News & Event
Posted:Feb 9, 2018 at 7:53 PM
Updated:Feb 10, 2018 at 12:04 AM
For 11 years, United Way’s 2-1-1 has been helping Rhode Islanders in need, handling 194,735 calls in 2017, many from people seeking financial help, information about health services, or food.
“Hello. United Way. 2-1-1. May I help you?”
Each time call center specialist Tony Medeiros answers the phone, he has no idea what awaits him on the other end of the line. United Way of Rhode Island’s 2-1-1 call center provides round-the-clock free assistance to those looking for help finding affordable food, housing, health care, transportation and more.
Twice last week, Medeiros took calls from people who were suicidal. Sometimes the most desperate calls he gets, he says, are from people seeking help with a gambling addiction. Others need help finding affordable housing.
One woman calls regularly to ask the time or the temperature. Medeiros thinks she’s lonely, so he’s started asking her about her day.
“That’s OK. She just needs to talk to somebody for a few minutes,” he said recently.
The call center acts as a one-stop-shop for resources. Its workers are trained on the offerings and applications processes of various social service and health-care programs, as well as church groups, nonprofits, shelters and more. When a person calls with one problem, call-center workers will talk through their living conditions to make them aware of other services that could also be of help.
On Sunday, United Way celebrates National 2-1-1 Day. United Way’s 2-1-1 service has been available in Rhode Island 24 hours a day, 365 days a year, since 2007.
“I listen to their story,” said Medeiros, whose shift starts at 6 a.m. “They might be saying one thing but there’s more going on. ... Sometimes people are in a domestic violence situation and they don’t even recognize it.”
United Way 2-1-1 took 194,735 calls in Rhode Island last year, a slight decrease from the 195,344 calls in 2016. But call specialists are finding higher anxiety among callers and are spending considerably more time on each call. In December 2016, the average call time was a little more than two minutes. In December 2017, the average call time was 5½ minutes, the organization reports.
Nationally, 2-1-1 answered a total of more than 14.3 million requests for help in 2017. The service is available for 94 percent of Americans, according to a spokesman for the United Way of Rhode Island, and in most parts of Canada.
Sandi Connors, executive vice president and director of strategic marketing and communications at United Way, said the trends in Rhode Island calls are reflected at 2-1-1 centers across the country. It’s not yet clear what is driving the changes, she said.
Some of the most difficult calls come from homeless families seeking shelter, Connors said. Some 72 families are currently on a waiting list for space in a family shelter.
“The hardest days are when we get the calls we can’t help,” Connors said.
Those days are often countered by others in which workers feel they’ve made a difference.
Program manager Tina Pearl remembered a call that came in to the hotline on Thanksgiving from an elderly woman who said there was an “uninvited guest” in her home. She had already called the police, who checked out the situation and determined there wasn’t an intruder. But the call center worker and Pearl determined they should also make a home visit.
It turned out there wasn’t anyone else in the home, Pearl said. The woman hadn’t eaten but she thought someone was coming over for dinner. She was confused, suffering from dementia and other health problems. They were eventually able to get her to the hospital.
“That’s why we go to work every day,” Pearl said.
2-1-1 calls, by the numbers
Here are some of the most common reasons Rhode Islanders called 2-1-1 in 2017.
Financial assistance: 162,936
Health information: 112,411
Courtesy of Providence Journal
Posted: Apr 27, 2018 at 12:01 AM
Updated: Apr 27, 2018 at 12:28 PM
Lunch won’t be served for another 15 minutes, but the line is already out the door at McAuley House on Elmwood Avenue.
PROVIDENCE, R.I. — Lunch won’t be served for another 15 minutes, but the line is already out the door at McAuley House on Elmwood Avenue.
Seemingly out of nowhere, dozens of people converge just after 11 o’clock. Many arrive by bus, others by foot and some by car, all knowing that during a day filled with uncertainty a meal at McAuley is something they can count on.
By 1 o’clock, volunteers and staff on this Friday during Lent will have served more than 200 plates of fish, rice, coleslaw, bread and dessert to the steady stream of “guests” — some homeless, but many who work and need help stretching a paycheck, especially at the end of the month. While breakfast and lunch are the main draw here, the staff helps with a full array of wraparound services — from securing bus passes and prescription eyewear to housing and medication — through its outreach center.
McAuley House is only one part of the lesser-known McAuley Ministries, which also runs a thrift store in Central Falls and a two-year transitional housing/workforce development program for 23 single mothers and their children in South Providence that is seeing impressive results.
