Social determinants of health

HPIO releases latest Health Value Dashboard

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The Health Policy Institute of Ohio has released the latest edition of its biennial Health Value Dashboardwhich found that Ohio ranks 44 on heath value compared to other states and D.C. (as displayed in the graphic above).

That means that Ohioans are living less healthy lives and spending more on health care than people in most other states.

The Dashboard is designed for policymakers and other public- and private-sector leaders to examine Ohio’s performance relative to other states, track change over time and identify and explore health disparities and inequities in Ohio. The report also highlights evidence-informed strategies that can be implemented to improve Ohio’s performance.

With more than 100 data metrics, the report can be a valuable tool as Ohio’s leaders continue to develop the state’s biennial budget over the next two months.

In the fifth edition of the Dashboard, HPIO identified three specific areas of strengths on which Ohio can build to create opportunities for improved health value in the state:

  • Strengthen Ohio’s workforce: Ohio can build upon recent success in attracting employers in high-growth industries to strengthen the workforce and reduce poverty
  • Foster mental well-being: Ohio can build upon expertise with, and community response to, the addiction crisis to become a national leader in behavioral health
  • Improve healthcare effectiveness: Ohio can build upon strengths in access to care to reinvigorate approaches to improving outcomes and controlling healthcare spending

Study: More than 1 in 5 adults with limited transit access forgo needed health care

More than 1 in 5 U.S. adults without access to a vehicle or public transportation missed or skipped a medical appointment in the previous year, according to a new national study (Source: “Over 1 in 5 skip health care due to transportation barriers,” Axios, April 28).

The new study found that while telehealth may have reduced transportation barriers for mental health, primary care and some other services, it's not accessible to all and can't substitute for in-person care for some medical needs, the Urban Institute researchers wrote.

The findings point to gaps that could be filled by Medicaid coverage of nonemergency medical transportation, which varies by state, or expanded access to telehealth where public transit options are limited, they said.

Transportation is one of the social drivers of health that HPIO examined in its recently released policy brief, Social Drivers of Infant Mortality: Recommendations for Action and Accountability in Ohio.


Graphic of the week

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Five years after HPIO’s report A New Approach to Reduce Infant Mortality and Achieve Equity identified 127 policy recommendations in housing, transportation, education and employment to reduce infant mortality in Ohio, the majority of those policy options saw some progress toward implementation (as illustrated in the graphic above).

In March, HPIO released a new follow-up report, Social Drivers of Infant Mortality: Recommendations for Action and Accountability in Ohio, that builds upon recommendations first included in the original report.
 
The new report found that, despite the efforts of many in both the public and private sectors, progress since 2011 in reducing infant mortality has been minimal and uneven, and Ohio’s infant mortality rate remains higher than most other states.

In recent weeks, HPIO has released action guides that highlights policy options for improving education and housing, two of the social drivers of infant mortality in Ohio. Guides on transportation, employment and racism are planned to be released in the coming months.


Graphic of the week

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Policy changes made in Ohio over the last decade that have expanded access to care also reduced the gap between Black and white Ohioans who report going without care due to cost, as displayed in the graphic above.

As Ohio observes Minority Health Month in April, it is clear that although progress has been made, there is still work to be done to eliminate health disparities. In HPIO’s 2023 Health Value Dashboard, which will be released in late April, the Institute found that if the racial gap in ability to pay for health care was fully closed, nearly 45,000 more Black Ohioans would not experience financial barriers to care.

HPIO is hosting a forum from 10:30 a.m.- 4 p.m. on Monday, May 1, focused on the release of the 2023 Dashboard. The event will be held in-person at the Grand Event Center in Grandview/Columbus. Throughout the forum, we will celebrate HPIO’s 20th anniversary. In appreciation of all of our supporters and partners, we will host a reception immediately following the forum, from 4 p.m.- 5:30 p.m. The last day to register is Friday, April 21, 2023.


HPIO releases housing action guide to address Ohio’s infant mortality rate


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The Health Policy Institute of Ohio has released an action guide that highlights policy options for improving housing, one of the social drivers of infant mortality in Ohio. 
 
HPIO recently produced the Social Drivers of Infant Mortality: Recommendations for Action and Accountability in Ohio report as an update to the 2017 A New Approach to Reduce Infant Mortality and Achieve Equity report.
 
The action guide takes a closer look at the housing recommendations in the Action and Accountability report and provides state and local health stakeholders with additional information and tools to support next steps.
 
Despite the efforts of many in both the public and private sectors, progress in reducing infant mortality since 2011 has been minimal and uneven (as illustrated in the graphic above), and Ohio’s infant mortality rate remains higher than most other states.

Infant mortality prevention efforts have largely focused on public health and healthcare interventions for pregnant women, such as safe sleep education and prenatal care access. While these efforts have likely contributed to the overall reduction in infant mortality, healthcare services alone are not enough to close gaps in birth outcomes in Ohio.
 
The guide and additional tools posted on HPIO’s website can be used to prioritize, advocate for and implement the recommendations.


