Achieving health equity by measuring and addressing behavioral and social determinants of health

The Rhode Island Department of Health seeks data to shape policy in order to reduce chronic diseases and eliminate health disparities. The Rhode Island Public Health Institute is conducting health interviews in low income neighborhoods using BRFSS questions on health status, physical activity, nutrition, cardiovascular disease, cancer and diabetes, with added questions about the quality of life in the neighborhood. The pilot project will demonstrate the cost and feasibility of conducting an in-home health survey of adults. Interviews are being conducted in five contiguous neighborhoods using a sampling frame randomized at the block segment and household levels in the spring and summer of 2009, with interviewees contacted in person by a two-person interview team. An adult in the household will be offered an interview. A small incentive will be provided those who complete interviews. Preliminary data on frequency distributions for key questions will be shared as will data on resources needed to conduct the survey, including key variables such as the number of contacts needed to achieve a completed interview, the amount of training and supervision required to assure fidelity to the interview protocol, and the IT support required for such a field operation. The pilot project is intended to create a bridge between government and community partners, to identify root causes of health inequity in the neighborhood as a prelude to policy reform responsive to social determinants of health. The project will support a comprehensive system of training, bi-directional technical assistance, and consultation services on policy, systems and local environmental change strategies to promote healthy communities.