From Lake Erie to Server Farms: What Ohio’s 2026 Election Means for Public Health

Introduction to Ohio’s 2026 Scientific Electoral Landscape

The state of Ohio represents a complex microcosm of modern environmental and public health governance, operating at the intersection of legacy industrial infrastructure, intensive agricultural production, and rapid high-technology expansion. State policymakers are currently navigating overlapping crises and opportunities, ranging from toxic cyanobacterial blooms in the Lake Erie basin and the proliferation of data centers straining the electrical grid, to deeply entrenched racial disparities in maternal and infant mortality. Concurrently, the legal architecture governing public health authority and reproductive autonomy is undergoing profound judicial reinterpretation.

As the state approaches the 2026 gubernatorial and legislative elections, these policy domains serve as critical battlegrounds. The contest to control the state's executive branch and the battle over the Republican supermajority in the Ohio General Assembly will dictate the state's trajectory. This report provides an advanced, comprehensive analysis of the current status of Ohio’s environmental and health policies, elucidating the underlying scientific mechanisms and regulatory frameworks, and projecting how the 2026 electoral crucible might alter this landscape.

Ecosystem Management and Water Quality Policy

Cyanobacterial Harmful Algal Blooms and the Maumee River TMDL

The western basin of Lake Erie suffers from severe, recurrent cyanobacterial harmful algal blooms (cyanoHABs), driven predominantly by non-point source nutrient runoff from the heavily agricultural Maumee River watershed¹. These blooms present acute public health threats by producing microcystins—potent hepatotoxins that can compromise drinking water supplies, as evidenced by the 2014 Toledo water crisis, while severely degrading aquatic ecosystems and local economies³.

To address this, Ohio initiated the H2Ohio program in 2019, a massive investment strategy aimed at reducing agricultural phosphorus runoff through voluntary nutrient management plans, precision fertilization, and the extensive restoration of natural wetlands¹. Administratively, the state was compelled under the federal Clean Water Act to establish a Total Maximum Daily Load (TMDL) for the Maumee Watershed, which received approval from the U.S. Environmental Protection Agency (EPA) in late 2023². Aligning with Annex 4 of the Great Lakes Water Quality Agreement, the TMDL targets a forty percent reduction in total phosphorus loading².

Despite these interventions, the Maumee TMDL has faced intense scientific and legal challenges from environmental organizations, including the Environmental Law and Policy Center, which argue the regulatory framework is fundamentally flawed². The primary scientific criticism centers on the distinction between total phosphorus and dissolved reactive phosphorus. The TMDL establishes load allocations solely for total phosphorus⁴. However, dissolved reactive phosphorus, which is entirely bioavailable to cyanobacteria without requiring enzymatic breakdown, is the primary driver of both the scale and toxicity of the blooms⁸. Empirical data demonstrate that while overall total phosphorus loads have decreased since the 1990s due to practices like no-till farming, dissolved reactive phosphorus loads have actually increased proportionally over the same period⁴. Legal filings assert that by failing to set specific, enforceable limits for dissolved reactive phosphorus and by categorizing concentrated animal feeding operations (CAFOs) strictly as non-point sources exempt from mandatory waste load allocations, the TMDL fails to meet the statutory requirements of the Clean Water Act⁴.

Furthermore, the exclusive regulatory focus on phosphorus mitigation overlooks critical ecological dynamics involving nitrogen. Advanced genomic and limnological analyses of Microcystis—the dominant bloom-forming cyanobacterium in Lake Erie—reveal that these organisms experience dual nitrogen and phosphorus stress¹⁰. Microcystis cannot fix atmospheric nitrogen and relies heavily on scavenged nitrogen from the water column¹². The microcystin molecule is exceptionally nitrogen-rich; thus, toxic strains exhibit a high nitrogen demand to synthesize the toxin, which they utilize partly as an intracellular defense mechanism against oxidative stress¹³.

Consequently, reducing phosphorus inputs without proportional nitrogen reductions can inadvertently create a highly favorable nitrogen-to-phosphorus ratio for the most toxic cyanobacteria strains. Under nitrogen-replete conditions, Microcystis preferentially produces microcystin-RR, a highly nitrogenous congener, whereas nitrogen limitation favors microcystin-LA, a variant with lower nitrogen content¹¹. Predictive Eulerian tracer models and environmental genomic simulations demonstrate that a dual nutrient reduction strategy—targeting both nitrogen and phosphorus simultaneously—is necessary not only to reduce the total biomass of the bloom but also to suppress its overall toxicity¹².

