Date November 29, 2023
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Rhode Islanders perceive steep challenges in cost of living and access to housing, health care, food

Results from this year’s R.I. Life Index survey, a partnership between Blue Cross and Blue Shield of Rhode Island and the Brown University School of Public Health, revealed sobering information about local quality of life.

PROVIDENCE, R.I. [Brown University]  The fifth annual Rhode Island Life Index, a statewide survey conducted by leaders at Blue Cross and Blue Shield of Rhode Island and the Brown University School of Public Health, shows that Rhode Islanders perceive steep challenges finding affordable housing, meeting the rising cost of living, and accessing health care and nutritious food.

The results capture how residents perceive their well-being in 2023 — a year the data portray as fraught with concerns about economic challenges — as well as the five-year period spanning the turbulent years before, during and after the COVID-19 pandemic. These findings bring to light perceptions that deteriorated during the pandemic and have since stabilized, but which continue to persist at troubling levels.

Survey leaders presented the results on Wednesday, Nov. 29, at the School of Public Health to key stakeholders, community partners, policymakers and members of the public health community.

The index is unique because it goes beyond statistics to show how community members assess their own health and well-being, said Dr. Ashish K. Jha, dean of the School of Public Health. While calling the results sobering, he said they also reveal important perspectives.

“There are real challenges facing the people of Rhode Island, and this survey provides a roadmap to reducing inequities and improving the health and quality of life for the people in the Ocean State, especially for those struggling the most,” Jha said. “The R.I. Life Index is providing critical information on the real-life experiences of Rhode Islanders — information we can all use to build healthier, more equitable communities for all.”

David Williams, a professor at Harvard University’s T.H. Chan School of Public Health who specializes in the study of social influences on health, was invited to discuss the significance of the findings. While commending the survey design and delivery, Williams agreed with Jha that the results show a lack of progress.

"It's not a surprise but it reminds us of the level of need that exists in Rhode Island and the work to be done to give everyone a fighting chance," Williams said.

Findings reveal the state of residents’ well-being

The R.I. Life Index asked Rhode Islanders for their perceptions on issues including the availability of affordable housing; programs and services for children and older adults; and access to health care, food, employment and transportation. On a scale of 0 to 100, higher scores indicated more positive perceptions.

In 2023, similar to previous years, 2,317 “random digitl dial” phone and web surveys were completed by adults randomly selected from across the state, in Spanish or English, with an intentional oversample of Black and Latinx residents. For the third year in a row, to ensure that Rhode Islanders who do not speak English at home are also represented, 582 surveys were conducted by community-based organizations in 16 languages.

Compared to 2022, the overall well-being score for the 2023 random digit dial survey dropped one point from 59 to 58, the lowest in five years. The overall score for the community-based organizations survey increased one point to 55.

In 2023, as housing prices hit record highs, the random digit dial survey score for affordable housing was 32, which meant that more than two-thirds of respondents perceived housing costs as out of reach. This was the second-lowest score in this year’s survey, and down from 44 in 2020.

As inflation persisted throughout the year, the score for cost of living was among the lowest in 2023. The score of 23, down from 31 in 2020, meant that more than three-quarters of random digit dial respondents perceived cost of living as a challenge.

The survey revealed that perceptions about health care access have worsened since the pandemic, dropping to a score of 64 in 2023 from 73 in 2019. The 2023 random digit dial score for access to nutritious food fell to 66 from a 2019 score of 73, representing the largest decline in a topic area since the index began.

The R.I. Life Index was launched in 2019 in recognition that health transcends what happens within the health care system and that factors such as employment, education and housing — collectively known as social determinants of health — contribute to health inequities. The index is updated every year by surveying a representative sample of Rhode Islanders to measure their perceptions of these health-related factors.

Principal survey methodologist Melissa Clark, a professor of health services, policy and practice, and director of the Survey Research Center at the School of Public Health, led a team of researchers from Brown and the Siena College Research Institute to design and oversee the 2023 survey. The R.I. Life Index is funded by Blue Cross and Blue Shield of Rhode Island.

“The R.I. Life Index reflects the reality of the people of Rhode Island, and unfortunately the data show that experience is getting harder for some, particularly for underserved communities,” said Martha L. Wofford, president and CEO of Blue Cross and Blue Shield of Rhode Island. “The index provides shared understanding so that we can have a shared agenda on how to address the gaps.”

This year, surveys were completed in person or by phone by six organizations: Capeverdean American Community Development, Center for Southeast Asians, Dorcas International, Genesis Center, Higher Ground International and Progreso Latino.

Coalition member organizations include BCBSRI; Community Provider Network of Rhode Island; United Way of Rhode Island; Latino Policy Institute; Rhode Island Department of Health; Rhode Island Community Food Bank; Brown University School of Public Health; HousingWorks R.I.; Rhode Island Kids Count; AARP Rhode Island; Economic Progress Institute; Rhode Island Foundation; Lifespan Community Health Institute; and Medical Legal Partnership Boston.