Public health advocates say a new Massachusetts law, signed last week, is revolutionary.
They say it will help put Massachusetts cities and towns on the same footing when it comes to health and safety at a time when many fear the incoming Trump administration will weaken federal public health protections.
Massachusetts has 351 cities and towns, and for many years, they've each been responsible for their own public health protections, from restaurant inspectors to vaccine distribution.
Even before the pandemic, health leaders recommended the state require the same standards for every town and provide funding to make that happen. In 2019, a state commission released a report called the Blueprint for Public Health Excellence.
The new law “establishes all the things that the commission said were missing in Massachusetts,” said commission member Phoebe Walker, director of community health for the Franklin Regional Council of Governments.
That includes data collection, standardized public health rules and training, and a directive that the state contribute to local public health.
“We really are the only state that up until now has not had state matching funding for health department functions,” Walker said. “And so, we have been comfortable with the inequity of saying, if your zip code can't afford a health department, you don't have to have one. And now we won't be anymore.”
This is especially important in rural communities in western Massachusetts, by “ensuring that rural residents are getting the same kind of quality protections as people were getting in wealthier cities,” she said. “And that really was not true before.”
The law provides incentives for towns to pool resources. Already, Walker said, 320 of the state’s 351 municipalities have entered cooperative agreements, sharing public health nurses, restaurant inspectors, social workers and other resources.
"What the bill changes is that it will now be required of everyone to prove that they can meet the requirements of protecting the public health of their residents, and if they can't do it alone, they'll need to look to their neighbors to see if they can do it together."
State Sen. Jo Comerford of Northampton, who helped write the law, said it's "deeply ironic" that Gov. Maura Healey signed the bill into law shortly after President-elect Donald Trump nominated Robert Kennedy Jr. — a science skeptic — as U.S. health secretary.
“In Massachusetts, we are doubling down on science and public health and the importance of public health at a time where federal protections are at risk,” Comerford said.
“I think that this legislation ensures that we have a structure here that can't be dismantled by action at the federal level, and that's good,” said Walker.
Another timely aspect of this legislation is the potential emergence of a new pandemic, as scientists are closely watching a new bird flu affect many parts of the world. Walker said she's already been in touch with other health leaders about that potential threat — and she believes the new law will make it easier to respond.
“It will ensure that there are epidemiologists and public health nurses with training in quarantining and investigation of outbreaks and people with the scientific background to explain to people what's a risk and what's not a risk,” she said.
Even so, Walker expects there could be some pushback to the new investment in public health.
“There are some people who feel very anxious about mandates with regards to public health in our country after the pandemic,” she said. “There are a lot of people who are wondering whether … the local governments and the federal government ordered the right things at the right times. I think they will be concerned, and I hope that the benefit of having their water protected, their food protected, etc. won't sway them into writing this off."
Another potential barrier to the law’s success would be consistent funding, Walker said. Already there has been an investment of $200 million in COVID relief funding to shore up the public health infrastructure. But going forward, the law requires the state to fund local public health on a yearly basis, and that could require advocacy and vigilance.
“That is the role of legislators like me,” Comerford said. “That's the role of public health advocates, that we continue to keep the focus."
