Table 1. Description of domain and variables used in OCOI construction.

Domain	Constituent measure descriptions
Family stability	1. Proportion of parents enrolled in Medicaid with a primary serious mental illness diagnosis
	2. Proportion of children living in a household with below-poverty income
	3. Proportion of births that include no father's first/middle/last name
	4. Proportion of families with a parent served by Medicaid who has an substance use disorder diagnosis
	5. Labor market engagement index (HUD; reversed)
Infant health	1. Proportion of births that resulted in an infant mortality
	2. Proportion of Medicaid infants who had an injury or poisoning in the first year of life
	3. Medicaid-enrolled infants with neonatal abstinence syndrome
	4. Medicaid-enrolled infants with NICU stay
	5. Proportion of infants born preterm
	6. Medicaid children with six or more well-child visits in first 15 months of life (reversed)
	7. Proportion of infants born to Medicaid-enrolled women with severe maternal morbidity
Children's health (noninfant)	1. Proportion of Medicaid-enrolled children ages 1–5 with a diagnosis of developmental delay including sight and hearing impairment
	2. Proportion of Medicaid children age 3–6 meeting continuous enrollment criteria with one or more well-child visits with a primary care physician (reversed)
	3. Proportion of Medicaid-enrolled children ages 6–17 with a diagnosis of asthma
	4. Proportion of Medicaid-enrolled children ages 6–17 with a diagnosis of mental illness
	5. Proportion of Medicaid enrolled children ages 6–17 with a diagnosis of a developmental disability
	6. Proportion of Medicaid enrolled children ages 6–17 with a diagnosis of diabetes
	7. Proportion of Medicaid enrolled children ages 6–17 who received psychotropic BH medication
	8. Proportion of Medicaid-enrolled children ages 6–17 with a diagnosis of obesity
Access	1. Proportion of Medicaid behavioral health visits for children that meet the access standards of CMS (reversed)
	2. Proportion of primary care visits for children that meet the access standards (driving time and driving distance) of CMS (reversed)
	3. Geographic isolation (rurality) of the Census tract
	4. Low transportation cost index
	5. Percent occupied housing units in tract without a vehicle
	6. Percent tract population within a distance from the supermarket
	7. Distance to nearest elementary school
Education	1. Percent youth who have dropped out
	2. Percent of adults in the tract with more than high school education
	3. Percent of youth (age: 5–17 years) not enrolled in school
	4. Proportion of children not meeting third grade reading standards
	5. Free lunch distribution (reversed)
	6. Graduation rate (reversed)
	7. School performance index (reversed)
	8. School's value-added score (reversed)
Housing	1. Percentage putting 50% of income toward mortgage
	2. Percentage of households with less than one person per room
	3. Percentage putting 50% of income toward rent
	4. Percent housing identified as vacant
	5. Percent renting
	6. Percentage living in same housing unit for less than 1 year
	7. Rate of evictions among renters
Environment	1. Tract land area not covered by vegetation
	2. Tract land area covered by open development (e.g., pavement, parking)
	3. Percent of housing units constructed prior to 1980
	4. Annual average of daily pm25 measurements
	5. Count of tobacco retail outlets within a 3/4 mile buffered tract boundary
	6. Environmental health hazard index (air quality)
Criminal justice	1. Average number of homicide, assault, and sexual assault incidents per person reported to police each year during the period 2017–2018
	2. The average number of robbery incidents per person reported to police each year during the period 2017–2018
	3. The average number of burglary, larceny-theft, and motor-vehicle theft incidents per person reported to police each year during the period 2017–2018
	4. The average number of drunkenness and driving under the influence incidents per person reported to police each year during the period 2017–2018
	5. The average number of drug crime incidents per person reported to police each year during the period 2017–2018

Abbreviations: BH, behavioral health; CMS, Centers for Medicare & Medicaid Services; HUD, Department of Housing and Urban Development; NICU, neonatal intensive care unit; OCOI, the Ohio Children's Opportunity Index.