COLUMBUS, Ohio -- The Health Policy Institute of Ohio recently released its latest Health Value Dashboard and the results were clear: Ohioans live less healthy lives and spend more on health care than people in most other states.
Ohio ranks 47th out of all states and the District of Columbia on health value, a measure of Ohio’s combined population health and healthcare spending.
Unfortunately, that is a familiar story for our state.
The 2021 Dashboard is the fourth edition released by HPIO since 2014. Ohio ranked 47th in 2014, 46th in 2017 and 46th again in 2019.
So why does Ohio consistently rank so poorly?
One reason is that many Ohio children experience early adversity and trauma.
More than one in five children in Ohio were exposed to multiple adverse childhood experiences, or ACEs, including child abuse, neglect and household challenges (such as parental incarceration or substance use). Ohio is near the bottom, ranking 39th out of 50 states and the District of Columbia, on the percent of children who have been exposed to multiple ACEs.
Reem Aly is the vice president of the Health Policy Institute of Ohio.
The research is clear that childhood adversity and trauma can have immediate and long-term negative health and economic impacts that persist across generations. Ohioans of color and Ohioans with low incomes, disabilities and/or who are residents of urban and Appalachian counties are more likely to experience multiple ACEs.
Recent HPIO analysis indicates that adult Ohioans who reported experiencing multiple ACEs were more likely to report depression, asthma, smoking, heavy drinking and delaying healthcare due to cost. If Ohioans’ exposure to ACEs were eliminated, an estimated 36% of depression diagnoses and 33% of current smoking could be prevented with the elimination of ACEs exposure.
Not only does childhood trauma have life-long and even generational impacts on the health of Ohioans; there are also significant economic consequences. HPIO analysis found that more than $10 billion in healthcare and related spending and $319 million in lost wages could be saved annually if ACEs were eliminated.
Some groups of Ohio children are at a higher risk of being exposed to ACEs. For example, one-third of Black and Hispanic children and more than half of children with disabilities have experienced early adversity and trauma. These disparities affirm the growing body of research connecting racism and other forms of discrimination (such as ableism and xenophobia) to ACEs, trauma and toxic stress.
The good news is that improvement is possible.
The Dashboard highlights policy examples that Ohio policymakers and private-sector partners can adopt to ensure all Ohio children live to their full potential. These include:
- Closing widening academic gaps by prioritizing federal COVID-19 relief funds for high-intensity tutoring, chronic absenteeism interventions and school-based trauma counseling for children who have experienced adversity, disruption and learning loss.
- Strengthening K-12 student wellness by allocating funds to evidence-based drug prevention, social emotional learning and school-based mental health.
- Expanding access to quality early childhood care and education by increasing eligibility for Ohio’s childcare subsidy to at least 200% of the federal poverty level, paying childcare workers more and streamlining rapid access to childcare.
As Ohio’s policymakers complete the state budget process, improving child health and well-being through these and other strategies, such as the mitigation of lead in homes, must be a priority. Policymakers and others can either advance or impede progress.
Ohio’s State Health Improvement Plan and the Minority Health Strike Force Blueprint offer a wide variety of other meaningful and evidence-informed ways to eliminate health disparities and support Ohio children and families facing adversity.
If we focus attention and energy on preventing and mitigating the impacts of ACEs, Ohio can be a national leader – both in tackling childhood adversity and trauma and on health value.
Reem Aly is vice president of the Health Policy Institute of Ohio, a statewide, nonpartisan institute based in Columbus.
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