Commonwealth Conversations: Public Health

A Smart Step Toward Reducing Alcohol Use Among Our Youth

  By Secretary of Health and Human Services Dr. JudyAnn Bigby

There’s no question that underage drinking is a serious public health problem in communities across the nation. Here in Massachusetts, we’ve made progress in reducing rates of alcohol consumption among our young people, but there’s still much more to be done.

That’s why I’m so encouraged by the recent announcement by the MBTA to no longer allow advertising for alcohol on any of its property, including subway cars and stations, buses and bus shelters, and commuter rail trains.

Why is this so important? We already know that that young people are especially vulnerable to peer pressure when it comes to drinking alcohol. What may come as a surprise is just how influential alcohol advertisements are on youth.

Here, the science is clear: the more alcohol ads that young people see, the more likely they are to drink. For example, one recent study showed that each alcohol advertisement that a teen sees above the monthly average (23) causes an increase in alcohol consumption of 1%. That same study indicated that youth in markets with greater alcohol advertising expenditures drank more.

That’s troubling – especially when we consider just how much young people are bombarded by alcohol messages. In 2008, for instance, alcohol advertisers spent close to $8 billion nationwide on outdoor advertising. One recent study published in the American Journal of Public Health showed that in urban areas, young people are exposed to alcohol advertisements almost as soon as they walk out their front doors. What’s more, there is substantial evidence that alcohol advertisements are disproportionately located in African-American neighborhoods.

We know the impact that alcohol advertising has on youth. So it’s important that we do everything we can to reduce the influence of advertising in environments where young people congregate.

For many young people in greater Boston, MBTA buses, subways and trains are a vital part of everyday life; in many cases the MBTA is their school bus. Our children deserve to ride to school, work, and social activities without being encouraged to consume alcoholic beverages.

What’s more, the MBTA is not alone in working to support underage drinking prevention efforts. With its recent decision, the T joins transit agencies in Chicago, Washington DC, San Diego, Philadelphia and San Francisco in rejecting these advertisements and supporting healthy development among our youth.

Working together, we can continue our forward movement in the battle against underage drinking in Massachusetts. I’m proud that the MBTA has joined us in this fight.

Celebrating the passage of the Affordable Care Act and Massachusetts’ role shaping it

Posted by:
JudyAnn Bigby, MD, Secretary of Health and Human Services

 

Today we celebrate the one-year anniversary of the enactment of the Patient Protection and Affordable Care Act, known to many by its nickname, ACA.  This historic legislation, closely modeled after the health care reforms that Massachusetts enacted in 2006, will eventually provide an additional estimated 32 million Americans with access to comprehensive, affordable health insurance coverage.  While most of the major reforms of the ACA do not go into effect until 2014, Massachusetts and its residents have already seen many benefits in this first year since the law’s passage.

Massachusetts already had many important protections in place for consumers with private health insurance; the ACA brought additional protections that became effective September 23, 2010, such as: prohibiting health insurers from having annual or lifetime limits on benefits and eliminating copayments for preventive services.

Recognition for reducing hospital readmissions

Posted by:
JudyAnn Bigby, MD, Secretary of Health and Human Services

 

One of the top priorities for the Patrick-Murray Administration and the Executive Office of Health and Human Services is to find ways to deliver quality care to individuals and contain the rising costs of health care in the Commonwealth. A key avenue for reducing costs is to lower the rate of hospital readmissions throughout the state by improving the coordination of care people receive across hospital and other settings by multiple providers. Every year (since 2005), the state’s Betsy Lehman Center for Patient Safety and Medical Error Reduction honors a healthcare provider, health organization, or individual for their leadership and innovation in patient safety with the Betsy Lehman Patient Safety Recognition Award. The theme for the 2010 Betsy Lehman Award highlighted the importance of issues related to patient care transitions. A six member Lehman Center Award Review Committee used a set of criteria to evaluate nominees on how well they could demonstrate that their efforts to make improvements had resulted in safer and more effective care transitions for patients across the healthcare continuum.  This year’s award recipient, MetroWest Medical Center/Vanguard Health Systems (MWMC), successfully implemented interventions that resulted in lowering the rate of readmissions for certain patients with congestive heart failure. MWMC has been a participant in the multi-state, multi-stakeholder State Action on Avoidable Re-hospitalizations initiative known as STAAR.

A Massachusetts milestone: health care payment reform legislation

Posted by:
JudyAnn Bigby, MD, Secretary of Health and Human Services

Yesterday marked a health care milestone in Massachusetts which I’m particularly pleased to blog about: Governor Patrick announced comprehensive health care payment and delivery reform legislation that is designed to control rising health care costs and improve patient care throughout the Commonwealth.

