disparities

Study finds U.S. political divides may explain reduced racial disparities in COVID deaths

New evidence suggests that the shrinking gap in U.S. COVID-19 racial death disparities is being driven by political division and increasing total deaths — mostly among white people — rather than by decreasing deaths among Black Americans (Source: “Study: US political divide may help explain shrinking racial COVID death gap,” Center for Infectious Disease Research and Policy, University of Minnesota, Nov. 1).

According to a new University of Wisconsin and UCLA study published in PLOS One, Black people still bear a larger COVID-19 death burden than white people, despite a relatively younger population, but suggest that a wider political chasm likely drove more deaths in the latter group as the pandemic evolved.

Researchers examined COVID-19 death disparities since the early months of the pandemic when Black Americans had far higher death rates than their white peers.

Black and Hispanic Americans are much more likely to work in jobs that must be done in person, leading to much higher exposure to the virus. "That didn't change as the racial differences in the mortality rate shifted," lead author Adeline Lo said. "Other factors — like geographical distribution, healthcare access, income equality — that contributed to the initial higher rate of Black deaths didn't go away either."

What did change was that levels of concern about COVID and adherence to protective public health measures (eg, lockdowns, closures, prohibitions on gathering) widened along political lines, with increasing deaths among white Americans. After initially issuing similar state mandates in the first few weeks of the pandemic, within one month, Republican-controlled states began lifting public health restrictions, lessening virus containment and leading white deaths to surpass those of Black people from April to October 2020.


CDC data shows people of color less likely to receive Paxlovid, other COVID treatments

People of color with a COVID-19 diagnosis were much less likely to receive Paxlovid and other treatments than white patients, according to new data from the Centers for Disease Control and Prevention (CDC) (Source: “CDC data: People of color much less likely to receive Paxlovid, other COVID treatments,” The Hill, Oct. 27).
 
The CDC findings are consistent across all age groups and underscore the persistent disparities surrounding access to COVID-19 treatments, especially the antiviral pill Paxlovid. Paxlovid is the most commonly prescribed medication and the preferred outpatient therapeutic for eligible patients, according to the CDC.
 
During a four-month period from April to July 2022, Paxlovid treatment was 36% lower among Black patients relative to white patients and 30% lower among Hispanic patients relative to non-Hispanic patients, according to the study.


Disparities in vision health linked to access challenges, study finds

A new study shows significant disparities in vision function among Black, Hispanic and poorer adolescents (Source: “Lack of Access Appears Tied to Disparities in Vision Health,” U.S. News, Sept. 16).

New research suggests a lack of access to vision care services has contributed to racial, ethnic and socioeconomic disparities in visual function among Black, Hispanic and poorer adolescents.

Findings of a new study published last month in JAMA Ophthalmology reveals approximately 16% of Black and 18% of Mexican American adolescents had worse than 20/40 vision in their better-seeing eye compared to 7% of white adolescents. After correcting for visual impairment, 3% of Black and 3% of Mexican American adolescents still had worse than 20/40 vision compared to 1% of white adolescents.

Study co-author Dr. Idsin Oke, a clinical scientist and pediatric ophthalmologist at Boston Children’s Hospital, said the findings highlight the importance of addressing barriers that could hinder access to vision care services for racial and ethnic minority youth.


Racial disparities in mental health cost U.S. $278 billion in four years, study finds

A new report estimates that racial mental health disparities cost the United States around $278 billion between 2016 and 2020, putting a price tag on a health equity issue that’s long plagued the nation (Source: “Racial Mental Health Disparities Cost US $278B in 4 Years,” Patient Engagement, HIT, Sept. 14).

According to the report from Satcher Health Leadership Institute at Morehouse School of Medicine, between 2016 and 2020, the U.S. saw an excess of 117,000 premature deaths among indigenous and racial or ethnic minorities due to mental health needs, adding $278 billion in excess costs.

“Investing in mental healthcare saves lives and dollars — we have known this for decades, but until now did not fully understand the monumental impacts of neglecting to act,” Daniel E. Dawes, a professor and the executive director of the Satcher Health Leadership Institute, said in a statement.


Graphic of the week

SuicideDisparities_StandAloneGraphic_04.14.2022
As national and state organizations mark September as Suicide Prevention Awareness Month, data show that while suicide deaths among young Ohioans have risen overall in Ohio over the past two decades, the increase has been sharpest among Black Ohioans.

In 1999, the suicide rates for both white Ohioans and Black Ohioans ages 10 to 24 were the same: 6.8 per 100,000 people. By 2020 (the most recent year for which data is available), the rate for white Ohioans had risen to 11.2 (an increase of 64%) and the rate for Black Ohioans had risen to 12.8 (an increase of 88%).

More-recent national research indicates that the disparity in suicide rates may have increased during the COVID-19 pandemic.

Reducing suicide and eliminating disparities are priorities of the Ohio Department of Health’s 2020-2022 State Health Improvement Plan (SHIP). Public- and private-sector leaders can implement strategies identified in the SHIP and Ohio’s 2020-2022 Suicide Prevention Plan, including suicide fatality review boards, behavioral health integration with primary care and education on safe storage of lethal means (i.e., firearms and medications).