“McAuley Ministries has always been a quiet ministry, hasn’t sought a lot of publicity, but we want people to know we’re much broader than just the meal site,″ said executive director Don Wolfe. “It’s really a spectrum of food, shelter, clothing and respect for the most vulnerable in the community.″
McAuley’s roots stretch back to the 1830s in Dublin, Ireland, when Catherine McAuley founded the Sisters of Mercy, creating a place for homeless mothers and their children. Her goal was to educate and train the young women to do something productive. When the Irish immigration came to the United States, the Sisters of Mercy came with them, some arriving in Providence. Today, two sisters still work at McAuley, one as an outreach worker, the other as an administrative assistant.
The first McAuley House in Rhode Island opened in 1975 in South Providence, before moving to its current location in 2004; McAuley Village with 23 apartments was built in 1990, modeled after a program in Hartford. The Warde-robe, named for Sister of Mercy Frances Warde, initially opened as a store for low-cost children’s clothing on Broad Street in Central Falls in 1996. Within walking distance for many, the locals called it The Nuns’ Store as it was created by two retired Sisters of Mercy.
Every Wednesday the community room in the basement of McAuley Village is packed by 5:15 p.m., as all the mothers who are not working or in class gather for a community dinner with their children. Every week a different mother cooks for everyone. It is a time to catch up, give the kids a chance to interact and hear from speakers who periodically come in after dinner to talk about things like parenting or nutrition.
“Many of our families have never lived in a place longer than two years, so this might be the first time in their lives that they have actually had a bed,″ said the Rev. Michele Matott, an Episcopal priest who serves as the administrator at the Village. “Often our residents are moving in from broken families themselves, domestic violence situation, shelters; they’ve never had a sense of community.″
The program is challenging, with specific expectations and regular status meetings to make sure the mothers are achieving certain benchmarks. Each resident is expected to contribute 30 percent of her paycheck toward rent ($50 per month if she’s in school). The mothers have to be at least 20 years old and their children 10 or younger. McAuley has childcare available in the building and counselors who begin working right away toward settling families in permanent housing when they leave. There is a nine- to 12-month waiting list to get into the McAuley Village program.
“We push them hard and there are times that they complain, but that’s what we seek, to develop a community where you can come and we talk about the issues and the problems you’re facing,″ Matott said, adding that McAuley has a 93-percent success rate of mothers remaining in housing after completing the program — and not going back into a shelter. The rate in New York City, she said, is about 30 percent.
“I am passionate about the program because if I had this opportunity I would have gone a lot further in my education,″ said Odette Delgado, who has been the resident services coordinator the past five years. Delgado said what makes the program unique is that all of the services are under one roof.
“I’m a single mom too, so I’ve been there,″ she said. “I make them aware this is a once-in-your-lifetime opportunity and you need to take advantage of it. Because right now you don’t have to worry about the things that you’re going to have to worry about once you’re out of here.″
Matott said that over the last five years, the women leaving McAuley Village have gone on to become medical assistants, x-ray technologists, pharmacy technicians, nurses, school bus drivers, childcare assistants, dental hygienists, dental assistants and accountants.
“It’s wonderful to watch them go from no education, no parenting skills and no job readiness skills and to see them in permanent housing with a full-time job often and their children have excelled in schools,″ she said.
At the north end of Broad Street in Central Falls, the Warde-robe has been a go-to place the past two decades for struggling families needing clothing and household items. The store has seen a transformation since Andres Montoya was hired three months ago as its new administrator. Being bilingual has been a big plus.
“We are able to provide gently used clothes for the community for a low price, but also we provide them a welcome smile and we always try to listen,″ said Montoya, who came to Rhode Island from Colombia when he was 21. He was looking to combine ministry with a retail touch, after working at Banana Republic for eight years.
“Sometimes you don’t really need to sell, sometimes people are in need of someone to listen to their struggles,″ he said.
Montoya has already made small, but significant, changes: separating out boys and girls clothing and putting signs throughout the store to direct customers to the inventory. He also puts a mannequin in a stylish dress out front with an “open” sign during store hours. And he has increased the hours of operation. The store is open from 10 a.m. to 3 p.m. Tuesday through Saturday.
He stressed that the store could not thrive without a cadre of volunteers. “The passion of my volunteers and the donations we receive,″ he said. “When you open the back door to receive donations you see the smile on their faces.”
Montoya said a men’s T-shirt averages 50 cents, a pair of pants $2.25. Customers often come in several times a week because new donations arrive daily. He is also mindful that while the store is a ministry, it also has to be self-sustaining financially.
“I like to implement different styles around the building just to enhance not only the presentation but also to make people aware of everything we have,″ he said.
Yvette Kenner came to McAuley House a month ago, after spending 10 years as the executive director of the South Providence Neighborhood Ministries six blocks away. She said she was attracted by McAuley House’s array of services for a population often facing multiple challenges.
“It’s tough because people don’t know where their next meal is coming from and when you’re elderly or young and on limited income, you’re saying to yourself, ‘What do I do, do I buy groceries this month, do I pay for medication this month, do I pay my electric bill this month?’” she said.
