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October 2022

November 2022

Graphic of the week

CJH_Pretrial_StandaloneGraphic_Fig3
In September, HPIO released a policy brief that explores the impact of pretrial incarceration and the money bail system on the health, safety and well-being of Ohioans and their communities. It is the latest in a series of HPIO publications on the connections between criminal justice and health.

Analysis from 2019 found the number of Ohioans incarcerated pretrial has increased since 2016, and 61% of people in local jails have not been convicted of a crime (outlined in graphic above).

The issue of how bail is determined in now before Ohio voters, who next week will decide on Issue 1. If passed, the issue would add language to the Ohio Constitution requiring Ohio courts to consider public safety when setting bail amounts, including the seriousness of the offense, a person’s criminal record, the likelihood a person will return to court and any other factor that the Ohio General Assembly may prescribe.

HPIO created an online resource page to make information on Ohio Issue 1 easily accessible. The resource page includes background on the initiative, information on the connections between criminal justice and health, research and analysis of Issue 1 and media coverage of the issue. The page also includes position statements from both proponents and opponents of the initiative.


CDC softens guidelines for opioid prescribing

The Centers for Disease Control and Prevention on Thursday softened its guidelines for U.S. doctors prescribing oxycodone and other opioid painkillers (Source: “US agency softens opioid prescribing guidelines for doctors,” Associated Press, Nov. 14).

The new CDC recommendations are an update to 2016 guidelines that added momentum to a decline in opioid painkiller prescriptions.

The previous guidance succeeded in reducing inappropriate and dangerous prescribing, some experts say. But they also were seen as a barrier to care, with some pharmacists refusing to fill prescriptions as doctors wrote them.

The new guidelines are designed to ensure that patients get compassionate and safe pain care, CDC officials said.

A draft released in February received 5,500 public comments. Some modifications were made, but several main changes stayed in place, including no longer suggesting limiting opioid treatment for acute pain to three days; dropping the specific recommendation that doctors avoid increasing dosage to a level equivalent to 90 milligrams of morphine per day; and urging doctors to not abruptly halt treatment for patients receiving higher doses of opioids unless there are indications of life-threatening danger.


1 in 8 working-age deaths attributed to alcohol use, CDC study finds

An estimated one in eight deaths of Americans ages 20 to 64 in the years 2015-19 was the result of injuries or illness caused by excessive alcohol use, according to a new study from the Centers for Disease Control and Prevention (Source: “Alcohol Deaths Claim Lives of Working-Age Americans,” New York Times, Nov. 1).

The study was published on Tuesday in the journal JAMA Network Open, assessed the effects of alcohol on people of working age, who accounted for nearly two-thirds of the country’s annual average of 140,000 alcohol-related deaths.

The rates of excessive alcohol use and related deaths have most likely climbed since the period of the CDC analysis. After the onset of the pandemic, a variety of data showed Americans drank more frequently, and deaths due to a narrower set of causes attributable to alcohol rose 25% in 2020 over the previous year.

Alcohol is a leading cause of preventable death in the United States, but it is often overshadowed by tobacco or opiates. And its effects on Americans’ health has been growing. Nearly a decade ago, a similar study found one in 10 deaths of working-age people was due to drinking, although researchers have changed the methodology, so a perfect apples-to-apples comparison is not possible.

This summer, HPIO released a Data Snapshot on death trends among working-age Ohioans.


Study finds U.S. political divides may explain reduced racial disparities in COVID deaths

New evidence suggests that the shrinking gap in U.S. COVID-19 racial death disparities is being driven by political division and increasing total deaths — mostly among white people — rather than by decreasing deaths among Black Americans (Source: “Study: US political divide may help explain shrinking racial COVID death gap,” Center for Infectious Disease Research and Policy, University of Minnesota, Nov. 1).

According to a new University of Wisconsin and UCLA study published in PLOS One, Black people still bear a larger COVID-19 death burden than white people, despite a relatively younger population, but suggest that a wider political chasm likely drove more deaths in the latter group as the pandemic evolved.

Researchers examined COVID-19 death disparities since the early months of the pandemic when Black Americans had far higher death rates than their white peers.

Black and Hispanic Americans are much more likely to work in jobs that must be done in person, leading to much higher exposure to the virus. "That didn't change as the racial differences in the mortality rate shifted," lead author Adeline Lo said. "Other factors — like geographical distribution, healthcare access, income equality — that contributed to the initial higher rate of Black deaths didn't go away either."

What did change was that levels of concern about COVID and adherence to protective public health measures (eg, lockdowns, closures, prohibitions on gathering) widened along political lines, with increasing deaths among white Americans. After initially issuing similar state mandates in the first few weeks of the pandemic, within one month, Republican-controlled states began lifting public health restrictions, lessening virus containment and leading white deaths to surpass those of Black people from April to October 2020.