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October 2020

September 2020

HPIO launches online ACEs resource page

As part of its Ohio Adverse Childhood Experiences (ACEs) Impact Project, HPIO has launched an ACEs resource page.

The web page lists resources and research to further understanding of the impacts of ACEs on health, organized in the following areas:

  • ACEs basics
  • Impacts of ACEs on health
  • Protective factors

Led by the Health Policy Institute of Ohio, the Ohio ACEs Impact Project includes the development of a series of three policy briefs and this resource page to build on current efforts to understand and address ACEs in Ohio.


Positive drug tests spike during pandemic

Illicit drug use appears to be scaling up in the United States since COVID-19 was declared a national emergency, a newly released report shows, and Ohio is in a region that is experiencing even higher rates of positive tests (Source: “Positive drug tests rising with coronavirus pandemic, report shows,” Cincinnati Enquirer, Sept. 24).

The report was co-authored by the U.S. Health and Human Services Department and drug-testing company Millennium Health and published in JAMA. Researchers found that after COVID-19 was declared an emergency, patients were: 67% more likely to test positive for fentanyl; 23% more likely to test positive for meth; 33% more likely to test positive for heroin; and 19% more likely to test positive for cocaine.

The Millennium Health study tracked drug use trends by evaluating 150,000 patients' urine drug tests and compared test results from before COVID-19 was declared a national emergency (Nov. 14, 2019, to March 12, 2020) to the period during COVID-19 (March 13, 2020, to July 10, 2020).

In the East North Central region, which includes Ohio, patients were:

  • 93% more likely to test positive for fentanyl.
  • 34% more likely to test positive for meth.
  • 59% more likely to test positive for heroin.
  • 31% more likely to test positive for cocaine.

Earlier this month, the Ohio Department of Public Safety announced that it is collaborating with the lab to become the first state to use real-time drug use trends data as a way to rapidly direct public health responses to the evolving addiction crisis.


Indoor nursing home visits to resume Oct. 12, DeWine announces

Indoor visitations at nursing homes and long-term care facilities will be permitted to restart across the state as soon as Oct. 12, Gov. Mike DeWine announced Thursday (Source: “Indoor nursing home visits can restart on Oct. 12, DeWine says,” Crains Cleveland Business, Sept. 25).

Outdoor visitation went into effect, after months of a complete shutdown, for assisted living in early June and for nursing homes in July. "We know it is going to get cold and that outdoor visitation will no longer work," DeWine said.

Ohio Department of Aging director Ursel McElroy said facilities will be required to have access to adequate testing, staffing and personal protection equipment before allowing indoor visitation. All facilities, she said, must report to the state coronavirus data that will be published on a dashboard. According to the new guidelines, visitors will be screened and required to wear a mask during the visit. Only two visitors are permitted at one time, with visits limited to 30 minutes.


Study: Many children do not receive follow-up care for mental health conditions

A large new study finds that mental health care for many children in the U.S. falls far short, particularly when it comes to the follow-up treatment they receive (Source: “New research shows many children with mental health conditions don’t get follow-up care,” Stat News, Sept. 22).

The study, published Monday in Proceedings of the National Academy of Sciences, examined insurance claims from children between the ages of 10 and 17 covered by Blue Cross Blue Shield. Of the more than 2 million children included in the study, nearly one in 10 had a claim related to mental illness between 2012 and 2018.

The authors found that only 71% of the children received treatment in the 3 months that followed an initial insurance claim — but the study found that rate varied widely from one ZIP code to the next. In the best-performing ZIP codes, nearly 90% of children received follow-up care within three months of an initial insurance claim. In the worst-performing areas, only half of the children got that care.

In the past, some experts have suggested that shortages of qualified mental health providers are to blame for shortcomings in adolescent mental health care, with pediatricians often left to fill the gap. But the authors concluded that the disparities detailed in the study couldn’t be simply explained by staffing shortages.

The study found that the number of therapists in a given area is slightly associated with the chance that a child will receive follow-up treatment — but is far more closely correlated with the type of treatment a child receives. In communities where there are more psychiatrists, drug-only treatment and treatment with red flag drugs is more common. In communities with more of a supply of therapists, therapy-only treatment is more prevalent.


HPIO data brief highlights disproportionate impact of COVID-19 on Ohio communities of color

Six months into the pandemic, data paints a stark picture of how Black and Hispanic Ohioans face an outsized risk from COVID-19 (Source: “Black, Hispanic Ohioans face outsized COVID-19 risk,” Dayton Daily News, Sept. 6).

According to a new HPIO data brief, Ohio COVID-19 disparities by race and ethnicity: September update, Black Ohioans make up about 13% of the state’s population but accounted for larger percentages of COVID-19 cases (22.8%), hospitalizations (30.6%) and deaths (18.7%), while white Ohioans make up about 82% of the state’s population, but accounted for smaller percentages of COVID-19 cases (53.1%), hospitalizations (56.9%) and deaths (77.5%), as of Aug. 29.

In conjunction with the release of the publication, which is a follow-up to one released by HPIO in May, the Institute also has released county-level data tables that show COVID-19 case information compared to racial and ethnic populations.

A major limitation for fully assessing the impact of racial and ethnic disparities across the state is the high percentage of coronavirus cases with unknown race and ethnicity data. In Ohio, on average, 13% of cases in each county are listed as “unknown” for race. Without complete counts of race and ethnicity for those who test positive for COVID-19, it is difficult to measure the full impact of racial and ethnic disparities.


CDC: Teen e-cigarette use drops

The number of high school students regularly using e-cigarettes dropped significantly over the past year, after several years of soaring use, according to a new government survey of teenagers (Source: “E-Cigarette Use Falls Sharply Among Teenagers, C.D.C. Finds,” New York Times, Sept. 9).

The encouraging public health news was tempered by evidence that many high school users were taking advantage of a regulatory loophole to get access to flavored products.

But the CDC data suggested that even greater progress may have been stymied by the growing popularity of a new product — disposable e-cigarettes, which, under a loophole in federal regulations, are still allowed to be sold in youth-friendly flavors.

The shifting trends were captured by the 2020 National Youth Tobacco Survey, an annual look at teen use of tobacco-related products, administered by the Centers for Disease Control and Prevention.


COVID pandemic leads to drop in preventive care

When the coronavirus pandemic hit, Americans vastly scaled back their preventive health care, and there is little sign that this deferred care will be made up (Source: “Missed Vaccines, Skipped Colonoscopies: Preventive Care Plummets,” New York Times, Sept. 11).

Vaccinations dropped by nearly 60% in April, and almost no one was getting a colonoscopy, according to new data from the nonprofit Health Care Cost Institute.

The data, drawn from millions of health insurance claims, shows a consistent pattern, whether it was prostate screenings or contraceptives: Preventive care declined drastically this spring and, as of late June, had not yet recovered to normal levels. Many types of such care were still down by a third at the start of this summer, the most recent data available shows, as Americans remained wary of visiting hospitals and medical offices.


HPIO to host online forum on adverse childhood experiences

HPIO is hosting an online forum Sept. 29 titled “Improving child health and wellbeing: Creating opportunities for all Ohio children to thrive.”

As the 2019 Health Value Dashboard illustrates, too many Ohioans face obstacles to health, which are often rooted in childhood conditions and experiences. This forum will discuss the impact of adverse childhood experiences (ACEs) on Ohioans including recent effects of the COVID-19 pandemic.

Attendees will learn about the biological impact of ACEs and trauma; best practices for screening, treatment and prevention; and considerations for Ohio's response to ACEs in the midst of the pandemic. For more information, or to register, visit the event page on HPIO’s website.