HPIO releases new brief on link between outdoor air pollution, health in Ohio

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The Health Policy Institute of Ohio has released a new 2021 Health Value Dashboard policy brief titled “A closer look at outdoor air pollution and health.”

Clean air and water, safe places to walk outside and access to healthy food are examples of conditions in the physical environment that affect the health and well-being of Ohioans. Outdoor air quality is included in the 2021 Health Value Dashboard™, where Ohio ranked 46th, meaning that most other states have cleaner outdoor air.

The brief found that there are differences in air pollution exposure from county to county, as illustrated in the graphic above. Hamilton and Cuyahoga counties have the highest levels of PM2.5 air pollution in the state, with high levels also reported across western and central Ohio.

Analysis by HPIO has found that the physical environment (including outdoor air quality) is strongly connected to a state’s overall health, only surpassed by public health and prevention. In fact, analysis of 2021 Dashboard data finds that the physical environment has a much stronger correlation with the overall health of a state than access to care or healthcare system performance.

The policy brief focuses on the importance of clean air and provides additional information on the outdoor air quality metric in the Dashboard, including how:

  • Air pollution affects health outcomes
  • Recent policy changes may affect air pollution
  • Outdoor air quality can be improved in Ohio

CDC: Kindergarten vaccination rate drops for third straight year

Vaccination rates for U.S. kindergarteners dropped last year for the third year in a row, and federal officials are starting a new campaign to try to bring them up (Source: “US kindergarten vaccination rate dropped again, data shows,” Associated Press via Warren Tribune Chronicle, Jan. 12).

Usually, 94% to 95% of kindergarteners are vaccinated against measles, tetanus and certain other diseases. The vaccination rates dropped below 94% in the 2020-2021 school year, during the first year of the COVID-19 pandemic.

A Centers for Disease Control and Prevention study released this week found rates dropped again in the 2021-2022 school year, to about 93%.

The pandemic disrupted vaccinations and other routine health care for children, and also taxed the ability of school administrators and nurses to track which children weren’t up-to-date on shots. CDC officials said decreased confidence in vaccines is another likely contributor.

Study finds fewer post-partum hospitalizations in Medicaid expansion states

States that expanded Medicaid under the Affordable Care Act (ACA) saw a 17% drop in hospitalizations among women during the first 60 days postpartum, new research shows (Source: “Medicaid expansion linked with fewer postpartum hospitalizations: research,” The Hill, Jan. 11).

According to a study published in the journal Health Affairs, states with expanded Medicaid coverage for residents with lower incomes saw a 17% drop in post-partum hospitalization within the first 60 days.

Expansion states included in the study were Iowa, Maryland, New Mexico and Washington. Rates were compared with non-expansion states Florida, Georgia, Mississippi and Utah.

Currently, 40 states (including Ohio) and Washington D.C., have expanded Medicaid under the ACA. Much of the Southeast region of the country continues to hold out on adoption, along with Texas, Kansas, Wyoming and Wisconsin.

U.S. traffic deaths fell slightly in first 3 quarters of 2022, federal data shows

U.S. traffic deaths fell 0.2% in the first nine months of 2022, reversing a sharp rise in the two prior pandemic years when speeding and other unsafe behavior increased, regulators said on Monday (Source: “U.S. says traffic deaths fell slightly in first nine months of 2022,” Reuters, Jan. 9).

The National Highway Traffic Safety Administration (NHTSA) estimated that 31,785 people died in traffic crashes through Sept. 30 compared with the 31,850 deaths in the same period in 2021. U.S. traffic deaths jumped 10.5% in 2021 to 42,915, the largest number killed on American roads in a year since 2005 after rising 7% in 2020.

The traffic fatality rate through September is still higher than in any pre-pandemic year since 2007. A total 4,766 more people were killed on U.S. roads in the 2022 ninth-month period versus in 2019.

Graphic of the week

Analysis included in HPIO’s policy brief, Health Impacts of Tobacco Use in Ohio, found that while overall smoking rates have declined over the past three decades, this has not been the case for people with low incomes. As a result, low-income communities experience a much greater impact of tobacco use than communities with higher incomes. In 1995, Ohioans with very low incomes (less than $15,000 a year) were 36% more likely than those with higher incomes ($50,000 or more a year) to smoke cigarettes. By 2020, this gap had increased to 107%, as illustrated in the graphic above.

