Population health

Ohio stays near bottom for black infant mortality

A new federal report found that Ohio ranked next to last for rates of infant mortality among African American babies (Source: “Ohio near bottom in black infant mortality,” Jan. 4, 2018).

Ohio continues to have among the highest rates in the nation of black babies dying before their first birthday.

Ohio infant mortality rate of 13.46 deaths for every 1,000 live births to black mothers from 2013 to 2015 was worse than all states except Wisconsin, according to data released Thursday by the National Center for Health Statistics. Ohio’s black infant mortality rate is more than double the state’s infant-mortality rate of 5.76 for babies born to white mothers during the same period.

To address the state’s high infant mortality rate, a Central Ohio organization is piloting a program that would provide housing assistance for women who are homeless or in unstable living conditions (Source: “Housing help being provided to assess impact on infant-mortality rate,” Columbus Dispatch, Feb. 2, 2018).

The $991,000 grant from the Ohio Housing Finance Agency was awarded to CelebrateOne last month to help 50 pregnant women in extremely low-income areas find and pay for housing. The grant will fund a two-year “Healthy Beginnings” pilot program that will provide rental assistance as well as health care and social services to women who are homeless or in unstable living conditions.

Housing was one of four areas highlighted in a report titled “A New Approach to Reduce Infant Mortality and Achieve Equity,” that HPIO was contracted to produce as part of Senate Bill 332. The report found that improving social and economic conditions such as housing, transportation, education and employment opportunities, could help Ohio make faster progress in reducing the number of babies dying before their first birthday

Kasich, other governors urge Congress to reauthorize CHIP funding

A bipartisan group of governors led by Ohio Republican Gov. John Kasich and Colorado Democratic Gov. John Hickenlooper is urging Congress to act quickly to reauthorize funding for the Children’s Health Insurance Program (Source: “Bipartisan group of governors calls for swift CHIP reauthorization,” The Hill, Dec. 12, 2017).

In a letter to Congress, the governors said their states are running out of money, and urged lawmakers to find a bipartisan solution.

Federal funding for CHIP expired on Sept. 30 and while states have been able to use leftover funds in the interim, some will run out of money by the end of the year. The recently-passed continuing resolution lifted restrictions to give the most-at-risk states access to a pool of unspent government funds, but that pool is rapidly being depleted.

The House passed a five-year CHIP extension in early November, but it was mostly on a party-line vote as Democrats objected to the bill’s offsets. The Senate Finance Committee cleared a CHIP extension but did not discuss offsets and the bill has yet to come to the floor for a vote. There’s hope among lawmakers that an agreement could be reached to include a CHIP renewal in the next government spending bill, but without an agreement on offsets, there’s a risk the renewal could slip to January.

Drug overuse by older Americans needs more attention, experts warn

For decades, experts have warned that older Americans are taking too many unnecessary drugs, often prescribed by multiple doctors, for dubious or unknown reasons, but the issue still attracts little attention (Source: “An Overlooked Epidemic: Older Americans Taking Too Many Unneeded Drugs,” Kaiser Health News, Dec. 12, 2017).

Researchers estimate that 25 percent of people ages 65 to 69 take at least five prescription drugs to treat chronic conditions, a figure that jumps to nearly 46 percent for those between 70 and 79.

Doctors say it is not uncommon to encounter patients taking more than 20 drugs to treat acid reflux, heart disease, depression or insomnia or other disorders.

At least 15 percent of seniors seeking care annually from doctors or hospitals have suffered a medication problem; in half of these cases, the problem is believed to be potentially preventable. Studies have linked polypharmacy to unnecessary death. Older patients, who have greater difficulty metabolizing medicines, are more likely to suffer dizziness, confusion and falls. And the side effects of drugs are frequently misinterpreted as a new problem, triggering more prescriptions, a process known as a prescribing cascade.

U.S. study: Guns second-leading cause of death among adolescents

Handguns and other firearms cause the deaths of more children in the United States each year than the flu or asthma, according to a comprehensive new report on gun violence and kids (Source: “Guns kill nearly 1,300 children in the U.S. each year and send thousands more to hospitals,” Los Angeles Times, June 19, 2017).

