Ohio Health Policy News

Recently released data shows that Ohioans continue to experience substantial financial burdens when paying for housing, and that Ohioans of color are disproportionately impacted.  

Last year, HPIO released a fact sheet on housing affordability and health equity that described how stable, affordable and safe housing is critical for good health. Above is a graphic from the publication, updated with the most-recently available data. 

The connections between housing and health are clear. Limited high-quality, affor 
dable housing stock forces many Ohioans into stressful and unsafe housing situations that can lead to long-term negative health consequences, such as high blood pressure and poor birth outcomes. 

HPIO’s fact sheet “Connections between Racism and Health: State and Local Policymakers,” further explains the connection between racism, housing and health: “Decades of racist housing policies, such as historical redlining and present-day predatory lending practices, have resulted in neighborhood segregation, concentrated poverty and disinvestment from Black communities in Ohio that continue to this day. As a result, Ohioans of color are more likely to experience harmful community conditions — such as food deserts and unsafe, unstable housing — that impact health.”  

The fact sheet includes action steps policymakers can take to support the health and well-being of Ohioans of color and move Ohio toward a more economically vibrant and healthier future. 

The fact sheet is one in a series of three that are companions to the HPIO policy brief “Connections between Racism and Health: Taking Action to Eliminate Racism and Advance Equity.” The other fact sheets in the series address private-sector organizations and individuals and community groups.

A new study has found that COVID-19 death rates among both Black and white people were higher in areas with more residential segregation, with rates for Black individuals almost twice as high (Source: “Study links racism, segregation to increased COVID deaths,” Atlanta Journal-Constitution, March 14).
 
The study from an Ohio University researcher, published in the journal Ethnicity & Disease, looked at systemic racism measures, as well as socioeconomic factors between Black and white residents, in every state. Using data on deaths through December 2020, they assessed whether state-level systemic racism and residential segregation predicted the probability of COVID-19 deaths among Americans, considering sociodemographic factors in the process.
 
“We were interested in doing this study because racial and ethnic disparities have been apparent amid COVID-19, and for some Americans, this may have been one of the first times they’ve learned about disparities,” said study author Berkeley Franz. “Health disparities are present with almost every illness and have persisted for years, and the gap isn’t closing, especially between Black and white Americans. We wanted to understand what was driving those disparities to find better ways to reduce them.”
 
What they found was the death rate was higher among Black individuals because of social environments rather than physiology or genetics. They hypothesized that in segregated neighborhoods, residents are less likely to have access to good quality schools, employment opportunities, health care and other resources.

Patients in underserved communities smoke at a rate double that of the general U.S. population, according to a new study (Source: “Smoking rate in underserved communities double that of general population, study says,” Medical Economics, March 7).
 
The American Cancer Society study, which was published in the journal Cancer, found that the prevalence of smoking among adults served at federally qualified health centers was 28.1%, compared to 14% reported for the general U.S. population.
 
Among other major findings in the study are that Black adults who smoked had more than two times the odds of reporting substance use disorders.
 
“Our study underscores the importance of understanding the association and increased risk of mental health conditions and substance use disorders among adults from underserved communities who smoke while also addressing socioeconomic risk factors to achieve better health outcomes,” said study author Dr. Sue C. Lin of the Health Resources and Services Administration within the U.S. Department of Health and Human Services. “The study further highlights the significance of tailored smoking cessation treatments for individuals from underserved communities that will support cancer prevention care.”

A new study has found that a child health-law partnership program in Cincinnati that helps improve living conditions for families with children who have chronic conditions has led to a nearly 40% drop in hospital admissions (Source: “Doctor-lawyer advocacy gives Cincinnati area kids better health outcomes, study shows,” Cincinnati Enquirer, March 23).
 
Child Help, the Cincinnati Child Health-Law Partnership, which was created by Cincinnati Children’s Hospital and Legal Aid of Greater Cincinnati, has assisted kids in more than 20,000 advocacy cases since the partnership started in 2008. Many of its cases involve kids whose living environment exacerbated chronic health conditions, such as an apartment with mold or cockroaches. Others address evictions that could leave children homeless. And some involve special needs children in schools. Left unheeded, the problems could end in poor health and repeated hospital admissions for children.
 
A study published March 7 in Health Affairs shows a 38% reduction in the hospitalization rate among children who got Child Help assistance from 2012 through 2017. 
 
Study co-author Dr. Andrew Beck of Cincinnati Children's division of general and community pediatrics said he wasn't surprised to find a drop in readmissions for the kids who were helped by the partnership. He just didn't know how great the drop would be.
 
“It reinforces the notion that our surroundings, socioeconomic and social determinants, impact health outcomes," he said. "It highlights the importance of clinical-community partnerships. It shows that support of these programs in new and innovative ways of reimbursing is important.”

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The Ohio General Assembly is considering two bills that would address the state’s skyrocketing drug overdose deaths. Recent resources from the Health Policy Institute of Ohio can inform their decisions.
 
The graphic above, from HPIO’s fact sheet Refocusing Ohio’s Approach to Overdose Deaths, displays the significant increase in overdose (OD) deaths in Ohio since 2000. It also shows how the state’s rate of OD deaths has increased much more than the U.S. overall. Since 2016, fentanyl and related drugs have been the most common drugs present in unintentional overdose deaths in Ohio.
 
