and claimed the lives of between 20 to 50 million people worldwide. The first MA outbreak happened in Boston and quickly spread to surrounding areas such as Lynn, an industrial town about 10 miles north, with a population of 90,000. This presentation describes the magnitude and medical challenges of the “epidemic” in Lynn as described in local newspapers. The progression of the virus can be followed from the small front page article “Hundreds of Grip Cases” on September 16 to the bold headline of “10,000 GRIP CASES IN LYNN” on September 24. These reports tell the day-to-day stories of the desperate need for hospitals and nurses, the challenges of mandatory closings of public places such as schools and theatres, and the temporary opening of a home for so many children orphaned by the sudden deaths of their young parents. Personal accounts of some of the victims are published in a way that is unthinkable in today’s protocols, all printed alongside the main story, the Great War.

   

• Lawrence Lithuanians and the Influenza Pandemic
  Presenter(s): Jonas A. Stundžia, Chair, Lawrence Historical Commission

   
  Lithuanians arrived in Lawrence starting in 1890, coinciding with the expansion of the American Woolen Co. After a failed 1905 revolt against the Tsar and their suffering of linguistic, religious and cultural persecution, they settled in cities like Lawrence. There they established two Catholic parishes and collectively purchased over 50 acres of land in Methuen that included a cemetery, three summer camps, and an old folks home. After their significant participation in the great textile strike of 1912, the self-confidence within the Lithuanian community had escalated to raise money for the publishing of educational books on health and the sciences. The presentation includes a rare family funeral photo from the influenza, excerpts from Lithuanian medical and educational books, municipal records that incorrectly categorized the Lithuanian community, and the explanation why. It will discuss how their benevolent societies provided medical services and the influenza story of Lithuanian orphan, Sophia.

   

• The Impact of Influenza and Public Policy in Lawrence, 1917 – 1919
  Presenter(s): Gwen Sweeney, Andover High School; Attorney Michael Sweeney

   
  The city of Lawrence was hard hit by the influenza pandemic of 1918. Presenters will analyze occurrence and mortality rates for tuberculosis and influenza in the city of Lawrence from 1917 thru 1919, by city ward and as a whole. Concurrent influences including documented reactions from public policy makers, the impact of WWI, and general living conditions within Lawrence will inform how misconceptions, fears and poor public policy throughout history impact public health yesterday, today and tomorrow. Research for the presentation was conducted at the Lawrence History Center, the Lawrence Public Library, and the Memorial Hall (Andover) Library.

• Dana-Farber Cancer Institute’s Center for Community-Based Research: Addressing Cancer and Other Health Inequalities in Lawrence
  Presenter(s): Shoba Ramanadhan, ScD, MPH, Dana Farber Cancer Institute; Vilma Martínez-Domínguez, Director, Lawrence Community Development Department

   
  For the past 13 years, the Viswanath Lab at Dana-Farber Cancer Institute’s Center for Community-Based Research has collaborated with the city of Lawrence Mayor’s Health Task Force (MHTF) to address cancer and other health inequalities in Lawrence. This relationship began with the MassCONECT project, a grant funded by the National Cancer Institute to bring academic partners at DFCI and the Harvard School of Public Health, three health-focused coalitions (including MHTF) policymakers, providers, and other important stakeholders together to address cancer disparities in Boston, Lawrence, and Worcester, MA. The Viswanath Lab and MHTF have continued to collaborate on a series of community-engaged research projects since that time and offer a series of reflections and insight on a long-standing, participatory research relationship explicitly aimed at leveraging diverse resources to address health inequalities. We will highlight important capacity-building activities, including training 16 students from Lawrence High School and Northern Essex Community College to collect data for a public opinion survey.

   
  An overview of the Research Guiding Documents developed by the Lawrence Mayor's Health Task Force in 2006 will be given, as well as the lessons learned through the CBPR partnership, as the MHTF aims to improve immigrant health in Lawrence, Mass.

   

• Food Insecurity in Lawrence: Addressing Social Determinants of Health through Community Partnerships
  Presenter(s): Julia Tse, MD, Greater Lawrence Family Health Center

   
  Social determinants of health (SDoH) contribute more to our general quality and length of life than the medical care we provide in our communities. In order to better understand and intervene upon one aspect of these social determinants, the Greater Lawrence Family Health Center (GLFHC) has recently launched a food insecurity campaign to reduce barriers and access to food for residents of Lawrence. Our initial pilot data suggests that up to 2/3 of our patients are food insecure. To help address this problem we have developed and implemented a protocol for food insecurity screening, and have partnered with the Greater Boston Food Bank and Project Bread to provide free monthly access to fruits and vegetables and assistance with obtaining governmental support. We have also started to engage in community partnerships, particularly with the Mayor’s Health Task Force of Lawrence, Greater Boston Food Bank, Project Bread, and Groundworks Lawrence, as a way to develop sustainable solutions to food insecurity. In this session we will review the history of this collaboration, with a focus on community partnership and engagement, and will describe preliminary results of informant interviews and focus groups regarding food insecurity and interventions, and how these and development of stakeholder relationships help to promote a community-oriented perspective. Author(s): Julia Tse, MD, GLFHC; Keith Nokes MD, MPH, GLFHC; Elise Carpenter MD, PhD, GLFHC; Raman Nohria, MD, GLFHC; Shannon Meyers MPH Candidate, Boston University School of Public Health.