Wetland Restoration Efficacy

The state's reliance on wetland restoration under the H2Ohio program to naturally filter these nutrients has shown significant localized success, though challenges remain regarding basin-wide scalability. Longitudinal empirical studies of flow-through wetlands in the Prairie Creek area of the Grand Lake St. Marys watershed provide robust performance metrics. Over an eight-year monitoring period, these pump-driven wetlands processed approximately 4.44 million cubic meters of agricultural runoff, representing roughly 5.7 percent of the total stream flow¹⁶.

Nutrient/Pollutant	Average Inflow Concentration (mg/L)	Average Outflow Concentration (mg/L)	Average Concentration Reduction (%)
Soluble Reactive Phosphorus	0.093	0.017	81.0%
Total Phosphorus	0.309	0.111	56.0%
Nitrate-Nitrogen	4.433	1.767	60.0%
Total Suspended Solids	Variable	Variable	10.0%

These reductions highlight the biochemical efficacy of wetlands in modulating the sorption and desorption equilibrium of phosphorus and mitigating nitrogen through denitrification¹⁶. However, to achieve the targeted forty percent nutrient reduction across the entire western Lake Erie basin using this mechanism alone, mathematical extrapolations suggest that over twelve percent of the total watershed area would need to be converted into actively managed flow-through wetlands¹⁶. This spatial reality underscores the limitations of end-of-pipe natural infrastructure without stringent, enforceable upstream non-point source abatement².

Drinking Water Infrastructure: Lead Pipes and PFAS

Simultaneous to managing surface water eutrophication, Ohio policymakers are confronting monumental challenges in municipal drinking water infrastructure, particularly regarding lead service lines and emerging contaminants like per- and polyfluoroalkyl substances (PFAS).

Under shifting federal mandates, Ohio public water systems have identified and reported 321,502 lead or galvanized service lines to the EPA¹⁸. To facilitate the identification, mapping, and extraction of these neurotoxic conduits, the Ohio EPA has dispersed millions of dollars in H2Ohio grant assistance to over 115 communities, prioritizing the protection of pediatric neurodevelopment from lead exposure²⁰.

However, the regulatory landscape for PFAS represents a vastly more complex and rapidly evolving policy domain. The ongoing construction of the massive Intel semiconductor fabrication facility in New Albany has brought intense scrutiny to industrial water consumption and chemical discharge²². Semiconductor manufacturing relies heavily on thousands of PFAS applications due to the chemicals' unique low surface energy and profound resistance to aggressive acids, oxidizers, and high-temperature plasmas utilized in nanoscale chip etching²⁴. While legacy long-chain PFAS compounds like PFOA and PFOS have largely been phased out of the supply chain, the industry has aggressively adopted short-chain alternatives, such as PFBS²³. These short-chain compounds are highly persistent, difficult to detect in standard environmental matrices, and highly resistant to traditional wastewater treatment methods like reverse osmosis and granular activated carbon²⁴.

In April 2024, the federal EPA finalized National Primary Drinking Water Regulations, imposing strictly enforceable Maximum Contaminant Levels for six PFAS compounds²⁷. This federal mandate drastically supersedes Ohio’s previous voluntary Action Plan 1.0, forcing the state to transition from health advisory benchmarks to rigorous statutory compliance.

Regulated PFAS Compound	Former Ohio Action Plan 1.0 Level (parts per trillion)	2024 Federal Maximum Contaminant Level (parts per trillion)
PFOA	>70 (single or combined with PFOS)	4.0
PFOS	>70 (single or combined with PFOA)	4.0
GenX (HFPO-DA)	>700	10.0
PFNA	>21	10.0
PFHxS	>140	10.0
PFBS	>140,000	Hazard Index Formula (with mixtures)

Under the new regulatory alignment, all Community and Non-Transient Non-Community Water Systems in Ohio must complete exhaustive initial sampling at every entry point to the distribution system by 2027, with total compliance mandated by 2029²⁸. Environmental advocacy groups warn that the state currently lacks specific industrial pre-treatment regulations for semiconductor wastewater²³. Without aggressive pretreatment protocols at the fabrication level, short-chain PFAS will be discharged into publicly owned treatment works, subsequently accumulating in surface waters or being distributed as contaminated agricultural biosolids²³. Consequently, balancing Intel's pledge to achieve net-positive water use by 2030 against the reality of complex chemical effluent remains a premier challenge for the Ohio EPA²².

