PROVIDENCE — During a year fraught with rising inflation and a housing crisis, Rhode Islanders feel they are facing intense hurdles to afford their most basic necessities — a perception that is becoming more challenging to overcome in the state’s underserved communities, according to a new report.
The 2023 Rhode Island Life Index, funded by Blue Cross & Blue Shield of Rhode Island in partnership with the Brown University School of Public Health, reveals trends in Rhode Islanders’ perceptions of quality of life issues.
This year’s report, which was published Wednesday, showed an overall index a score of 58, which is one point lower than in 2022, marking the lowest index score of the report’s history. Scoring is on a scale of 0 to 100, with higher scores indicating more positive perceptions.
The availability of affordable housing, programs and services for children and older adults, access to health care and food security, transportation, and job opportunities were among the key issues the index has asked Rhode Islanders to share their perceptions on over the last five years. Collectively these topics are known as social determinants of health, and can contribute to health inequities, according to Martha Wofford, the CEO and president of Blue Cross Blue Shield of Rhode Island.
In many of these categories, Rhode Island residents reported they were facing more struggles in 2023 compared to previous years, particularly when it came to the cost of living — which had the index’s lowest score at 23. That means more than three-quarters of respondents perceive the cost of living as a challenge.
Regardless of their demographic details, the cost of living was perceived as the largest and most persistent challenge among Rhode Islanders, but scores were lowest for all subgroups for Black Rhode Islanders who lived in core cities. The score among Black Rhode Islanders younger than 55 was 18, and was 16 for those who were 55 and older.
During an event unveiling the index’s findings on Wednesday, keynote speaker David Williams, who is professor at the Harvard T.H. Chan School of Public Health, said the report showed that Rhode Island is “not making as much progress as we would like to see in the right direction.”
“In some ways,” he said, “[Rhode Island] is even going backwards. It just reminds us of the level of need that exists in a wealthy state like Rhode Island, and there’s work to be done to give everyone a fighting chance.”
The lack of available safe and affordable housing, Williams explained, has been a critical issue across the United States, and “it’s obviously playing a big role here too.”
These scores “reflect 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 Wofford.
Since joining BCBSRI in 2021, Wofford has placed significant emphasis on the production of affordable housing units, and has repeatedly sported the phrase “housing is health care” in multiple interviews with the Boston Globe. Along with Carolyn Belisle, BCBSRI’s director of corporate responsibility, they’ve worked to put the health insurer’s money where their mouth is when it comes to Rhode Island’s housing crisis, and have provided millions in funding for various housing and homelessness prevention programs.
In 2023, housing prices across the nation hit record highs. In Rhode Island, which has New England’s oldest housing stock, average home prices hit a historic high of $455,000 in September. In this year’s Life Index, the score for affordable housing was 32, which means that more than two-thirds of survey respondents perceive housing costs as out of reach. That’s one point lower than the score for affordable housing in 2022. Since 2020, scores related to the perceptions of available housing have dropped by 12 points.
Perceptions about access to medical services have also fallen as staffing shortages and other disruptions have ripped through the health care industry. It was one of the largest drops in scores for the core cities, according to the 2023 index, down 7 points to 64 since 2019.
The Life Index was launched in 2019 to show that “health is about much more than what happens within the health care system,” and to focus on meeting basic human needs and social determinants of health. The survey was conducted online and by phone through a statewide digit dialing system that selects people by generating random telephone numbers. Six community organizations also interviewed Rhode Islanders in 16 different languages. In 2023, 2,317 adults completed the survey.
This story has been updated with comments from David Williams.