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August 2020

HPIO brief explores the health impact of adverse childhood experiences

The Health Policy Institute of Ohio has released a new policy brief, "Adverse Childhood Experiences (ACEs): Health Impact of ACEs in Ohio."

The brief summarizes current research on how ACEs impact health and well-being and provides new data and analysis on the prevalence of ACEs in Ohio and the impact of ACEs on the health of Ohioans.

In addition, the brief expands on what we know from national research by exploring these questions:

  • To what extent could Ohio’s health outcomes be improved by preventing ACEs?
  • Which ACEs have the most significant impact on the health of Ohioans?

Preventing and mitigating the impact of ACEs are critical components of any plan to advance the health and well-being of Ohioans. Ohio Governor Mike DeWine and other policymakers have already taken significant strides to improve the health and well-being of Ohio’s children, including the creation of the Governor’s Office of Children’s Initiatives and improvements to the state’s child welfare and home visiting systems. In addition, the 2020-2022 State Health Improvement Plan (SHIP) includes reduction of ACEs as a priority.

Policymakers and other stakeholders can use the Ohio-specific data and analyses provided in this brief to inform future approaches to reduce ACEs exposure in Ohio.


Number of ‘red counties’ drops in state’s latest COVID-19 advisory map

Just six Ohio counties are red or Level 3 in the state’s latest coronavirus advisory map, the lowest number in the nine weeks Ohio’s been utilizing the color-coded system (Source: “Just six of 88 counties are red on latest Ohio coronavirus advisory map,” Cleveland.com, Aug. 27).

Gov. Mike DeWine unveiled the latest map on Thursday showing the following six counties in red: Lorain, Erie, Lucas, Mercer, Preble and Montgomery.

The county color coding in is based on numerous factors, including:  50 or more cases per 100,000 residents over a two week period, an increase in new cases for five days, cases in non-congregate living areas, emergency room visits, doctor visits, hospitalizations, intensive-care unit occupancy.

“The big story this week is we have 76 counties at the same level as they were last week, which is the smallest movement between levels that we have experienced so far,” DeWine said.


Eights states say they will not follow new CDC COVID-19 testing guidance

Several large U.S. states are not heeding new federal health officials’ calls to reduce COVID-19 testing of some exposed to the virus (Source: “California, Florida, New York, Texas will not follow new U.S. COVID-19 testing plan,” Reuters, Aug. 27).

Arizona, California, Connecticut, Florida, Illinois, Texas, New Jersey and New York all plan to continue to test asymptomatic people who have been exposed to COVID-19, despite new guidance from the Centers for Disease Control and Prevention (CDC) suggesting that such tests may not be needed.

The CDC said this week that people exposed to COVID-19 but not symptomatic may not need to be tested, shocking doctors and politicians and prompting accusations the guidance was politically motivated. Even before the CDC guidance, coronavirus testing in the United States had dropped. The United States tested on average 675,000 people a day last week, down from a peak in late July of over 800,000 people a day.


COVID-19 rates up in rural Ohio counties, down in urban counties

The rate of COVID-19 cases in some rural Ohio counties has begun to increase, while some urban centers are seeing improvement, state data shows (Source: “Data indicates COVID growing in rural counties, slowing in urban areas,” Springfield News Sun, Aug. 20, 2020).

The new data was released Thursday as part of a weekly update by the Ohio Department of Health. The counties each receive an advisory on a scale of 1-4 based on seven indicators of how prolific coronavirus is in a community. The full data for each county can be found at www.coronavirus.ohio.gov.

Gov. Mike DeWine attributed the improvements in more urban counties to longer adoption of masking in public.

“What has happened is we’ve seen the urban areas with a bigger percentage of people wearing mask for a longer period of time and we’re seeing those numbers go down. Unfortunately we’re seeing those numbers go up in our rural areas,” DeWine said during his afternoon press conference.