DeWine vetoes law prohibiting local tobacco bans

Ohio Gov. Mike DeWine vetoed legislation Thursday that would’ve preempted local bans on flavored tobacco (Source: “Ohio Gov. DeWine vetoes tobacco measure that would prohibit local bans,” Ohio Capital Journal, Jan. 6).

“This measure is not — is not in the public interest,” DeWine said of HB 513.

Because a new General Assembly has begun, DeWine’s office contends lawmakers can’t initiate a veto override.

Speaking Thursday, DeWine acknowledged the merit of uniform statewide policy. “The easiest way to do that, it seems to me, is to have a statewide ban of flavored cigarettes and flavored vaping,” DeWine said.

State health director Dr. Bruce Vanderhoff noted Ohio’s rates of tobacco use are higher than national averages, and tobacco remains the leading preventable cause of death in the state. According to Vanderhoff, deaths attributable to tobacco use top 20,000 a year. And treating tobacco-related illness isn’t cheap. According to the Health Policy Institute of Ohio, he said, health care costs tied to cigarettes are about $6.8 billion a year.

CDC projects surge in diabetes among young Americans in coming decades

The U.S. Centers for Disease Control and Prevention (CDC) last week warned a surge of diabetes among young Americans is on the horizon, saying diagnoses for the population are expected to soar in the coming decades (Source: “CDC warns of future surge in diabetes among young Americans,” The Hill, Dec. 29).

The CDC cited a new study published in the journal Diabetes Care, which models a nearly 700% increase of Type 2 diabetes diagnoses in Americans under the age of 20 through 2060, if an expected upward trend continues.

Type 1 diabetes could also increase 65% among young Americans in the next 40 years following the same trend.

Millions of Americans of all ages have diabetes, which is the seventh leading cause of death in the U.S. and extremely costly for those living with it. Diabetes is not curable.

Based on the expected surge in the new study, about 526,000 young Americans could have both types of diabetes by 2060, compared to a total of 213,000 for the population in 2017.

Federal study finds racial disparities in access to health data

Research by the federal Office of the National Coordinator for Health IT has found racial and ethnic disparities in patient access to, and usage of, electronic health records (Source: “Report confirms racial disparities in patient access to their health data,” Healthcare IT News, Jan. 5).

Published in the Journal of the American Medical Informatics Association, the ONC study found that in 2019 and 2020, "black and Hispanic individuals were significantly less likely to report being offered and subsequently accessing their portal."

Black and Hispanic people were not offered (5.2 percentage points less likely) and did not access patient portals (7.9 percentage points less likely) nearly as often as white people. 

But when offered access, disparities largely diminished. According to the study, "individuals offered a portal and encouraged to use it by their providers "were 21 percentage points more likely to access it."

"Taken together, our findings point to the important role of healthcare providers in increasing access to EHI by offering portals and encouraging their use," study coauthor Chelsea Richwine, an economist with ONC's Office of Technology, wrote.

Special edition: Looking forward, looking back


We get it, you are busy and it’s hard to keep up with everything that comes into your inbox. Our team at HPIO has been very busy this year too. As 2022 wraps up, we are using this edition of Ohio Health Policy News to share a few highlights of our work from this year, organized by the three main types of work we do. You can also find previews of some of what we have planned for 2023.  

Thank you for your continued interest in our work and your support of our mission to advance evidence-informed policies that improve health, achieve equity and lead to sustainable health care spending. 


HPIO translates complex data and evidence into actionable policy insights. We dig deep into trends and consider the policymaking landscape to inform action, focusing attention on key health needs through data snapshots and visualizations. 


Coming in 2023: 


HPIO assesses the strengths and needs of our state and communities and creates actionable plans. We excel at tapping into data from public sources and insights gathered through advisory committees, focus groups, listening sessions and surveys. 


Coming in 2023: 


HPIO conducts evaluations to articulate and measure progress toward program and policy goals and creates tools that enable other organizations to efficiently assess outcomes. 


Coming in 2023: