Health is more than healthcare
Health is so much more than what happens within the healthcare system. We know health outcomes do not rest solely on medical interventions, but also greatly depend on meeting basic human needs.
Blue Cross & Blue Shield of Rhode Island (BCBSRI) and the Brown University School of Public Health are proud to present the fifth annual RI Life Index, which captures Rhode Islanders’ perceptions of social determinants of health and well-being. For BCBSRI, the Index serves as a driver of our mission to create access to high quality care for all Rhode Islanders. We believe the Index will help us to build healthier communities throughout Rhode Island. This is our long-term commitment. We must continue to listen, learn and act.
Key Findings
In keeping with the goal of measuring certain social determinants of health year over year, we annually ask the same core group of questions that speak to quality of life and quality of community. Below you’ll see the complete list of questions that comprise the “index” of quality of life and quality of community. We use these questions to benchmark progress.
In 2023 we can report on trends based on five years of collected data. For both core and non-core cities, the largest declines over the past five years have been in access to nutritious food. By age, the largest five-year declines have been in healthcare access for younger adults and access to nutritious food for older adults. There have also been notable decreases in all scores for Latinx respondents and almost all scores for Black respondents. Since the start of the pandemic in 2020, the larger declines have been in cost of living, access to affordable housing, and access to healthcare, with the largest drops in non-core cities.
After seeing a drop in 2020 during the pandemic, positive perceptions of programs and services for children have remained relatively stable, but down from their highest score in 2019. Perceptions about programs and services for older adults have declined somewhat across the five years.
RI Life Index
We show here a composite score of essential drivers of health and well-being as defined for the RI Life Index. The topic areas comprising the composite score focus on community life and quality of community elements, including affordable housing, quality education and good jobs. For all measures, we first display the scores from the random digit dial (RDD) survey conducted from March through June of 2023. Further data can be viewed broken down by core city and non-core areas, race, and age. Clicking deeper you can view five years of trends for most measures as well as the survey questions with specific responses.
2023
RI LIFE INDEX
Topics include access to affordable housing, childcare and activities for youth, quality education, affordable and nutritious food, good jobs, medical care, programs for seniors, transportation services, feeling safe at home, and cost of living.
58
RI Life Index
53
LATINX
53
<55
58
Age 55+
BLACK
52
<55
49
Age 55+
WHITE
50
<55
55
Age 55+
60
LATINX
57
<55
60
Age 55+
BLACK
57
<55
57
Age 55+
WHITE
59
<55
62
Age 55+
Summary: Perceptions of Community
The report begins at the widest point of the lens, with summaries of perceptions of community that incorporate a range of social determinants of health, and quickly moves into a breakdown of those key factors. For all core measures, we first display the scores from the random digit dial (RDD) survey conducted from March through June of 2023. Further data can be viewed broken down by core city and non-core areas, race, and age. Clicking deeper you can view five years of trends for most measures as well as the survey questions with specific responses.
PERCEPTIONS OF COMMUNITY
QUALITY OF COMMUNITY
DEFINITION
Quality of community scoring represents a summary of how residents rate social and economic aspects of their community, including the following topics:
- Access to childcare
- Activities for youth
- Employment
- Access to affordable food
- Cost of living
- Availability and quality of services and programs for seniors
QUESTION WORDING: For each statement, tell me if that statement is completely descriptive, somewhat descriptive, not very descriptive, or not descriptive at all of your community.
52
Quality of Community
49
LATINX
48
<55
52
Age 55+
BLACK
47
<55
43
Age 55+
WHITE
48
<55
50
Age 55+
54
LATINX
51
<55
53
Age 55+
BLACK
52
<55
52
Age 55+
WHITE
52
<55
56
Age 55+
PERCEPTIONS OF COMMUNITY
COMMUNITY LIFE
DEFINITION
Community life scoring represents a summary of how residents perceive the lived experiences of typical individuals in their community, in the following areas:
- Employment
- Education
- Convenient locations for nutritious food
- Access to affordable housing
- Access to healthcare
- Feeling safe at home
QUESTION WORDING: For each statement, please tell me how likely each is for a typical person living in your community: very likely; somewhat likely; somewhat unlikely; and very unlikely
66
Community
Life
59
LATINX
59
<55
66
Age 55+
BLACK
58
<55
56
Age 55+
WHITE
54
<55
62
Age 55+
68
LATINX
66
<55
70
Age 55+
BLACK
65
<55
63
Age 55+
WHITE
67
<55
71
Age 55+
Perceptions of Community: Vulnerable Residents
Here we show perceptions of Rhode Island's most vulnerable residents. For all measures, we first display the scores from the random digit dial (RDD) survey conducted from March through June of 2023. Further data can be viewed broken down by core city and non-core areas, race, and age. Clicking deeper you can view five years of trends for most measures as well as the survey questions with specific responses.
