Ohio Health Value Review– October 2017 January 23, 2018
The Ohio Health Value Review is a quarterly electronic update from the Health Policy Institute of Ohio designed to strengthen connections between public health and healthcare partners in Ohio and highlight opportunities for different sectors to work together to improve health value in our state. If you have questions about the newsletter or have suggested tools or resources you would like to see included in future editions, please contact Nick Wiselogel, HPIO’s Vice President of Strategic Communications.
Ohio opioid addiction crisis calls for comprehensive policy response
Opiate addiction and the rising number of overdose deaths in Ohio have dominated news headlines in recent years.
In 2015, Ohio had the third highest drug overdose death rate in the country1.
Between 2010 and 2016, unintentional injuries surpassed cancer as the leading cause of premature death in Ohio, and more than 70 percent of accidental deaths are because of drug overdoses. Unintentional drug overdose deaths alone (a subcategory of unintentional injuries) became the second leading cause of premature death in Ohio in 2016, surpassing heart disease 2.
Prescription drug overdose deaths (excluding fentanyl) peaked in Ohio in 2011 and opioid prescribing peaked in 2012.3 As prescription opioid deaths were declining, deaths from heroin and fentanyl rose substantially (see graphic below)4, and studies have found that many heroin users first became addicted to prescription pain killers before transitioning to heroin.567 In recent years, Ohio has also seen a growing number of overdose deaths involving cocaine and benzodiazepines.
These trends indicate that although policy changes may reduce the supply of one type of drug (such as prescription opioids), other drugs may emerge and be widely used unless the underlying demand for addictive substances is also reduced through effective prevention and treatment.
There is evidence for what works to prevent, treat and recover from addiction. Progress is being made across the country and throughout Ohio, but more can be done to identify and implement effective strategies in a widespread and coordinated way. That is why HPIO is launching the Addiction Evidence Project, which will provide state policymakers and other stakeholders with tools to:
- Quickly find existing information about what works
- Review addiction policy changes enacted in Ohio in recent years
- Assess the extent to which those policies aligned with existing standards and evidence
- Identify areas where Ohio policy could be better aligned with standards and evidence, including potential gaps in Ohio’s response to the opiate crisis
HPIO plans to soon post three types of tools on its forthcome HPIO Addiction Evidence Project website:
- Resource page: Hub for clinical standards/guidelines, expert consensus statements/recommendations, model policies and evidence registries
- Policy inventory: List of legislation, regulations, funding allocation amounts, practice guidelines, state agency initiatives and legislative initiatives
- Policy scorecard: Analysis of strengths and gaps in Ohio’s policy response to addiction
HPIO will develop these tools in phases, starting with prevention, treatment and recovery. Future phases will address harm reduction, overdose reversal, children services, law enforcement, criminal justice reform and surveillance and evaluation, depending on resource availability and capacity.
While there is no quick or easy answer to the problem of opiate addiction in Ohio, it is encouraging that proven strategies are available and state policymakers are working to make progress on this health challenge.
