Ohio Health Policy News

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.

A study released this week found that an often overlooked burden for patients seeking cancer treatment is the ongoing cost of parking (Source: “Cancer patients endure an overlooked financial burden: hospital parking fees,” Stat News, Dec. 7).

A new paper in the Journal of Medical Imaging and Radiation Sciences found that the charges are actually eating into patients’ financial well-being, particularly for people who have cancer and have to make frequent visits to the hospital for treatments like radiation and chemotherapy.

Other research in the U.S. has similarly found hospital parking prices contribute to what’s known as “financial toxicity” — the idea that having a serious illness like cancer is stressful and costly on its own, and only made worse when people may have to cope with other expenses like travel while potentially missing work and losing income.

Many community hospitals in rural and suburban areas of the U.S. don’t charge anything for parking. But if people need or want more specialized care in a larger city, where parking is more scarce, they often will encounter some kind of parking fee. And if a loved one is stuck in the hospital for days, weeks, or months, hospitals can saddle families and visitors with hundreds if not thousands of dollars in parking costs.

The Food and Drug Administration (FDA) on Thursday announced a plan to ban sales of menthol-flavored cigarettes in the United States, a measure many public health experts hailed as the government’s most meaningful action in more than a decade of tobacco control efforts (Source: “F.D.A. Moves to Ban Sales of Menthol Cigarettes,” New York Times, April 28).
 
The ban would most likely have the deepest impact on Black smokers, nearly 85% of whom use menthol cigarettes, compared with 29% of white smokers, according to a government survey. If effective in reducing smoking, the ban could significantly diminish the burden of chronic disease and limit the number of lives cut short by one of the most hazardous legal products available.
 
Public health experts say menthol cigarettes have been heavily marketed to Black people, to devastating effect: African American men have the highest rates of lung cancer in America, according to the Centers for Disease Control and Prevention.

A new study has found that social determinants such as age, sex, marital status, and education level were associated with risk of cardiovascular disease for American Africans (Source: “SDOH Drive Cardiovascular Mortality Disparities for African Americans,” Patient Engagement HIT, Jan. 6).

The study from Mayo Clinic Proceedings found a higher occurrence of cardiovascular disease and associated clinical and social determinant risk factors than past studies, suggesting these issues are worse than previously understood.

The study analyzed 644 African American individuals from Minnesota, using data gathered from May to December 2019 to examine the association between age- and sex-adjusted cardiovascular disease risk factors, sociodemographic characteristics and health beliefs. 

A new report offers hope on the lung cancer front: Overall cancer rates are being driven down because patients are being diagnosed at an earlier stage in their disease and living longer due to better access to care, higher screening rates and improved treatments (Source: “Progress on Lung Cancer Drives Overall Decline in U.S. Cancer Deaths,” HealthDay News, Jan. 12).

Still, lung cancer remains the leading cause of cancer death in the country, according to the annual Cancer Statistics report conducted by the American Cancer Society and released Wednesday.

In 2018, 28% of lung cancers were detected at a localized stage, compared with 17% in 2004. Nearly one-third (31%) of lung patients now survive three years past diagnosis, compared to 21% a decade ago.

But lung cancer still causes 350 deaths a day -- more than breast, prostate and pancreatic cancers combined -- and is responsible for the most cancer deaths by far, according to the report.

The Ohio Senate passed a bill this week that would expand medical cannabis conditions to migraines, autism spectrum disorder, opioid use disorder and any condition that could “reasonably be expected to be relieved” from the drug (Source: “Ohio Senate passes bill expanding medical marijuana to any patient whose symptoms ‘may reasonably be expected to be relieved’ by drug,” Cleveland.com, Dec. 15).

Senate Bill 261 passed 26 to 5. It now heads to the Ohio House.

In addition to broadly expanding medical conditions, the bill would change other aspects of the Ohio medical marijuana program. The bill would expand the forms of medical marijuana that can be legally sold to include pills, capsules and suppositories, oral pouches, oral strips, oral or topical sprays, salves and inhalers. Smoking marijuana would still be prohibited but vaping would continue to be allowed.

