This year is one of great challenges and changes in social, political, and health systems. Sometimes it seems like “everything is up in the air.” Nonetheless, BACH and its members are actively engaged in many efforts to shape these changes in ways that reflect the needs of Boston’s residents including its most vulnerable.

One of the biggest changes is in the way that health care will be paid for. Right now, most health care is “transactional.” That means that your health care provider charges your insurance company for each appointment, test, and treatment they provide. The system of payment is rapidly moving towards “global payments.” This will mean that the provider gets a certain amount of money from the insurer for each person they care for. The hope is that this will give incentives to hospitals and health centers to get more involved in community prevention because it will be in their financial interest to keep you healthy, not just treat you when you get sick.

Here are some of the ways we are working to shape this change:

• We are advocating for the inclusion of Community Health Workers (CHWs) as an integral part of the health team which would support their important work in helping people navigate the complex health and social service systems and make home-based interventions (as simple as paying for clean air filters in homes where kids have asthma).
• We are advocating with others to have the health care system address social determinants of health and invest more heavily in the things that are essential to good health…everything from affordable housing to improved food systems in neighborhoods that do not have enough healthy food available.
• Through the Passport to Public Health monthly meetings in Boston’s neighborhoods and Learning Communities, we help residents learn about and take action on a range of health issues.
• People, particularly in lower income and communities of color, are faced with potentially traumatic events daily, whether the micro-aggressions of racism or the consequences of violence and drug use. BACH funded 7 organizations to increase their ability to respond to residents coping with trauma. And we are helping to include ways to prevent psychological trauma and promote resilience in the City of Boston’s Resilience Plan.
• With our community partners and the Boston Public Health Commission, our Healthy Community Champions of the Let’s Get Healthy, Boston! Initiative are working to increase the number of smoke-free housing units, promoting and providing ways for people to have affordable access to healthy food and physical activity in order to prevent chronic illness.

All of these efforts are grounded in our commitment to achieving racial and ethnic health equity. This is why, in May, BACH and its members were an important part of the Boston Alliance for Race and Equity Summit, which is part of a national movement to have city governments put meaningful and accountable health equity goals as an integral part of their operational and policy goals.

My hope is that, whether through BACH or any of our passionate neighborhood and citywide partners, more of our members and residents become involved in community efforts to improve the chances of all Bostonians to lead healthy lives.

David Aronstein, BACH Director, daronstein@hria.org