2022 RI Life Index Finds Social Determinants of Health Barriers in RI

Blue Cross Blue Shield of Rhode Island (BCBSRI) released its 2022 RI Life Index for the fourth year in a row in order to assess social determinants of health barriers and the impact on residents’ perceived health and wellbeing. This year, the survey painted a bleak portrait of Rhode Islanders’ perceived health and wellness.

“Not surprisingly, Rhode Islanders are struggling with key factors that affect their health, such as cost of living and housing. By shining a light on gaps in basic needs through the RI Life Index, we can create a shared agenda with the community to address these gaps,” Martha L. Wofford, president and chief executive officer at BCBSRI, said in the press release.

“At Blue Cross, we look forward to continuing to tackle these hard problems with the RI Life Index Coalition so that all Rhode Islanders regardless of skin color, zip code, or language have access to affordable housing and healthy food and can live their healthiest life. There is much to do.”

BCBSRI interviewed 2,093 Rhode Islanders via landline telephone, cell phone, or web survey. The survey launched in April 2022 and ran through June 2022.

The researchers identified four core cities, which are metropolitan areas in which a quarter or more of all children are living below the federal poverty level. An area can receive a score of up to 100 if all survey respondents gave it the highest rating.

The RI Life Index score overall was a 59 out of 100. This represents a departure from the trend of the previous three years, in which 2019 the score was 62, 2020 the score was 62, and 2021 the score was 63.

The highest-ranked categories were perceptions of community for children (72), racial equity (73), and food security (80). The lowest-ranked categories were cost of living (26) and affordable housing (33). Affordable housing has been a perpetual issue across the US, which is why housing was one of the top areas of social determinants of health spending for major payers between 2017 and 2021.

Non-core areas continued to report better wellness through the RI Life Index than the four core cities. But even these areas saw a dip in perceived wellness. While in previous years, the score hovered around 64 or 65, in 2022 the score for non-core areas dropped to 61. In core cities, the score was 55, a slight decline from 57 and 56 in 2021 and 2020 respectively.

White respondents continued to report the highest scores, but in 2022 the gap shrank considerably.

In 2021, White respondents had a clearly more positive perception of their wellbeing with a score of 64 compared to 60 among Latinx individuals and 57 among Black respondents. But in 2022, White respondents reported a score of 60, which nearly matched Latinx respondents’ score of 59 and was not far from the Black respondents’ score of 56.

Seniors were more likely to have a higher score, as has been the case for the past three years. But this year the gap between seniors and those under the age of 55 widened. In 2022, seniors reported a life index score of 63, whereas those under the age of 55 reported a score of 57.

“Now in its fourth year, this survey offers crucial information about how Rhode Islanders are faring through the COVID-19 pandemic, and especially about the health barriers facing people of color and people living in lower socioeconomic communities,” Megan L. Ranney, MD, deputy dean of the Brown University School of Public Health, said in the press release. “This data offers policy makers, public health practitioners, and community leaders the information we all need as we seek to eliminate health inequities in our state.”

In the past, the RI Life Index has provided key data for BCBSRI as the payer tries to tackle social determinants of health barriers and direct its healthcare spending and social risk spending appropriately.