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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.”


For first time since 1990, EPA adds chemical to list of pollutants

After three decades, the federal government has expanded its list of chemicals too dangerous for Americans to breathe (Source: “For the first time in over 30 years, the EPA adds to its list of hazardous air pollutants,” Washington Post, Jan. 5).

The Environmental Protection Agency (EPA) added a powerful dry-cleaning solvent, 1-bromopropane, to its list of hazardous air pollutants. Researchers, bureaucrats and even many chemical makers have viewed it for years as a dangerous airborne pollutant suspected to damage nerves and cause cancer.

Yet it took a decade of prodding to prompt EPA officials to register it as a hazardous air toxic. The final rule was announced in a notice published in the Federal Register on Wednesday. The designation allows the agency to set limits on emissions of the solvent, valued by dry cleaners, auto shops and other businesses for its ability to treat dirty fabrics and greasy metal parts.


White House unveils plans to remove lead pipes, paint

The Biden administration released a new plan this week for removing the country’s lead water pipes (Source: “Biden administration releases plan for tackling lead pipes,” The Hill, Dec. 16). 

The plan, announced Thursday in a fact sheet, notes that the Environmental Protection Agency (EPA) will “begin to develop” new regulations for lead and copper pipes. 

Exposure to lead can have negative health effects, especially in children, for whom it can cause brain and nervous system damage and slowed growth and development. 

The Biden administration’s plans would also distribute about $3 billion in funds from the bipartisan infrastructure law for lead service line replacement next year, and said it would be “calling on states to prioritize underserved communities.”

The EPA and Labor Department will also create regional technical assistance hubs that seek to “fast track” the removal process. Meanwhile, the Housing and Urban Development Department will distribute grants to remove lead paint and other hazards in low-income communities. 


New HPIO brief explores intersection between criminal justice, health and race

The Health Policy Institute of Ohio has released a new brief titled, Connections between Criminal Justice and Health: Insights on Justice and Race.

According to the brief, “The two-way relationship between criminal justice and health is influenced by racism and other forms of discrimination, which can drive poor outcomes in both sectors.”

Building on HPIO's Connections between Criminal Justice and Health policy brief released in June, this brief highlights the many ways that racism impacts criminal justice outcomes, finding that:

  • Disparities in the criminal justice system are not inevitable, and although unjust biases, policies and structures exist, improvement is possible.
  • Ohioans of color experience barriers to justice stemming from a long history of racism in the criminal justice system that casts a shadow over modern policymaking.
  • Public and private stakeholders can take meaningful action to eliminate racism in the criminal justice system and improve health, safety and well-being for every Ohioan.

Study links historic redlining to current Black maternal health disparities

Despite coming to an end in the 1960s, institutionally racist policies like redlining still contribute to poor health outcomes and Black maternal health disparities, according to new research (Source: “Decades-Old Policy Fuel Black Maternal Health Disparities,” Patient Engagement HIT, Oct. 5).

A relic of the 1930s, redlining was a discriminatory practice in which the US Home Owners’ Loan Corporation designated thousands of areas as “unsafe” for issuing a homeowner’s loan. “Unsafe” usually meant there was a higher proportion of Black people living in a given neighborhood, creating a system of divestment that made it harder for Black people to own a home.

The study, which was published in the Journal of the American Medical Association, found that poor outcomes happening today were largely concentrated in areas that in the 1940s had been deemed “hazardous” for homeowner’s loans by the HOLC. In other words, the racist policymaking of the mid-20th century is still having negative health equity impacts today.

“This structure of disinvestment, which formally stretched forward into the 1960s, has far-reaching impacts,” the researchers explained. “The legacy of historic redline racial discrimination correlates with modern social and health inequities.”


Reports find health problems tied to climate change are worsening

Health problems tied to climate change are getting worse, according to two reports published Wednesday (Source: “Reports: Health problems tied to global warming on the rise,” Associated Press, Oct. 21).

The annual reports commissioned by the medical journal Lancet tracked 44 global health indicators connected to climate change, including heat deaths, infectious diseases and hunger. All of them are getting grimmer, said Lancet Countdown project research director Marina Romanello, a biochemist.

This year’s reports — one global, one just aimed at the United States — found that in the U.S., heat, fire and drought caused the biggest problems. An unprecedented Pacific Northwest and Canadian heat wave hit this summer, which a previous study showed couldn’t have happened without human-caused climate change.


Study: 1 in 20 Ohio children has elevated lead levels in blood, more than twice national rate

Ohio children have elevated levels of lead in their blood at more than two times the national rate, according to a study released Monday (Source: “Ohio kids’ show elevated lead blood levels at more than twice the national rate, study finds,” Ohio Capital Journal, Sept. 28).

The research, from JAMA Pediatrics, found about 5.2% of Ohio children have elevated levels of lead in their system.

Nationally, the rate is about 1.9%. Ohio ranked second nationally in terms of states with the highest rates of children with elevated blood levels.

Lead is a neurotoxin linked to developmental, mental, and physical impairment, and young children are especially vulnerable. There’s no safe level of exposure for children, though their blood is considered elevated when it contains 5 micrograms per deciliter.

Ohio is one of six states with kids’ proportions of elevated blood levels more than twice the national average, along with Nebraska (6%), Pennsylvania (5%), Missouri (4.5%), Michigan (4.5%) and Wisconsin (4.3%).