PERCEPTIONS OF COMMUNITY
CHILDREN
DEFINITION
How do residents rate programs and services available for children?
TOPICS: Place to raise children; access to quality education; activities for youth
71
Children
62
LATINX
64
<55
69
Age 55+
BLACK
62
<55
59
Age 55+
WHITE
57
<55
62
Age 55+
75
LATINX
71
<55
76
Age 55+
BLACK
69
<55
69
Age 55+
WHITE
74
<55
77
Age 55+
PERCEPTIONS OF COMMUNITY
OLDER ADULTS
DEFINITION
How do residents rate the availability of services in their community for older adults?
TOPICS: Availability of special transportation services; availability of social and civic programs; quality of healthcare services;
64
Older Adults
62
LATINX
61
<55
64
Age 55+
BLACK
61
<55
52
Age 55+
WHITE
60
<55
65
Age 55+
65
LATINX
59
<55
67
Age 55+
BLACK
65
<55
64
Age 55+
WHITE
62
<55
69
Age 55+
Perceptions of Community: Social Determinants of Health
Here we show perceptions of specific social determinants of health. For all measures, we first display the scores from the random digit dial (RDD) survey conducted from March through June of 2023. Further data can be viewed broken down by core city and non-core areas, race, and age. Clicking deeper you can view five years of trends for most measures as well as the survey questions with specific responses.
PERCEPTIONS OF COMMUNITY
COST OF LIVING
DEFINITION
How do residents rate the cost of living in their community?
TOPICS: Affordable, high-quality childcare; cost of quality housing; difficulty paying for utilities
23
Cost of Living
22
LATINX
21
<55
26
Age 55+
BLACK
18
<55
16
Age 55+
WHITE
23
<55
24
Age 55+
24
LATINX
27
<55
21
Age 55+
BLACK
26
<55
26
Age 55+
WHITE
22
<55
24
Age 55+
PERCEPTIONS OF COMMUNITY
HEALTHCARE ACCESS
DEFINITION
How do residents rate their ability to access healthcare?
TOPICS: Access to routine medical care; access to mental health or substance abuse treatment
67
Healthcare
Access
64
LATINX
61
<55
69
Age 55+
BLACK
64
<55
60
Age 55+
WHITE
59
<55
70
Age 55+
68
LATINX
65
<55
71
Age 55+
BLACK
62
<55
66
Age 55+
WHITE
66
<55
72
Age 55+
PERCEPTIONS OF COMMUNITY
AFFORDABLE HOUSING
DEFINITION
How do residents rate access to affordable, quality housing?
TOPICS: Cost of housing; availability of affordable housing
32
Affordable
Housing
30
LATINX
31
<55
33
Age 55+
BLACK
31
<55
34
Age 55+
WHITE
25
<55
30
Age 55+
33
LATINX
32
<55
34
Age 55+
BLACK
33
<55
34
Age 55+
WHITE
33
<55
34
Age 55+
PERCEPTIONS OF COMMUNITY
JOB OPPORTUNITIES
DEFINITION
How do residents rate job opportunities and job training programs?
TOPICS: Availability of jobs; employment with living wage; access to adult education
55
Job Opportunities
50
LATINX
49
<55
57
Age 55+
BLACK
50
<55
48
Age 55+
WHITE
49
<55
50
Age 55+
57
LATINX
54
<55
57
Age 55+
BLACK
52
<55
44
Age 55+
WHITE
57
<55
58
Age 55+
PERCEPTIONS OF COMMUNITY
ACCESS TO NUTRITIOUS FOOD
DEFINITION
How do residents rate access to affordable, nutritious food?
TOPICS: Access to nutritious affordable food; convenience of location of nutritious food
66
Access to
Nutritious
Food
59
LATINX
58
<55
61
Age 55+
BLACK
56
<55
53
Age 55+
WHITE
57
<55
60
Age 55+
68
LATINX
66
<55
67
Age 55+
BLACK
64
<55
70
Age 55+
WHITE
67
<55
71
Age 55+
Actual Experiences
Here we show data on the actual experiences of respondents with regard to their economic situation, food security, and racial equity. For all measures, we first display the scores from the random digit dial (RDD) survey conducted from March through June of 2023. Further data can be viewed broken down by core city and non-core areas, race, and age. Clicking deeper you can view five years of trends for most measures as well as the survey questions with specific responses.
