The 2022 State of Ohio Families: Challenges and Promises

In terms of relationship status, the majority of adults 65 years and older in Ohio are currently married (55.0%), 23.4% are widowed, 15.8% are separated or divorced, and 5.9% are never married (U.S. Census Bureau, Citation2019a). Regarding their educational level, 23.6% hold a bachelor’s degree or higher; 24.6% attended some college or hold an associate degree; 39.2% have a high school degree, GED, or alternative, with only 12.6% having less than a high school education (U.S. Census Bureau, Citation2019a). Of those for whom poverty status is determined, 8.3% are below 100% of the poverty level, 7.9% are between 100 and 149% of the poverty level, and 83.8% are at or above 150% of the poverty level. Only 3.5% of Ohioans did not fall into any poverty categories, meaning that these individuals live above the poverty level categories (U.S. Census Bureau, Citation2019a).

Data from the Survey of Income and Program Participation 2018 (see U.S. Census Bureau, Citation2020a) indicate that there are an estimated 72 million grandparents (31 million grandfathers and 41 million grandmothers) in the U.S. This is an increase from an estimated 64 million grandparents in 2008 (Bates, Citation2020). In Ohio, there are an estimated 2,856,330 grandparents (∼24.4% of the total population of Ohio); 1,657,622 are grandmothers and 1,198,709 are grandfathers (∼14.2 and 10.2% of the total population, respectively).

According to the American Community Survey, in Ohio an estimated 4.0% of adults 60 years and older currently live with grandchild(ren) and only 1.5% are responsible for their grandchild(ren) (U.S. Census Bureau, Citation2019c). Approximately 7.0% of children (under 18 years old) in Ohio live with their grandparents who are the householders (Grandfamilies.org, Citation2020). Additionally, grandparent caregivers are White (76.2%), Black or African American (19.3%), Hispanic or Latino origin (2.8%), and other races (2.9%) (Grandfamilies.org, Citation2020).

Concerns regarding the impact of the coronavirus pandemic and the associated governmental restrictions have focused a spotlight on older adults and children. Although few studies to date have considered the pandemic’s influence on intergenerational family relationships, a study of grandparents (all of whom lived in Ohio) conducted during the pandemic and its associated restrictions offers some insights into the grandparent–grandchild relationship (Bates, Citation2020). Grandparents in the study were a mix of caregiving and non-caregiving, non-residential grandparents and lived in various parts of the state. When asked about what advice grandparents would give to other grandparents, the study participants suggested ways to take care of themselves and their grandchildren, the need to prepare for the future, and how to remain connected with grandchildren even though they could not be together in person. Grandparents demonstrated for their grandchildren resiliency to the crucibles of life, hope and faith in the future, and an ability to adapt and to try new things (such as video-chat technology). Their stabilizing examples are likely to have a lasting positive impact on grandchildren.

Food system

Ohio is a microcosm of America when it comes to the food system challenges of healthy food access, food insecurity, and diet-related chronic diseases. Ohio’s foodshed exists within large and small urban communities, growing suburban and exurban communities, and very rural areas. Each of these geographic entities presents unique experiences and challenges for individuals and families procuring and consuming food. The U.S. Department of Agriculture defines food insecurity as “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways” (ERS, Citation2020). Some estimates suggest that Ohio food insecurity has jumped from 13.9% in 2018 to 18.1% in 2020 due to the pandemic (Feeding America, Citation2020). In 2020, Ohio ranked in the top 10 states in the number of people who are food insecure, with childhood food insecurity estimated at 18.9% in 2020 (Feeding America, Citation2020).

