Prepared by: Samantha R. Rosenthal, PhD, MPH, Anna Cimini, MA & Stephen L. Buka, ScD Department of Epidemiology Brown University School of Public Health On behalf of the Rhode Island State Epidemiology and Outcomes Workgroup [December 2016]
INTRODUCTION The purpose of this report is to identify and present documentation on substance use (i.e., alcohol, tobacco, and other drugs) and mental health indicators for both adults and youth in the communities of Rhode Island as compared to the State. In particular, we focus on demographics, prevalence indicators, risk and protective factors, and consequences. The report is designed to be used as a resource by various RI state agencies, such as the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH); the State Epidemiological Outcomes Workgroup (SEOW); and the many community-based Substance Abuse Prevention Task Forces in RI. It is important to note that this is a working document. The Rhode Island Community Profiles 2016 is understood to be an evolving document, to be improved and updated regularly both with additional indicators and years of data, when available. ACKNOWLEDGEMENTS Thank you to SEOW membership and BHDDH staff. Funding for this report comes from the Substance Abuse and Mental Health Services Administration Award number U579SP020159. The Brown University Team Stephen Buka, ScD Samantha Rosenthal, PhD, MPH Anna Cimini, MA Department of Behavioral Healthcare, Developmental Disabilities and Hospitals Rebecca Boss, MA, Interim Director Elizabeth Kretchman, CPSS, Associate Administrator, Program Services and Community Engagement Unit Linda Barovier, CPSS, Associate Administrator, Policy and Planning Candace Rodgers, MPH, CHES, SPF-PFS Project Director Daniel Fitzgerald, Rhode Island Prevention Coordinator NOTE: For the purposes of this report New Shoreham and Block Island are synonymous and Block Island will be referenced throughout. Suggested Citation: Rosenthal SR, Cimini A, Buka SL. On behalf of the State Epidemiology and Outcomes Workgroup of Rhode Island and the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals. Rhode Island Community Profiles 2016. Cranston, RI: Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, 2016.
CONTENTS OF THE PROFILE Overall Demographics o Population per Square Mile in Rhode Island Communities o Gender Distribution in Rhode Island Communities o Age Distribution in Rhode Island Communities o Racial/Ethnic Distribution in Rhode Island Communities o Unemployment in Rhode Island Communities o Below Federal Poverty Level in Rhode Island Communities Individual Profile o Demographics o Prevalence High School o Prevalence Middle School o Risk and Protective Factors o Consequences Overdose o Consequences Substance Abuse Admissions o Consequences Mental Health Admissions o Consequences Suicidality
Central Falls Providence Pawtucket North Providence Woonsocket West Warwick East Providence Newport Cranston Warwick Bristol Barrington Warren Cumberland Middletown Johnston Lincoln Narragansett RHODE ISLAND TOTAL Smithfield East Greenwich Westerly Portsmouth North Kingstown Coventry Jamestown Tiverton South Kingstown North Smithfield Burrillville Scituate Charlestown Hopkinton Richmond Glocester Little Compton West Greenwich Block Island Foster POPULATION PER SQUARE MILE IN RHODE ISLAND COMMUNITIES 3,666 3,520 3,195 2,821 2,312 2,227 1,939 1,702 1,285 1,237 1,223 1,170 1,120 1,008 807 791 755 748 606 588 561 538 535 504 290 214 212 189 188 180 167 121 116 92 91 5,553 5,342 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 8,197 9,652 15,043 Source: 2014 American Communities Survey 5 Year Aggregated Estimates
