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March 2023

HPIO brief offers strategies for reducing social drivers of infant mortality in Ohio

The Health Policy Institute of Ohio has released a new policy brief, Social Drivers of Infant Mortality: Recommendations for Action and Accountability in Ohio, that builds upon recommendations first included in a report the Institute completed 5 years ago.
For many years, policymakers and community leaders across Ohio have worked to reduce high rates of infant mortality. Decisionmakers have explored this issue through multiple advisory committees, collaborative efforts, investments, legislation and other policy changes. For example, the Ohio General Assembly passed Senate Bill 322 in 2017, which adopted recommendations from the Ohio Commission on Infant Mortality’s 2016 report and required the creation of the 2017 Social Drivers of Infant Mortality (SDOIM) report: A New Approach to Reduce Infant Mortality and Achieve Equity, which was completed by HPIO under contract with the Ohio Legislative Service Commission.

Despite the efforts of many in both the public and private sectors, progress since 2011 has been minimal and uneven (as illustrated in the graphic above), and Ohio’s infant mortality rate remains higher than most other states.

Infant mortality prevention efforts have largely focused on public health and healthcare interventions for pregnant women, such as safe sleep education and prenatal care access. While these efforts have likely contributed to the overall reduction in infant mortality, healthcare services alone are not enough to close gaps in birth outcomes in Ohio.

Improvements in factors beyond access to care are needed to reinvigorate Ohio’s stalled progress on infant mortality reduction.

The new HPIO report prioritizes specific and actionable steps leaders can take to create change in five areas: Housing, transportation, education, employment and racism.

States consider laws to combat suicides by gun

As lawmakers and mental health advocates wrestle with how to stop suicides by firearm, some are looking to a novel idea at work in a handful of states: Register yourself as a suicide risk so you can’t buy a gun on a whim (Source: “To Prevent Gun Suicide, States Consider Allowing People to Deny Themselves a Gun,” Pew Stateline, March 16).

Mass shootings often get more attention, but suicide deaths by firearm represents a majority of firearm deaths in most states. In the United States, suicides make up 57% of all gun deaths, or about 117,000 out of 206,000 firearm deaths in the past five years, according to federal Centers for Disease Control and Prevention preliminary data

Since 2018, UtahVirginia and Washington state have passed laws creating registries for those who think they could become suicidal and don’t want the ability to buy a gun on a whim. Maryland lawmakers are considering such legislation this spring.

U.S. Reps. Pramila Jayapal, a Washington state Democrat, and John Curtis, a Utah Republican, sponsored federal legislation last year, but it did not advance beyond the House Judiciary Committee. Jayapal plans to reintroduce the bill during this congressional session

Healthcare worker shortages remain challenging three years after pandemic began

Three years after the COVID-19 pandemic began, the healthcare field in Ohio and across the country continues to be challenged by worker shortages, which threaten the quality of care (Source: “3 years since COVID got here, health care remains changed,” Dayton Daily News, March 12).

Even prior to the pandemic, shortages of medical staff were linked to the quality of patient of care, medical errors and increased risks of dying, according to the American Association of Colleges of Nursing.

In response to the shortage, Ohio hospitals are working to address employee burnout, attract new talent and fill gaps by other means, including innovation with telehealth options. The American Hospital Association said their members also contract with outside agencies to fill gaps, but they say prices with those agencies have risen dramatically from what they were prior to the pandemic.

CDC: Maternal death rate spiked 40% in 2021

Maternal death rates surged by nearly 40% during the second year of the pandemic, widening disparities as Black women again faced alarmingly high, disproportionate rates, a new federal analysis shows (Source: “The rate of women dying in childbirth surged by 40%. These deaths are preventable.,” Columbus Dispatch, March 16).  

In 2021, there were about 33 maternal deaths per 100,000 live births – a 38% increase from the year before, according to the report released Thursday from the National Center for Health Statistics at the Centers for Disease Control and Prevention.

Experts say COVID-19 likely contributed to the increases, but that the sobering rates continue to reveal deep flaws in health systems, such as structural racism, implicit bias and communities losing access to care. 

