Ohio Health Policy News

Millions more Americans had difficulty securing enough food in 2022 compared to the year prior, including 1 million more households with children, a new report from the U.S. Department of Agriculture (USDA) showed (Source: “Millions more Americans were food insecure in 2022 than 2021 – USDA,” Reuters, Oct. 25).
 
The increase interrupted a years-long trend of declining hunger in the United States. Previous reports from food banks and the U.S. Census Bureau have indicated that hunger is increasing as Americans with lower incomes struggle to recover from the pandemic and from the end of expanded food assistance.
 
"The report is a stark reminder of the consequences of shrinking our proven safety net," Agriculture Secretary Tom Vilsack said in a statement.
 
The USDA report, which did not provide an explanation for the rise, found that 12.8% of households - equivalent to 17 million households - struggled to get enough food in 2022, up from 10.2%, or 13.5 million households, in 2021.

A months-long investigation by the Washington Post concludes that decisions made by policymakers over the past several decades have led to poorer health outcomes and lower life expectancy for Ohioans compared to those in other states (Source: “How red-state politics are shaving years off American lives,” Washington Post, Oct. 3).

Many of those early deaths can be traced to decisions made years ago by local and state lawmakers over whether to implement cigarette taxes, invest in public health or tighten seat-belt regulations, among other policies, an examination by the Washington Post found.

“States’ politics — and their resulting policies — are shaving years off American lives,” according to the Post.

Ohio has plummeted nationally when it comes to life expectancy rates, moving from middle of the pack to the bottom fifth of states during the last 50 years, the Post found. Ohioans have a similar life expectancy to residents of Slovakia and Ecuador, relatively poor countries.

According to analysis from Jennifer Karas Montez, director of the Center for Aging and Policy Studies at Syracuse University, roughly 1 in 5 Ohioans will die before they turn 65.

HPIO’s 2023 Health Value Dashboard provides additional insight on how Ohio compares to other states and D.C. on a wide range of metrics.

A new analysis suggests that a federally-funded, state-administered initiative to provide meals to children in daycare settings positively affects not just children but also their families, tying subsidized child-care meals to better child health and lower rates of household food insecurity (Source: “Subsidized meals in child care tied to healthier kids and families,” Washington Post, Sept. 24).

The study of the Child and Adult Care Food Program (CACFP), published in the Journal of the Academy of Nutrition and Dietetics, found children who received subsidized meals in child-care settings were 30% less likely to have household food insecurity, 39% less likely to have poor or fair health, and 41% less likely to be admitted to the hospital from the emergency room than their peers who ate meals provided by their parents while in care.

Researchers interviewed primary caregivers of 3,084 young children receiving ER or primary care in Baltimore, Boston, Little Rock, Minneapolis and Philadelphia between 2010 and 2020. All of the children were between 13 and 48 months old and lived in low-income households, and all received subsidized care outside the home for 20 hours or more per week. Most of the children were eligible for CACFP.

The poverty rate in the U.S. has risen dramatically in the year since pandemic benefits ran out — and the child poverty rate has more than doubled, according to U.S. Census Bureau's annual data on poverty, income and health insurance released Tuesday (Source: “Child poverty more than doubles — a year after hitting record low, Census data shows,” NPR, Sept. 12).

Just a year ago, child poverty hit a historic low of 5.2%. The latest Census Bureau figures put it at 12.4%, the same as the overall poverty rate. The surge happened as record inflation was rising and a lot of pandemic relief was running out, but Census officials and other experts say a key was the child tax credit.

In 2021, Congress increased the amount of the credit as part of the American Rescue Plan and expanded eligibility to include millions more families with low incomes.

When the tax credit ended, surveys found many parents had trouble paying bills and covering basic expenses like rent and groceries.

Heat-related illness and deaths in the U.S. are on the rise, and an increase in drug use and homelessness is a significant part of the problem, according to public health officials and data from the Centers for Disease Control and Prevention (Source: “Heat-Related Deaths Are Up, and Not Just Because It’s Getting Hotter,” KFF Health News, Sept. 8).

Heat was the underlying or contributing cause of about 1,670 deaths nationwide in 2022, for a rate of about 5 deaths per million residents, according to provisional data from the CDC. That’s the highest heat-related death rate in at least two decades. The next-highest death rate was logged in 2021.

The simplest explanation for the increase is that it is getting hotter. The last eight years were the hottest on record, according to NASA figures dating to the late 1800s. But factors other than climate change also play a role.

Substance abuse, especially misuse of methamphetamines, has emerged as a major factor in heat-related illness. Methamphetamines can cause body temperature to increase to dangerous levels, and the combination of meth abuse, heat, and homelessness can be fatal.

“With any environmental crisis, people experiencing homelessness experience it first, they experience it worst, and they experience it longest,” said Katie League, behavioral health manager for the National Health Care for the Homeless Council.

The Health Policy Institute of Ohio has released an action guide that highlights policy options for improving employment, 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 employment recommendations in the Action and Accountability report and provides state and local health stakeholders with additional information and tools to support next steps.

“Employment that pays a self-sustaining wage and offers health insurance and other benefits can pave the way for good health and positive birth outcomes,” according to the guide.
 
The action guide highlights policies prioritized by HPIO’s Social Drivers of Infant Mortality Advisory Group. For example, one policy recommendation in the brief is for state and local policymakers to expand paid family leave benefits to 12 weeks or more and eliminate or mitigate the impact of waiting periods to access paid leave for public employees. Sixteen states and the District of Columbia have paid family leave laws, as illustrated above.

HPIO recently released similar action guides on housing, education and transportation. In the coming weeks, HPIO plans to release another guide on eliminating racism.
 
The guide and additional tools posted on HPIO’s website can be used to prioritize, advocate for and implement the recommendations.

The Health Policy Institute of Ohio has released an action guide that highlights policy options for improving transportation, 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 transportation recommendations in the Action and Accountability report and provides state and local health stakeholders with additional information and tools to support next steps.

The guide highlights how transportation affects health and overall well-being in several ways, including by impacting access to care, health behaviors and health outcomes through the ability to get to health care, jobs, school, child care, social services, grocery stores, parks, libraries and other destinations. As illustrated above, Ohioans who are insured through Medicaid face particular challenges with avoiding or delaying care due to a lack of transportation.

Earlier this spring, HPIO released similar action guides on housing and education. In the coming weeks, HPIO plans to release guides on employment and eliminating racism.
 
The guide and additional tools posted on HPIO’s website can be used to prioritize, advocate for and implement the recommendations.

With wildfire smoke from Canada causing air quality warnings in many states, data from HPIO’s 2023 Health Value Dashboard shows that Ohio was already lagging behind most other states on metrics related to outdoor air pollution (as displayed in the graphic above).
 
Inhaling polluted air (e.g., wildfire smoke), even in amounts lower than current National Ambient Air Quality Standards, increases the likelihood of poor health outcomes. Longer exposure to polluted air further increases negative health outcomes, which include effects on:

• Maternal and infant health
• Lung, heart and cognitive conditions
• Cancers

 Analysis of Dashboard data finds that the physical environment, which includes outdoor air quality, has a stronger correlation with the overall health of a state than access to care. This suggests that improving environmental conditions, like air quality, can improve the health and well-being of Ohioans.

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.

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.