Kenner is both a smiling face, a calming voice and a forceful presence when necessary as hundreds of people pass through the doors of McAuley House every day, beginning with a breakfast offering of yogurt and cereal. McAuley House has also transitioned into a healthy foods program, where every meal is carefully planned with good eating habits in mind.
McAuley Ministries’ annual budget is $1.5 million, most of which the nonprofit raises by contributions from individual donors, grants, foundations and from corporate sponsors. And for the past decade corporate partners have participated in the Lunch on Us program, committing to help with lunches for an entire month — often bringing in 40 or 50 employees over the course of four weeks to help.
“Every corporate volunteer says they want to come back,″ said Wolfe, the executive director who will retire this summer after 12 years. “Everybody has something in their heart that says they want to give to someone in need and this is a real opportunity to do that. It was an eye-opener for me to come and work here. It’s an eye-opener for many folks to see folks who are in a different financial level, different financial stresses, to be thankful for what you have — and to the best of your ability to support those folks in need. We all need to do that.″
The Rhode Island Spotlight is a 501(c)(3) nonprofit organization that relies, in part, on donations. For more information, go to RhodeIslandSpotlight.org. Reach Jim Hummel at Jim@RhodeIslandSpotlight.org.
For a look at the work of McAuley Ministries, visit us online at providencejournal.com/rispotlight.
By G. Wayne Miller
Journal Staff Writer
Posted Dec 24, 2017 at 6:35 PM
Updated Dec 24, 2017 at 6:35 PM
PROVIDENCE, R.I. — A home for the holidays.
Homeless no more.
That is the story Lisbeth Matos Cruz brings us this Christmas, courtesy of Crossroads Rhode Island, which assisted Cruz and her son Jamuel, 15, in finding an apartment after they were forced to leave the discomfort of the place where they had been living.
Not now. Their new apartment on this recent wintry afternoon was warm and warmly decorated.
“I am thankful for mama,” read one line on a Thanksgiving card Jamuel had created.
“I am thankful for family,” read another.
The card topped the Christmas tree that the son and mother had placed in the kitchen, where a poinsettia graced the table. A Christmas tree, on their first Christmas they would not celebrate in their native Puerto Rico.
Through translator Cynthia Dukes, her case manager at Crossroads, Lisbeth recounted the circumstances that brought her to the mainland, and then — almost — to the city streets.
“I was looking for a better way of life and a better education for my son,” Lisbeth said, when she left Puerto Rico. They lived with a relative in Rhode Island initially, but by June circumstances had grown intolerable.
“His way of living was not the best,” Lisbeth said.
Staff and students studying English with her at Dorcas International advised her to call United Way’s 211 help number. Lisbeth was connected to Crossroads, which provided temporary housing in its family shelter for her and Jamuel as they worked toward a more durable life.
“Philosophically, Crossroads follows the very effective ‘housing first’ model,” Laura Calenda, chief marketing and philanthropy officer told The Providence Journal. “Research shows that providing individuals and families with a stable place to call home is a critical first step to helping them address the other issues which may have led to them being homeless. In fact, 75 to 91 percent of households remain housed a year after rapid ‘rehousing.’ ”
Lisbeth, who had no job, either, embraced the approach.
“I really just wanted the little help I need to get out of the situation I was in, being homeless,” she said. “I did not want to have to depend on the government helping me. So I looked for work and getting myself back on my feet.”
In September, Crossroads found her the apartment. According to Calenda, Crossroads “owns or manages 375 housing units throughout the state” and provides assistance with more than 150 additional units on the private market.
Lisbeth gave momentary thought to returning to Puerto Rico, where her grown children live, but September’s Hurricane Maria, which devastated the island, eliminated that option.
Mother and son were Rhode Islanders. And Lisbeth in late November entered the workforce, finding employment with a packaging firm.
“I am 100-percent grateful to Crossroads and to the staff,” she told The Journal.
“We’re thrilled that we were able to give Lisbeth and her son the helping hand they needed to get their lives back on track,” said Calenda. “We are also hard at work finding permanent homes for the 63 children in 26 families that are currently staying in our shelters. No one should have to be homeless for the holidays.”
“I’m getting emotional,” Lisbeth said, tears filling her eyes. “I feel good. I’m very thankful.”
For those who are where she once was, she said “take the opportunity that any agency like Crossroads gives you. Put effort in, follow the rules, and let them help you.”
And, of course, “Feliz Navidad, and a happy New Year.”
