Ohio Health Policy News

Researchers have found that older adults who are don’t have close relationships, can’t rely on others for help, aren’t active in community groups or religious organizations or live in neighborhoods that feel unsafe have less physiological strength and a reduced biological ability to bounce back from illness or injury (Source: “Being ‘Socially Frail’ Comes With Health Risks for Older Adults,” Kaiser Health News, March 23). 
 
Many of these factors have been linked to poor health outcomes later in life, and are compounded by social drivers of health such as low socioeconomic status, poor nutrition, insecure housing and inaccessible transportation.
 
Social frailty assumes that each factor contributes to an older person’s vulnerability and that they interact with and build upon each other. This way of thinking about older adults’ social lives, and how they influence health outcomes, is getting new attention from experts in the U.S. and elsewhere. In February, researchers at Massachusetts General Hospital and the University of California-San Francisco published a 10-item “social frailty index” in the Proceedings of the National Academy of Sciences journal.
 
Using data from 8,250 adults 65 and older who participated in the national Health and Retirement Study from 2010 to 2016, the researchers found that the index helped predict an increased risk of death during the period studied in a significant number of older adults, complementing medical tools used for this purpose.

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 42^nd 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.

A new study suggests that lack of access to food and the stress caused by food insecurity were associated with an increased risk of cardiovascular disease (Source: “Food insecurity can affect heart disease, research says,” Dayton Daily News, Feb. 13).

A recent JAMA study found economic food insecurity was associated with risks of coronary heart disease and these associations persisted after further adjustment for diet quality and perceived stress. High frequency of unfavorable food stores was not associated with coronary heart disease, heart failure, or stroke, researchers said. Researchers pointed to economic food insecurity as a potential target for intervention to improve health outcomes.

Food insecurity disproportionately impacts Black, Hispanic and single-parent households. The U.S. Department of Agriculture found in 2018 that 11.1% of all U.S. households were food insecure — with 13.9% of all households with children also food insecure.

The average life expectancy of Americans fell precipitously in 2020 and 2021, the sharpest two-year decline in nearly 100 years and a stark reminder of the toll exacted on the nation by the continuing coronavirus pandemic (Source: “U.S. Life Expectancy Falls Again in ‘Historic’ Setback,” New York Times, Aug. 31).

In 2021, the average American could expect to live until the age of 76, federal health researchers reported on Wednesday. The figure represents a loss of almost three years since 2019, when Americans could expect to live, on average, nearly 79 years.

While the pandemic has driven most of the decline in life expectancy, a rise in accidental deaths and drug overdoses also contributed, as did deaths from heart disease, chronic liver disease and cirrhosis, the new report found.

Earlier this summer, HPIO released a data snapshot detailing death trends among working-age Ohioans, a major driver of lower life expectancy. “The increasing death rate for working-age Ohioans is part of a long-term trend, starting in the early 2000s, in which Ohio is doing worse than the U.S. overall,” the analysis found.

A new national study found that a quarter of children are not regularly screened for vision problems (Source: “Children’s Vision Problems Often Go Undetected, Despite Calls for Regular Screening,” Kaiser Health News, June 9).

According to the National Survey of Children’s Health, in 2016-17 one in four children were not regularly screened for vision problems.

Eye exams for children are required under federal law to be covered by most private health plans and Medicaid. Vision screenings are mandated for school-age children in 40 states and the District of Columbia, and 26 states require them for preschoolers, according to the National Center for Children’s Vision and Eye Health at the nonprofit advocacy organization Prevent Blindness (Ohio requires exams for school-age children but not preschool).

Still, many children who are struggling to see clearly are being overlooked. The pandemic has only exacerbated the issue since classes moved online, and for many students in-school vision screenings are the only time they get their eyes checked. Even when campuses reopened, school nurses were so swamped with covid testing that general screenings had to be put to the side, said Kate King, president-elect of the National Association of School Nurses.

The Centers for Disease Control and Prevention estimates that more than 600,000 children and teens are blind or have a vision disorder.

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.

The Health Policy Institute of Ohio, in partnership with the Ohio State University College of Nursing Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, has released a new policy brief titled A Call to Action: Improving Clinician Wellbeing and Patient Care and Safety.

A growing body of research indicates that healthcare clinicians face serious problems related to their overall health and wellbeing, including high rates of burnout, depression, addiction and suicide. Understanding the relationship between clinician well-being and patient care and safety enables state policymakers and healthcare leaders to implement evidence-informed policies and programs that improve outcomes for clinicians and their patients.

This brief serves as a call to action to improve clinician wellbeing and its impacts on patient care and safety, providing a:

• Framework for the relationship between clinician wellbeing and patient care and safety
• Summary of research findings
• Review of evidence-informed policies, programs and practices that improve clinician wellbeing and support high-quality, safe patient care
• Set of evidence-informed state policy options

The Health Policy Institute of Ohio is hosting a forum on Oct. 2 in Columbus titled “Promoting Healthy Behaviors and Personal Responsibility: Politics, Perceptions and Health.”

In Ohio and across the country, there is a growing interest in encouraging healthy behaviors and promoting personal responsibility to improve health. This forum will explore the role policymakers and others can play in engaging people in their health.

Speakers will address diverse perspectives on the issue. The event also will address how community conditions impact our health choices and potential policy implications in Ohio.

Speakers include:

• Joan Alker, Executive Director/Co-Founder, Center for Children and Families, Research Professor, Georgetown University McCourt School of Public Policy
• Dr. Bruce Rogen, Chief Medical Officer, Cleveland Clinic Employee Health Plan
• Dr. Megan Amaya, Assistant Professor of Clinical Nursing, Director of Health Promotion and Wellness, Ohio State University College of Nursing
• And more to be announced

Researchers estimate that cutting smoking in each state by 1% in a year would lower the cost to taxpayer-supported Medicaid by $2.6 billion the following year, including more than $60 million a year in Ohio, according to findings of a new study (Source: “Cutting smoking could save Medicaid $2.6B during a year, study says,” United Press International, April 12, 2019).

According to the study, which was published in JAMA Network Open, a 1% drop would have median savings of $25 million for states each year, with California leading at more than $630 million.

The researchers looked at state-by-state rates of Medicaid recipients who also smoked. They figured that reducing smoking in that group by 1% would lower per-capita health care spending by 0.118%.

Researchers estimate that 15% of U.S. Medicaid costs are attributable to cigarette smoking. Fourty-six percent of working-age Ohio Medicaid enrollees were current smokers in 2017.

Ohio lawmakers are considering a law banning drivers from smoking if there’s a passenger in the car under the age of 6 (Source: “Ohio may ban smoking in cars with young children,” Dayton Daily News, March 19, 2019).

Senate Bill 78, sponsored by state Sen. Tina Maharath, D-Canal Winchester, proposes a $500 fine for violators of the law, and for subsequent violations be fined $500 plus $250 for each additional violation.

The bill has been referred to the Senate Judiciary Committee. Similar bills have been considered in prior  legislative sessions. The law has been promoted to protect children from the health consequences of second-hand smoke, which can lead to asthma, ear infections and other health problems.

Ohio has a poor record when it comes to children exposed to the health risks of secondhand smoke. Ohio ranked 49th on the percentage of children who live in a home where someone uses tobacco and smokes inside the home, according to the Health Policy Institute of Ohio’s 2017 Health Value Dashboard. The 2019 Health Value Dashboard is set to be released early next month.