Industrial Disaster Response and Soil Contamination Methodology

The regulatory capacity of the Ohio EPA and federal partners was severely tested by the February 2023 Norfolk Southern train derailment in East Palestine. The derailment, alongside the subsequent intentional venting and atmospheric combustion of highly unstable vinyl chloride and other volatile organic compounds, catalyzed one of the most complex acute environmental contamination events in recent state history³¹.

Subsequent scientific reviews of the disaster response have exposed severe methodological deficiencies in the sampling protocols approved by the EPA and executed by railway contractors like Arcadis³¹. To determine the footprint of toxic fallout, contractors eschewed systematic geographic grid sampling in favor of highly subjective visual inspections, walking properties to identify visible soot and ash deposition before authorizing a soil sample³¹. Furthermore, samples were reportedly collected using substandard containment—such as standard consumer plastic bags—and were taken exclusively from superficial depths of zero to just over one inch (for surface samples) and one to six inches (for subsurface samples)³¹.

Independent limnological and soil analyses have starkly contradicted the regulatory assurances of safety in East Palestine. Researchers hypothesized and later confirmed that the open-air combustion of vinyl chloride, interacting with transition-metal oxides present in the railway tracks and native soil minerals, facilitated the formation of environmentally persistent free radicals (EPFRs) alongside highly toxic dioxins and furans³⁵. Independent testing of soil samples collected within a two-mile radius of the derailment site detected highly elevated EPFR concentrations averaging 3.00 × 10^17 spins per gram, and dioxin/furan toxic equivalence (TEQ) levels averaging 32.8 picograms per gram—drastically exceeding the local background TEQ average of 10.7 picograms per gram³⁵. Crucially, the independent studies found robust positive correlations between the EPFR concentrations and specific dioxin/furan congeners, unequivocally indicating a shared, anthropogenic origin rooted in the chemical combustion event³⁵. The discrepancy between the independent findings and the initial regulatory data highlights systemic vulnerabilities in how state and federal agencies evaluate chemical fallout, a highly salient issue in heavily industrialized regions of Ohio.

Energy Policy, Grid Resilience, and Large-Load Tariffs

Beyond chemical contamination, Ohio’s environmental and infrastructure policy is currently defined by the staggering energy demands of the rapidly expanding cloud computing and artificial intelligence sectors. The state has emerged as a premier destination for hyperscale data center development, resulting in unprecedented strain on regional electrical grids and severe economic implications for residential ratepayers³⁶.

According to the latest load forecast reports from PJM Interconnection—the regional transmission organization managing Ohio’s grid—the summer peak load in transmission zones served by utilities like American Electric Power (AEP) Ohio and AES Ohio is projected to increase by 5.3 percent and 5.2 percent per year, respectively, over the next decade³⁷. This represents a radical acceleration from just a few years prior, driven by an estimated 17.6 to 28.1 gigawatts of proposed and speculative data center load³⁷. For context, a single ten-gigawatt data center complex demands more continuous electrical power than all residential households in Ohio combined³⁷.

This explosive industrial demand operates under a highly regressive cost-shifting mechanism. Because data centers require massive localized supplemental transmission projects to safely interconnect to the grid, the capital costs of these infrastructure upgrades are typically rolled into the general rate base and distributed among all consumers³⁷. Following a highly constrained PJM capacity auction in 2024, the average residential electricity bill for Ohio ratepayers spiked by 25.7 percent by mid-2025, reaching an average of $214 per month³⁷. Consequently, an estimated 15.7 percent of Ohio households were pushed into severe energy poverty, where utility bills consume more than six percent of total household income³⁷.

