Fall River indicators summary

Overview of

Current Data:

City of Fall River

Prepared for the Healthy Cities Design Team

January 24, 2003

Susan Linn Bershefsky

Grant Writer

City of Fall River

One Government Center

Fall River, MA 02722

(508) 324-2662

grantwriter@fallriverma.org

Table of Contents

General Demographics		2-5
	U. S. Census Bureau Statistics 2000	2-5
	Sex & Age	2
	Race	3
	Relationship	4
	Households by Type	4
	Housing Occupancy	4
	Housing Tenure	5
	Equalized Property Valuations	5
Healthy People 2010 Indicators		5-15
	<1. Physical Activity	5-6
	2. Weight	6
	3. Tobacco Use	6-7
	4. Substance Abuse	7-8
	5. Sexual Behavior and Infectious Diseases	9
	6. Mental Health	10
	7. Injury/Violence	11-14
	8. Environmental Quality	14-15
	9. Immunization (no data included)	15
	10. Health Insurance	15
Other Indicators		15-22
	Poverty	16
	High School Graduation & Education	16-19
	Early Detection of Cancer	20
	Disability	20
	Chronic Disease	21
	Dental Health	22
	References	22-24

Profile of General Demographic Characteristics: 2000

Data Set: Census 2000 Summary File 1 (SF 1) 100-Percent Data

Geographic Area: Fall River city, Massachusetts

Subject	Number	Percent
Total population	91,938	100.0
SEX AND AGE
Male	42,953	46.7
Female	48,985	53.3
Under 5 years	5,846	6.4
5 to 9 years	6,483	7.1
10 to 14 years	6,229	6.8
15 to 19 years	5,834	6.3
20 to 24 years	6,214	6.8
25 to 34 years	14,322	15.6
35 to 44 years	13,061	14.2
45 to 54 years	10,772	11.7
55 to 59 years	4,298	4.7
60 to 64 years	3,307	3.6
65 to 74 years	6,957	7.6
75 to 84 years	6,294	6.8
85 years and over	2,321	2.5
Median age (years)	35.7
18 years and over	69,759	75.9
65 years and over	15,572	16.9
(continued)

RACE
One race
White	89,593	97.4
Black or African American	2,283	2.5
American Indian and Alaska Native	172	0.2
Asian	1,987	2.2
Asian Indian	154	0.2
Chinese	216	0.2
Filipino	69	0.1
Japanese	26	0.0
Korean	31	0.0
Vietnamese	99	0.1
Other Asian	1,392	1.5
Native Hawaiian and Other Pacific Islander	25	0.0
Native Hawaiian	5	0.0
Guamanian or Chamorro	3	0.0
Samoan	1	0.0
Other Pacific Islander	16	0.0
Some other race	1,311	1.4
Two or more races	2,345	2.6
HISPANIC OR LATINO AND RACE

Hispanic or Latino (of any race)	3,040	3.3
White alone	82,274	89.5
Not Hispanic or Latino	88,898	96.7
(continued)
RELATIONSHIP
Total population	91,938	100.0
In households	90,047	97.9
Spouse	15,613	17.0
Child	27,611	30.0
HOUSEHOLDS BY TYPE
Total households	38,759	100.0
Family households (families)	23,558	60.8
With own children under 18 years	11,608	29.9
Married-couple family	15,613	40.3
With own children under 18 years	6,602	17.0
Female householder, no husband present	6,391	16.5
Nonfamily households	15,201	39.2
Households with individuals under 18 years	12,467	32.2
Households with individuals 65 years and over	10,949	28.2
Average household size	2.32
Average family size	3.00
HOUSING OCCUPANCY
	Total housing units	100.0
Occupied housing units	38,759	92.6
Vacant housing units	3,098	7.4
For seasonal, recreational, or occasional use	100	0.2
Homeowner vacancy rate (percent)	1.4
Rental vacancy rate (percent)	6.7
(continued)
HOUSING TENURE
Occupied housing units	38,759	100.0
Owner-occupied housing units	13,521	34.9
Renter-occupied housing units	25,238	65.1

Equalized Property Valuations

Municipality	EPV Per Capita - 2000	State Rank (of 351)
Brockton	$35,319	336
Fall River	$31,223	345
Lawrence	$20,134	351
Lowell	$29,728	347
Lynn	$33,743	339
New Bedford	$30,137	346
Somerville	$49,797	292
Springfield	$27,994	350
Worcester	$34,812	337
Average	$32,543

The following 10 indicators were selected for inclusion in this report because they are the "Leading Health Indicators for Healthy People 2010". Federal definitions follow each indicator.