HPIO brief offers strategies for reducing social drivers of infant mortality in Ohio

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The Health Policy Institute of Ohio has released a new policy brief, Social Drivers of Infant Mortality: Recommendations for Action and Accountability in Ohio, that builds upon recommendations first included in a report the Institute completed 5 years ago.
 
For many years, policymakers and community leaders across Ohio have worked to reduce high rates of infant mortality. Decisionmakers have explored this issue through multiple advisory committees, collaborative efforts, investments, legislation and other policy changes. For example, the Ohio General Assembly passed Senate Bill 322 in 2017, which adopted recommendations from the Ohio Commission on Infant Mortality’s 2016 report and required the creation of the 2017 Social Drivers of Infant Mortality (SDOIM) report: A New Approach to Reduce Infant Mortality and Achieve Equity, which was completed by HPIO under contract with the Ohio Legislative Service Commission.

Despite the efforts of many in both the public and private sectors, progress since 2011 has been minimal and uneven (as illustrated in the graphic above), and Ohio’s infant mortality rate remains higher than most other states.

Infant mortality prevention efforts have largely focused on public health and healthcare interventions for pregnant women, such as safe sleep education and prenatal care access. While these efforts have likely contributed to the overall reduction in infant mortality, healthcare services alone are not enough to close gaps in birth outcomes in Ohio.

Improvements in factors beyond access to care are needed to reinvigorate Ohio’s stalled progress on infant mortality reduction.

The new HPIO report prioritizes specific and actionable steps leaders can take to create change in five areas: Housing, transportation, education, employment and racism.


Graphic of the week

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New data analysis by the Health Policy Institute of Ohio shows that more Ohioans report having high blood pressure than people in other states (as illustrated in the graphic above).
 
The analysis also found that hypertension is more common among Black Ohioans and Ohioans with lower incomes, groups that often experience high rates of chronic stress, a leading contributor to high blood pressure.
 
There is emerging research establishing a link between higher rates of hypertension among African Americans and the chronic stress of discrimination and racism.

According to an HPIO policy brief on the connections between racism and health, “chronic exposure to racism renders communities of color more vulnerable to negative health outcomes across the life span and can lead to early death.”

The data graphic is the second produced by HPIO in February, which is American Heart Month, a designation designed to spotlight heart disease.


States test adding ‘food as medicine’ programs to Medicaid

More states are testing Medicaid programs that’ll provide more people with healthy foods and, potentially, lower health care costs (Source: “Can food cure high medical bills? Pilot 'food as medicine' programs aim to prove just that.” USA Today, Feb. 15). 
 
Medicaid typically only covers medical expenses, but ArkansasOregon and Massachusetts received approval from the Centers for Medicare & Medicaid Services last year to use a portion of their Medicaid funds to pay for food programs, including medically tailored meals, groceries and produce prescriptions (fruit and vegetable prescriptions or vouchers provided by medical professionals for people with diet-related diseases or food insecurity). The aim is to see whether providing people with nutritious foods can effectively prevent, manage, and treat diet-related diseases.  
 
study published last fall estimated that if all patients in the U.S. with mobility challenges and diet-related diseases received medically tailored meals, 1.6 million hospitalizations would be avoided, with a net savings of $13.6 billion annually. Another study in 2019 found that over the course of about a year, the meals resulted in 49% fewer inpatient admissions and a 16% cut in health care costs compared with a control group of patients who did not receive the meals. 
 
This spring, the American Heart Association and the Rockefeller Foundation plan to launch a $250 million “Food is Medicine” Research Initiative to determine if such programs can be developed cost-efficiently enough to merit benefit coverage and reimbursement for patients.


Global study: Students lost one-third of school year due to pandemic, still haven’t recovered

Children experienced learning deficits during the Covid pandemic that amounted to about one-third of a school year’s worth of knowledge and skills, according to a new global analysis, and had not recovered from those losses more than two years later (Source: “Students Lost One-Third of a School Year to Pandemic, Study Finds,” New York Times, Jan. 30).

Learning delays and regressions were most severe in developing countries and among students from low-income backgrounds, researchers said, worsening existing disparities and threatening to follow children into higher education and the work force.

The analysis, published Monday in the journal Nature Human Behavior and drawing on data from 15 countries, provided the most comprehensive account to date of the academic hardships wrought by the pandemic. The findings suggest that the challenges of remote learning — coupled with other stressors that plagued children and families throughout the pandemic — were not rectified when school doors reopened.


Graphic of the week

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A critical aspect of preventing adverse childhood experiences (ACEs) is ensuring that children have a strong start in life and home visiting is a key prevention strategy.

According to an estimate from the Ohio Department of Health, more than 83% of Ohioans who need home visiting are not enrolled in a program identified as “evidence-based” by the U.S. Department of Health and Human Services Home Visiting Evidence of Effectiveness (HomVEE) review (as illustrated in the graphic above).

Analysis from HPIO has found that home visiting programs are an evidence-based, multi-generational strategy proven to prevent and mitigate the impacts of ACEs. Trained providers (home visitors) visit expectant parents and families with infants and young children, providing one-on-one support for healthy parent and child development, early education and family needs. Participation in home visiting programs is typically voluntary.

These findings will be included in a new policy brief that HPIO plans to release next month as part of its Ohio ACEs Impact project.