Ohio Health Policy News

In October, HPIO released a publication detailing the state’s progress in taking action on four key evidence-informed strategies to prevent adverse childhood experiences (ACEs): Early childhood education, early childhood home visiting, medical-legal partnerships and family income supports.

Among the findings in the brief are that the need for home visiting services is greater among groups of Ohioans most at risk for childhood adversity (as illustrated in the graphic above). For example, while 38.2% of Hispanic children, ages 0-5, in Ohio were exposed to ACEs, only 8.7% of the pregnant women and primary caregivers receiving ODH- and ODM-funded home visiting services were Hispanic in Federal fiscal year 2021.

HPIO is hosting an online forum from 11 a.m. to 1 p.m. Dec. 13 to highlight the four key strategies from the brief. Speakers at the forum will include:

• Marie Curry, Managing Attorney, Community Legal Aid
• Dr. Robert Kahn, VP for Health Equity Strategy and the Fisher Child Health Equity Center, Cincinnati Children’s Hospital Medical Center
• Robyn Lutz, Administrative Nurse Manager Labor and Delivery, OhioHealth Grant Medical Center
• Jeanne Wickliffe, Program Manager Maternal Infant Home Visiting Program, The Center for Family Safety and Healing at Nationwide Children’s Hospital
• And more to be announced!

New analysis from the Health Policy Institute of Ohio, conducted as part of Domestic Violence Awareness Month, found that Ohio children are more likely to witness domestic violence than children in the U.S. overall.

In 2020, the most recent year for which data is available, 6.9% of Ohio children witnessed domestic violence, compared to the national average of 5.4% (as displayed in the graphic above). That percentage translates to an estimate of more than 171,000 Ohio children having witnessed domestic violence in their home, according to the National Survey of Children’s Health.

Earlier this week, the Ohio Domestic Violence Network reported that 131 people died from domestic violence in the year ending June 30, 2021. That is a 20% increase in fatalities from the year before and a 62% increase from two years prior.

Witnessing domestic violence is an adverse childhood experience (ACE) that can cause long-lasting harms that persist throughout life. For more information on ACEs and evidence-informed strategies to prevent them, visit HPIO’s Ohio ACEs Impact Project.
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Help and resources are available for victims of domestic violence. The Ohio Domestic Violence Network has a help line at 1-800-934-9840 and the National Coalition Against Domestic Violence has an anonymous 24/7 helpline at 1-800-799-7233 (SAFE). The OhioHealth Sexual Assault Response Network of Central Ohio also provides advocacy and emotional support services.

A new publication from the Health Policy Institute of Ohio details the state’s progress in taking action on four key evidence-informed strategies to prevent adverse childhood experiences (ACEs): Early childhood education, early childhood home visiting, medical-legal partnerships and family income supports.
 
“Ensuring a strong start for children and strengthening economic supports for families both contribute to making sure that every child in Ohio has the opportunity to reach their full health potential” the publication states.
 
Among the findings in the brief are that the need for home visiting services is greater among groups of Ohioans most at risk for childhood adversity (as illustrated in the graphic above). For example, while 38.2% of Hispanic children, ages 0-5, in Ohio were exposed to ACEs, only 8.7% of the pregnant women and primary caregivers receiving ODH- and ODM-funded home visiting services were Hispanic in Federal fiscal year 2021.
 
The publication released today is the first of three examining opportunities to prevent ACEs in Ohio. ACEs are potentially traumatic events that occur during childhood and can generally be grouped into three categories: abuse, household challenges and neglect. 
 
In 2020 and 2021, HPIO released a series of policy briefs on the health and economic impacts of ACEs and elevated 12 evidence-based, cost-effective strategies (programs, policies and practices) that prevent ACEs before they happen and improve health. HPIO’s new series is focused on analyzing the implementation status of these strategies in Ohio.
 
HPIO’s previous research found that Ohio can eliminate more than $10 billion in annual healthcare and related spending attributable to ACEs exposure.

A critical aspect of preventing adverse childhood experiences (ACEs) is ensuring that children have a strong start in life and home visiting is a key prevention strategy.

According to an estimate from the Ohio Department of Health, more than 83% of Ohioans who need home visiting are not enrolled in a program identified as “evidence-based” by the U.S. Department of Health and Human Services Home Visiting Evidence of Effectiveness (HomVEE) review (as illustrated in the graphic above).

Analysis from HPIO has found that home visiting programs are an evidence-based, multi-generational strategy proven to prevent and mitigate the impacts of ACEs. Trained providers (home visitors) visit expectant parents and families with infants and young children, providing one-on-one support for healthy parent and child development, early education and family needs. Participation in home visiting programs is typically voluntary.

These findings will be included in a new policy brief that HPIO plans to release next month as part of its Ohio ACEs Impact project.

A new policy brief, “Adverse Childhood Experiences (ACEs): A strategic approach to prevent ACEs in Ohio,” identifies 12 cost-beneficial strategies that state leaders can use to prevent adverse childhood experiences.