On Friday afternoon, the Ohio Department of Health reported 113,046 cases of COVID-19 (an increase of 6,489 since last Friday), 12,719 hospitalizations (an increase of 591 this week) and 3,955 deaths (171 more reported since last Friday). The increase in cases and hospitalizations was smaller than last week, while the number of COVID-19 deaths is up slightly.


Study: Residential segregation significant factor in COVID-19 spread

A new national study found that counties with the highest percentage of white residents have had the lowest rates of coronavirus infections, an indication that residential segregation is a significant factor in the pandemic’s spread (Source: “Residential segregation plays a role in coronavirus disparities, study finds,” Washington Post, Aug. 17, 2020).

That doesn’t mean white people have more immunity but rather that they have been better able to limit their exposure than have Black people, Latinos and Native Americans, who have been disproportionately infected by the novel coronavirus and killed by COVID-19, the disease the virus causes.

Neither does it mean that people of color are engaging in reckless behavior, according to the study by amfAR. Rather, their higher rate of infection is due to “poverty and living in densely occupied households, living in localities with greater air pollution, lack of health insurance and being employed in jobs that increase exposure to” the coronavirus.

“We need to stop victim-blaming communities of color for these types of diseases,” Greg Millett, vice president and director of public policy for amfAR, the Foundation for AIDS Research, said in a recent interview about the study, which notes a similar pattern for infection rates for HIV. “Where you live determines your health in the United States … and we need to take immediate action to make sure we reduce these disparities in communities of color.”

The Health Policy Institute of Ohio last week released a new data brief, "Connections between Racism and Health: Taking Action to Eliminate Racism and Advance Equity" and an accompanying resource page to support state and local efforts to eliminate racism. 


HHS OKs pharmacists administering shots to boost vaccine rates

The federal Department of Health and Human Services is giving permission to pharmacists nationwide to administer all scheduled shots to children as young as 3, including the flu vaccine, a measure intended to boost childhood vaccination rates that have sagged during the coronavirus pandemic (Source: “New Measures Aim to Boost Vaccine Rates for Flu and Children’s Shots,” New York Times, Aug. 20, 2020).

The new emergency rule allowing state-licensed pharmacists to give federally scheduled vaccines to children ages 3 through 18 is supposed to encourage widespread immunization as schools open during the pandemic and to resolve a patchwork of state laws that govern shots and age limits.

The Department of Health and Human Services noted that a federal report in May said that childhood vaccination rates had dropped precipitously in the first months of the pandemic. New York City’s numbers had especially plummeted. At the time, many parents were afraid to venture out to doctors’ offices and many pediatricians restricted their hours to emergency cases.

Protecting against the impending flu season in the United States is foremost on the minds of public health officials, who worry about the confluence of cases of flu and Covid-19 hitting hospitals this fall and winter. On Wednesday, Massachusetts announced that it will require all students, ranging from 6-month-olds in day care centers to those under 30, to get flu shots by Dec. 31. It is the first state to institute such a sweeping requirement for the shot, which is rarely mandated in the U.S.


HPIO brief outlines action steps to address health impact of racism, DeWine releases Blueprint to address disparities

The Health Policy Institute of Ohio has released a new data brief, "Connections between Racism and Health: Taking Action to Eliminate Racism and Advance Equity" and an accompanying resource page to support state and local efforts to eliminate racism. 

As state and local leaders commit to address racism as a public health crisis, this publication outlines action steps that can be taken to eliminate racism and advance equity. This brief provides:

  • A definition and explanation of racism
  • A brief summary of research on the connections between racism and health
  • Action steps that individuals, groups, public and private organizations and state and local government leaders can take to eliminate racism and advance equity

On Thursday, Gov. Mike DeWine announced the release of the COVID-19 Ohio Minority Strike Force Blueprint (Source: “DeWine: ‘Racism is a public health crisis',” Dayton Daily News, Aug. 13, 2020), a document that includes 34 recommendations to address racism and promote long-term health equity in Ohio.