As measured by the 18-question Food Security Supplement of the nationally representative Current Population Survey of the U.S. census, food insecurity is highest among Black households, Hispanic households, households with children headed by a single parent, households with children under 6, households with children, and single men and women (Coleman-Jensen et al., Citation2020). The nature of food insecurity differs in the urban, suburban, and rural contexts (Remley et al., Citation2021). Although food insecurity within suburban communities is often overlooked, the collective raw numbers of suburban food insecure families are higher than within core metro and rural areas (Kneebone & Garr, Citation2010). Challenges that food insecure families in suburbs face include lack of awareness or access to social services including emergency feeding sites, lack of transportation options, and stigma (Allard & Roth, Citation2010). The rural southeastern Appalachian region has the highest rate of food insecurity in the state.

Limited access to healthy and affordable food is another challenge for Ohio’s food system. In rural areas of the state, consumers often have limited grocery store options and thus pay higher food prices due to a lack of retail competition. They may also have transportation difficulties and experience more stigma associated with accessing food assistance programs (Mulangu & Clark, Citation2012). In urban areas of Ohio, there are challenges accessing full-service grocery stores that provide healthy options, and therefore many are reliant on corner stores (Pike et al., Citation2017). However, in urban areas, there are better public transportation options and more awareness of food assistance services, and less stigma associated with using them (Allard & Roth, Citation2010). As a result of these factors, over two million Ohio residents, including more than half a million children, live in lower-income communities underserved by supermarkets (Tucker et al., Citation2014). According to the Robert Wood Johnson Foundation, Ohio’s healthy food environment, as measured by a composite of income and proximity to healthy foods, ranks lower than the national average (Robert Wood Johnson Foundation & University of Wisconsin Population Institute, Citation2022).

Compared to the U.S. as a whole, Ohioans have a larger occurrence of diet-related chronic diseases. Ohio’s rates of diabetes (11.1%), heart disease (7.4%), cancer (7.1%), and are higher when measured against all U.S. adults (ODH, Citation2018). In 2018, chronic diseases in Ohio cost 31.9 billion in direct medical costs (ODH, Citation2018). Chronic diseases may be costly to manage, and, in some cases, people make difficult tradeoffs between paying for food or medicine (Seligman et al., Citation2012). As with food insecurity, the highest rates of overall health problems, such as diabetes, also tend to be in the southeastern Appalachian region, and are prevalent within Black and Hispanic communities of Ohio’s inner cities and suburbs (University of Wisconsin Population Health Institute, Citation2021). These areas often have many factors that are related to chronic disease and poor health, such as unhealthy behaviors, poverty, lack of access to healthy foods, lack of access to health care, education, food insecurity, and lack of opportunities for physical activity (University of Wisconsin Population Health Institute, Citation2021).

Home ownership, housing, and homelessness

Ohio has a homeownership rate of 66% (OHFA, Citation2021). When examined by regions, rates of homeownership are the highest in Southeast Ohio (71.0%) and lowest in Central Ohio (61.8%). Homeownership rates in rural areas are much higher (74.0%) than in urban areas (46.0%). The discrepancy in homeownership between rural and urban areas can be explained by the higher number of multifamily rental properties in urban areas. Just over a quarter (26.5%) of all Ohio housing units were built before the 1950s, and more than three-quarters were built before 1980 when lead-based paint was banned.

Housing opportunities for families influence the availably of resources and quality of other factors including economic security, education, and health. Current trends in Ohio show that housing construction and vacancy rates remain low, while home costs are rising. About two-thirds of individuals and families in Ohio (68%) owned their home in 2019, slightly above the national average of 65%. The value of homes has risen at a steady rate since the recession of the late 2000s, in both nominal and real values, which benefits families who already own a home because their home has increased in value. The Ohio-wide median home value increased from a low of $131,522 in 2013 to $151,100 in 2018 (OHFA, Citation2021). As home values increase, so do home prices. The median home price-to-income ratio in Ohio is 2.36. The Ohio ratio is still much smaller than the national ratio of 3.50 in 2018, pointing to greater affordability of housing for Ohio families.

