New report card gives Massachusetts mixed grades on health and wellness programs

Innovative programs in place but more support, coordination needed

July 18, 2011

Boston, MA — A compelling new report card  released today by the Healthy People/Healthy Economy Coalition grades Massachusetts on its progress in improving the health of our residents through our policies, programs, and practices, and the effect they have on the economy. While the state has taken important strides to combat the rising rates of obesity and chronic disease amongst residents, a stronger commitment, increased resources, and more coordination are needed for the state to achieve top marks and become a national health and wellness leader.

From 1980 to 2010, the rising cost of medical services has consumed a rapidly increasing percentage of household, business, municipal and state budgets, squeezing out investments in public health, education, safety and the environment. As this spending mismatch has widened, obesity rates have doubled, greatly increasing the risk and prevalence of preventable chronic diseases such as Type 2 diabetes. One key goal of the Healthy People/Healthy Economy Coalition is to promote public policy that will stem the rising tide of preventable chronic disease and redirect resources from treatment to prevention.

The report card reflects analysis conducted by the Boston Foundation and NEHI, a national health policy institute, on policies for 14 different health indicators in four key areas: physical activity; access to healthy foods; investments in health and wellness; and citizen education and engagement. None of the indicators received an A grade, five received a B, two received a C grade, four received a D, two received an F and one (health literacy) received an Incomplete (meaning the policy was at a very early or experimental stage).

Policies given a B grade :

  • Biking and Walking: Grassroots efforts have improved the rate of biking and walking but more federal funds are needed to support the infrastructure for these modes of transportation.
  • Employee Health Promotion: In 2010, Mass. enacted a promising set of policies to promote employee health and wellness, but the challenge is turning the policies into practice on a wide scale.  
  • Farmers’ Markets: While the state’s farming community is relatively small, Massachusetts is leading the way with policies to expand access to locally grown food. 
  • School-BMI Reporting: The Mass. Public Health Council requires school-based BMI reporting and this could be strengthened by writing the regulation into law.

Policies given a C grade :


  • Healthy School Meals: Reforming school lunches remains a challenge given funding constraints and federal limitations.
  • Primary Care: There are enormous assets for primary care but the state’s health reform and health care payment reform strategies have not yet put the expansion of coordinated team-based care at the center of improvement plans.

Policies given a D grade :

  •     Food Deserts: A 2011 report found that Mass. is the fourth worst state in the U.S. for having areas where healthy, affordable food is difficult to obtain. While many groups are working to address this, the state and other stakeholders need to execute plans to fill the gaps in access.
  • Health Impact Assessments: Debate over more extensive use of HIAs, which would raise public awareness about the critical role of healthy environments in determining health, has been limited.    
  • Trans Fat Policy: While the visibility of this issue has diminished as major fast food chains drop the use of trans fats, the state has yet to take binding action.    
  • Youth Physical Activity: A recent report shows Mass. has the worst score in the U.S. for physical activity among high school students.

Policies given an F grade :


  • Public Health Funding: Mass. public health programs have a long track record for serving as national models but continued severe budget cuts threaten to weaken them at a time when public and community health programs should be seen as vital elements in improving the health of residents.   
  •  Sugar-Sweetened Beverages: As one of few states in the country to grant favorable tax status to the purchase of soft drinks, the Legislature has held hearings about eliminating the exemption but action appears unlikely at present.

The report card was released this morning at a forum held at the Boston Foundation, which featured a keynote address by Michele Leuck, President and Chief Executive Officer of the Colorado Health Institute, which has pioneered the use of critical health indicators to measure the overall health of the state. This was followed by a panel discussion featuring: Mayor Scott Lang of New Bedford; Rear Admiral Mike Milner, Assistant Surgeon General for the U.S. Department of Health and Human Services; Dr. Sandra Stratford, Chief Medical Officer of the Raytheon Corporation; and Valerie Bassett, Executive Director of the Massachusetts Public Health Association.  

The Healthy People/Health Economy Coalition, a powerful group of business, civic, and public health leaders whose aim is to make Massachusetts the national leader in health and wellness, is led by co-chairs Paul S. Grogan, President and Chief Executive Officer of the Boston Foundation, Valerie Fleishman, Executive Director of NEHI, and Ranch Kimball, former Chief Executive Officer of the Joslin Diabetes Center.

“It is critical that we engage with our partners in the public and private sectors to advocate for decisive changes needed to improve health in Massachusetts, reduce unsustainable rates of spending on health care, and improve our economy. The report card is meant to identify areas where Massachusetts has taken important steps to advance the health of its citizens, as well as rolling up our sleeves and getting to work on the areas where we have fallen short,” said Mr. Grogan.

“Business and civic leaders all recognize the need to reduce unsustainable rates of spending on health care to help improve our economy,” said Mr. Kimball. “We know these are not easy goals, but we all believe they are essential to improving the health and the future competitiveness of the Commonwealth.”

“Healthy behaviors account for 50 percent of what keeps us healthy but yet only four percent of our total national health expenditures are spent in this area,” said Ms. Fleishman. “The report card helps identify areas where we can improve this imbalance, which is vital to getting our health and escalating health care costs back on the right track.”

In the future, the report card will connect our progress on policies with health outcomes and costs.


Healthy People/Healthy Economy is a coalition to make Massachusetts the preeminent state in the country for health and wellness. The coalition is targeted at stemming a rising tide of preventable chronic illness and the threat it poses to the Commonwealth's health, fiscal stability and economic competitiveness. The Boston Foundation and NEHI with the support of the Massachusetts Department of Public Health and numerous other valuable contributors, have launched Healthy People/Healthy Economy to create a broad coalition for action in the many areas that impact health and health behaviors.


The Boston Foundation, Greater Boston’s community foundation, is one of the oldest and largest community foundations in the nation, with assets of $733 million. In Fiscal Year 2010, the Foundation and its donors made more than $82 million in grants to nonprofit organizations and received gifts of close to $83 million. The Foundation is made up of some 900 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. For more information about the Boston Foundation, visit or call 617-338-1700.


NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs. In partnership with members from all across the health care system, NEHI conducts evidence-based research and stimulates policy change to improve the quality and the value of health care. Together with this unparalleled network of committed health care leaders, NEHI brings an objective, collaborative and fresh voice to health policy. For more information, visit