We eliminate conditions and harmful environments that leave people sick or injured

Our region is home to many communities whose environments stand as barriers to their desire for healthier, more resilient, and economically stable lives. Under-investment in communities of color has created structural barriers to success and new programs, like those around clean energy investments, have frequently passed over these places. In addition, communities of color are often subject to environmental disparities and public health, living in neighborhoods located close to densely congested highways or home to hazardous power plants, our without access to fresh fruits and vegetables. We must make policy changes that help all communities in Massachusetts meet existing environmental and public health challenges.

Enhance community resilience and sustainability to meet the present and future challenges

We must make investments that strengthen communities by better preparing individuals and families to deal with natural hazards like floods and heat waves as well as meet the new challenges we expect from these natural events. We can build a more resilient region by making structural investments that foster community resiliency as well as positioning our residents to benefit from new technologies that are intended to increase economic and energy security.

  • Expand the Mass Solar Loan Program to more effectively reach low-income households that are “credit invisible” or have unscored credit records.

    As of the close of 2017, the Mass Solar Loan Program is close to full utilization of the funding allocated to the program. Only 13% of Mass Solar Loan recipients had FICO scores equal to or lower than 680, and over 70% of the loans went to recipients with FICO scores over 720.1 People and communities of color have been targeted by predatory lenders and risky loan products, or are more likely to operate in an unscored economy. When a lending program is based solely on FICO scores, people of color are disenfranchised from taking advantage of the program.

    Solstice, a community solar provider, is currently researching and testing an alternative to FICO scores called an Energy Score, which takes into consideration utility payment performance, housing characteristics, financial characteristics, and demographic characteristics to establish a more inclusive and accurate prediction of whether or not an applicant is considered credit-worthy.2 A program of this kind could increase access for households that stand to benefit the most from participation in the Mass Solar Loan Program. The Mass Solar Program needs additional funding in order to expand this valuable program to more effectively support low-income households.

    1. Mass Solar Loan. Program Performance, 2017. http://www.masssolarloan.com/program-performance 

    2. Solstice. EnergyScore: For a More Inclusive Solar Future, 2017. https://solstice.us/solstice-blog/2017/11/27/energyscore-for-a-more-inclusive-solar-future 

  • Protect at-risk populations from current and future environmental hazards.

    The Legislature is currently considering a proposal, An Act relative to environmental justice and toxics reduction in the Commonwealth, which would require all Executive Offices to develop policies and strategies to achieve environmental justice. This would include the appointment of a Director of Environmental Justice at the Executive Office of Energy and Environmental Affairs.1

    The proposal would also create a supplemental fund to support environmentally beneficial projects in low-income communities. The proposal is particularly important because we often see low-income communities living in climate-vulnerable locations. As superstorms and pollutants impact our municipalities, we have to make sure that all residents live somewhere they can expect to remain safe from current and predicted climate hazards.

    1. In Massachusetts a community is recognized as an Environmental Justice community if any of the following are true: (1) Block group whose annual median household income is equal to or less than 65 percent of the statewide median ($62,072 in 2010); or (2) 25% or more of the residents identifying as minority; or (3) 25% or more of households having no one over the age of 14 who speaks English only or very well - Limited English Proficiency (LEP). http://www.mass.gov/eea/agencies/massdep/service/justice/ 

  • Aim for elimination of indoor environmental hazards, beginning with those that directly affect children in our urban centers.

    Massachusetts has experienced tremendous progress overall in eliminating indoor environmental hazards such as lead and pests. The progress has not occurred evenly across the state or Metro Boston region as disparities still persist geographically and racially. A twofold approach can assist us in sustaining our progress so that we can eliminate exposures especially for children whose lives can be deeply affected by these hazards. One action is to increase funding for services to treat and eliminate indoor lead exposures for children. The second is to adequately fund the state’s Bureau of Environmental Health so that they have a sufficient number of staff and inspectors to monitor and address indoor pollutants in water, air, and materials that can lead to chronic health conditions and even cancer.

  • Provide a comprehensive energy efficiency program offering to meet the needs of moderate-income customers and renters across the Commonwealth.

    The Mass Save income-eligible program in Massachusetts is nationally recognized for its success, but it is currently limited to serving households at or below 60% of Area Median Income, or about $62,000 for a family of four in the Metro Boston region. The Utility Energy Efficiency Program Administrators were directed by the Massachusetts Department of Public Utilities to provide a moderate-income offer in the 2016-2018 Three Year Energy Efficiency Plan and are rolling out a pilot in 2018. As Mass Save develops a new Three Year Plan we must engage in robust advocacy to ensure that the state’s energy efficiency programs meet the needs of historically underserved populations and that appropriate resources are allocated to serve low income households, while at the same time identifying and approving additional program funding mechanisms, especially for moderate-income customers.

