3 steps for addressing health equity in Mass.
Emphasize prevention, improve data, empower diverse voices
MAURA HEALEY made history when she was sworn in as the 73rd governor of Massachusetts. She will have no shortage of challenges to tackle in the early days of her administration—but it is critical that she places health equity at the top of her list.
For generations, marginalized communities in Massachusetts and across the nation have suffered worse health outcomes than major controlling groups—and that disparity has only been magnified by the COVID-19 pandemic. A recent report from the Blue Cross Blue Shield of Massachusetts Foundation and Manatt Health spells out these impacts in no uncertain terms: Black and Hispanic people in Massachusetts are two to three times more likely to contract COVID, be hospitalized due to COVID, or die from COVID than their White or Asian counterparts.
These disparities are not new nor are they unique to Massachusetts, but we cannot take solace in the fact that our failures are longstanding or widespread. We need to act. Here are three steps Healey can take to help ensure health equity:
Emphasize prevention, not just treatment: Obviously, essential health care occurs in hospitals or doctor’s offices—but just as vital is how people live outside of those settings. Do they have a safe home to recover after an illness? Sufficient food to meet their nutritional needs? Access to education to get a good job? Adequate transportation and childcare so they can keep that job?
These are some of the social determinants of health, and public health research tells us that these non-medical factors can account for up to 70 percent of our overall well-being. If we want to truly improve our health outcomes, we need to increase our investments in illness prevention and health promotion. Addressing social determinants of health can help reduce ailments, increase equity, and drive economic growth for all.
Collect better data to drive precision interventions: We have clear evidence that health inequities in Massachusetts negatively impact residents based on their race, gender, sexual identity, geographic location, and many other factors. However, all too often we lack the data to make actionable recommendations that solve these problems; the data is siloed away, reliant on insufficient sample sizes, or simply does not exist.
Healey should fill these data needs by creating collectives of leaders from the private sector, public sector, academia, and communities to standardize metrics on health equity for both payers and providers. Aligning these requirements will provide vital information on patient demographics, allowing us to identify shortfalls that need to be addressed and hold ourselves accountable.
Empower diverse voices in both government and health care: As the first woman and the first member of the LGBTQ+ community elected to the governor’s office, Healey understands the value of bringing underrepresented groups to the table to share their lived experiences. Establishing health care equity positions throughout state government and ensuring diverse officials are placed in leadership positions enables her to advance this vital issue, which has long been at the center of her work.
The governor should also bring the state’s resources to bear to encourage people from underrepresented backgrounds to enter health care and public health. Increasing the diversity of our health care providers would bolster this valuable workforce, improve culturally competent care throughout Massachusetts, and foster trust between clinicians and patients. At every turn, these investments will increase equity and improve patient outcomes.
Clearly, we cannot eliminate all health inequities overnight. Fortunately, Healey does not have to start from scratch. There are advocates across Massachusetts who have long pushed for progress, and they are eager to partner with the governor. I am proud to be a member of one such organization, the Health Equity Compact, which has brought together elected officials, academics, public health and health care experts, and private sector leaders to listen to the concerns of community members and channel those conversations into legislation that will advance health equity in Massachusetts. Healey has long engaged with these leaders, and I am hopeful that she will continue that effort throughout her time as governor.
Massachusetts has long been a national leader in enacting reforms that drive our health system forward. Right now, we have an opportunity to continue that legacy in a way that expands equity and erases a system that assigns health care winners and losers based on the circumstances of one’s birth. I am confident that Healey has the ambition and the ability to face this crisis—but this isn’t a one person job. It will take all of us coming together to ensure that every person across the Commonwealth can lead a healthy, fulfilling, and valuable life.
So let’s get to work.
Lumas Joseph Helaire is the assistant dean for population health management and health equity education at the T.H. Chan School of Public Health at Harvard University.