The Healthiest Towns

Norm and Frasier didn't get out and exercise much — unless you count those triceps reps with beer steins. As for Ally, all those 85-hour workweeks clearly took their toll on her frazzled mental state — not to mention her pencil-thin figure. And Spenser — he was too busy dodging bullets and running red lights to score very high on the life-expectancy list. No, we Bostonians haven't always been viewed as the healthiest lot. This is, after all, the home of the Fenway Frank, clam chowder, and the Boston cream pie, a city where the number of Starbucks is exceeded only by the supply of Irish pubs. Our dreadful eating habits are topped by our obsessive work habits. We come in early and stay late. And when we finally do drive home at the end of the day, look out. Pedestrians may have the right of way here, but when was the last time you stepped into a crosswalk without first saying a prayer?

But if all this is true — if Bostonians really do drive too fast, work too hard, and stuff themselves with fatty foods and frothy ale — then explain why this keeps being ranked as one of the healthiest places in America to live. First, put Boston fourth out of 50 cities in health and wellness. Then the United Health Foundation ranked Massachusetts the third-healthiest state. Then came the cleanest bill of health when Men's Health magazine's “Best and Worst Cities for Men” named Boston number one in 2001. (We slipped to number nine last year, but who's counting?) Across the gender aisle, Self magazine's “Healthiest Places for Women” put the Boston area in the top 10 out of 200 metro regions in 2000 and 2001, and in the top 20 last year. (Nice stats, ladies, but let's pick up the pace!)

Come to think of it, we are a pretty hardy bunch. We run 26.2 miles every April. Tom Brady is our poster child. And when a blizzard hits, we don't get cabin fever like those wimpy southerners. We ski to the supermarket and snowshoe to work. Our new governor doesn't even curse, never mind drink or smoke. More tangible reasons that our city and our state are tops in health come from various studies. Massachusetts boasts a low overall mortality rate, comparatively low percentage of people who are uninsured, and high level of prenatal care. We smoke less than people in all but three states (and are bound to smoke still less when Boston puts the kibosh on cigarettes in bars next month). We even suffer fewer motor-vehicle deaths than any other state, contradicting the myth of the crazy Boston driver. (Apparently, there's so much traffic that we can't get going fast enough to hurt ourselves.) And we boast a higher number of healthcare workers per capita than anywhere else in the country, according to the New England Healthcare Institute, a Cambridge think tank.

It was accolades like these that ultimately inspired us to dig deeper and find the healthiest of the healthy — the cities and towns in and around Boston in which the air and water are cleanest; the streets, safest; and the tumors and heart palpitations, fewest.

After all, if you ask people what their top factors are in choosing a place to live, “health” might not even crack the top five. Schools, transportation, location, and price would all come first. But at the end of the day, what matters more than living in a place that will give you and your children as many days as possible?

To help define what makes a healthy town, we took 13 statistics, divided them into three categories (general health, environment, and safety), and handed them over to statisticians Elaine Allen and Norean Sharpe at Babson College, who crunched them into a single ranking. (For a complete description of our methodology, see page 85.) Their conclusion: Small is beautiful, at least when it comes to health and well-being. Even though the stats were adjusted for population, “the larger cities and towns seemed to take a much bigger hit on pollution, crime, and death rate,” says professor Allen.

Perhaps not surprisingly, our results turned up a healthy crescent in the more affluent Metro West area, stretching up Route 128 and out Route 2 from top-rated Dover in the south, past third-ranked Lincoln, fourth-ranked Wayland, and fifth-ranked Carlisle, and out west to number two Bolton.

But a smattering of towns to the east and west of Boston prove that healthy doesn't always mean expensive — while tony, close-in suburbs such as Newton and Cambridge scored surprisingly low. And dismal scores in towns like Marblehead and Wilmington may serve as disturbing evidence of lingering pollution there.

For the most part, however, our rankings did what any good vice cop would do in solving a crime: followed the money. Things haven't changed much over the last few centuries — the rich are still basking in the warm glow of rosy cheeks, and the poor are still sniffling and sneezing in the alleys. The wealthy are the ones who can best afford the doctors and hospitals that keep our tickers ticking. They're the ones most able to venture out to where the houses are farther apart and crime is less of a nuisance. And they're the ones most likely to have the political clout to push that unsightly toxic waste dump into someone else's backyard. Of the top 20 towns on our list, 60 percent have median house prices higher than $500,000. (Five — including Weston, Wellesley, and Lincoln — have median prices topping $700,000).

“Frankly, it does seem to revolve around affluence,” says Alan Lyman, president of Century 21 Westward Homes, which serves the western suburbs. “I don't think Wellesley has healthier air or water or anything of that sort. People here tend to have more access to health facilities or have more money to spend on better healthcare.” Being a quick hop down the Mass. Pike from some of the world's best hospitals doesn't hurt, either.

These towns also have a benefit more urban populations lack: space. If trees are the lungs of the environment, then top-rated Dover could belt out Aida without taking a breath. Its back roads are a hilly slalom course with horse crossing signs and Mercedes SUVs in front of houses hidden among the birches and pines. More than a third of Dover's land area is open space, and hiking and horseback riding are common. Even the town center seems to be just a clearing among the trees, with a few municipal buildings and a gas station whose bathroom is so clean you could eat off the sink.

