Oklahomans, with good reason, have much to feel proud about, but the quality of their general health is so poor that it threatens to overshadow much that is positive about the state.
The fact that Oklahoma lags behind the rest of the nation on most major health indicators is nothing new. But the latest State of the State’s Health Report paints a picture so bleak that state officials said Oklahoma’s poor national standing should be a cause for alarm.
“Oklahoma’s poor health status is unacceptable and change must occur,” Oklahoma State Board of Health President Barry L. Smith and Interim Commissioner of Health Rocky McElvany said in a joint statement. “We must strive together to improve the health of the citizens of our state and make Oklahoma a healthier place to live for the current and future generations of Oklahomans.”
The report, which was released by the Oklahoma State Board of Health in May, reviews 33 key health indicators such as heart disease and cancer deaths, diabetes prevalence, fruit and vegetable consumption and smoking that contribute to the state’s overall health status. It represents a departure from previous reports in that the indicators are ranked using a “report card” format.
Of the major health indicators included in the report, Oklahoma received an F in eight and a D on 16 others. None of the indicators received an A.
Each county in the state has its own section in the report using the same indicators. As the attached graphic indicates, Carter County also gets a failing grade on many of those health measures. Carter County Health Department Administrator Mendy Spohn said everyone needs to take responsibility for solving the state’s and county’s poor health status.
“Public health is so complex and difficult an issue that 45 people (the number of county health department employees) cannot solve the problem,” she said. “We cannot do it alone.”
The report does show the state has made progress in certain areas. Oklahoma’s adult smoking rate dropped to less than 25 percent in 2008.
Oklahoma ranks in the top half of all states for childhood immunizations.
And many formerly uninsured citizens secured health insurance through the Oklahoma Health Care Authority’s Insure Oklahoma program.
Spohn said other initiatives, such as the Carter County Turning Point Coalition, have shown they can make a positive impact in their local communities. Several of the state’s health indicators are highlighted below along with their corresponding scores.
Leading Causes of Death
• Heart disease kills more men and women than all types of cancer combined. One in 4 heart disease deaths among males and 1 in 10 in females occurs before the age of 65. The report indicates that many people do not know the signs or symptoms of a heart attack and therefore do not respond appropriately by calling emergency services. Only Mississippi has a higher rate of deaths due to heart disease. Grade — D
• Cancer is the second-leading cause of death in the nation and Oklahoma. The state is ranked 15th in the nation for the highest cancer mortality rate. Grade — D
• A stroke occurs when a blood clot blocks an artery or a blood vessel breaks, interrupting the blood flow to an area of the brain. Stroke is the third-leading cause of death in the state. On average, 26 strokes occur each day in Oklahoma, with six of them resulting in death. Grade — F
• Chronic lower respiratory disease is a group of illnesses, including chronic bronchitis and emphysema, that cause airflow blockage and breathing-related problems. Smoking is the primary risk factor for CLRD. Grade — F
• Oklahoma has an increased prevalence of diabetes, outpacing the national average during the past decade. Public health officials estimate more than 14 percent of all adults in the state have diabetes. Those with diabetes were three to four times more likely to report having hypertension and cardiovascular diseases than those without the condition. Grade — D
Risk Factors and Behaviors
• Oklahoma ranks 50th in the consumption of fruits and vegetables. A diet high in fruits and vegetables is associated with a decreased risk for chronic diseases such as heart disease, diabetes and some forms of cancer. Grade — F
• Oklahoma is ranked as the fifth-least physically active state. Almost 30 percent of the state’s adult population reported they had not participated in any type of physical activity or exercise in the last 30 days. Physical activity plays an important role in preventing or reversing many health problems. Grade — F
• Smoking is the state’s primary cause of preventable death. Smoking is a major contributor to each of the four leading causes of death — heart disease, cancer, stroke and CLRD. Grade — F
• Two-thirds of all Oklahomans are overweight or obese. Adult obesity rates have doubled since 1980, and childhood obesity rates have tripled. Oklahoma was ranked the sixth most obese state in the nation for adults in a recent study. The report indicated while obese older Americans don’t necessarily die earlier than their slimmer peers, their health care costs are greater. Grade — D
• Oklahoma ranked last in the nation for adults who had a dental visit within the last year. Research suggests that oral health is integral to general health. Grade — F
Unhealthy Choices
Many factors influence citizens’ health standing including income, race, insurance and place of residence. For example, black residents have higher rates of heart disease and stroke deaths than other ethnic groups. And Oklahoma is largely rural, which increases travel time to health care facilities.
But other factors such as poor eating habits, lack of exercise and the high numbers of smokers can be blamed on poor personal choices. For example, some of the risks factors for heart disease and stroke are obesity, physical inactivity, diabetes, hypertension, high cholesterol and smoking.
Spohn said it is not always easy for people to change their behavior even when they know it is in their best interest. For example, 15 percent of all Oklahomans don’t buckle up when they are in the car, even when there is ample evidence that seat belts save lives.
“(Poor personal decisions) cut across all socioeconomic and educational levels,” she said. “Education alone will not work.”
Spohn said she would like to hear from people with ideas about how the troubling health trends can be reversed.
“I invite them to come to one of our Turning Point meetings held on the second Thursday of every month at noon here at the health department,” she said. “We need to know why we aren’t reaching people.”
The 2008 State of the State’s Health Report is available at the Oklahoma State Department of Health’s Web site at www.ok.gov/health/.
Steve Biehn, 221-6546