In response to this crisis, the Public Utilities Commission of Ohio and state legislators have advanced novel regulatory frameworks, most notably House Bill 706 and the AEP Data Center Tariff³⁶. These policies aim to segregate massive data centers into an independent customer class, imposing stringent financial requirements on facilities exhibiting a peak monthly demand of 25 megawatts or greater³⁷. Under these frameworks, data centers are required to sign binding, long-term contracts of at least twelve years, providing up-front financial guarantees from parent corporations to cover potential exit fees³⁷. Crucially, they are subjected to a minimum billing demand, forcing them to pay for at least 85 percent of their contracted electrical capacity regardless of their actual operational usage, thereby insulating residential ratepayers from the financial fallout of speculative overbuilding or stranded assets³⁷. However, concurrent legislation, such as House Bill 15, authorizes data centers to bypass the grid entirely by constructing behind-the-meter, on-site natural gas or fuel-cell generation facilities, a policy that directly conflicts with the state's broader emissions reduction objectives⁴⁰.

Public Health Disparities and Systemic Interventions

While environmental policies mitigate external exposures, Ohio’s internal public health metrics expose profound, entrenched systemic disparities, particularly in the realm of maternal and infant mortality. Despite decades of targeted interventions through initiatives like the Ohio Equity Institute, the state continually exhibits mortality rates that highlight deep racial and socio-economic inequities⁴¹.

Maternal Mortality and the PAMR Findings

The Ohio Pregnancy-Associated Mortality Review (PAMR) committee provides exhaustive clinical abstractions of maternal deaths occurring during pregnancy or within one year postpartum⁴³. The committee's most recent comprehensive data from 2021 paints a distressing statistical picture. The pregnancy-related mortality ratio (PRMR) in Ohio spiked to 36.9 deaths per 100,000 live births, but this aggregate number obscures a severe racial divide. Non-Hispanic Black women experienced a PRMR of 74.9 per 100,000 live births—more than three times the rate experienced by non-Hispanic White women (23.4 per 100,000)⁴³.

Year	Overall Ohio PRMR (per 100k)	Non-Hispanic Black PRMR (per 100k)	Non-Hispanic White PRMR (per 100k)
2018	23.7	28.3	14.5
2020	27.1	38.5	25.7
2021	36.9	74.9	23.4

Note: Data derived from ODH and PAMR vital statistics⁴³. 2019 data was suspended due to pandemic resource allocation⁴⁴.

Most alarmingly, the PAMR clinical review boards determined that 88 percent of these pregnancy-related deaths were entirely preventable⁴³. Infections, heavily exacerbated by the COVID-19 pandemic and postpartum sepsis, accounted for 35 percent of all deaths⁴³. Other leading causes included mental health conditions (overdoses, depressive disorders) at 17 percent, and thrombotic embolisms at 15 percent⁴³.

The systemic failures driving these fatalities are predominantly rooted in clinical and structural deficiencies. The PAMR committee cited non-adherence to medical guidelines, inadequate clinical risk assessment resulting in the misinterpretation of early warning signs, and a severe lack of care coordination during the highly vulnerable "fourth trimester" (the postpartum period extending up to one year after birth) as primary contributing factors⁴⁵. The persistence of these disparities across income and education brackets strongly indicates that chronic toxic stress, resulting from structural racism, induces physiological weathering that severely compromises maternal health outcomes⁴⁶.

Infant Mortality and the Opioid Settlement

Infant mortality mirrors these maternal statistics. While the state achieved a record low overall infant mortality rate of 6.5 deaths per 1,000 live births in 2024, the Black-White disparity ratio remains stubbornly fixed at approximately 2.4 to 2.8⁴¹. Black infants die at a rate of 13.7 to 14.2 per 1,000 live births, compared to 5.4 for White infants⁵⁰. Prematurity, low birth weight, and Sudden Infant Death Syndrome (SIDS) remain the dominant etiologies, with Black infants succumbing to prematurity at three times the rate of White infants, and SIDS at nearly four times the rate⁴¹.

Addressing the behavioral health components of these mortality metrics, particularly maternal substance use disorder, is heavily intertwined with the state's allocation of opioid litigation funds. Ohio established the OneOhio Recovery Foundation to manage the massive influx of pharmaceutical settlement revenue. The statutory distribution formula allocates 55 percent of the funds directly to the centralized OneOhio foundation for long-term health and recovery programming, 30 percent directly to local government health departments, and 15 percent to the state's general executive agencies⁵⁴. How effectively these funds are deployed to support maternal mental health and prenatal addiction interventions will serve as a critical determinant of future mortality trends.