Looks can sometimes be deceiving, however, says 65-year-old Bonnie Miskolczy of Carlisle, who, along with her husband, Gabor, cross-country skis and grows organic vegetables. Despite the healthy lifestyle of her community, she worries about the toxic Superfund site upwind of the town, and the ChemLawn trucks she sees pouring fertilizers onto her neighbors' green lawns every summer. She even remembers aerial DDT spraying decades ago — before the toxic pesticide was banned. “There's a history here in the environment,” she says, “and there is only so much it can take. Unless you look under the surface, who knows?”

Despite the strong showing from rich Metro West bedroom communities, affluenza, it turns out, isn't the only medicine for influenza. Three towns at the top of our list show it's still possible to live healthily and have money left over for a gym membership. Groveland, Sharon, and Middleton all have median house prices of less than $400,000, yet scored high due to their rural environs. “When we were looking at homes, we were thinking along two lines: physical health and mental health,” says Steven Linkovich, who, along with his wife, Denise, moved to Groveland from Melrose. They found Groveland's Sunday-afternoon attitude to be a perfect destresser after a tiring week in the city. “I see more and more couples moving up here,” Linkovich says, “trying to find a relaxed environment even if they have to move a little farther away from the city to do it.”

Sharon even has a history as a sanitarium for people recovering from tuberculosis. As one developer claimed in the 1880s, “the wonderful effects of Sharon air on those suffering from almost any form of disease [have] long been known.” This developer attributed the positive effects to a surplus of ozone. Whether or not there are holes in that theory, Sharon still places an inordinate emphasis on health for a predominantly working-class town of postwar Cape and ranch houses. Real estate agent Dave Wluka says residents start running around Lake Massapoag before sunrise to train for the annual Massachusetts Triathlon, held in Sharon every summer. And a gargantuan “community center” on the shores of the lake offers more than 50 types of recreational activities, from archery and volleyball to judo and Afro-American dance.

On the flip side, no matter how much exercise you get, there are some aspects of an environment you can't control. Salem and Marblehead scored dismally in the category of general health, hurt by higher-than-expected rates of some types of cancer. The culprit could very well be the Salem Harbor Station power plant — one of five remaining power plants in the state that were commissioned before the Clean Air Act took effect, and which has been spewing sulfur dioxide and other chemicals into the air ever since. A first-of-its-kind study by the Harvard School of Public Health blames the plant for 30 premature deaths a year, as well as 400 extra visits to the emergency room and about 2,000 asthma attacks. Governor Mitt Romney cited the study in February when he nixed giving the power plant a two-year extension to comply with clean-air regulations, which it must now do by October 2004.

In other towns, the threats come not from the air, but from water. Wilmington has one of the highest age-adjusted mortality rates in the state. It's also got a number of hazardous waste sites and recently had to temporarily shut down one of its water wells because of contamination. “Wilmington's a mess,” says Matthew Wilson, director of Toxics Action Center, which has put two separate hazardous sites in the town on its “dirty dozen” list of contaminated places. (Other sites in eastern Massachusetts are in Jamaica Plain, Marlborough, Lynnfield, and Methuen.) As the Woburn case featured in the film A Civil Action made clear, however, establishing a link between a disease cluster and a single polluter can be difficult. “Sometimes there is an obvious source,” says Wilson, “and other times it's a combination of different factors — the drinking water, air pollution, pesticide use, a nearby nuclear power plant. It's a cumulative effect.”

For residents worried about toxic sites near their own homes, two Web sites help identify potential hazards. The state's Department of Environmental Protection ( dep) lists every chemical spill, from oil leaks to the more critical Tier I sites of commercial hazardous waste. The state has also established the Toxics Use Reduction Institute at the University of Massachusetts Lowell (, which records the amounts of toxic chemicals companies release into the environment. Another factor to consider is whether your house is attached to your town's water supply or has its own well. In the first case, you are relying on the town's own monitoring to ensure that your water is safe. In the latter, you're responsible for testing your own water and often saddled with the bill for cleanup.

Of course, there are other things that can affect your health. Crime, for one. Surprisingly, when the figures are adjusted for population, the cities with the greatest number of violent crimes aren't always the biggest or most dense. Arlington and Newton, for example, actually have less violent crime per person than bucolic Sherborn and Essex. And while violent crime is the most immediate thing many people think about when they consider safety, it's not necessarily the best factor to consider.

Some towns on our list literally went up in flames for their high proportion of structure fires. There's little difference on the face of things between Topsfield and Boxford, both sleepy communities north of Boston — except that Topsfield had 60 structure fires last year to Boxford's 11.

Another indication of projected well-being is public-safety spending, which includes police, fire, and emergency medical services, along with preparedness for disasters that these days include terrorist attacks. This spending varies enormously from town to town, even among the most rural ones that collect buckets of property tax money — though it should be noted that many of these towns have volunteer EMS and fire departments, which cut their costs considerably (something not accounted for in our study).

It's just one of the many caveats to consider in using our ratings. Who's to say whether a high number of fires is more important than a huge amount of open space or significant cancer rates? Everyone has an opinion about what makes towns healthy. In the end, though, it's the people who live in them who determine the health of those communities, in the way they drive, how often they see a doctor, what they eat, and the aggressiveness with which they fight to protect their streets and yards. So get out and exercise. Get a cancer screening. Learn who's polluting your backyard. Lobby your selectman on police and fire spending. Then go ahead and eat that Boston cream pie.