1. Physical activity: Percentage of population whose participation in physical activity with significant cardiovascular benefits meets or exceeds recommended levels with respect to the number of times per week and the number of minutes per time

Percentage of Adults Who Were Regularly Physically Active

Fall River CHNA	Massachusetts	2010 Target
26.8%	31%	30%

Data from 1994-1999 BRFSS Survey.

The percentage of adults who participated in any leisure-time physical activity in the past month in the Greater Fall River CHNA was significantly lower than the state average.

2. Weight: Percentage of population whose body mass index is no more than 20% lower and no more than 20% higher than that recommended for their age and gender

Percentage of Adults Who Are Overweight

Fall River CHNA	Massachusetts	U.S. Baseline	2010 Target
28%	26%	30.3%	15%

Data for CHNA, Massachusetts and US Baseline from BRFSS 1994-1999.

The difference between Fall River and Massachusetts is not statistically significant.

Fruits and Vegetables Consumption

	Year	Number	CHNA %	MA %	US %	HP2000 % ob-jectives
Consumed 5 or more servings of fruits and vegetables/day	94, 96, 98	582	24.9	29.1	23.6	50

Tobacco use: Prevalence of any use of tobacco products among youth up to age 17

Fall River Youth Risk Behavior Survey
Have you ever smoked cigarettes regularly, that is, at least one cigarette per day for 30 days?

18.8% YES 78.7% NO 2.5% No Answer

Percentage of Adults Who Currently Smoke

Fall River CHNA	Massachusetts	U.S. Baseline	2010 Target
27.5%	21.2%	22.9	12%

Data from BRFSS 1994-1999

The number of adults who smoke in the Fall River CHNA is significantly higher than the overall Massachusetts rate, while the number of adults who smoke in the Cape & Islands CHNA is lower than the overall Massachusetts rate.

4. Substance Abuse

In two of the CHNAs served by PC 10, there were more treatment admissions to publicly funded programs due to heroin than alcohol. Fall River in particular had much higher rates of treatment for heroin than alcohol. This pattern is very different from statewide patterns of publicly funded treatment admissions.

The City of Fall River has a particularly high rate of alcohol and other drug-related deaths. (47 per 100,000). The data does not separate out alcohol from illegal drug deaths, but since binge drinking in Fall River is significantly lower than the Massachusetts rate, it is likely that many of these deaths were heroin related.

Percentage of Adults who report binge drinking in previous month

Fall River CHNA	Massachusetts	U.S. Baseline	2010 Target
11.0%	17.9%	14.4	6%

Data from BRFSS 1994-1999

Drinking and Driving

	Fall River CHNA	MA
Drove after drinking in past month	2.0%	2.70%

Socio-Demographic Characteristic of Admissions to Publicly Funded Substance Abuse Treatment by CHNA of Residence

Primary Drug	Fall River		Massachusetts
	N	%	%
Alcohol	1466	33	48
Heroin	2419	54	35
Cocaine	176	4	4
Crack	64	1	4
Marijuana	235	5	6
Other	96	2	3
Total	2673	100	100

Substance Abuse Indicators: Fall River

	Area Count	Area Crude Rate	State Crude Rate
Admissions to DPH funded treatment programs	3,560	3872.2	1900.9
Injection drug user admissions to DPH funded treatment program	1,771	1926.3	521.9
Alcohol and other drug related hospital discharges	252	278.1	324.3
	Area Count	Area Age-adjusted Rate	State Age-adjusted Rate
Alcohol and other drug use deaths	40	47.0	20.4

Crude rates are expressed per 100,000 persons. Age adjusted rates are expressed per 100,000 persons.

