Physical environment

HPIO releases new brief on link between outdoor air pollution, health in Ohio

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The Health Policy Institute of Ohio has released a new 2021 Health Value Dashboard policy brief titled “A closer look at outdoor air pollution and health.”

Clean air and water, safe places to walk outside and access to healthy food are examples of conditions in the physical environment that affect the health and well-being of Ohioans. Outdoor air quality is included in the 2021 Health Value Dashboard™, where Ohio ranked 46th, meaning that most other states have cleaner outdoor air.

The brief found that there are differences in air pollution exposure from county to county, as illustrated in the graphic above. Hamilton and Cuyahoga counties have the highest levels of PM2.5 air pollution in the state, with high levels also reported across western and central Ohio.

Analysis by HPIO has found that the physical environment (including outdoor air quality) is strongly connected to a state’s overall health, only surpassed by public health and prevention. In fact, analysis of 2021 Dashboard data finds that the physical environment has a much stronger correlation with the overall health of a state than access to care or healthcare system performance.

The policy brief focuses on the importance of clean air and provides additional information on the outdoor air quality metric in the Dashboard, including how:

  • Air pollution affects health outcomes
  • Recent policy changes may affect air pollution
  • Outdoor air quality can be improved in Ohio

Graphic of the week

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New analysis from the Health Policy Institute of Ohio has found air quality across the country, including Ohio, has improved in recent years because of federal policy changes, such as the Clean Air Act. Ohio’s air quality is now better than the U.S., although the state still has room to improve to ensure that Ohioans are breathing clean air. While much of this improvement results from federal legislation, state and local policymakers have a role to play in improving air quality in the state.
 
The analysis will be included in a new Health Value Dashboard spin-off brief that HPIO plans to release next month. The brief will take a closer look at the link between outdoor air quality and health and provide additional information on the outdoor air quality metric in the Dashboard, including how:

  • Air pollution affects health outcomes
  • Recent policy changes may affect air pollution
  • Outdoor air quality can improve in Ohio 

UPDATED (01.13.2023): Since the publication of this graphic by HPIO, the source updated data for air quality from 2018-2020, which altered the Ohio and US values. Updated data can be found on the America's Health Ranking website. An updated version of the graphic is included in HPIO's January 2023 policy brief Health Value Dashboard: A Closer Look at Outdoor Air Pollution and Health.


Schools slow to use federal COVID funding to improve indoor air quality

Despite billions of dollars in federal covid-relief money available to upgrade heating and air-conditioning systems and improve air quality and filtration in K-12 schools, U.S. public schools have been slow to begin projects that have the potentional to improve the overall health of students (Source: “Covid Funding Pries Open a Door to Improving Air Quality in Schools,” Kaiser Health News, June 13).

According to a report released this month from the Centers for Disease Control and Prevention, fewer than 40% of public schools had replaced or upgraded their HVAC systems since the start of the pandemic. Even fewer were using high-efficiency particulate air, or HEPA, filters in classrooms (28%), or fans to increase the effectiveness of having windows open (37%).

Both the CDC and White House have stressed indoor ventilation as a potent weapon in the battle to contain covid. And a wealth of data shows that improving ventilation in schools has benefits well beyond covid.

Good indoor air quality is associated with improvements in math and reading; greater ability to focus; fewer symptoms of asthma and respiratory disease; and less absenteeism. Nearly 1 in 13 U.S. children have asthma, which leads to more missed school days than any other chronic illness.


HHS launches office of environmental justice to address health inequities

The Department of Health and Human Services (HHS) has announced it is establishing an Office of Environmental Justice (OEJ), bringing awareness to the impact of environmental health inequities (Source: “HHS Launches Office of Environmental Justice, Tackles Health Inequity,” Patient Engagement HIT, June 3).
 
“The blunt truth is that many communities across our nation – particularly low-income communities and communities of color – continue to bear the brunt of pollution from industrial development, poor land-use decisions, transportation, and trade corridors,” HHS Secretary Xavier Becerra said in the press release. “Meeting the needs of these communities requires our focused attention. That’s why HHS is establishing the Office of Environmental Justice.”
 
Until June 18, 2022, the OEJ will be seeking public comment to identify the best strategies for addressing environmental injustices and health inequities for disadvantaged communities.


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.


Latest data show racial disparities in housing cost burden persists in Ohio

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Recently released data shows that Ohioans continue to experience substantial financial burdens when paying for housing, and that Ohioans of color are disproportionately impacted.  

Last year, HPIO released a fact sheet on housing affordability and health equity that described how stable, affordable and safe housing is critical for good health. Above is a graphic from the publication, updated with the most-recently available data. 

The connections between housing and health are clear. Limited high-quality, affor 
dable housing stock forces many Ohioans into stressful and unsafe housing situations that can lead to long-term negative health consequences, such as high blood pressure and poor birth outcomes. 