Reproductive Autonomy and Public Health Law

The legal foundation underpinning women's healthcare in Ohio was fundamentally reconstructed in November 2023 with the passage of Issue 1, the Reproductive Freedom Amendment, which enshrined the explicit constitutional right to make and carry out individual reproductive decisions⁵⁵. The implementation of this amendment has triggered immediate and sweeping judicial review of the state's historical public health statutes.

In the ongoing litigation of Preterm-Cleveland v. Yost, a coalition of reproductive healthcare providers successfully secured a preliminary injunction from the Franklin County Court of Common Pleas against multiple state statutes restricting abortion access⁵⁵. The enjoined statutes included a mandatory 24-hour waiting period, mandatory dual in-person clinical visits, and the compelled disclosure of state-mandated anatomical information regarding gestational development⁵⁵.

Evaluating the statutes under the new constitutional standard—which prohibits the state from directly or indirectly burdening reproductive healthcare access—the court found that the regulations violated foundational principles of medical ethics. The ruling determined that the 24-hour waiting period and compulsory visits forced clinicians to deviate from evidence-based best practices, denying time-sensitive healthcare for purely political, rather than medical, purposes⁵⁵. While currently undergoing appellate review, this judicial precedent fundamentally alters how the state legislature can approach public health regulation, requiring a strict clinical justification for any mandate impinging on bodily autonomy.

Legislative Overrides and Emergency Health Authority

Conversely, the state's structural capacity to manage acute public health crises remains tightly constrained by recent legislative actions restricting executive authority. During the height of the COVID-19 pandemic in 2021, the Ohio General Assembly passed Senate Bill 22, overriding a gubernatorial veto to enact sweeping limitations on emergency health orders⁵⁹.

Senate Bill 22 grants the legislature the unilateral authority to cancel any state of emergency declaration and to selectively rescind specific epidemiological mandates issued by the governor or the state health director⁵⁹. Furthermore, the legislation severely curtails the autonomy of local municipal and county health boards, restricting their ability to enforce localized quarantines, mandate disease diagnoses, or implement rapid prophylactic measures⁵⁹. In the event of a future environmental or biological crisis—whether a novel pathogen outbreak or localized atmospheric contamination resembling the East Palestine disaster—the state's scientific and epidemiological response is subject to immediate legislative nullification. This dynamic shifts the epicenter of public health crisis management from clinical experts to the highly politicized arena of the legislature⁵⁹.

The 2026 Electoral Crucible

The vast and highly technical web of environmental, infrastructural, and public health policies in Ohio is highly sensitive to the upcoming 2026 state elections. The gubernatorial race, combined with the strategic battle for control of the General Assembly, presents starkly divergent ideological visions that will definitively shape the state's regulatory future for the next decade.

The Gubernatorial Policy Divide

The campaign to succeed the term-limited incumbent governor has highlighted the profound philosophical rift regarding the state's role in the environment and economy. The leading candidates, Republican Vivek Ramaswamy and Democrat Dr. Amy Acton, offer antithetical platforms on energy, utility regulation, and healthcare economics⁶⁴.

Acton, a physician and former state health director, has anchored her platform in public health equity, environmental stewardship, and consumer protection⁶⁵. Her primary health policy initiative is a proposal for a one-time state-funded buyout of medical debt for low-income Ohioans, modeled on successful pilot programs in other states, alongside the creation of "Ohio Rx," an initiative leveraging Medicaid purchasing power to drive down pharmaceutical costs⁶⁵. Environmentally, Acton’s platform strongly opposes the cost-shifting inherent in data center expansion. She advocates for appointing consumer-focused utility commissioners to the PUCO, scaling back fossil fuel dependency, and integrating battery storage to stabilize the grid without burdening residential ratepayers⁶⁴. Acton aligns closely with the objectives of groups like the Ohio Environmental Council, supporting robust funding for wetland restoration (H2Ohio) and halting the expansion of fossil fuel extraction on public lands⁶⁴.

