Delivery of Care

Health Equity Zones expand to Cranston, West End of Providence, East Providence

Rhode Island has emerged as the leading national pioneer in developing community-based Health Equity Zones

Image courtesy of ONE Neighborhood Builders newsletter

The Health Equity Zone serving Olneyville will be expanding to serve adjacent neighborhoods in Federal Hill, Hartford and Valley, according to ONE Neighborhood Builders, the local HEZ backbone agency.

By Richard Asinof
Posted 5/6/19
The expansion of the Health Equity Zone initiative into the communities of East Providence, Cranston and the West End of Providence highlights the success being achieved at developing community-based action plans that create local solutions to improve health outcomes.
Which political talk show, radio talk show host, political columnist or reporter will be the first to talk about the success of Health Equity Zones in Rhode Island? How will the braiding of resources with the Working Cities Challenge spearheaded by the Federal Reserve Bank of Boston be accomplished with Health Equity Zones? Will other communities in Rhode Island follow the programmatic lead of the Health Equity Zone in South County and develop a Zero Suicide Initiative? Would the developers of the Wexford Innovation Complex and its anchor tenants benefit from a walking tour of Health Equity Zone activities in Olneyville?
The convergence of Health Equity Zones and the Working Cities Challenge appears to be a work in progress. But the opportunity for community-driven engagement around health and economic development promises to be something that funders will be paying particular attention to as a way to braid limited resources together and leverage them in achieving better outcomes. The voices in the community are often stifled by a combination of factors, including a lack of access to be invited the conversations by decision-makers.
The narrowness of the silos in reporting the news in Rhode Island needs to be recognized as a fundamental problem: if climate change is a big problem, then make it part of the daily weather reports; if the business model for hospitals is unsustainable, then explore how resources could be better spent, for instance, by investments in emergency rooms dedicated to older Rhode Islanders, not just trauma; if alcohol is a co-morbidity of some 80 percent of overdose deaths, then create better access and intervention around alcohol intoxication.
Communities can help lead the charge with bottom-up innovation strategies that reflect their needs.

PROVIDENCE – At a time when the two leading hospital systems in Rhode Island, Care New England and Lifespan, are engaged in an escalating war of words over plans by Partners Healthcare in Boston to merge with Care New England, one of the more significant news events when it comes to achieving better health outcomes is occurring well beneath the radar screen: the expansion of the innovative Health Equity Zone initiative to three more communities in Rhode Island, bringing the total number to 10 operating in the state.

On Monday, May 6, the R.I. Department of Health is slated to announce that the agency is expanding its support and funding for three new communities to establish Health Equity Zones, a community-driven collaborative approach to achieving better health outcomes – in East Providence, in Providence’s West End neighborhood, and in three census tracts of Cranston.

In awarding new Health Equity Zones, each of the successful applications were submitted by a municipal or nonprofit, community-based organization that will serve as the “backbone” agency for the local Health Equity Zone. In East Providence, the agency will be the East Bay Community Action program; in Cranston, the agency will be the Comprehensive Community Action Plan; and in the West End of Providence, the agency will be the West Elmwood Housing Corporation.

The initial steps undertaken by the new Health Equity Zones will be to facilitate a community-led process to organize a collaborative of community partners, to conduct a needs assessment, and implement a data-driven plan of action to address the obstacles to health and well being in local neighborhoods, with the R.I. Department of Health providing the seed funding for those activities.

The three new Health Equity Zones were chosen from nearly 20 applicants from communities across Rhode Island. Together, they will share in approximately $1.4 million in funding with seven existing Health Equity Zones that are receiving support to continue their work in local communities.

Braiding together resources
The five-year-old innovative initiative, launched in 2014, supports a place-based approach that brings people together to build healthy, resilient communities across Rhode Island, with an emphasis on health, not just health care.

The Health Equity Zone initiative is grounded in research that has demonstrated up to 80 percent of health outcomes are determined by factors outside clinical settings, such as access to affordable, healthy foods, high-quality education, employment opportunities and safe neighborhoods. The model encourages and equips community members and collaborative partners to create healthy places for people to live, learn, work and play.

“These communities are taking the forces that shape their health and well-being into their own hands,” said Dr. Nicole Alexander-Scott, director of the R.I. Department of Health, in a news release announcing the expansion plans. “I can’t wait to see what they accomplish over the next few years as we continue to lift up this initiative up as a national model of how such an infrastructure led by community members can create the conditions needed for every person to thrive.”

At the same time, the current Health Equity Zone in Olneyville will be expanding its geographic reach, with plans to serve the adjacent neighborhoods of Federal Hill, Hartford and Valley in Providence. [See link below to ConvergenceRI story, “At home in the hub of Olneyville.”]

Funders are taking notice
The Rhode Island Foundation, in announcing $3.6 million in new health grants in the fall of 2018, put the focus of those awards in investments in health equity zones.

Similarly, the Working Cities Challenge initiative has been engaged in dialogue with the Health Equity Zone initiative to discuss ways to braid together and leverage resources to support efforts underway in Newport, Providence and now Cranston.

Ana Novais, the executive director at the R.I. Department of Health, said that the important takeaway from the new expansion of the Health Equity Zone initiative was the growing recognition of the importance of the role of health equity in addressing the social, economic and environmental determinants of health.

Whatever health care system is designed or planned, Novais explained, there is now a growing recognition of “the importance of having community-led planning processes, community-led prioritization, and plans of action being driven and implemented by the community.”

Housing, education, and health, Novais continued, “All of those things that we often take for granted, and are at the root causes of inequalities, can only be properly addressed at the local levels. We continue to put that message forward. We want to do whatever we can to make sure that Health Equity Zones are seen as a key critical infrastructure at the local level. That is our vision.”

Novais added: “I hope that everyone can hear that. People are paying attention, locally and nationally.” During the recent legislative budget hearing, Novais reported that numerous people spoke up about how much they champion and appreciate the work being done by Health Equity Zones.

The innovative approach of Health Equity Zones pioneered in Rhode Island has also developed a growing national audience, thanks in part of Dr. Alexander-Scott’s presidency of the Association of State and Territorial Health Officials, which she assumed in September of 2018.

In regard to the ongoing conversations about developing a statewide health plan and a statewide education plan, in which the Rhode Island Foundation is playing a leading role as a convener, Novais said it was important that healthy equity be fully integrated as part of those conversations.

“I think the message of health equity is that we all have equal opportunities to achieve the highest potential, regardless of where you start, regardless of your zip code [where you live], skin color, culture, accent, and language,” Novais said.

That is a message that should be central to any initiative in our state, she continued, whether it involves education, housing or health plans. “We see this as being our commitment to the agenda we put forward at whatever table we sit at. We bring that message, and we make sure that it is heard and that it is integrated into the plans. Yes, it is important.”

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