“It is wrong that in Ohio today, the overall life expectancy of African American Ohioans is four years shorter than white Ohioans. It’s wrong that African American Ohioans have a higher rate of heart disease, higher rates of hypertension and diabetes. It’s wrong that our African American citizens are two and half times more likely to live in poverty, and African American children in Ohio are three times more likely to live in poverty than their white brothers and sisters,” DeWine said during his press conference.

DeWine also announced the creation of the Governor’s Equity Advisory Board and released Ohio’s Executive Response: A Plan of Action to Advance Equity. The plan includes 10 commitments from the DeWine administration designed to begin addressing the recommendation’s in the Strikeforce’s blueprint.


HPIO releases updated data brief on COVID-19 in Ohio

The Health Policy Institute of Ohio has released a new data brief, "COVID-19 in Ohio: August Update."

Topics covered in the brief include:

  • The current status of COVID-19 testing in Ohio
  • How COVID-19 compares to other causes of death
  • Where COVID-19 ranks among Ohio's leading causes of death in 2020
  • The full health impact of COVID-19

In May, HPIO released brief comparing COVID-19 death to other leading causes of death. That brief was followed by one analyzing COVID-19 disparities by race, which will be updated in the coming weeks. HPIO also has created an online COVID-19 resource page with links to resources including analysis and evidence-informed recommendations for mitigating the spread of the virus.

On Friday afternoon, the Ohio Department of Health reported 106,557 cases of COVID-19 (an increase of 7,942 since last Friday), 12,128 hospitalizations (an increase of 681 this week) and 3,784 deaths (166 more reported since last Friday).


CDC survey: Young adults, people of color report rising levels of anxiety, depression

A new C.D.C. survey indicates that young people, as well as Blacks and Latinos of all ages, are showing signs of deteriorating mental health as the COVID-19 pandemic continues and some are resorting to substance abuse (Source: “Young Adults Report Rising Levels of Anxiety and Depression in Pandemic,” New York Times, Aug. 13, 2020).

According to findings reported by the Centers for Disease Control and Prevention, U.S. residents reported signs of eroding mental health in reaction to the toll of coronavirus illnesses and deaths, and to the life-altering restrictions imposed by lockdowns.

The researchers argue that the results point to an urgent need for expanded and culturally sensitive services for mental health and substance abuse, including telehealth counseling. In the online survey completed by some 5,400 people in late June, the prevalence of anxiety symptoms was three times as high as those reported in the second quarter of 2019, and depression was four times as high.

Nearly 41 percent overall reported symptoms of at least one adverse reaction, ranging from anxiety and depression to post-traumatic stress disorder. Nearly 11 percent said they had suicidal thoughts in the month leading up to the survey, with the greatest clusters being among Black and Latino people, essential workers and unpaid caregivers for adults. Men were more likely to express such feelings than women were.


Study finds asymptomatic people carry high amounts of COVID-19 virus

A new South Korean study found more evidence that people without COVID-19 symptoms can carry as much of the virus as those who have symptoms (Source: “Even Asymptomatic People Carry the Coronavirus in High Amounts,” New York Times, Aug. 6).

Of all the coronavirus’s qualities, perhaps the most surprising has been that seemingly healthy people can spread it to others. This trait has made the virus difficult to contain and continues to challenge efforts to identify and isolate infected people.

Discussions about asymptomatic spread have been dogged by confusion about people who are “pre-symptomatic” — meaning they eventually become visibly ill — versus the truly asymptomatic, who appear healthy throughout the course of their infection.

The new study, published Thursday in JAMA Internal Medicine, offers more definitive proof that people without symptoms carry just as much virus in their nose, throat and lungs as those with symptoms, and for almost as long. The study’s estimate that 30 percent of infected people never develop symptoms is in line with findings from other studies. In a television interview on Wednesday, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, estimated 40 percent of COVID-19 cases were asymptomatic.

On Friday afternoon, the Ohio Department of Health reported 98,675 cases of COVID-19 (an increase of 7,516 since last Friday), 11,447 hospitalizations (an increase of 657 this week) and 3,489 deaths (163 more reported since last Friday).