Ohio Health Policy News

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.

Children experienced learning deficits during the Covid pandemic that amounted to about one-third of a school year’s worth of knowledge and skills, according to a new global analysis, and had not recovered from those losses more than two years later (Source: “Students Lost One-Third of a School Year to Pandemic, Study Finds,” New York Times, Jan. 30).

Learning delays and regressions were most severe in developing countries and among students from low-income backgrounds, researchers said, worsening existing disparities and threatening to follow children into higher education and the work force.

The analysis, published Monday in the journal Nature Human Behavior and drawing on data from 15 countries, provided the most comprehensive account to date of the academic hardships wrought by the pandemic. The findings suggest that the challenges of remote learning — coupled with other stressors that plagued children and families throughout the pandemic — were not rectified when school doors reopened.

States that expanded Medicaid under the Affordable Care Act (ACA) saw a 17% drop in hospitalizations among women during the first 60 days postpartum, new research shows (Source: “Medicaid expansion linked with fewer postpartum hospitalizations: research,” The Hill, Jan. 11).

According to a study published in the journal Health Affairs, states with expanded Medicaid coverage for residents with lower incomes saw a 17% drop in post-partum hospitalization within the first 60 days.

Expansion states included in the study were Iowa, Maryland, New Mexico and Washington. Rates were compared with non-expansion states Florida, Georgia, Mississippi and Utah.

Currently, 40 states (including Ohio) and Washington D.C., have expanded Medicaid under the ACA. Much of the Southeast region of the country continues to hold out on adoption, along with Texas, Kansas, Wyoming and Wisconsin.

The U.S. Centers for Disease Control and Prevention (CDC) last week warned a surge of diabetes among young Americans is on the horizon, saying diagnoses for the population are expected to soar in the coming decades (Source: “CDC warns of future surge in diabetes among young Americans,” The Hill, Dec. 29).

The CDC cited a new study published in the journal Diabetes Care, which models a nearly 700% increase of Type 2 diabetes diagnoses in Americans under the age of 20 through 2060, if an expected upward trend continues.

Type 1 diabetes could also increase 65% among young Americans in the next 40 years following the same trend.

Millions of Americans of all ages have diabetes, which is the seventh leading cause of death in the U.S. and extremely costly for those living with it. Diabetes is not curable.

Based on the expected surge in the new study, about 526,000 young Americans could have both types of diabetes by 2060, compared to a total of 213,000 for the population in 2017.

In October, HPIO released a publication detailing the state’s progress in taking action on four key evidence-informed strategies to prevent adverse childhood experiences (ACEs): Early childhood education, early childhood home visiting, medical-legal partnerships and family income supports.

Among the findings in the brief are that the need for home visiting services is greater among groups of Ohioans most at risk for childhood adversity (as illustrated in the graphic above). For example, while 38.2% of Hispanic children, ages 0-5, in Ohio were exposed to ACEs, only 8.7% of the pregnant women and primary caregivers receiving ODH- and ODM-funded home visiting services were Hispanic in Federal fiscal year 2021.

HPIO is hosting an online forum from 11 a.m. to 1 p.m. Dec. 13 to highlight the four key strategies from the brief. Speakers at the forum will include:

• Marie Curry, Managing Attorney, Community Legal Aid
• Dr. Robert Kahn, VP for Health Equity Strategy and the Fisher Child Health Equity Center, Cincinnati Children’s Hospital Medical Center
• Robyn Lutz, Administrative Nurse Manager Labor and Delivery, OhioHealth Grant Medical Center
• Jeanne Wickliffe, Program Manager Maternal Infant Home Visiting Program, The Center for Family Safety and Healing at Nationwide Children’s Hospital
• And more to be announced!

A new publication from the Health Policy Institute of Ohio details the state’s progress in taking action on four key evidence-informed strategies to prevent adverse childhood experiences (ACEs): Early childhood education, early childhood home visiting, medical-legal partnerships and family income supports.
 
“Ensuring a strong start for children and strengthening economic supports for families both contribute to making sure that every child in Ohio has the opportunity to reach their full health potential” the publication states.
 
Among the findings in the brief are that the need for home visiting services is greater among groups of Ohioans most at risk for childhood adversity (as illustrated in the graphic above). For example, while 38.2% of Hispanic children, ages 0-5, in Ohio were exposed to ACEs, only 8.7% of the pregnant women and primary caregivers receiving ODH- and ODM-funded home visiting services were Hispanic in Federal fiscal year 2021.
 
The publication released today is the first of three examining opportunities to prevent ACEs in Ohio. ACEs are potentially traumatic events that occur during childhood and can generally be grouped into three categories: abuse, household challenges and neglect. 
 
In 2020 and 2021, HPIO released a series of policy briefs on the health and economic impacts of ACEs and elevated 12 evidence-based, cost-effective strategies (programs, policies and practices) that prevent ACEs before they happen and improve health. HPIO’s new series is focused on analyzing the implementation status of these strategies in Ohio.
 
HPIO’s previous research found that Ohio can eliminate more than $10 billion in annual healthcare and related spending attributable to ACEs exposure.

The latest government study on teen vaping suggests there’s been little progress in keeping e-cigarettes out of the hands of high school students (Source: “New survey suggests little progress against U.S. teen vaping,” Associated Press, Oct. 7).
 
The new data from the Centers for Disease Control and Prevention seems to show more teens are vaping, with 14% saying they had done so recently, according to survey results released Thursday. In last year’s survey, about 11% said they had vaped recently.
 
But experts cautioned that a change in the survey makes it difficult to compare the two: This year, a much higher percentage of participants took the survey in schools, and vaping tends to be reported more in schools than in homes.
 
Despite its persistence, vaping appears to be less popular than it was: In 2019, 28% of high schoolers said they had recently vaped.

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.

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.

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.