5. Sexual Behavior & Infectious Diseases

Births to Adolescent Mothers (1999) Number / % of All Births

Fall River	State
152/13.9%	6.9%

Rate of Chlamydia trachomatis infections, ages 15 – 19

Fall River	Massachusetts Rate:
43 Cases 771.4 per 100,000	699.7 per 100,000

Infectious Disease: Fall River

	Area Count	Area Crude Rate	State Crude Rate
Newly diagnosed AIDS cases	10	11.0	13.9
Persons alive with AIDS	91	100.4	110.2
AIDS and HIV-related deaths	5	5.4	3.6
Tuberculosis	NA	NA	4.5
Pertussis	13	14.1	21.5
Acute Hepatitis-B	NA	NA	0.3
Syphilis	NA	NA	6.6
Gonorrhea	20	21.8	43.7
Chlamydia	138	150.1	158.5
	Area Count	Area Age-specific Rate	State Age-specific Rate
Syphilis, ages 15-19	0	0.0	2.2
Gonorrhea, ages 15-19	NA	NA	155.6
Chlamydia, ages 15-19	56	959.9	763.9

Crude rates are expressed per 100,000 persons. Age-specific rates are expressed per 100,000 persons in the specific age group.

6. Mental Health

Adult Suicide Rate 1999

	Fall River	Massachusetts
Suicide Rate per 100,000	11.1	6.7

Durfee High School Students:
Is there at least one teacher or other adult in this school that you could talk to if you had a problem?

Yes	No	Not Sure	No Answer
61%	24.4%	12.7%	2.0%

Outside of school, is there an adult(s) you can talk to about things that are important to you?

Yes; parent/family member	Yes; non-family adult	Yes; both A & B	No	Not sure	No answer
37.3%	8.6%	36.9%	8.9%	63.9%	1.4%

During the past 12 months, did you ever feel so sad or helpless almost every day for two weeks or more in a row that you stopped doing some usual activities?

Yes	No	No Answer
29.1%	68.8%	2.1%

During the past 12month, did you ever seriously consider attempting suicide?

Yes	No	No Answer
18.1%	79.8%	2.1%

7. Injury/Violence : Number of preventable deaths attributed to intentional and unintentional injury

Injury Indicators: Fall River

	Area Count	Area Age-adjusted Rate	State Age-adjusted Rate
Motor vehicle related injury deaths	9	9.5	7.6
Suicide	3	3.5	6.2
Homicide	0	5.8	2.0

Age adjusted rates are expressed per 100,000 persons.

Rate of deaths from Motor Vehicle accidents is higher in the Cape & Islands and Fall River CHNAs than in Massachusetts as a whole.

1997 Violence Related Gunshot and Sharp Instrument Wounds

Fall River	Massachusetts Rate
55 Incidents; 59.4 per 100,000	27.1 per 100,000

Fall River Durfee High Schools Students Responses to the Youth Risk Behavior Survey 2001

When you rode a motorcycle during the past 12 months, how often did you wear a helmet?
I did not ride	Never	Rarely	Sometimes	Mostly	Always	No Answer
75.5%	5.5%	2.3%	0.7%	1.6%	13.1%	1.2%
When you rode a bicycle during the past 12 months, how often did you wear a helmet?
I did not ride	Never	Rarely	Sometimes	Mostly	Always	No Answer
31.9%	53.9%	4.6%	3.7%	2.3%	3.0%	0.6%
How often do you wear a seatbelt when riding in a car driven by someone else?
Never	Rarely	Sometimes	Mostly	Always	No Answer
12.2%	12.7%	19.2%	25.6%	29.8%	0.5%
(Continued)
During the past 30 days, how many times did you ride in a car or other vehicle driven by someone who had been drinking alcohol?
0 times	1 time	2 or 3 times	4 or 5 times	6 or more times	No answer
70.4%	10.8%	6.9%	3.4%	7.4%	1.0%
During the past 30 days, how many times did you drive a car or other vehicle when you had been drinking alcohol?
0 times	1 time	2 or 3 times	4 or 5 times	6 or more times	No answer
86.8%	4.6%	3.3%	2.1%	2.3%	0.9%
During the past 30 days, on how many days did you carry a weapon such as a gun, knife, or club?
0 days	1 day	2 or 3 days	4 or 5 days	6 or more days	No answer
82.8%	3.4%	4.2%	1.4%	5.9%	2.3%

Crime

Fall River Crime Rates (2000 FBI Uniform Crime Reports)