  • Establish and fund a pilot program for shared electric vehicle services in Environmental Justice communities.

    Lower-income families of color are less likely to own a vehicle than white and higher-income families. Additionally, households in the lower third of the income range dedicate more of their household income to transportation costs than the upper third of the national income range. Providing shared mobility services with electric vehicles that have zero tail pipe emissions within EJ communities could improve access to opportunity and improve local air quality through reduced emissions. The state would need to allocate significant new resources to support a successful program, which could be modeled after experimental programs that some municipalities are already trying. Along with other New England states, Massachusetts is currently considering a regional cap and trade program for transportation-related emissions. If this passes, it could be a significant new source of funding available to reinvest in programs and initiatives designed to reduce emissions from the transportation sector, including the one described here.

70% of Mass Solar Loan loans went to recipients with FICO scores above 720.

BEST PRACTICE

Climate Justice Initiatives

Climate Justice recognizes that the negative effects of climate change fall most harshly on those who contributed the least to its causes, low-income communities and communities of color. As the climate changes, these populations will often be the first to face negative health outcomes, financial hardships, and social and cultural disruptions. Climate justice proponents seek to spread the burdens of climate change, as well as the benefits addressing climate change, more fairly across all segments of society.

In 2012, California created a model for climate justice legislation by passing a bill that allocates resources to the communities most hurt by climate change. Twenty-five percent of proceeds from California’s Greenhouse Gas Reduction Fund will pay for projects in disadvantaged communities, which they identify through the CalEnviroScreen1 a methodology used to identify communities that are burdened by multiple sources of pollution.

  1. California Environmental Protection Agency and the Office of Environmental Health Hazard Assessment. CalEnviroScreen, 2017. http://oehha.ca.gov/ej/ces11.html 

Eliminate food insecurity among families

Families in our region are healthier when they do not have to worry about access to nutritious foods. Unfortunately, many children and adults in the Metro Boston region do not have access to enough nutritious food to support an active and healthy life, and as a result we see many resulting health issues. We can reduce these health issues by focusing on eliminating food insecurity. Most importantly, we can see the greatest impact on equality of outcomes by focusing on those who experience insecurity and health related issues the most.

  • Reduce the 'SNAP gap'

    The Legislature is currently considering a proposal that would establish a common application for individuals who receive state benefits. It would allow those individuals who are eligible to apply simultaneously for the Supplemental Nutrition Assistance Program (SNAP) and other income support and benefit programs, when the individual applies for or renews MassHealth coverage or other state application or renewal processes. The legislation address the fact that an estimated 680,000 people who are receiving MassHealth are likely also eligible for SNAP but are not currently enrolled.

  • Fund and expand the Healthy Incentives Program

    The statewide Healthy Incentives Program (HIP) was launched in April 2017, which will apply a one-dollar incentive on every SNAP benefit dollar spent on vegetables and fruits when purchased at four types of SNAP retailers selling locally-grown produce: farmers markets, farm stands, community supported agriculture programs, and mobile markets. It is modeled after a regional Massachusetts pilot which found that participants consumed over 25 percent more fruits and vegetables than did non-participants. The proposed bill would permanently establish an incentives program that would ensure sustainability of the current 3-year HIP and expand the types of SNAP retailers eligible to participate in the program.

  • Support the Massachusetts Food Trust initiative

    The Massachusetts Food Trust Program, established in 2014, would provide loans, grants and technical assistance to support new and expanded healthy food retailers and local food enterprises in low- and moderate-income communities. This could include supermarkets, corner stores, farmers’ markets, mobile markets, community kitchens, food co-ops, food truck commissaries, indoor and outdoor greenhouses, and food distribution hubs. This private partnership program was a recommendation of the Grocery Access Task Force, a public-private partnership, which met for about two years to tackle this problem. Support for the program should include a launch of the program in the next year and sustained capital and operating funds for the program so that it achieves its intended statewide impact.

An estimated 680,000 people who receive MassHealth are likely also eligible for SNAP but not currently enrolled.

Use economic incentives to reduce population health risks

Our communities are stronger when families have fair access to services and products that are supportive and healthful. Unfortunately, what should be simple is frequently made difficult for certain populations, including people of color and families trapped in poverty. For example, food marketers target unhealthy foods to communities of color and to children,[^52] [^53] and when these foods contribute to health issues like diabetes and hypertension, little community-based support is provided to help manage these conditions. As a result, we see health issues persist and those who already experience systemic challenges in their daily life have to shoulder additional burdens. We can change this by shifting where dollars come from and how we invest in the services that create pathways for people, especially those most at risk, to enjoy healthier lives.

