Why a RI Life Index?
At Blue Cross & Blue Shield of Rhode Island, our vision to passionately lead a state of health and well-being across Rhode Island was the impetus for the creation of the Index. In order to address social determinants of health such as safe and affordable housing, access to transportation, the availability of nutritious food, and financial stability, we needed a clear assessment of the landscape. As a proud local company and the state’s largest health insurer, we are committed to building a healthier Rhode Island. Information we learn from the Index will inform our work going forward. 

 

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Who created the Index? Who funded the Index?
Blue Cross & Blue Shield of Rhode Island and the Brown University School of Public Health partnered to create the RI Life Index. The survey is funded by Blue Cross & Blue Shield of Rhode Island.

 

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How will information from the RI Life Index be used?
The Index will enable BCBSRI, as well as community-based organizations and others working in public health to measure progress in improving the perceptions of health and well-being over time. This data will also help boots-on-the-ground community-based organizations in their essential work to improve the lives of all Rhode Islanders. By summarizing firsthand perceptions of the residents of our state, the Index offers qualitative data that can be paired with other resources to complete a portrait of the state’s health landscape.

For example, the 2020 Status Report on Hunger in Rhode Island, an annual report issued by the Rhode Island Community Food Bank, noted “The pandemic recession left an unprecedented number of Rhode Islanders without the means to feed their families. During July and August 2020, a random sample of 2,100 households were surveyed as part of the RI Life Index, an initiative of Blue Cross & Blue Shield of Rhode Island and the Brown University School of Public Health. Researchers found that 25 percent of households were worried about having adequate food. This is the highest level of food insecurity recorded in Rhode Island in twenty years.”

Additionally, several of the health equity zones (HEZ) sponsored by the Rhode Island Department of Health have found the Index to be a rich source of information in their efforts to build healthier, more resilient communities. In fact, the RI Life Index data has been uniquely helpful to organizations seeking to stand up new health equity zones in Rhode Island, as it provides a view into their specific community’s health and well-being priorities.

These are just two recent examples of how data from the report can be leveraged to underscore important points about factors influencing health and well-being and to advance the conversation about solutions to longstanding challenges.

 

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How was the survey designed?
Working in concert with experts at Siena College Research Institute, researchers at the Brown University School of Public Health designed and oversaw the survey. The principal survey methodologist for the RI Life Index is Melissa Clark, Ph.D., Professor of Health Services, Policy and Practice, Associate Dean for Education, and Director of the Survey Research Center, Brown University School of Public Health.

 

 

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How was the 2021 survey administered?
From April through July 2021, we randomly selected adult residents by landline telephone, cell phone, or web with geographic representation across the state of Rhode Island. Interviews lasted approximately 15 minutes and were conducted in English or Spanish. In total, 2123 surveys were completed with an oversample of Black and Latinx Rhode Islanders. Of the total surveys completed, 622 were conducted by landline, 1147 by cell phone, and 354 though a web survey tool. Community-based organizations conducted an additional 414 interviews in person and by telephone in 11 different languages. The data collected from these interviews are presented separately from the data collected from randomly selected residents. 

The survey featured three sets of questions about respondents’ perceptions of their communities. One set of questions asked respondents to rate statements about their communities in terms of whether the statement was completely descriptive, somewhat descriptive, not very descriptive, or not descriptive at all. A second set of questions asked respondents to rate how likely each aspect of life was for a typical person living in their community—very likely, somewhat likely, somewhat unlikely, or very unlikely. The third set of questions asked respondents about housing availability and affordability. We also included questions about programs and services for children and older Rhode Islanders and questions about respondents’ actual experiences around food security, economic situation, confidence in managing health problems, reasons for not seeing a doctor, access to technology, confidence in using technology, and reasons for not having high-speed internet access at home. 

 

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How were phone numbers obtained?
The design of the landline sample was conducted so as to ensure the selection of both listed and unlisted telephone numbers, using random digit dialing. Landline telephone numbers were purchased from ADSE Survey Sampler. The cell phone sample was drawn from a sample of dedicated wireless telephone exchanges from within Rhode Island. Cell phone telephone numbers were purchased from Dynata. Respondents were screened for residence in the state of Rhode Island. The online sample was provided by Lucid, a market research platform that runs an online exchange for survey respondents. The samples drawn from this exchange matched a set of demographic quotas on age, gender, and region. 

 

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POP Score – how does that work?
POP, or percent of the possible, scores represent how close respondents believe their community is to an ideal or healthy community in the particular areas we asked about. A POP score of 100 is the highest possible score and is reached when every single respondent rates each of the individual indicators at the highest value. POP scores range from 0 to 100. In the survey, negative outcomes were reversed so that a higher POP score indicates moving toward a healthier community.

 

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Why is the data not available broken out by ZIP code?
Due to the survey size, the data cannot be broken down into ZIP code. There are too few survey respondents in some ZIP codes, which could cause their information to be identifiable.

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Can the data collected as part of the annual RI Life Index be integrated with complementary data collected by other organizations, like Health Equity Zones, ONE Neighborhood Builders, and United Way of Rhode Island, to name a few?
Because the RI Life Index survey method is designed to be anonymous and all potentially identifying characteristics are separated from the publicly available data, the possibilities for data integration are limited at best. This intentional survey method allows for greater participation and typically richer data, which can be used to reinforce existing data resources. The only identifier within our evaluation is the ZIP Code, which allows us to present results at a geographic level but limits the ability for full integration of these results with other data sources. We plan to facilitate sessions with the Health Equity Zones and to continue working with other community-based organizations to ensure that RI Life Index data drives action to address pressing community needs.

 

 

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Who are the members of the RI Life Index Coalition? 
It’s clear that in order to tackle the many social factors influencing health outcomes, key community partners must join together. That’s why we convened the RI Life Index Coalition, a group of community leaders who are shaping the next steps in the RI Life Index journey, helping to animate and activate the Index, and providing thought leadership on viable solutions to the challenges identified. Coalition members also provide recommendations about best to leverage existing data resources. The following organizations, all of which are all working in the arenas highlighted within the survey, including basic human needs and social services, are participating on the Coalition:

  • AARP Rhode Island
  • Blue Cross & Blue Shield of Rhode Island
  • Brown University School of Public Health
  • Economic Progress Institute
  • HousingWorks RI
  • Lifespan Community Health Institute
  • Medical Legal Partnership Boston
  • Rhode Island Community Food Bank
  • Rhode Island Department of Health
  • Rhode Island Kids Count
  • Rhode Island Foundation
  • United Way of Rhode Island

 

 

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How often will the Index be produced?
The survey will be conducted on an annual basis.

 

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How do you decide which topics to cover?
A core group of 18 questions that address quality of life and quality of community will be asked each year so that we may measure progress year over year. The remainder of the survey question topics are determined by the RI Life Index Coalition, based on the need to fill knowledge gaps in other existing data resources.

We know that there are social factors that make achieving well-being harder for particular demographic groups. In 2020 and 2021, we focused on the impact of social determinants of health on Black and Latinx Rhode Islanders.