Massachusetts shows steady climb on health and wellness report card

June 18, 2013

Grades improve in 8 of 14 health and wellness factors, as group applauds BMI successes, decries sugar-sweetened beverages inaction\

Boston - The third annual Healthy People/Healthy Economy report card finds that overall, Massachusetts is making slow headway on many policies related to public health, but a failure to address the special tax status of sugar-sweetened beverages is among the issues which continue to raise concerns. The report was released Tuesday morning at an Understanding Boston forum at the Boston Foundation.

The Healthy People/Healthy Economy Third Annual Report Card revisited progress in 14 issue areas that can be linked to improvements in public health. Massachusetts scored higher in eight areas than it did in 2012, but the overall “GPA” on the indicators was dragged down by the state’s failure to address the sales tax exemption for candy and soda – now the only F on the report card.

Averaged together, the Commonwealth’s “GPA” in the 14 issue areas rose for the second straight year, from just 1.77 (C-) in the 2011 report to 2.10 (C) in the 2012 report card and 2.33 (C+) in 2013.

“In areas like transportation funding, public health support and school-based health initiatives, this report card shows encouraging progress,” said Paul S. Grogan, President and CEO of the Boston Foundation and co-chair of the Healthy People/Healthy Economy Coalition. “It’s surprising that amidst these improvements that we have yet to see an end to the folly of giving soda and candy preferential tax treatment, when we know their role in the obesity epidemic.”

A bill (H. 2634) put forth by the Healthy People/Healthy Economy Coalition and sponsored by Rep. Kay Khan (D-Newton) would remove the sales tax exemption on soda and candy and direct the funds toward the state’s Prevention and Wellness Trust Fund as a consistent source of funding for critical public health initiatives.

The 2013 Report Card features a positive first, as well – an A-, received in the category of School-Based BMI (Body Mass Index) Reporting.

“The A-minus in school-based BMI reporting highlights the implementation of a thoughtful approach to obesity awareness in schools,” said Ranch Kimball, co-chair of the Healthy People/Healthy Economy Coalition and former President and CEO of the Joslin Diabetes Center. “BMI has given parents, students and communities a starting point for a critical discussion not just of obesity and overweight, but of the programs that can be put into place to reduce the number of young people facing the detrimental health impacts of being overweight as adults.”

“The report card underscores the progress and challenges before us and the need for stronger investment in prevention and public health,” said Valerie Fleishman, co-chair of the Healthy People/Healthy Economy Coalition and Executive Director of NEHI. “Keeping people healthy is one of the most effective ways to rein in health care spending.”

Rep. Khan’s bill would also codify the BMI measurement for students in Grades 1, 4, 7, and 10 – ensuring that this critical tool in improving overall community health is maintained in coming years, and it would set a minimum of 30 minutes of physical activity for students daily, either in class time or during recess each school day.


Areas of Improvement:

School-Based BMI Reporting: A- (up from B in 2012) – Promising new evidence suggests that the state’s school-based BMI program is creating positive results for students and families. Despite this, there has been pushback from legislators based on media reports and parent misunderstanding.

*Primary Care: B+ (up from B) – The new state health care law creates special incentives for developing strong, patient-centered primary care in Massachusetts. The Executive Office of Health and Human Services (EOHHS) has set the goal for all primary care practices to become patient-centered medical homes by 2015.

*Healthy School Meals: B (up from B-) – The Commonwealth is now fully implementing the most stringent requirements in the country for the sale of ‘competitive’ foods in schools. USDA regulations governing school lunch and breakfast programs were amended by the Healthy-Hunger Free Kids Act of 2010. Rules and regulations are being finalized, with state implementation ongoing.

Healthy Transportation Systems: B- (up from C) – The Legislature passed revenue measures to address the shortfall in funding for transportation and to improve the performance of state transportation agencies; it has not yet provided any long-term stability in financing. The state continues a promising start to healthy transportation planning.

*Food Deserts: C+ (up from C) – The state’s Grocery Access Task Force has reported a new round of recommendations and legislation has been filed to establish a food financing program to support the development, renovation and expansion of supermarkets, farmers markets, and other retailers selling healthy foods within underserved communities; now action must follow.

*Health Impact Assessments: C+ (up from C) – Agencies and advocates are utilizing health impact assessments to make health goals a priority in policy-making but little formal action is under way to expand their use. More work needs to be done to educate and garner support in the development and business communities.

Health Literacy: C (up from I) – There are many ongoing initiatives to improve health care by addressing barriers posed by poor health literacy. Now the focus should be on successful implementation.

Public Health Funding: D (up from F) – The state created a $60 million Prevention and Wellness Trust Fund—the first of its kind in the nation and a major step forward—but funds have not yet been released. The state continues to underfund the Department of Public Health and key programs.

* - recognition for two consecutive years of improvement


Biking and Walking: B (down from B+ in 2012) – Massachusetts was recognized in 2013 by the League of American Bicyclists as the 6th most “bicycle friendly” state. MassDOT remains the only state DOT in the nation to actively organize and lead a statewide Bike Week celebration. But urgent pedestrian, rider and driver safety concerns need to be addressed and more equity is needed. Comprehensive zoning reform, filed in the Legislature, is key.


Farmers’ Markets: B+ – Farmers’ markets and urban gardening have expanded further, and access to fresh, healthy foods for lower-income families has increased. Work is under way to develop the Boston Public Market, which will be permanent and open year-round.

Employee Health Promotion: B – Massachusetts’s 2012 health care cost law adds more incentives for employee health programs. Now more employers need to adopt effective and equitable programs.

Youth Physical Activity: C – Massachusetts youth score surprisingly low in national rankings of reported daily and weekly physical activity. Legislation to increase physical activity in schools (with a daily requirement) is still pending, and action is uncertain.

Trans Fats Policy: D – Little or no new action to ban artificial trans fats is foreseen. Chelsea enacted one of the strictest such bans in the country on Jan. 1 but is delaying its implementation.

Sugar Sweetened Beverages: F – Even though Massachusetts remains one of the relatively few states that grant favorable tax status to soft drinks, the Legislature refused once again to remove that preferential treatment in the 2014 budget, despite wide public support to do so. Legislation on the issue is still pending.


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.

The Boston Foundation, Greater Boston’s community foundation, is one of the oldest and largest community foundations in the nation, with net assets of more than $900 million.  In 2012, the Foundation and its donors made $88 million in grants to nonprofit organizations and received gifts of close to $60 million. The Foundation is a partner in philanthropy, with 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 that address the region’s most pressing challenges. For more information about the Boston Foundation and TPI, 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