Achieving a Racially and Ethnically Equitable Health Care Delivery System in Massachusetts

This report and toolkit were created in partnership with Blue Cross Blue Shield of Massachusetts Foundation.

This report proposes a vision and action plan that offers an organizing structure, process, and set of practical steps for achieving a racially and ethnically equitable health care delivery system in Massachusetts. The report is accompanied by a Health Equity Action Plan Toolkit (Toolkit) of evidence-based interventions, policies and programs that health care providers, health care delivery system leaders, and other stakeholders can deploy to achieve their health equity goals.

Systemic racism has long pervaded and been perpetuated by the health care delivery system itself—which encompasses hospitals and health systems, community health centers, community mental health settings, primary care and specialty physician offices, nursing facilities and home health agencies, and other care delivery settings. Systemic racism results in inequities and manifests in health care delivery policies, practices, bias, and discrimination that contribute to stark and widening health care disparities among racial and ethnic groups. The focus of this report is on racial and ethnic inequities in the health care delivery system.

In Massachusetts, health disparities among people of color are estimated to represent an economic burden of $5.9 billion each year due to avoidable health care spending, lost labor productivity, and premature death.1,2 The causes and impact of health inequities in Massachusetts, as elsewhere, are multiple, complex and inter-related. Inequities in access to adequate housing, food, education and other vital needs are stark and directly impact people’s health. Many populations experience health inequities, including people of color and people for whom English is not their primary language, as well as those with disabilities and those in the LGBTQIA+ community.  The action plan and toolkit can be considered a first phase in a larger system-wide effort to eliminate all inequities that affect people’s health.

To read the full health equity report, view here.

To access the toolkit, view here.


1 Anthony, S., Boozang, P., Elam, L., McAvey, K., & Striar, A. (2021). Racism and racial inequities in health: A data informed primer on health disparities in Massachusetts. Blue Cross Blue Shield of Massachusetts Foundation.

2 Gaskin, D. J., LaVeist, T. A., Turner, A., & Obbin, S. (2023). The time is now: The $5.9 billion case for Massachusetts health equity reform. Blue Cross Blue Shield of Massachusetts Foundation.

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