PHOENIX – Any child can experience abuse or neglect – and one expert says if this is not addressed, that child’s health and well being later in life will suffer.
Dr. Vincent Felitti is the author of a major study on adverse childhood experiences.
He says sometimes adults have to ask the tough questions to find out what's really going on in a child's life – but even professionals can have a hard time addressing trauma, because it is such a personal experience.
"All of this has attracted intense intellectual interest,” Felitti says, “but great resistance to picking it up and using it in clinical practice."
Felitti says trauma can be caused by physical or emotional neglect, sexual abuse and exposure to alcoholism or depression.
He adds while adverse childhood experiences can affect anyone, they are hallmarks of children in the child welfare and juvenile justice systems.
Arizona law requires suspected child abuse or neglect to be reported to Child Protective Services or law enforcement by a number of people, including teachers, clergy, medical personnel and parents.
Felitti says the short and long-term outcomes of exposure to abuse and neglect can mean a multitude of problems.
"Chronic emotional distress, chronic depression, suicidality, biomedical disease,” he points out, “specifically fractures, liver disease, osteoporosis, heart disease, cancer, social malfunction, violence."
He says it is possible to help a child who has faced maltreatment, but prevention provides the best outcome.
"The numerical magnitude of these problems, as well as their complexity, makes dealing with them after the fact of limited use," he explains.
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By Vanessa Davidson / Broadcast version by Farah Siddiqi reporting for the Kent State-Ohio News Connection Collaboration.
Around 1,000 more people moved into Ohio than moved out of it in 2023, according to Census data.
At the same time, Ohio is aging: Between 2010 and 2024, the percentage of Ohioans aged 65 and older increased from 14.1% to 18.7%, which is about one percentage point higher than the national average.
“Younger people are more likely to move to pursue job opportunities, and there are lots of opportunities in Ohio, but they're not all evenly distributed,” said Robert J. Graham, senior research scholar and associate director of Scripps Gerontology Center at Ohio’s Miami University.
Because younger adults tend to concentrate in urban areas for jobs, rural areas are experiencing the impact of an aging population the most.
“There are some [people] that say, ‘Hey, I want to go to college. I want to increase my education and get new opportunities,’ or ‘I'm looking for jobs,’ and those jobs tend to be created in more urban areas, or suburban [areas], and the rural areas in particular are seeing the face of that,” Graham said.
“They're having an increasing aging population and decreasing number of young adults and people to fill important services that are needed in their communities,” he added.
On the other hand, according to a 2025 data study from SmartAsset, Columbus, Cincinnati and Cleveland saw an influx of new residents in 2023. Columbus saw an estimated 75,500 (around 8.4% of the city’s population) adults between 25 and 44 move in. Newcomers in that age range accounted for 6.9% of Cincinnati’s population and 6.4% of Cleveland’s.
Forbes included Cincinnati, Dayton and Columbus on its 2024 “best cities for young professionals” list.
In addition to employment opportunities, cities like Cincinnati, Dayton and Columbus in Ohio allow for more cultural and social diversity compared to their rural counterparts.
“Cleveland has a wide range of cultures, a large food scene, some very, very, very good public museums, gardens,” said Kent State junior fashion design major Lily Blackburn, who is from Illinois. “The city’s very beautiful, the architecture is really cool, the nightlife is not bad, the [art] museum is free, [and] the botanical gardens are really cool.”
Still, many Ohioans opt to move to other states.
“If I'm being honest, I would not look here in Ohio for jobs that are inside my major,” said Blackburn, the KSU student.
According to Census data, in 2023, around 18,500 Ohioans moved to Florida and around 13,500 to Texas. (Around the same number of people moved from Florida to Ohio, but only 8,500 Texans moved to Ohio.) Between 11,000 and 13,000 moved to each of Ohio’s neighboring states of Pennsylvania, Kentucky and Indiana.
