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January 2021

Welcome to the first racism and health special edition of Ohio Health Policy News

As the Health Policy Institute of Ohio wrote in its statement on racism and health last year, “The data and research evidence are clear that racism is a systemic and ongoing public health crisis with serious consequences for the health of Ohioans.”

In order to keep the connection between racism and health front and center for policymakers, HPIO is devoting the last edition of Ohio Health Policy News each month to the topic. We will continue to include stories about health equity throughout the month, but these special editions will put a spotlight on the issue.


Children in families with low incomes face extra challenges during pandemic

In communities struggling with poverty and gun violence, the coronavirus has only inflamed the difficulties that many families already were enduring (Source: “How the Pandemic Has Been Devastating for Children From Low-Income Families,” New York Times, Dec. 29).

Since March, according to data from the Centers for Disease Control and Prevention, there has been a 24 percent spike nationwide in mental-health-related emergency room visits among children between the ages of 5 and 11, and a 31 percent rise among those between 12 and 17, compared with the same period last year.

The disruptions to daily life — and the associated stresses of lives on pause — have been perhaps most acutely felt by children from low-income families, experts said, many of whom live in predominantly Black and Latino neighborhoods that have been plagued by a rise in gun violence and disproportionately high coronavirus infection rates.

While most children should bounce back from isolation and remote learning, childhood development experts said, those growing up amid other adversities like systemic racism, domestic violence, abuse and poverty are struggling to cope with the turmoils of the pandemic — and face greater obstacles in recovering.


New tool aims to ensure equity in COVID-19 planning, response and recovery

A coalition of the largest metropolitan health departments in the U.S. has released a tool designed to provide health departments with resources to ensure that health equity is considered in COVID-19 planning.

The Equity Lens Tool was created by Human Impact Partners and commissioned by the Big Cities Health Coalition.

“The Equity Lens Tool can be used by anyone working in a health department’s COVID-19 planning, response, and recovery contexts— particularly those leading or coordinating—who aims to ensure equity in a proposed decision,” according to a release from Human Impact Partners. “It will not be a panacea to solve the persistent inequities in our society, yet it does provide one approach to share decision-making power and directly improve people’s lives.”


Study: Black infant mortality rate cut dramatically when Black doctors provide care

A new study has found that although Black newborns are three times as likely to die as white newborns, when the doctor of record for Black newborns — primarily pediatricians, neonatologists and family practitioners — was also Black, their mortality rate, as compared with white newborns, was cut in half (Source: “Mortality rate for Black babies is cut dramatically when Black doctors care for them after birth, researchers say,” Washington Post, Jan. 13)

The new study of births in Florida by University of Minnesota School of Public Health researchers found an association, not a cause and effect, and the researchers said more studies are needed to understand what effect, if any, a doctor’s race might have on infant mortality.

The researchers cautioned that it wasn’t practical for all Black families to seek Black doctors to care for their babies, not only because there are too few of them, but also because the reasons for the disparity in care need to be understood and addressed.

In a New England Journal of Medicine opinion article from July, one of the study’s authors wrote that, “We believe that medical schools and training programs should equip every clinician, in every role, to address racism. And licensing, accreditation and qualifying procedures should test this knowledge as an essential professional competency.”

This could include mandating education about implicit bias and social justice, which can better prepare doctors of any race to properly treat at-risk patients, regardless of their socioeconomic backgrounds or race. Medical schools have come under increasing pressure to include such education and counteract training that in the past wrongly taught doctors that there were genetic differences among different races.


In case you missed it: HPIO fact sheet outlines actions needed to eliminate racial disparities in infant mortality

Earlier this week, HPIO released a new fact sheet titled “Taking action: Eliminating racial disparities in infant mortality.”

The fact sheet highlights that, “For many years, Ohio’s infant mortality rate has been higher than most other states... Ohio’s policymakers and health leaders have acted on this issue through multiple advisory committees, collaborative efforts, investments, legislation and other policy changes.”

The fact sheet includes troubling infant mortality disparities data (see graphic below) and information on what can drive change and move Ohio forward. It highlights three action steps that are needed to eliminate racial disparities in infant mortality. Future efforts must:

  • Dismantle racism and address its consequences
  • Improve health across the life course, not just pregnancy
  • Maintain improvements in access to clinical care, while also advancing meaningful policy changes to improve community conditions

FactSheet_IMRacialDisparities_Figure1


HPIO fact sheet outlines actions needed to eliminate racial disparities in infant mortality

HPIO has released a new fact sheet titled “Taking action: Eliminating racial disparities in infant mortality.”

The fact sheet highlights that, “For many years, Ohio’s infant mortality rate has been higher than most other states... Ohio’s policymakers and health leaders have acted on this issue through multiple advisory committees, collaborative efforts, investments, legislation and other policy changes.”

In December 2020, Gov. Mike DeWine announced the creation of a new task force focused on eliminating racial disparities in infant mortality by 2030. The task force will host listening sessions in 11 counties, providing an opportunity for members to learn about promising programs, evaluation results and barriers to improving maternal and infant health for Black families.

The fact sheet includes troubling infant mortality disparities data and information on what can drive change and move Ohio forward. It highlights three action steps that are needed to eliminate racial disparities in infant mortality. Future efforts must:

  • Dismantle racism and address its consequences
  • Improve health across the life course, not just pregnancy
  • Maintain improvements in access to clinical care, while also advancing meaningful policy changes to improve community conditions

Black Americans lag behind in COVID-19 vaccination rates

Black Americans are receiving COVID-19 vaccinations at dramatically lower rates than white Americans in the first weeks of the chaotic rollout, according to a new analysis (Source: “Black Americans Are Getting Vaccinated at Lower Rates Than White Americans,” Kaiser Health News, Jan. 17).

About 3% of Americans have received at least one dose of a coronavirus vaccine so far. But in 16 states that have released data by race, white residents are being vaccinated at significantly higher rates than Black residents, according to the Kaiser Health News analysis — in many cases two to three times higher.

In the most dramatic case, 1.2% of white Pennsylvanians had been vaccinated as of Jan. 14, compared with 0.3% of Black Pennsylvanians.

The vast majority of the initial round of vaccines has gone to health care workers and staffers on the front lines of the pandemic — a workforce that’s typically racially diverse made up of physicians, hospital cafeteria workers, nurses and janitorial staffers. If the rollout were reaching people of all races equally, the shares of people vaccinated whose race is known should loosely align with the demographics of health care workers. But in every state, Black Americans were significantly underrepresented among people vaccinated so far.


HPIO analysis: 36% of depression in Ohio potentially preventable with elimination of adverse childhood experiences

A new HPIO fact sheet, The Link between Adverse Childhood Experiences (ACEs) and Poor Health, includes first-of-its-kind analysis in Ohio that estimates that 36% of depression diagnoses in Ohio can be attributed to experiencing multiple adverse childhood experiences, or ACEs.

That means that if exposure to ACEs were eliminated among Ohioans, an estimated 36% of depression diagnoses could be prevented.

Similarly, in Ohio, 33% of current smoking, 25% of inability to afford care, 24% of asthma, 20% of chronic obstructive pulmonary disease and 19% of heavy drinking is potentially preventable with the elimination of exposure to ACEs.

The fact sheet is an excerpt from the HPIO policy brief Adverse Childhood Experiences (ACEs): Health Impact of ACEs in Ohio, which was released in August. Last week HPIO released a fact sheet describing the prevalence of ACEs in Ohio, which highlighted that more than two-thirds of Ohioans have been exposed to at least one ACE.


Ohio orders 2 million rapid COVID-19 tests for local health departments

The state of Ohio entered a deal with two health care companies to purchase at least 2 million rapid antigen coronavirus tests to distribute to local health departments for broader use, Gov. Mike DeWine said Thursday (Source: Ohio to purchase 2 million rapid coronavirus tests to send to local health departments,” Cleveland.com, Jan. 21).

DeWine described the $50 million deal with Abbott Pharmaceuticals and eMed as a significant expansion of testing for the public that will make the instant tests more widely available, providing a tool for local health departments to respond to potential outbreaks in communities. Along with the tests from Abbott, eMed will also provide telehealth services for anyone who takes one.

“We have used CARES Act dollars and this will make testing more broadly available,” DeWine said. “We’ve given local health departments some broad guidelines. We’ve asked them to make the test widely available in their communities.”


HPIO analysis: More than two-thirds of Ohioans exposed to adverse childhood experiences 

Analysis by the Health Policy Institute of Ohio has found that more than two-thirds of Ohioans have been exposed to adverse childhood experiences, or ACEs.

The finding was included in a new fact sheet released by HPIO based on a policy brief the Institute released in August. 

ACEs, potentially traumatic events that occur during childhood, can generally be grouped into three categories: abuse, household challenges and neglect. 

“Exposure to ACEs is a pervasive problem affecting many children in Ohio and across the country,” the policy brief stated. “National data and analysis provide clear evidence that ACEs exposure is linked to poor health and well-being through adulthood, including disrupted neurodevelopment, social problems, disease, disability and premature death.”

More than one-third of Ohio adults (36%) reported exposure to two or more ACEs. Ohioans of color, with low incomes, with disabilities and who are residents of urban or Appalachian counties were more likely to report exposure to multiple ACEs. 

Among Ohioans who reported exposure to at least one ACE, the most common type of ACE reported was emotional abuse (57%), followed by substance use by a household member (41%) and parental divorce (36%).