Children's health

States not ready to meet mental health needs of students this fall, report finds

A report released this week from advocacy group Mental Health America found that a majority of states are not ready to address youth mental health as schools prepare to reopen for in-person learning in the fall (Source: “Analysis: Most states not ready to tackle youth mental health ahead of fall,” The Hill, July 20). 

The analysis reports that just 14 states have fully expanded Medicaid to cover mental health services in schools, and only a handful have legislation requiring mental health education. The lack of access and education make states unprepared to deal with mental health issues among children, which were exacerbated by the pandemic, the report said. 

Children of color are more likely to receive school-based mental health services than white children, so limited resources can also lead to disparities in who is getting care. And although Black and Latino children are less likely than white children to get mental health treatment for depression, they made up the largest increases in the proportion of youth experiencing suicidal ideation between 2019 and 2020, the report said.

Advocates say the coronavirus pandemic worsened an already existing mental health crisis devastating young people. The percentage of 12- to 17-year-olds who reported a past-year major depressive episode doubled over the past 10 years, according to the National Survey on Drug Use and Health. 


HPIO report summarizes maternal, infant health outcomes from Columbus housing project

The Health Policy Institute of Ohio recently completed a final report summarizing the outcome and process evaluation results of CelebrateOne's Healthy Beginnings at Home (HBAH) housing stabilization pilot program, which is designed to improve maternal and infant health outcomes for families with low incomes in the Columbus area. A nine-page executive summary and a longer final report are available. 

The report includes five key findings and 16 recommendations and policy changes to strengthen HBAH replication and improve housing and health outcomes for pregnant women and their families. Insights from the evaluation can be valuable for other programs in Ohio that aim to improve maternal and infant health through housing interventions. 

This report builds upon the following work: 


Children could face long-term education and health challenges following pandemic, experts warn

After more than a year of isolation, widespread financial insecurity and the loss of an unprecedented amount of classroom time, experts say many of the youngest Americans have fallen behind socially, academically and emotionally in ways that could harm their physical and mental health for years or even decades (Source: “Damage to Children’s Education — And Their Health — Could Last a Lifetime,” Kaiser Health News, July 1).

“This could affect a whole generation for the rest of their lives,” said Dr. Jack Shonkoff, a pediatrician and director of the Center for the Developing Child at Harvard University. “All kids will be affected. Some will get through this and be fine. They will learn from it and grow. But lots of kids are going to be in big trouble.”

Many kids will go back to school this fall without having mastered the previous year’s curriculum. Some kids have disappeared from school altogether, and educators worry that more students will drop out. Between school closures and reduced instructional time, the average U.S. child has lost the equivalent of five to nine months of learning during the pandemic, according to a report from McKinsey & Co. that was released in December.

Educational losses have been even greater for some minorities. Black and Hispanic students — whose parents are more likely to have lost jobs and whose schools were less likely to reopen for in-person instruction — missed six to 12 months of learning, according to the McKinsey report.


Maternal morbidity higher in majority-Black neighborhoods, study finds

People who live in majority-Black neighborhoods have a higher likelihood for maternal health complications, according to a study released earlier this month (Source: “Majority-Black Neighborhoods See Maternal Health Disparities,” Patient Engagement HIT, April 13, 2021).

The new data from Penn Medicine, published in Obstetrics and Gynecology, found a 2.4% increase in maternal morbidity for every 10% increase in Black residents within a given neighborhood.

Previous data has shown that maternal morbidity, or any unexpected labor outcome with major long- or short-term consequences, have a disproportionate impact on Black women compared to white women. This health disparity exists even after controlling for factors such as education level and income, prompting many health equity experts to consider the role that structural racism and implicit bias can play in health outcomes.

“This study gives us a blueprint for addressing racial disparities in health care at the neighborhood and population-level,” said co-author Lisa Levine, MD, an assistant professor of Obstetrics and Gynecology at Penn. “Investing in neighborhoods that have been historically segregated, lacked access to government services, and subjected to racism will help to improve not only severe maternal morbidity, but also a host of other health outcomes for patients.”


Feds consider adding text option to new 988 suicide hotline

Recognizing that many Americans rely on texting, U.S. regulators are weighing whether to require that phone companies allow people to text the new 988 suicide hotline (Source: “Texting option weighed for upcoming ’988′ suicide hotline,” Associated Press, April 22).

The Federal Communications Commission (FCC) last summer voted to require a new “988” number for people to call to reach a suicide-prevention hotline. Phone companies have until July 2022 to implement it. Once it’s in place, people will be able to dial 988 to seek help, similar to how 911 is used for emergencies. Currently, the National Suicide Prevention Lifeline uses a 10-digit number, 800-273-TALK (8255), which routes calls to about 170 crisis centers across the country.

Crisis counselors began responding to texts sent to the Lifeline last August, the FCC said. On Thursday, the agency voted unanimously to start a process that would also require phone companies to let people text 988. The agency noted the importance of texting for young people and those who are deaf, hard of hearing or have speech disabilities.

“While a voice hotline has its benefits, traditional telephone calls are no longer native communications for many young people. Texting is where they turn first,” said FCC Acting Chairwoman Jessica Rosenworcel in a statement. “So it’s time to make the suicide prevention hotline text accessible with 988.”