“If you look at some of where state populations are growing — a lot of the growth over the past couple of decades has taken place in areas in the South. So, Texas and parts of the Carolinas and Florida and Georgia, places like that,” said Jacob Duritsky, vice president of strategy, research and talent at TeamNeo.
According to Duritsky, there’s not a single driving force behind that migration. Factors like diversity, the job market and climate all contribute.
“What's actually happening is our economy is diversifying,” said Jacob Duritsky. In Northeast Ohio, he said, “We're seeing healthcare growing. We're seeing professional services growing. So, along with the decline of manufacturing, that was offset by gains in other industries.”
Some cities, including Cleveland, are finding ways to incentivize younger residents to stay.
“The [Cleveland] Town Alliance has a whole strategy around college retention,” said Duritsky. “We have tens of thousands of students who are going in our institutions. I think one of the best opportunities we have is to start to retain those people in greater numbers.”
Ohio saw its highest-ever total number of jobs in 2024. Duritsky believes that’s key to keeping young people in the state.
“If we can keep our educated young people here by giving them opportunities to find internships and first jobs, by getting them into the community and experiencing all this sort of social and civic life that's here, I think that's one of the ways we start to move the dial,” said Duritsky.
This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.
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Indiana's third grade reading scores show progress but gaps remain.
The latest IREAD3 results show about 82% of students passed in 2024, up slightly from the year before. But scores are still below pre-pandemic levels. Special education students, English learners, and low-income children struggle the most.
Tami Silverman, president and CEO of the Indiana Youth Institute, said early childhood shapes literacy skills and many Indiana children lack access to quality early learning.
"We know that 27 of Indiana's 92 counties had proficiency levels below the state average," Silverman observed. "That's actually up from prior years, so that's five more than what it was."
Several programs help close gaps, including On My Way Pre-K, which gives low-income children access to preschool, Reach Out and Read Indiana promotes early reading and Dolly Parton's Imagination Library sends free books to kids. A $9.5 million Lilly Endowment grant will expand after-school and summer reading programs.
Indiana is aiming for 95% reading proficiency by 2027 but Silverman pointed out financial struggles create more barriers.
"Some of those financial hardships bring on stressors like food insecurity, housing instability," Silverman outlined. "All of those things inhibit early learning, including but not limited to literacy."
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Hoosier teens are nearly 3% more likely to have used cocaine, methamphetamines or heroin than other teens nationwide, according to the National Center for Drug Abuse Statistics, and the types of drugs they choose are producing deadly side effects.
Indianapolis-based nonprofit Overdose Lifeline partners with other states to offer substance use prevention education programs.
Justin Phillips, founder and CEO of Overdose Lifeline, said young people are sharing prescription drugs like Adderall and Xanax with their peers and dying from suicide and overdoses at alarming rates. She stressed the numbers are preventable.
"Onset can be as early as 12, and it varies according to the substance that they're using," Phillips reported. "We have a lot of challenges around vaping right now, which is a nicotine and/or a cannabis vape."
Philips advocates for early intervention when abuse is identified to help prevent it from becoming chronic. She added research has shown when a substance is introduced to the brain before age 15, it is five times more likely to alter the brain structure and create an addiction.
Last year, more than 700 Hoosiers of all ages died of drug-related overdoses. Although rare, Phillips pointed out cases are appearing in Indiana of people mixing the animal tranquilizer Xylazine with fentanyl or other drugs. She noted it is especially dangerous, because Xylazine does not respond to the overdose drug naloxone and can cause other damaging side effects.
"Xylazine isn't really something someone wants to use, so people are really spending more time trying to avoid Xylazine through testing," Phillips explained. "It's the fentanyl that we have the biggest concern around with young people, because there's fentanyl and almost everything you purchase illicitly."
She added people are able to purchase unregulated drugs on social media and the dark web. Overdose Lifeline offers a chatbot known as "KATE," which stands for Knowledge, Advocacy, Trust and Education, which answers self-care questions if a loved one is using, what to do if someone overdoses and how to talk to someone who is using drugs.
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