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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What will the partners do with the information in the Index?
The data collected from the RI Life Index will help boots-on-the-ground organizations in their essential work to improve the lives of all Rhode Islanders. The data collected is intended to complement existing data surrounding social determinants of health that other organizations have collected.

 

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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 the survey. The principal survey methodologist for the RI Life Index is Melissa Clark, Ph.D, Professor of Health Services, Policy and Practice and Professor of Obstetrics and Gynecology; and Associate Dean for Academic Affairs at Brown University.

 

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How was the survey administered?
Randomly selected Rhode Island residents representing the entirety of the state’s zip codes were contacted in April and May of 2019 via landline telephone, cell phone, or web. Interviews lasted approximately 15 minutes and were conducted in both English and Spanish. In total, 2209 surveys were completed with an oversample of individuals age 55 and older. The margin of error for the total sample of 2,209 is +/- 2.4%, including the design effects resulting from weighting with a 95% confidence interval. This means that in 95 out of every 100 samples of the same size and type, the results obtained would vary by no more than plus or minus 2.4 percentage points from the results obtained if every member of the population was interviewed.

Of the surveys, 902 were conducted by landline, 900 by cell phone, and 407 though a web survey tool.

Three sets of questions were used to ask respondents about their perceptions. The first set asked them 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. The 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 final set of questions asked respondents to specifically rate the experiences of older adults in their community from very good to very poor.

In the final section of the survey, we included questions about personal and household access to healthcare, social integration, emergency department use, concerns about discrimination in healthcare, experiences with opioid abuse, and overall mental and physical health.

 

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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 would cause their information to be identifiable.

 

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What were some of the highlights of the first RI Life Index?
Overall, Rhode Islanders have positive feelings about several aspects of their communities, including access to safe and reliable transportation; availability and quality of civic, social, and healthcare services for older adults and the ability to age in place; and programs and services available for children.

The most prominent finding of the first RI Life Index, however, is the lack of access to safe and affordable housing in the state. Respondents in both the core and non-core cities had low perceptions of housing with an overall POP score of 48, based on questions surrounding cost of housing, difficulty paying for utilities, and access to internet connection. Many Rhode Islanders shared that they struggle to find affordable housing and jobs that pay well enough to ensure financial stability.

 

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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. The RI Life Index Coalition is a newly established group of community leaders who will shape 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 will 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:

  • Age-Friendly Rhode Island
  • Blue Cross & Blue Shield of Rhode Island
  • Brown University School of Public Health
  • Economic Progress Institute
  • HousingWorks RI
  • Lifespan Community Health Institute
  • 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 set of 25 perception questions will be repeated each year to track progress year over year. The remainder of the survey question topics will be determined by the RI Life Index Coalition, based on the need to fill knowledge gaps that can inform the work of the agencies represented on the Coalition.