In contrast, Ramaswamy, an entrepreneur who recently ran in the national presidential primaries, champions a platform of aggressive deregulation, sweeping tax reform, and maximal fossil fuel utilization⁶⁴. Arguing that increased domestic energy production is the only viable mechanism to reduce consumer utility costs, Ramaswamy asserts that fossil fuels are an absolute necessity for economic flourishing and enthusiastically supports the expansion of natural gas and coal extraction on state lands⁶⁴. He has promised to eliminate the state income tax and rollback property taxes, arguing that these cuts will provide citizens the disposable income necessary to handle their own healthcare costs, rejecting state-sponsored medical debt relief as an unwarranted "bailout"⁶⁴. Instead, he proposes reducing Medicaid expenditures by aggressively prosecuting fraud in coordination with the federal administration⁶⁵. Environmentally, while committing to maintaining the H2Ohio program, he advocates for streamlining environmental permitting and shifting the regulatory burden away from agriculture toward urban runoff and industrial actors⁶⁴.

The Battle for the General Assembly Supermajority

Simultaneous to the executive race, the 2026 elections represent a critical juncture for the Ohio General Assembly. The legislature is currently governed by a deeply entrenched Republican supermajority, controlling the 99-seat House of Representatives with a 65-34 margin, and the 33-seat State Senate with a 24-9 margin (following the 2024 cycles)⁷⁰.

Chamber	Total Seats	Seats Required for Simple Majority	Seats Required for Supermajority (Veto Override)	Current Republican Seats (Approx. 2025/2026)	Current Democratic Seats
Ohio Senate	33	17	22	24	9
Ohio House	99	50	66	65	34

Note: Seat counts reflect ongoing vacancies and recent electoral shifts leading into the 2026 cycle⁷⁰.

This supermajority grants the prevailing party near-absolute dominance over the legislative apparatus. It enables the legislature to bypass the gubernatorial veto—a power utilized to enact Senate Bill 22's health order restrictions—and allows for the frequent use of "emergency clauses." Attaching an emergency clause to a bill enacts it immediately upon passage, bypassing standard implementation delays and crucially insulating the legislation from citizen-led referendum challenges⁷⁴.

National political organizations, recognizing the profound implications of this dynamic, have designated Ohio as a premier "Powerbuild" battleground state for 2026⁷⁵. The strategic objective is not necessarily to seize outright control of the chambers, but to flip enough seats to permanently break the two-thirds supermajority threshold in the Senate and prevent its reassembly in the House⁷⁴. Breaking the supermajority would fundamentally rebalance the separation of powers in Ohio. It would force bipartisan negotiation on state budgets, restore the viability of the executive veto, and re-enable direct democratic challenges to controversial environmental and healthcare statutes. Furthermore, the legislators elected in 2026 will preside over the post-2030 census redistricting process, ensuring that the outcomes of this election will dictate the state's political geography and subsequent environmental and health policy trajectory for the next decade⁷⁴.

Conclusion

Ohio operates at the bleeding edge of national policy challenges, forced to balance the preservation of its natural ecosystems and the health of its citizens against the demands of intensive agriculture and explosive high-technology industrialization. From the nutrient-laden, cyanobacteria-choked waters of the Maumee River watershed to the highly complex, invisible threat of short-chain PFAS effluent from semiconductor fabrication, state regulators are navigating an increasingly fraught ecological reality. These external environmental pressures are mirrored by severe internal public health crises, where structural inequities continue to drive preventable, catastrophic outcomes in maternal and infant mortality.

The upcoming 2026 elections represent a profound crucible for the state. The stark divergence in the gubernatorial platforms—pitting aggressive deregulation and fossil fuel expansion against public health equity and rigorous environmental oversight—coupled with the battle to dismantle the legislative supermajority, guarantees that the electoral outcome will immediately reshape the state's legal and administrative frameworks. As massive data centers demand unprecedented electrical capacity and the legacy of industrial disasters continues to haunt marginalized communities, the policy decisions enacted in the wake of 2026 will dictate the resilience, equity, and vitality of Ohio for generations.

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45. Trends in pregnancy-related deaths in Ohio are worsening, https://www.communitysolutions.com/resources/trends-in-pregnancy-related-deaths-in-ohio-are-worsening

46. Objectives What is the Ohio Pregnancy- Associated Mortality Review, https://ccme.osu.edu/storage/Webcasts-Files/1024/Maternal%20Morbidity%20and%20Mortality%20-%204.pdf

47. Understanding Pregnancy-Related Deaths in Ohio, https://www.groundworkohio.org/post/understanding-pregnancy-related-deaths-in-ohio

48. New report explores trends, causes and timing of pregnancy-related, https://www.communitysolutions.com/resources/first-several-weeks-postpartum-highest-risk-for-maternal-death

