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RIDOH director seeks smarter spending

Nicole Alexander-Scott MPH’11 outlines plans to address health inequity in Rhode Island

Nicole Alexander-Scott MPH’11, assistant professor of pediatrics and medicine at the Alpert Medical School and director of the Rhode Island Department of Health, stressed the need for health equity in Rhode Island in a speech at the Taubman Center for American Politics and Policy Thursday.

While serving as director of RIDOH for almost six months, Alexander-Scott has focused on environmental determinants of health, access to health services and health equality, said James Morone, director of the Taubman Center, in his introduction.

“Our overarching goal as a department of health is to demonstrate for Rhode Island the importance of public health,” Alexander-Scott said.

To accomplish this goal, RIDOH must address its leading priorities: confronting social and environmental determinants of health, eliminating disparities and ensuring access to quality health services for all Rhode Islanders, including vulnerable populations, Alexander-Scott said. “People’s life expectancy outcome — how long they live — should not depend on the ZIP code that (they’re) from,” she said.

While people usually think first of racial and ethnic gaps in health, huge disparities persist across other facets, such as gender, sexual orientation, educational status, income, ability and geographic area, Alexander-Scott said. The drug overdose epidemic in Rhode Island is disproportionately affecting men, and Providence County has the highest rates of sexually transmitted infections in the state, she added.

Alexander-Scott also addressed the need to cut costs for health care spending. The average life expectancy in the United States increased by 25 years between 1900 and 1960, while health care spending only increased by 4 or 5 percent, she said. But the average life expectancy increased by less than five years between 1960 and now, while health care spending rose by 18 percent, she said.

Health care spending should be smarter, Alexander-Scott said, adding, “We want to decrease health care spending, but we also want to think about how we’re spending overall.”

A rich potential exists for partnerships between RIDOH and the many academic institutions in the state, Alexander-Scott said. There is a “tremendous benefit in having the academic, clinical world … match and partner synergistically with the public health world,” she said. To help facilitate and formalize this relationship, the department is creating the RIDOH Academic Center, she said, adding, “We cannot do it alone.”


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