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August 2021

New report highlights health inequities by state

Earlier this month, the creators of the America’s Health Ranking report released the first edition of a companion document focused on health disparities in the U.S. (Source: “United Health’s inaugural ‘Disparities Report’ highlights health inequities,” MinnPost, Aug. 4).

The inaugural edition of the United Health Foundation’s “American’s Health Ranking Disparities Report” described the breadth, depth and persistence of health disparities in the U.S.

While previous reports have focused on the health of seniors, the health of women or on those who’ve served in the U.S. military, this year’s report focused on areas where one group has a disadvantage compared to another. The study’s results were broken down by all 50 states and the District of Columbia.


White Americans got disproportionate share of healthcare dollars in 2016, study finds

White Americans received 72% of all healthcare spending in 2016 despite making up 61% of the population, according to a new study that found major disparities in racial and ethnic health spending (Source: “Study: White Americans got disproportionate amount of healthcare dollars in 2016,” Fierce Healthcare, Aug. 17).

The study, published last week in the Journal of the American Medical Association and conducted by the Institute for Health Metrics and Evaluation at the University of Washington, found that African Americans make up 12% of the population and accounted for 11% of healthcare spending. However, the spending was skewed based on how African Americans were getting care. African Americans got 26% less outpatient care compared to whites but spent 12% more on emergency department care, the study found. This likely contributed to African Americans getting more expensive care when conditions worsened instead of getting more preventive outpatient care, experts said.

“Hispanic and Asian Americans received the least spending relative to their proportion of the population: Hispanic patients benefited from 11% of healthcare spending despite accounting for 18% of the population, while Asian, Native Hawaiian and Pacific Islander individuals received 3% of spending while making up 6% of the population,” according to a release on the study.


Increased access to care insufficient for closing racial health gap, new studies find

A series of studies in the Journal of the American Medical Association found that while access to care has improved in recent years, the racial health gap has remained (Source: “Racial Inequities Persist in Health Care Despite Expanded Insurance,” New York Times, Aug. 17).

The new issue of JAMA offers studies on disparities in the utilization of health care services and in overall health spending. Together, the findings paint a portrait of a nation still plagued by medical haves and have-nots whose ability to benefit from scientific advances varies by race and ethnicity, despite the fact that the ACA greatly expanded insurance.

The racial health gap did not significantly narrow from 1999 to 2018, despite decreases in uninsured rates due to the passage of the Affordable Care Act, according to one study whose author said it was tantamount to “a comprehensive national report card.”

Despite innovations like Medicare Advantage, which increased access to health care overall, Medicare beneficiaries who are minorities — defined as Black, Hispanic, Native American or Asian-Pacific Islander — still have less access than white or multiracial individuals to a physician who is a regular source of care.

Overall, Black women face a much higher risk of dying from pregnancy complications than white women, with maternal mortality rates of 41.7 per 100,000 live births for Black women, compared with 13.4 per 100,000 live births for white women.


HPIO analysis identifies 12 strategies to prevent childhood trauma in Ohio

A new policy brief, “Adverse Childhood Experiences (ACEs): A strategic approach to prevent ACEs in Ohio,” identifies 12 cost-beneficial strategies that state leaders can use to prevent adverse childhood experiences.

Earlier analysis from HPIO’s Ohio ACEs Impact project found that more than one-third of Ohio adults (36%) reported exposure to two or more ACEs. And first-of-its-kind analysis by HPIO estimated that more than $10 billion in annual healthcare and related spending could be avoided in Ohio if exposure to ACEs was eliminated.

“ACEs are not inevitable and Ohioans are resilient,” the new report states. “Exposure to ACEs does not have to determine future hardship. There are strategies that state policymakers and others can deploy to prevent ACEs and safeguard the well-being of Ohio children and families who have experienced adversity and trauma.” 

The report also highlights steps Ohio’s public and private leaders can take to ensure that communities across the state are equipped to support children and families that are most at risk for experiencing adversity and trauma – including Ohioans of color and Ohioans with low incomes, disabilities and/or who live in urban and Appalachian areas.


COVID-19 booster shots could begin Sept. 20 in Ohio, ODH director says

Ohio Health Department Director Dr. Bruce Vanderhoff said the state is getting ready to give booster shots for adults who received either the Pfizer or Moderna vaccines starting as early as Sept. 20 (Source: “Ohio prepares to administer COVID-19 booster shots as early as Sept. 20,” Columbus Dispatch, Aug. 18). 

"This plan is still subject to the FDA’s evaluation and determination of the safety and effectiveness of a booster dose," Vanderhoff said. 

The news comes hours after the Biden administration announced it was asking the U.S. Food and Drug Administration to authorize a third shot for the general population. The Centers for Disease Control and Prevention recommended the third shot for immunocompromised Americans last week as infections from the delta variant continue to rise. 