Between 2012 and 2014, an average of 1,287 children and adolescents died each year as a result of gun violence, making firearms second only to motor vehicle crashes as a cause of injury-related deaths in that age group.

The new analysis, published Monday in the journal Pediatrics, represents an unusually comprehensive look at the toll that guns take on children. It draws from federal databases of injuries and deaths, hospital records, and an effort launched in 2003 to track violent deaths and the circumstances surrounding them in at least 17 states so far.

Between 2010 and 2014, the states with the highest rates of firearm-related homicide among children were largely concentrated across the South (Alabama, Florida, Georgia, Louisiana, Mississippi, South Carolina and Tennessee). Other states near the top of the list included four in the Midwest (Illinois, Missouri, Michigan and Ohio), two in the West (California and Nevada), and three in the Northeast (Connecticut, Maryland and Pennsylvania).

HPIO co-hosting regional forum in Chicago on health systems, population health

The Health Policy Institute is partnering with organizations from other Midwestern states to host the Midwest Forum on Hospitals, Health Systems and Population Health. The forum will take place Nov. 29 to Dec. 1 at the Westin Michigan Avenue in Chicago.

Those interested in the forum can sign up to receive email updates about the event. Event organizers have also released a call for abstracts, which are due by 11:59 p.m. central time on Friday, June 16. 

The Midwest Forum on Hospitals, Health Systems and Population Health: Partnerships to Build a Culture of Health will bring together organizations and key stakeholders dedicated to improving the health of all Americans. The goal of the meeting is to engage attendees in a broad dialogue across sectors to solve complex issues to improve the health of communities and integrate clinical and community health and prevention strategies. Participants will share innovative models that are working and inspire the audience to take action to help transform the existing system of care in the United States to a system that strategically plans for and supports the health of its population.

Building on health equity as the core forum theme, topics include:

  • The policy environment for population health and health system transformation
  • Using data for care coordination and population health
  • Aligning financial incentives and payment for population health
  • The role of purchasers and payers in population health
  • Integrating physical and behavioral health
  • Developing clinical/community linkages
  • Connecting health with community development
  • How to engage consumers and patients in population health
  • Collaborating on and leveraging community health needs assessments and planning
  • Partnerships for health equity and social determinants of health

CDC: U.S. life expectancy gap between blacks, whites is closing

New data from the Centers for Disease Control and Prevention has found that although black Americans still face a disparity in death rates compared to whites, the gap is closing (Source: “Black Americans Are Living Longer, C.D.C. Reports,” New York Times, May 2, 2017).

According to the CDC data, black Americans who live to 65 may now expect to live longer than whites of the same age.

The narrowing gap in death rates first emerged at the start of this century, and it shows no signs of abating. Both black and white Americans are living longer, but the death rate among blacks has been dropping faster than that among whites.

Fifteen years ago, black Americans had a life expectancy at birth of 71.8 years. For whites, the figure was 77.3 years. Blacks now have a life expectancy of 75.6 years, and whites can expect to live on average for 79 years.

But disparities remain, the researchers found. Blacks aged 35 to 64 are 50 percent more likely than whites to have high blood pressure. The homicide rate among blacks aged 18 to 34 is nine times as high as the rate among whites. Among blacks aged 35 to 49, the homicide rate is five times as high as it is among whites.

Life expectancy drops in U.S. for first time in more than 20 years

For the first time in more than two decades, life expectancy for Americans declined last year (Source: “U.S. life expectancy declines for the first time since 1993,” Washington Post, Dec. 8, 2016).

Rising fatalities from heart disease and stroke, diabetes, drug overdoses, accidents and other conditions caused the lower life expectancy revealed in a report released Thursday by the National Center for Health Statistics. In all, death rates rose for eight of the top 10 leading causes of death.

Overall, life expectancy fell by one-tenth of a year, from 78.9 in 2014 to 78.8 in 2015, according to the latest data. The last time U.S. life expectancy at birth declined was in 1993, when it dropped from 75.6 to 75.4, according to World Bank data.

