The Impact
The Rhode Island Health Equity Institute, a division within the RI Dept. of Health, was created in 2019 to oversee the Health Equity Zone initiative and provide data, resources, and research to RI Dept of Health divisions and to the HEZ backbone groups. This group was key in establishing a tiered response from the very beginning of the pandemic. The Institute helped leverage relationships with communities and the existing HEZ infrastructure to manage a community-driven approach to testing, vaccination and meeting basic needs on an emergency basis.
This structure had several unanticipated benefits, including streamlining the process for RIDOH. Each backbone entity maintained a relationship with RIDOH, and the CBOs had contractual relationships with the backbone entities. That reduced the number of potential touch points for RIDOH and allowed resources to flow quickly through already existing payment channels. The HEZ backbone entity would field the individual requests, issues and concerns - and manage those needs through a single point of contact for the Health Department.
In addition to resources, information was disseminated to the residents and CBOs quickly through the backbone entities. This included real-time information about testing, vaccines, and case counts. RIDOH was able to get hot spot data to partners in those locations to inform decisions about pop-up clinics or resource distribution. Having the ability to quickly distribute updated and real-time information to providers delivering services was critical to the community, and beneficial to the Department of Health. This data sharing also was important for vaccine distribution. Understanding the cold spot data by neighborhood helped identify sections where local street teams could distribute information, conduct pop-up vaccination clinics, help residents register online, and touch base on other needs in the community.
Most importantly, this structure also provided key communication channels to RIDOH and the highest levels of government to help inform the crisis response. For example, it allowed for the localization of resources that considered transportation options and accessibility based on resident feedback. It facilitated the creation of materials and programs that were culturally and linguistically sensitive, and leveraged trusted messengers who could address vaccine hesitancy. It also uncovered the root of vaccine hesitancy for various populations within the Pawtucket Central Falls HEZ specifically. The recent pre-pandemic history had made certain immigrant populations in the community concerned enough to keep them away from National Guard-managed vaccination clinics. A simple request to the Guard to wear civilian clothes on clinic days made a demonstrable difference.