Vanderhoff said vaccines such as the COVID-19 shot aren't designed to provide indefinite immunity to infection. What they give people is "a reserve of cells" that protect against severe illness, hospitalization and death. 

"I’ll reiterate what I’ve said before. Protection against severe illness and death was the target of the vaccine," Vanderhoff said. 


Ohio nears $808 million opioid settlement

The state of Ohio took a major step forward this week in reaching a massive settlement deal with distributors sued over their role in the opioid epidemic (Source: “Ohio set to reach $808 million opioid settlement after more counties, cities sign on,” Columbus Dispatch, Aug. 19).

The "OneOhio" opioid settlement now has been agreed to by more than 99% of litigating local governments – 142 of the 143 entities said yes as of Wednesday – above the absolute minimum of 96% for any deal to be considered. The only holdout, Scioto County, can still sign onto the deal until this Friday at 5 p.m.

The 96% mark, while necessary, does not guarantee that the distributors will be paying out $808 million. The companies still need to sign off on it.

If the distributors – Dublin-based Cardinal Health; McKesson, based in Texas; and AmerisourceBergen, of Pennsylvania – do give approval, roughly 30% of the money would go to local communities, which then would be used for treatment and prevention programs for opioid addiction. Another 15% would go to Ohio for legal costs, and the rest would go to a foundation controlled by local government representatives.


White House announced $8.5 billion for rural healthcare providers

The White House announced last week that it is allocating nearly $9 billion to help healthcare providers in rural U.S. communities that are struggling to fight COVID-19 (Source: “White House announces $8.5B boost to help rural areas fight COVID-19,” United Press International, Aug. 13).

The funding, $8.5 billion from the American Rescue Plan, will go to help rural hospitals stay open long-term, improve rural healthcare and strengthen their ability to fight COVID-19.

Other actions for the funding include expanding access to vaccines, testing and supplies, training new health providers, expanding telehealth services, opening access to pulmonary rehabilitation services and expanding Veterans Affairs training programs.


More than half of Ohioans have at least one dose of COVID vaccine, ODH reports

State health officials reported this week that Ohio’s vaccination rate finally surpassed 50% as 5,845,986, or 50.01% of Ohioans, have now received at least one dose (Source: “Ohio vaccination rate hits 50%,” Youngstown Vindicator, Aug. 9).

However, the statewide percentage of those who have completed the vaccination process is 46.46%.

Delaware County has the highest vaccination rate in Ohio, with 64.27% having at least one dose and 60.98% completing the process, according to ODH statistics.

The county with the lowest vaccination rate is Holmes County at 15.9%. The county is referred to as “Amish country” and is home to popular Amish tourism areas such as Walnut Creek and Sugar Creek. The county with the next lowest vaccination rate is Adams County in southern Ohio at 28.29%, according to the ODH.


Biden administration revokes permission for Ohio Medicaid work requirements

The federal Centers for Medicare and Medicaid Services told the Ohio Department of Medicaid this week that it cannot proceed with its plans to require some people on the health coverage program to work to keep their coverage (Source: “Biden administration nixes Ohio’s Medicaid work requirements,” Cleveland Plain Dealer, Aug. 11).

In a 23-page letter, sent to the state on Tuesday, CMS says that work requirements do not “ promote the statutory objectives of Medicaid” because they would likely result in thousands of people losing coverage.

This is a change from the administration of former President Donald Trump, which had approved the state’s work requirements program in 2019. The Ohio Department of Medicaid was directed to submit a work requirement program by the Ohio General Assembly in the 2017 budget bill.

Work requirements were supposed to begin Jan. 1, but were postponed because of the coronavirus pandemic.


Community groups running short of naloxone, warn of potential increase in overdose deaths

An affordable antidote for opioid overdoses has become more difficult to obtain amid a fatal epidemic, in what advocates have called a “perfect storm” with deadly consequences (Source: “Affordable naloxone is running out, creating a perfect storm for more overdose deaths, activists say,” Washington Post, Aug. 11).

After a manufacturing issue halted Pfizer’s production of the single-dose injectable naloxone in April, groups that distribute a significant amount of the lifesaving medicine say they are facing an unprecedented obstacle to reverse drug overdoses as they reach an all-time high. Organizers say the insufficient supply has been felt unequally across the country.

Pfizer, which offers naloxone at a discount to a national buyer’s club made up of harm prevention programs, said it may take until February before it can meet demand again. The Opioid Safety and Naloxone Network Buyer’s Club, the national consortium of more than 100 harm reduction programs that have provided millions of doses since 2012 to communities at a reduced price, says the unprecedented scarcity is expected to have deadly consequences.

The Department of Health and Human Services (HHS) will be able to spend $30 million allocated in the American Rescue Plan — the first federal funds designated specifically for harm reduction by Congress — on naloxone once it is available. In the meantime, according to HHS, states can seek funds through grant programs run by the Substance Abuse and Mental Health Services Administration.