Medicare eligibility drives down racial disparities, study finds

Access to Medicare may help address racial disparities in insurance coverage, access and self-reported outcomes, according to a new study (Source: “Medicare eligibility erases many healthcare disparities in US,” Healthcare Dive, July 26).

The research, published in JAMA Internal Medicine, tracked more than 2.4 million Americans and found that immediately after turning 65, and thus becoming eligible for Medicare, coverage for Black respondents increased from 86.3% to 95.8%. Among Hispanic respondents, coverage increased from 77.4% to 91.3%.

The JAMA study has validated the importance of Medicare in terms of leveling the playing field for Americans when it comes to healthcare access — a gap that has been exacerbated by the COVID-19 pandemic. Whereas there are significant gaps in access to healthcare and disparities among ethnic groups, reaching Medicare age wipes much of them out.

Disparities in insurance coverage were cut by 53% between Black people and white people, and 51% for Latino people versus white people. The proportion of Black and Latino people who self-reported their health as poor also dropped significantly after they became eligible for Medicare.


Organizations aim to connect patients, therapists of color

A number of new organizations aim to digitally connect patients with mental health providers who value and understand different cultures (Source: “It’s Hard to Search for a Therapist of Color. These Websites Want to Change That.,” New York Times, July 16).

In recent years there has been an expanding number of digital companies and nonprofits created to help people of color find a therapist they can trust — someone who is not only skilled in the best evidence-based treatments but also culturally competent. In other words, a provider who is aware of their own world views, knowledgeable about diversity and trained to connect with different types of clients.

The founders of these organizations say there has always been a need for such services, and even more so now that people are coping with the stressors of the pandemic and the racial reckoning that followed the killing of George Floyd by the Minneapolis police.

Studies have shown that mental health treatments can be more effective when a client feels that their therapist values culture.

It can be difficult for people of color to locate a therapist with a shared cultural background.  An American Psychological Association report found that only 5% of psychologists are Hispanic and 4% are Black — 86% are white. A similar disparity exists among the country’s social workers and psychiatrists.


Study finds link between neighborhood disadvantage and COVID-19 disparities

New research has found a strong link between COVID-19 and neighborhood disadvantage, a finding that supports earlier contentions of the connection between social factors and coronavirus disparities (Source: “How Neighborhood Disadvantage Drove COVID Health Disparities,” Patient Engagement HIT, July 21).

The study examined the connection between COVID-19 inequity and subway ridership in New York City. Neighborhoods that ranked higher on a COVID-19 inequity index — meaning that the neighborhood saw more factors that could put inhabitants at risk — also had higher subway ridership even after COVID-19 forced city-wide shutdowns.

Daniel Carrión, a researcher from Mount Sinai, said needing to ride the subway — or work an essential job — had a strong link to the unequal infection rates seen during the height of the coronavirus pandemic, largely because it limits the ability to socially distance.

“For us, subway utilization was a proxy measure for the capacity to socially distance,” Carrión, a postdoctoral researcher in the Department of Environmental Medicine and Public Health at the Icahn School of Medicine, told PatientEngagementHIT in an interview.

Although public health experts have made the link between the social determinants of health leading to actual infection, not just poor outcomes, Carrión and his colleagues put some data behind that. Social disadvantage was linked with higher subway utilization, and ultimately to higher infection rates and starker disparities.

“Folks like me were able to stay home for the majority of the pandemic and work from home. I didn't need to use public transit whereas others did. What we found was that areas that had higher COVID inequity indices were also riding the subways more after the stay-at-home orders compared to folks that were low in the COVID inequity index.”


Low number of Black dermatologists could hurt quality of care, providers warn

For people of color, basic dermatological conditions sometimes go undiagnosed or misdiagnosed by doctors unfamiliar with treating darker skin, healthcare professionals say (Source: “Skin color matters: In dermatology, patients' diversity calls more Black doctors,” Columbus Dispatch, July 29).

According to a June 2017 study published in the Dermatology Journal of the American Medical Association, 3% of dermatologists in the United States were Black. In 2020, 13.4% of the U.S. population was Black or African American, according to the U.S. Census.

A lack of diversity in any medical field can hurt the quality of care given. And a doctor from one ethnic or racial background might be able to offer information not necessarily taught in school.


Opiate settlement could mean $1B for Ohio treatment, prevention programs

Ohio and other states reached a $26 billion settlement with the three largest drug distributors as well as manufacturer Johnson & Johnson that is expected to surge cash into opioid treatment and prevention programs (Source: “Ohio could get $1B from multibillion dollar deal with opiate maker and three distributors,” Columbus Dispatch, July 21).

Ohio's cut of the cash could hit $1.03 billion if local jurisdictions sign onto the agreement, according to Ohio Attorney General Dave Yost's office.

The agreement comes after nearly four years of negotiations. Under the settlement, J&J will pay up to $5 billion over nine years and the three distributors — McKesson Corp., AmerisourceBergen and Ohio-based Cardinal Health Inc. — will collectively pay up to $21 billion over 17 years. 

