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September 2022

Graphic of the week

SuicideTrend_Demographics_StandAloneGraphic
At the conclusion of Suicide Prevention Awareness Month, new analysis from the Health Policy Institute of Ohio details the changing demographic trends in suicide deaths in Ohio (as illustrated in the graphic above).

According to data from the Ohio Public Health Data Warehouse, between 2007 and 2021 (the most-recent year in which data is available), suicide deaths increased for both male and female Ohioans, with a greater increase among males. Suicides among Black Ohioans have increased 56% over the past 14 years, compared to a 34% increase for white Ohioans. In terms of age groups, Ohioans ages 25-64 remain the most likely to die by suicide, although rates have increased for all ages since 2007.

Earlier this month, HPIO released a graphic illustrating how, between 2007 and 2021, the rate of suicide deaths in Ohio that involved a firearm increased by more than 50% and how, in 2021, suicides involving a firearm accounted for more than all other methods combined.

Suicide is preventable and the state’s 2020-2022 Suicide Prevention Plan includes evidence-informed strategies that both public- and private-sector leaders can implement to address the issue.

If you or someone you know is experiencing emotional distress or a suicidal crisis, please call the 988 Suicide and Crisis Lifeline, the Trans Lifeline at 877-565-8860 or the Trevor Project at 866-488-7386. If you don’t like talking on the phone, consider using the Crisis Text Line at www.crisistextline.org or text “4HOPE” to 741-741.


Four of five pregnancy-related deaths are preventable, CDC finds

Eighty percent of pregnancy-related deaths, including those caused by opioid overdose, excessive bleeding, heart problems and infections, are preventable, according to a new federal report (Source: “Majority of pregnancy-related deaths can be prevented, CDC says,” WKSU radio via WOSU, Sept. 27).

According to the report from the Centers for Disease Control and Prevention, the leading underlying cause of death varied by race and ethnicity. Cardiac and coronary conditions were the leading underlying cause of pregnancy-related deaths among non-Hispanic Black people, mental health conditions were the leading underlying cause for Hispanic and non-Hispanic White people, and hemorrhage was the leading underlying cause for non-Hispanic Asian people.

Earlier this year, the CDC released a report highlighting evidence-informed state strategies for preventing pregnancy-related deaths.


Multistate compact allows out-of-state doctors smoother path to license in Ohio

As the health care sector faces ongoing staffing challenges, some hope a new tool can attract more health professionals to Ohio (Source: “Out-of-state doctors can now be more easily licensed in Ohio,” Columbus Dispatch, Sept. 28).

Last year, Ohio became the 35th state to join the Interstate Medical Licensure Compact, which allows physicians from one state to get another state's license without having to redo the entire licensure process that a first-time doctor would have to go through.

At least 175 out-of-state doctors have applied for a license to practice in Ohio through the compact, according to the State Medical Board of Ohio. About 141 of those have been granted since the board began accepting applications in early August. There are a total of 95,668 active medical licenses in Ohio as of June.

Around 130 Ohio doctors have also taken steps to get licensed in another state through the compact, per the medical board.

Ohio recently joined similar multi-state compacts for nurses, counselors and physical therapists as well.


Graphic of the week

HomeVisitingUnmetNeed_StandaloneGraphic_09.23.2022

A critical aspect of preventing adverse childhood experiences (ACEs) is ensuring that children have a strong start in life and home visiting is a key prevention strategy.

According to an estimate from the Ohio Department of Health, more than 83% of Ohioans who need home visiting are not enrolled in a program identified as “evidence-based” by the U.S. Department of Health and Human Services Home Visiting Evidence of Effectiveness (HomVEE) review (as illustrated in the graphic above).

Analysis from HPIO has found that home visiting programs are an evidence-based, multi-generational strategy proven to prevent and mitigate the impacts of ACEs. Trained providers (home visitors) visit expectant parents and families with infants and young children, providing one-on-one support for healthy parent and child development, early education and family needs. Participation in home visiting programs is typically voluntary.

These findings will be included in a new policy brief that HPIO plans to release next month as part of its Ohio ACEs Impact project.


U.S. Preventive Services Task Force recommends anxiety screenings for all adults under 65

A panel of medical experts on Tuesday recommended for the first time that doctors screen all adult patients under 65 for anxiety, guidance that highlights the extraordinary stress levels that have plagued the United States since the start of the pandemic (Source: “Health Panel Recommends Anxiety Screening for All Adults Under 65,” New York Times, Sept. 20).

The advisory group, called the U.S. Preventive Services Task Force, said the guidance was intended to help prevent mental health disorders from going undetected and untreated for years or even decades. It made a similar recommendation for children and teenagers earlier this year.

The panel, appointed by an arm of the federal Department of Health and Human Services, has been preparing the guidance since before the pandemic. The recommendations come at a time of “critical need,” said Lori Pbert, a clinical psychologist and professor at the University of Massachusetts Chan Medical School, who serves on the task force. Americans have been reporting outsize anxiety levels in response to a confluence of stressors, including inflation and crime rates, fear of illness and loss of loved ones from Covid-19.