Most maternal deaths – which happen during pregnancy, labor or within 42 days of birth, per the CDC – are preventable. The United States' maternal death rate continues to be higher than other wealthy, developed countries, and the new data shows a roughly 60% increase in overall rates in 2021 from 2019, the year before the start of the pandemic.

Graphic of the week


Analysis from HPIO found that there are differences in air pollution exposure from county to county, as illustrated in the graphic above. Hamilton and Cuyahoga counties have the highest levels of PM2.5 air pollution in the state, with high levels also reported across western and central Ohio.

The finding was included in HPIO’s recently released Health Value Dashboard policy brief titled “A closer look at outdoor air pollution and health.”

Clean air and water, safe places to walk outside and access to healthy food are examples of conditions in the physical environment that affect the health and well-being of Ohioans. Outdoor air quality is included in the 2021 Health Value Dashboard™, where Ohio ranked 46th, meaning that most other states have cleaner outdoor air.

HPIO is planning to release the 2023 Health Value Dashboard in early May.

State launches new online overdose dashboard

Ohio has launched a new website with data on drug overdoses in all 88 counties (Source: “New state dashboard helps communities better understand factors behind opioid overdoses,” Ideastream, March 9).

The state dashboard shows that nearly 1,500 people died in 2021 across the state from overdoses that included cocaine.

Local Ohio organizations working in drug addiction have often found it challenging to respond without reliable data about overdoses in their communities – especially as fentanyl exploded into the drug supply, said Ohio State University College of Social Work Professor Bridget Freisthler.

The National Institutes of Health-funded dashboard is part of an effort to learn what local tools are most effective in combating opioid misuse.

74% of East Palestine residents report headaches following train derailment

Almost three in four East Palestine residents who completed a health assessment after the Feb. 3 Norfolk Southern derailment reported experiencing headaches, Gov. Mike DeWine’s office reported last week (Source: “East Palestine update: 74% of residents reported experiencing headaches, according to health surveys,”, March 3).

Late Friday afternoon, the governor’s office released the results of the survey done by federal, state and local officials. Residents completed an “after chemical exposure” community survey – with 168 questionnaires completed – aimed at providing information on how people may be impacted.

The other most common symptoms among East Palestine residents include anxiety (64%), coughing (61%), fatigue/tiredness (58%) and irritation, pain or burning of skin (52%).

Residents answered the surveys when they visited the East Palestine Health Assessment Clinic, which is run by the Ohio Department of Health and the Columbiana County Health District, as well as during door-to-door visits by U.S. Department of Health and Human Services representatives.

Study: Nearly half of child poisoning deaths caused by opioids

A review of poisonings among children five and younger found that opioids contributed to nearly half of deaths from 2005 to 2018, largely from accidental overdoses, according to new research (Source: “Opioids Are Leading Cause of Child Poisoning Deaths, Study Finds,” New York Times, March 8).

The study, published on Wednesday in the journal Pediatrics, analyzed 731 poisoning-related deaths that occurred from 2005 to 2018 across 40 states. The authors found that opioids, a class of synthetic drugs that includes prescribed pain relievers but also illegal narcotics such as heroin and fentanyl, contributed to nearly half, or 47%, of those deaths.

About 41% of the poisoning deaths resulted from accidental overdoses, according to the study, which described 18% as “deliberate” poisonings.

Graphic of the week


New data analysis from the Health Policy Institute of Ohio found that while Ohio’s rate of traffic deaths has remained below the U.S. over the past decade, fatalities related to drivers operating a motor vehicle under the influence of alcohol or drugs have increased 78% in the state from 2017 to 2021 (as illustrated in the graphic above).

The data also shows a spike in fatalities in both Ohio and the U.S. in 2020, coinciding with the COVID-19 pandemic. According to preliminary research by the federal Department of Transportation’s National Highway Traffic Safety Administration (NHTSA), people who continued to drive during the pandemic may have engaged in riskier behavior including speeding, failure to wear seat belts and driving under the influence of alcohol or other drugs.

Ohio ranked 15th in the nation (out of the 50 states and D.C.) in motor vehicle deaths in HPIO’s 2021 Health Value Dashboard. HPIO plans to release its 2023 Dashboard in May.