GENDER DISTRIBUTION IN RHODE ISLAND COMMUNITIES Little Compton North Smithfield Westerly Smithfield East Providence North Providence Barrington South Kingstown Johnston Burrillville Bristol West Warwick Warwick Middletown Providence Cumberland Tiverton Richmond Lincoln RHODE ISLAND TOTAL North Kingstown Coventry Pawtucket Block Island East Greenwich Newport Warren Woonsocket Glocester Cranston Narragansett Jamestown West Greenwich Portsmouth Scituate Charlestown Central Falls Foster Hopkinton Male (%) Female (%) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Source: 2014 American Communities Survey 5-Year Aggregated Estimates
AGE DISTRIBUTION IN RHODE ISLAND COMMUNITIES Block Island Narragansett Bristol Newport South Kingstown Foster Jamestown Smithfield North Providence Hopkinton Warwick Johnston Charlestown North Smithfield Glocester Little Compton Tiverton Scituate Cranston Warren Coventry Portsmouth RHODE ISLAND TOTAL Cumberland Westerly West Warwick Burrillville East Providence North Kingstown Lincoln Providence Pawtucket East Greenwich Middletown Richmond Woonsocket Barrington West Greenwich Central Falls 0 14 15 24 25 44 45 64 65+ 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Source: 2014 American Communities Survey 5 Year Aggregated Estimates
RACIAL/ETHNIC DISTRIBUTION IN RHODE ISLAND COMMUNITIES Glocester Scituate Warren North Smithfield Little Compton Coventry Narragansett Block Island Burrillville Foster Richmond Jamestown Bristol Hopkinton Charlestown Portsmouth Westerly Smithfield East Greenwich Barrington North Kingstown Cumberland Warwick West Greenwich South Kingstown West Warwick Lincoln Johnston North Providence East Providence Newport Middletown Cranston RHODE ISLAND TOTAL Woonsocket Pawtucket Providence Central Falls White Black Hispanic Other 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Source: 2014 American Communities Survey 5-Year Aggregated Estimates
Pawtucket Providence Central Falls West Greenwich Coventry Warren Foster East Providence Cranston West Warwick RHODE ISLAND TOTAL Warwick Middletown Burrillville North Providence Tiverton Bristol Westerly North Kingstown Charlestown Portsmouth Woonsocket Smithfield Little Compton Scituate Glocester Johnston Richmond Lincoln South Kingstown Barrington Newport North Smithfield Cumberland East Greenwich Jamestown Block Island Hopkinton Narragansett UNEMPLOYMENT IN RHODE ISLAND COMMUNITIES 7.00% 6.90% 6.80% 6.40% 6.20% 6.10% 5.90% 5.60% 5.50% 5.50% 5.50% 5.20% 5.20% 5.20% 5.20% 5.10% 4.80% 4.70% 4.70% 4.60% 4.60% 4.40% 4.30% 4.20% 4.20% 3.90% 3.80% 3.40% 3.30% 3.30% 3.30% 3.00% 2.60% 2.40% 8.80% 8.50% 8.20% 7.90% 7.70% 0% 1% 2% 3% 4% 5% 6% 7% 8% 9% 10% 9.30% Source: 2014 American Communities Survey 5-Year Aggregated Estimates
Central Falls Providence Woonsocket Pawtucket West Warwick Narragansett RHODE ISLAND TOTAL Newport East Providence Cranston Charlestown Little Compton North Providence Warren Westerly Johnston Bristol Block Island South Kingstown Burrillville Lincoln Jamestown North Kingstown Coventry Portsmouth Warwick Middletown Foster Scituate East Greenwich Tiverton West Greenwich Cumberland Richmond North Smithfield Smithfield Glocester Hopkinton Barrington BELOW FEDERAL POVERTY LEVEL IN RHODE ISLAND COMMUNITIES 1.8% 11.5% 11.5% 11.2% 11.2% 11.1% 10.9% 10.3% 10.0% 10.0% 9.4% 8.9% 8.9% 8.7% 8.6% 8.3% 8.3% 8.2% 8.0% 7.9% 7.3% 7.1% 6.2% 6.1% 6.1% 6.0% 5.6% 5.6% 5.0% 4.6% 4.1% 3.9% 3.8% 14.3% 16.0% 16.0% 0% 5% 10% 15% 20% 25% 30% 35% 21.4% 26.1% 29.7% 31.7% Source: 2014 American Communities Survey 5-Year Aggregated Estimates
