Graphic of the week

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Analysis released by HPIO last month found that regardless of payor, Black mothers were more likely to experience worse maternal health outcomes than mothers of other races (see graphic).

A new HPIO fact sheet on the topic, titled “Racial and geographic disparities in maternal morbidity and mortality,” includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.


As COVID testing plunges, cases begin creeping up

Testing for COVID-19 has plummeted across the globe, making it much tougher for scientists to track the course of the pandemic and spot new, worrisome variants as they emerge and spread (Source: “Pandemic gets tougher to track as COVID testing plunges,” Associated Press, May 10).

Experts say testing has dropped by 70% to 90% worldwide from the first to the second quarter of this year — the opposite of what they say should be happening with new omicron variants on the rise in places such as the United States and South Africa.

Reported daily cases in the U.S., for example, are averaging 73,633, up more than 40% over the past two weeks, according to data compiled by Johns Hopkins University. But that is a vast undercount because of the testing downturn and many tests are being taken at home and not reported to health departments.


Study finds gun owners less likely to discuss suicidal ideations

More people are openly discussing their struggles with mental illness, but a new Ohio State led study finds we may be asking the wrong questions for those at risk of suicide, particularly gun owners (Source: “Study: Mental health assessments fail to identify suicidal ideation among gun owners,” WOSU, May, 11).

The study, published in the Journal of the American Medical Association, reveals that gun owners are less likely to share their suicidal thoughts, although data shows guns are the way most people end their lives.

“Suicidal crises tend to come on suddenly, but don’t last very long. So, if we limit access to lethal methods during that short window of time, that could potentially prevent a suicide,” said OSU clinical psychologist Craig Bryan. “Consider reaching out to someone that you trust; a fellow gun owner, a friend, a family member, a loved one, and saying 'Hey maybe now's not the time to have ready access to firearms. Can you help me lock them up? Would you hold them or babysit them for a while?'“

Immediate help and resources are available for anyone who is in crisis. You can call the Suicide Prevention Lifeline 24/7 at 1-800-273-TALK (1-800-273-8255), or text the Crisis Text Line at 741741.


Hospitals move to address nursing staff burnout

One-third of nurses in the United States plan to leave their jobs by the end of the year and another 20% plan to leave the industry altogether, according to two new surveys  (Source: “How to curb nurse burnout? Hospitals adding job flexibility to stem staff shortages,” Cincinnati Enquirer, May 9).

The reasons are largely due to the incessant burnout, stress, and fatigue that nurses have experienced during the COVID-19 pandemic. But other factors include financial considerations and a perceived lack of flexibility in the industry as well as too few advancement opportunities. 

In response, hospitals are beginning to look inward at how to retain talent and alleviate burnout, particularly among nursing staff as shortages stretch into the foreseeable future. Health systems are pivoting to accommodate the changing needs of nurses.


Newly released County Health Rankings spotlights connection between income and health

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Newly released data from County Health Rankings show that Black Ohioans have the lowest median household income among groups of Ohioans and have, by far, the highest rate of premature death (years of potential life lost before age 75, which reflects the burden of deaths that potentially could have been prevented).
 
Between 2018 and 2020, Black Ohioans collectively lost 13,374 years of life before turning 75 years old (see graphic above). That is nearly as many years lost as Hispanic (5,858) and white Ohioans (8,224) combined.  At the same time, the median household income for Black Ohioans is $12,352 less than Hispanic Ohioans, $28,065 less than white Ohioans and $43,782 less than Asian Ohioans.
 
“Individual efforts alone cannot overcome the structural barriers that maintain the racial wealth divide,” County Health Rankings states. “Structural barriers include laws, policies, institutional practices, and economic arrangements that create unequal conditions.”
 
The latest edition of the County Health Rankings, released this week, includes a new curated list of strategies to address racial wealth building, a key to eliminating health disparities.
 
“Research shows that income inequality has a negative effect on overall population health,” according to the Rankings. “Economically unequal societies often have higher rates of physical and mental illness, violence, and incarceration.”

Throughout April, HPIO has marked National Minority Health Month by creating a series of data visualizations to illustrate health disparities in Ohio.


