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May 2022

June 2022

Graphic of the week

AlcoholTobaccoTrend_HighSchool_Standalone

Analysis from HPIO late last year found that the most notable change in tobacco use in recent years has been the shift away from combustible cigarettes and toward e-cigarettes among teens and young adults (see graphic above). By 2019, only 4.9% of Ohio high school students reported that they had smoked a cigarette in the past 30 days, while e-cigarettes surpassed alcohol and became the most commonly used drug among teens. Similarly, the percent of 18-24-year-olds reporting e-cigarette use jumped 77% from 2016 to 2020, making this the group of adults with the highest rate of e-cigarette use in 2020 (19%).

Learn more in HPIO’s fact sheet, Tobacco, Alcohol and Health Series: Health Impacts of Excessive Alcohol Use in Ohio.

 


100 million Americans have medical debt, study finds

More than 100 million people in America ― including 41% of adults ― are carrying medical debt, according to an investigation by KHN and NPR (source: “100 million people in America are saddled with health care debt,” Kaiser Health News via Ohio Capital Journal, June 21).

The investigation reveals a problem that, despite new attention from the White House and Congress, is far more pervasive than previously reported. That is because much of the debt that patients accrue is hidden as credit card balances, loans from family, or payment plans to hospitals and other medical providers.

To calculate the true extent and burden of this debt, the KHN-NPR investigation draws on a nationwide poll conducted by KFF for this project.

In the past five years, more than half of U.S. adults report they’ve gone into debt because of medical or dental bills, the KFF poll found. A quarter of adults with health care debt owe more than $5,000. And about 1 in 5 with any amount of debt said they don’t expect to ever pay it off.

Nationwide, according to the poll, Black adults are 50% more likely and Hispanic adults are 35% more likely than whites to owe money for care.


FDA effectively bans Juul e-cigarette sales in U.S.

The Food and Drug Administration (FDA) on Thursday ordered Juul to stop selling e-cigarettes on the U.S. market, a profoundly damaging blow to a once-popular company whose brand was blamed for the teenage vaping crisis (Source: “F.D.A. Orders Juul to Stop Selling E-Cigarettes,” New York Times, June 23).

The FDA order affects all of Juul’s products on the U.S. market, the overwhelming source of the company’s sales. Juul’s sleek vaping cartridges and sweet-flavored pods helped usher in an era of alternative nicotine products that became exceptionally popular among young people, and invited intense scrutiny from antismoking groups and regulators who feared they would do more harm to young people than good to former smokers.

In its ruling, the agency said that Juul had provided insufficient and conflicting data about potentially harmful chemicals that could leach out of Juul’s proprietary e-liquid pods.


Walmart expands doula services for employees to address racial disparities in birth outcomes

Walmart is expanding health care coverage for employees who want to enlist the services of a doula, a person trained to assist women during pregnancies, to address racial inequities in maternal care (Source: “Walmart expands health services to address racial inequality,” Associated Press, June 22).

After first offering doulas to employees in Georgia last year, the nation’s largest retailer said Wednesday that it will expand the same benefit to its employees in Louisiana, Indiana and Illinois.

Black women are three times more likely to die from a pregnancy-related cause than white women, largely due to differences in the quality of health care, underlying chronic conditions and structural racism, according to the Centers for Disease Control and Prevention. Employing a doula as a part of a birthing team decreases C-sections by 50%, shortens the time of labor by 25% and decreases the need for other medical interventions by more than 50%, according to the National Black Doulas Association.

Earlier this month, the Ohio House passed a bill that would provide Medicaid coverage for licensed doula services. (Source: “Doula services could soon be covered by Medicaid after racial equity bill passes Ohio House,” Ohio Capital Journal, June 9).


Graphic of the week

FastestGrowingCauses_WorkingAgeOhioans_StandAlone
Analysis released last week by HPIO found that nearly all leading causes of death among working-age Ohioans (ages 15-64) have increased since 2007, with the exception of cancer (see graphic above).

Unintentional injuries, including unintentional drug overdoses and motor vehicle crashes, increased the most from 2007 to 2021 (123%) among the leading causes. Chronic liver disease increased 74% and homicide deaths were up 62%. 

The analysis, which is compiled in a new data snapshot, “Death Trends among Working-age Ohioans,” found that the overall number of deaths among working-age Ohioans increased 51% from 2007 to 2021, from 25,885 to 39,034. If the annual number of deaths had remained constant since 2007, 58,344 fewer working-age Ohioans would have died.


Ohio set for rollout of COVID vaccines for children younger than 5

With federal approval of pediatric COVID-19 vaccines expected soon, vaccine providers in Ohio have begun placing orders for vaccines for children less than 5 years old, and the first deliveries are expected on Monday, state health officials said (Source: “Ohio ready for rollout of pediatric COVID-19 vaccines when approved, state health official says,” Cleveland.com, June 16).

“The one group that has still been waiting has been our youngest children, those less than 5 years of age and now that appears likely to change,” Ohio Department of Health director Dr. Bruce Vanderhoff said Thursday in a press briefing.

The vaccine advisory committee to the U.S. Food and Drug Administration recently voted unanimously to recommend approval of Pfizer’s application for a vaccine for those ages 6 months through 4 years old. Moderna has applied for a COVID-19 vaccine for ages 6 months through 5 years old.