Courtesy of Providence Journal
Homelessness in Rhode Island is on the rise. The state saw a 1.7 percent increase in homelessness this year according to a new report by U.S. Department of Housing and Urban Development (HUD). Statewide, 1,180 people experienced homelessness on a single day earlier this year. Nearly 400 were children in homeless families; almost 100 were veterans. Of even greater concern, Rhode Island’s chronically homeless population nearly doubled, increasing from 136 to 240.
After years of successfully reducing homelessness, Rhode Island’s homeless numbers are heading in the wrong direction. The solution to ending homelessness is actually pretty simple. Our “Housing First” model effectively gets people off the streets, out of shelter — and into permanent, affordable housing with the support services necessary to help them remain housed. Unfortunately, Rhode Island simply does not have enough housing that is affordable and meets people's needs.
Fortunately, social service agencies like Crossroads Rhode Island step in to bridge the gap. But hundreds of thousands of dollars in state and federal funding cuts, including the loss of Housing Stabilization dollars through Medicaid, Road Home and the Neighborhood Opportunities Program, are significantly reducing the amount of aid available for 2018 and beyond.
It’s the chronically homeless, the state’s most vulnerable population, who are likely to pay the price. Many of these individuals struggle with physical and mental illness, hunger and poverty — fighting every day just to survive. Without adequate funding for housing and support programs, they will end up back on the street, sleeping in doorways, camping under highway overpasses or staying in shelters.
Recently, 283 people slept in a Crossroads shelter, including 53 children in 27 families. Others sought refuge at different shelters — or bundled up in outdoor places where no one should have to spend a cold, winter night.
It may seem counter-intuitive, but helping those people find permanent housing solutions will ultimately cost taxpayers far less than keeping them in shelters. Research shows that the chronically homeless are much higher users of Medicaid, police, fire and rescue and other services.
A 2013 study of 67 chronically homeless Rhode Island Medicaid users revealed charges of $59,651 per person, more than double Medicaid charges for the average housed, disabled adult. In fact, over the course of 26 months, those 67 individuals cost the state $9.3 million in Medicaid costs alone.
Over the last three years, Crossroads helped more than 3,000 people move into permanent housing—and stay there. Several had been living in shelters for 10 years or more. Ten years. Let that sink in. Imagine how much it cost taxpayers to shelter those individuals for more than a decade, never mind what it would be like to live in a homeless shelter for that long.
The bottom line is that programs like “Housing First” save more taxpayer dollars than reducing funding. Working together, we can reduce the number of men, women and children experiencing homelessness, help save taxpayer dollars and find every Rhode Islander a safe place to call home this holiday season.
— Karen Santilli is president and CEO of Crossroads Rhode Island.
Wednesday, November 1, 2017
2200 Southwood Drive, Nashua, NH
We invite you to be a part of the second New England Lead Conference taking place on Wednesday, November 1, 2017 in Nashua, NH. Hosted by the New England Lead Coordinating Committee, the conference will include a variety of educational sessions focusing on lead prevention, policy, model programs, outreach, the EPA’s Renovation, Remodeling and Repair Rule (RRP), lead abatement, compliance, and the economics of lead poisoning.
Read more >
October 4, 2017 in Events, Local Interest
The Narragansett Times: Dziobek steps down as Welcome House director
By KENDRA GRAVELLE Sep 29, 2017
SOUTH KINGSTOWN—When Joseph Dziobek accepted the position of executive director of Welcome House of South County nearly three years ago, he had expected the job would make for a simple transition into retirement.
But what was intended as a part-time gig turned into much more than that for Dziobek, who this week left his post.
“It’s been a challenge,” said Dziobek, whose last day on the job was Monday. “And it’s been very satisfying—I feel very close to the people who have been a part of it.”
Dziobek, 66, took the job at Welcome House after retiring from his career as CEO of Fellowship Health Resources. He said he intended only to stay for two or three years.
October 4, 2017 in Local Interest
Final Days to Register: 2017 Housing Fact Book Release
Date: Wednesday, October 11, 2017
Luncheon: 12:00pm - 1:30pm
Location: Rhode Island Convention Center, 1 Sabin Street, Providence RI
October 3, 2017 in Events, Local Interest
Rhode Island College: The Defamation Experience
Monday, October 30, 2017
5:00PM - Doors Open
6:00PM - Performance
SPONSORED BY: THE DIVISION OF COMMUNITY EQUITY AND DIVERSITY AND THE DIVISION OF STUDENT SUCCESS
THE PLAY * THE DELIBERATION * THE DISCUSSION
September 27, 2017 in Events, Local Interest
NLIHC: Sign Letters to Support Equitable Housing Recovery after Devastating Hurricanes
Help ensure that low income people and neighborhoods are treated fairly after Hurricanes Harvey, Irma, and Maria. A broad coalition of national, state, and local organizations is calling on Congress, FEMA, and HUD to ensure that the federal response to Hurricanes Harvey, Irma, and Maria is complete and equitable for everyone, especially families and individuals with the lowest incomes who are often the hardest hit by disasters and have the fewest resources to recover afterwards.
