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RIDOH Health Equity Summit Focuses on Building Healthy and Resilient Communities

More than 700 community members, legislators, municipal leaders, members of the business community, and representatives from fields including public health, healthcare, law enforcement, and education gathered today at the Rhode Island Department of Health (RIDOH)'s third annual Health Equity Summit to discuss how to build healthier, more resilient communities, and a healthier, more resilient Rhode Island.

In more than 60 different workshops, attendees examined how certain health issues affect specific communities differently, and how to partner with communities to address those health issues in ways that improve health and economic opportunities for all Rhode Islanders. The workshops at the Summit included sessions on healthy aging, transgender health, healthy housing, climate change, mental health, infant mortality, and gentrification, among dozens of other topics. The theme of the Summit was Building Healthy and Resilient Communities.

"Rhode Island is a place that embraces diversity, tolerance, and equal opportunity for everyone," said Governor Gina M. Raimondo. "An important part of ensuring that all Rhode Islanders have an equal opportunity to thrive is to address the underlying issues that determine whether people and communities are healthy, such as job opportunities, housing, and education. I applaud everyone at today's Health Equity Summit for rolling up their sleeves and contributing their time and talent, and for helping build a healthier Rhode Island."

"No matter what you look like, what you sound like, where you live, or who you love, everyone deserves the chance to be as healthy as possible and to live in as healthy a community as possible," said Director of Health Nicole Alexander-Scott, MD, MPH. "To make this a reality, we need to work together to build healthy and resilient communities that bounce forward after adverse events, such as those related to climate change, and that support healthy living for everyone. Today's Health Equity Summit was a critical step in this process, and in coming together to put action to our talk about building a healthier, more resilient Rhode Island."

Different health outcomes for different communities, also referred to as health disparities, exist throughout Rhode Island. For example:

- Teenagers living in rural areas of Rhode Island report some of the highest rates of drug, alcohol, and cigarette use in the state; - Individuals who identify as lesbian, gay, or bisexual are diagnosed with depression at double the rate of Rhode Islanders who do not identify this way (44% have ever had a diagnosis of depression, versus 22%); - The infant mortality rate for African-American Rhode Islanders is almost double the state average (11.2 per 1,000 live births, as opposed to 6.6); and - More than half of Native American children in Rhode Island (54%) live in poverty.

Differences in health outcomes like these are the result of different community-level factors, such as exposure to marketing of unhealthy products, access to transportation and health services and care, education, job opportunities, social supports, housing, and discrimination. Factors such as these are described as the socioeconomic and environmental determinants of health.

Because health outcomes are overwhelmingly determined by these community-level factors, many of RIDOH's public health interventions are now focused in communities, led by our communities. The most prominent example is Rhode Island's Health Equity Zones (HEZs). HEZs are community-led Collaboratives in nine regions throughout the state that are working to address these underlying, community-level determinants of health. For example, the Washington County HEZ has worked to address mental health concerns among residents by providing evidence-based, mental health first aid and suicide prevention training to more than 1,000 police officers, clergy members, teachers, parents, and staff of youth-serving organizations. As a result of the HEZ infrastructure pulling the community together the Substance Abuse Mental Health Services Association awarded the Washington County HEZ, Healthy Bodies Healthy Minds a $2 million grant to reach zero suicides. A second example is the work of the Pawtucket and Central Falls HEZ to revitalize a dilapidated city building in Pawtucket to create affordable housing units, a job training program for youth, and a market and kitchen space with locally-grown fresh fruits and vegetables and healthy prepared foods, called Harvest Kitchen.

"It's amazing to see so many partners working together to improve opportunities for Rhode Island families and neighborhoods," said Brent Kermen, Principal of William D'Abate Elementary School and a member of the Olneyville HEZ Collaborative who participated in the Summit as a panelist. "I see the impact of this work on a daily basis. The HEZ initiative is providing community members in my neighborhood with a sense that others care about them and believe in them making them want to give more and more to their community. That alone makes a tremendous difference."

All nine of the HEZs were represented at the Summit.

The keynote speaker at the Summit was Edward P. Ehlinger, MD, MSPH, a former Minnesota Health Commissioner. In addition to the breakout sessions and speaking portions, the Health Equity Summit featured a poster session, resource tables, and performances by the Inner City Rhythm Drummers, AS220 Youth ZuKrewe, and the musician Kim Trusty.

In addition to the wide range of communities and fields represented at the Summit, representatives from several State agencies participated in dialogues about how to improve health outcomes for the Rhode Islanders they serve. Those agencies included the Executive Office of Health and Human Services; the Rhode Island Department of Environmental Management; the Rhode Island Office of Veterans Affairs; the Rhode Island Department of Corrections; the Rhode Island Department of Children, Youth, and Families; the Rhode Island Department of Education; the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals; the Office of the Health Insurance Commissioner; and Health Source RI.

The Health Equity Summit was also an opportunity for Dr. Alexander-Scott to launch the 2019 President's Challenge for the Association of State and Territorial Health Officials (ASTHO). As Rhode Island's Director of Health, Dr. Alexander-Scott's yearlong term as the President of ASTHO, which is the national organization for state health directors, begins this month, giving the opportunity to elevate Rhode Island's leadership in health equity under Governor Raimondo. The theme of the President's Challenge mirrors the theme of the Health Equity Summit: Building Healthy and Resilient Communities. ASTHO will be working over the coming year with state and territorial health departments to help them implement initiatives that, similar to the HEZ initiative in Rhode Island, are focused on addressing the factors in people's communities that most significantly impact health outcomes. The challenge is aligned with the National Association of County and City Health Officials (NACCHO) and the U.S. Surgeon General's focus on community health and economic prosperity.

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