Ohio Health Policy News

Newly released data from County Health Rankings show that Black Ohioans have the lowest median household income among groups of Ohioans and have, by far, the highest rate of premature death (years of potential life lost before age 75, which reflects the burden of deaths that potentially could have been prevented).
 
Between 2018 and 2020, Black Ohioans collectively lost 13,374 years of life before turning 75 years old (see graphic above). That is nearly as many years lost as Hispanic (5,858) and white Ohioans (8,224) combined.  At the same time, the median household income for Black Ohioans is $12,352 less than Hispanic Ohioans, $28,065 less than white Ohioans and $43,782 less than Asian Ohioans.
 
“Individual efforts alone cannot overcome the structural barriers that maintain the racial wealth divide,” County Health Rankings states. “Structural barriers include laws, policies, institutional practices, and economic arrangements that create unequal conditions.”
 
The latest edition of the County Health Rankings, released this week, includes a new curated list of strategies to address racial wealth building, a key to eliminating health disparities.
 
“Research shows that income inequality has a negative effect on overall population health,” according to the Rankings. “Economically unequal societies often have higher rates of physical and mental illness, violence, and incarceration.”

Throughout April, HPIO has marked National Minority Health Month by creating a series of data visualizations to illustrate health disparities in Ohio.

The Food and Drug Administration (FDA) on Thursday announced a plan to ban sales of menthol-flavored cigarettes in the United States, a measure many public health experts hailed as the government’s most meaningful action in more than a decade of tobacco control efforts (Source: “F.D.A. Moves to Ban Sales of Menthol Cigarettes,” New York Times, April 28).
 
The ban would most likely have the deepest impact on Black smokers, nearly 85% of whom use menthol cigarettes, compared with 29% of white smokers, according to a government survey. If effective in reducing smoking, the ban could significantly diminish the burden of chronic disease and limit the number of lives cut short by one of the most hazardous legal products available.
 
Public health experts say menthol cigarettes have been heavily marketed to Black people, to devastating effect: African American men have the highest rates of lung cancer in America, according to the Centers for Disease Control and Prevention.

The push to reduce poor maternal health outcomes has seen new momentum as federal lawmakers and Biden administration officials previewed their priorities — including reversing a rise in maternal disparities among Black women (Source; “Lawmakers, advocates hopeful for more bills to curb maternal deaths,” Roll Call, April 20).
 
The United States leads among developed nations in its poor maternal mortality rates, referring to deaths during or up to one year after childbirth. These deaths — alongside maternal morbidity, or long-term health problems arising from pregnancy or childbirth — are growing problems nationally.
 
Last week, HPIO released a fact sheet titled “Racial and geographic disparities in maternal morbidity and mortality.” The fact sheet includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.

In the past three years, states have begun training medical providers to stop acting on unconsciously held beliefs, known as implicit bias (Source: “With Implicit Bias Hurting Patients, Some States Train Doctors,” Pew Stateline, April 21).
 
Since 2019, at least four states — California, Maryland, Michigan and Washington — have adopted policies requiring at least some healthcare workers to take implicit bias training, some as a prerequisite for professional licensure or renewal.
 
Bills on implicit bias training in health care have been introduced in state legislatures over the past two years in many other states, including Illinois, Indiana, Nebraska, New York, Oklahoma, South Carolina, Tennessee and Vermont. Minnesota passed a law last year requiring obstetrics units to offer implicit bias training.
 
Even without laws, some health systems in recent years began offering or requiring training in implicit bias, as have some medical schools, including Harvard, Icahn School of Medicine at Mount Sinai in New York and Ohio State University.

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The percent of Ohioans who are uninsured dropped by almost half from 12.3% to 6.4% between 2011 and 2019 (see graphic above).

Every race saw a drop in the percent of uninsured, with the percentage of Asian and Black Ohioans dropping most dramatically compared to other groups. Despite these gains in access, however, Ohioans of color are still more likely to be uninsured than white Ohioans.

Much of the drop in Ohio’s uninsured population is attributable to the state’s 2014 decision to expand Medicaid eligibility as part of the Affordable Care Act. In HPIO’s 2021 Health Value Dashboard™, Ohio ranked seventh out of the 50 states and the District of Columbia for access to care — the first time Ohio has ranked in the top quartile on any Health Value Dashboard domain.

While access is clearly a bright spot for the state, the Dashboard found that Ohio’s population health outcomes remain poor. Access to care is critical, particularly for Ohioans with serious health conditions. But the Dashboard and national research shows that health is shaped by many factors, including social, economic and physical environments.

