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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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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.


Graphic of the week

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Data released earlier this year from County Health Rankings show that Black Ohioans have the lowest median household income among groups of Ohioans and have, by far, the highest rate of premature death (years of potential life lost before age 75, which reflects the burden of deaths that potentially could have been prevented).

Between 2018 and 2020, Black Ohioans collectively lost 13,374 years of life before turning 75 years old (see graphic above, which was originally released by HPIO in April). That is nearly as many years lost as Hispanic (5,858) and white Ohioans (8,224) combined.  At the same time, the median household income for Black Ohioans is $12,352 less than Hispanic Ohioans, $28,065 less than white Ohioans and $43,782 less than Asian Ohioans.

“Individual efforts alone cannot overcome the structural barriers that maintain the racial wealth divide,” County Health Rankings states. “Structural barriers include laws, policies, institutional practices, and economic arrangements that create unequal conditions.”

The latest edition of the County Health Rankings includes a curated list of strategies to address racial wealth building, a key to eliminating health disparities.


FDA effectively bans Juul e-cigarette sales in U.S.

The Food and Drug Administration (FDA) on Thursday ordered Juul to stop selling e-cigarettes on the U.S. market, a profoundly damaging blow to a once-popular company whose brand was blamed for the teenage vaping crisis (Source: “F.D.A. Orders Juul to Stop Selling E-Cigarettes,” New York Times, June 23).

The FDA order affects all of Juul’s products on the U.S. market, the overwhelming source of the company’s sales. Juul’s sleek vaping cartridges and sweet-flavored pods helped usher in an era of alternative nicotine products that became exceptionally popular among young people, and invited intense scrutiny from antismoking groups and regulators who feared they would do more harm to young people than good to former smokers.

In its ruling, the agency said that Juul had provided insufficient and conflicting data about potentially harmful chemicals that could leach out of Juul’s proprietary e-liquid pods.


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.


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.


Newly released County Health Rankings spotlights connection between income and health

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Newly released data from County Health Rankings show that Black Ohioans have the lowest median household income among groups of Ohioans and have, by far, the highest rate of premature death (years of potential life lost before age 75, which reflects the burden of deaths that potentially could have been prevented).
 
Between 2018 and 2020, Black Ohioans collectively lost 13,374 years of life before turning 75 years old (see graphic above). That is nearly as many years lost as Hispanic (5,858) and white Ohioans (8,224) combined.  At the same time, the median household income for Black Ohioans is $12,352 less than Hispanic Ohioans, $28,065 less than white Ohioans and $43,782 less than Asian Ohioans.
 
“Individual efforts alone cannot overcome the structural barriers that maintain the racial wealth divide,” County Health Rankings states. “Structural barriers include laws, policies, institutional practices, and economic arrangements that create unequal conditions.”
 
The latest edition of the County Health Rankings, released this week, includes a new curated list of strategies to address racial wealth building, a key to eliminating health disparities.
 
“Research shows that income inequality has a negative effect on overall population health,” according to the Rankings. “Economically unequal societies often have higher rates of physical and mental illness, violence, and incarceration.”

Throughout April, HPIO has marked National Minority Health Month by creating a series of data visualizations to illustrate health disparities in Ohio.


DeWine announces funding for housing assistance program aimed at improving birth outcomes

Gov. Mike DeWine announced this week that $2.5 million is going to the Coalition of Homelessness and Housing in Ohio “to help improve birth outcomes and reduce infant mortality by providing stable housing for low-income families” (Source: “Ohio Gov. Mike DeWine announces $2.5 million for program to help pregnant women, improve birth outcomes,” WKYC-TV (Cleveland), April 6).
 
Gov. DeWine’s office said the Housing Assistance to Improve Birth and Child Outcomes Program will assess the impact of rental assistance on factors that contribute to infant mortality. The project aims to increase housing stability of low-income households with children while improving maternal and infant health outcomes.
 
The program is an expansion of Healthy Beginnings at Home (HBAH), a housing stabilization pilot project designed to improve maternal and infant health outcomes for low-income families that launched in 2017 with funding from the Ohio Housing Finance Agency. That program, which provided 49 pregnant women in Columbus with rental assistance and other services, was implemented by CelebrateOne, a Columbus-based infant mortality prevention collaborative.
 
CelebrateOne contracted with HPIO to complete a final report summarizing the outcome and process evaluation results of HBAH. 


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.


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.”