September 27, 2017 in Local Interest, National News
Roger Williams University: Social Justice Month Events
Thursday, Oct 19
Mary Tefft White Center
How Housing Works
4:00pm – 6:00pm
Sponsored by Housing Works RI and RWU Chief Diversity Officer
Keywords: socioeconomic status, race, jobs, housing, equity
Workshop with Brenda Clement, Director of Housing Works Rhode Island and Ame Lambert, RWU Chief Diversity Officer.
An overview of housing issues in Rhode Island and connections to the larger social justice agenda.
September 25, 2017 in Local Interest
Providence Journal: People on the move for the week of Sept. 17
Posted Sep 13, 2017 at 5:34 PM
Updated Sep 13, 2017 at 5:34 PM
Rhode Island LISC
Rhode Island Local Initiatives Support Corportation has welcomed two new employees. Jeremiah O’Grady, of Lincoln, joined LISC as program officer after spending more than 12 years at ONE Neighborhood Builders as real estate project manager and director of asset management and operations.
Liz Klinkenberg, of Warwick, was hired as communications director. She brings more than 15 years of public relations experience to her new position, including work for The Miami Herald and The Providence Journal.
The Providence American: Reed Announces $300k in Community Development Grants for NeighborWorks Affiliates
WASHINGTON, DC – In an effort to promote healthy, vibrant neighborhoods across Rhode Island, U.S. Senator Jack Reed today announced an additional $300,000 in federal funding for three Rhode Island-based affiliates of NeighborWorks America (NeighborWorks). These federal funds will help NeighborWorks Blackstone River Valley, ONE Neighborhood Builders, and West Elmwood Housing Development Corporation to provide affordable housing opportunities, generate job growth, and enhance economic stability for working families. Earlier this year, Senator Reed also helped to secure over $750,000 in federal funding for NeighborWorks affiliates in Rhode Island, bringing total NeighborWorks investment in the state to above $1 million for fiscal year 2017.
September 21, 2017 in Federal News, Local Interest
The Providence American: Providence Unveils PVD Gives Donation Station
PROVIDENCE, RI – Mayor Jorge O. Elorza today joined members of the City Council, public safety officials, and community leaders who have been named to the PVD Gives commission for the unveiling of the City’s first Donation Station at Kennedy Plaza. The retrofitted parking meter is one of ten stations that will be installed across the city to collect funds that will support local organizations that provide housing and services to those in need.
“PVD Gives and the new Donation Stations make it easier to give back,” said Mayor Jorge Elorza. “Our collective generosity can make all the difference in the lives of those striving to get back on their feet. I encourage visitors and residents to chip in and be part of the solution.”
September 21, 2017 in Local Interest
Providence Journal: Report: New England losing 65 acres of forestland per day
By Steve LeBlanc / Associated Press
Posted Sep 19, 2017 at 11:21 AM
Updated Sep 19, 2017 at 11:21 AM
BOSTON — New England has been losing forestland to development at a rate of 65 acres per day — a loss that comes at a time when public funding for preservation of open land, both state and federal, has also been on the decline in all six states.
That’s the conclusion of a report released Tuesday by the Harvard Forest, a research institute of Harvard University.
The study found public funding for land conservation in New England dropped by half between 2008 and 2014 to $62 million per year, slightly lower than 2004 levels.
PROVIDENCE, R.I. — Jalen Hayre was just shy of his second birthday when he and his young single mother, Joanna N. Ravello, moved into an apartment on Smith Hill. It offered independence and the rent was affordable, but the building was old.
“The owner probably did what he could, but it wasn’t well-kept,” said Joanna when The Journal visited the home she shares with her now-grown son. “Lots of chipping paint, lots of dust all over the house, on the windowsills.”
Jalen liked to stand at those windows, watching children play in the driveway below.
“He’d look down and laugh and giggle,” recalled Joanna.
He’d also ingest the dust and paint, which had lead. Toddlers get into everything.
Before the move, Jalen and Joanna had been living with Joanna’s parents. The boy had been developing normally.
“Thriving,” said Joanna, who was receiving welfare benefits then and who today, having earned a doctoral degree, is the director of Community and Organizational Development with the University of Rhode Island’s Office of Community, Equity and Diversity.
But in his new home, the laughing and giggling boy became someone else.
“He was super-cranky,” Joanna said. “He wasn’t eating. He wasn’t meeting some of his milestones.”
Her mother thought the move had unsettled Jalen. Perhaps he missed his grandparents.
It was 1995, and in Rhode Island, lead poisoning of children was beginning to emerge as a public-health crisis. But outside of medical circles, many people were only vaguely familiar with the potential effects of lead on the developing child, if familiar at all.
