To the editor:
Despite being home to the best healthcare facilities in the world, Massachusetts’ public health system is fractured. As health directors and state representatives concerned about local public health, we have seen many of our local health departments working overtime to prevent and responding to COVID-19 in the community, including countless hours of contact tracing, enforcing the frequently updated COVID-19 guidelines, and trying to educate our residents about how to protect themselves and others from the virus. Health departments in our region and throughout the commonwealth are working with scant resources and a widely varied level of expertise; they are overwhelmed and exhausted.
Even before the pandemic, our local public health system faced serious challenges. While some health departments in our region were fortunate to have dedicated, credentialed staff and support from their town leaders, many communities have so little funding or trained staff they were unable to meet even basic responsibilities.
Even our well-run departments with qualified staff struggle to meet the wide range of regulations and responsibilities that they are tasked to deal with on a daily basis. These range from inspecting housing units, unsanitary conditions, food establishments, children’s summer camps, public and semi-public pools, septic systems and bodywork establishments, to protecting residents from substandard housing and lead poisoning, managing insect-borne diseases, animal control, hazardous waste disposal and responding to cases of communicable disease. The list goes on.
When the COVID-19 pandemic hit, the virus exposed every weakness and inequity in the system. Boards of Health that were accustomed to dealing with restaurant inspections and camp regulations suddenly had to make life-or-death decisions about protecting each town’s citizens. They had to take on contact tracing, enforcement of frequently changing guidelines, outreach to citizens and businesses, working with schools to protect our youth, holding vaccination clinics, taking part in trainings to stay on top of the daily changes, and more.
And while nothing would have stopped the pandemic from occurring, adequate funding and staffing would have allowed for effective community-level contact tracing, timely implementation of isolation and quarantine, consistent enforcement of public health regulations, and more effective and equitable vaccine distribution. These measures would have meant fewer deaths, fewer hospitalizations and lower costs to the health care system.
Now, we have a chance to transform our state’s local public health system and implement the critical safeguards it should provide. By dedicating funds from the American Rescue Plan Act of 2021 (ARPA) coming to Massachusetts from the federal government, we can bring local public health infrastructure and capacity in every community up to par, and create a statewide system that if efficient, effective, and equitable.
We have urged the legislature and Gov. Charlie Baker to make new investments; and we are tremendously grateful that they have responded with important new funding over the last two years. In 2020, the state enacted the State Action for Public Health Excellence (SAPHE) Act, which provides incentives to cities and towns that share services across municipal boundaries.
These are important steps in the right direction, but the dollars invested over the last two years fall far short of what is needed to truly transform this fractured system. We are grateful to the House for including $150 million over the next three years to begin to address these concerns.
Failure to act now would represent acceptance of the status quo and would perpetuate inequity and poor health outcomes. Massachusetts must act decisively to ensure that all residents — regardless of their race, income, or zip code — receive high-quality public health protections. The time to act is now.
State Rep. Marcos A. Devers
State Rep. Tram T. Nguyen
State Rep. Andy X. Vargas
Public Health Director, Lynn
Board of Health Administrator, Essex
Leslie Whelan, R.S.
Rockport Health Agent