Chronic disease management

Graphic of the week


New data analysis by the Health Policy Institute of Ohio shows that more Ohioans report having high blood pressure than people in other states (as illustrated in the graphic above).
The analysis also found that hypertension is more common among Black Ohioans and Ohioans with lower incomes, groups that often experience high rates of chronic stress, a leading contributor to high blood pressure.
There is emerging research establishing a link between higher rates of hypertension among African Americans and the chronic stress of discrimination and racism.

According to an HPIO policy brief on the connections between racism and health, “chronic exposure to racism renders communities of color more vulnerable to negative health outcomes across the life span and can lead to early death.”

The data graphic is the second produced by HPIO in February, which is American Heart Month, a designation designed to spotlight heart disease.

States test adding ‘food as medicine’ programs to Medicaid

More states are testing Medicaid programs that’ll provide more people with healthy foods and, potentially, lower health care costs (Source: “Can food cure high medical bills? Pilot 'food as medicine' programs aim to prove just that.” USA Today, Feb. 15). 
Medicaid typically only covers medical expenses, but ArkansasOregon and Massachusetts received approval from the Centers for Medicare & Medicaid Services last year to use a portion of their Medicaid funds to pay for food programs, including medically tailored meals, groceries and produce prescriptions (fruit and vegetable prescriptions or vouchers provided by medical professionals for people with diet-related diseases or food insecurity). The aim is to see whether providing people with nutritious foods can effectively prevent, manage, and treat diet-related diseases.  
study published last fall estimated that if all patients in the U.S. with mobility challenges and diet-related diseases received medically tailored meals, 1.6 million hospitalizations would be avoided, with a net savings of $13.6 billion annually. Another study in 2019 found that over the course of about a year, the meals resulted in 49% fewer inpatient admissions and a 16% cut in health care costs compared with a control group of patients who did not receive the meals. 
This spring, the American Heart Association and the Rockefeller Foundation plan to launch a $250 million “Food is Medicine” Research Initiative to determine if such programs can be developed cost-efficiently enough to merit benefit coverage and reimbursement for patients.

Graphic of the week


New data analysis by HPIO shows that Ohio has a higher rate of heart disease mortality than most other states (as illustrated in the graphic above).

The rate in Ohio is 67% higher than Minnesota, the state with the lowest rate.

Heart disease is the leading cause of death in both Ohio and the U.S., according to CDC data. Last year, HPIO released a Data Snapshot on death trends among working-age Ohioans that found heart disease is also the third-leading cause of death among Ohioans ages 15-64. Ohio ranked 42nd in heart disease in HPIO’s 2021 Health Value Dashboard (the 2023 Dashboard is expected to be released in early May).

February is American Heart Month, a designation designed to spotlight heart disease.

CDC projects surge in diabetes among young Americans in coming decades

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.

Study: Cost of hospital parking overlooked burden for cancer patients

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).

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.

FDA moves to ban menthol cigarettes with aim of reducing smoking-related disparities

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.

Study links cardiovascular disease risk for African Americans with social determinants of health

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. 

Report: Lung cancer rates dropping because of better access, screening, treatment

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.

Ohio Senate passes bill expanding medical cannabis

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,”, 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.

Heart disease, diabetes, other leading causes of death up in 2020, federal data shows

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).