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HPIO Releases 2024 Biennial Health Value Dashboard and 12 Policy Options to Improve Health Value

Health Policy Institute of Ohio (HPIO) recently released its biennial Health Value Dashboard — a tool developed to track Ohio’s progress toward health value, which is a measure of Ohio’s performance on population health outcomes and healthcare spending. The dashboard also includes 12 policy options to improve health value and create opportunities for prosperity and well-being throughout Ohio.

Ohio ranks 44^th on health value out of 50 states, indicating that Ohioans live less healthy lives and spend more on healthcare than people in most other states. The dashboard highlights the potential cause of such a low ranking and provides four policy priorities that can improve Ohio’s health value.

1. Mental Well-Being

Adult depression in Ohio ranks 41 among states. From 2011 to 2021, 25% of Ohio adults reported this condition. The numbers among high school students are also concerning. In 2021, 43% reported consistently feeling sad or hopeless for two weeks or more. These numbers were higher among gay, lesbian or bisexual students, at 76%.

Policies to drive improvement in Ohio:

• Improve access to telemental health services and reduce existing barriers for patients, such as gaps in insurance coverage and lack of broadband availability.
• Fund programs with evidence of mental health benefits, such as mental health first aid, cross-age youth peer mentoring and trauma-informed schools.
• Improve the behavioral health crisis system, including the 988 lifeline and mobile crisis response, ensuring that these services are adequately funded and available across the state.

2. Tobacco and Cannabis Prevention

Nicotine dependence and tobacco are leading drivers of poor health outcomes, such as cancer, heart disease and stroke, and contribute to higher healthcare spending. In 2021, 20% of Ohio high school students reported using electronic vapor products are least once in the past 30 days. While Ohio ranks 33^rd on youth e-cigarette use, it ranks 46^th on adult smoking.

Cannabis use among Ohio teens in 2021 was low at 13.3% — ranking 10^th among the 43 states that provided data. This low number is expected to increase with the recent legalization of recreational marijuana use for adults.

Policies to drive improvement in Ohio:

• Establish state-level tobacco retailer licensing and fund robust public health enforcement of “Tobacco 21” age restrictions.
• Implement marketing restrictions on tobacco and cannabis products and prohibit product types that are attractive to children and adolescents — including flavors.
• Ensure that Ohio’s new cannabis regulatory framework balances important policy goals such as protecting youth health and promoting equity.

3. Healthcare Affordability

Ranking 16^th among states, Ohio has seen major policy changes that have improved access to care, including the expansion of Medicaid eligibility. In 2022, only 6% of Ohioans were uninsured, compared to 14% in 2010. While Ohio’s uninsured rate is lower than most states, access to affordable care is still unobtainable for many residents.

Ohio ranks 45 out of 49 states in potentially avoidable emergency department visits for employer-insured enrollees. These are visits that could have been prevented if affordable care was accessible earlier in a lower-intensity setting.

Policies to drive improvement in Ohio:

• Establish a healthcare cost study commission to examine the key contributions to high healthcare spending, as well as ways to lower costs for consumers and employers.
• Ensure timely access to primary care, mental health, substance use disorder and dental services by strengthening provider network accuracy and adequacy and increasing provider workforce capacity.
• Monitor the results of the new federal All-Payer Health Equity Approaches and Development (AHEAD) model, through which the federal government will collaborate with selected states to improve health, advance health equity and reduce healthcare cost growth.

4. Creating Opportunities to Thrive

Many Ohioans continue to face barriers to health where they live, work and play. Discriminatory policies and practices have shaped where Ohioans of color live and whether they have access to safe neighborhoods free from harmful conditions, such as air pollution. Ranking 41 in outdoor air quality, Ohio has seen historical practices like redlining result in disinvestment, concentrated poverty and depleted property values in neighborhoods where Ohioans of color live. These same areas are more likely to be industry developed and result in greater levels of air pollution.

Food insecurity continues to be an important issue in Ohio, among children especially. Factors like discrimination and poverty can cause barriers to opportunity, such as an inability to access healthy foods, stable housing and meaningful employment.

Policies to drive improvements in Ohio:

• Increase the presence and accessibility of green spaces and parks that provide environmental and health benefits to communities, prioritizing areas that have historically lacked access to green spaces.
• Increase food access to Ohioans most at-risk of food insecurity through initiatives such as the Special Supplemental Nutrition Program for Woman, Infants and Children (WIC) and Senior Farmers’ Market Nutrition Programs.
• Use health equity impact assessments to identify the potential health impacts of proposed policies, programs and services on systematically disadvantaged groups.

Where Ohio is Doing Well and Where it can Improve

Ohio ranks 2^nd in the category of “accreditation of local health departments” — where Ohio is the only state that requires accreditation of local health departments. Other positive rankings include routine checkup, fourth grade reading, youth marijuana use, received mental health treatment in past year — children, and medications for opioid use disorder.

Areas in which Ohio ranks in the bottom quartile: preventative dental care — children, drug overdose deaths, total Medicare spending per beneficiary, state public health workforce, health security surveillance, and toxic pollutants.

Combining all of these factors, Ohio ranks 44^th overall. The four policy areas and 12 policy options detailed in the dashboard can be an effective starting point for achieving improved health and healthcare access. With these, Ohio policymakers have many options to build on Ohio’s assets to create opportunities for prosperity and well-being throughout the state. You can view the full Health Policy Institute of Ohio Health Value Dashboard 2024 by visiting their website.