Health value graphic
Health value tools
Population health and healthcare spending
Issue 2: Drug Price Standards Initiative – HPIO resource page, includes research and resources on drug pricing
Social and economic environment
Adverse Childhood Experiences Among US Children – Fact sheet from the Child & Adolescent Health Measurement Initiative
Connections between education and health No. 3: The importance of early learning – HPIO policy brief
Connections between income and health – HPIO policy brief
Patterns of Collaboration Among Health Care and Social Services – Commonwealth Fund
In Focus: Creating Pathways and Partnerships to Address Patients’ Social Needs -A Commonwealth Fund article, part of its “Transforming Care” series
Ohio Early Childhood Education Gubernatorial Reference Manual -Groundwork Ohio
Access to care
Selling Health Insurance Across State Lines – A National Academy for State Health Policy brief, part of its series titled “Lessons from States: Questions for Policymakers”
Health Care is Local: Impact of Income and Geography on Premiums and Premium Support – National Academy for State Health Policy
Interactive Maps: Estimates of Enrollment in ACA Marketplaces and Medicaid Expansion – Kaiser Family Foundation
Key Facts about the Uninsured Population – Kaiser Family Foundation fact sheet
Health System Dashboard – A Dashboard of U.S. health system performance, created by the Peterson Center on Healthcare and the Kaiser Family Foundation
Public health and prevention
U.S. E-Cigarette Regulations – 50 State Review (2017) -Public Health Law Center
Technical Packages for Violence Prevention: Using Evidence-based Strategies in Your Violence Prevention Efforts – Centers for Disease Control and Prevention
6 Reasons Why Parks Matter for Health – RWJF Culture of Health blog
Promoting Physical Activity in High-Poverty Neighborhood Parks – Rand Corporation policy brief
Strategies to Strengthen Health and Housing Partnerships Through Medicaid to Improve Health Care for Individuals Experiencing Homelessness – National Academy for State Health Policy
Complete Streets Local Policy Workbook – National League of Cities
- As overall care quality improves, socioeconomic disparities remain – Fierce Healthcare news article
- ProMedica announces $50 million to address community health – Toledo Blade news article
- CWRU gets federal money to establish new Minority Health and Health Disparities Center of Excellence – Cleveland Plain Dealer news article
State Health Improvement Plan (SHIP) priority topics
Mental health and addiction
- The opioid epidemic: A new National Academies interactive guide – National Academies of Sciences, Engineering, and Medicine
- Prevalence, Treatment, And Unmet Treatment Needs Of US Adults With Mental Health And Substance Use Disorders– Health Affairs
- Medicaid’s Role in Addressing the Opioid Epidemic – Kaiser Family Foundation infographic
- Costs and Outcomes of Mental Health and Substance Use Disorders in the US -JAMA infographic
- In Focus: Expanding Access to Addiction Treatment Through Primary Care – A Commonwealth Fund article, part of its “Transforming Care” series
- New Numbers Reveal Huge Disparities in Opioid Prescribing – Stateline news article (Pew Charitable Trusts)
- The United States Can Reduce Socioeconomic Disparities By Focusing On Chronic Diseases – Health Affairs Blog
- Multiple Chronic Conditions in the United States – Rand report
Maternal and infant health
- Birth Equity-A Path forward — Children’s Defense Fund-Ohio
- 2016 Ohio Infant Mortality Data: General Finding – Ohio Department of Health
- Access To Obstetric Services In Rural Counties Still Declining, With 9 Percent Losing Services, 2004-14 – Health Affairs
Nov. 17 – HPIO Online seminar: The path forward: What’s on the horizon for health policy?
The third in a series of three seminars on federal health policy, the webinar will feature Leanne Gassaway, Senior Vice President of State Affairs, America’s Health Insurance Plans and Matt Salo, Executive Director, National Association of Medicaid Directors
HPIO is partnering with organizations from other Midwestern states to host a three-day forum in Chicago. The goal of the meeting is to engage attendees in a broad dialogue across sectors to solve complex issues to improve the health of communities and integrate clinical and community health and prevention strategies.
- Number of deaths due to drug overdose per 100,000 population (age adjusted). CDC WONDER. Get cite from Dashboard sources.
- Premature death refers to years of potential life lost (YPLL) before age 75, age-adjusted rate per 1,000 population. Ohio Department of Health Bureau of Vital Statistics
- 2016 Ohio Drug Overdose Data: General Findings. Ohio Department of Health, 2017.
- 2016 Ohio Drug Overdose Data: General Findings. Ohio Department of Health, 2017.
- Associations of nonmedical pain reliever use and initiation of heroin use in the United States. Muhuri, et. Al. 2013. Accessed 9/27/17: https://www.samhsa.gov/data/sites/default/files/DR006/DR006/nonmedical-pain-reliever-use-2013.htm#tab2note1
- Lankenau, et. Al. Misuse of prescription and illicit drugs among high-risk young adults in Los Angeles and New York. Journal of Public Health Research, 2012. https://www.ncbi.nlm.nih.gov/pubmed/22798990
- Compton, et. Al. Relationship between nonmedical prescription-opioid use and heroin use. New England Journal of Medicine. 2016. http://www.nejm.org/doi/pdf/10.1056/NEJMra1508490