Crimes per 100,000 population

Natl. average

Fall River, MA

Boston, MA

Population

114,967

93,106

570,888

Violent crimes
murder, rape, robbery & assault

506.1

588.6

1,282.6

Property crimes
burglary, larceny & auto theft

3,617.9

3,307.0

5,000.7

Murder

5.5

0.0

6.8

Forcible rape

32.0

41.9

56.9

Robbery

144.9

160.0

429.3

Aggravated assault

323.6

386.7

789.5

Burglary

728.4

839.9

709.6

Larceny-theft

2,475.3

1,991.3

3,017.8

Motor vehicle theft

414.2

475.8

1,273.3

Arson

32.2

n/a

Intimate Partner Violence

	Intimate Partner Abuse, Past 12 Months Women Ages 18-59
Fall River/New Bedford	6.5%
Massachusetts	5.5%

Relationship Violence among Youth –Durfee High School Students Responses to the 2001 Youth Risk Behavior Survey

Have you ever been hurt physically or sexually by a date or someone you were going out with? (All students)
I have never been out ….	No	Yes, physically	Yes, sexually	Both ways	No answer
19.3%	68.2%	6.2%	2.3%	3.3%	0.0%
Have you ever been hurt physically or sexually by a date or someone you were going out with? (12^th grade female responses only)
7.3%	78.2%	12.7%	0.0%	1.8%

Juvenile Arrests – 1994-2000

Year	Arrests
1994	1,025
1995	899
1996	954
1997	1,065
1998	918
1999	567
2000	649
2001	949

The 949 arrests in 2001 represent an 8% decrease in juvenile arrests since 1994.

Durfee High School Students’ Self-Reported Gang Involvement – 2001 Youth Risk Behavior Survey

Are you involved in a gang?

Yes	No	No Answer
10.2%	87.1%	2.7%

Environmental Quality : Percentage of population living in areas where air quality meets or exceeds all National Ambient Air Quality Standards and whose community water systems receive a supply of drinking water that meets the Safe Drinking Water Act Regulations.

Premature Mortality Due to Particulate Air Pollution in 239 American Cities: New Bedford-Fall River, MA

*PM-10 Concentration**
	1990-1994 Average Annual Mean:	19.3
	Rank by PM-10 Concentration:	227	of 239
Mortality Attributable to Air Pollution
	Risk Ratio for Cardiopulmonary Mortality:	1.03
	Adult Cardiopulmonary Attributable Deaths:	64	(38-90)
	Attributable Deaths per 100,000 Population:	13
	Rank by Number of Attributable Deaths:	150	of 239
	Rank Attributable Death Rate:	217	of 239

*PM-10 is particulate matter 10 microns or smaller in diameter. Concentrations are reported in ug/m³

A Comparison of PM-10 Concentrations in Fall River with National Standards

Location	Average Annual Mean PM-10* Concentration (1990-1994)	Annual Mean PM-10 Concentration: National Ambient Air Quality Standards:	Annual Mean PM-10 Concentration: NRDC* Recommended Standards*
Fall River	19.6	50	17

*PM-10 is particulate matter 10 microns or smaller in diameter. Concentrations are reported in ug/m³

**National Resources Defense Council

Water Quality:

According to the Wattupa Water Board, the Fall River Water Department produces an annual "Consumer Confidence Report" on the quality of the drinking water supplied to the City. Furthermore, each day both the raw water supply and the finished water produced is tested against a battery of standards. In every category of analysis, both the city’s raw and finished water meet or exceed all State and Federal Safe Drinking Water parameters.

Lead poisoning

	Area Count	Area Rate	State Rate
Lead poisoning cases (blood lead levels greater than or equal to 25 µg/dL in children ages 6 mos - 5 yrs)	1	0.2	0.8

Immunization

(No data available at time of report.)

10. Health insurance: Percentage of population under age 65 who report that they currently have health insurance coverage

Percentage of Adults without Health Insurance

Fall River CHNA	Massachusetts	U.S. Baseline	2010 Target
11.4%	9.2%	12.5%	0%

Data from BRFSS 1994-1999

Health Access and Utilization

	Year	Number	CHNA	MA
Routine checkup more than 5 years ago	94-99	1149	8.2%	5.9%
Wanted to see doctor but could not because of cost	94-99	1163	9.3%	8.1%

OTHER INDICATORS

Poverty: Percentage of population within household incomes less than 100% of the federal poverty limit

Poverty/Demographic Information, CHNA Health Indicators Report

	Fall River	State
Per Capita Income	$10,966	$17,224
Population below 100% of poverty level	14.3%	8.9%
Population below 200% of poverty level	36.7%	21%
Children less than 18 years of age living below 100% of poverty line	21.7%	13.2%
Person’s 65 years and older	17.8%	13.7%

