Massachusetts has a decentralized governance structure where the 351 cities and towns are independently organized for the delivery of local public health services and operate autonomously from the Massachusetts Department of Public Health. Some Massachusetts communities have established public health districts to more effectively and efficiently deliver public health services. Massachusetts does not provide dedicated state funding to support local public health core operations.

The cities and towns, each with its own Board of Health, are responsible for assuring access to a comprehensive set of services defined by state law and regulations. Massachusetts local boards of health are charged with a complex set of responsibilities including enforcement of state sanitary, environmental, housing, and health codes. These include, but are not limited to:

  • Protection of the food supply through inspections of restaurants and other food establishments;
  • Inspections and permitting of septic systems, landfills, and other solid waste facilities;
  • Health care and disease control, including timely reporting and response to communicable diseases, occupational health and safety violations, food poisoning a, and rabies;
  • Inspections of pools, beaches, camps, motels, and mobile home parks;
  • Enforcement of state lead poisoning regulations and sanitary code in housing;
  • Enforcing no-smoking laws;
  • Developing, testing, and building awareness of emergency preparedness plans for a wide range of hazards; and
  • A wide array of other responsibilities, including issuing burial permits, regulating pesticides, inspecting massage and tattoo parlor, issuing health reports, and more.

The Massachusetts Association of Health Boards provides a summary of Duties of Local Boards of Health in Massachusetts on its web site.

In addition to these responsibilities, some boards of health have resources that allow them to extend their role beyond those established through statute or regulation. For example, some boards of health manage school health programs; others partner with community-based organizations for community health improvement planning, policy and program development, and/or prevention activities using grants or other funding.

More information about local public health in Massachusetts can be found in a report prepared by the Massachusetts Coalition for Local Public Health:


This information is provided by the Department of Public Health.