  • Tax soda and other sugary beverages

    The Legislature is currently considering a proposal that would create a tiered excise tax on sugary drinks with rates based on the amount of added sugar each beverage contains. As the amount of sugar increases, the amount of tax would also increase. Sugary drink taxes have been successfully implemented across the country, generating significant new revenue that can be reinvested in a wide range of programs and creating a reduction in the overall consumption of sugary beverages. Researchers have estimated that an excise tax of a penny per ounce of sugar on sugar-sweetened beverages would prevent 45,900 cases of obesity by 2025, saving the Commonwealth $33.40 for every dollar invested in implementation of the bill.[^54] Revenue from a tiered excise tax could raise approximately $368 million in the first year,[^55] and would decrease annually as consumption decreases. The revenue would be reinvested into public health initiatives, including access to clean and safe drinking water, the Prevention and Wellness Trust Fund, and other programs focused on children.

  • Fund the Prevention and Wellness Trust Fund

    The Prevention and Wellness Trust Fund (PWTF) has increased access to preventative services for nearly one million people across the Commonwealth. The Fund does not rely on state funding, but has been supported by a small assessment on health insurers. The program has been nationally recognized as a model because it has increased access to preventative services for nearly 1 million people across Massachusetts, including 22,000 students with asthma. Funding sunset for the program in 2017 – despite positive findings regarding improved outcomes and cost controls from the program evaluation – and new dedicated funding source was not approved. Without new resources, all PWTF partnerships will be eliminated by June 2018. The legislature must fund a new funding source for the program, which could include continuing the assessment on health insurers, or closing an existing tax loophole on flavored cigars and rededicating the funds to the PWTF.

An excise tax of a penny per ounce of sugar on sugar-sweetened beverages would prevent 45,900 cases of obesity by 2025, saving the Commonwealth $33.40 for every dollar invested in implementation of the bill.

BEST PRACTICE

Access to Contraception

In November 2017, Governor Baker signed a law making contraception free to all Massachusetts women. The bill required Massachusetts health insurance companies to provide coverage for most contraceptive drugs, devices and products without requiring a copay. Research has long shown that contraception has significant health benefits for people with uteruses because it can reduce the risk for ovarian and endometrial cancers, and it can treat conditions like endometriosis, polycystic ovary syndrome or uterine fibroids.[^56] On top of that, women with unintended pregnancies are more likely to receive delayed or no prenatal care. This legislation will make it easier for women to get the health care that they need and to take family planning decisions back into their own hands.

Invest in programs that prevent harm and foster recovery

Violence and addiction not only affect those directly involved, but their effects also ripple outward among family members and surrounding neighborhoods. In 2017, over 1,000 Massachusetts residents died from opioid overdose. In Boston, 16 teenagers were killed by guns, a figure that represents a doubling from the previous year. The causes of violent behavior and addition are complex. But, if we are going to offer any hope of turning the tide of these avoidable deaths, we must focus our efforts on prevention and recovery rather than condemnation and punishment.

  • Increase funding for the Shannon Grant and the Safe and Successful Youth Initiative

    Since 2006, the Commonwealth has used the Senator Charles E. Shannon Community Safety Initiative to curb youth violence, gang violence and substance abuse through regional, multi-disciplinary efforts. Communication across municipal lines and coordination between public safety officers and social service agencies is what sets Shannon Grants apart from other efforts to fund local law enforcement prevention programs. The Safe and Successful Youth Initiative, implemented in 2011, combines public health and public safety approaches to eliminate serious violence among high-risk urban youth. The program provides funding to support an intervention strategy that provides education, training and workforce development programs, as well as street outreach and trauma counseling. Funding programs that allow young people to create strong community relationships have a strong public health benefit for the youth in the program and for the communities where they live, providing a safe place for young people to go every day, with safe adults and mentors they can trust. Funding for the Shannon program should be restored to its high of $13 million and funding for the Safe and Successful Youth Initiative should be restored to $11 million.

  • Create better access to long-term treatment for people suffering from Substance Use Disorders

    Connecting individuals with substance use disorders (SUDs) to immediate treatment options and a continuum of wrap-around services over the long-term is critical to saving lives and aiding in recovery. Successful programs that enhance recovery services and support these vital connections should be replicated and expanded. Immediate treatment options after an incident or overdose, such as medically-aided treatment and recovery coach monitoring programs, are vital for short-term response. But in order to help people in the long-term, programs that offer housing, food, transportation and employment, alongside continued treatment, are needed. Opportunities to create and expand such services on a regional basis should be developed and funded.  And too often, individuals with SUDs end up in the criminal justice system and return to using when released from prison. Support and treatment for individuals suffering from addiction must therefore be available in prison but also after people return to their communities.

In 2017, over 1,000 Massachusetts residents died from opioid overdose. In Boston, 16 teenagers were killed by guns, a number that doubled since 2016.