   

• Vision Screening and Rehabilitation in Lawrence
  Presenter(s): Michael A. Sandberg, PhD; Martha Velez, Director, Lawrence Senior Center

   
  Evidence for visual impairment and eye disease in the Hispanic population of Lawrence, MA is widespread. Based on Dr. Sandberg’s years of vision screening in the District 33N Lions Eyemobile (often with the help of the Lawrence Latin Lions Club and the Lawrence Senior Center), he will describe the causes of low vision and legal blindness, report how his data were obtained, present findings on the prevalence of glaucoma and on the prevalence of uncorrected refractive error in Lawrence, and indicate their quality-of-life significance. In the case of glaucoma (and other sight-threatening diseases) a mechanism for patient management in Lawrence was developed to address these issues through community outreach and service. For uncorrected refractive error in Lawrence, a plan has been formulated that would involve a multi-year collaboration of eye-care professionals, business, and government that has not yet been implemented, but partners are currently being sought.

Located in Lawrence’s Pemberton Park, the Casey Bridge Encampment, also known as ‘Tent City’, was one of the largest homeless encampments in New England. Using this encampment as an example, we’ll show the ways that chronic homelessness is the product of various health disparities, and how the presence of homelessness, especially encampments, can affect multiple populations and contribute to larger societal and systemic issues. We dissect the common causes of homelessness in the larger society and specific to Lawrence. And, we review efforts by the Mayor’s Health Taskforce and Greater Lawrence Family Health Center’s Homeless Healthcare program to address the needs of the homeless.

• Past as Prologue: Lawrence Public Health, An Historical Overview
  Presenter(s): Savannah Gillis, Andover High School

   

  As the country was captivated by the international conflict of the early 20th century, it is often forgotten that the greatest enemy was domestic. The 1918 influenza pandemic ravaged and reshaped communities. Lawrence, MA, a mill town with a booming industrial population, became a microcosm for the effects of the public health crises on American communities. The city’s policy decisions reflected the country’s urgent need to deal with threatening health crises. This presentation discusses the cause of the rapid spread of influenza by investigating the effects of housing policies outlined in The Report of the Lawrence Survey (1911). These policies fell far short of providing adequate living spaces and exacerbated the outbreak. Lawrence saw similar patterns in the assessment of public health needs between 1990 and the early 2000’s. The city traded an influenza pandemic for broader public health issues related to poverty, demographic shifts, and once again, housing policy. Lessons and mistakes from the 1918 influenza pandemic as well as the state of Lawrence at the turn of the new century provide insight into how policy makers can address public health crises in the future.

   

• Threats Breed Solutions: Innovations in Public Health
  Presenter(s): Patricia Jaysane, PhD

   

  In the final quarter of the 19th century Lawrence reached the apex of both manufacturing achievement and threats to the health of its citizens. The dangers included advanced technological innovations, failed infrastructure, and increased exploitation of immigrant workers. Among the efforts to address these concerns two figures pivotal to the Lawrence and national public health issues were Hiram Mills and Susan Crocker. These people, one internationally recognized and the second otherwise little known, were instrumental in charting the future of public health in Lawrence, but also influencing the path forward for the well-being of Americans overall. In this session their work will be described and analyzed.

   

• Creating Health Equity by Training the Doctors Our Communities Need
  Presenter(s): Wendy Barr, MD, Dr. Cara Marshall and Dr. Keith Nokes (Lawrence Family Medicine Residency)

   

  Primary health care access is a national problem, particularly acute in rural and poor urban communities. The Community Health Center movement was established to remedy health care access inequities. Greater Lawrence Family Health Center (GLFHC) was founded in 1980 to provide access to high quality, culturally sensitive primary health care for Lawrence and its growing Latino population. Unique among health centers, GLFHC took the bold step of starting its own Family Medicine residency training program in 1994, with the goal of educating the future physician workforce for Lawrence and similar communities. This residency, now the model for the national Teaching Health Center program, has graduated 175 Family Physicians who continue to provide care to Lawrence and underserved populations around the country and the world. In this presentation, we’ll review the history of the health center movement and GLFHC in particular, the establishment of the residency program and its significant impact on services and health outcomes among patients and the community.

