Physical environment

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

HousingAffordabilityByRace_StandAlone_03.24.2022

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.


White House unveils plans to remove lead pipes, paint

The Biden administration released a new plan this week for removing the country’s lead water pipes (Source: “Biden administration releases plan for tackling lead pipes,” The Hill, Dec. 16). 

The plan, announced Thursday in a fact sheet, notes that the Environmental Protection Agency (EPA) will “begin to develop” new regulations for lead and copper pipes. 

Exposure to lead can have negative health effects, especially in children, for whom it can cause brain and nervous system damage and slowed growth and development. 

The Biden administration’s plans would also distribute about $3 billion in funds from the bipartisan infrastructure law for lead service line replacement next year, and said it would be “calling on states to prioritize underserved communities.”

The EPA and Labor Department will also create regional technical assistance hubs that seek to “fast track” the removal process. Meanwhile, the Housing and Urban Development Department will distribute grants to remove lead paint and other hazards in low-income communities. 


Federal grant aims to address social determinants of health in Black neighborhoods in Cleveland

The Case Western Reserve University School of Medicine and University Hospitals Harrington Heart & Vascular Institute have received an $18.2 million federal grant from the National Institutes of Health to lead a multi-organizational effort addressing cardiovascular health disparities (Source: “CWRU, UH receive $18.2 million federal grant to address social determinants of health in Black neighborhoods,” Cleveland.com, Oct. 12).

The initiative involves CWRU, UH and Wayne State University in Detroit. The institutions will work to address social drivers of health in Black communities in Cleveland and Detroit, according to a joint statement from CWRU and UH.

The initiative’s goal is to reduce cardiovascular complications and hospitalizations by improving blood pressure, lipids and glucose targets for Black patients who are at high risk for poor heart health, said Dr. Sanjay Rajagopalan, the principal investigator of the initiative.

Education, socio-economic status, geography and environmental factors contribute to the burden of cardiovascular disease in the United States, Rajagopalan said in the statement.

“There are seismic gaps that exist in health care for Black Americans that continue to result in disproportionate and disappointingly poor outcomes,” he said. “This transformative grant will help to address some of these health disparities.”


Reports find health problems tied to climate change are worsening

Health problems tied to climate change are getting worse, according to two reports published Wednesday (Source: “Reports: Health problems tied to global warming on the rise,” Associated Press, Oct. 21).

The annual reports commissioned by the medical journal Lancet tracked 44 global health indicators connected to climate change, including heat deaths, infectious diseases and hunger. All of them are getting grimmer, said Lancet Countdown project research director Marina Romanello, a biochemist.

This year’s reports — one global, one just aimed at the United States — found that in the U.S., heat, fire and drought caused the biggest problems. An unprecedented Pacific Northwest and Canadian heat wave hit this summer, which a previous study showed couldn’t have happened without human-caused climate change.


Study: 1 in 20 Ohio children has elevated lead levels in blood, more than twice national rate

Ohio children have elevated levels of lead in their blood at more than two times the national rate, according to a study released Monday (Source: “Ohio kids’ show elevated lead blood levels at more than twice the national rate, study finds,” Ohio Capital Journal, Sept. 28).

The research, from JAMA Pediatrics, found about 5.2% of Ohio children have elevated levels of lead in their system.

Nationally, the rate is about 1.9%. Ohio ranked second nationally in terms of states with the highest rates of children with elevated blood levels.

Lead is a neurotoxin linked to developmental, mental, and physical impairment, and young children are especially vulnerable. There’s no safe level of exposure for children, though their blood is considered elevated when it contains 5 micrograms per deciliter.

Ohio is one of six states with kids’ proportions of elevated blood levels more than twice the national average, along with Nebraska (6%), Pennsylvania (5%), Missouri (4.5%), Michigan (4.5%) and Wisconsin (4.3%).


Study finds link between neighborhood disadvantage and COVID-19 disparities

New research has found a strong link between COVID-19 and neighborhood disadvantage, a finding that supports earlier contentions of the connection between social factors and coronavirus disparities (Source: “How Neighborhood Disadvantage Drove COVID Health Disparities,” Patient Engagement HIT, July 21).

The study examined the connection between COVID-19 inequity and subway ridership in New York City. Neighborhoods that ranked higher on a COVID-19 inequity index — meaning that the neighborhood saw more factors that could put inhabitants at risk — also had higher subway ridership even after COVID-19 forced city-wide shutdowns.

Daniel Carrión, a researcher from Mount Sinai, said needing to ride the subway — or work an essential job — had a strong link to the unequal infection rates seen during the height of the coronavirus pandemic, largely because it limits the ability to socially distance.

“For us, subway utilization was a proxy measure for the capacity to socially distance,” Carrión, a postdoctoral researcher in the Department of Environmental Medicine and Public Health at the Icahn School of Medicine, told PatientEngagementHIT in an interview.

Although public health experts have made the link between the social determinants of health leading to actual infection, not just poor outcomes, Carrión and his colleagues put some data behind that. Social disadvantage was linked with higher subway utilization, and ultimately to higher infection rates and starker disparities.

“Folks like me were able to stay home for the majority of the pandemic and work from home. I didn't need to use public transit whereas others did. What we found was that areas that had higher COVID inequity indices were also riding the subways more after the stay-at-home orders compared to folks that were low in the COVID inequity index.”