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This study reports physical and psychological health outcomes following mindfulness-based stress reduction (MBSR) training in an inner city environment. Results show: (a) the relative difficulty contacting referrals; (b) a relatively high completion rate (65%) eleven people have enrolled in the program; and (c) clinically and statistically significant reductions over the eight weeks of the intervention period in measures of medical symptoms (MSCL) and anxiety (BAI), and corresponding increases in self-esteem (Self-Esteem Inventory) and mental health (SF- 36). A small follow-up sample characteristic of the larger population showed maintenance of these changes for periods of up to seven years. The limitations of this uncontrolled descriptive study and the particular challenges and rewards of working in this environment are discussed.