Hyperlinks in this story point to related issues among the other eight winners of the Robert Wood Johnson Foundation’s Culture of Health Prize of 2015

In a year marked by racial violence in cities such as Baltimore and Ferguson, Mo., residents of this city of 42,000 across the Mystic River from Boston held three forums between police and residents. One meeting in June attracted more than 100 people; two other sessions were only for teenagers.

“What makes Everett special is being able to have a space to talk about racial issues,” says Antonio Amaya, director of La Comunidad Inc., a nonprofit that helps Spanish-speaking immigrants.

Everett has been forced to come to terms with issues of racial justice, immigration, and assimilation. In 1990, foreign-born residents accounted for 11 percent of the population. By 2013, they made up 41 percent.

The rapid change in the city’s ethnic profile has been the impetus for action. Groups from all across the city — local government, police, public schools, health centers, churches, and nonprofits — have come together to examine cultural and racial inequities and how they might affect residents’ well-being. Partners have worked to defuse racial tension while also taking steps to ensure that all people have an opportunity for good health.

They have gone deep, looking at ways to remove barriers to healthy lifestyles and address the needs of vulnerable residents, including teens who are homeless, immigrants without documentation, and people re-entering society from prison. The result is that Everett’s city and community leaders are able to talk in broad terms about all the factors affecting the welfare of residents. They see health in its totality — everything from the need for more mental health services in schools to securing more quality jobs and affordable, safe homes for struggling residents.

“We realized a long time ago that we need to start talking about health equity, racial justice, and social justice, so all of our residents can be healthy, not just those who have the means to be healthy,” says Kathleen O’Brien, director of the Everett Community Health Partnership, a coalition of groups committed to raising the bar on health in Everett. “We’ve been working really hard on some really tough issues, and having that noticed on a national scale is just amazing.”

A Cultural Crossroads

Neighborhood children do the limbo during a Sunday block party sponsored by the One Everett Organization in Everett, Mass.

Everett is a compact city, covering just 3.4 square miles. Many working-class residents worry that the escalating costs in Boston’s neighborhoods will price them out, as gentrification spreads across the Mystic River. The local economy could change dramatically: In 2014, the Massachusetts Gaming Commission awarded Wynn Resorts a license to build a $1.6-billion hotel and casino on an empty waterfront site in Everett. The project could bring as many as 4,000 jobs to the region.

On Broadway, the main street that bisects Everett, storefront signs are in Portuguese and Chinese, restaurants serve Salvadoran pupusas as well as Brazilian barbecue, and churches offer Sunday services in Spanish, Portuguese, Italian, and Haitian Creole.

Many families in Everett can trace their roots to first-wave immigrants from Italy and Ireland. More recent residents have arrived from Central and South America, particularly El Salvador and Brazil, as well as Morocco, Haiti, Puerto Rico, and the Dominican Republic.

Neighbors who measure their ties to Everett not in years but decades will relay two stories that were critical turning points in the city’s history. Both go a long way toward explaining how Everett became a more welcoming place.

The first happened in 1994, when a Latina in sixth grade broke her leg in three places at school. She had no health insurance. “The parents didn’t speak English and didn’t know that there was a health insurance policy that they could have purchased for $18 a year to cover their daughter during the school day,” recalls Jackie Coogan, a retired public school teacher in Everett.

Coogan was so disturbed by the incident that she founded the Joint Committee for Children’s Health Care in Everett (JCCHCE), a nonprofit that helps steer Everett residents, especially newcomers, through the maze of health care. It also connects them to social services offered through its network of more than 30 partnering agencies. The committee has an office on the second floor in Everett City Hall. Staffers offer services in English, Spanish, Portuguese, Arabic, French and Italian. To date the JCCHCE has provided assistance with health insurance, education, and awareness to more than 40,000 children and adults.  Between August 2014 and July 2015, JCCHCE enrolled more than 4,500 people in state-provided health insurance.

The group has a satellite office nearby at St. Anthony’s Parish. One of the first people that many immigrants from Brazil meet when they move to Everett is Sister Elisete Signor, who arrived in the United States 15 years ago and runs the church’s Scalabrini Center. Born in Brazil to Italian parents and previously a missionary in Paraguay, she speaks Portuguese, Italian and Spanish and is “still learning English.”

Signor is a navigator for newcomers. She may help someone to sign up for health insurance or explain how to enroll a child in school or how to make a doctor’s appointment.

“It’s only simple things,” Signor says, “but sometimes they are not English speakers, and at our organization they can get help in so many languages, so this is great.”

From tragedy comes progress

Gustavo Castilho, a member of Teens in Everett Against Substance Abuse, surveys one of the guests at the One Everett block party.

The second story involves a lost 12-year-old girl from neighboring Chelsea who drowned in 2004 in the Mystic River. There were signs in English about swimming and safety. The girl knew only Spanish.

Patrick Johnston, an Everett police officer with a marine unit, saw rescuers pull the child’s body from the water. He said the incident forced residents to look in the mirror. Everett was changing fast, but Johnston and many others felt the city needed to be more responsive and sensitive to the needs of the immigrant community.

“We couldn’t have an ‘us against them’ mentality,” Johnston says.

A multicultural alliance was started through the mayor’s office, which brought together people from all sectors of the community to begin hashing out issues. At the top of the list were police interactions.