Another important lender criterion, which is indicative of the financial health of Ohio families, is the debt-to-income ratio. This ratio is at a median value of 1.13 in Ohio, compared to 1.39 across the nation in the fourth quarter of 2018. This ratio indicates that, compared to the nation, a larger number of Ohio homeowners have completely paid off their mortgages and own their homes outright (OHFA, Citation2021). A related indicator of homeownership in Ohio is the mortgage loan denial rate. Many homebuyers work with a mortgage lender to obtain a mortgage to purchase a home. The denial rate in Ohio at 23% is slightly lower than the national average of closer to 25%, indicating that a larger number of homebuyers in Ohio meet lender financial criteria, compared to the national average.

Ohio families spend about 19% of their income on housing, including mortgage payments compared to 21% of income nationally. Although this translates to lower housing costs overall for most, about 8% of Ohio homeowners are severely cost burdened [i.e., defined as spending more than 50% of their income on housing, compared to 11% nationally (OHFA, Citation2021)]. Data from 2018 indicate that 10% of homeowners reporting severe housing cost burdens lived in rural, Southeast Appalachian Ohio (OHFA, Citation2021). In 2019, the median home price in Ohio was $132,317, which was 2.4 times the median household income of $58,642, making homeownership unaffordable to many prospective homebuyers.

Rent has also been increasing in Ohio from a low in 2012 at $733 per month median gross rent to $825 in 2020 (U.S. Census Bureau, Citation2021b). Overall, however, the amount of gross rent as a share of income has been steadily declining since 2010 and is currently at 28%, as compared to 31% in 2010 in Ohio, and 30% nationally in 2018. Similarly, the rate of severely rent burdened households has steadily decreased in Ohio, from a high of 28% in 2010 to 23% in 2018. The national prevalence of severely rent-burdened households is higher, at 25% (OHFA, Citation2021). Currently, families with incomes at or below 50% of the area median income, 80 of 100 families have access to rental units that are both affordable and available in Ohio, compared to 57 of 100 families nationally. Among very low-income families, about 44 of 100 Ohio families with incomes at or below the federal poverty level have access to rental units that are both affordable and available, compared to 36 of 100 families in this income range nationally.

A key challenge for housing Ohio families is the homeownership chasm between White and Black families. The gap increased, rather than decreased, by 5 percentage points, from 32 percentage points in 2006 to 37 percentage points in 2018. Whereas at least 70% of White Ohio families own their homes, only about 35% of Black Ohio families can call themselves homeowners (OHFA, Citation2021). This gap is the widest in Ohio for the two lowest-income quintiles.

A second key challenge for housing Ohio families is the still higher rate of delinquency and default among Ohio homeowners, compared to the nation. The 90-day mortgage payment delinquency rate in 2019 is at 1.8% compared to 1.4% nationally (OHFA, Citation2021). Designated one of the “hardest hit” states, that rate is of course much lower than the 7.5% 90-day delinquency rate at the height of the housing crisis in Ohio in 2009.

During the pandemic, the 90-day mortgage payment delinquency rate more than doubled from 1.8% in January 2020 to 3.8% in November 2020 for Ohioans but stayed below the national rate of 4.1%. For renters in Ohio, the monthly rent delinquency rate increased from 12.4% in April 2020 by 10 percentage points to 22.7% in July 2020. This stark increase is greater than the national monthly rent delinquency rate of 18.1% in July 2020 (OHFA, Citation2021).

There are over 10,000 individuals experiencing homelessness in Ohio each day (United States Interagency Council on Homelessness, Citation2019). Children are not immune to this experience. According to data from the U.S. Department of Education, around 34,180 public school students dealt with homelessness in the 2017–2018 school year, with 374 students living unsheltered, 5,209 living in shelters, 1,958 in hotels/motels, and 26,639 doubled up (United States Interagency Council on Homelessness, Citation2019).