“You weren’t aware of the hazards,” Joanna told The Journal. You didn’t know that lead “can affect nearly every system in the body,” according to the Centers for Disease Control and Prevention, and that children are particularly vulnerable. Brain damage from lead poisoning can be irreversible, affecting a youngster’s lifelong personal, social and economic prospects.
But Jalen’s pediatrician’s office knew. A practitioner drew blood for testing.
A lethal level of lead was detected. The boy’s life was saved during an admission to Hasbro Children’s Hospital, but medicine could not undo the damage to Jalen’s brain.
Twenty-five years old now, Jalen still lives with his mother, in a different home untainted by lead. He has experienced difficulty finding employment, and he continues to need support.
“I feel like I’m not living an easy life,” he said during a recent visit at his home.
And yet, he maintains an uplifting attitude.
“Don’t fall into negativities,” he said. “You’ve got to be positive in your life.”
With lead no longer used in the manufacture of paint, and state and federal laws requiring owners to reduce levels of the toxin in housing, cases of child lead poisoning have declined in recent years in Rhode Island and the nation.
According to state Department of Health data, 11,716 Rhode Island children age 6 or younger in 2002 were found to have concentrations of five micrograms or more of lead per deciliter of blood — five and higher being a threshold of concern on the so-called BLL, or Blood Lead Level, scale. In 2017, that number had dropped to 953 children age 6 or younger. (Rhode Island law requires health-care providers to conduct at least two blood lead screening tests on all children by 3 years of age and report results to the health department within 10 days; after age 3, annual screenings are required through age 6, though they do not have to be blood tests. Not all children necessarily visit a provider regularly, however.)
Just as in 1995, children of color — such as Jalen, who is black — and children living in poverty today are disproportionately affected by lead poisoning, which can also be traced to “corrosion of lead service lines where a house or building’s water pipe connects to the public water main,” according to Rhode Island Kids Count, which tracks children’s health. Lead-contaminated water in Flint, Michigan, created a public-health crisis that has made national headlines in recent years.
But health disparities are not limited to children poisoned by lead — or to children.
Race, ethnicity, income, insurance coverage, education, exposure to trauma and stress, and where one resides, among other factors, also affect health outcomes for people of all ages. If you are poor, you are more likely to experience worse health than if you are not. If you are black, Hispanic or Native American, you are more likely to experience worse health than if you are white. If you live in certain ZIP codes, you face formidable odds.
“The conditions and environments in which we live, work and play have an enormous impact on our health, often dictating the availability and quality of resources that help people live healthy lives,” the Department of Health’s 2015 Minority Health Facts report states.
Differences “frequently result in inequalities in opportunities like quality childcare and education, access to healthy foods and safe places to be physically active,” the report concludes. “Rhode Island’s racial and ethnic minority populations often feel the burden of these inequalities.”
Example: Among white adults, 11.5 percent reported “being unable to afford to see a doctor when needed at least once in the last year,” according to the health department. The corresponding percentage for Hispanic/Latinos was 31.3 percent; for Black/African-Americans, 17.3 percent; and for Native Americans, 21.6 percent.
Another example: Among white adults, according to the health department, 10.8 percent reported “having no person they thought of as their personal healthcare provider(s),” typically a primary-care physician. The corresponding percentage for Hispanic/Latinos was 32.3 percent; for Black/African-Americans, 20.8 percent; and for Native Americans, 21.1 percent.
Here are some income statistics: Just over 11 percent of the white population in Rhode Island is living in poverty, according to the health department, compared with nearly 36 percent of the Hispanic/Latino population, 28.4 percent of the Black/African American population, and 42.2 percent of the Indigenous population.
“The Opportunity Atlas,” a landmark interactive tool published Monday by the Census Bureau with Harvard researcher Raj Chetty and John N. Friedman of Brown, provides snapshots of a child’s race and the parent income for census tracts across America. Red-shaded neighborhoods in Central Falls, Pawtucket, Providence and Woonsocket, all cities with large minority populations, confirm the correlation in Rhode Island between race and income.
While a better way is possible, Rhode Island and America have not summoned the will to get there, assert many experts, including Dr. Michael Fine, former director of the state Department of Health.
“A lot of this is fixable, and we don’t do it,” said Fine, now health policy adviser for the City of Central Falls and a leader and practitioner at Blackstone Valley Community Health Care.
Fine blames in part what he calls “a health-care services market” that emphasizes hospital care over primary care and is driven by profit, hobbled by lobbyists and burdened by bureaucratic waste. As he notes, despite spending more for health care than any other country, the U.S. has some of the worst health outcomes among the industrialized nations.
