The financial woes of the state’s mass transit systems threaten to undermine public health in Massachusetts, according to a health report card issued today by The Boston Foundation and NEHI, a Cambridge health policy institute.

Kay Lazar reports in today’s Globe that the group gave the state credit for increasing access to fresh fruits and vegetables through farmer markets and other programs, regulating junk food in public schools, and improving bike and walking paths. But the report noted that increasing fares and cuts in services atthe MBTA and mass transit elsewhere in the state could diminish use of public transportation.

The report explains the benefit of improving public health this way:

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In Massachusetts, experts calculate that a 5 percent reduction in preventable chronic diseases would save more than $450 million annually—almost four times the MBTA’s annual budget gap and about four-fifths of the current annual budget of the Massachusetts Department of Public Health.

The report card noted more challenges, Lazar wrote:

Other key health areas reviewed by the coalition saw no progress toward improvement, including employee health programs, efforts to ban use of artery-clogging trans fats in restaurants, state funding for public health, and a campaign to remove the tax exemption for sugar-sweetened beverages.

Sugary drinks are blamed by nutrition specialists for helping to fuel the country’s obesity epidemic. Massachusetts exempts soda from the sales tax, like other food, and health advocates have long sought an end to that policy. Massachusetts is one of only 16 states, according to the report, that does not impose a sales tax on soda.

The report notes that since 2001, the state Department of Public Health budget has been cut 25 percent, forcing reductions in disease-prevention programs.

See the full report card on the foundation’s website.