In March 2020, Yost and Gov. Mike DeWine announced that local governments had signed off on a plan on how opioid settlement money would be divvied up. The OneOhio agreement calls for 30% of the money to be earmarked for community recovery programs at the local level, 55% for a statewide foundation and 15% to the state.


CDC: Life expectancy drop in 2020 largest since WWII

U.S. life expectancy fell by a year and a half in 2020, the largest one-year decline since World War II, public health officials said Wednesday (Source: “US life expectancy in 2020 saw biggest drop since WWII,” Associated Press, July 21).

The decrease for both Black Americans and Hispanic Americans was even worse: three years.

The drop, spelled out in a new report from the Centers for Disease Control and Prevention, is due mainly to the COVID-19 pandemic, which health officials said is responsible for close to 74% of the overall life expectancy decline. More than 3.3 million Americans died last year, far more than any other year in U.S. history, with COVID-19 accounting for about 11% of those deaths.

Black life expectancy has not fallen so much in one year since the mid-1930s, during the Great Depression. Health officials have not tracked Hispanic life expectancy for nearly as long, but the 2020 decline was the largest recorded one-year drop.

Causes of death other than COVID-19 also played a role. Drug overdoses pushed life expectancy down, particularly for white Americans; and a rise in homicides was a small but significant reason for the decline for Black Americans, said Elizabeth Arias, the report’s lead author.

Other problems further affected Black and Hispanic people, including lack of access to quality health care, more crowded living conditions and a greater share of the population in lower-paying jobs that required them to keep working when the pandemic was at its worst, experts said.


States not ready to meet mental health needs of students this fall, report finds

A report released this week from advocacy group Mental Health America found that a majority of states are not ready to address youth mental health as schools prepare to reopen for in-person learning in the fall (Source: “Analysis: Most states not ready to tackle youth mental health ahead of fall,” The Hill, July 20). 

The analysis reports that just 14 states have fully expanded Medicaid to cover mental health services in schools, and only a handful have legislation requiring mental health education. The lack of access and education make states unprepared to deal with mental health issues among children, which were exacerbated by the pandemic, the report said. 

Children of color are more likely to receive school-based mental health services than white children, so limited resources can also lead to disparities in who is getting care. And although Black and Latino children are less likely than white children to get mental health treatment for depression, they made up the largest increases in the proportion of youth experiencing suicidal ideation between 2019 and 2020, the report said.

Advocates say the coronavirus pandemic worsened an already existing mental health crisis devastating young people. The percentage of 12- to 17-year-olds who reported a past-year major depressive episode doubled over the past 10 years, according to the National Survey on Drug Use and Health. 


HPIO webinar to explore connections between criminal justice, health

The research evidence is clear that poor mental health and addiction are risk factors for criminal justice involvement and that incarceration is detrimental to health.

On Thursday, July 29, HPIO is hosting a webinar to explore key findings from its latest brief, Connections between Criminal Justice and Health.

The brief summarizes research on the complex connections between criminal justice and health, with a focus on the impact of criminal justice involvement on health and well-being. Register here!


Ohio set new record for overdose deaths in 2020, CDC reports

The toll of fatal drug overdoses last year hit Ohio even worse than initially thought, according to newly released data from the Centers for Disease Control and Prevention (CDC) (Source: “Capitol Insider: As feared, Ohio smashes record for drug overdose deaths last year,” Columbus Dispatch, July 16).

The new figures showed that the agency projected Ohio to hit 5,215 drug deaths — fourth in the U.S. for the nation's seventh-largest state — breaking the record of 4,854 set in 2017. The CDC warned that the 2020 figure will grow; the current total is regarded as underreported due to incomplete data.

In 2014, Ohio led the country in overdose deaths — although the 2020 total is some 2.5 times higher.

A big jump was feared by many because of the COVID-19 pandemic last year. Indeed, overdose deaths for the nation as a whole increased every month last year, the CDC data show.

In all, the U.S. saw 93,331 people die from drug overdoses in 2020, a 29.4% leap over 2019.


DeWine signs bill banning COVID-19 vaccine requirements at public schools, universities

Gov. Mike DeWine signed a bill this week that will prevent public schools and universities from mandating COVID-19 vaccines for students and staff until they receive full approval from federal officials (Source: “Gov. DeWine signs bill to ban requiring COVID-19 vaccine at Ohio public schools, universities,” Columbus Dispatch, July 14).

Language added to House Bill 244 will prevent schools and universities from requiring vaccines that haven't received full U.S. Food and Drug Administration (FDA) approval. All three COVID-19 vaccines were approved under emergency use authorization, a rigorous protocol that includes clinical trials. 

The new law doesn't take effect for 90 days, and the vaccines might receive full FDA approval in that window, making the language moot.

"We are confident the three main COVID vaccines – the Pfizer, Moderna and Johnson & Johnson – will receive full FDA approval," said DeWine spokesman Dan Tierney, adding that the full approval will help reduce vaccine hesitancy.

The bill doesn't apply to private universities or the hospitals connected to public universities. Several private universities and colleges, such as Kenyon College and Ohio Wesleyan University, will require students to be vaccinated. Some have exceptions for religious or medical reasons.