Substance abuse and mental health

Health disparities

As with addressing any public health concern, addressing health disparities begins with defining the magnitude and distribution of the problem (Satcher & Higginbotham, Citation2008). Ohio ranked 39th in overall health outcomes in 2020 and 42nd in social and economic factors (United Health Foundation, Citation2020). In a recent state-level comparison of health valueFootnote² in 2021, Ohio ranked 46 out of 50 states, with persistent disparities in outcomes between different races, ethnicities, and geographies (HPIO, Citation2021). Poverty, unemployment, high school graduation, housing, and health care access were all noted to be predictors of health disparities. In nearly all cases, Black families were most impacted by these and other determinants. When comparing both social- and health-related outcomes for Black families vs. those of other races, HPIO identified 16 different indicators where a disparity ratio between Black families and a comparison race was >2.0 (meaning at least a 2-fold higher rate for Black families compared to the race with the lowest rate). That includes a disparity ratio of 2.8 for school absenteeism, 3.0 for child poverty, 3.9 for food insecurity, 5.4 for incarceration, and 17.3 for the perception of being treated unfairly due to race.

One of the starkest disparities in health outcomes in Ohio exists with infant mortality. The Ohio Department of Health’s 2019 Infant Mortality Annual Report (ODH, Citation2019a) noted that Black babies born in Ohio are nearly three times more likely to die by their first birthday than White babies, a trend that has not only existed for more than two decades but has worsened during the past 10 years. The same report notes that Black babies are more than three times as likely to be born premature and have rates of sudden unexplained infant death nearly four times higher than White babies. Although the causes of these disparities are multifactorial, several key determinants have been implicated. Maternal health before and during pregnancy is worse for Black mothers compared to White mothers, with Black mothers more likely to be obese, less likely to have adequate prenatal care, and more likely to be housing insecure and lack a safe place for their baby to sleep (ODH, Citation2019b). Comparatively, Asian American/Pacific Islander women in Ohio had the lowest infant mortality rate in 2019 (4.4 per 100,000), and Hispanic women had a slightly higher rate than White women at 5.8. While additional data on maternal health for women of other races was not reported, neonatal mortality rates for Hispanic babies were lower than that of non-Hispanic neonates (4.4 per 1,000 compared to 4.6).

Ohio challenge takeaways

Ohio, like many other states, has a variety of challenges to address in the areas of educational attainment, workforce development and employment, access and affordability of early care and learning, a growing aging population, food access, and security, housing access and affordability, substance abuse and mental health, and health disparities, Overall, Ohio is seeing positive trends in educational attainment, employment, and income during the past decade. The economy is growing and there are many reasons to be optimistic, including lower unemployment and moderate growth in household income. The majority of Ohioans own their homes or have access to affordable rentals, and the income burden of renting has continued to decrease over the last decade. Ohioans are living longer and nearly one-fourth of Ohio’s population are grandparents.

However, there are ongoing challenges that must be addressed to ensure all Ohio families can thrive. Many Ohioans are still struggling to find accessible and affordable child care, which was difficult before the pandemic but is even more challenging now as many providers are still understaffed, posing an ongoing disparity in women returning to work. Many Ohioans are still spending a sizable amount of their income on housing and child care, as much as 40% (Freddie Mac, Citation2019). Ohioans continue to experience higher rates of substance abuse, mental health concerns, and health disparity issues compared to many other states, often ranking in the lower third. In particular, there are significant disparities, particularly for Black Ohioans and those living in the Appalachian region of the state in the areas of educational attainment, home ownership, food security, and an overrepresentation of health disparities.

Innovations in early childhood education and educational attainment

• Ohio has made efforts through the Step Up To Quality (SUTQ) program since 2005 to provide equitable, high-quality experiences to all children. SUTQ is a five-star quality rating and improvement system administered by the Ohio Department of Education and the Ohio Department of Job and Family Services (ODJFS). SUTQ recognizes and promotes learning and development programs that meet quality program standards that exceed licensing health and safety regulations (ODJFS, Citation2021b). A recent study of the SUTQ program found that children receiving publicly funded childcare who attended higher-rated programs at any time between birth and third grade English Language Arts (ELA) test administration scored higher than children in lower-rated programs in both the Kindergarten Readiness Assessment (KRA) and third grade ELA test and statistically significantly higher in all KRA domains than children in non-rated programs (ODJFS, Citation2020a, Citation2020b).