The Governor's proposal, “An Act Improving the Quality of Health Care and Controlling Costs by Reforming Health Systems and Payments,” builds upon the Patrick-Murray Administration's bold leadership and success in achieving universal access to health care in Massachusetts. The bill takes the next important step: it offers a solution to ensuring that health care is universally affordable.  This legislation changes the model for payments to providers and recognizes that doctors, nurses, and other providers want – first and foremost – to take care of their patients.

By encouraging the growth of “integrated care organizations” (ICOs), comprised of groups of providers that work together to achieve improved health outcomes for patients at lower costs, the bill offers alternatives to the current fragmented system that individuals find too complicated to navigate, especially when they have significant medical problems. Over the long term, providers who emphasize health and wellness or help individuals manage chronic medical issues, improve health and reduce system costs, but most importantly, make the patient experience better. In the current model, providers are not rewarded for those outcomes.  Through this legislation, the Commonwealth will change incentives in the payment system by providing the necessary infrastructure and support for global and other alternative payment methods and innovations. 

The problem with health care in Massachusetts: The way we pay for it.

Posted by:
JudyAnn Bigby, MD, Secretary of Health and Human Services

 

In the four years since I assumed the role of Health and Human Services Secretary of Massachusetts, residents of the Commonwealth have witnessed significant changes in the health care landscape. We have successfully implemented health care reform to achieve 98% coverage of all state residents; the Affordable Care Act was signed into law by President Obama on March 23, 2010; and the state has accomplished near universal coverage of all children – an estimated 99.8%, including 20,000 more children enrolled in MassHealth during the past year alone.

Yet significant challenges persist that are fundamental to the health care delivery system in Massachusetts, namely, it operates in a high-cost, fee-for-service environment, rather than as a model that encourages coordinated, patient-centered and cost-effective care.  A leading priority of the Patrick-Murray Administration during its second term is to address systemic health care costs in Massachusetts. To achieve meaningful change in this arena, the enduring elements of health care costs must be tackled in a comprehensive way. Integral to achieving this goal is putting the right tools in place so that the state can ensure success of this key agenda item.

Reforming Primary Care In the Commonwealth: Putting the Patient First

Posted by:
JudyAnn Bigby, MD, Secretary of Health and Human Services

 

Last week, the Executive Office of Health and Human Services announced the invitation of 46 primary care practices to participate in the Patient-Centered Medical Home Initiative.  This is a tremendous milestone in a progression that is essential to making sure that every person in Massachusetts receives high-quality, patient-centered primary care.

While the term ‘Patient-Centered Medical Home’ may not be as familiar to residents of the Commonwealth as ‘primary care,’ medical homes are vital to improving patient care, achieving good outcomes and lowering costs, both in Massachusetts and nationally. The state’s Patient-Centered Medical Homes Initiative is one of the key ways we are reforming the health care system in Massachusetts to be more responsive to people’s needs. The Patient-Centered Medical Homes Initiative is one solution to eliminating fragmented, uncoordinated care that risks a patient’s health and adds to the cost of care; it is a way to mitigate the increasing prevalence of chronic illness and poor management of chronic disease; and offers a solution to make primary care more attractive as a medical specialty.  The project recognizes the need to make it possible for primary care doctors to provide access to their patients when they need to be seen, to have the time to answer their questions and concerns, and to review their medical records and coordinate their care with others. It also recognizes the value of having nurse educators or community health workers or pharmacists as members of the medical home team.

Breast Cancer Awareness and Prevention

Posted by:
JudyAnn Bigby, MD, Secretary of Health and Human Services

October is Breast Cancer Awareness Month, which is not only a time be aware of breast cancer, but it’s an opportunity to learn more about the proactive steps women can take to protect themselves. 

According to the Centers for Disease Control (CDC):

• Breast cancer is the most common cancer among adult women in the United States, and the second leading cause of death from cancer among women.
• One out of every eight adult women will get breast cancer in her lifetime.
• The risk of breast cancer increases with age.
• Although White women are the most likely to get breast cancer, Black women have the highest mortality rate. 

What can you do to make a difference in the fight against breast cancer? 

1. For women 40 and older, consider getting a mammogram.  Early detection means that treatment can begin earlier in the course of the disease, possibly before it has spread to other parts of the body.  According to National Cancer Institute (NCI), studies show that screening with mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74, especially for those over age 50.  So, if you are in your 40s, ask your health care provider whether you should get a mammogram. If you are 50 or older, consider scheduling a mammogram today. For more information about mammography, please visit:  http://www.cancer.gov/cancertopics/factsheet/Detection/mammograms.

