Social determinants of health – factors such as access to healthy food, availability of safe affordable housing, and transportation options for accessing education, jobs and medical care – contribute enormously to the health outcomes of individuals and communities. Variability in access to these key factors in Massachusetts has resulted in deep inequities in health outcomes across race and income. In an effort to reduce inequity and deliver better health outcomes, MPHA is partnering with healthcare providers, insurers, the state and other organizations to address these “upstream” health drivers. Our goal is to ensure that health care is delivered in a more efficient, cost-effective manner and with a greater focus on wellness, equity and prevention.
Funding the Prevention and Wellness Trust Fund
Established in 2012, the Massachusetts Prevention & Wellness Trust Fund (PWTF) is the first program in the country to invest on a large scale in evidence-based community strategies to prevent illness, improve health outcomes and reduce health inequalities across race, ethnicity, and income. Between 2014-2018, PWTF funded successful clinical-community partnerships focused on childhood asthma, falls among older adults, hypertension, and tobacco use.
Despite being recognized as a national model by other states, national health care and public health organizations, and the Centers for Disease Control & Prevention, the Fund was not reauthorized in 2018. Now, MPHA is leading the charge to restore funding to this important program.
Convening the Alliance for Community Health Integration
The Alliance for Community Health Integration (ACHI) works to harness the Massachusetts health care system to promote health equity and address the social needs of patients. As a coalition of public health, consumer advocacy, social service, and community organizations, ACHI is uniquely positioned to strengthen connections between health care providers and social service organizations, advocate for more impactful hospital investments in local communities, and partner with healthcare leaders to promote affordable housing options for all Massachusetts residents.
While MPHA usually focuses on state policy efforts to promote health equity, we cannot remain silent in the face of ongoing federal attacks against our immigrant neighbors. As a result, MPHA has joined with nine other organizations to sign an Amicus Brief (also known as a Friend of the Court Brief) supporting a lawsuit filed by the Commonwealth of Massachusetts and more than a dozen other states. The lawsuit seeks to halt implementation of the new Public Charge Rule by the U.S. Department of Homeland Security, pending judicial review. In an initial victory, a federal court has ruled in favor of the plaintiffs. The order, issued by the U.S. District Court for the Southern District of New York in State of New York v. Department of Homeland Security and Make the Road New York v. Cuccinelli, blocks the regulation from taking effect for the foreseeable future while this lawsuit is decided.
Historically, the Public Charge Rule ensured that legal foreign residents applying for an extension of stay or a change of status were not “primarily dependent on the Government for subsistence, as demonstrated by either the receipt of public cash assistance for income maintenance or institutionalization for long-term care at Government expense.” The newly revised rule expands the definition of Public Charge to include the receipt of non-cash benefits, such as the Supplemental Nutrition Assistance Program (SNAP), Medicaid and housing vouchers/subsidies. Not only is this revision cruel and unjust, but it creates even greater fear in immigrant communities already facing increased levels of repression.
The Amicus Brief provides information to the court regarding the impact that the new Public Charge Rule will have on public health, by dramatically raising the barriers that legal noncitizens face when accessing healthcare. Specifically, the rule undermines the legally protected doctor-patient relationship and drastically inhibits the ability of healthcare providers to address the social determinants of health.