THE ISSUE
COVID-19 has laid bare and exacerbated the magnitude of health disparities in Massachusetts. While racial inequities are not unique to the health care system, they are reflected in persistent health disparities and increased disease burden for communities
of color. People of color are disproportionately affected by chronic health conditions such as diabetes, asthma, hepatitis, and hypertension, as well as issues related to infant mortality, maternal mortality and morbidity, and police brutality. Access
to quality medical care is just one factor influencing health outcomes. Social determinants of health, including the conditions in the environments where people are born, live, learn, work, play, worship, and age, affect a wide range of health, functioning,
and quality-of-life outcomes and risks and, as such, are key components of any work to advance health equity. In addition, factors such as community support, school quality, home conditions, employment opportunities, air and water quality, and community
safety all impact health greatly and help to explain why some individuals are healthier than others. These non-medical factors may impact overall health risk profiles, physical activity opportunities, and access to healthy food.
While the scope of addressing social determinants of health involves analyzing broader systematic inequities and remains daunting, this area is full of opportunities to increase overall population health and promote health equity. Physicians can and should
be at the forefront of addressing health more comprehensively, both at the population level and the individual patient level.
OUR STANCE
Health care is a basic human right, and accordingly, we believe that the provision of health care services and optimization of the social determinants of health are ethical obligations of a civil society. The MMS strives to advance health equity in all of our advocacy. We believe that policymakers should work alongside health leaders to develop policies that will dismantle structural racism and inequities in care. We recognize racism as a public health crisis that requires significant systemic
change to overcome in all sectors and industries, including health care. We further acknowledge racism as a social determinant of health and a root cause of many health inequities and negative health outcomes. Furthermore, the Medical Society understands
that inequities in income and wealth pose pressing public health problems that are rooted in and perpetuated by racism.
The Massachusetts Medical Society is committed to being an antiracist organization and will work to promote equity and racial justice by prioritizing antiracism in its policies, strategic plan, governance, and activities. Furthermore, striving for equity
in health and health care encompasses concerns related to all inequitable disparities in health and health care, not just those based on race. Accordingly, the advocacy of the Medical Society seeks to focus on all issues of health inequity, aiming
to eliminate all forms of discrimination, including but not limited to those related to racial identification, national or ethnic origin, sexual orientation, gender identity, age, sex, religious affiliation, disability status, immigration status,
or economic status.
The Medical Society supports policies aimed at improving social determinants of health for all people and works with physicians, health systems, and payers to develop sustainable, innovative care delivery and payment models to improve social determinants
of health for all patients.
The MMS believes the Commonwealth should emphasize the impact of social determinants of health on health care access, outcomes, and cost. Specific areas of focus should include:
- flexible funding to address health-related social needs.
- the incorporation of social determinants in payment policies and performance measurement.
- research and evaluation of innovative interventions and policies to build the evidence base.
In order to address both interpersonal and structural racism and promote health equity, the Massachusetts Medical Society has developed an Antiracism Action Plan to provide the framework to help the MMS dismantle structural racism within the MMS, as well
as actively work to eliminate racism affecting MMS members, Massachusetts physicians, patients, and the public. Identifying opportunities and advocating at the federal, state, and local levels on racism, poverty, violence, and other social determinants
of health are key goals for the Medical Society.
OUR ADVOCACY
The MMS advocates for policies at the state and federal levels that aim to reduce health disparities. As part of these efforts, we continue to advocate for increasing diversity in the health care workforce through policies that expand access to medical
education for those seeking to enter the workforce and that promote equitable development of health care workforce diversity and capacity. In our advocacy, the MMS approaches the root causes of health disparities by promoting policies focused on social
determinants of health, including nutrition, housing, lived environment, maternal health, and others. On the federal level, the MMS has supported the Anti-Racism in Public Health Act. In the 2023–24 state legislative session, the MMS is supporting
An Act to advance health equity (H.1250/S.799), comprehensive legislative reforms proposed by the Health Equity Compact to prioritize
equity in state government, standardize and report on data to advance health equity, and improve access to and quality of care for our patients.
Physicians can and should be at the forefront of addressing health more comprehensively. The Medical Society advocates for ensuring that the physician voice is consistently present in conversations surrounding health policy in the Commonwealth and in
Congress.
For more information on MMS policies related to health equity, antiracism, social determinants of health, and other issues, please see our policy compendium here.
