The Small Story

ROXBURY—Other men are fidgeting, staring out the window, waiting for their time at Whittier Street Health Center to end.

Not Charles.

Charles takes a seat in the second row, a 29-year-old man in a crisp white T-shirt. He leans forward. He asks questions.  

He’s required to take this class on men’s health, as part of a prison release program. But this is helpful information right here, about disease and how to prevent it.  One thing, he already knows:

“Black guys die early.”

For years, Whittier has been trying to change that, working in one of the neediest neighborhoods in the city, and using these Wednesday night “rap” sessions to introduce low-income, men of color to healthy living. One of the main goals: connect them to the health care at Whittier, and keep them coming back.

Dalton Skerritt, director of Whittier’s Men’s Health Clinic, can tick off the facts: higher rates of diabetes hospitalizations, higher rates of death from AIDS. In Boston, black men are about three times more likely to die of prostate cancer than white men, according to the city’s 2009 Health of Boston report. What he wants to know from these students is why.

Bad eating habits, lack of exercise, genetics—all are factors, he confirms, when the men call those answers out. But there’s something else, something bigger.

“Oh!” comes a call from the back of the room. “Check-ups!”

Early screenings and regular check-ups. These things are, to use Dalton’s favorite word, “key.” But young men are significantly less likely than young women to have seen a doctor in the last year, according to a recent Centers for Disease Control report. 

Childbirth will often get women in the rhythm of regular doctor visits. But men are not always aware of the need to check in. Or they’re aware, and unwilling to go.

“Men wait until their foot is dropping off to go to the emergency room,” Dalton says.

In low-income communities of color, there is also the problem of access to comprehensive quality care. Whittier was already running at capacity before the recession- in the past year, visits jumped 20 percent. And still, the clinic is only serving about six percent of the neighborhood. 

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A slight man, quick to smile, Dalton darts around the room in his orange shirt, in his multi-colored striped tie.  He hugs a concrete support, to show how AIDS can put a “headlock” on your T cells. He stumbles around, sloppy, demonstrating a warning sign for disease.  

“You think he’s drunk,” Dalton says, imitating a stranger on the street. “But he could be getting ready for a diabetic coma.”

For the past three years, Dalton has taught this health education class, mostly for the men in the clinic’s Post Prison Release Program. In some ways, he’s an unlikely candidate for the post. Until several years ago, he was a special markets manager for the beer company, Guinness.

But growing up in the Caribbean, he saw plenty of people in pain. And through the years, he made it his business to mentor other men—help them with the GED, encourage them to get check-ups. He gave them the hope he had—until his wife and baby died in a car crash, and he lost track of it.

He came out the other end mostly through music and prayer. He remarried. He raised his remaining child. But what he wanted now was different. What he wanted was this job at Whittier, the chance to connect again with men who might need his help. 

Dalton can’t do anything about the violence in Roxbury, Mattapan, and the other struggling neighborhoods Whittier serves. But he can talk them through the other threats, from the chronic diseases to the domestic fights to the daunting job search after prison.

He can be their man in pressed pants and tie, the professional they rely on for help. He tells them again and again: Happy to write anyone a reference.

“I do that for you- no problem,” he says, with that Caribbean lilt. “I don’t even hesitate.”

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Over the years, Whittier has become a neighborhood fixture, the only community health center in Boston that's federally funded to reach out to public housing residents. Gains have been made, but the challenges are steep; one in four residents has high blood pressure, and Roxbury still has the highest infant mortality rate in the city.

The center's services are tailor-made to address the problems that sometimes come with poverty: there is substance abuse counseling and anger management groups and domestic violence outreach. The Men’s Health Clinic meets another specific need, staff there say--designed for men, run by men.

Hundreds of clients pass through the clinic every year, some referred by other agencies, others drawn in by the clinic’s annual Men’s Health Summit.

Many come from the clinic’s Post Prison Release Program, where Dalton spends much of his time.

The process is intensive. He visits the men three times before they are released, trying to determine their health needs; schedules a free check up within days of their release; connects them to services in the clinic, and beyond; then follows them for three months through daily case management.

“You’re building a serious relationship here,” he says.

A lot is at stake. Studies show ex-offenders have higher rates of chronic disease and mental illness, and often disappear into the fabric of the community without connecting to health care. 

In time, they develop conditions that are harder to cure—and more costly for the state to treat. There’s also the public health risk, when an infectious disease like AIDS goes undiagnosed, and spreads in the community. 

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At the end of Dalton’s eight-week course, he gives each graduate a certificate. For the ex-offender, it's something to put on the resume, when every little thing counts. He also encourages his graduates to become Men’s Health Ambassadors, earning $25 for each presentation they make on men’s health, in a shelter, or a halfway house.

Of the 22 men seated before him tonight, he has no doubt that some will drift off the radar when their time at Whittier is done.

But Dalton is not discouraged. He sees low recidivism rates for the men in his program, and that’s something. Recently, Dalton says, The Department of Corrections asked for his help in designing a health education curriculum.

And there will always be success stories to sustain him—like the graduate who went to college, and found himself a stable job. Just the other day, that man noticed a rash while gardening, and instead of ignoring it, or going to the emergency room, he came here, to Whittier. 

On the way to see his doctor, he stopped by Dalton’s office to say hello.