Family violence

ACEs cost Ohio $10 billion a year in healthcare costs, new HPIO analysis finds

First-of-its kind analysis by the Health Policy Institute of Ohio has found that if adverse childhood experiences (ACEs) are eliminated, more than $10 billion in annual healthcare and related expenses could be avoided in Ohio.

The analysis is included in a new HPIO policy brief, Adverse Childhood Experiences (ACEs): Economic Impact of ACEs in Ohio. The study also found that focusing action on reducing ACEs, particularly those associated with behavioral health, can yield significant savings. For example, more than $4.5 billion in annual spending to treat depression in Ohio is attributable to ACEs.

“The research is clear that ACEs result in both significant health and economic impacts,” the brief states. “Economic costs from ACEs are incurred across the public and private sectors, including substantial costs to the healthcare system. The economic burden of ACEs also impacts the state child protection, behavioral health, criminal justice and education systems, as well as private sector businesses. By preventing and mitigating the impacts of ACEs, policymakers and others can put Ohio on a path towards improved health value.”

The brief is the second in three planned briefs as part of HPIO’s Ohio ACEs Impact Project. In August 2020, HPIO released the first brief, Adverse Childhood Experiences (ACEs): Health impact of ACEs in Ohio.

Children in families with low incomes face extra challenges during pandemic

In communities struggling with poverty and gun violence, the coronavirus has only inflamed the difficulties that many families already were enduring (Source: “How the Pandemic Has Been Devastating for Children From Low-Income Families,” New York Times, Dec. 29).

Since March, according to data from the Centers for Disease Control and Prevention, there has been a 24 percent spike nationwide in mental-health-related emergency room visits among children between the ages of 5 and 11, and a 31 percent rise among those between 12 and 17, compared with the same period last year.

The disruptions to daily life — and the associated stresses of lives on pause — have been perhaps most acutely felt by children from low-income families, experts said, many of whom live in predominantly Black and Latino neighborhoods that have been plagued by a rise in gun violence and disproportionately high coronavirus infection rates.

While most children should bounce back from isolation and remote learning, childhood development experts said, those growing up amid other adversities like systemic racism, domestic violence, abuse and poverty are struggling to cope with the turmoils of the pandemic — and face greater obstacles in recovering.

Ohio House passes bill strengthening domestic violence law

The Ohio House voted 94-0 last week in favor of making sweeping changes to the state’s domestic violence law to better protect victims from further abuse (Source: “Ohio House moves to strengthen domestic violence law,” Dayton Daily News, May 20, 2020).

Advocates for House Bill 3 say it will establish a better system for identifying when high-risk domestic violence situations could escalate. The bill now goes to the Senate for consideration.

The legislation, co-sponsored by Republican Rep. Sara Carruthers and Democrat Rep. Janine Boyd, calls for expanding domestic violence to include strangulation of a family or household member; creating a new protection order for domestic violence victims that law enforcement can request when courts are closed; requiring police departments to connect high-risk victims to help programs and use lethality assessment screening tools; requesting the supreme court review evidence rules to consider changes that may help victims; and increasing police officer training in intervention techniques.

According to data from the Ohio Attorney General’s Office, there were 38,475 domestic violence incidents last year in Ohio.

Report finds 91 domestic-violence deaths in Ohio in past year

The Ohio Domestic Violence Network announced this week that there were 91 domestic violence deaths in 69 cases in Ohio from July 1, 2017, to June 30, 2018 (Source: “Ohio saw 91 domestic-violence deaths in past fiscal year,” (Kent) Record Courier, Oct. 10, 2018).

The total is a decrease from the previous fiscal year, when statistics compiled from media reports over the same time span showed 116 deaths across the state. The fatality report also provides details about the circumstances of the crimes, such as how many of the 69 cases that were reviewed included multiple deaths (21), how many children were killed (three) and how many attackers were killed by an intervening third party (nine). 

In at least 46 percent of the fatal incidents, “the victims did leave or were in the process of leaving,” the report found. 

Study: Overdose risk increases after childbirth for women with addiction

A new study shows that women with an opioid addiction are at high risk of an overdose during the year that follows childbirth (Source: “For addicted women, the year after childbirth is the deadliest,” Tribune News Service via Canton Repository, Sep 3, 2018).

The study, published last month, tracked more than 4,000 Massachusetts women with an opioid addiction for a year before and a year after delivery. The results confirmed for the first time what many practitioners had observed: Opioid overdose deaths decline during pregnancy and peak in the seven to 12 months postpartum.

Since the study only included Massachusetts residents (the state with the lowest uninsured rate in the nation), lack of insurance following childbirth was not a contributing factor. Even so, postpartum gaps in opioid treatment, such as the discontinuation of addiction medications, may have contributed to some overdose deaths, according to the study.

And it’s not just from overdose deaths. A 2012 analysis of vital statistics reports from 17 states (Ohio was not included in the study) shows that postpartum women are also at heightened risk for suicide and homicide by a partner.

Growing evidence suggests that women should receive continuous medical attention during what is now called the “fourth trimester” — a period lasting at least a year after childbirth. Even for women without an opioid addiction, the likelihood of severe depression soars. Research indicates that nearly 15 percent of all mothers suffer postpartum depression. For minority women and those living in poverty, the rate can more than double.