The Health Policy Institute of Ohio recently released a brief, Alcohol, Tobacco and Health: Implications for Future Cannabis Policy, that lays the groundwork for future cannabis policy discussions by applying lessons learned from tobacco and alcohol policy to upcoming decisions about recreational cannabis legalization.

The U.S. saw remarkable increases in the death rates for heart disease, diabetes and some other common killers in 2020, and experts believe a big reason may be that people stayed away from the hospital for fear of catching COVID-19 (Source: “US deaths from heart disease and diabetes climbed amid COVID,” Associated Press, June 9).

The death rates — posted online this week by federal health authorities — add to the growing body of evidence that the number of lives lost directly or indirectly to the coronavirus in the U.S. is far greater than the officially reported COVID-19 death toll of nearly 600,000 in 2020-21.

Earlier this year, the Centers for Disease Control and Prevention reported that nearly 3.4 million Americans died in 2020, an all-time record. Of those deaths, more than 345,000 were directly attributed to COVID-19. The CDC also provided the numbers of deaths for some of the leading causes of mortality, including the nation’s top two killers, heart disease and cancer.

Earlier research done by demographer Kenneth Johnson at the University of New Hampshire found that an unprecedented 25 states, including Ohio, saw more deaths than births overall last year (most states typically have more births than deaths).

In rural America, more people die from chronic health conditions and substance abuse than in suburbs and cities, and the gap is widening.

A new study has found that the difference in rural and urban death rates tripled over the past 20 years mostly due to deaths among middle-aged white men and women (Source: “Study: Death rates from chronic conditions, 'deaths of despair' rising in rural U.S.,” United Press International, June 9).

This gap is partly due to access to care, but other factors also contribute, said lead researcher Dr. Haider Warraich, a cardiologist at Brigham and Women's Hospital in Boston and the VA Boston Healthcare System. In terms of access, rural areas have seen a wave of hospital closures driven largely by economics, especially during the COVID-19 pandemic, he said.

"But it's hard to disconnect health from other factors in our societies," Warraich said. "I think it's linked to the overall economic outlook of rural America as well, and also, health behaviors that contribute to poor health, such as poor nutrition, lack of exercise, smoking, substance use, etc."

For the study, which was published in the Journal of the American Medical Association, Warraich and his colleagues used federal government health data for 1999 through 2019. They found that age-adjusted death rates dropped in both rural and urban areas over that period. But the gap widened dramatically as death rates rose among white rural residents between 25 and 64.

Over the study period, rural death rates increased 12% for that group. Although death rates dropped among rural Black residents, they still had a higher death rate than all other groups in both rural and urban areas, researchers noted.

More than 40% of Americans live with unhealthy air, with certain cities and types of Americans far more prone to be affected, according to a new national study (Source: “More than 40% in U.S. live in cities with unhealthy air, study says,” United Press International, April 21).

The American Lung Association's annual "State of the Air" report, which was released this week, found that people of color are 61% more likely to live in a county with unhealthy air than are white people and three times more likely to live in a county with failing air-quality grades across the board.

Moreover, the report says climate change continues to worsen air pollution in much of the country. Research also shows that air pollution can make COVID-19 worse, the authors pointed out.

Experts are expressing concern that a reduction in cancer screenings over the past year will soon result in an increase in advanced cases (Source: “Advanced Cancers Are Emerging, Doctors Warn, Citing Pandemic Drop in Screenings,” New York Times, March 17).

Months of lockdowns and waves of surging COVID-19 cases throughout last year shuttered or reduced hours at clinics and cancer-testing labs, resulting in steep declines in the number of screenings, including for breast and colorectal cancers, experts have said.

Numerous studies showed that the number of patients screened or given a diagnosis of cancer fell during the early months of the pandemic. By mid-June, the rate of screenings for breast, colon and cervical cancers were still 29% to 36% lower than their prepandemic levels, according to an analysis of data by the Epic Health Research Network. Hundreds of thousands fewer screenings were performed last year than in 2019, according to the network data.

While it is too early to assess the full impact of the delays in screenings, many cancer specialists say they are concerned that patients are coming in with more severe disease.

“There’s no question in practice that we are seeing patients with more advanced breast cancer and colorectal cancer,” said Dr. Lucio N. Gordan, the president of the Florida Cancer Specialists & Research Institute, one of the nation’s largest independent oncology groups.