Coronavirus: Is Northeast Ohio’s aging population pushing death rates higher in the region?

Akron Beacon Journal (OH)

The Ohio Department of Health added 50 names on Tuesday to the coronavirus death toll, bringing the statewide total to 324 deceased, or 2.77 deaths for every 100,000 Ohioans.

But some counties -- including Portage and Mahoning -- have strikingly higher death rates. And, as a region, Northeast Ohio has recorded more deaths than the rest of the state.

North of Dayton, Darke and Miami counties are leading Ohio in per capita deaths with 19.5 and 17.9 deaths per 100,000 people. Next are Mahoning and Portage counties with 15.2 and 12.2 deaths per 100,000 people, respectively.

And while Cuyahoga County still has more deaths, the per capita death rate is five times higher in Portage County, where local health officials reported on Tuesday a new total of 20 COVID-19 deaths and 146 confirmed cases to date.

The data are preliminary. New COVID-19 deaths known locally have yet to be reported to the state. And the overall figures may be too small, statistically speaking, to draw reliable conclusions, at least until testing becomes more available and more cases and deaths are reported.

Christopher Woolverton, professor of epidemiology at Kent State University's College of Public Health, said he doesn't have access to details on patients who have tested positive for the virus and those who have died. But as an epidemiologist, he said demographics tend to play a big role in differences between communities.

"As a scientist, one of the first questions I'd ask is if the demographics are the same," he said. For instance, he said, people who are elderly tend to have poorer outcomes from diseases such as coronavirus.

With an older and rapidly aging population, Northeast Ohio is more vulnerable to COVID-19 deaths than other parts of the state, according to a Beacon Journal analysis of U.S. census and Ohio Department of Health data.

And there are some peculiarities in the data that raise alarms for the region's most senior population.

Eighty-six of Ohio's 324 recorded deaths involved patients who never made it to a hospital, whether they remained at home or under hospice care at a nursing home. And more than half of those unhospitalized deaths (44) occurred in the Northeast Ohio counties of Columbiana (1), Cuyahoga (7), Geauga (2), Lorain (2), Mahoning (12), Medina (1), Portage (6), Stark (8), Summit (2) and Wayne (3).

Ohio's elderly population are especially overrepresented in the unhospitalized death count. Of the more than 200 patients over age 70 who have died of COVID-19, 76% were reportedly not hospitalized.

From Akron and Canton north to Cleveland and east to Youngstown and Warren, the region is also amassing a disproportionate number of COVID-19 deaths. More than half (53%) of all Ohio deaths have been recorded in 13 local counties where, on the whole, seniors account for a greater share of the overall general population.

But the numbers are still out of whack. Only a third of the state's residents live in Northeast Ohio.

At least two counties are driving up the region's elderly and overall death rates. High-risk patients in the 70-and-older age group account for 73% of deaths statewide but as much as 83% in Mahoning and 90% in Portage, where health officials have reported cases in nursing homes.

The higher mortality rate, in part, can be attributed to one of the most quickly aging corners of a state that already skews older than the national average.

Mahoning County has Ohio's second-highest portion of residents (3.6%) ages 85 and older. Portage County, at 1.7%, ranked 30th among Ohio's 88 counties. These statewide rankings also held true for the 75 and older population for both Northeast Ohio counties.

Other area counties with above average senior populations include Trumbull, Richland, Geauga, Tuscarawas, Lake, Columbiana, Stark, Cuyahoga and Ashtabula.

Portage County Commissioner Vicki Kline said she is concerned for the county's seniors, and people who live in nursing homes and assisted-living facilities.

"This is very scary," she said. "I am concerned for our elderly, and concerned about Portage County people."

Among Ohio's most populous counties, for which disability data is surveyed by the U.S. Census Bureau, Portage ranks high with 15.3% of residents disabled. Other area counties like Tuscarawas also rank high but have yet to report a single COVID-19 related death.

Despite having high per capita COVID-19 deaths rates, Portage and Mahoning counties ranked in the better half of Ohio's most populous counties for residents with health insurance.

Statewide criteria call for prioritizing testing for the sickest patients as well as those at highest risk for complications, including the elderly.

Becky Lehman, public information officer for the Portage County Health District, said tests are being offered primarily to seniors.

"Approximately 58% of our COVID-19 positive cases are our vulnerable population [65 years of age and older]. As a result of our testing criteria focusing on 65 years or older, that explains the higher rate of this age being positive for COVID-19," she said.

Lehman said the "strict testing guidance" ensures that people in long-term care facilities, other seniors and health care professionals, are being tested.

"In addition, the majority of persons who have died with COVID-19 had co-morbidities," or other chronic health conditions, she added. She did not know how many of those people were residents of the county's 18 long-term care facilities.

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