2. Get involved.  There are many local and national organizations working to raise awareness about breast cancer.  A number of breast cancer organizations participate in the State Employee Responding as Volunteers (SERV) program and the Commonwealth of Massachusetts Employee Charitable Campaign (COMECC). Consider donating your time, or making a monetary contribution to a reputable organization.   

There is some good news to report. National health care reform, or the Affordable Care Act (ACA), requires that by 2014 group health plans cannot require co-pays for preventative services, including breast cancer screenings.  This is an important reflection of increased awareness about preventative care and provides us with a preview of how national health care reform will have a profound positive impact on all Americans, including residents of the Commonwealth.

Kudos to Department of Children and Families Commissioner McClain

Posted by:
JudyAnn Bigby, MD, Secretary of Health and Human Services

 

During a legislative hearing last November, Department of Children and Families (DCF) Commissioner Angelo McClain attributed his motivation to accept the role of DCF Commissioner to his own experience as a youth within the community residence system in Texas.  He stressed that the support and encouragement he received living with other at-risk youth for several of his adolescent years was essential to his work today at DCF, and expressed the sincere belief that every child, with sustained encouragement and support, can succeed.

Commissioner McClain was recently honored as a 2010 Distinguished Alumnus of Cal Farley's Boys Ranch in Amarillo, Texas. Cal Farley’s is a child and family service provider specializing in residential and community-based services.

The Boys Ranch established this award to honor graduates who carry on the ranch’s spirit of family and community through fellowship, association and support. Commissioner McClain has leveraged his experience at the ranch to inform a career of service to his community, and is an inspiring example of hard work and determination.

At a ceremony for Distinguished Alumni in Amarillo earlier this month, Commissioner McClain was presented with this distinct honor. He is one of only a handful of individuals to receive this award.

Similarly, Commissioner McClain’s professional background adds to his unique perspective and qualifications to lead the Department of Children and Families.  Following graduation from college, the Commissioner worked as a frontline social worker for the Texas DCF.  His unusual perspective, first as a youth who benefited from out-of-home care, and then as a social worker who provided direct support to children and families, has given him firsthand knowledge that he has applied throughout his work improving the lives of children and families in Massachusetts.

Commissioner McClain has professed that early on, he knew that helping people would be ‘something good to do,’ and something that he felt deeply committed to. It’s gratifying for me to see Commissioner McClain honored for his ‘good work,’ and for his dedication to improving others’ lives. I’d like to extend my sincere congratulations to the Commissioner and express my abiding appreciation for the “good work” he does leading DCF every day. He is integral to our collective efforts to support children and strengthen families throughout the Commonwealth. He is the leader we need.

To read more about Cal Farley’s Boys Ranch and its commitment to providing a safe and supportive environment for kids, go to: http://www.calfarley.org

First Open Meeting on National Health Care Reform

Posted by:
JudyAnn Bigby, MD, Secretary of Health and Human Services

 

Earlier this week, the Executive Office of Health and Human Services hosted an open meeting for stakeholders on ‘Implementing Federal Health Reform in Massachusetts.’ The meeting was an opportunity to share updates and learn more about ongoing work around the implementation of the Patient Protection and Affordability Care Act  (PPACA or ACA) and what impact it will have on the Commonwealth of Massachusetts. This week’s meeting was the first meeting of planned quarterly meetings. EOHHS has established an internal Working Group on federal reform implementation representing multiple agencies across state government.

A great step forward for healthier eating and living in the Commonwealth

Posted by:
JudyAnn Bigby, MD, Secretary of Health and Human Services

 

Congratulations are in order for the Department of Transitional Assistance!  Massachusetts was recently selected by the U.S. Department of Agriculture (USDA) to conduct the first ever Healthy Incentives Pilot (HIP), a program that will encourage low-income families to purchase more fruits and vegetable with their Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) benefits. 

 

The 2008 federal Farm Bill authorized $20 million for USDA to test whether incentives to buy fresh produce will increase the purchase of healthy foods by SNAP participants. Massachusetts was chosen competitively based on a strong, comprehensive proposal submitted by the Department of Transitional Assistance (DTA).  As the only state to receive this grant, approximately 7,500 SNAP households in Hampden County will be randomly selected to participate in HIP.  For every SNAP dollar spent on allowable fruits and vegetables, these households will receive an additional 30 cents in SNAP benefits on their Electronic Benefit Transfer (EBT) card.