Economic data indicates that Fall River residents have among the lowest average incomes in MA. Additional indicators of the community’s high degree of low socioeconomic status residents:

54.7% of public school children meet low income guidelines, up from 49.9% in 1994;
24% of children ages five to 17 receive public assistance;
12.3% of children ages five to 17 live below the poverty level;
65% of elementary school children receive subsidized school lunches; and,
Of the Female-Headed Households in Fall River, 37.8% earn incomes below the federal poverty level. Of the female –headed household with children, 54.5% earn incomes below the poverty level.

High school graduation & Education: Percentage of population ages 18 to 24 who have completed high school

Drop-Out Rate. While the BMC Durfee High School dropout rate has declined, 27% of our students do not pursue the traditional path of graduation. Furthermore, despite improvements, the chart below shows that our dropout rate is significantly higher than the statewide rate while the attendance rate is significantly lower. Also troubling is the increase in the percentage of chronically absent students.

Dropout and Attendance 1999

	% of Fall River	% of MA
Dropout Rate	5.2	3.6
Attendance Rate	91.8	94.4

Plans of Graduates. Seventy percent (70.0%) of the BMC Durfee High School Class of 2001 planned to further their education. This compares to 51.4% of graduates who planned to further their education in 1984. (This percentage includes graduates attending two- and four-year colleges, business schools, and technical schools.)

Plans of High School Graduates 1999

	% of Fall River District	% of MA State
Four-Year College	31.1	52.8
Two-Year College	33.3	20.6
Work	20.7	16.0

MCAS Scores

Six MCAS tests have been administered since 1998 and one has been administered since 1999. Fall River’s score on these tests increased by 46 points since the baseline year of 1995.

MCAS Charts for Fall River

Comparison of Percentages of Fall River District to Statewide Students Scoring in "Needs Improvement" and "Failing" Ranges on the 2000 Massachusetts Comprehensive Assessment Examination

	Grade 4			Grade 8			Grade 10
	Fall River	MA	Differ-ence	Fall River	MA	Differ-ence	Fall River	MA	Differ-ence
English Language Arts	94	77	+17	67	39	+28	79	64	+15
Mathematics	81	50	+31	92	67	+25	85	67	+18
Science/ Technology	60	37	+23	85	64	+21	90	74	+16

SAT Scores

The total SAT scored of Durfee High School students have increased by 15 points from 1995 to 2001. Verbal scores have increased by four points and math scores have increased be eleven points over this period. However, although the percentage of BMC Durfee students taking the SAT has increased by five percentage points from t1995, the percentage taking the SAT in Fall River (46%) is lower than the state average (69%), the average of similar communities (54%), and the aspirant community average (79%). Furthermore, while the combined SAT scores of Durfee students have increased by 15 points, Fall River’s SAT scores for the Class of 2001 are 95 points lower than the state average.

Educational Attainment of Fall River residents

Location	0-8 yrs of school	%of Pop. w/No High School Diploma	%H.S. Grads w/o College Experience	%Some College/Assoc.		% w/ Bach Degree of Higher
Fall River	33.1%	53.3%	23.9%		14.3%	8.4%
MA	8.0%	20.0%	29.7%		23.0%	27.2%

Early detection of cancer: Percentage of uterine/cervical, colorectal, and breast cancers detected at an early stage

Cancer Screening

	Year	Number	CHNA %	MA %	US %	HP2000 % objectives
Breast Cancer Screening
Had mammogram in last two years	94-99	387	82.7	78.9
Received clinical breast exam in the past year	94-99	383	72.3	72.5
Cervical Cancer Screening
Had a Pap-smear within the last three years	94-99	581	82.5	86.2	85.5	85
Colorectal Screening
Ever had a proctoscopic exam	95,97, 99	304	27.0	31.5	40.5	40

Disability: Average number of days per year lost to school, work, homemaking, and other social roles (e.g., volunteering) for a defined population.