The overall death rate rose 1.2 percent in 2015, its first uptick since 1999. More than 2.7 million people died, about 45 percent of them from heart disease or cancer.

The report’s lone bright spot was a drop in the death rate from cancer, probably because fewer people are smoking, the disease is being detected earlier and new treatments have been developed recently, experts said.

2016 state health assessment draft released

The Governor’s Office of Health Transformation and the Ohio Department of Health today released a draft of the 2016 state health assessment.

The state health assessment is a comprehensive and actionable picture of health and wellbeing in Ohio. The purpose of the state health assessment is to:

  • Inform identification of priorities for the upcoming state health improvement plan
  • Provide a template for state agencies and local partners (uniform set of categories and metrics to use in related assessments)

The report includes information from several sources in order to provide a comprehensive picture of health and wellbeing in Ohio. Using existing data, this document presents data profiles on health outcomes and a broad range of factors that impact health outcomes, healthcare spending and disparities. These data profiles are followed by summaries of new information collected for this assessment, including qualitative information gathered through key informant interviews and regional forums. The Health Policy Institute of Ohio was commissioned to facilitate the state health assessment process and produce the publication.

The public is invited to provide input on the state health assessment until noon on July 5, 2016.

The final state health assessment is expected to be released later this summer, followed by the release of the 2016 state health improvement plan later this year.

Study finds income, geography have major impact on life expectancy

A study published this week found that the life expectancy of Americans with low incomes is substantially lower than those with higher incomes, although the gap between income levels varies widely by geography (Source: “Income inequality is chipping away at Americans’ life expectancy,” Vox, April 11, 2016).

According to the study, publishing in JAMA,  men who were among the top 1 percent of income earners lived 15 years longer than men in the bottom 1 percent. For women at the extremes of the income distribution, life expectancy differed by 10 years.

But there's evidence that the gaps aren't inevitable and vary significantly from region to region.  The New York Times created an interactive county-level map to illustrate the geographical variations in life expectancy.

In an accompanying editorial, Steven Woolf, director of Virginia Commonwealth University's Center on Society and Health, and Jason Purnell of Washington University write that the study findings should be a call to action for physicians to not only consider how social status and income may affect their patients' health, but also to reach beyond medicine and work with others across sectors in order to improve the health of populations.

"Clinicians and health care systems find it unrealistic and overwhelming to tackle complex social problems, but they are not alone," Woolf and Purnell write. "Teachers, police officers, parents, employers, and many others also feel powerless to solve social problems without partners. Meaningful change requires broader thinking. ... As the history of tobacco control teaches, multilevel interventions across the socioecological framework— from legislation to marketing — are essential to advance population health."

Poll: Ohioans’ health tied to income, education

New analysis from the Ohio Health Issues Poll shows that Ohioans with higher incomes and more education, two upstream factors of health, reported being in better health.

The 2015 Ohio Health Issues Poll (OHIP), funded by Interact for Health, asked Ohio adults “In general, would you say your health is excellent, very good, good, fair or poor?” Nearly half of Ohio adults (47 percent) reported that their health was excellent or very good. About 3 in 10 (33 percent) said their health was good, and 2 in 10 (20 percent) reported fair or poor health.

Better self-reported health, however, is strongly associated with higher incomes, OHIP found. In 2015, nearly 6 in 10 adults earning more than 200 percent of the Federal Poverty Level (56 percent) reported excellent or very good health. This compares with only 35 percent of adults earning 200 percent FPL and below.

Likewise, OHIP found that adults with more education reported better health. More than 6 in 10 college graduates (64 percent) reported excellent or very good health. Only 4 in 10 Ohio adults with less than a college degree reported excellent or very good health.

The findings mirror new national research released on Friday by economists at the Brookings Institution that found that life expectancy for the bottom 10 percent of wage earners improved by just 3 percent for men born in 1950 compared with those born in 1920. For the top 10 percent, though, it jumped by about 28 percent (Source: “Disparity in Life Spans of the Rich and the Poor Is Growing,” New York Times, Feb. 12, 2016).  

“This may be the next frontier of the inequality discussion,” said Peter Orszag, a former Obama administration official now at Citigroup, who was among the first to highlight the pattern.