• Ohio State University Extension is helping lead the effort to increase the number and quality of providers by offering a pathway to certification and higher education through Child Development Associate credentialing. In 2020 alone, 51 sessions with over 100 h of instruction reached 500+ early childhood professionals, impacting over 5,000 children.

• Ohio’s governor signed a bill that provided emergency relief grants and “Hero Pay” to care providers and professionals through the Coronavirus Response and Relief Supplemental Appropriations Act, intended to support the childcare workforce. Through this initiative, childcare providers became eligible for Hero Pay of $300 per quarter up to a total of $1,200 per individual provider.

• Attainment Goal 2025. To meet the ongoing challenge of educational attainment for all, the Ohio Department of Education created a state-wide goal that 65% of Ohioans, ages 25 to 64, will have a degree, certificate, or other postsecondary workforce credentials of value in the workplace by 2025 (Ohio Department of Higher Education, Citationn.d.). Some of the dashboards to ensure the goal is met include ACT Scores, 8th grade reading, and math proficiency, 4-year high school graduation rate, certificates by Ohio Technical Centers, and post-secondary enrollment.

• Ohio’s Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) project is focused on eliminating college access barriers for low-income and first-generation college students and their parents to increase their success in readiness for post-secondary education. Ohio’s GEAR UP project will serve ∼8,000 students enrolled at 17 schools in six diverse communities.

• Choose Ohio First provides competitive scholarship funding to support undergraduate and qualifying graduate students for high-demand academic programs, with a particular focus on recruiting underrepresented STEM students, including women and students of color.

Innovations in economic and workforce development

• Innovative Workforce Incentive Program, supported by a $34 million investment over the next 2 years, is focused on increasing the number of high school students who earn industry-recognized credentials in priority industry sectors. Schools receive aid to establish these programs and additional incentive dollars when students earn eligible credentials.

• ApprenticeOhio provides oversight and technical support to employers developing apprenticeship programs. This program provides individuals aged 16 or older a chance to pursue a career as a skilled worker and earn while they learn without taking on additional debt. Each program includes 2,000 hours of on-the-job training and 144 hours of classroom instruction annually. There are over 19,000 registered apprentices working in Ohio, in over 200 different occupations through this innovative program, and apprentices who complete their programs earn an average of $60,000 a year.

• OhioMeansJobs–Readiness Seal is a formal designation that students can earn on their diplomas and high school transcripts that indicates they have a strong work ethic and the professional experiences that businesses are seeking.

• Ohio TechNet (OTN) is a consortium of education and training institutions to support manufacturer workforce needs (OTN, Citationn.d.). OTN has helped facilitate the development of new or enhanced programs that have trained thousands. Many students complete training with little to no debt and enter the workforce in both entry-level and skilled positions.

• Project Lead the Way (PLTW) provides real-world experiential learning in computer science, engineering, and biomedical science for PreK–12 students and teachers. A recent study shows PLTW students outperform their peers in school, are better prepared for postsecondary studies and are more likely to consider STEM careers, compared to their non-PLTW peers. Students find PLTW programs relevant, inspiring, engaging, and foundational to their future success (PLTW, Citationn.d.).

Additionally, 87% of 6th to 8th grade students and 92% of high school students participating in PTLW reported that the course made them more interested in STEM, and 70% of students reported that the program helped them in other areas they wanted to study further.

• College Credit Plus is Ohio’s dual enrollment program that provides students in grades 7 to 12 the chance to earn college and high school credits at the same time by taking college courses with participating colleges and universities. In the most recent annual report during the sixth year of the program, College Credit Plus has served over 76,000 students and saved families over $158 million in tuition for the 2020–2021 year and over $883 million over the total length of the program.

