On June 29th policymakers, nonprofit organization heads and leaders in the health care field gathered at the Boston Foundation to discuss a new report on health in Massachusetts— the product of a continuing partnership between the Foundation and the New England Healthcare Institute (NEHI). The report, called Healthy People in a Healthy Economy A Blueprint for Action in Massachusetts, is the second researched and written by NEHI with foundation support. It contains an action planto combat the findings of the previous report, published in 2007 and titled The Boston Paradox: Lots of Health Care, Not Enough Health, which focused on the growing crisis of preventable chronic disease.“That compelling report drew our attention to the rise of preventable diseases, which not only threatens the physical health of Greater Boston’s residents but is crowding out investment in other crucial priorities,” said Paul S. Grogan, President and CEO of the Boston Foundation, opening the Understanding Boston forum. “This is not a recipe for a vigorous society. The good news is that we can do something to change our priorities and there is a role for all of us.”
Valerie Fleishman, Executive Director of NEHI, spoke next, pointing out that what she called the “Great Recession” has only made the issue more urgent. “As people lose their jobs or see their incomes decline, they find it more difficult to afford out-of-pocket medical costs and health insurance premiums,” she said. “And people lose the means to eat healthfully and exercise regularly, while health care costs continue to climb.”
These recession-related repercussions could not come at a worse time in the state’s battle against both rising health care costs and the rising tide of preventable chronic illness. Today, more than half of all Massachusetts residents are either overweight or obese. Diabetes has jumped nearly 40 percent in a decade, and three out of every five people with Type 2 diabetes will develop complications such as heart disease, stroke or eyesight problems.
NEHI's Tom Hubbard, principal author of the report, said that recent research indicates that personal behaviors and environmental factors have a much greater impact on health status than access to health care. “Indeed, health care alone accounts for only 10 percent of overall health status,” he said, “while lifestyle and environmental factors account for about 70 percent.”
Mr. Hubbard said that NEHI and the Boston Foundation are launching a comprehensive effort to address both spiraling health care costs and the rising tide of preventable disease through a campaign to improve overall health and fitness, building on initial progress made by the Commonwealth’s Mass in Motion program. The effort will involve seven sectors, from schools and government to the food industry and physicians, with a series of focused strategies.
Saying that the role of state government is crucial to progress, Mr. Grogan introduced Lauren Smith, Medical Director of the Massachusetts Department of Public Health. “I was nodding my head over every page of this report, which presents a tremendous amount of information,” said Dr. Smith, who emphasized the disparities along racial lines. “Minority neighborhoods are more likely to have fast food and less likely to have supermarkets that sell fresh vegetables and fruit,” she said. “It’s interesting that I find myself focusing on issues related to healthful foods and activities now, which is the stuff they never taught me in medical school!”
Carole Simpson, former national network news anchor and a Leader in Residence at Emerson College, facilitated a discussion among four health leaders.
David Cutler, an economist from the Kennedy School of Government, emphasized that “pricing can pay a powerful role in changing behavior”—a factor that was proven to be effective in the movement to end smoking.
Bruno Nardone, representing IBM Global Business Services, said that it is important for employers to create a culture that focuses on prevention and to give employees incentives so that “wellness and prevention become a priority.”
Ruth Ellen Fitch, President and CEO of The Dimock Center, a community health center that primarily serves people of color, said that it is important to take a “surround sound” approach to prevention, so that residents are getting messages about healthy choices from a variety of sources.
Ranch Kimball, President and CEO of Joslin Diabetes Center, shocked the audience when he asked those who had or knew someone who had diabetes—and the vast majority raised their hands. He made the powerful point that some types of diabetes are preventable through healthy diet and exercise.
All of the panelists agreed that the effective and successful campaign against cigarettes presents a great model for affecting other unhealthy activities. Carole Simpson ended the discussion with encouraging words about the Obama Administration’s approach to the issue, which also is focusing on prevention as a way to control health care costs and achieve a healthy economy. “I’m very encouraged that President Obama has placed prevention as a high priority,” she said,” and that prevention is being embraced by Washington policymakers.”
Back to TBF News Summer 2009
