disparities

Baby formula shortage puts spotlight on long-standing health disparities

As parents across the United States struggle to find formula to feed their children, the pain is particularly acute among Black and Hispanic women, who have historically faced obstacles to breastfeeding, including a lack of lactation support in the hospital, more pressure to formula feed and cultural roadblocks (Source: “Baby formula shortage highlights racial disparities,” Associated Press, May 27).

Low-income families buy the majority of formula in the U.S. and face a particular struggle: Experts fear small neighborhood grocery stores that serve these vulnerable populations are not replenishing as much as larger retail stores, leaving some of these families without the resources or means to access formula.

The Centers for Disease Control and Prevention estimates that 20% of Black women and 23% of Hispanic women exclusively breastfeed through six months, compared to 29% of white women. The overall rate stands at 26%. Hospitals that encourage breastfeeding and overall lactation support are less prevalent in Black neighborhoods, according to the CDC.

The racial disparities reach far back in America’s history. The demands of slave labor prevented mothers from nursing their children, and slave owners separated mothers from their own babies to have them serve as wet nurses, breastfeeding other women’s children. In the 1950s, racially targeted commercials falsely advertised formula as a superior source of nutrition for infants. And studies continue to show that the babies of Black mothers are more likely to be introduced to formula in the hospital than the babies of white mothers.


Study: Communities of color have much higher air pollution rates

A block-by-block analysis of air quality in the San Francisco Bay area found that communities of color are exposed to 55% more of a chemical that contributes to smog than mostly White communities (Source: “Block-by-block data shows pollution’s stark toll on people of color,” Washington Post, May 25).

The data released Tuesday by Aclima, a California-based tech company that measured the region’s air quality block-by-block for the first time. While the Environmental Protection Agency gauges an area’s air quality with fixed monitors, the new survey unearthed more granular data by sending low-emission vehicles equipped with sophisticated technology to traverse neighborhoods at least 20 times each.

These forays revealed that poor people of all ethnicities experience a 30% higher exposure to nitrogen dioxide compared to wealthier residents, and concentrations can vary up to 800% from one end of a block to the next.


Year after federal funds announced to fight COVID disparities, states still not moving forward

A year after the Biden administration announced $2.25 billion would be sent to states to address COVID health disparities, little of the money has been used (Source: “States Have Yet to Spend Hundreds of Millions of Federal Dollars to Tackle COVID Health Disparities,” Kaiser Health News, May 16).

The Biden administration in March 2021 announced it was allocating the money to address COVID health disparities, the largest federal funding initiative designed specifically to help underserved communities hardest hit by the virus.

Two months later, the Centers for Disease Control and Prevention awarded grants to every state health department and 58 large city and county health agencies. The money is intended to help limit the spread of COVID-19 among those most at risk in rural areas and within racial and ethnic minority groups, as well as improve their health. The CDC initially said the grant had to be spent by May 2023, but earlier this year told states they could apply to extend that time.

A year after the funding was announced, little of the money has been used, according to a Kaiser Health News review of about a dozen state and county agencies’ grants (Ohio was not included in the analysis).


Newly released County Health Rankings spotlights connection between income and health

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Newly released data from County Health Rankings show that Black Ohioans have the lowest median household income among groups of Ohioans and have, by far, the highest rate of premature death (years of potential life lost before age 75, which reflects the burden of deaths that potentially could have been prevented).
 
Between 2018 and 2020, Black Ohioans collectively lost 13,374 years of life before turning 75 years old (see graphic above). That is nearly as many years lost as Hispanic (5,858) and white Ohioans (8,224) combined.  At the same time, the median household income for Black Ohioans is $12,352 less than Hispanic Ohioans, $28,065 less than white Ohioans and $43,782 less than Asian Ohioans.
 
“Individual efforts alone cannot overcome the structural barriers that maintain the racial wealth divide,” County Health Rankings states. “Structural barriers include laws, policies, institutional practices, and economic arrangements that create unequal conditions.”
 
The latest edition of the County Health Rankings, released this week, includes a new curated list of strategies to address racial wealth building, a key to eliminating health disparities.
 
“Research shows that income inequality has a negative effect on overall population health,” according to the Rankings. “Economically unequal societies often have higher rates of physical and mental illness, violence, and incarceration.”

Throughout April, HPIO has marked National Minority Health Month by creating a series of data visualizations to illustrate health disparities in Ohio.


Federal legislation proposed to reduce maternal deaths

The push to reduce poor maternal health outcomes has seen new momentum as federal lawmakers and Biden administration officials previewed their priorities — including reversing a rise in maternal disparities among Black women (Source; “Lawmakers, advocates hopeful for more bills to curb maternal deaths,” Roll Call, April 20).
 
The United States leads among developed nations in its poor maternal mortality rates, referring to deaths during or up to one year after childbirth. These deaths — alongside maternal morbidity, or long-term health problems arising from pregnancy or childbirth — are growing problems nationally.
 