Demographics Total Population: 6,673 Total Households: 2,390 GENDER AGE 49.70% 50.30% Male (%) Female (%) 85 YEARS+ 75 TO 84 YEARS 65 TO 74 YEARS 60 TO 64 YEARS 55 TO 59 YEARS 45 TO 54 YEARS 35 TO 44 YEARS 25 TO 34 YEARS 20 TO 24 YEARS 15 TO 19 YEARS 10 TO 14 YEARS 5 TO 9 YEARS UNDER 5 YEARS 1.20% 2.60% 7.40% 10.90% 9.10% 12.50% 6.60% 9.30% 6.90% 4.80% 6.60% 2.60% 19.40% HEALTH INSURANCE RACE/ETHNICITY 10.80% 89.20% No Health Insurance (%) Health Insurance (%) EMPLOYMENT MULTIRACIAL 0.20% OTHER RACE 0.00% NH/PI** 0.00% ASIAN 2.20% AI/AN* 0.00% BLACK 1.30% WHITE 92.30% HISPANIC OR LATINO 3.90% **Native Hawaiian or Pacific Islander; *American Indian or Alaska Native ANNUAL HOUSEHOLD INCOME $200,000 OR MORE 10.30% 29.80% $150,000 TO $199,999 6.30% $100,000 TO $149,999 $75,000 TO $99,999 5.50% 64.70% $50,000 TO $74,999 $35,000 TO $49,999 9.40% $25,000 TO $34,999 5.90% $15,000 TO $24,999 2.90% Employed (%) Unemployed (%) $10,000 TO $14,999 2.90% Not in Labor Force (%) LESS THAN $10,000 4.10% * Note: 0% Armed forces for this municipality 15.80% 17.80% 24.60% SOURCE: All demographic variables are from 2014 American Community Survey 5-Year Aggregated Estimates
Prevalence High School 45 Alcohol Use PAST 30 DAYS Percent of High School Students 40 35 30 25 20 15 10 5 30.5 27.6 32.4 27.7 25.7 13.2 Highest Value RI Average Lowest Value 0 2011 2012 2012 2013 2013 2014 Percent of High School Students 20 18 16 14 12 10 8 6 4 2 Cigarette Use PAST 30 DAYS 11.6 11.8 9.7 9.0 5.0 5.7 Percent of High School Students 60 50 40 30 20 10 Felt Sad or Hopeless PAST 12 MONTHS 39.5 32.8 29.2 28.8 20.1 18.4 0 2011 2012 2012 2013 2013 2014 0 2011 2012 2012 2013 2013 2014 NOTE: Highest/lowest indicates the highest/lowest value across all communities in a given school year; Highest/Lowest community may vary by school year. RHODE ISLAND EXETER Under the influence of alcohol at school PAST 12 MONTHS 2012 2013 10.7% 5.2% 2013 2014 9.5% 4.8% Marijuana use PAST 30 DAYS 2012 2013 57.0% 56.7% 2013 2014 60.8% 54.2% Prescription Drug Misuse PAST 30 DAYS 2012 2013 57.4% 48.1% 2013 2014 55.7% 44.0% SOURCE: Rhode Island Department of Education SurveyWorks
Prevalence Middle School 2013 2014 Middle School Prevalence EXETER RHODE ISLAND Past 30 Day Cigarette Use 5.3 2.8 Past 30 Day Alcohol Use 8.8 6.8 Ever Used Marijuana 9.0 7.4 Ever Misused Prescription Drugs 3.4 5.0 Felt Sad or Hopeless Past 12 Months 26.7 28.5 0 5 10 15 20 25 30 Percent of Middle School Students NOTE: Due to changes in survey questions from year to year, trend comparisons for middle school data were unavailable. SOURCE: Rhode Island Department of Education SurveyWorks
Risk and Protective Factors Percent of High School Students 90 80 70 60 50 40 30 20 10 0 Made Fun of at School 70.9 70.7 36.2 32.8 31.6 25.8 2011 2012 2012 2013 2013 2014 Highest Value RI Average Lowest Value Percent of High School Students 25 20 15 10 5 0 Physical Fight at School PAST 12 MONTHS 10.0 8.5 9.4 8.9 4.9 7.0 2011 2012 2012 2013 2013 2014 NOTE: Highest/lowest indicates the highest/lowest value across all communities in a given school year; Highest/Lowest community may vary by school year. 2013 2014 Middle School Prevalence EXETER RHODE ISLAND Made Fun of at School 42.1 43.3 Physical Fight at School PAST 12 MONTHS 10.9 13.1 0 5 10 15 20 25 30 35 40 45 50 Percent of Middle School Students NOTE: Due to changes in survey questions from year to year, trend comparisons for middle school data were unavailable. SOURCE: Rhode Island Department of Education SurveyWorks
Consequences Overdose SOURCE: Numerators Hospital Discharge Data and ED Data. Denominators Appropriate <18 or 18+ population, American Community Survey 2014 5 year Aggregated Estimates SOURCE: Numerator Behavioral Health On Line Database. Denominator 18+ population from American Community Survey 2014 5 year Aggregated Estimates SOURCE: Overdose Data (RIDOH); Methadone Data (BHDDH)
