Why is Mahoning County’s COVID-19 death rate among the worst in Ohio? We took a look at health data – Mahoning Matters

Mahoning County's rate of COVID-19 deaths per 100,000 people is the second-highest in Ohio and at least four times higher than similar-size counties. The contributing factors will likely linger long after the pandemic, experts said.

Mahoning County has by far the worst COVID-19 death rate among the most populous Ohio counties. That fact cant be attributed to any handful of factors, rather long-standing deficiencies in public health that have left the county unhealthier than its peers, officials said.

Thats why its important for public health to continue to improve those conditions we have in the area, county Health Commissioner Ryan Tekac told Mahoning Matters. When a virus comes in and attacks those individuals, if we would have had improved health conditions, we could have hoped for a better outcome.

Nearly 300 COVID-19 deaths were reported in the county as of Nov. 17, according to Ohio Department of Health statistics. Thats about 130 deaths per 100,000 people, the second-highest rate in Ohio behind Monroe County, which reported 20 deaths as of Nov. 17, but only has about 13,600 residents.

Mahoning Countys death rate is also at least four times higher than counties with similar populations, like Warren, Lake, Delaware and Clermont, according to ODH and census data. It also fares far worse than those counties in prevalence and mortality rates of several comorbidities that put COVID-19 patients at higher risk issues like heart and liver diseases, diabetes, smoking and obesity, which are known to complicate COVID-19, according to the U.S. Centers for Disease Control and Prevention.

Click here to open a full-size version of this table.

You put all these things together and now we understand why residents of Mahoning County are living three years shorter than the average for the United States and 2 years [shorter than] the average for the state of Ohio, said Dr. Iahn Gonsenhauser, Ohio State University Wexner Medical Centers chief quality and patient safety officer.

COVID-19 is a vascular disease, meaning it affects blood vessels, he said. Though doctors didnt understand that at first and they continue to learn more about the disease it explains why patients can have widely varying symptoms including rashes, blood clots and strokes, he said. Each of the comorbidities listed above has their own impact on the cardiovascular system.

Ischemic heart disease is a broad term for afflictions caused by low oxygen supply, often due to a heart attack, Gonsenhauser said. Cirrhosis, or scarring of the liver, also creates problems for the cardiovascular system, he said.

Patients who have diabetes, are obese or who smoke also share some of the same risks as those with coronary artery disease, or blockage of the arteries leading to the heart.

In the case of extreme obesity, COVID-19 patients may struggle to expand their chest to compensate for the decreased lung function caused by the disease, Gonsenhauser added.

As seen in the data above, Mahoning also has a slightly older population compared to the other counties something Tekac and other local health officials have noted as a factor in the countys COVID-19 death rate.

Mahoning also has the most nursing homes among those counties, and twice as many as some others, according to Ohio Development Services Agency statistics. As of Nov. 15, there were nearly 3,500 Mahoning Valley Medicaid consumers in registered nursing homes, according to federal data, and more than 1,800 just in Mahoning County.

Nearly three-quarters of Mahoning Countys total COVID-19 deaths as of Monday occurred in the countys long-term care facilities, according to Mahoning County Public Health.

When looking at how those five counties stacked up, Gonsenhauser immediately noted theyre all fairly far from a major tertiary care hospital, like Cuyahogas Cleveland Clinic or MetroHealth, where COVID-19 outcomes are generally better.

Mahoning County has nine hospitals, while the other counties have two at most, according to ODSA. Mahoning and Trumbull counties two major health care providers are Mercy Health and Steward.

Its not to say that local and regional hospitals dont provide excellent care we know that they do but their capacity for providing the highest level, the highest intensity care is usually significantly lower, said Gonsenhauser.

Those major tertiary centers are the end of the line where patients go when they need the highest acuity care, he said. But more often than not, patients tend to check into the hospital that's closest to home.

But in regards to COVID-19, what seems to matter more is how patients have cared for themselves over the years. The threat now posed by COVID-19 is compounded by years of disregard for public health, Gov. Mike DeWine has said.

Gonsenhauser said he wonders if that kind of admission from public officials will ever come with an apology.

This is likely the result of long-standing deficiencies in support of public health and socioeconomic health care disparities that have been developing over decades and longer still, he said. This is not a problem that emerged over the past handful of years. This is a problem that has emerged over a historic lack of focus on public health in our country.

Gonsenhauser also pointed to Mahoning Countys high poverty rate, 18.4 percent in 2019, which was the 7th-highest in Ohio that year, several points higher than the state and countrys, and at least twice as high as the other similar-sizecounties.

Social determinants of health like poverty, race or access to healthy foods, transportation and housing, have a profound impact on health outcomes and COVID-19 is no exception. Its up to officials and residents to change, Gonsenhauser said.

I think the story is pretty clear. The question is, what can the county and what can the residents of the county do? How do they change? he said. This is not a COVID problem. This is a problem that will persist for Mahoning County long after COVID is gone.

Reporter David Knox compiled data used in this report, in collaboration with Your Voice Ohio.

See original here:
Why is Mahoning County's COVID-19 death rate among the worst in Ohio? We took a look at health data - Mahoning Matters