HPIO seeking candidates for program evaluation and policy positions

The Health Policy Institute of Ohio is seeking applicants for the following full-time positions:

All three positions would be key members of a highly collaborative team and would support HPIO’s mission to advance evidence-informed policies that improve health, advance equity, and lead to sustainable healthcare spending.

Information about specific responsibilities and qualifications for the positions, as well as how to apply, are posted on HPIO’s website.


Uninsured rate for children dropped during pandemic, federal data shows

The rate of children without health insurance declined during the COVID-19 pandemic, likely the result of a provision passed by Congress that barred states from dropping anyone from Medicaid during the public health emergency (Source: “More Children Have Gained Health Insurance During Pandemic,” Pew Stateline, Sept. 21).

According to an analysis of new U.S. Census Bureau data by Georgetown University’s Center for Children and Families, the child uninsurance rate in 2021 was 5.4%, compared with 5.7% in 2019, the year before the pandemic took hold.

The center described that change as a “small but significant decline,” equating to 200,000 more children with health insurance in 2021 than in 2019. Overall, about 4.2 million children were uninsured in 2021, according to the analysis.

The data comes from the Census Bureau’s American Community Survey, which provides annual estimates of income, education, employment, health insurance coverage and housing costs and conditions for U.S. residents. The Census Bureau did not release standard results in 2020 because of difficulties in data collection in the pandemic’s first year.

The Georgetown analysis speculated that the downward trend in child uninsurance was the result of Congress’s provision in the Families First Coronavirus Response Act, passed in March 2020, that prohibited states from involuntarily dropping anyone from Medicaid, the health plan covering lower-income Americans.


Firearms most common method of suicide in Ohio, HPIO analysis finds

SuicideMethodsTrend_StandaloneGraphic_09.16.2022

Firearms are the most common method of suicide in Ohio, according to analysis from the Health Policy Institute of Ohio (as illustrated in the graphic above).

Between 2007 and 2021 (the most-recent year in which data is available), the rate of suicide deaths in Ohio that involved a firearm increased by more than 50%. In 2021, suicides involving a firearm accounted for more deaths than all other means combined.

Suicide is preventable and the state’s 2020-2022 Suicide Prevention Plan include evidence-informed strategies that both public- and private-sector leaders can implement to address the issue.

September is Suicide Prevention Awareness Month. If you or someone you know is experiencing emotional distress or a suicidal crisis, please call the 988 Suicide and Crisis Lifeline, the Trans Lifeline at 877-565-8860 or the Trevor Project at 866-488-7386. If you don’t like talking on the phone, consider using the Crisis Text Line at www.crisistextline.org or text “4HOPE” to 741-741.


Federal report finds telehealth fraud during pandemic cost Medicare $128 million

The federal government eased telehealth requirements at the beginning of the COVID-19 pandemic so more Americans could get remote care with fewer obstacles.
 
A report released last week by federal government investigators found that nearly $128 million in telehealth claims submitted during the first year of the pandemic may have been fraudulent (Source: “'Guardrails' needed? Telehealth fraud cost Medicare $128M in first year of COVID pandemic, feds say,” USA Today, Sept. 11).
 
Investigators said less than 1% of the 742,000 Medicare-certified doctors and other providers of telehealth services submitted roughly a half million problematic claims. Yet the billings are concerning enough that government investigators urged the Biden administration to tighten oversight to ensure millions of Americans can access remote care while safeguarding taxpayer dollars.
 
Before 2020, Medicare largely restricted telehealth to people who accessed medical care via video and audio connections set up in rural clinics. Amid the pandemic, Medicare allowed recipients in cities and suburbs to get care remotely, often from their home, via a phone call or a video chat. Medicare also more than doubled the types of services eligible for reimbursement to make it easier for people to get care without the risk of COVID-19 exposure during a visit to a clinic or hospital.


First month of new 988 crisis line leads to jump in calls, texts

The new 988 Suicide and Crisis Lifeline is already reaching more Americans in distress – and connecting them to help faster — than the old 10-digit suicide prevention line it replaced July 16 (Source: “New 988 mental health crisis line sees jump in calls and texts during first month,” NPR, Sept. 10).

New data released last week by the U.S. Department of Health and Human Services show that in August – the first full month that 988 was operational — the Lifeline saw a 45% increase in overall volume of calls, texts and chats compared to August 2021.
 
The number of calls answered went up from 141,400 to 216,000 – a more than 50% increase, according to HHS officials. And texts answered went up by a whopping 1000% – from 3,400 in August, 2021, to 39,900 in August of this year. The number of chats on the Lifeline's website that were answered saw a 195% increase.
 
While the 988 Lifeline is accessible nationally, with a national network of call centers, it essentially functions as a state-run system. And states vary vastly in how much they have invested in the former 10-digit Lifeline and associated services. According to a recent analysis by the National Institute of Mental Illness, very few states have passed legislation to supplement the recent federal funds into 988 (Ohio has partial 988 implementation legislation pending).