Rhode Island Rural Health Data Book August 21, 2017 Rural Health Data Summit, Colorado

Acknowledgements Jill D’Errico Senior Public Health Promotion Specialist Office of Primary Care and Rural Health Katelyn Edel, MPH Brown University Student Assistant (2015-2017) Katelyn is now in medical school in the Penn State Rural Physician Program

Purpose To assess and review the health needs, behaviors and health statuses of people living in rural Rhode island from the perspective of social determinants of health The data book was intended as a replacement for a previous document that had been produced under contract by a vendor and to correct some of the perceived problems with that work regarding lack of comparability of data across variables. The construction of the data book also took inspiration from “Rural Data for Action’ published by the New England Rural health RoundTable which is a regional analysis of rural health for New England.

What data are included? Healthcare delivery and provider workforce Healthcare utilization Health related behaviors and health risks Health outcomes and status 1. How many FTEs we have in the state for primary care, mental health and dental health 2. Whether or not people have insurance, what is the usage rate of primary care and mental health services 3. Exercise rates and weight status, pregnancy related behaviors, personal safety 4. What is the cancer prevalence rate, top five causes of death, maternal and child health indicators

Data Sources Databases of governmental agencies and non-governmental organizations Research publications and reports Online resources Jill and Katelyn met with nearly every program within the Department of Health in order to determine how they should be included in an assessment of rural health. A good example of how that shaped the report is the map of radon exposure in the state.

Definition of Rural in Rhode Island OPCRH defines any town with a population size of less than 25,000 and a population density of less than 1,000 individuals per square mile as a rural community 18 towns designated as rural Rhode Island evaluated the rural definitions used by federal agencies as well as those used by other states, especially the neighboring states of Connecticut and Massachusetts to identify the appropriate measure of rurality Federal definitions consider commuting patterns, proximity to urban centers or population size to determine rural areas Under FORHP definition, Block Island is the only town in RI considered rural

Data Strengths and Challenges BRFSS data used for nearly all measures for uniformity Small sample size, risks to validity and reliability Data accessed from CDC lack city- and town-level data State level data may not reflect the true picture Diversity amongst rural towns each has its own unique challenges and opportunities

How Report is Being Used Used as a baseline report to measure the changes in indicators for rural population over the years Used for reference Shared with external stakeholders and internal partners

Lila Bhattarai Public Health Epidemiologist Office of Primary Care and Rural Health Rhode Island Department of Health Lila.Bhattarai@Health.ri.gov