Ohio public health

Biden administration announces $7.4 billion in public health spending

The White House announced Thursday that it is investing $7.4 billion to hire more public health workers to deal with the coronavirus pandemic and future health crises (Source: “Biden announces $7.4 billion to hire more public health workers amid pandemic,” Washington Post, May 13).

The money will come from the $1.9 trillion coronavirus relief package, which Congress passed in March.

The Biden administration said $4.4 billion will go toward boosting states’ overstretched public health departments, allowing them to hire disease specialists to do contact tracing, case management, and support outbreak investigations and school nurses to help schools reopen. Some of the money will also go to expanding the Epidemic Intelligence Service at the Centers for Disease Control and Prevention — which plays a critical role in containing outbreaks.

The remaining $3 billion will be used to create a new grant program to train and modernize the country’s public health workforce. Applicants for those grants will be asked to prioritize recruiting staff from the communities they will serve, especially those from underrepresented backgrounds.

HPIO’s 2021 Health Value Dashboard, which was released last month, found that one reason Ohio ranks poorly on health value (47th out of the 50 states and D.C.) is that the state’s sparse public health workforce leads to missed opportunities for prevention. Data in the Dashboard shows that only three states spend less on public health than Ohio.

Public health officials concerned about sustaining resources after pandemic passes

After the pandemic is over, public health officials across the U.S. fear that they will be back to scraping together money from a patchwork of sources to provide basic services to their communities — much like after 9/11, SARS and Ebola (Source: “Public Health Experts Worry About Boom-Bust Cycle of Support,” Kaiser Health News/Associated Press, April 19).

Funding for the federal Public Health Emergency Preparedness program, which pays for emergency capabilities for state and local health departments, dropped by about half between the 2003 and 2021 fiscal years, accounting for inflation, according to Trust for America’s Health, a public health research and advocacy organization.

Spending for state public health departments dropped by 16% per capita from 2010 to 2019, and spending for local health departments fell by 18%, Kaiser Health News and the Associated Press found in a July investigation. At least 38,000 public health jobs were lost at the state and local level between the 2008 recession and 2019. Today, many public health workers are hired on a temporary or part-time basis. Some are paid so poorly they qualify for public aid. Those factors reduce departments’ ability to retain people with expertise.

The recently released HPIO Health Value Dashboard found that one reason Ohio ranks poorly for health value compared to most other states and D.C. is that Ohio’s “sparse public health workforce leads to missed opportunities for prevention.”

The report also found that “Ohioans spend a lot on downstream medical care, but investment in public health infrastructure is limited and prevention policies could be stronger.”

Wealthier counties in Ohio also have highest COVID vaccine rates

ounties in Ohio with the highest incomes also have the highest vaccination rates, according to analysis from the Columbus Dispatch (Source: “Wealthier Ohio counties more likely to have higher COVID vaccination rates,” Columbus Dispatch, April 19).

The Dispatch found a 27-percentage point difference in vaccination rates between Ohio's wealthiest and poorest counties. Delaware County, the wealthiest county in the state, is also the most vaccinated against COVID-19.

The connection does not come as a surprise to most experts who see it as a result of long-term disparities in health care.

In Ohio, vaccines were distributed to each county mostly based on population and a few risk factors. But the state didn't require Ohioans to get their shots in their counties of residence, meaning people with the time and the means could travel to get vaccinated.

People with more flexibility in their jobs tend to make more money and have good access to transportation, said HPIO President Amy Rohling McGee. That translates to more access to COVID-19 shots and health care services as a whole, she said.

DeWine plans to target COVID-19 vaccines to areas with case spikes, higher demand

As daily coronavirus cases have begun to rise in Ohio, the state will rush shots to areas with increased spread, Gov. Mike DeWine announced Thursday (Source: “Ohio will rush coronavirus vaccines to areas with case spikes,” Cleveland Plain Dealer, April 1).

That may head off a fourth wave that Ohio physicians have warned about, spurred by more contagious variants of the virus.

“As we vaccinate more and more people, it will be harder and harder for this virus to travel from person to person,” he said. “But, you know, in the next month, next two months, we’re concerned.” 

In addition to sending doses to locales across the state with increasing cases, DeWine announced more efforts to increase the overall number of Ohioans who are vaccinated. He said that each week, the state will look at where vaccine demand is greatest and allocate more doses to those areas.

Vaccine supply expected to increase as eligibility widened

An expected 25% increase in the number of COVID-19 vaccines in coming weeks led the state to make everyone 16 and older eligible to get inoculated starting March 29, Gov. Mike DeWine said (Source: “State’s vaccine supply to increase 25 percent,” (Warren) Tribune Chronicle, March 19).

The state is receiving about 400,000 vaccine doses each week, and that will go up to 500,000 a week starting March 29, he said Thursday.

Beginning today, the minimum age to be eligible for the vaccine is going from 50 to 40. Also, those with certain medical conditions are eligible today. Starting March 29, all those who are at least 16 years old will be eligible for the vaccine.

Of the state’s 88 counties, 62 are at Level 3, 21 are at Level 2 (orange) and 5 are at Level 1 (yellow). No counties are at the highest Level 4 (purple).