Disability and Limitations

	With Disability or Limitation	With Disability or Limitation AND Need Help with Activities
Fall River/New Bedford	22.1%	8.2%
Massachusetts	16.4%	4.8%

Chronic Disease

Chronic Disease Indicators: Fall River

	Area Count	Area Age-adjusted Rate	State Age-adjusted Rate
Total deaths (all causes)	1,159	942.8	814.0
Total cancer deaths	278	235.6	206.6
Lung cancer deaths	78	69.9	56.1
Breast cancer deaths	15	19.9	26.9
Cardiovascular disease deaths	459	351.9	287.3

Age adjusted rates are expressed per 100,000 persons.

Chronic Conditions/Preventive Health

	Year	Num-ber	CHNA %	MA %	US %	HP 2000 % object-tives
Hypertension Awareness
Had blood pressure checked within the last 2 years	95, 97, 99	576	95.9	95.5	94.3
Ever told had high blood pressure	95, 97, 99	575	29.2	21.6	22.7
Cholesterol Screening
Had cholesterol checked in last 5 years	95, 97, 99	563	75.6	75.5	69.7	75
Ever had high cholesterol	95, 97, 99	421	36.8	28.3
Diabetes
Ever told had diabetes	94-99	1162	6.1	4.3	4.8	2.5
Health Status
Reported Health was fair or poor	94-99	1158	15.2	11.5	12.9
Prevented from usual activities by poor physical/mental health	94-99	1152	5.1	4.7

Dental Health

Dental Health

	Dental Visit in Past Year	6+ Teeth Missing from Disease
Fall River/New Bedford	61.5%	27.2%
Massachusetts	76.8%	17.8%
US Median	68.1%	10.9%

^{United States Census Bureau (2000). "Profile of General Demographic Characteristics: 2000: Data Set: Census 2000 Summary File 1 (SF 1) 100-Percent Data Geographic Area: Fall River city, Massachusetts," [On-line]. Available: http://factfinder.census.gov/servlet/BasicFactsServlet (2003, January 16).

^{Massachusetts Department of Revenue as cited in University of Massachusetts Dartmouth Center for Policy Analysis (2002). "Fall River Public Schools Community Report Card 2001." Dartmouth, MA: author. P. 4.
^{Institute on Medicine: Division of Health Promotion and Disease Prevention: Committee on Leading Health Indicators for Healthy People 2010 (1999). "Leading Health Indicators for Healthy People 2010: Final Report." Chrvala, C.A. & R.J. Bulger (Eds.), [On-line]. Available: http://www.nap.edu/html/healthy3/ (2002, January 15).
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Massachusetts Department of Public Health: Bureau of Health Statistics, Research, and Evaluation: Chronic Disease Surveillance Program (2001). "Health Risks and Preventive Behaviors: Results from the Behavioral Risk Factor Surveillance System (1994-1999): Greater Fall River CHNA." Boston, MA: author.}}}}}^{Fall River Public Schools – 2001 High School Responses to the Youth Risk Behavior Survey. Unpublished document.

^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Massachusetts Department of Public Health (2002). "Massachusetts Community Health Information Profile: Health Status Indicators Report for Fall River." Boston: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Massachusetts Department of Public Health (2002). "Massachusetts Community Health Information Profile: Health Status Indicators Report for Fall River." Boston: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Fall River Public Schools – 2001 High School Responses to the Youth Risk Behavior Survey. Unpublished document.
^{Massachusetts Department of Public Health (2002). "Massachusetts Community Health Information Profile: Health Status Indicators Report for Fall River." Boston: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.}}}}}}}}}}}}}}}^{Fall River Public Schools – 2001 High School Responses to the Youth Risk Behavior Survey. Unpublished document.

Sperling’s Best Places (2000). "Fall River, MA and Boston, MA Crime Rate Comparison from the 2000 FBI Uniform Crime Reports," [On-line]. Available: http://www.bestplaces.net/html/crimecompare3.asp?lcity=9087&rcity=9059&view=T (2003, January 20).

