Massachusetts shows modest improvement on health and wellness report card
Grades improve in 7 of 14 health and wellness factors, but critical investments, legislation needed to reduce costs, improve health
June 19, 2012
Healthy People/Healthy Economy Coalition finds that Massachusetts has made some progress improving the health of its residents with policies, programs and practices, but the new grades find plenty of room for the state to become a national health and wellness leader.
The Healthy People/Healthy Economy Second Annual Report Card revisited progress in 14 issue areas that can be linked to improvements in public health. Massachusetts scored higher in seven areas than it did in 2011, but budget and service concerns dropped the grade for the development of “healthy transportation systems,” and the Commonwealth was given failing grades for its handling of sugar sweetened beverages and public health funding for the second straight year.
Averaged together, the Commonwealth’s “GPA” in the 14 issue areas rose from just 1.77 (C-) in the 2011 report to 2.10 (C+) in the 2012 report card.
“While the new report card finds progress is being made – we are a long way from making the needed shift from a focus on disease care to one on prevention, and we have not stemmed the rise in obesity, hypertension and other chronic disease,” said Paul S. Grogan, President and CEO of the Boston Foundation and co-chair of the Healthy People/Healthy Economy Coalition, along with Valerie Fleishman, Executive Director of the NEHI and Ranch Kimball, former CEO of the Joslin Diabetes Center.
“The Report Card shows that the conversation about health outcomes and the need for prevention has risen,” said Kimball. “But the words must be followed by actions and resources for us to curtail the untenable rise in health care spending that is crowding out investment in prevention.”
“Cost containment is necessary, but not sufficient over the long term” said Fleishman. “These indicators remind us that health does not begin or end at the hospital doors. Policy changes in transportation, education and many other sectors are necessary to improving our citizens’ health and ending the vicious cycle of poor health and rising health care costs.”
The report notes that according to the Massachusetts Budget and Policy Center, public and private health care spending in the Commonwealth totaled $65 billion in 2010, with Massachusetts state spending on health care approaching $14 billion. Meanwhile, the state spent just $524 million in public health programs.
THE 2012 REPORT CARD
Areas of Improvement:
Biking and Walking: B+ (up from B in 2011) – Projects such as Boston’s Hubway bike-sharing program, initiatives in Mass in Motion communities across the state and “complete streets” planning that includes accommodations for cyclists, walkers and public transit make Massachusetts a national leader.
Farmers’ Markets: B+ (up from B) – Massachusetts is a national leader in the growth and operation of farmers’ markets, and options for low-income residents are growing.
Primary Care: B (up from C) – The physician community continues to move toward models of primary care and care coordination that emphasize prevention and the treatment of preventable chronic disease. Pending health care payment reforms may boost primary care further.
Healthy School Meals: B- (up from C) – Later in 2012, Massachusetts will begin to implement some of the strongest standards in the country for sales of “competitive foods in school vending machines, stores and lunchrooms. But those standards have not been implemented yet.
Food Deserts: C (up from D) – new projects at the local level and statewide organizing – through Act FRESH and the Grocery Access Task Force – are leading to innovative recommendations for future action.
Health Impact Assessments: C (up from D) – Health impact assessments (HIAs) are showing their usefulness, but legislative action to expand their use seems unlikely at this time.
Youth Physical Activity: C (up from D) – Massachusetts still lags in measures of physical activity in schools, but individual school districts are stepping up physical activity, and legislation to expand activity programs statewide is getting consideration.
Downgrades:
Healthy Transportation Systems: C (down from B) – Shaky financing of transportation (including the MBTA) and the looming threats of service cuts and fare increases outweighs commitments to health in transit planning and design.
Unchanged:
Employee Health Promotion: B – Massachusetts is laying a foundation for improved employee health programs through Mass in Motion, the Commonwealth Connector Authority and the Group Insurance Commission – but business and employee participation are still lower than desired.
School-Based BMI Reporting: B – Implementation of a 2009 Public Health Council regulation on measurement of BMI in schools continues.
Trans Fats Policy: D – There are few signs of any impending action to ban the use of trans fats in Massachusetts restaurants, and federal efforts appear to have stalled as well.
Public Health Funding: F – With few exceptions, state funding for public health continues to decline. While the Massachusetts Department of Public Health has been able to leverage federal funding to expand its healthy eating/active living efforts, that funding is in jeopardy, too – and the need for increased resources is critical.
Sugar Sweetened Beverages: F – Boston has made strides to remove sugary beverages from public schools and hospitals, but again in 2012, Massachusetts failed to remove the tax exemption for soft drinks, costing the state valuable funds for public health.
Health Literacy: I – Little concerted action is underway in Massachusetts or elsewhere to improve health literacy, but health care providers are stepping up their focus on patient-centric care measures and improved patient experience.
A new section of this year’s report card examines where the Commonwealth stands on ten research-proven determinants of health – including both health and environmental factors. Of those factors – the Commonwealth gets recognized for improvements in just one – access to health care.
The Healthy People/Healthy Economy Coalition was launched in 2010 by the Boston Foundation and NEHI with the goal of shifting our state’s focus from “health care” to “health” and making Massachusetts the national leader in health and wellness. In addition to developing these annual report cards, the Coalition has advocated on a number of public health issues, including increased funding for public health programs, an end to the sales tax exemption for sugar-sweetened beverages and for the return of daily physical activity for all students, tax credits for healthy food businesses, health impact reports for public capital building projects and the inclusion of body mass index (BMI) in student physical exams.
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The Boston Foundation, Greater Boston’s community foundation, is one of the oldest and largest community foundations in the nation, with net assets of $850 million. In 2011, the Foundation and its donors made almost $78 million in grants to nonprofit organizations and received gifts of $81 million. The Foundation is made up of some 850 separate charitable funds established by donors either for the general benefit of the community or for special purposes. The Boston Foundation also serves as a major civic leader, provider of information, convener and sponsor of special initiatives designed to address the community’s and region’s most pressing challenges.
In 2012, the Boston Foundation and The Philanthropic Initiative (TPI) merged, with TPI operating as a distinct unit of the Boston Foundation. TPI pioneered the field of strategic philanthropic advising over 20 years ago and remains a national leader today. Through its consulting services and its work to advance the broader field of strategic philanthropy, TPI has influenced billions of dollars of giving worldwide. TPI’s Center for Global Philanthropy promotes international giving from the U.S. and indigenous philanthropy abroad.
For more information about the Boston Foundation and TPI, visit www.tbf.org or call 617-338-1700.