PROVIDENCE – The concept of health equity is simple and direct: everyone has an equal opportunity to take advantage of resources to help them to live a longer, healthier life.

In practice, to achieve health equity, the work is focused on addressing the disparities in population health that are related to unequal economic and social conditions in neighborhoods and communities.

Translated, it is about making investments in health, wellness and prevention at the community level, not just in the health care delivery system.

Here in Rhode Island, under the direction of the R.I. Department of Health, 11 Health Equity Zones, or HEZ, were created in 2015 in communities across the state, under a three-year grant from the Centers for Disease Control and Prevention.

The 11 HEZ are now entering their second year of operation, with an infusion of a new round of funding, ranging from $200,000 to $400,000, depending on their progress.

The HEZ were actually the second phase of work begun under the Centers for Health, Equity and Wellness program at the agency, which targeted at neighborhood interventions, and were awarded to single community agencies.

Under the HEZ program, each of the initial 11 awards – in Providence, South Providence, Pawtucket and Central Falls, North Providence, Olneyville, West Providence, Washington County, West Warwick, Woonsocket, Bristol and Newport – were organized around a collaborative of numerous agencies and groups, rather than one community agency.

The vision of the health equity zones is different than focusing on services to rescue folks in trouble, according to Ana Novais, the executive director at the R.I. Department of Health, in an interview with ConvergenceRI in April of 2015.

“What we are saying with the Health Equity Zones is different,” Novais explained. “Unless you work in the community, addressing the conditions that are creating that burden of disease, you are always going to be rescuing people. And, there is no money, not enough money, to rescue people indefinitely. If you start to diminish the conditions that led to the poor outcomes, then you are going to be more successful.”

The HEZ program also attempted to look at population health in a different way, according to Novais. Rather than defining population health as the patients being served under a health care delivery system program, the HEZ takes that approach one step further: to think about population health and the population that you serve as the population that surrounds where you are – “the larger, broader community that you are interfacing with.”

The broader context, Novais explained, opens the door for a better continuum of services. “I don’t like to talk about health care delivery systems,” she said. “I like to talk about health delivery systems. It clearly identifies the need for community engagement.”

Health Equity Institute launched
On Friday evening, April 29, the R.I. Department of Health will celebrate Minority Health Month at an event entitled “Advancing Health Equity in Rhode Island,” from 5 to 7 p.m., at the State House.

At the gathering, which is billed as networking event for “minority health and health equity champions in Rhode Island,” the agency will officially announce the launch the newly created Health Equity Institute.

Speakers at the program will include Dr. Nicole Alexander-Scott, director of the R.I. Department of Health, Novais, and Carol Hall-Walker, the associate director of the Division of Community Health at the agency.

Alexander-Scott has been a strong advocate in advancing the concept of health equity. In an interview with ConvergenceRI in June of 2015, she said: “We want to make sure that all Rhode Islanders have the opportunity to live in the healthiest communities and have the healthiest lives that they can.” She continued: “If I could change the department name, it would be to the Department of Health and Health Equity.” [See link to ConvergenceRI story below.]

A year ago, the agency convened the first Health Equity Summit; a second summit is planned for October of this year. [See link to ConvergenceRI story below.]

The work of the numerous HEZ programs, with their different approaches developed to address community needs, have received some media attention.

In South County, in October of 2015, the tangible results from one of the HEZ were unveiled as the South County Healthy Bodies, Healthy Minds community approach to promoting long-term health. The effort is targeting childhood obesity and children’s mental health, based upon several evidence-based programs, working in collaborative fashion with numerous partners. The programs included healthy eating, healthier lifestyles, early, early childhood literacy, and adolescent mental health. [See link to ConvergenceRI story below.]

More recently, at an event on March 31, the Woonsocket HEZ celebrated its comprehensive needs assessment and the beginning of its efforts to address gaps in accessing healthy, affordable foods. The event featured a tour of the new culinary incubator space under construction at NeighborWorks Blackstone River Valley.

At the event, which featured First Gentleman Andy Moffitt, Alexander-Scott said, in praise of the efforts underway: “Health does not begin in the doctor’s office. Health starts in the places where we live, learn, work and play.”

Second-year investments in HEZ
Here are the second-year investments that are being made in the 11 HEZ in Rhode Island:

• Providence, $399,856
• South Providence, [To be determined]
• Pawtucket and Central Falls, $353,965
• North Providence, $299,500
• Olneyville, $349,300
• West Providence, $210,000
• Washington County, $340,000
• West Warwick, $329,500
• Woonsocket, $365,000
• Bristol $321,225
• Newport, $400,000