If you or someone you know is experiencing emotional distress or a suicidal crisis, please call the 988 Suicide and Crisis Lifeline; the Trans Lifeline at 877-565-8860 or the Trevor Project at 866-488-7386. If you don’t like talking on the phone, consider using the Crisis Text Line at www.crisistextline.org or text “4HOPE” to 741-741.


Ohio infant mortality rates dropped in 2020, new ODH report finds

Ohio saw a slight dip in its infant mortality rate in the first year of the COVID-19 pandemic, according to new 2020 data released by the Ohio Department of Health (Source: “State report: Ohio infant mortality rate 'lowest it has been in past decade',” Columbus Dispatch, Aug. 19).

According to the ODH report, there were 6.7 infant deaths per 1,000 live births in 2020, down from 6.9 the year prior. Black infants specifically saw a bigger decrease in that time frame, from 14.3 deaths per 1,000 births to 13.6, which is 2.7 times the rate of white infants. In total, 864 infants died before their first birthday in 2020.

The new infant mortality rate is "the lowest it has been in the past decade," according to the report, but it's still far above from the 2028 target of 6 or fewer deaths per 1,000 births for every racial group that was set out in the 2020-2022 State Health Improvement Plan.

"Racial and socio-economic inequities persist," the report acknowledged. "The infant mortality rate not only serves as a key indicator of maternal and infant health but is also an important measure of the health status of a community."


Graphic of the week

MedianIncome_YPLL_StandAloneGraphic_Final
Data released earlier this year 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, which was originally released by HPIO in April). 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 includes a curated list of strategies to address racial wealth building, a key to eliminating health disparities.


Graphic of the week

Dashboard_DisparitiesGraphic_StandAlone

 

HPIO’s 2021 Health Value Dashboard concluded that one reason Ohio ranks poorly (47th out of the 50 states and D.C.) is that many Ohioans experience poorer outcomes and live shorter lives because of policies, systems and beliefs that discriminate against and unfairly limit access to resources. According to the Dashboard, racism and other forms of discrimination drive troubling differences in outcomes across Ohio. This includes racist and discriminatory beliefs and interactions among Ohioans and structural racism and discrimination embedded within systems and across sectors, rooted in ageism, ableism, xenophobia, homophobia and other “isms” or “phobias.”  As the graphic above shows, Ohioans experiencing the worst health outcomes are also more likely to be exposed to risk factors for poor health. These include trauma and adversity, toxic stress, violence and stigma, and inequitable access to resources.

Earlier this week, HPIO hosted the first meeting of its Health Value Dashboard Advisory Group as it begins planning for the 2023 Dashboard. The new edition is expected to be released in March or April 2023.


In rural areas, COVID hits Black, Hispanic communities hardest, although gap appears to be narrowing

At the peak of the Omicron wave, Covid killed Black Americans in rural areas at a rate roughly 34% higher than it did white people, new research has found, although the gap appears to be narrowing in recent months (Source: “In Rural America, Covid Hits Black and Hispanic People Hardest,” New York Times, July 28).

Across the small towns and farmlands, new research has found, Covid killed Black and Hispanic people at considerably higher rates than it did their white neighbors. Even at the end of the pandemic’s second year, in February 2022, overstretched health systems, poverty, chronic illnesses and lower vaccination rates were forcing nonwhite people to bear the burden of the virus.

In towns and cities of every size, racial gaps in Covid deaths have narrowed. That has been especially true recently, when major gains in populationwide immunity have tempered the kind of pressure on health systems that appears to hurt nonwhite Americans the most.


Insurer reduces healthcare disparities after tying executive bonuses to the issue

A California-based Medicare Advantage plan is touting its success at improving health disparities by tying its executives’ bonuses to the issue (Source: “How one insurer tied executive performance bonus to reducing healthcare disparities,” MedCity News, July 25).

One aspect SCAN Health Plan looked at was medication adherence among its members, numbering  270,000 across Arizona, California and Nevada. While medication adherence exceeded 80% for all of SCAN’s members, there was still a difference between races. About 86% of the company’s White members took cholesterol medications as prescribed, compared to 83% of Black members and 81% of Hispanic members, according to an essay from the company published in Harvard Business Review.

A year after launching the initiative, SCAN Health brought cholesterol medication adherence up to 87.4% for Black members, 86.6% for Hispanic members and 89.6% for White members. Similar improvements were seen in diabetes medication adherence.

SCAN officials say the company achieved the improvement in disparities by tying about 10% of its senior managers’ bonuses to their success in achieving this disparity reduction.

The company chose this course of action “to make it real,” SCAN CEO Sachin Jain said. “It’s not real until you make it real for people. Otherwise, it’s kind of like ‘Oh, yeah, it’d be great if we did this.’ And we wanted to send a strong signal to our organization that this was not something that was nice to have. This is a must do.”