Keynote: Fine Calls for Community Health Stations Across Rhode Island

Published in the Woonsocket Call on May 20, 2018

Last week, the Rhode Island Minority Elder Task Force (RIMETF) held a Health and Wellness Fair at the Cape Verdean Progressive Center in East Providence to put a spot light on minority health care needs.

Dr. Michael Fine, a primary care physician who formerly was the state’s Health Director, and now serves as Senior Population Health and Clinical Officer at the Blackstone Valley Community Health Care, Inc., gave the keynote address, calling for an overhaul of America’s ailing health care delivery system.

Although RIMETF’s primary mission is to raise money and seek grants to provide limited emergency assistance to low-income seniors in crisis situations, the organization also promotes the advancement of inclusive programs for minority elders, says Susan Sweet, the nonprofit’s founder, a former state official who advocated for, developed and operated programs and services provided to the state’s vulnerable populations, including elders. She continued that work after retirement from the state. “During the last two decades, RIMETF provided more than $53,000 in grants,” she said.

According to Sweet, RIMETF’s $200 grants help low income seniors to pay utility costs, rent, food, medications, clothing, furniture, personal healthcare items and other necessities of life. She says that 80 grants are given out annually, about half going to minority applicants.

But, the decision to host a Health and Wellness Fair on May 11, 2018, was tied to minorities having a lack of access to health care services and to have Dr. Fine outline a better way of providing care to Rhode Island’s minorities, adds Sweet. “To this day the state’s diverse minorities continue to remain in the dark about health care programs and services that they can access and that lack of information has a detrimental impact on their health and well-being,” says Sweet.

Health Disparities in Rhode Island

During his thirty-minute keynote, Dr. Fine, a primary care physician who formerly was the state’s Health Director, and now serves as Senior Population Health
and Clinical Officer at the Blackstone Valley Community Health Care, Inc., provided the details as to how lack of access to health care adversely impacts the health and life expectancy of Rhode Island’s minorities.

According to Dr. Fine, infant mortality in the African American population is about three times as high than in the white population. Diabetes is about two times more common in the African-American population than it is in the white population. He also noted that life expectancy in the United States is 4.5 years less among the African American population than it is among the white population.

Zeroing in on Cape Verdeans, Dr. Fine noted that the Rhode Island Department of Health does not track the health of this minority group separately from other groups. The state’s primary care practices and community health centers don’t have a good way to decide who counts as a Cape Verdean for health tracking purposes, he said. But about half of the Cape Verdean community in Rhode Island live in Pawtucket and Central Falls, so that health information collected using the electronic medical record by Blackstone Valley Community Health Center (BVCHC), Inc, provides the first ever look at the health status of Cape Verdeans in Rhode Island.

It’s difficult to know if that data is complete, because it doesn’t allow us to count all Cape Verdeans at the BVCHC, but only those people who speak Cape Verdean Creole or those who identify themselves as having been born in Cape Verde. “Because we have no complete way to identify the health status of the Cape Verdean population, we have no certain way to identify specials needs and opportunities to provide better health care to this minority group,” says Dr. Fine. In addition, because Cape Verdean Creole is not a written language, “we have no way to certify Cape Verdean medical translators” which means some of the health care needs of Cape Verdeans go unaddressed, he adds.

But, there are better ways to improve the health care of Rhode Island’s Cape Verdeans, says Dr. Fine. “We must make sure that all Cape Verdeans are enrolled in a primary care practice or community health center,” he says, noting that electronic medical systems can provide better measures of the health of this population.

Dr. Fine called for Cape Verdeans to be appointed to boards of health care organizations to represent them in decision of allocation of resources, to demand better translation services, and to improve delivery of health care to Rhode Island’s Cape Verdeans.

As to Rhode Islanders, Dr. Fine noted that 25 to 45 percent don’t get primary care and prevention. As a result, there are 1,200 unnecessary deaths a year from heart disease and stroke. There are 200 unnecessary deaths a year from colon cancer and 65-70 unnecessary cases of HIV. Up to 200,000 Rhode Islanders remain smokers, he says.

Dr. Fine continued to detail the negative impact on the health of Rhode Islanders if they did not visit a primary care physician. More than 1,500 babies are born to teenagers, more than a third to minorities. Not to mention that there are 330 to 400 avoidable deaths from influenza every year due lack of immunization (500,000 Rhode Islanders are currently not immunized every year). And there are 330 deaths a year from prescriptions and other drug overdoses, he says.

It’s Time for a Change

Dr. Fine warns that major changes must be made to the nation’s health care delivery system to reduce spiraling health care costs and to provide better access. This solution can be modeled after his Central Falls Neighborhood Health Station (CFNHS), he says. It’s a multi and interdisciplinary approach, bringing a wide variety of health care professionals together, from physician, nurses, physician assistants, mental health workers, nutritionists, substance abuse workers and midwifes, to rehabilitation professionals, CFNHS’s must also provide urgent care and primary care services, be open on weekends and have “sick today access appointments.” Says Dr. Fine.

Fine has documented early successes in the CFNHS’s delivery of health care. Adolescent pregnancy was been reduced by 24 percent in 2016 and emergency medical service runs were reduced by 5 percent in just 12 months.

Dr. Fine envisions a Neighborhood Health Station in every community of 10,000 persons. When up and running, “we’ll increase life expectancy, reduce infant mortality and revitalize the local economy,” he says, by reducing health care costs.

Concluding the Health and Wellness Fair, Director Charles J. Fogarty, of the Rhode Island Division of Elderly Affairs, who will be retiring next month, was recognized by RIMETF for his 40 years of public service and his support for the work of the Minority Elder Task Force.

For more details regarding the work of the RI Minority Elder Task Force or to make a donation, write RIMETF, 5 Leahy Street, Rumford, RI 02916 or call Lori Brennan Almeida, Chairperson, at 401-497-1287.

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