Black Americans are dying from COVID-19 at nearly 2½ times the rate of white people nationwide, according to the COVID Tracking Project, and despite representing roughly 13 percent of the population, they’ve accounted for 22 percent of coronavirus deaths in cases in which race and ethnicity are known. And yet, in a sign of deep-seated and well-earned distrust in the U.S. medical establishment, surveys have shown consistently that Black Americans are less willing than other racial and ethnic groups to accept a coronavirus vaccine. Read more.
State Releases Health Disparity Report
In mid-April, Gov. Tom Wolf and Lt. Governor John Fetterman announced the creation of a COVID-19 Response Task Force for Health Disparity to help communicate issues about how the pandemic is affecting the state’s minority and marginalized populations. After months of weekly meetings and outreach from task force members to marginalized community members, the task force completed its report and presented it to the governor earlier this week. The report includes six recommendations focused on these policy topics related to health disparity, ranked in order of urgency: housing, criminal justice, food insecurity, health disparity, education and economic opportunities. According to the report, each area either directly or indirectly affects the health of Pennsylvanians and must be addressed to appropriately remove the disparities that have existed for generations and have only been exacerbated by the pandemic. The work of the task force will help inform an internal steering committee on dismantling racism that Gov. Wolf established recently. Read the Governor’s press release.
NACCHO National Profile of Local Health Departments
The National Association of County & City Health Officials (NACCHO) received funding support from the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation to profile approximately 2,800 local health departments (LHDs) across the country. Each LHD is coded as urban or rural based on the population it serves. Find more information here.
Rural Health Research Center Finds Continued Declines in Maternity Care in Rural U.S. Counties
A new HRSA-funded University of Minnesota (UMN) study published in the Journal of the American Medical Association (JAMA) finds that rural U.S. counties continue to see declines in hospital-based obstetrics services. Updated data from 2014-2018 shows that an additional 5.7% of rural counties lost obstetric services, on top of the 52.9% of counties that already lacked them.
While UMN pointed to the ongoing trend of losing services as a concern, they also highlighted examples of rural communities successfully supporting births locally. One case study in rural Iowa identified continuity of care and specialized nursing staff as key factors that have enabled their success.
Read the study (PDF – 1.2 MB).
Study Sheds Light on Regional Differences in Infant Mortality Among Black Americans
Infant mortality rates in the USA are highest among Black Americans, yet there are considerable differences between regions of the country. Infant mortality among Blacks is highest in the Midwest and lowest in the West and Northeast. To examine the state and county-level factors that might explain these patterns, researcher Ashley Hirai of MCHB collaborated on a study published in PLOS ONE that was led by Veni Kandasamy, a former HRSA fellow now at John Hopkins University.
The study looked at many factors. When taken together, those factors explained one-third of the regional differences. Factors that “protected” Black infants—or in other words, were associated with lower infant mortality—included: being born in a state with higher levels of Black-White marriage rates (proxy for social integration); being born in a state with higher maternal and child health funding per capita; and, being born in a county with higher levels of Black household income.
To learn more, find the full article in PLOS ONE or contact Ashley Hirai.
New Brief: Addressing Opioid Use in Rural Communities
The opioid epidemic continues to have a devastating impact in rural areas disproportionately affected by a lack of infrastructure to provide treatment for opioid use disorders (OUDs). Critical Access Hospitals (CAHs), often the hubs of local systems of care, can play an important role in addressing OUDs. Using a substance use framework developed for the Flex Monitoring Team’s earlier study of CAH substance use strategies, this brief highlights strategies adopted by CAHs to combat opioid use in their communities. It also identifies resources that State Flex Programs can use to support CAHs with this challenging population health issue.
The report may accessed here or on the Flex Monitoring Team website.
CDC Releases Provisional Overdose Mortality Data During the COVID-19 Pandemic
The Centers for Disease Control and Prevention (CDC) released provisional data showing a 6.6% increase in provisional drug overdose mortality for the 12 months ending in January 2020; this is compared to an increase of 4.8% and 3.0% for the 12 months ending in December 2019 and November 2019, respectively. Deaths involving synthetic opioids, cocaine, and psychostimulants with abuse potential (including methamphetamine) continue to rise when compared to the previous year. Even as we pour time, treasure, and talent into addressing the COVID-19 pandemic, there is still important work to do on the opioid crisis that has ravaged lives and communities across the county, especially now as we are also dealing with the COVID-19 pandemic that could markedly affect our nation’s mental health and risk of substance use. This provisional data comes as the CDC also releases a Morbidity and Mortality Weekly Report (MMWR) on Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic in the U.S. from June 24-30, 2020. Communities have faced mental health challenges related to COVID-19–associated morbidity, mortality, and mitigation activities.
Study Finds Racial Bias in COVID-19 Hospital Aid
The federal government has systematically shortchanged communities with large Black populations in the distribution of billions of dollars in COVID-19 relief aid meant to help hospitals struggling to manage the effects of the pandemic. According to a study published in the Journal of the American Medical Association, the funding inequities resulted from a formula that allocated large chunks of a $175 billion relief package based on hospital revenue, instead of numbers of COVID-19 cases or other health data. Read more.
Long-Term COVID Complications Could Cost Billions
With mounting evidence that some COVID-19 survivors face months, or possibly years, of debilitating complications, health care experts are beginning to study possible long-term costs. Bruce Lee, M.D., of the City University of New York estimated that if 20 percent of the U.S. population contracts the virus, the one-year post-hospitalization costs would be at least $50 billion, before factoring in longer-term care for lingering health problems. Read more.
CMS Report to Congress: Reducing Telehealth Barriers for Pediatric Medicaid Populations
The report from the Centers for Medicare & Medicaid Services (CMS) outlines state-level policy that can reduce barriers to using telehealth for treating substance use disorders (SUDs) among pediatric Medicaid populations. Medicaid coverage and state laws regarding telehealth vary by state, so this report highlights how delivering care to children with SUD differs between telehealth and in-person visits in terms of costs and quality of care. While the field is still emerging, there are promising practices that could improve access to care where options for SUD treatment is limited.