States rejecting laws holding parents responsible when kids get guns

In state after state, proposals that would create or toughen laws intended to keep kids from getting ahold of unsecured guns have stalled — caught up in a debate over whether they are effective prevention measures or just government overreach (Source: “States rejecting bills intended to keep guns away from kids,” USA Today and Associated Press, May 24, 2017).

Child access prevention laws allow prosecutors to bring charges against adults who fail to safely store their loaded guns, especially when they are obtained by minors and used to harm.

Public health experts say the laws could significantly reduce unintentional shootings that kill and injure hundreds of children every year, particularly if they allow for felonies against violators and are paired with educational campaigns to raise awareness.

But legislative efforts in dozens of states have run into opposition from lawmakers aligned with the National Rifle Association. Critics say the laws trample on the rights of gun owners who should be able to store their firearms however they want, and unfairly single out guns. Swimming pools and prescription drugs also can cause accidental deaths of children, they say.

Even in states that have such laws, they are rarely used when unsecured guns contribute to the death of a child. An AP-USA TODAY Network analysis found the laws were invoked in 14 out of 152 deaths of children under age 12 over the last three years. Five of those came in Texas, where the offense is a misdemeanor, although grand juries later declined to issue indictments in two of them.

Fed, state officials cautiously optimistic about exchange improvements

With just one month to go until the start of Obamacare’s second open enrollment period, state and federal officials are being cautiously optimistic about their health exchange websites—assuring the public that there won’t be a repeat of last year’s technological nightmare (Source: “Will Obamacare’s State Exchanges Be Ready for Round 2?” Fiscal Times, Oct. 15, 2014)

Speaking to health reporters earlier this month, Health and Human Services Secretary Sylvia Burwell touted the newly revamped as a vast improvement over last year’s website—which was plagued with technical glitches. But when asked about how some of state exchanges that had trouble last year are shaping up, Burwell hesitated and said HHS is monitoring them on a state-by-state basis.

Last year, 14 states and the District of Columbia decided to create their own exchanges. Of those, at least four states--Massachusetts, Maryland, Oregon and Nevada—had websites that suffered from serious technical troubles. Still, officials from all four states say their websites will be ready for the second enrollment period—after going through lengthy and expensive repair efforts. 

HPIO, partners release family violence profiles of all 88 Ohio counties

The Health Policy Institute of Ohio and its partners in the Ohio Family Violence Prevention Project, under the leadership of Kenneth Steinman of The Ohio State University College of Public Health, have released profiles of family violence in all 88 counties in Ohio.

Links to all 88 profiles can be found at:

To coincide with the release, HPIO is hosting five regional forums throughout the state. Each forum will present data on child abuse/neglect, intimate partner violence and elder abuse/neglect and provide training to those interested in using the information to build support for prevention. The events are scheduled from 9:30 a.m. to 12:30 p.m.  on April 9 in West Chester, April 12 in Columbus, April 16 in Nelsonville, April 19 in Toledo and April 23 in Akron (the forum are free, but registration is required; see for more details about the forums and specific locations).

“Family violence is a compelling issue because it is common, consequential, and yet preventable,” said Steinman, noting that the most striking findings from the county profiles are that family violence is much more common than many believe, it has a tremendous negative impact on families affected by it and there are proven prevention methods that can be adopted at the local level.

HPIO to host regional forums on family violence prevention

The Health Policy Institute of Ohio invites you to attend one of five free, half-day regional forums to discuss county-level findings on family violence in Ohio. The forums, titled "Using Family Violence Data to Build Support for Prevention in Ohio," will present data on child abuse/neglect, intimate partner violence and elder abuse/neglect and provide training to those interested in using the information to build support for prevention.

At the end of this forum, participants will be able to:

  • describe at least four sources of family violence data in Ohio;
  • demonstrate the ability to access online sources of family violence data in Ohio;
  • prepare an accurate, compelling graph that conveys at least one of the following themes: (1) family violence in your county is as common as other widely recognized threats to health and well-being, (2) many cases in your county never come to the attention of authorities, (3)both prevention and intervention are key to curtailing family violence. 

All sessions will be held from 9:30 am to 12:30 pm.

Cincinnati (West Chester)/Butler County - April 9, 2010
Columbus (Grove City)/Franklin County - April 12, 2010
Nelsonville/Athens County - April 16, 2010
Toledo (Maumee)/Lucas County - April 19, 2010
Akron/Summit County - April 23, 2010

To register, visit this page

Ohio House, Senate OK teen dating violence prevention bill

After being approved 32-0 in the Ohio Senate, a bill requiring schools to incorporate dating violence prevention into their health curriculum appears poised to be signed into law by Gov. Ted Strickland (Source: “Ohio Senate approves dating-violence prevention bill,” Youngstown Vindicator, Dec. 16, 2009).

House Bill 19, which was previously approved in the House and was sponsored by Rep. Sandra Stabile Harwood, D-Niles, was named the Tina Croucher Act in memory of an 18-year-old from southwestern Ohio who was killed by her ex-boyfriend in 1992.

The law would require schools to teach children in grades seven through 12 about teen dating violence prevention, including information on recognizing signs of dating violence and characteristics of healthy relationships.

The promotion of school-based prevention measures is one of the major recommendations in the Ohio Family Violence Prevention Project’s White Paper on Family Violence (pdf, 36 pages), which was published in 2008. The Project is a collaborative effort between the Health Policy Institute of Ohio and The Ohio State University School of Public Health, through support from the HealthPath Foundation of Ohio.