A task force of state lawmakers and health experts called on the Legislature to create a statewide office and a Cabinet-level position focused on equity, and to immediately initiate an equity-focused review of the state’s response to COVID-19 in its final report released Thursday.
The report also urged Governor Charlie Baker to develop an equity-focused approach to investing the state’s nearly $5.3 billion in federal relief funds, encouraging him to funnel the dollars toward populations with the highest infection numbers and lowest vaccination rates.
“The overarching theme of these recommendations is that equity must be the ‘North Star’ for guiding every decision about the response and recovery from the COVID-19 pandemic, and beyond,” read the report.
The task force, which was convened by the Legislature in June 2020 in response to stark racial inequities in the rates of COVID-19 infection and hospitalization, was charged with making recommendations to address such disparities, in addition to those experienced by other underrepresented communities, such as immigrants and people with disabilities.
Its final report, entitled “A Blueprint for Health Equity,” was approved Thursday by 13 of the task force’s 16 members, including Democratic Senators Sonia Chang-Diaz and Julian Cyr, and Democratic Representatives José Tosado, Chynah Tyler, and Carlos González, who chairs the MA Black and Latino Legislative Caucus.
Though health disparities have long plagued communities of color, the pandemic heightened focus on the issue and galvanized work on it. The 99-page report includes 31 recommendations that touch all aspects of health, including oral health and behavioral health, as well as other factors that affect health, such as access to food and housing.
“Everything but the kitchen sink is in the report,” Cyr said.
The report estimates that quality medical care accounts for just 20 percent of health status; the other 80 percent is attributable to social, economic, and environmental factors, “as well as the effects of racism.”
Michael Curry, CEO of the Massachusetts League of Community Health Centers, who co-chaired the task force, said its recommendations offer the state a roadmap to improve health equity.
“They all go back to this overall, overarching theme, which is everyone wants to live healthy, and everyone wants to have access to living their best lives, and they can’t do that unless we solve for some of these systemic issues,” he said.
The report also recommended steps for continued pandemic response, such as heightening vaccine equity efforts; focusing on vulnerable populations, such as essential workers and incarcerated persons; and funding research on the intermediate and long-term effects of COVID-19.
Republican Representative Donald Wong, who chairs the House Asian Caucus, voted against the report, along with aides to the minority leaders of the House and Senate, who are also Republicans.
After the vote, González expressed concern about why Wong chose to vote against it.
“If there’s something that we need to tweak, that may or may not have addressed some issues in the Asian American community, we need to look at that,” González said.
Wong did not say why he voted against the report and said he agrees with “a lot of things” in it.
Dr. Assaad Sayah, the chief executive officer of the Cambridge Health Alliance, who co-chaired the task force, said he was surprised that the vote was not unanimous, stressing that it was based on the testimony of hundreds of stakeholders — including health care workers, patients, and activists from hard-hit communities — at three public hearings.
Chang-Diaz said lawmakers should immediately launch on several recommendations, such as funding the Healthy Incentives Program, taking up eviction protections, and passing the Work & Family Mobility Act, which will allow undocumented immigrants to get driver’s licenses.
“The report is also quite explicit about the need for an after action report on our handling of the pandemic and the need to put in place legislation requiring that straightaway,” said Chang-Diaz, who recently launched a bid for governor.
Dr. Cassandra Pierre, an epidemiologist at Boston Medical Center who was on the task force, said the pandemic has presented an opportunity for systematic change. “We cannot just let things go back to the way they were,” she said.
Several members acknowledged that it will be a challenge to enact all the components of such a comprehensive report.
“This is a solid blueprint, but the devil is in the details and what ends up getting done,” Cyr said. “I think it remains to be seen, is there the political will to do this challenging work?”
Terry MacCormack, a spokesman for Baker, a Republican, noted that his administration recently filed $2.9 billion plan for federal aid dollars that includes equity-related efforts, such as $1 billion for housing initiatives, as well as investments in workforce training, addiction treatment, and local infrastructure.
MacCormack also noted that the Commonwealth’s Vaccine Advisory Committee is in the process of implementing a $30 million vaccine equity initiative, focused on the state’s 20 hardest hit communities.
A spokeswoman for Senate President Karen Spilka, a Democrat, said that she is “currently reviewing” the report, and that the Senate “will be looking to these recommendations to help guide the conversation moving forward, as well as inform any possible future legislative action.”
A spokeswoman for House Speaker Ronald Mariano, also a Democrat, said he has committed to passing legislation this session to address health inequities, and appreciates the task force’s work.
Camille Caldera can be reached at firstname.lastname@example.org.