By Ashley Johnson/Broadcast version by Mary Schuermann Kuhlman
Reporting for the Kent State-Ohio News Connection Collaboration

Dancing in a white-and-black t-shirt and gray sweatpants to Jordyn's "Big Up's," social-media influencer Charli D'Amelio seems like she's just having fun. But her TikTok video is a #distancedance challenge aimed at preventing the spread of COVID-19 among the app's dedicated users.

D'Amelio's video is a part of Ohio Gov. Mike DeWine's effort to encourage young people to stay at home and keep their distance while in public. In March, DeWine reached out to Proctor and Gamble chief executive David Taylor with the idea of creating something that would spread the message to a younger audience.

Taylor, along with chief brand officer Marc Pritchard, reached out to Grey New York CEO Debby Reiner and social-media director Kenny Gold. Together they presented the #distancedance concept with D'Amelio as the leading star.

"They thought, 'Charli's amazing, she's got a lot of followers, she can create a distance dance, and then we can challenge other TikTokers and others to do the distance dance,'" Pritchard said. "And then when they post it, what we can do is donate product."

As an incentive to circulate the video on the mobile-video app, P&G promised to donate a product to those in need for every new #distancedance video shared. D'Amelio promoted #distancedance on "Entertainment Tonight "in May and "The Tonight Show Starring Jimmy Fallon" in March. The number of videos (and products donated through the relief organizations Feeding America and Matthew 25:Ministries) then climbed to 3.5 million.

Since its release, D'Amelio's video has garnered 15.9 billion views. The #distancedance challenge is TikTok's most viewed hashtag challenge to date, and D'Amelio now is the most followed account on the platform with 60 million followers.

DeWine's own TikTok account features six videos educating people on social distancing and letting viewers know that "we are in this together." Celebrities such as Cleveland Cavaliers basketball player Kevin Love, Olympicgold-medal runner Mary Wineberg and Cincinnati Bengals football player Joe Burrow also make appearances to help inform Ohio citizens.

One video, "Social distancing works," breaks down what can happen when distancing isn't practiced, and ihas been aired locally in television commercials.

The governor isn't the only public-health advocate in Ohio using TikTok to reach young people. Dr. Nicole Baldwin, a Cincinnati pediatrician, made national headlines when she posted a video on Jan. 11 advocating for vaccines.

The video quickly went viral and Baldwin encountered both positive and negative responses. While Baldwin received backlash from anti-vaccinators on TikTok, she said most of the negativity came from Facebook and Twitter. Baldwin still is creating videos and believes young people are listening.

"I get a lot of DMs from people who saw me on TikTok," Baldwin said, "young adults who have questions about medicine and going to medical school and different things."

Baldwin turned to TikTok because she wanted to reach a different, younger demographic than she does on her other social-media accounts. She said she tries to share public-health information that is evidence-based from the Centers for Disease Control and Prevention or the World Health Organization.

Since then, Baldwin has created more videos on TikTok highlighting how to properly wear a face mask and achieve appropriate hygiene. Through her videos, she also has urged viewers to stay at home and given advice to future medical students. Along with her various social-media platforms, the pediatrician also runs a blog with tips on how to stay healthy and other advice for parents and children.

Although Pritchard said the #distancedance campaign is the only one he and DeWine have planned so far, he'd be open to working with the Ohio governor again in the future.

Eve Mueller, DeWine's deputy director of communications, said the idea of using TikTok to spread the message of social distancing was a great way to get a younger audience to listen.

"I think it's smart to engage the tools in a way that people communicate,' she said, "and communicate it the way that they communicate it."

This collaboration is produced in association with Media in the Public Interest and funded in part by The George Gund Foundation.



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Health disparities in Texas are not only making some people sick, but affecting the state's economy.

A new study shows Texas is losing $7 billion a year because it does not adequately address quality-of-life issues and the health care needs of its lower-income residents.

The research was sponsored by the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and St. David's Foundation.

Brian Sasser, chief communications officer for the Episcopal Health Foundation, said health care includes more than doctors' visits and medication.