Study: Teens who try drugs, alcohol more likely to develop addiction than those who are older

Adolescents and teenagers who experiment with marijuana and prescription drugs are more likely to get hooked on them than young people who try these drugs for the first time when they are college-aged or older, according to a new analysis of federal data (Source: “Teenage Brains May Be Especially Vulnerable to Marijuana and Other Drugs,” New York Times, March 29).

The research suggests that young people may be particularly vulnerable to the intoxicating effects of certain drugs and that early exposure might prime their brains to desire them. The findings have implications for public health policymakers, who in recent years have called for increased screening and preventive measures to reverse a sharp rise in marijuana vaping among teenagers.

The new study, published in JAMA Pediatrics, focused on two age groups: adolescents between the ages of 12 and 17 and young adults aged 18 to 25. Alcohol was by far the most commonly used substance in both groups: A quarter of adolescents and 80% of young adults said they had used it. About half of young adults said they had tried cannabis or tobacco. But among adolescents, that number was smaller: Roughly 15% said they had experimented with cannabis, and 13% said they had tried tobacco.

Most troubling to the authors of the new study was how many people went on to develop a substance use disorder, indicating that their experimentation had spiraled into an addiction. The researchers found that within a year of first trying marijuana, 11% of adolescents had become addicted to it, compared to 6.4 % of young adults. Even more striking was that within three years of first trying the drug, 20% of adolescents became dependent on it, almost double the number of young adults.


HPIO fact sheet outlines link between K-12 student wellness, health equity

The Health Policy Institute of Ohio released a new fact sheet titled “K-12 Student Wellness and Health Equity,” which explores the connection between student wellness and health.

According to the fact sheet, “Research has shown that schools can positively impact academic success and educational attainment through student wellness and health improvement efforts, such as school-based health care, drug and violence prevention and social-emotional learning programs.”

The fact sheet notes:

  • Nearly one quarter of Black children in Ohio (22%) were chronically absent during the 2019-2020 school year, compared to 8% of white children in Ohio.
  • The percent of high school students in Ohio who did not graduate in four years was 3.2 times higher for students with low incomes compared to peers with higher incomes.
  • Among children in Ohio with special healthcare needs who needed care coordination, 41% did not receive needed care coordination in 2018-2019.
  • The suicide rate for youth, ages 8-17, in Appalachian counties in Ohio was 1.5 times higher than the overall youth suicide rate in 2018.

The fact sheet also includes links to existing state plans and resources that include strategies policymakers can focus on to improve K-12 student wellness.


Addressing racial disparities in infant mortality requires dismantling structural racism

Black babies in Ohio are born too early and too small — factors that contribute to dying before their first birthdays at a rate twice that of white babies (Source: “Black babies dying at alarming rate: How can their lives be saved?,” Dayton Daily News, March 14, 2021).

While disparities in income and educational attainment play a role, Black mothers with higher incomes and education are still more likely to live in disadvantaged neighborhoods, face biases from health care professionals and toxic stress from racism that erodes health on a cellular level, according to the Health Policy Institute of Ohio. Some research indicates the health impacts of that stress can be passed on.

Policymakers need to dismantle structural racism with reforms that create equitable access for communities of color to housing, jobs, education and quality, less-biased health care, say experts at HPIO. In the short-term, local groups should continue connecting minority and at-risk moms with assistance services.


HPIO fact sheet explores COVID-19 impact on ACEs

The Health Policy Institute of Ohio has released a new fact sheet, “The impact of the COVID-19 pandemic on Adverse Childhood Experiences (ACEs).”

The COVID-19 pandemic has resulted in unprecedented health, social and economic challenges for all Ohioans. These challenges are far-reaching, including loss of loved ones, unemployment, business closures, disruption to K-12 education and increased stress and social isolation.

The full extent of the impacts of the pandemic on children and youth will take years to discern. However, early indicators of childhood adversity signal the impact of the pandemic on potential challenges to Ohio’s health, well-being and economic vitality for years to come. The fact sheet includes links to recent reports that provide evidence-informed policies that can be implemented in Ohio to prevent and mitigate the impacts of ACEs and eliminate disparities.

The fact sheet is the latest in a series of HPIO publications and an online resource page to examine the impact of adverse childhood experiences (ACEs) in Ohio. Other publications include:


Pandemic could cause more childhood lead poisoning, CDC says

Lead screenings for children plummeted last spring, and stay-at-home orders may have increased household exposure to the toxic metal (Source: “More Childhood Lead Poisoning Is a Side Effect of Covid Lockdowns,” New York Times, March 11).

Over the past half-century, public health officials have made enormous progress in protecting American children from lead poisoning and the irreversible neurological damage it can cause. Since the 1970s, the percentage of children with high levels of lead in their blood has plummeted.

But in 2020, when Covid-19 cases spiked, lockdowns and day care closures confined young children to their homes, where lead exposure can be particularly high. The growing national emergency also delayed lead-removal efforts and disrupted routine childhood lead screenings, leaving health officials unable to identify and treat many children living in lead-laden homes.

Last month, the Centers for Disease Control and Prevention estimated that in the early months of the pandemic, roughly 10,000 children with elevated levels of lead in their blood may have gone undetected.

There is no safe level of exposure to lead, which can disrupt neurological and cognitive development, causing learning disabilities, behavioral problems and developmental delays.