To combat these trends, HPIO’s brief, Taking Action to Strengthen Ohio’s Addiction Response, provides a prioritized set of policy recommendations. Some of those recommendations are included in legislation before the General Assembly.
 
The Ohio General Assembly is currently considering Senate Bill 296, which would expand access to naloxone by more broadly authorizing who can distribute the overdose reversal medication. The bill would also legalize fentanyl test strips and other drug-checking technology so that people can check drugs for the presence of fentanyl and other lethal substances in the drug supply. 

Also under consideration in the Ohio Senate is Senate Bill 288, a criminal justice reform omnibus bill that includes a provision to make initial improvements to Ohio’s Good Samaritan law. Designed to prevent overdose deaths, Good Samaritan policies provide immunity from drug charges for bystanders who call for help.

Ohio is working on legislation to set up 988, a new suicide and mental health support line that is set to launch nationwide in July (Source: “Four months from launch, Ohio lawmakers debate costs of new 988 mental health line,” Ohio Capital Journal, March 17).
 
Service providers see the transition to a simple, three-digit number as an important step in suicide prevention. But the new number’s rollout has been challenging. That easy-to-remember number likely means more callers, and more callers means more staff and potential technology upgrades for agencies.
 
The number, which will accept calls and texts, was created through federal legislation signed by former President Donald Trump in 2020. The legislation does not include direct federal funding, however, but gives states the go-ahead to impose fees on related services.
 
According to the National Alliance on Mental Illness, only four states so far have passed legislation establishing 988 with ongoing funding from service fees — Colorado, Nevada, Virginia and Washington.

The first year of the COVID-19 pandemic saw more Americans drinking heavily or using illicit drugs — but apparently not smoking (Source: “US adult smoking rate fell during first year of pandemic,” Associated Press, March 17).
 
U.S. cigarette smoking dropped to a new all-time low in 2020, with 1 in 8 adults saying they were current smokers, according to survey data released Thursday by the Centers for Disease Control and Prevention. Adult e-cigarette use also dropped, the CDC reported.
 
CDC officials credited public health campaigns and policies for the decline, but outside experts said tobacco company price hikes and pandemic lifestyle changes likely played roles.
 
“People who were mainly social smokers just didn’t have that going on any more,” said Megan Roberts, an Ohio State University researcher focused on tobacco product use among young adults and adolescents.
 
What’s more, parents who suddenly were home with their kids full-time may have cut back. And some people may have quit following reports that smokers were more likely to develop severe illness after a coronavirus infection, Roberts added.

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Both homicides and suicides have significantly increased in Ohio over the past two decades and firearms have been used in a greater percentage of those deaths, new analysis from the Health Policy Institute of Ohio has found (see graphic above).
 
Between 1999 and 2020 (the most-recent year in which data is available), suicide deaths in Ohio increased 49% from 1,102 to 1,644 and homicides increased 123% from 450 to 1,004.
 
The percent of homicides in which a firearm was used has also risen steadily over the past two decades. In 1999, a firearm was used in 57% of homicides, and in 2020 that percentage increased to 82%. In 2020, a firearm was used in 54.9% of suicides.
 
“As Ohio policymakers debate firearm safety legislation, it is important that they consider the latest data on the trends between suicide, homicide and firearms,” said HPIO President Amy Rohling McGee.

As COVID-19 continues to decline in Ohio, the state is looking at the next phase and its impact (Source: “Ohio entering new phase as COVID approaches endemic status,” Dayton Daily News, March 10).

“As the days and weeks pass it becomes increasingly clear that not only are we leaving the omicron surge behind us but we’re entering a new phase,” Ohio Department of Heath Director Dr. Bruce Vanderhoff said.

The variant, which is more contagious but less likely to result in serious illness, has helped push COVID closer to an endemic rather than a pandemic. And compared to the start of the COVID-19 pandemic, Ohio has multiple tools to monitor to battle the virus, including coronavirus therapeutics and treatments, and the vaccine.

Though the virus is on the decline, Vanderhoff noted the last two years a spring and summer lull was followed by a surge.

Gov. Mike DeWine announced last Friday that $25.9 million will be awarded for 136 new or expanded School-Based Health Centers throughout Ohio (Source: “Governor awards $25.9M in School-Based Health Center funds,” Bellefontaine Examiner, March 7).

The Ohio Department of Health is awarding 15 contracts, totaling $25,910,983, to create 29 new School-Based Health Centers and expand services in 107 existing School-Based Health Centers.

The Governor’s Office said the new and expanded clinics will provide primary care services and preventative care in the school setting. Some of the expanded clinics will add vision, dental, behavioral health and other healthcare services. These clinics eliminate many barriers to obtaining care including transportation; parents missing time at work and lack of a provider or medical home. In many cases, they also limit the time out of the classroom.

“Studies have shown that health and wellness are interconnected,” Gov. DeWine said. “A student who is not healthy or who is chronically absent is not able to achieve their full potential. These partnerships between healthcare providers and schools supports the whole child and ensures that every child may realize their full potential.”