"Everything from increasing access to affordable health insurance to investing in under-resourced neighborhoods to give them more options, whether that's exercise options or food options," Sasser outlined. "Look at policy changes that expand health insurance coverage for new moms."

The report breaks down the economic costs of preventable health differences for every Texas county. It found Bexar, Dallas, Harris, Tarrant and Travis counties are losing the most money annually because of health disparities.

The amount of the economic impact depends on the racial and ethnic makeup of the county and the size of its working-age population. Sasser added the report shows Black and Hispanic children are more likely to grow up in neighborhoods with high poverty levels, and higher rates of diabetes and obesity.

"What can we do to work to make sure that the rate of diabetes isn't dramatically different between white households and Black households?" Sasser asked. "That we can make sure the food insecurity isn't dramatically different between someone who makes over $100,000 and someone who makes less than $30,000?"

The Texas Legislature has passed laws to address some of the disparities, including House Bill 12. It extends Medicaid health coverage for 12 months for new mothers, and pays for maternal health services for community health workers and doulas.

There is light at the end of the tunnel for Tennesseans struggling with opioid addiction, as a bill has been passed to increase access to treatment for opioid use disorder at Community Health Centers.

More than 3,800 lives were lost to overdose in the state in 2021, according to the Tennessee Department of Health.

Emily Waitt, policy and advocacy manager for the Tennessee Primary Care Association, said the original bill limited the number of patients nurse practitioners and physician assistants could treat with buprenorphine. The update removes the limitations, allowing more Tennesseans to access medication assisted treatment in their communities.

"It allows NPs and PAs to prescribe to 100 patients at a time, versus 50," Waitt explained. "Basically doubling the number of patients that they can prescribe to."

Community Health Centers serve more than 423,000 patients across Tennessee, regardless of their insurance status or ability to pay. About 7.7% of Tennesseans do not have health insurance.

Libby Thurman, CEO of the Tennessee Primary Care Association, said bringing the treatment to rural health centers expands access to a crucial service for patients who otherwise could not afford it. She noted it is important because people in remote areas often face challenges finding specialists and treatment facilities.

"We really wanted to work on this issue, because we know our Community Health Centers are where patients go for care," Thurman emphasized. "We really believe in an integrated model. So we want to treat the whole person, including if they are struggling with an addiction issue or a substance abuse disorder issue."

Health Centers offer behavioral health care, including counseling, along with treatment. The clinics also focus on creating a supportive network to help patients with family resources, job assistance and community connections.

While Black Maternal Health Week is wrapping up, health disparities for pregnant Black women continues to be an issue.

From April 11-17 this year, the high death rate of Black mothers is in the spotlight. Black women are three times more likely to die from pregnancy-related causes than their white counterparts.

Dr. Patricia Egwuatu, a family practice physician at Kaiser Permanente in Seattle, said racism is at the root of the disparities, which create barriers to health care access. She pointed out lack of access can lead to problems during pregnancy that are preventable or treatable.

"They may exist prior to pregnancy and then it gets worse during pregnancy if it's not managed as part of that maternity care," Egwuatu emphasized. "There are more pregnant women that have chronic conditions such as hypertension, diabetes and heart disease that are amplified during pregnancy."

The White House released a proclamation recognizing Black Maternal Health Week. The Biden administration began recognizing the week in 2021.

Egwuatu noted there are some warning signs any pregnant woman should be aware of and check in with their physician if they develop.

"You might get some changes in your vision that is not your normal. So, like, fuzziness, you can't see as well, or an excruciating headache," Egwuatu outlined. "You could also develop new swelling in your lower extremities that's making it difficult to get around or even new shortness of breath."

Egwuatu stressed physicians also need to recognize the role of racism in medicine. She argued continuous medical education is important for learning how to confront biases, and it is important for doctors to understand how they can provide people with resources.

"Asking the questions about personal barriers," Egwuatu suggested. "Does a patient have issues with getting to work, child care, transportation? What's their education, what's their cultural background and language? And do they even have a cell phone so we can connect with them?"