a conversation with Carrie Bridges

by Reza Corinne Clifton

Carrie Bridges is not a native Rhode Islander. She "claims" North Carolina, because that's where she attended Junior High School through college, and she is originally from Chicago, Illinois. Most of her family lives there in the windy city, though her three brothers live in North Carolina, Michigan, and, at the time of this interview, in the South American country, Chile.

But that hasn't stopped Bridges from committing to reduce health disparities in the nation's smallest state. As a matter of fact, as chief of the Office of Minority Health (OMH) at the Rhode Island Department of Health (DOH), it is a top priority. And it was work with OMH that brought her to Rhode Island in the first place.

Bridges had just finished a Masters Degree program at the School of Public Health at Boston University when she was selected for a three-year fellowship with the Centers for Disease Control and Prevention (CDC). "The ultimate goal of the fellowship,"explains Bridges, was "to get more professionals working in state, local, or federal public health systems," including here in Rhode Island.

Curious about her journey from fellow to chief, I talked to Bridges on a busy day in April, during the height of what was, then, National Minority Health Month. We talked about the exciting work coming out of her office. I caught a glimpse of what a leader in public health looks like.

Welcome to Rhode Island: The first year of the CDC fellowship program,Bridges worked at the organization's main office in Atlanta, Georgia.But during year two and three, she was assigned to Rhode Island to work on what at the time, was a new initiative of OMH – the Refugee Health Program. By August 2006, the fellowship was done. But Bridges stayed on as a contractor until January 2007,when she "applied for and became a [fulltime] state employee," she says referring to the position she still holds.

"I loved it," says Bridges of that first position with the Refugee Health Program, which is why taking the next step made sense. "I was passionate[about Minority Health]," recalls Bridges, "because of the work I had been doing" as a fellow.

She also realized that she had become woven into the fabric of Rhode Island. Reflecting on the "great community organizations and individuals"with whom she had partnered previously, it was clear to her that "it was a wonderful opportunity to stay and do the work," she had started.

Rhode Island charm - quahogs, Del's lemonade and public health? Rhode Island's peculiar charms have been documented in television show sand movies alike, but Bridges recognizes them as well – at least in the Public Health arena. The state is"unique," says Bridges, because it is 1of 2 states in the country with a health department system that does not consist of local or municipal departments or sectors. "People in Rhode Island,"explains Bridges, "generally identify themselves by their city or town; not along county [or municipal] lines."

The result, says Bridges, is that "a lot of the direct services" and initiatives of DOH are in actuality accomplished through "contracts to community organizations," community action programs, and hospitals. In fact, says Bridges her first assignment with the Refugee Health Program provides a perfect example of how local partners and the department often interact.

The CDC, recalls Bridges, sent her to help OMH create the Refugee Health Program – after community advocates expressed concern about service-coordination for refugees settling in Rhode Island. To get it off the ground, the department worked closely with external partners like International Institute of Rhode Island and the (Catholic) Diocese of Providence. Their shared goals included coordinating all levels of care and training refugee-servicing providers.

Public health in Rhode Island - engaging community, closing the gap: Bridges continues to value community partnerships and public in put in her role as chief of minority health. They were central to many of her recent initiatives, like work she did a few months back for immigrants who had come from Africa – a group that has grown in the state as changes in armed conflicts, immigration policy,and general demographics occur.

Within the immigrant community, cites Bridges, "Rhode Island has representation from over 40 African nations!" Driven by collaboration with external players like the American Cancer Society, the African Alliance of Rhode Island, and different African nurses organizations (Nigerian, Liberian, etc.) – says Bridges, "we realized that we had not addressed African health in a very concerted way."

The result of their observations and partnerships was OMH's "first ever, African Health Summit," held May 31 at the Met School in Providence. They produced it in conjunction with the aforementioned organizations as well as churches, Neighborhood Health Plan of Rhode Island, and others. And the target audience, says Bridges of the conference, was everyday people rather than providers. "Screenings, educational panels on how to navigate the system, and exhibitors from different organizations" were just some of the pieces on-hand for attendees.

The May 1 Health Conference for Latina Women (more), says Bridges, is another example of this type of reflection and collaboration.Partners of that one included DOH, Women and Infants Hospital, Area Health Education Centers, American Cancer Society, Rhode Island Foundation, YWCA Northern Rhode Island, and leaders in the Latino community.The primary language used for information delivery was Spanish, with English provided through interpreters.

But how does Bridges respond to people who might say that they felt left out or not served by a conference conducted in Spanish? "We're here to improve Rhode Island public health as a whole, and this is a way [to arrive]there. We need to demystify the health care system; we need to improve access; [and] we need to give people resources to make healthy choices."More simply she states, "We need to empower people."

For Bridges it goes back to one of her charges as chief of minority health at DOH. "We have a goal to eliminate  health disparities, and we have data that says those disparities exist." She refers to a "ground-breaking report" by the Institute of Medicine and other healthcare groups, which identified discrimination as the biggest factor for national and state-by-state health disparities.

"In this team and in this department,"it's not just the close and easy to see "causes of poor health," says Bridges, but "racism, discrimination,"language barriers, poverty, education,"safe housing" and other harder pieces to address.

"The groundwork was laid before I arrived," says Bridges, referencing colleagues like Ana Novais – who held the position prior to Bridges – and DOH director, Dr. David Gifford."We have a commitment," continues Bridges, to reduce disparities and creates solutions related to "race and ethnicity,sex, age, geographic locations, sexual orientation, income, and educational level," and other factors.

Therefore, "no," she will tell you, neither the May 1 nor the May 31 conference was intended to serve all Rhode Islanders. They were targeted, "to be more effective."