Our Work

As the Oct. 5 voter registration deadline approaches ahead of the Nov. 3 midterm election, U.S. Census data found that voter participation in Ohio increased by 4 percentage points from 2012 to 2024, as illustrated above.

In HPIO’s 2026 Health Value Dashboard, Ohio ranked 25th out of 51 states on civic engagement, which included both voting registration (75.1% of citizens of voting-age) and voter turnout (67.4% of citizens voting-age). These have both improved over the last four presidential elections since 2012.

In 2023, HPIO visualized data from Healthy Democracy Healthy People (HDHP), a nonpartisan initiative of national public health and civic engagement organizations, that showed a two-way relationship between voting and community health.

HDHP developed a Health and Democracy Index that compares public health indicators and voter turnout to restrictiveness of state voting policies. The analysis found that states with more inclusive voting policies and greater levels of civic participation tend to be healthier.

Ohioans can register to vote online with a valid driver’s license or Ohio identification number, name, date of birth, address and the last four digits of the registrant’s Social Security number.

The Health Policy Institute of Ohio has released a new policy explainer on updating Ohio’s tobacco policy to address nicotine pouch use.

Oral nicotine pouches are small, often flavored, dissolvable packets that users place under their lips to absorb nicotine through the gums. Use of oral nicotine pouches, also known as ONPs or white snus, is becoming more common, with sales of the products spiking nationally from 3.3 million units sold in 2017 to 619.6 million sold in 2024, as illustrated above.

Because the product is relatively new, there is limited research on the health risks of ONPs, especially for long-term use. However, the CDC states: “There are no safe tobacco products, including nicotine pouches. This is especially true for youth, young adults, and women who are pregnant.”

The new HPIO policy explainer highlights what is known and unknown about nicotine pouch use in Ohio and describes current policy surrounding nicotine pouches.

Data from the Agency for Healthcare Research and Quality shows that the percentage of outpatient healthcare facilities in Ohio that are independently owned is lower than in all but five states, as illustrated above.

Only 3 in 10 Ohio outpatient facilities (31.6%) were independently owned in 2022, meaning that nearly 70% of facilities in the state had corporate or health-system ownership.

Independently owned healthcare practices have become much less common across the U.S. as health systems and facilities have rapidly consolidated and integrated in the past 25 years. Between 2002 and 2020, there were more than 1,000 hospital mergers in the U.S., with health systems often purchasing practices at different levels of care (a strategy known as vertical integration).

While these types of mergers can, in theory, improve efficiency, research suggests they have led to increased healthcare costs and worsened health outcomes. Additionally, the growth of corporate ownership in healthcare, including the rise of private equity acquisitions, has raised concerns about care access and quality for patients.

In the last few years, many states have taken action to monitor consolidation, mergers and corporate ownership in healthcare. For example, Indiana passed legislation to increase scrutiny over healthcare transactions, while Oregon has added new restrictions on corporate ownership of practices to ensure that financial interests do not interfere with patient care.