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Purpose <p>Rhode Island’s 14 Health Equity Zones (HEZ) initiative is an innovative public health approach to improve well-being by uniting community stakeholders to create healthier neighborhoods. We sought to identify the association between HEZ and colorectal cancer (CRC) screening among populations with anticipated vulnerabilities.</p> Methods <p>This study used deidentified health insurance claims data from HealthFacts RI, Rhode Island’s all-payer claims database, to calculate CRC screening rates by race/ethnicity, insurance type, substance use, and/or mental health diagnoses across ZIP codes from 2017 to 2022. ZIP code(s) were matched to the corresponding HEZs and non-HEZs, resulting in a sample size of 973,433 individuals in HEZs and 312,619 in non-HEZs.</p> Results <p>Rates of CRC screening were 62.4% in the HEZs versus 64.1% in the non-HEZs (<i>p</i> &lt; 0.01). Among Medicaid beneficiaries, rates of CRC screening were 47.8% in HEZs versus 45.8% in non-HEZs (<i>p</i> &lt; 0.01).</p> Conclusions <p>The population living in HEZs underwent CRC screening at a lower rate overall compared to non-HEZs. We found that individuals with Medicaid insurance coverage had the lowest CRC screening rates, and HEZs appear to mitigate the screening rates in this group of patients. Other Medicaid expansion states should replicate Rhode Island’s HEZ model to improve screening among Medicaid beneficiaries.</p>

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Evaluating the impact of health equity zones to mitigate disparities in cancer screening: study of colorectal cancer screening in rhode island

  • 期刊论文

  • 发表日期：

    2025年12月24日

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  • Alexander T. Pralea,
  • Erica Lamy,
  • Victoria Fruh,
  • Steve Kwon

摘要

Purpose

Rhode Island’s 14 Health Equity Zones (HEZ) initiative is an innovative public health approach to improve well-being by uniting community stakeholders to create healthier neighborhoods. We sought to identify the association between HEZ and colorectal cancer (CRC) screening among populations with anticipated vulnerabilities.

Methods

This study used deidentified health insurance claims data from HealthFacts RI, Rhode Island’s all-payer claims database, to calculate CRC screening rates by race/ethnicity, insurance type, substance use, and/or mental health diagnoses across ZIP codes from 2017 to 2022. ZIP code(s) were matched to the corresponding HEZs and non-HEZs, resulting in a sample size of 973,433 individuals in HEZs and 312,619 in non-HEZs.

Results

Rates of CRC screening were 62.4% in the HEZs versus 64.1% in the non-HEZs (p < 0.01). Among Medicaid beneficiaries, rates of CRC screening were 47.8% in HEZs versus 45.8% in non-HEZs (p < 0.01).

Conclusions

The population living in HEZs underwent CRC screening at a lower rate overall compared to non-HEZs. We found that individuals with Medicaid insurance coverage had the lowest CRC screening rates, and HEZs appear to mitigate the screening rates in this group of patients. Other Medicaid expansion states should replicate Rhode Island’s HEZ model to improve screening among Medicaid beneficiaries.