PERCEPTIONS OF COMMUNITY
ECONOMIC SITUATION
DEFINITION
How do residents rate their current financial situation?
TOPICS: Personal economic and financial situation; money in savings
59
Economic
Situation
53
LATINX
43
<55
48
Age 55+
BLACK
47
<55
49
Age 55+
WHITE
57
<55
62
Age 55+
62
LATINX
48
<55
61
Age 55+
BLACK
51
<55
49
Age 55+
WHITE
58
<55
68
Age 55+
PERCEPTIONS OF COMMUNITY
FOOD SECURITY
DEFINITION
How do residents rate their level of food security?
TOPICS: Worries about having enough food; financial ability to buy food
81
Food Security
73
LATINX
62
<55
66
Age 55+
BLACK
66
<55
70
Age 55+
WHITE
80
<55
83
Age 55+
84
LATINX
74
<55
87
Age 55+
BLACK
77
<55
72
Age 55+
WHITE
83
<55
88
Age 55+
PERCEPTIONS OF COMMUNITY
RACIAL EQUITY
DEFINITION
How do residents rate racial equity at work, when seeking healthcare, and in personal interactions?
TOPICS: Treatment at work; experiences seeking healthcare; unfair treatment; fear for personal safety
73
Racial Equity
69
LATINX
67
<55
74
Age 55+
BLACK
59
<55
62
Age 55+
WHITE
75
<55
74
Age 55+
74
LATINX
69
<55
69
Age 55+
BLACK
62
<55
65
Age 55+
WHITE
76
<55
77
Age 55+
Special Topics
Here you will see findings from this year’s special topics, reported as percentages rather than POP scores.
Confidence in Accessing Mental Health Care
DEFINITION
If you or a close friend or family member needed mental health care, how confident are you that you would know how to go about getting that care?
(Percent responding Somewhat or Very Confident)
77%
(32% SOMEWHAT;
45% VERY)
Core City: 75%
(32% SOMEWHAT; 43% VERY)
Non-Core City: 77%
(32% SOMEWHAT; 45% VERY)
Note: Due to a survey administration error, this item was not asked of individuals living alone.
DEFINITION
Now thinking about the children less than 18 in your life: If they needed mental health care, how confident are you that you would know how to go about getting them care? (Percent responding Somewhat or Very Confident)
80%
(31% SOMEWHAT;
49% VERY)
Core City: 81%
(36% SOMEWHAT; 45% VERY)
Non-Core City: 79%
(29% SOMEWHAT; 51% VERY)
Note: Only asked of those with children living in their household.
Confidence using technology
DEFINITION
Overall, how confident do you feel using computers, smartphones, or other electronic devices to do the things you need to do online?
85%
(26% SOMEWHAT;
58% VERY)
Core City: 84%
(23% SOMEWHAT; 61% VERY)
Non-Core City: 85%
(28% SOMEWHAT; 57% VERY)
Characteristics of the RDD Sample
Seventy percent of respondents lived in non-core areas; 30% resided in core cities. Approximately one in four (26%) respondents reported living alone; 30% lived in households with at least one child under the age of 18. Fifty-one percent of survey participants identified as female, 47% identified as male, and the remainder did not identify a gender. Half (50%) were aged 18 to 49. Thirty-two percent reported having a high school education or less. Of those who reported their income, 44% had a household income of less than $50,000. Seventy-one percent identified as non-Hispanic white, 85% identified as heterosexual/straight, and 32% indicated they were living in a household in which at least one person had a disability.
# of people in household
1: 26
2: 29
3+: 43
# of children
<18 in household
0: 69
1: 13
2+: 17
Gender
Female: 51
Male: 47
Age
18-34: 28
35-49: 22
50-64: 26
65+: 21
Education
High school or less: 32
Some college: 39
Bachelors or higher: 28
Income
<$25K: 21
$25K-$49K: 23
$50K-$99K: 23
>$100K: 22
Race/Ethnicity
White: 71
African American/Black: 5
Hispanic/Latinx: 12
Other: 9
Sexual
Orientation
Heterosexual/Straight: 85
Bisexual: 6
Lesbian/Gay/Homosexual: 3
Other: 1
Someone in household has
a disability
Yes: 32
No: 67
Note: Percentages may not total to 100% due to rounding and/or missing data.
* "Other" includes: Asian, Native American/Alaskan Native, Native Hawaiian/Other Pacific Islander, and Multi-racial