Population health

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.”

CDC reports pre-pandemic childhood vaccine disparities

New research from the U.S. Centers for Disease Control and Prevention found disparities in vaccination coverage prior to the COVID-19 pandemic (Source: “Disparities Found in Vaccination Coverage by Age 24 Months Before COVID-19,” HealthDay News, Oct. 18).

The study, which was published in the CDC’s Morbidity and Mortality Weekly Report, found that in 2017 and 2018, coverage disparities were seen for race/ethnicity, poverty status and health insurance status. Children who were not privately insured had lower coverage with most vaccines.

"Persistent disparities in vaccination coverage by health insurance status, race and ethnicity, and poverty status indicate that improvement is needed to achieve equity in the national childhood vaccination program," the authors write.

CDC: Life expectancy drop in 2020 largest since WWII

U.S. life expectancy fell by a year and a half in 2020, the largest one-year decline since World War II, public health officials said Wednesday (Source: “US life expectancy in 2020 saw biggest drop since WWII,” Associated Press, July 21).

The decrease for both Black Americans and Hispanic Americans was even worse: three years.

The drop, spelled out in a new report from the Centers for Disease Control and Prevention, is due mainly to the COVID-19 pandemic, which health officials said is responsible for close to 74% of the overall life expectancy decline. More than 3.3 million Americans died last year, far more than any other year in U.S. history, with COVID-19 accounting for about 11% of those deaths.

Black life expectancy has not fallen so much in one year since the mid-1930s, during the Great Depression. Health officials have not tracked Hispanic life expectancy for nearly as long, but the 2020 decline was the largest recorded one-year drop.

Causes of death other than COVID-19 also played a role. Drug overdoses pushed life expectancy down, particularly for white Americans; and a rise in homicides was a small but significant reason for the decline for Black Americans, said Elizabeth Arias, the report’s lead author.

Other problems further affected Black and Hispanic people, including lack of access to quality health care, more crowded living conditions and a greater share of the population in lower-paying jobs that required them to keep working when the pandemic was at its worst, experts said.

CDC: Life expectancy in U.S. drops by a full year in first half of 2020

Life expectancy in the United States dropped a staggering one year during the first half of 2020 as the coronavirus pandemic caused its first wave of deaths, health officials are reporting (Source: “US life expectancy drops a year in pandemic, most since WWII,” Kaiser Health News, Feb. 17).

Minorities suffered the biggest impact, with Black Americans losing nearly three years and Hispanics, nearly two years, according to preliminary estimates Thursday from the Centers for Disease Control and Prevention.

This is the first time the CDC has reported on life expectancy from early, partial records; more death certificates from that period may yet come in. It’s already known that 2020 was the deadliest year in U.S. history, with deaths topping 3 million for the first time.

Federal officials ask pharmacists to help boost childhood immunization rates

Federal officials are asking pharmacists to undergo additional training to help reverse the slump in child immunization rates caused by the coronavirus pandemic (Source: “Feds Look to Pharmacists to Boost Childhood Immunization Rates,” Kaiser Health News, Dec. 3).

Fears over COVID-19 have led parents to avoid the doctor’s office and pediatricians to curtail in-person care. As a result, many children are missing routine vaccinations.

In August, the Department of Health and Human Services took steps to override restrictions in many states that kept state-licensed pharmacists from immunizing children. However, challenges remain in getting pharmacists fully integrated into the nation’s framework of childhood vaccinations, immunization experts said.

A key issue is that few pharmacists participate in the Vaccines for Children program, a federal initiative that purchases vaccines for the nation’s neediest kids. Half of children in the U.S. receive immunizations through the program, which purchases government-recommended vaccines for kids ages 0 to 18 who are low-income, uninsured or belong to an indigenous group. Compared with last year, VFC-funded orders for vaccines overall are down 9.6 million doses as of Nov. 9, said a spokesperson from the Centers for Disease Control and Prevention. Measles-containing vaccines are down an estimated 1.3 million doses.

Without solving the issues that keep pharmacists from participating in the Vaccines for Children program, said Claire Hannan, executive director of the Association of Immunization Managers, the steps to give parents more access to immunizations through drugstores may ultimately help only Americans wealthy enough to use it.

COVID-19 cases, hospitalizations and deaths continue to climb in Ohio

Another 324 Ohioans tested positive for the coronavirus since Thursday, bringing the statewide total of confirmed cases to 5,836 as of 2 p.m. Friday, the Ohio Department of Health reported (Source: “Coronavirus: Confirmed cases increase to 5,836; Ohio changing the way it reports virus data,” Columbus Dispatch, April 10, 2020).

That represents a 5.8% increase in cases from yesterday. The number of confirmed deaths in Ohio increased to 227 Friday, representing a 6.5% increase in deaths, from Thursday to Friday.

There are 1,755 Ohioans hospitalized for COVID-19 as of Friday, including 548 people admitted to intensive care units.