In 2016, according to the Kaiser Family Foundation, health expenditures in the U.S. were $10,348 per person, compared with $5,500 per person in Germany, $4,752 per person in Canada and $4,192 in the United Kingdom. But for such key measures as infant mortality, life expectancy at 60 years and “adults age 18 to 64 with at least two of five common chronic conditions,” the U.S. lagged, according to The Commonwealth Fund. The expenditure and outcome gaps held true for many other countries, as well.
People of color fare worse than that already inferior U.S. average. “Race influences health through a number of mechanisms: through stress, poverty, education and reduced access to medical care,” Fine writes in his new book, “Health Care Revolt.”
Consider low birth weight, defined as infants who are born weighing less than 5 pounds, 8 ounces — babies “at greater risk for physical and developmental problems than infants of normal weights,” says Kids Count. In Rhode Island, 11.2 percent of black infants and 8.2 percent of Hispanic babies born from 2012 to 2016 entered the world at low birth weight, compared with 6.7 percent of white babies, according to the organization, which cites poverty, violence and stress as among the causes.
And consider asthma, a chronic respiratory disease that can be life-threatening. According to Kids Count, people under the age of 18 in predominantly white and comparatively wealthy East Greenwich experienced a rate of 2.3 “emergency department visits with primary asthma diagnosis” per 1,000 children — compared with rates of 13.7, 11.5 and 10.7, respectively, in comparatively poorer and less white Providence, Central Falls and Woonsocket.
A parent in prison can also affect a child’s health. As Kids Count writes, “Children of incarcerated parents experience high rates of physical and mental health problems” and educational disadvantages. “Parental incarceration increases children’s risk for learning disabilities, ADHD, conduct problems, developmental delays, and speech problems.”
Here, too, Rhode Island’s racial-minority groups suffer. One child of an imprisoned parent was reported in mostly white Barrington on Sept. 30, 2017, compared with 983 such children in Providence, 318 in Pawtucket and 253 in Woonsocket, according to Kids Count.
“Our health outcomes are influenced by the medical care available, to some extent,” Fine told The Journal, “but are much more a function of our history, society, and culture — by the environmental exposures left over from the manufacturing of a hundred years ago, by income inequality, by the twin legacies of mill culture and slavery, by attitudes and choices around substance and alcohol use and abuse, by education, housing, and community development.”
Said Fine: “Until we get an engaged and educated electorate who can make choices, I don’t see a way to change it. That’s why I think, at the end of the day, this has become a political problem.”
The health disparities of such conditions as low birth weight and asthma are echoed in lead poisoning.
Of the 87 children who will be entering kindergarten next year who were screened for the toxin in overwhelmingly white and comparatively well-to-do North Smithfield, none tested positive, Kids Count data shows. That compared with 292, or 11.3 percent, of the same-age children in Providence and 32 children, or 10.7 percent of those tested, in Central Falls.
But today’s situation is an improvement over the time when Jalen Hayre was born and in the decades before, when lead-based paint was used in housing everywhere. Lawsuits against paint manufacturers and landlords, legislation, growing awareness, and press coverage — here in Rhode Island through stories by Journal staff writer Peter Lord — helped bring about change.
So did the efforts of the state health department and researchers such as Dr. Patrick M. Vivier, Brown University professor and director of Brown’s Hassenfeld Child Health Innovation Institute who served on the staff of Lifespan’s Hasbro Childen’s Hospital.
During a visit to his office on South Main Street, Vivier shared three maps depicting levels of lead poisoning, old housing and poverty in Rhode Island from 2006 to 2016, with red showing the highest concentrations of each factor, and blue the lowest. Red dominated in Providence, Central Falls, Pawtucket and Woonsocket.
“There are other issues, like water supply,” Vivier said, “but it doesn’t appear to be the driver of the issues. Paint is the main villain. It’s house paint for me. We have an old housing stock.”
And in some of that old housing stock, in poor areas of Rhode Island, those shaded red in “The Opportunity Atlas,” the lead paint remains.
On a recent visit with Joanna Ravello and Jalen Hayre, the mother and son recount the obstacles Jalen has faced as a result of the cognitive impairments caused by his lead poisoning.
“I developed with learning disability and developmental disability,” Jalen said. “It was very hard to, like, maintain it.” Even today, he said, “it takes time and patience to learn as much as I can.”
Jalen was enrolled in special education through public high school, and he has held jobs since becoming an adult, including a seasonal position recently at an Amazon warehouse in Massachusetts. He is looking for another job now.
“Finding a place to work is very difficult,” he said.
Joanna, who identifies as black West Indian, sees lead poisoning and health disparities in general as issues of racial and social justice. If “caring for others, giving back” are truly an American ethos, she said, “it’s time that we move beyond these rhetorical commitments to actually doing something.”
Her son agrees, and frames his views through the lens of his own experience.