• Ohio State University Extension provides financial literacy and career exploration to over 14,000 teens annually with 450 community partners through Real Money/Real World. The Real Money/Real World program was developed by Ohio State University Extension and is designed for youth ages 12 to 18. The curriculum includes an interactive spending simulation that provides participants the opportunity to make lifestyle and budget choices similar to those they will make as adults. In a state-wide evaluation of Real Money/Real World, 85% of students reported being more likely to have a plan for their money, 83% reported being more aware of how their spending impacts other people and opportunities, and 72% reported being more likely to consider training or education after high school. Ohio Treasurer Robert Sprague recognized this program as a Compass Award honoree, which recognizes best practice programs working to advance financial literacy and empowerment.

Innovations in divorce education

• Ohio State University Extension offers a confidential, self-paced online learning experience for separating and divorcing parents titled Successful Co-Parenting Online©. This asynchronous course helps participants successfully navigate the dissolution/divorce process to reduce the negative effects of separation and divorce on children and promote positive adjustment. According to the 2021 data, between 34.0 and 53.9% of participants who completed the evaluation reported a positive change in knowledge related to the topics of taking care of themselves, their children, and improving communication and problem-solving (Bates, Citation2022). Nearly 90% of participants indicated that they learned new information as a result of taking the course and ∼91% of participants now feel more prepared to co-parent.

Innovations in food systems support

• Nutrition education programs can help individuals and families make healthy and economical food choices in the context of their communities, environments, and chronic disease condition. Over 250,600 adults, teens, and youth are reached each year in Ohio with SNAP-Ed direct education programs and another 5,896 adults and 3,350 youth are reached annually via the Expanded Food and Nutrition Program (EFNEP).

• Ohio has many food councils and health coalitions that are instrumental in fostering policy, system, and environmental change to address determinants of food insecurity and chronic disease. As an example, The Ohio State University’s Initiative for Food and AgriCultural Transformation (InFACT) is working with the Council for Development Finance Agencies as well as other colleges and universities to imagine a new model to develop the innovative financing strategies to support the food system infrastructure that will be needed to serve the growing demand for more regionally sourced and sustainably grown food.

• Cuyahoga County has implemented Produce Perk’s Produce Prescription (PRx) Program for Maternal Health. The PRx program addresses infant mortality by providing produce prescription services to low-income, pregnant Ohioans, which provides essential financial resources for them to purchase fresh fruits and vegetables from Ohio farmers and Ohio-owned grocery retailers. In its first year, 91% of births reached a programmatic goal of at least 37 weeks gestation, and 95% of births reached the birthweight goal of equal to or >5½ pounds. Of the patients enrolled, 85% were African American/Latina and the majority received Medicaid benefits. There are currently 500 mothers enrolled in the program who receive support through 1-year postpartum.

• In response to the challenge of healthy food access, the Healthy Food for Ohio program was initiated in 2015 to support the development of new and existing grocery stores and other healthy food retail in underserved areas throughout the state. In many communities, grassroots food policy councils are also working to promote access to healthy foods by coordinating the efforts of food system partners, such as growers, processors, distributors, retailers, food service providers, and consumers themselves (Ohio Food Policy Council Network, Citation2019).

Innovations in successful aging

• Ohio recently launched a 2020–2022 Strategic Action Plan on Aging with the goal of advancing elder justice and equity and “aims to strengthen existing structures, supports, and programs, and create new and expanded opportunities allowing every Ohioan to achieve optimal health and well-being as they age” (Ohio Department of Aging, Citation2020a, p. 4).

• Ohio State University Extension works independently and collaboratively with local Area Agencies on Aging and other aging-focused organizations, such as the North Central Region Aging Network (NCRAN), to help aging Ohioans achieve optimal health and well-being. Aging-specific educational materials available through the NCRAN website (https://ncran.org) and regularly held webinars provide Extension professionals and other practitioners with needed professional development training to teach aging topics in local communities (North Central Region Aging Network, Citation2022).