This April, HPIO is creating a series of data graphics in recognition of National Minority Health Month. 

The Health Policy Institute of Ohio has released a new fact sheet titled “Racial and geographic disparities in maternal morbidity and mortality.”

The fact sheet includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.

“With collaboration from both public and private partners, it is possible to reduce severe maternal morbidity and mortality and improve health outcomes for Ohio mothers,” according to the fact sheet. “Policymakers and other stakeholders can implement evidence-based strategies to ensure that parents and babies in Ohio are healthy and thriving.”

Hundreds of thousands of Ohioans may lose Medicaid coverage this summer when the federal government's COVID-19 emergency declaration ends, according to a new national report (Source: “More than 400,000 Ohioans at risk of losing Medicaid coverage this summer as COVID emergency ends,” Cincinnati Enquirer, April 19).

Around 3.3 million Ohioans were enrolled in Medicaid this fiscal year as of February, an increase from around 2.8 million from 2020. Under the declaration, Ohio and other states were unable to take people off Medicaid, even if they become ineligible. A new Commonwealth Fund report estimates that as many as 400,000 Ohioans could lose their coverage at the conclusion of the public health emergency.

Last week, HPIO released a new fact sheet, “Ohio Medicaid Basics Update: Trends in Enrollment and Expenditures During the COVID-19 Pandemic,” which details enrollment and spending trends in Ohio Medicaid due to the COVID-19 pandemic.

HPIO is also hosting a free online forum May 3, titled “What’s on the Horizon for Ohio’s Medicaid Program? Innovation, Equity and Unwinding the Public Health Emergency.”

President Joe Biden is sending his administration’s first national drug control strategy to Congress as the U.S. overdose death toll hit a new record of nearly 107,000 during the past 12 months (Source: “Biden drug control plan stresses harm reduction, treatment,” Associated Press, April 21).

The strategy, released Thursday, is the first national plan to prioritize harm reduction, said White House drug czar Dr. Rahul Gupta. The strategy calls for changes in state laws and policies to support the expansion of harm reduction.

For an overview of harm reduction policy in Ohio, see HPIO’s “Ohio Addiction Policy Scorecard: Overdose Reversal and Other Forms of Harm Reduction.”

While suicide deaths among young Ohioans have risen overall in Ohio over the past two decades, the increase has been sharpest among Black Ohioans. 

In 1999, the suicide rates for both white Ohioans and Black Ohioans ages 10 to 24 were the same: 6.8 per 100,000 people. By 2020 (the most recent year for which data is available), the rate for white Ohioans had risen to 11.2 (an increase of 64%) and the rate for Black Ohioans had risen to 12.8 (an increase of 88%).  

More-recent national research indicates that the disparity in suicide rates may have increased during the COVID-19 pandemic.  

Reducing suicide and eliminating disparities are priorities of the Ohio Department of Health’s 2020-2022 State Health Improvement Plan (SHIP). Public- and private-sector leaders can implement strategies identified in the SHIP and Ohio’s 2020-2022 Suicide Prevention Plan, including suicide fatality review boards, behavioral health integration with primary care and education on safe storage of lethal means (i.e., firearms and medications). 

This April, HPIO is spotlighting health disparities in Ohio as part of National Minority Health Month.  

If you or someone you know is experiencing emotional distress or a suicidal crisis, please call the National Suicide Hotline toll-free at 1-800-273-8255. 

The Health Policy Institute of Ohio has released a new fact sheet, “Ohio Medicaid Basics Update: Trends in Enrollment and Expenditures During the COVID-19 Pandemic.”
 
Since the COVID-19 pandemic began in March 2020, enrollment in, spending on and federal funding for Ohio Medicaid have increased significantly. Drawing from the foundational information provided in HPIO’s Ohio Medicaid Basics 2021 policy brief, this fact sheet provides information on:

• Changes to the Medicaid program due to the COVID-19 pandemic
• Enrollment changes during the COVID-19 pandemic
• Ohio Medicaid spending during the COVID-19 pandemic

“Ohio policymakers must be agile in their response to new challenges facing Medicaid enrollees as the COVID-19 pandemic continues, including the end of the (public health emergency) and potential loss of Medicaid eligibility for tens of thousands of Ohioans,” the fact sheet concludes. “State policymakers and other stakeholders must also balance the benefits of the Medicaid program with budgetary and administrative challenges to improve health, achieve equity and promote sustainable healthcare spending in Ohio.”