Last week, HPIO released a fact sheet titled “Racial and geographic disparities in maternal morbidity and mortality.” The fact sheet includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.


States adopt policies to require implicit bias training for health workers

In the past three years, states have begun training medical providers to stop acting on unconsciously held beliefs, known as implicit bias (Source: “With Implicit Bias Hurting Patients, Some States Train Doctors,” Pew Stateline, April 21).
 
Since 2019, at least four states — California, Maryland, Michigan and Washington — have adopted policies requiring at least some healthcare workers to take implicit bias training, some as a prerequisite for professional licensure or renewal.
 
Bills on implicit bias training in health care have been introduced in state legislatures over the past two years in many other states, including Illinois, Indiana, Nebraska, New York, Oklahoma, South Carolina, Tennessee and Vermont. Minnesota passed a law last year requiring obstetrics units to offer implicit bias training.
 
Even without laws, some health systems in recent years began offering or requiring training in implicit bias, as have some medical schools, including Harvard, Icahn School of Medicine at Mount Sinai in New York and Ohio State University.


Uninsured rate drops for all races in Ohio, with biggest reduction among Asian and Black Ohioans

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The percent of Ohioans who are uninsured dropped by almost half from 12.3% to 6.4% between 2011 and 2019 (see graphic above).

Every race saw a drop in the percent of uninsured, with the percentage of Asian and Black Ohioans dropping most dramatically compared to other groups. Despite these gains in access, however, Ohioans of color are still more likely to be uninsured than white Ohioans.

Much of the drop in Ohio’s uninsured population is attributable to the state’s 2014 decision to expand Medicaid eligibility as part of the Affordable Care Act. In HPIO’s 2021 Health Value Dashboard, Ohio ranked seventh out of the 50 states and the District of Columbia for access to care — the first time Ohio has ranked in the top quartile on any Health Value Dashboard domain.

While access is clearly a bright spot for the state, the Dashboard found that Ohio’s population health outcomes remain poor. Access to care is critical, particularly for Ohioans with serious health conditions. But the Dashboard and national research shows that health is shaped by many factors, including social, economic and physical environments.

This April, HPIO is creating a series of data graphics in recognition of National Minority Health Month


HPIO fact sheet explores drivers of maternal health disparities, spotlights what works to address them

The Health Policy Institute of Ohio has released a new fact sheet titled “Racial and geographic disparities in maternal morbidity and mortality.”

The fact sheet includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.

“With collaboration from both public and private partners, it is possible to reduce severe maternal morbidity and mortality and improve health outcomes for Ohio mothers,” according to the fact sheet. “Policymakers and other stakeholders can implement evidence-based strategies to ensure that parents and babies in Ohio are healthy and thriving.”


Black women in Ohio 2.2 times more likely to die from pregnancy-related causes, data shows

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According to the most-recent data, Black women in Ohio are 2.2 times more likely to die from a cause related to pregnancy and have a 1.85 times higher rate of maternal morbidity (i.e., health problems related to pregnancy and childbirth) than white women.
 
Differences in healthcare access and conditions such as housing, transportation and income, as well as the cumulative impacts of toxic stress and discrimination, all contribute to stark disparities in maternal outcomes across the state.
 
Improving maternal health and eliminating disparities are priorities of the Ohio Department of Health’s 2020-2022 State Health Improvement Plan.
 
Next week is the fifth annual Black Maternal Health Week, an event that coincides with National Minority Health Month. As part of its annual recognition of Minority Health Month, the Ohio Commission on Minority Health has released an extensive calendar of events. Throughout the month, HPIO is releasing new data graphics exploring health disparities in the state. More information and resources about health equity in Ohio are available on HPIO’s website.
 
HPIO plans to release a fact sheet on maternal mortality and morbidity in Ohio later this month.


DeWine announces funding for housing assistance program aimed at improving birth outcomes

Gov. Mike DeWine announced this week that $2.5 million is going to the Coalition of Homelessness and Housing in Ohio “to help improve birth outcomes and reduce infant mortality by providing stable housing for low-income families” (Source: “Ohio Gov. Mike DeWine announces $2.5 million for program to help pregnant women, improve birth outcomes,” WKYC-TV (Cleveland), April 6).
 
Gov. DeWine’s office said the Housing Assistance to Improve Birth and Child Outcomes Program will assess the impact of rental assistance on factors that contribute to infant mortality. The project aims to increase housing stability of low-income households with children while improving maternal and infant health outcomes.
 
The program is an expansion of Healthy Beginnings at Home (HBAH), a housing stabilization pilot project designed to improve maternal and infant health outcomes for low-income families that launched in 2017 with funding from the Ohio Housing Finance Agency. That program, which provided 49 pregnant women in Columbus with rental assistance and other services, was implemented by CelebrateOne, a Columbus-based infant mortality prevention collaborative.
 
CelebrateOne contracted with HPIO to complete a final report summarizing the outcome and process evaluation results of HBAH.