• Gender Equality and Health: What is the Relevance to Lawrence?
  Presenter(s): Margaret E. Greene, PhD, GreeneWorks

   

  Good health cannot be achieved in the context of profound social injustice. Greater attention is being focused on addressing the impact that social inequality along dimensions of race, ethnicity, and socioeconomic status make to undermining health. Gender inequalities likewise inhibit health, and an increasing number of public health programs are recognizing the wisdom of addressing these inequalities in an effort to improve health for all. At least two important changes contribute to an emerging interest in gender norms and health. First, science has helped to highlight that the nature versus nurture distinction is false, creating a huge opportunity to understand how biology and social factors interact to create health disparities. Second, an evolution in global health discourse on gender inequality and norms has been captured in the Sustainable Development Goals to which most of the world’s countries have committed. This presentation illustrates the impact of addressing inequitable gender norms on a variety of health outcomes through a series of tested programmatic examples in diverse settings. North America.

   

• Faith, Death, and Space: Religion at an Institution for the Developmentally Disabled
  Presenter(s): Ashlynn Rickord, MTS, Public Health Museum at Tewksbury Hospital

   

  Today, as we walk along Washington Street in downtown Boston, ride the T, or go to church, it is not uncommon to encounter someone with a disability. However, just a mere hundred years ago, those with a disability would rarely be seen in the public sphere, instead many were sent to state schools far away from urban centers. For those subjugated to live out their days at an institution, the religious aspect of campus life was very important to the patients, yet the few histories and texts that touch on institutional life for the disabled rarely mention this element. Faith, Death, and Space is an exploration into the under-told story of religion at institutions for the developmentally disabled. Focused around the Walter E. Fernald State School, the first school for the disabled in the Western Hemisphere, and using recently uncovered archival resources and firsthand narratives from oral histories, the presenter delves into the history of spirituality, the place of religion in death, and the architectural space that was created for the disabled to worship within.

   

• Point After Club and Public Policy: A Community of Support for Individuals in Recovery from Mental Illness in Lawrence
  Presenter(s): Tom Coppinger, Director, Point After Club

   

  Point After Club services include supports geared toward employment, education, social activities and relationships, life skill development, housing, connecting to community resources, health and wellness, arts-based rehabilitation, and advocacy with a focus on self-help, peer support, and empowerment of its membership, with staff and members working side by side to manage all of the Clubhouse operations and governance. Our Clubhouse focuses on the strengths of each individual, providing membership the opportunity to live, learn, and engage in meaningful work, while contributing their talents to the Point After Club community. The presenter will discuss their work in the community and touch upon upcoming changes in public policy pertaining to the treatment of mental health in the United States.

   

This session will review the current status of the opiate epidemic and how it directly applies to Lawrence. The root causes of addiction will be reviewed and a framework for understanding the disease of addiction will be provided. The negative effects of societal stigma associated with the disease are analyzed as well as current treatment options. Efforts at Greater Lawrence Family Health Center to reduce opiate addiction through our suboxone/vivitrol program are described along with a review of how to train and recruit more doctors willing to partake in the battle against addiction.

MA physicians led the national campaign against midwifery at the beginning of the twentieth century. Particular attention was paid to immigrant midwives who served newly arrived mother in cities like Lawrence. This presentation examines: the legal and public relations campaign against midwives; the trends and patterns in the practice of Lawrence midwives from different ethnic groups; and, the current state of midwifery in MA. This work is based primarily on a review of Lawrence birth records and contemporary state data. From 1896 to 1907, the proportion of Lawrence births attended by midwives increased to more than 40%. After a MA court ruling made midwifery illegal, Lawrence midwives continued practicing until September 1914 when several were arrested. Outcomes of midwife attended births were comparable or better than those of local physicians. Lawrence continues to be an immigrant community with 88% of all births to Hispanic mothers, though midwives play a much smaller role. Infant mortality in Lawrence was ranked 8th highest in MA in 2011-2013. In 2015 midwives attended 11,812 births (16.5%) of all births in MA, the seventh highest proportion in the U.S. The experiences of Lawrence midwives serve as an example of the persistence of midwifery in immigrant communities even after changes to their legal status.

Learn how the growth of Lawrence” mirrored the growth of the playground movement. The concept of providing places for people to exercise their bodies and minds is relatively new. This presentation will show how Lawrence has been at the forefront of creating outdoor spaces for play. The panelists will present an overview of what is play and why we need it by outlining the science of play and the history of the playground movement. Participants will also learn the history of the Lawrence park system, its contribution to the playground movement, and what the city is doing to create the contours for residents to fall downhill to a healthier lifestyle.