HEART of Communities offers community-connected, innovative care and lifestyle support to eligible patients living with diabetes, hypertension, or obesity in Mattapan

BOSTON — A first-of-its-kind collaboration between Boston Medical Center (BMC), Mass General Brigham, and Mattapan Community Health Center (MCHC), aims to improve health outcomes for cardiometabolic disease — a major driver of premature mortality and health disparities in Mattapan. The HEART of Communities initiative will offer coordinated clinical care and community-informed lifestyle programming to eligible community members, steps away from their homes.

“We believe health equity starts by addressing the real conditions people face every day,” said Alastair Bell, MD, President & CEO of BMC Health System. “By working alongside our trusted partners in Mattapan, eligible patients will receive care that’s not only high-quality but also rooted in the needs and strengths of the community.”

“Managing chronic health conditions goes far beyond the walls of a hospital or clinic,” said Anne Klibanski, MD, Mass General Brigham President and CEO. “This unique collaboration is dedicated to treating the whole patient by bringing personalized clinical care right into their neighborhood, along with an extensive network of community resources. Our collective goal is to create healthier communities by reducing longstanding chronic health conditions.”

Following generations of historic disinvestment and systemic barriers, Mattapan residents face some of the greatest challenges to accessing quality healthcare. According to the Health of Boston 2023-2024 report, Mattapan has the highest age-related heart disease mortality rate in the city, along with significantly higher age-adjusted diabetes mortality rates compared to the Boston average.

“This innovative collaboration between patients and leading healthcare organizations aims to change the trajectory of lives in Mattapan by meeting their full range of needs, right where they live. Care will be delivered where and how it is needed the most and tailored in a way that will have a significant impact,” said Guale Valdez, MBA, Mattapan Community Health Center President & CEO. “This coordinated effort allows us to dig deeper and provide personalized care while building community among neighbors living with chronic conditions.”

The intensive six-month program empowers Mattapan residents, who are patients of BMC, Mass General Brigham, or MCHC, to work with healthcare providers to build personalized support structures that enhance their overall health and well-being. In small groups, patients are paired with a Community Wellness Advocate, receiving guidance on managing medications and incorporating tools like glucose monitors, blood pressure cuffs, and activity trackers into their daily routines. The program also addresses social risk factors that disproportionately impact health through a comprehensive approach. This includes providing economic mobility support via job placement and mentoring, ensuring nutrition security with food and cooking programs, integrating behavioral health care, and reducing isolation through group sessions and programming.

HEART of Communities is made possible by two donors and works with community leaders and business owners to connect local patients with neighborhood resources to support their health goals. The first cohort launched in the spring with more than 100 participating Mattapan community members. The program hopes to scale the community-informed approach in other Boston neighborhoods.

 

About Boston Medical Center

Boston Medical Center models a new kind of excellence in healthcare, where innovative and equitable care empowers all patients to thrive. We combine world-class clinicians and cutting-edge treatments with compassionate, quality care that extends beyond our walls. As an award-winning health equity leader, our diverse clinicians and staff interrogate racial disparities in care and partner with our community to dismantle systemic inequities. And as a national leader in research and the teaching affiliate for Boston University Chobanian & Avedisian School of Medicine, we’re driving the future of care. For more information, please visit bmc.org.

 

About Mass General Brigham

Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals. For more information, please visit massgeneralbrigham.org.

 

About Mattapan Community Health Center

Mattapan Community Health Center (MCHC) is a Federally Qualified Health Center whose mission is to improve the health and well-being of diverse populations in Mattapan and surrounding communities by providing exceptional, comprehensive integrated health services. MCHC offers primary care for all ages, behavioral health, dental, OB/GYN, HIV and Substance Use Disorder services in the heart of Mattapan. Through strong connections with community organizations and an understanding of the challenges faced by our residents, Mattapan Community Health Center excels in high quality, equitable care. For more information please visit, mattapanchc.org.