Earlier analysis from HPIO’s Ohio ACEs Impact project found that more than one-third of Ohio adults (36%) reported exposure to two or more ACEs. And first-of-its-kind analysis by HPIO estimated that more than $10 billion in annual healthcare and related spending could be avoided in Ohio if exposure to ACEs was eliminated.

“ACEs are not inevitable and Ohioans are resilient,” the new report states. “Exposure to ACEs does not have to determine future hardship. There are strategies that state policymakers and others can deploy to prevent ACEs and safeguard the well-being of Ohio children and families who have experienced adversity and trauma.” 

The report also highlights steps Ohio’s public and private leaders can take to ensure that communities across the state are equipped to support children and families that are most at risk for experiencing adversity and trauma – including Ohioans of color and Ohioans with low incomes, disabilities and/or who live in urban and Appalachian areas.

The Health Policy Institute of Ohio has released a new fact sheet, “The impact of the COVID-19 pandemic on Adverse Childhood Experiences (ACEs).”

The COVID-19 pandemic has resulted in unprecedented health, social and economic challenges for all Ohioans. These challenges are far-reaching, including loss of loved ones, unemployment, business closures, disruption to K-12 education and increased stress and social isolation.

The full extent of the impacts of the pandemic on children and youth will take years to discern. However, early indicators of childhood adversity signal the impact of the pandemic on potential challenges to Ohio’s health, well-being and economic vitality for years to come. The fact sheet includes links to recent reports that provide evidence-informed policies that can be implemented in Ohio to prevent and mitigate the impacts of ACEs and eliminate disparities.

The fact sheet is the latest in a series of HPIO publications and an online resource page to examine the impact of adverse childhood experiences (ACEs) in Ohio. Other publications include:

• Adverse Childhood Experiences (ACEs): Health Impact of ACEs in Ohio
• Adverse Childhood Experiences (ACEs): Economic Impact of ACEs in Ohio
• Fact sheet: Exposure to Adverse Childhood Experiences (ACEs) in Ohio
• Fact sheet: The link between Adverse Childhood Experiences (ACEs) and poor health

A new HPIO fact sheet, The Link between Adverse Childhood Experiences (ACEs) and Poor Health, includes first-of-its-kind analysis in Ohio that estimates that 36% of depression diagnoses in Ohio can be attributed to experiencing multiple adverse childhood experiences, or ACEs.

That means that if exposure to ACEs were eliminated among Ohioans, an estimated 36% of depression diagnoses could be prevented.

Similarly, in Ohio, 33% of current smoking, 25% of inability to afford care, 24% of asthma, 20% of chronic obstructive pulmonary disease and 19% of heavy drinking is potentially preventable with the elimination of exposure to ACEs.

The fact sheet is an excerpt from the HPIO policy brief Adverse Childhood Experiences (ACEs): Health Impact of ACEs in Ohio, which was released in August. Last week HPIO released a fact sheet describing the prevalence of ACEs in Ohio, which highlighted that more than two-thirds of Ohioans have been exposed to at least one ACE.

As part of its Ohio Adverse Childhood Experiences (ACEs) Impact Project, HPIO has launched an ACEs resource page.

The web page lists resources and research to further understanding of the impacts of ACEs on health, organized in the following areas:

• ACEs basics
• Impacts of ACEs on health
• Protective factors

Led by the Health Policy Institute of Ohio, the Ohio ACEs Impact Project includes the development of a series of three policy briefs and this resource page to build on current efforts to understand and address ACEs in Ohio.

HPIO is hosting an online forum Sept. 29 titled “Improving child health and wellbeing: Creating opportunities for all Ohio children to thrive.”

As the 2019 Health Value Dashboard illustrates, too many Ohioans face obstacles to health, which are often rooted in childhood conditions and experiences. This forum will discuss the impact of adverse childhood experiences (ACEs) on Ohioans including recent effects of the COVID-19 pandemic.

Attendees will learn about the biological impact of ACEs and trauma; best practices for screening, treatment and prevention; and considerations for Ohio's response to ACEs in the midst of the pandemic. For more information, or to register, visit the event page on HPIO’s website.

The Health Policy Institute of Ohio has released a new policy brief, "Adverse Childhood Experiences (ACEs): Health Impact of ACEs in Ohio."

The brief summarizes current research on how ACEs impact health and well-being and provides new data and analysis on the prevalence of ACEs in Ohio and the impact of ACEs on the health of Ohioans.

In addition, the brief expands on what we know from national research by exploring these questions:

• To what extent could Ohio’s health outcomes be improved by preventing ACEs?
• Which ACEs have the most significant impact on the health of Ohioans?

Preventing and mitigating the impact of ACEs are critical components of any plan to advance the health and well-being of Ohioans. Ohio Governor Mike DeWine and other policymakers have already taken significant strides to improve the health and well-being of Ohio’s children, including the creation of the Governor’s Office of Children’s Initiatives and improvements to the state’s child welfare and home visiting systems. In addition, the 2020-2022 State Health Improvement Plan (SHIP) includes reduction of ACEs as a priority.

Policymakers and other stakeholders can use the Ohio-specific data and analyses provided in this brief to inform future approaches to reduce ACEs exposure in Ohio.