Ohio Health Policy News

The Health Policy Institute of Ohio has released the latest edition of its biennial Health Value Dashboard, which found that Ohio ranks 44 on heath value compared to other states and D.C. (as displayed in the graphic above).

That means that Ohioans are living less healthy lives and spending more on health care than people in most other states.

The Dashboard is designed for policymakers and other public- and private-sector leaders to examine Ohio’s performance relative to other states, track change over time and identify and explore health disparities and inequities in Ohio. The report also highlights evidence-informed strategies that can be implemented to improve Ohio’s performance.

With more than 100 data metrics, the report can be a valuable tool as Ohio’s leaders continue to develop the state’s biennial budget over the next two months.

In the fifth edition of the Dashboard, HPIO identified three specific areas of strengths on which Ohio can build to create opportunities for improved health value in the state:

• Strengthen Ohio’s workforce: Ohio can build upon recent success in attracting employers in high-growth industries to strengthen the workforce and reduce poverty
• Foster mental well-being: Ohio can build upon expertise with, and community response to, the addiction crisis to become a national leader in behavioral health
• Improve healthcare effectiveness: Ohio can build upon strengths in access to care to reinvigorate approaches to improving outcomes and controlling healthcare spending

More than 1 in 5 U.S. adults without access to a vehicle or public transportation missed or skipped a medical appointment in the previous year, according to a new national study (Source: “Over 1 in 5 skip health care due to transportation barriers,” Axios, April 28).

The new study found that while telehealth may have reduced transportation barriers for mental health, primary care and some other services, it's not accessible to all and can't substitute for in-person care for some medical needs, the Urban Institute researchers wrote.

The findings point to gaps that could be filled by Medicaid coverage of nonemergency medical transportation, which varies by state, or expanded access to telehealth where public transit options are limited, they said.

Transportation is one of the social drivers of health that HPIO examined in its recently released policy brief, Social Drivers of Infant Mortality: Recommendations for Action and Accountability in Ohio.

While the recent drop in life expectancy has been attributed to the COVID-19 pandemic and a spike in drug overdoses, some academic experts and activists said the trend also underscores the lasting health consequences of mass incarceration (Source: “As US Life Expectancy Falls, Experts Cite the Health Impacts of Incarceration,” Kaiser Health News, April 27).

A major reason the U.S. trails other developed countries in life expectancy is because it has more people behind bars and keeps them there far longer, said Chris Wildeman, a Duke University sociology professor who has researched the link between criminal justice and life expectancy.

Although no one has proven that incarceration alone shortens life expectancy, research from the early 2000s did show the death rate for people leaving prison was 3.5 times higher than for the rest of the population in the first few years after release. Another study found that currently or formerly incarcerated Black people suffered a 65% higher mortality rate than their non-Black peers.

Over the past several years, HPIO has developed several resources exploring the connection between criminal justice and health.

The Biden administration on Thursday rolled out proposals to set national standards for care in Medicaid and children’s health care plans, amid upheaval for millions of Americans’ coverage in both programs (Source: “Biden officials propose slate of Medicaid transparency changes,” Stat News, April 27).

A pair of draft rules released by federal health officials Thursday would require Medicaid plans to book enrollees for appointments within two weeks. The rules would also require states to track and report the quality of care patients receive, to share provider payment rates and to oversee these changes through “secret shopper” surveys.

However, while the agency proposed a slew of reporting requirements, the changes did not come with clear penalties or incentives for improving wait time and care.

The draft plans come as states reassess Medicaid and Children’s Health Insurance Program enrollment in the wake of the Covid-19 emergency. Congress allowed states to begin removing people from Medicaid rolls this month, ending a pandemic freeze that saw Medicaid coverage balloon with more than 20 million new enrollees. An estimated 18 million people could lose coverage in the next year, according to a KFF survey of state Medicaid programs.

Five years after HPIO’s report A New Approach to Reduce Infant Mortality and Achieve Equity identified 127 policy recommendations in housing, transportation, education and employment to reduce infant mortality in Ohio, the majority of those policy options saw some progress toward implementation (as illustrated in the graphic above).

In March, HPIO released a new follow-up report, Social Drivers of Infant Mortality: Recommendations for Action and Accountability in Ohio, that builds upon recommendations first included in the original report.
 
The new report found that, despite the efforts of many in both the public and private sectors, progress since 2011 in reducing infant mortality has been minimal and uneven, and Ohio’s infant mortality rate remains higher than most other states.

In recent weeks, HPIO has released action guides that highlights policy options for improving education and housing, two of the social drivers of infant mortality in Ohio. Guides on transportation, employment and racism are planned to be released in the coming months.

Overdose fatalities among older Americans quadrupled over the past two decades, a new study found (Source: “Overdose deaths of older Americans quadrupled in past 20 years,” Washington Post, April 17).