“Treat people with lead poisoning with proper respect,” he said. “You’ve got to do whatever you can to save those young children from being lead poisoned. If they are lead poisoned, please guide them through life and help them as much as you can.”
His counsel to others like him?
“It may be a sad life, but you can do it. ... You’ve just got to fight through the pain.”
Joanna and Jalen shared some of their story in a documentary by University of Rhode Island filmmaker and professor Kendall Moore. Watch it here:http://bit.ly/2OzPOj3
The Health Department has established nine Health Equity Zones around the state with the ambition “to eliminate health disparities using place-based strategies to promote healthy communities.” Learn more at:http://bit.ly/2pEak3T
Physical and mental health disparities were explored in The Journal’s 2015 award-winning series, “Race in Rhode Island.”
R.I. health providers working to lessen disparities in care
While the herculean reform that health expert and advocate Dr. Michael Fine endorses remains distant, efforts on a smaller scale are addressing health disparities.
One in Rhode Island is Blackstone Valley Community Health Care, “committed to providing high quality, accessible, affordable, comprehensive health care to the residents of the lower Blackstone Valley” by means of “a model of primary care that stresses prevention, education, and patient empowerment,” according to the center’s website. Fine practices medicine there and is a center leader.
Another is the Lifespan Community Health Institute, whose stated aim is “to eliminate health disparities and promote health equity through healthy behaviors, healthy relationships, and healthy environments.” The institute, headquartered on Prairie Avenue in South Providence, offers dozens of innovative programs, many free or at reduced cost.
Among them: health screening and immunization clinics; educational mentoring; the Transitions Clinic, which supports people recently released from prison; diabetes prevention; so-called “community health ambassadors,” a networking and education resource for front-line health professionals; Food is Medicine, a course teaching how to prepare affordable and nutritious meals; and Financial Literacy, which teaches money management.
Although Lifespan runs five hospitals — Rhode Island, Miriam, Newport, Hasbro Children’s and Bradley — the emphasis at the institute and related Lifespan initiatives is not hospital care. The same holds true for community programs run by Care New England, CharterCare and others in the state.
“Socioeconomic factors — things like income, education, housing status, social networks — these are the things that have the greatest impact and longest-term impact on health outcomes,” says Lifespan Community Health Institute director Carrie Bridges Feliz.
Using a chart labeled “Health Impact Pyramid,” she breaks it down: “Health-care services only account for about 10 percent of what determines your health status. Genetics is about 20 percent ... Seventy percent of what drives your health status is determined by behavior and environment.” The latter two can be changed, given individual and societal will.
On Twitter: @GWayneMiller
Posted Jan 3, 2018 at 8:28 PM
Updated Jan 3, 2018 at 8:28 PM
PROVIDENCE — The start of a new year brought clergy to the State House Wednesday to call for action from Rhode Island lawmakers to combat poverty.
At the 10th annual Fighting Poverty with Faith Vigil in the State House rotunda, members of the Rhode Island Interfaith Coalition called for new measures to help provide affordable housing, make child care more affordable and strengthen public health insurance programs.
“Sadly, we are not yet where we need to be,” said Maxine Richman of the Jewish Alliance of Greater Rhode Island and the Coalition’s Steering Committee. “12.8 percent of Rhode Islanders and 17 percent of children — that’s over 35,000 Rhode Island children — are still living in poverty. We find these numbers unacceptable.”
The coalition’s list of legislative priorities for the year ahead includes:
Republicans and Democrats in Congress have been battling over a permanent re-authorization of the federally funded CHIP program for months. States are faced with a potential decision over whether to pick up the costs if their federal funding runs out.
Gov. Gina Raimondo has identified Medicaid spending as an area she is scrutinizing for savings to plug a state budget gap, but said she hopes to avoid benefit cuts.
For the fourth consecutive year, Raimondo spoke at the vigil, which also featured Senate President Dominick Ruggerio. Both mentioned some of the policies they have supported that are designed to help the poor.
“A lot of people feel the economic resurgence — they got a job or they got a raise,” Raimondo said. “But we are not going to stop until everyone does. Too many people are being left out.”
Raimondo has consistently said she supports providing driver’s licenses for unauthorized immigrants — and did again on Wednesday — but will wait for the General Assembly to approve them instead of trying to create them through executive order.
The vigil took place with a major winter storm approaching New England that could place poor Rhode Islanders, particularly the homeless and those struggling to heat their homes, under additional stress.
The vigil’s keynote speech from Rev. Nikita McCallister, pastor of Bethany Baptist Church in Pawtucket, was all about love.
“When you do experience gridlock, conflict, complacency and hyper-partisanship in your politics, I challenge you to apply a little more love,” McCallister said.
On Twitter: @PatrickAnderso_
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