• In collaboration with local hospitals, Ohio State University Extension offers Grandparents Helping Grandchildren in Times of Stress to kinship care providers (often are grandparents raising grandchildren) who took on care for their grandchildren following the removal of parental substance abuse issues to deal with the stress of caregiving and stepping into the role of a parent due to the impact of these stresses on children in their families. One hundred percent of participants reported learning new information that they plan to use to help them cope with their own stress as they raise the children of family members.

Innovations in housing

• Power of Home, a collaboration of The Ohio State University, the Ohio Housing Finance Agency, the local enterprise Framework Homeownership, and other partners, is an online tool to support homeowners who have incomes of around $40,000 and a median savings of $1,200 when unexpected home expenses arise (Alliance for the American Dream, Citationn.d.). The Keep Home™ app builds homeowner confidence and knowledge with features that provide information on financial issues like interest rates, home values, and pricing for home repairs and improvements, as well as tools to help homeowners reduce their monthly expenses and increase their property values.

• Ohio’s Continuum of Care program focuses on services and funding for families and individuals experiencing homelessness and helps them achieve self-sufficiency while they move toward stable housing.

• Ohio State University Extension offers Home Buyer Education Training/Counseling approved by the U.S. Department of Housing and Urban Development. In one county alone in 2020, they have helped 156 participants purchase homes and another 55 were pre-approved for mortgage loans in preparation to purchase homes of their own.

• Ohio State University Extension offers financial literacy/coaching through collaboration with Community Properties of Ohio, Action for Children, Community Housing Network, Columbus Foundation, Central Community House, and other public/private partnerships. In 2021, 75% of the 225 individuals trained reported they were able to purchase a home of their own, reduce their debt, clean up their credit, and/or save money for an emergency savings fund.

Innovations in substance abuse and mental health

• The Ohio Department of Mental Health and Addiction Services has a variety of initiatives to combat substance abuse and mental health, including Take Charge Ohio to address pain management and medication misuse; Start Talking! Building a Drug-Free Future, a youth drug prevention program; and Project Dawn to prevent overdose deaths with Naloxone.

• Ohio State University Extension partners with the Ohio State University College of Pharmacy, Cardinal Health, and local Ohio pharmacists to educate people of all ages about the potential dangers of misusing prescription medications through a curriculum that can be customized for different age groups and venues. The Generation Rx program was founded in 2007 by Ohio State University faculty and has been deployed by the Ohio State University College of Pharmacy in partnership with the Cardinal Health Foundation since 2009. Over 100,000 adults and peer educators have used Generation Rx to educate their communities about safe medication-taking practices and Generation Rx network members have educated nearly 3 million people nationwide.

• Ohio State University Extension has trained over 800 participants on Trauma-Informed Approaches to working with individuals affected by traumatic events. More than 1,400 individuals were trained in Mental Health First Aid assistance in the last 5 years, and an initiative to address farmer stress and suicide in rural Ohio has been implemented.

• Ohio State University Extension is partnering with local substance use action teams to offer Mindful Wellness to adults interested in practicing mindfulness to reduce stress in their lives. Ninety-five percent of participants reported learning new information to identify and reduce stress, with 80% reporting plans to implement mindfulness practice into their regular routine.

• Ohio State University Extension is partnering with the Children’s Trust Fund to offer Parent Café and Education for parents at risk for child abuse, with an emphasis on building protective factors and strengthening concrete and social supports. After attending three to six sessions, 67% reported improvement in family function, 60% on social-emotional support, 53% on nurturing and attachment, 40% on knowing how to help their child learn, and 46% on not losing control when disciplining their child.

• Nationwide Children’s Hospital in Columbus recently opened the $159 million Big Lots Behavioral Health Pavilion as a national hub for innovative approaches to youth mental health issues.