According to research published in the journal JAMA Psychiatry, the rate of fatal overdoses for U.S. residents 65 and older rose from 3 deaths per 100,000 people in 2002 to 12 deaths per 100,000 people in 2021.

Using data from the Centers for Disease Control and Prevention, researchers reported data that indicates 83% were accidental, 13% were intentional (suicide), 4% were undetermined and 0.07% (five deaths) were homicides.

The study’s most recent data showed that 57% involved an opioid, 39% involved a stimulant and 18% involved both. Of unintentional overdoses, 74% stemmed from illicit drugs, such as fentanyl, heroin, cocaine or methamphetamines. But 68% of intentional overdoses involved prescription drugs, such as antidepressants, antiepileptics, benzodiazepines, sedative-hypnotics and opioids.

People all over the world lost confidence in the importance of routine childhood vaccines against killer diseases like measles and polio during the COVID-19 pandemic, according to a new report from UNICEF (Source: “People lost faith in childhood vaccines during COVID pandemic, UNICEF says,” Reuters, April 20).

In 52 of the 55 countries surveyed, the public perception of vaccines for children declined between 2019 and 2021, according to a report from the UN agency.

The data was a "worrying warning signal" of rising vaccine hesitancy amid misinformation, dwindling trust in governments and political polarization, UNICEF, the United Nations Children's Fund, said.

"We cannot allow confidence in routine immunizations to become another victim of the pandemic," Catherine Russell, UNICEF executive director, said in a statement. "Otherwise, the next wave of deaths could be of more children with measles, diphtheria or other preventable diseases.”

About 1 in 4 people in the United States – more than 119 million residents – live with air pollution that can hurt their health and shorten their lives, according to a new report (Source: “A quarter of Americans live with polluted air, with people of color and those in Western states disproportionately affected, report says,” CNN, April 19).

The report found that there were improvements in air quality overall. Generally, 17.6 million fewer people were breathing unhealthy air than in last year’s report, due largely to falling levels of ozone in some regions. Around 25% more counties got an A grade in the report for lower levels of ozone pollution.

However, the report also found that the number of people living in counties with failing grades for daily spikes of particle pollution was the highest it has been in a decade.

One driver of the high amounts of particle pollution are the wildfires that have consumed hundreds of thousands of acres. Those fires are why the regions with the highest concentrations of air pollution are largely in the West. 

Not everyone experiences pollution the same way in the U.S. Regardless of the region, communities of color bear the brunt of the problem. Specifically, although people of color make up 41% of the overall U.S. population, they are 54% of the nearly 120 million people living in counties with at least one failing grade for unhealthy air. And in the counties with the worst air quality, 72% of the 18 million residents are people of color, the report said.

Earlier this year, HPIO released a Health Value Dashboard fact sheet titled “A Closer Look at Outdoor Air Pollution and Health” that focuses on the importance of clean air and provides additional information on the outdoor air quality metric in the Dashboard.

Policy changes made in Ohio over the last decade that have expanded access to care also reduced the gap between Black and white Ohioans who report going without care due to cost, as displayed in the graphic above.

As Ohio observes Minority Health Month in April, it is clear that although progress has been made, there is still work to be done to eliminate health disparities. In HPIO’s 2023 Health Value Dashboard, which will be released in late April, the Institute found that if the racial gap in ability to pay for health care was fully closed, nearly 45,000 more Black Ohioans would not experience financial barriers to care.

HPIO is hosting a forum from 10:30 a.m.- 4 p.m. on Monday, May 1, focused on the release of the 2023 Dashboard. The event will be held in-person at the Grand Event Center in Grandview/Columbus. Throughout the forum, we will celebrate HPIO’s 20th anniversary. In appreciation of all of our supporters and partners, we will host a reception immediately following the forum, from 4 p.m.- 5:30 p.m. The last day to register is Friday, April 21, 2023.

The Health Policy Institute of Ohio has released an action guide that highlights policy options for improving education, one of the social drivers of infant mortality in Ohio. 

HPIO recently produced the Social Drivers of Infant Mortality: Recommendations for Action and Accountability in Ohio report as an update to the 2017 A New Approach to Reduce Infant Mortality and Achieve Equity report.
 
The action guide takes a closer look at the education recommendations in the Action and Accountability report and provides state and local health stakeholders with additional information and tools to support next steps.
 
Despite the efforts of many in both the public and private sectors, progress in reducing infant mortality since 2011 has been minimal and uneven, and Ohio’s infant mortality rate remains higher than most other states.

Infant mortality prevention efforts have largely focused on public health and healthcare interventions for pregnant women, such as safe sleep education and prenatal care access. While these efforts have likely contributed to the overall reduction in infant mortality, healthcare services alone are not enough to close gaps in birth outcomes in Ohio.

Last week, HPIO released a similar housing action guide.
 
The guide and additional tools posted on HPIO’s website can be used to prioritize, advocate for and implement the recommendations.