Boston – A new coalition has been created to respond to an epidemic of chronic preventable disease driven by soaring rates of obesity that threatens to undermine our physical wellbeing and crowd out critical investment in the region’s future. A partnership between the Boston Foundation and the New England Healthcare Institute has been joined by leaders from business, health care, civic and nonprofit sectors to build on the achievements that have made Massachusetts a global leader in health care, to catalyze a health revolution.
This is the first time such a partnership has formed in support of a comprehensive agenda, from public education to public policy advocacy. One goal is both symbolic and very real: the coalition will advocate for repeal of the current sales tax exemption afforded to soft drinks sold in Massachusetts. Widely considered a leading cause of obesity in children, repeal of this exemption would generate more than $50 million a year which could be used to support other programs that promote greater health and wellness.
The goals of the new coalition include:
• Expand physical activity and access for every resident;
• Increase access to healthy foods in every neighborhood
• Create incentives for health and wellness; and
• Encourage citizen education and engagement in the issue.
“This is a national problem with a great potential for a local solution,” said Paul S. Grogan, President and CEO of the Boston Foundation, and a co-chair of the coalition. “Our region’s record of accomplishment as a world center of medical innovation provides an example and a platform on which we can launch a new culture of public health and wellness.”
A soaring rate of obesity among local residents stands at the heart of the coalition’s work, because of the consequences and the pace of this destructive trend.
“In Massachusetts, 30 percent of our children and 58 percent of all residents are either overweight or obese, and the obesity rate has risen fully 8 percent in just eight years,” said Valerie Fleishman, Executive Director of the New England Healthcare Institute, and a co-chair of the coalition. “That has driven rates of Type 2 diabetes, heart disease and stroke to sobering rates, with serious consequences for all of us.
The trend in health status also has dire implications for the economic wellbeing of the Commonwealth, a fact integral to the work of the coalition.
“Obesity-related expenditures cost Massachusetts $1.8 billion a year already, and overall spending on health care has topped $60 billion a year,” said Ranch Kimball, former CEO of the Joslin Diabetes Center and a former Massachusetts Secretary of Housing and Economic Development. “Freeing up even a fraction of the cost of health care will create new resources to address the compelling needs of the Commonwealth—including the very strategies that can make us all healthier and bend the curve on this rising level of preventable chronic disease that threatens our future.”
The current coalition was years in the making, building on new research by a partnership between the Boston Foundation and the New England Healthcare Institute. This began with a groundbreaking report in 2007, Boston Paradox: Plenty of Health Care, Not Enough Health, that identified a serious mismatch between the determinants of health and the current investment in health care.
New research drives coalition creation
According to the Boston Paradox report, which is currently available online at www.healthypeoplehealthyeconomy.org, about 50 percent of our health status is determined by diet, exercise, smoking, stress and safety—in other words, behaviors and choices taken. Yet the vast majority of American health dollars—fully 88 percent—is spent on access to care and on treatment, with just 4 percent spent on the very lifestyle options and choices that, in fact, determine outcomes.
The result is that while many Americans believe that our health care system is the best in the world, our health is declining on most measures, including survival rates for adults age 45-65, compared to other nations, which spend far less per capita on care.
The new coalition builds on the success of Mass in Motion, a program developed by the Massachusetts Department of Public Health; local efforts such as Shape Up Somerville, which has been nationally recognized as a model for building healthier communities; and important grass roots efforts to raise awareness and improve health in urban communities where statistics can be grimmest. It seeks to tap the collective strengths of the region’s world-class institutions, a pioneering community of health professionals and a heritage of activism, innovation and accomplishments in public health.
The coalition seeks to make a significant change in the culture of health. In the words of John Auerbach, Commissioner, Massachusetts Department of Public Health, speaking at a forum held at the Boston Foundation as part of the organizing process for the coalition being launched today, “What we’re really talking about today is changing the conditions of people’s lives and public health writ large. We are at a turning point, with the opportunity to develop a critical mass of well-coordinated activities.”
The long term goals of the coalition include:
- Reduce the rates of overweight and obesity;
- Reduce rates of preventable chronic disease, such as Type 2 diabetes, heart disease, stroke and certain types of cancer;
- Reduce health care costs through increased prevention and health promotion.
The coalition provides benchmarks for measuring success in each area of proposed activity. In the area of expanding physical activity, benchmarks include structured recess in schools; increased out-of-school physical activity and the opportunity to walk to school; increased access to safe bicycle paths and greater walkability for all residents; and increased usage and a greater number of parks and playgrounds.
For increased access to healthy foods, benchmarks for success include having more farmers markets and public markets; more healthy meals served in schools; a reduction in sugar-sweetened beverage consumption; the elimination of so called “food deserts,” areas with limited access to healthy foods, through business development; and the elimination of trans fats from the general diet.
To create incentives for health and wellness, benchmarks for success include an increase in employee health promotion programs; sustainable public health funding to promote health and wellness; and the use of payment incentives by payers and employers. The bottom line in this area is to incorporate incentives to improve healthy behaviors at the workplace, at home and in the community.
In the fourth goal area, encouraging citizen education and engagement, benchmarks for success include menu labeling in all restaurants; implementation of Body Mass Index screening and reporting; comprehensive, statewide public health awareness campaigns for better health; the use of health impact assessments; and greater public understanding of the linkages between healthy behaviors and overall health.
As the members of the coalition work together with colleagues in virtual all aspects of civic life, a consistent emphasis will be placed on measurement, tracking the successes and identifying continuing challenges in the quest for improving the culture of public health. The Healthy People/Healthy Economy Scorecard will be an annual report that tracks progress in Massachusetts towards implementation of policies, practices and programs that improve the rates of health and wellness. The first scorecard will be released in June of 2011.