DeWine: Ohio on track to open vaccines to all adults by May 1

Ohio is on track to open access to COVID-19 vaccines to all adults by President Biden's May 1 milestone and could lift restrictions in the next seven to eight weeks, Gov. Mike DeWine said Friday (Source: “Gov. Mike DeWine: Coronavirus restrictions could be lifted 'in 7 to 8 weeks',” Columbus Dispatch, March 12).

President Biden said Thursday he wants states to make all adults eligible for the vaccine by May 1. Biden noted that does not mean all Americans will immediately receive a vaccine after that date, but that "you’ll be able to get in line beginning May 1."

"Within a month, it’s going to be pretty open," DeWine said Friday.

On Thursday, Ohio's incidence rate was 155 new cases per 100,000 residents during the past two weeks – down from 179 the week before. DeWine said when that rate reaches 50, he will lift all state health orders including a mask mandate and restrictions on bars, restaurants, entertainment venues and more.

"We certainly could be out of this in seven or eight weeks," DeWine said. "What we don’t really know is the impact this variant is having or will have as it spreads throughout the state."

Report: Ohio ranks near the bottom for public health preparedness

A new national report found that Ohio ranked as one the least-prepared states for future public health emergencies (Source: “Report: Ohio Lags in Public Health Preparedness,” Spectrum News, March 10).

According to Trust for America’s Health’s new report, “Ready or Not,” Ohio is in the lowest preparedness tier, in part, because Ohio ranks the lowest in the percentage of hospitals in healthcare coalitions that focus on response preparedness.

The report indicates that the COVID-19 pandemic has shown that many states were not prepared for a public health crisis. “We weren’t as prepared as we should have been for a pandemic,” the group’s policy director, Rhea Farberman, said. “That’s something that the public health experts have been warning us about for decades.”   

According to data from HPIO’s 2019 Health Value Dashboard, Ohio ranked 48th out of the 50 states and D.C. in per capita emergency preparedness funding and 45th out of 50 in state public health workforce.

COVID vaccination rates lag for Black Ohioans

Of the more than 1.8 million Ohioans who have received at least one COVID-19 vaccination dose, only 5.6% went to Black Ohioans, who comprise about 13% of Ohio’s population (Source: “Black Ohioans are 13% of state population, but 5.6% of the vaccine recipients,” Ohio Capital Journal, March 5).

Part of the explanation for the gap: Black people comprise 14.3% of the general population in the U.S., according to 2019 census estimates. However, because of lower life expectancy, they comprise just 9.7% of the 65-and-up population, which most states have prioritized for the vaccines.

“It is likely a conglomeration of a number of different factors,” said Reem Aly, a vice president at the Health Policy Institute of Ohio. “It is going to be inequities we see in access to care, historically, we know that there is racism within the health care system and there is an understandable mistrust in Black communities of health care providers. That is certainly contributing to the issue.”

ACEs cost Ohio $10 billion a year in healthcare costs, new HPIO analysis finds

First-of-its kind analysis by the Health Policy Institute of Ohio has found that if adverse childhood experiences (ACEs) are eliminated, more than $10 billion in annual healthcare and related expenses could be avoided in Ohio.

The analysis is included in a new HPIO policy brief, Adverse Childhood Experiences (ACEs): Economic Impact of ACEs in Ohio. The study also found that focusing action on reducing ACEs, particularly those associated with behavioral health, can yield significant savings. For example, more than $4.5 billion in annual spending to treat depression in Ohio is attributable to ACEs.

“The research is clear that ACEs result in both significant health and economic impacts,” the brief states. “Economic costs from ACEs are incurred across the public and private sectors, including substantial costs to the healthcare system. The economic burden of ACEs also impacts the state child protection, behavioral health, criminal justice and education systems, as well as private sector businesses. By preventing and mitigating the impacts of ACEs, policymakers and others can put Ohio on a path towards improved health value.”

The brief is the second in three planned briefs as part of HPIO’s Ohio ACEs Impact Project. In August 2020, HPIO released the first brief, Adverse Childhood Experiences (ACEs): Health impact of ACEs in Ohio.

Ohio begins adding 4k deaths to COVID-19 totals following data collection error

Ohio Department of Health officials announced this week that they had overlooked about 4,000 deaths that occurred over the past several months and would begin reporting them to the public this week (Source: “Ohio Begins Adding In 4,000 Overlooked Covid Deaths,” New York Times, Feb. 12).

The first 650 or so of Ohio’s older deaths were reported Thursday, accounting for about 17% of all coronavirus deaths announced nationwide that day. On Friday the Ohio Department of Health reported about 2,500 additional deaths. The backlog in Ohio was expected to inflate the national death average in the coming days.

“You’ll see a jump today, tomorrow, maybe the next day,” Gov. Mike DeWine said at a news conference on Thursday. “We’re not sure exactly how many days it’s going to take, but you’re going to see a distorted number.”

During a routine employee training event, Ohio health officials discovered that thousands of deaths, some of which dated back to October, had not been properly merged between one reporting system and another, according to an ODH press release. “This was a failure of reconciliation not taking place,” Gov. DeWine said, “so we’re getting that straightened out.”