The state also reported another “probable” 42 cases of the virus, per an expanded definition of COVID-19 from the Centers for Disease Control and Prevention. That expanded consideration means there are an additional four deaths on top of 227 confirmed that can likely be attributed to the coronavirus, according to the state.

Until now, cases were only counted if they had been confirmed by a lab test, DeWine said. People will be counted in this new category if they are diagnosed through new, rapid methods of testing, DeWine said. It will also include a patient who has been exposed to a confirmed case and does not test positive for another disease.

HPIO is gathering the most relevant new research on COVID-19 on its Coronavirus in Ohio resource page. Sign up here for regular email summaries from HPIO of COVID-19 research. For the most up-to-date Ohio information on the pandemic, visit coronavirus.ohio.gov

Medicaid OKs Ohio plan to reduce lead in homes

Medicaid approved a plan this week that will remove hurdles and expand the ways Ohio can use federal healthcare money to keep children in families with low incomes safe from lead (Source: “Medicaid-approved changes remove barriers for Ohio’s lead clean-up program,” Cleveland Plain Dealer, Aug. 20, 2019).

The state first pursued new funding for lead abatement in 2017 through its Children’s Health Insurance Program. In its biennial budget that year, the state committed to spending about $300,000 to leverage $10 million in Medicaid funding for lead abatement work in high-risk homes across the state.

But the program was not as successful as hoped, with just $1.2 million of the available $10 million spent in the two-year period. Instead of expanding the program in his first budget, Gov. Mike DeWine opted to create a new version of the plan, approved by the Centers for Medicaid Services, that eliminates some of the bureaucratic impediments that kept property owners and tenants from being able to use the money to remove lead hazards.

DeWine tasks RecoveryOhio with addressing overdose rates among black men

ov. Mike DeWine is calling for increased efforts to battle addiction in the minority community as Ohio’s highest drug overdose death rate now belongs to black men (Source: “With drug death rate zooming among black men, Ohio Gov. DeWine wants action,” Columbus Dispatch, April 5, 2019).

DeWine last week appointed a minority health working group to develop recommendations as part of his RecoveryOhio initiative to improve addiction and mental health treatment across the state.

“We need to ensure that we are serving all Ohioans with mental health and substance abuse disorder” regardless of race, DeWine said. “We need to take a hard look at how we deliver services.”

Dr. Amy Acton, director of the Ohio Department of Health, said new analysis of 2017 unintentional drug overdose deaths showed 449 non-Hispanic black men among the toll, a rate of 64.6 deaths per 100,000. That number, for the first time in recent years, surpassed the rate of 63.7 deaths per 100,000 white non-Hispanic men (2,744 total deaths), who long had been the most likely to die of drug overdoses, particularly those involving opioids such as fentanyl.

New Ohio alcohol laws: Good for business, troublesome for health

New Ohio laws in the past decade have widened access to alcohol, a move that’s allowed the beer, wine and liquor industry to flourish. But, leaders in addiction prevention say the rapid expansion may threaten public health (Source: “Latest Ohio alcohol laws bolster business,” Dayton Daily News, April 7, 2019).

A Dayton Daily News investigation found Ohio’s governor has signed into law at least 12 bills that further relaxed alcohol restrictions statewide since 2012. They included everything from allowing microdistilleries to offer visitors a taste of their products and sell limited quantities for carryout to lowering the permit fees for craft breweries and allowing open containers of alcohol at outdoor events.

Liquor sales in Ohio have jumped more than $500 million in the past decade, and since 2012, the number of craft brewers in the state have increased more than 400%.

As Ohio’s alcohol laws have changed, however, binge drinking rates have creeped higher and increased access may be to blame. Binge drinking is commonly defined as four drinks for a woman and five for a man within a two-hour period, according to the National Institute on Alcohol Abuse and Alcoholism. 

The overall percentage of Ohioans who binge drink increased from 17% in 2011 to 19% as of this year, according to a survey from the University of Wisconsin Population Health Institute.

Public housing authorities express increased interest in addressing social determinants of health

The nation’s public housing authorities are seeking closer links to health insurers and medical care providers to address social determinants of health (Source: “Public Housing Authorities Seek Closer Ties To Health Insurers,” Forbes, Dec. 27, 2018).

The Council of Large Public Housing Authorities (CLPHA) says half of the nation’s public housing authorities are “pursuing health investments in housing.” Yet only 13% of large public housing authorities have “dedicated housing-health staff members,” research from the council and its partner, the Public and Affordable Housing Research Corporation, shows.

“Recent research shows that housing is both a social determinant of health and a platform for other services that improve life outcomes,” Council of Large Public Housing Authorities executive director Sunia Zaterman said. “What we’re learning from our members and the other public housing authorities that responded to our survey is that partnerships with the health care sector are the most effective way for public housing authorities to serve the health needs of their residents.”

Click here to see HPIO’s work related to social determinants of health in Ohio.