Next, FDA leadership is expected to issue its approval. On Friday and Saturday, the U.S. Centers for Disease Control and Prevention advisory committee will meet to make recommendations for the vaccines’ uses. The CDC director must then approve the committee’s recommendations.


Schools slow to use federal COVID funding to improve indoor air quality

Despite billions of dollars in federal covid-relief money available to upgrade heating and air-conditioning systems and improve air quality and filtration in K-12 schools, U.S. public schools have been slow to begin projects that have the potentional to improve the overall health of students (Source: “Covid Funding Pries Open a Door to Improving Air Quality in Schools,” Kaiser Health News, June 13).

According to a report released this month from the Centers for Disease Control and Prevention, fewer than 40% of public schools had replaced or upgraded their HVAC systems since the start of the pandemic. Even fewer were using high-efficiency particulate air, or HEPA, filters in classrooms (28%), or fans to increase the effectiveness of having windows open (37%).

Both the CDC and White House have stressed indoor ventilation as a potent weapon in the battle to contain covid. And a wealth of data shows that improving ventilation in schools has benefits well beyond covid.

Good indoor air quality is associated with improvements in math and reading; greater ability to focus; fewer symptoms of asthma and respiratory disease; and less absenteeism. Nearly 1 in 13 U.S. children have asthma, which leads to more missed school days than any other chronic illness.


HPIO analysis finds spike in deaths among working-age Ohioans

WorkingAgeTrend_Graph_StandAloneOhioans between the ages of 15 and 64 are dying at a much higher rate than they were 15 years ago, according to new analysis from the Health Policy Institute of Ohio.

The analysis, which is compiled in a new data snapshot, “Death Trends among Working-age Ohioans,” found that the number of deaths among working-age Ohioans increased 51% from 2007 to 2021, from 25,885 to 39,034. If the annual number of deaths had remained constant since 2007, 58,344 fewer working-age Ohioans would have died.

“These mostly preventable deaths have a tremendous impact on Ohio families, communities and society,” according to the data snapshot. “In addition, the loss of a large number of working-age adults negatively affects Ohio’s economy and businesses.”


The increasing death rate for working-age Ohioans is part of a long-term trend, starting in the early 2000s, in which Ohio is doing worse than the U.S. overall. That trend, combined with the long-term decline in Ohio’s labor force participation rate and recent factors related to the pandemic, have made it more difficult for Ohio employers to fill open positions.

“There are many effective strategies to address addiction, promote mental health and support access to healthy food and physical activity,” all factors that could improve Ohio’s working-age death rate, according to the analysis. “Public and private partners can work together to ensure more Ohio workers have the opportunity to live a healthy and productive life.”


Ohio House approves Medicaid coverage of doulas in attempt to address racial disparities

A bill that is aiming to combat racial disparities in infant and maternal mortality rates passed the Ohio House during a session Wednesday (Source: “Doula services could soon be covered by Medicaid after racial equity bill passes Ohio House,” Ohio Capital Journal, June 9).

House Bill 142 would provide Medicaid coverage for licensed doula services.

Between 2008 and 2017, Black women died during birth about two and a half times more than white women, according to the Ohio Department of Health. Black women also have twice the amount of birth complications, which ODH data show cannot be attributed to factors such as the pregnant person’s income, education, marital status, tobacco/ alcohol use and insurance coverage.

Doulas “can save lives,” said Dorian Wingard, partner and COO of Restoring Our Own Through Transformation (ROOTT), an organization dedicated to addressing the needs of women of color. “They can prevent the death of mothers, they can prevent the death of children.”

Doula services can also result in lower rates of preterm births, as well as help save money for families, according to Wingard.

Republican state Rep. Tom Brinkman, one of the bill’s sponsors, said he convinced his fellow Republicans to vote for the bill by explaining that it could allow Ohio to save money, since doula services lead to fewer preterm births, which are expensive for the state.

“The hardest thing was to talk to my colleagues and say, ‘look, we are going to expand Medicaid, which we don’t necessarily want to do because we’re trying to restrain costs, but what it’s going to do is result in overall savings because we won’t be paying for [as many complications],” Brinkman said.


Study: 1 in 4 children not receiving regular vision screenings

A new national study found that a quarter of children are not regularly screened for vision problems (Source: “Children’s Vision Problems Often Go Undetected, Despite Calls for Regular Screening,” Kaiser Health News, June 9).

According to the National Survey of Children’s Health, in 2016-17 one in four children were not regularly screened for vision problems.

Eye exams for children are required under federal law to be covered by most private health plans and Medicaid. Vision screenings are mandated for school-age children in 40 states and the District of Columbia, and 26 states require them for preschoolers, according to the National Center for Children’s Vision and Eye Health at the nonprofit advocacy organization Prevent Blindness (Ohio requires exams for school-age children but not preschool).

Still, many children who are struggling to see clearly are being overlooked. The pandemic has only exacerbated the issue since classes moved online, and for many students in-school vision screenings are the only time they get their eyes checked. Even when campuses reopened, school nurses were so swamped with covid testing that general screenings had to be put to the side, said Kate King, president-elect of the National Association of School Nurses.

The Centers for Disease Control and Prevention estimates that more than 600,000 children and teens are blind or have a vision disorder.