HPIO’s fact sheet “Connections between Racism and Health: State and Local Policymakers,” further explains the connection between racism, housing and health: “Decades of racist housing policies, such as historical redlining and present-day predatory lending practices, have resulted in neighborhood segregation, concentrated poverty and disinvestment from Black communities in Ohio that continue to this day. As a result, Ohioans of color are more likely to experience harmful community conditions — such as food deserts and unsafe, unstable housing — that impact health.”  

The fact sheet includes action steps policymakers can take to support the health and well-being of Ohioans of color and move Ohio toward a more economically vibrant and healthier future. 

The fact sheet is one in a series of three that are companions to the HPIO policy brief “Connections between Racism and Health: Taking Action to Eliminate Racism and Advance Equity.” The other fact sheets in the series address private-sector organizations and individuals and community groups.


Ohio University study links COVID death rates to residential segregation

A new study has found that COVID-19 death rates among both Black and white people were higher in areas with more residential segregation, with rates for Black individuals almost twice as high (Source: “Study links racism, segregation to increased COVID deaths,” Atlanta Journal-Constitution, March 14).
 
The study from an Ohio University researcher, published in the journal Ethnicity & Disease, looked at systemic racism measures, as well as socioeconomic factors between Black and white residents, in every state. Using data on deaths through December 2020, they assessed whether state-level systemic racism and residential segregation predicted the probability of COVID-19 deaths among Americans, considering sociodemographic factors in the process.
 
“We were interested in doing this study because racial and ethnic disparities have been apparent amid COVID-19, and for some Americans, this may have been one of the first times they’ve learned about disparities,” said study author Berkeley Franz. “Health disparities are present with almost every illness and have persisted for years, and the gap isn’t closing, especially between Black and white Americans. We wanted to understand what was driving those disparities to find better ways to reduce them.”
 
What they found was the death rate was higher among Black individuals because of social environments rather than physiology or genetics. They hypothesized that in segregated neighborhoods, residents are less likely to have access to good quality schools, employment opportunities, health care and other resources.


Study: Smoking rates double in underserved communities

Patients in underserved communities smoke at a rate double that of the general U.S. population, according to a new study (Source: “Smoking rate in underserved communities double that of general population, study says,” Medical Economics, March 7).
 
The American Cancer Society study, which was published in the journal Cancer, found that the prevalence of smoking among adults served at federally qualified health centers was 28.1%, compared to 14% reported for the general U.S. population.
 
Among other major findings in the study are that Black adults who smoked had more than two times the odds of reporting substance use disorders.
 
“Our study underscores the importance of understanding the association and increased risk of mental health conditions and substance use disorders among adults from underserved communities who smoke while also addressing socioeconomic risk factors to achieve better health outcomes,” said study author Dr. Sue C. Lin of the Health Resources and Services Administration within the U.S. Department of Health and Human Services. “The study further highlights the significance of tailored smoking cessation treatments for individuals from underserved communities that will support cancer prevention care.”


Cincinnati program that improves family living conditions leads to better child health outcomes, study finds

A new study has found that a child health-law partnership program in Cincinnati that helps improve living conditions for families with children who have chronic conditions has led to a nearly 40% drop in hospital admissions (Source: “Doctor-lawyer advocacy gives Cincinnati area kids better health outcomes, study shows,” Cincinnati Enquirer, March 23).
 
Child Help, the Cincinnati Child Health-Law Partnership, which was created by Cincinnati Children’s Hospital and Legal Aid of Greater Cincinnati, has assisted kids in more than 20,000 advocacy cases since the partnership started in 2008. Many of its cases involve kids whose living environment exacerbated chronic health conditions, such as an apartment with mold or cockroaches. Others address evictions that could leave children homeless. And some involve special needs children in schools. Left unheeded, the problems could end in poor health and repeated hospital admissions for children.
 
A study published March 7 in Health Affairs shows a 38% reduction in the hospitalization rate among children who got Child Help assistance from 2012 through 2017. 
 
Study co-author Dr. Andrew Beck of Cincinnati Children's division of general and community pediatrics said he wasn't surprised to find a drop in readmissions for the kids who were helped by the partnership. He just didn't know how great the drop would be.
 
“It reinforces the notion that our surroundings, socioeconomic and social determinants, impact health outcomes," he said. "It highlights the importance of clinical-community partnerships. It shows that support of these programs in new and innovative ways of reimbursing is important.”


For first time since 1990, EPA adds chemical to list of pollutants

After three decades, the federal government has expanded its list of chemicals too dangerous for Americans to breathe (Source: “For the first time in over 30 years, the EPA adds to its list of hazardous air pollutants,” Washington Post, Jan. 5).

The Environmental Protection Agency (EPA) added a powerful dry-cleaning solvent, 1-bromopropane, to its list of hazardous air pollutants. Researchers, bureaucrats and even many chemical makers have viewed it for years as a dangerous airborne pollutant suspected to damage nerves and cause cancer.

Yet it took a decade of prodding to prompt EPA officials to register it as a hazardous air toxic. The final rule was announced in a notice published in the Federal Register on Wednesday. The designation allows the agency to set limits on emissions of the solvent, valued by dry cleaners, auto shops and other businesses for its ability to treat dirty fabrics and greasy metal parts.