At the time, complaints were mounting, particularly from members of the Brazilian community, who perceived racial profiling in the incidence of traffic stops. Police Chief Steve Mazzie met with members of the community multiple times. On the heels of these discussions, the department put down in writing — in Spanish, Portuguese, Arabic and Haitian Creole — what people should expect when stopped by police. He also dispatched officers for crash courses in Spanish and Portuguese.

Last June, after protests in Baltimore, Mazzie joined Bishop Robert G. Brown, the African-American chaplain of the police department, in addressing a forum on police relations at Zion Church Ministries. Several people in the older, diverse crowd questioned the department’s hiring practices. Of 100 officers, only six were people of color. Mazzie explained how officers were selected and pledged to add more diversity to the force.

“If something did happen in Everett,” Mazzie told the crowd, “we’d be able to absorb it and deal with it because we’ve established long-lasting relationships.”

Amaya of La Comunidad says the ongoing conversations on racial issues and police tactics “have not been easy.” But they have created a way for people from different communities to discuss sensitive matters.

“We have done it, and we have improved a lot, but there is more to do,” Amaya says.

Health is so much more

Rebecca Noelle Zama directs the pronunciation portion of the lesson during class for English as a Second Language at La Comunidad in Everett, Mass.

Race, poverty, and health intersect in communities across the nation, and the Everett Community Health Partnership works behind the scenes to address how these issues converge in Everett.

Launched a decade ago by Cambridge Health Alliance, the coalition focuses on the links between health and factors such as racism, income, jobs, education, and housing. Everett has high rates of chronic diseases, especially diabetes and hypertension, with rising rates of obesity, particularly among children of color.

“Health is so much more than just healthy eating and active living,” says O’Brien, the partnership’s director. “It's good jobs. It's housing. It's mental health. It’s safe neighborhoods. It's a chain link, and without one of them, all of it could fall apart.”

The health partnership has tackled such concerns as substance abuse, teen pregnancy, improving fitness, developing youth leaders, and training police and community leaders in mental health first aid. The group also started “Energize Everett” in 2009 to improve the availability of fresh produce and to boost physical activity. Everett now hosts a farmers’ market and has community gardens tended by dozens of families. The city even converted an old public high school into an affordable community fitness center.

Many immigrant-led organizations that work with Latino, Haitian, and Brazilian communities have taken on jobs as a core concern. They have formed a coalition called One Everett, which recognizes that a living wage is the foundation for a healthy life. Families in Everett earn a median household income of $48,319, compared with $65,981 statewide.

At One Everett’s first block party, volunteers conducted surveys on a variety of issues — housing, jobs, education, transportation, immigration, and city services. The Rev. Myrlande Guillaume-DesRosiers, executive director of the Everett Haitian Community Center, a nonprofit that provides healthy housing and civil rights advocacy for residents, says that the city is “making great strides,” but he also finds room for improvement.

“We want to connect older immigrants to new immigrants. One Everett has become a voice for the entire community — children, adults, seniors and organizations. Everybody can be heard.

One Everett joined a regional campaign that successfully advocated for higher base pay for workers at Boston’s Logan International Airport. Only four miles from the airport, Everett is home to hundreds of airport service employees. They now earn $1-an-hour more than the state’s new minimum wage of $9 an hour.

On the horizon, One Everett is pressing for access to jobs that would arrive with the Wynn Casino. Members of One Everett testified at licensing hearings and continue to press the Massachusetts Gaming Commission for diversity in hiring for construction and casino jobs.

Education, a foundation of health

Isaiah Ricardi Jean, center, 5, jumps during a game for children at a block party sponsored by the One Everett Organization in Everett, Mass.

But it is in this city’s diverse public school system where many of the community’s challenges are being met with the most innovative solutions. Enrollment has jumped from 5,700 to 7,500 students over the past decade. Students come from families speaking 50-plus languages and dialects.

Schools must contend with a changing student body, high rates of poverty, and the challenges that often come along with them: substance abuse, emotional distress, and teen pregnancy. The district has responded by bringing more services directly to students in the schools. Cambridge Health Alliance operates a clinic at the high school, offering medical services, counseling, and confidential reproductive health care.

“The bottom line is we have a responsibility to these young people,” Everett’s school superintendent Frederick Forestiere says.

The high school has formed a partnership with a program called YouthHarbors that helps homeless young people. The district has 153 students without permanent homes. Some fled trauma in their homelands and suffer post-traumatic stress disorder. Many Haitian youth arrived alone in Everett after the 2010 earthquake.

“When people hear PTSD, they think of military veterans, and that’s simply not the issue in the schools,” says John Obremski, principal of the George Keverian School, a K-8 elementary school with 50 students who receive emotional or mental health counseling. “A traumatic episode for a child could be leaving their home country to come here.”

Through a $1.2-million federal grant, the school system has added seven counselors and opened a mental health clinic at Keverian. Cambridge Health Alliance runs it and serves several hundred students from the district. Meanwhile, a nonprofit provider of mental health services in Everett — Eliot Community Human Services — has added services for children and families, hired 24 additional clinicians in the past three years, and works within all the Everett Public Schools.

“A healthy community isn’t going to work in isolation,” Obremski says. “It has to work in cooperation, and it takes an entire community to work together in order to solve the problems.