Consequences Substance Abuse Admissions 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Substance Abuse Admissions by Age Group, Fiscal Years 2012 2014 2012 RI 2012 2013 RI 2013 2014 RI 2014 %18 21 %22 30 %31 45 %46 65 %OVER 65 NOTE: Admissions may not be unique individuals; patients could have presented for treatment multiple times. Admissions under 18, with unknown municipality, out of state, or with unknown age were excluded. 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Substance Abuse Admissions by Race/Ethnicity, Fiscal Years 2012 2014 2012 RI 2012 2013 RI 2013 2014 RI 2014 NOTE: Admissions may not be unique individuals; patients could have presented for treatment multiple times. Admissions with unknown municipality, out of state, or with unknown race/ethnicity were excluded. White Black Hispanic Other 65% 60% 55% 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Substance Abuse Admissions by Primary Substance, Fiscal Years 2012 2014 2012 RI 2012 2013 RI 2013 2014 RI 2014 Alcohol Heroin/Other Opiates Marijuana Cocaine/Other/Unknown NOTE: Admissions may not be unique individuals; patients could have presented for treatment multiple times. Admissions with unknown municipality or out of state were excluded. SOURCE: Behavioral Health On Line Database (BHDDH)
Consequences Mental Health Admissions 40% 30% 20% 10% Mental Health Admissions by Age Group, Fiscal Years 2012 2014 NOTE: Mental Health admissions may be for mental health treatment or co morbid mental health and substance abuse treatment. Admissions may not be unique individuals; patients could have presented for treatment multiple times. 0% 2012 RI 2012 2013 RI 2013 2014 RI 2014 % <18 % 18 21 % 22 30 % 31 45 % 46 65 % >65 100% 80% 60% 40% 20% 0% Mental Health Admissions by Race/Ethnicity, Fiscal Years 2012 2014 2012 RI 2012 2013 RI 2013 2014 RI 2014 White Black Hispanic Other NOTE: Mental Health admissions may be for mental health treatment or comorbid mental health and substance abuse treatment. Admissions may not be unique individuals; patients could have presented for treatment multiple times. Admissions with unknown race/ethnicity were excluded. 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Mental Health Admissions by Primary Diagnosis, Fiscal Years 2012 2014 2012 RI 2012 2013 RI 2013 2014 RI 2014 Anxiety Major Depression Other Mood Disorder Schizophrenia Other NOTE: Mental Health admissions may be for mental health treatment or co morbid mental health and substance abuse treatment. Admissions may not be unique individuals; patients could have presented for treatment multiple times. Anxiety (ICD 9 CM: 300.00 02, 300.21 23, 300.29 30, 308.30, 309.21, 309.81) Major Depression (ICD 9 CM: 296.2 296.3) Other Mood Disorder (ICD 9 CM: 296.0, 296.4 296.89, 296.9, 300.4, 301.13, 311) Schizophrenia (ICD 9 CM: 295) Other (Adjustment Disorder 309.00, 309.24, 309.28, 309.30, 309.40; Attention Deficit Disorder 314; Conduct Disorder 312.80, 312.90, 313.81; Dementia 290, 293 294; Autism 299, 315; Other Psychotic Disorder 297 298; Personality Disorder 312.30 39; No diagnosis or Unknown) SOURCE: Behavioral Health On Line Database (BHDDH)
Consequences Suicidality Percent of High School Students 20 18 16 14 12 10 8 6 4 2 0 Considered Suicide PAST 12 MONTHS 12.1 12.2 11.4 9.9 9.1 7.5 2011 2012 2012 2013 2013 2014 Highest Value RI Average Lowest Value Percent of High School Students 12 10 8 6 4 2 0 Attempted Suicide PAST 12 MONTHS 5.6 5.8 5.4 4.8 4.0 1.7 2011 2012 2012 2013 2013 2014 NOTE: Highest/lowest indicates the highest/lowest value across all communities in a given school year; Highest/Lowest community may vary by school year. 2013 2014 Middle School Prevalence EXETER RHODE ISLAND Considered Suicide PAST 12 MONTHS 10.6 11.3 Attempted Suicide PAST 12 MONTHS 4.5 5.9 0 2 4 6 8 10 12 Percent of Middle School Students SOURCE: Rhodes Island Department of Education SurveyWorks