FDA moves to ban menthol cigarettes with aim of reducing smoking-related disparities

The Food and Drug Administration (FDA) on Thursday announced a plan to ban sales of menthol-flavored cigarettes in the United States, a measure many public health experts hailed as the government’s most meaningful action in more than a decade of tobacco control efforts (Source: “F.D.A. Moves to Ban Sales of Menthol Cigarettes,” New York Times, April 28).
 
The ban would most likely have the deepest impact on Black smokers, nearly 85% of whom use menthol cigarettes, compared with 29% of white smokers, according to a government survey. If effective in reducing smoking, the ban could significantly diminish the burden of chronic disease and limit the number of lives cut short by one of the most hazardous legal products available.
 
Public health experts say menthol cigarettes have been heavily marketed to Black people, to devastating effect: African American men have the highest rates of lung cancer in America, according to the Centers for Disease Control and Prevention.


Federal legislation proposed to reduce maternal deaths

The push to reduce poor maternal health outcomes has seen new momentum as federal lawmakers and Biden administration officials previewed their priorities — including reversing a rise in maternal disparities among Black women (Source; “Lawmakers, advocates hopeful for more bills to curb maternal deaths,” Roll Call, April 20).
 
The United States leads among developed nations in its poor maternal mortality rates, referring to deaths during or up to one year after childbirth. These deaths — alongside maternal morbidity, or long-term health problems arising from pregnancy or childbirth — are growing problems nationally.
 
Last week, HPIO released a fact sheet titled “Racial and geographic disparities in maternal morbidity and mortality.” The fact sheet includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.


States adopt policies to require implicit bias training for health workers

In the past three years, states have begun training medical providers to stop acting on unconsciously held beliefs, known as implicit bias (Source: “With Implicit Bias Hurting Patients, Some States Train Doctors,” Pew Stateline, April 21).
 
Since 2019, at least four states — California, Maryland, Michigan and Washington — have adopted policies requiring at least some healthcare workers to take implicit bias training, some as a prerequisite for professional licensure or renewal.
 
Bills on implicit bias training in health care have been introduced in state legislatures over the past two years in many other states, including Illinois, Indiana, Nebraska, New York, Oklahoma, South Carolina, Tennessee and Vermont. Minnesota passed a law last year requiring obstetrics units to offer implicit bias training.
 
Even without laws, some health systems in recent years began offering or requiring training in implicit bias, as have some medical schools, including Harvard, Icahn School of Medicine at Mount Sinai in New York and Ohio State University.


Uninsured rate drops for all races in Ohio, with biggest reduction among Asian and Black Ohioans

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Click for larger version


The percent of Ohioans who are uninsured dropped by almost half from 12.3% to 6.4% between 2011 and 2019 (see graphic above).

Every race saw a drop in the percent of uninsured, with the percentage of Asian and Black Ohioans dropping most dramatically compared to other groups. Despite these gains in access, however, Ohioans of color are still more likely to be uninsured than white Ohioans.

Much of the drop in Ohio’s uninsured population is attributable to the state’s 2014 decision to expand Medicaid eligibility as part of the Affordable Care Act. In HPIO’s 2021 Health Value Dashboard, Ohio ranked seventh out of the 50 states and the District of Columbia for access to care — the first time Ohio has ranked in the top quartile on any Health Value Dashboard domain.

While access is clearly a bright spot for the state, the Dashboard found that Ohio’s population health outcomes remain poor. Access to care is critical, particularly for Ohioans with serious health conditions. But the Dashboard and national research shows that health is shaped by many factors, including social, economic and physical environments.

This April, HPIO is creating a series of data graphics in recognition of National Minority Health Month


HPIO fact sheet explores drivers of maternal health disparities, spotlights what works to address them

The Health Policy Institute of Ohio has released a new fact sheet titled “Racial and geographic disparities in maternal morbidity and mortality.”

The fact sheet includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.

“With collaboration from both public and private partners, it is possible to reduce severe maternal morbidity and mortality and improve health outcomes for Ohio mothers,” according to the fact sheet. “Policymakers and other stakeholders can implement evidence-based strategies to ensure that parents and babies in Ohio are healthy and thriving.”