49. Eliminating racial disparities in infant mortality | Publications, https://www.healthpolicyohio.org/our-work/publications/eliminating-racial-disparities-in-infant-mortality

50. Eliminating Disparities in Infant Mortality Task Force, https://childrenandyouth.ohio.gov/for-providers/infant-mortality-taskforce

51. Analyzing Decades of Disparities in Ohio's Maternal and Infant Deaths, https://ojph.org/article/6415/galley/6824/view/

52. Black infant mortality in Ohio is higher than white babies - Signal Akron, https://signalakron.org/more-black-babies-die-in-ohio-compared-to-white-babies/

53. Infant Mortality in Ohio - America's Health Rankings, https://assets.americashealthrankings.org/ahr_case_studies_ohio_120617.pdf

54. OneOhio Distributor Settlement Fact Sheet_April 2023, https://caribou-sunflower-jt3h.squarespace.com/s/OneOhio-Distributor-Settlement-Fact-Sheet_April-2023-mmpr.pdf

55. Ohio Injunction Issued for Abortion Statutes at Odds with State, https://www.shipmangoodwin.com/insights/ohio-injunction-issued-for-abortion-statutes-at-odds-with-state-constitutional-reproductive-rights.html

56. Preterm-Cleveland v. Yost 24 CV 002634 | Civil Rights Litigation, https://clearinghouse.net/case/45356/

57. Preterm-Cleveland, et al. v. Yost, et al. (waiting period challenge), https://www.acluohio.org/cases/preterm-cleveland-et-al-v-yost-et-al-waiting-period-challenge/

58. https://law.justia.com/cases/ohio/first-district-court-of-appeals/2026/c-240668.html

59. Local Health Officials Oppose Senate Bill 22 - WYSO, https://www.wyso.org/news/2021-03-29/ohio-legislature-overturns-veto-of-sb-22

60. Ohio Legislature Overrides DeWine's Veto, Allowing Lawmakers To, https://www.statenews.org/government-politics/2021-03-24/ohio-legislature-overrides-dewines-veto-allowing-lawmakers-to-rescind-health-orders

61. The (Un?)intended Consequences Of COVID-19-Era Judicial, https://www.healthaffairs.org/content/forefront/un-intended-consequences-covid-19-era-judicial-decisions-and-new-public-health-related

62. Gov. Mike DeWine Promises Veto Of Bill Limiting Public Health Orders, https://www.wosu.org/news/2021-03-12/gov-mike-dewine-promises-veto-of-bill-limiting-public-health-orders

63. Ohio General Assembly Passes Limits to Authority of State and, https://fisheldowney.com/ohio-general-assembly-passes-limits-authority-state-local-officials-respond-emergencies/

64. Where Ohio's front-runners for governor stand on ag, energy and the, https://www.farmanddairy.com/news/where-ohios-front-runners-for-governor-stand-on-ag-energy-and-the-environment/902446.html

65. What Ohio's candidates for governor would do about medical costs, https://signalohio.org/health-care-cost-medical-debt-ohio-governor-candidates-plan-election-2026/

66. Amy Acton - Ballotpedia, https://ballotpedia.org/Amy_Acton

67. Dr. Amy Acton for Governor, https://actonforgovernor.com/

68. Ohio Environmental Council Releases 2026 Gubernatorial Policy, https://theoec.org/news-and-information/ohioforward2026/

69. Vivek Ramaswamy - Wikipedia, https://en.wikipedia.org/wiki/Vivek_Ramaswamy

70. Ohio Senate - Wikipedia, https://en.wikipedia.org/wiki/Ohio_Senate

71. Ohio State Senate elections - Ballotpedia, https://ballotpedia.org/Ohio_State_Senate_elections

72. 2026 Ohio House of Representatives election - Wikipedia, https://en.wikipedia.org/wiki/2026_Ohio_House_of_Representatives_election

73. Ohio General Assembly - Ballotpedia, https://ballotpedia.org/Ohio_General_Assembly

74. Breaking the GOP supermajority in the Ohio House is one of our top, https://www.facebook.com/theDLCC/posts/breaking-the-gop-supermajority-in-the-ohio-house-is-one-of-our-top-priorities-in/1439237651566589/

75. The DLCC Target Map 2026, https://www.dlcc.org/the-dlcc-target-map-2025-2026/