^{Massachusetts Department of Public Health: Bureau of Health Statistics, Research, and Evaluation: Health Survey Program (2002). "A Profile of Health among Fall River/New Bedford Adults (1997-1999): Greater Fall River CHNA." Boston, MA: author.
^{Fall River Public Schools – 2001 High School Responses to the Youth Risk Behavior Survey. Unpublished document.
^{Fall River Police Department: Department of Planning and Research as cited in University of Massachusetts Dartmouth Center for Policy Analysis (2002). Fall River Public Schools Community Report Card 2001. Dartmouth, MA: author.
^{Fall River Public Schools – 2001 High School Responses to the Youth Risk Behavior Survey. Unpublished document.
^{National Resources Defense Council (2003). "Breath-taking: Premature Mortality Due to Particulate Air Pollution in 239 American Cities," [On-line]. Available: http://www.nrdc.org/air/pollution/bt/5403.asp (2003, January 20).
^{National Resources Defense Council (2003). "Breath-taking: Premature Mortality Due to Particulate Air Pollution in 239 American Cities," [On-line]. Available: http://www.nrdc.org/air/pollution/bt/5403.asp (2003, January 20).
^{Terrio, J.V. (2003). "Wattupa Water Board Memo on Water Quality in Fall River." Personal communication with Susan Linn Bershefsky, January 16, 2003.
^{Massachusetts Department of Public Health (2002). "Massachusetts Community Health Information Profile: Health Status Indicators Report for Fall River." Boston: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{Massachusetts Department of Public Health: Bureau of Health Statistics, Research, and Evaluation: Chronic Disease Surveillance Program (2001). "Health Risks and Preventive Behaviors: Results from the Behavioral Risk Factor Surveillance System (1994-1999): Greater Fall River CHNA." Boston, MA: author.
^{Health Care of Southeastern Mass., Inc./Southeast Center for Healthy Communities (2001). "Analysis of Health Indicators in the Southeast Coastal Prevention Center Area and Massachusetts." Fall River, MA: author.
^{University of Massachusetts Dartmouth Center for Policy Analysis (2002). "Fall River Public Schools Community Report Card 2001." Dartmouth, MA: author.}}}}}}}}}}}} Massachusetts Department of Education (2001a). "Directory Profiles," [On-line]. Available at: http://profiles.doe.mass.edu/home.asp?mode=o&so=-&ot=5&o=572&view=oth

(2002, January 30).

^{University of Massachusetts Dartmouth Center for Policy Analysis (2002). "Fall River Public Schools Community Report Card 2001." Dartmouth, MA: author.} Massachusetts Department of Education (2001a). "Directory Profiles," [On-line]. Available at: http://profiles.doe.mass.edu/home.asp?mode=o&so=-&ot=5&o=572&view=oth (2002, January 30).

^{University of Massachusetts Dartmouth Center for Policy Analysis (2002). "Fall River Public Schools Community Report Card 2001." Dartmouth, MA: author.
^{Massachusetts Department of Education (2001a). "MCAS Charts Fall River," [On-line]. Available at: http://profiles.doe.mass.edu/mcas/mcas.asp?district=095&districtname=Fall River&school=&schoolname= (2003, January 16).}} Massachusetts Department of Education (2001a). "Directory Profiles," [On-line]. Available at: http://profiles.doe.mass.edu/home.asp?mode=o&so=-&ot=5&o=572&view=oth (2002, January 30).

Massachusetts Department of Education (2001a). "Directory Profiles," [On-line]. Available at: http://profiles.doe.mass.edu/home.asp?mode=o&so=-&ot=5&o=572&view=oth (2002, January 30).

^{Massachusetts Department of Public Health: Bureau of Health Statistics, Research, and Evaluation: Chronic Disease Surveillance Program (2001). "Health Risks and Preventive Behaviors: Results from the Behavioral Risk Factor Surveillance System (1994-1999): Greater Fall River CHNA." Boston, MA: author.
^{Massachusetts Department of Public Health: Bureau of Health Statistics, Research, and Evaluation: Health Survey Program (2002). "A Profile of Health among Fall River/New Bedford Adults (1997-1999): Greater Fall River CHNA." Boston, MA: author.
^{Massachusetts Department of Public Health (2002). "Massachusetts Community Health Information Profile: Health Status Indicators Report for Fall River." Boston: author.
^{Massachusetts Department of Public Health: Bureau of Health Statistics, Research, and Evaluation: Chronic Disease Surveillance Program (2001). "Health Risks and Preventive Behaviors: Results from the Behavioral Risk Factor Surveillance System (1994-1999): Greater Fall River CHNA." Boston, MA: author.
^{Massachusetts Department of Public Health: Bureau of Health Statistics, Research, and Evaluation: Health Survey Program (2002). "A Profile of Health among Fall River/New Bedford Adults (1997-1999): Greater Fall River CHNA." Boston, MA: author.}}}}}}}}