Yet, there is still room for improvement. Many Oklahomans continue to be obese. A large percentage of pregnant women do not receive prenatal care and many babies are born with low birth weight, especially among African-American people. Too many youth begin smoking or using tobacco products every year. Some Oklahomans don’t have the same access to quality health services as others. We must create and assure conditions where the healthy choice is the easy choice to address the health challenges we face in our state and meet the goals of Healthy Oklahoma 2020.
This plan focuses our efforts on making improvements in key strategic areas and creating a culture of health. Making improvements in these flagship issues will have the greatest impact on the health of Oklahomans now and for future generations.
Tobacco continues to be the leading preventable cause of death in Oklahoma, causing about 6,000 deaths in our state per year. Smoking kills more Oklahomans than alcohol, auto accidents, AIDS, suicides, murders and illegal drugs combined. 31
Oklahomans spend approximately $1.62 billion per year on smoking-related health costs, while the tobacco industry spends an estimated $160.3 million dollars annually to market tobacco products in Oklahoma. 32, 33, 34
The Oklahoma adult smoking prevalence decreased from 26.1% in 2011 to 23.3% in 2012 and remained steady at 23.7% in 2013.2 Oklahoma’s adult smoking rate is still far above the national average of 17.8%. 35
Approximately one in four Oklahoma adults smoke compared to one in five nationally.2 The percentage of public high school students who were current, frequent smokers decreased from 9.1% in 2009 to 5.5% in 2013.5 Each year about 4,400 Oklahoma children become new daily smokers. 36
OHIP measures focus on 1) decreasing the incidence of chronic disease caused by or impacted by tobacco use and secondhand smoke exposure and 2) decreasing the proportion of Oklahoma children who become new daily smokers.
The factors leading to obesity are complex. Public health approaches that affect large numbers of different populations in multiple settings—communities, schools, worksites and healthcare facilities—are needed. Policy and environmental initiatives that create incentives to make healthy nutrition choices and physical activity opportunities available will prove most effective in combating obesity. 38
Today’s experiences and exposures influence tomorrow’s health (timeline), the path of one’s health is particularly affected during critical or sensitive periods (timing), the broader community environment strongly affects the capacity to be healthy (environment) and inequality in health reflects more than genetics and personal choice (equity). If, as a state, we take advantage of these life course opportunities – we will greatly accelerate improvement in our overall health as the next generation arrives equipped to live, work and lead this state with vitality and purpose.
In order to achieve further improvement in birth outcomes, women must practice healthy behaviors and be engaged in primary and preventive healthcare services throughout their reproductive lives, including the time before they become pregnant (preconception) and between pregnancies (inter-conception). Making health a priority for children and adolescents ensures the health of future generations.
During this time of physical and mental growth, children and adolescents can learn to build a strong foundation for healthy behavior. Research has shown that many medical conditions affecting adults have roots in childhood.
Mental health and substance abuse issues are among the most pressing concerns facing our state today. In the past year, 21.9% of adult Oklahomans reported having a mental health issue and 12% experienced a substance abuse issue40 representing 700,000 to 950,000 Oklahomans living with diseases of the brain.
Oklahoma consistently ranks among the highest in the region, and nationally, for rates of mental illness and addiction, as well as prescription drug abuse, underage drinking and suicide. Oklahoma ranks 49th nationally for mental illness among adults,40 11th worst for suicide at 17.6 per 100,000 people (670 deaths),41 45th at 19.8 per 100,000 people for drug overdose deaths42 and is tied at 44th in its ranking for the number of “poor mental health days.” 8
Divorce, unemployment, child welfare involvement, academic failures, accidents, unwanted pregnancies, homelessness, crime and incarceration are all potential consequences of these illnesses if left untreated.
Ties to other chronic health issues are also well documented. According to the Medical Expenditure Panel Survey (MEPS) data from 2003, mental disorders are the third leading chronic disease in the nation – behind only cancer and heart disease.
The projection of growth percentage in the number of people reporting mental disorders between 2003 to 2023 is 53.8%, which will be more prevalent than heart disease (projected at 41%), diabetes (projected at 53%), and stroke (projected at 29%).42 Life expectancy for people with untreated behavioral health diseases is significantly less than the general population, upwards of 25 – 30 years.43
Dedicated attention to diseases of the brain is critical to improving the health of our state.
Access to Food and Food Insecurity
In 2012, it is estimated that 17.2% (656,300) of Oklahomans experience lack of access to enough food for all household members and uncertain availability of nutritiously adequate foods, including nearly 239,380 children.17 Out of the 77 counties in Oklahoma, residents in 43 counties have to travel more than 10 miles to reach a full service grocery store in rural areas and more than a mile to a grocery store in urban areas.18
The percentage of Oklahomans paying home mortgages that are 30% or more of their income is 24.4%. Approximately 18% of Oklahomans are paying 35% or more of their income. Approximately 45% of Oklahomans are paying rent at or above 30% of their income and 36.3% pay rent at 35% or more of their income.11
In 2014, Oklahoma was ranked 47th in the health of older adults, an improvement from a 49th ranking in 2013.19 Significant challenges for the health of older adults in Oklahoma include the highest rate of hip fractures among Medicare beneficiaries, the second highest rate of physical inactivity, the third highest rate of falls, the seventh highest ranking overall on unhealthy behaviors, and the lowest rate of hospitalized older adults who received recommended care for heart attack, heart failure, pneumonia, and surgical procedures. Oklahoma ranked the last overall in public health policies and programs supporting older adults.19 Older adults are currently 14.2% of Oklahoma’s population and their numbers are projected to increase by 36.8% from 2015 to 2030.11, 19
Approximately 15.8% of Oklahomans living at home have a disability.11 Nearly 9 out of 10 Oklahoma adults have difficulty using everyday information that is routinely available in healthcare facilities, retail outlets, media, and communities.20
Personal Health Behaviors and Health Outcomes
Many Oklahomans engage in lifestyles and behaviors that put them at a higher risk for chronic diseases, disabilities, and deaths. These behaviors are directly related to the leading causes of death in Oklahoma, including cardiovascular disease, cancer, stroke, respiratory disease, and unintentional injuries.
This includes initiatives that prevent disease at the earliest stage possible, providing care coordination to individuals with chronic conditions (both physical and behavioral) in order to reduce significant health consequences and excessive healthcare utilization, payment strategies that reward health providers and systems for achieving population health improvement and better integrating healthcare systems with community level health improvement initiatives.
Recent efforts to address Oklahoma’s health system
transformation have resulted in the identification of four core areas of work:
1. Health Efficiency and Effectiveness
2. Health Information Technology (IT)
3. Health Workforce, and
4. Health Finance.
The Oklahoma Health Improvement Plan is designed to inspire an entire state to work collaboratively together to help Oklahomans live healthier, happier, and longer lives. While great strides have been made in recent years, more work is needed as many Oklahomans are dying unnecessarily and prematurely. Integrating the input and findings derived from published health data, stakeholder and community engagement, and evidence-based frameworks and practices, the 2015-2019 OHIP proposes new ways of interacting, new structures for communication, and a renewed hope that progress on issues of mutual interest can be achieved through private-public and tribal partnerships as well as individual Oklahomans’ commitment and involvement.
ALL OKLAHOMANS ARE ASKED TO DO THEIR PART AND PARTICIPATE IN CREATING A CULTURE OF HEALTH THROUGH THE FOLLOWING ACTIONS:
Adopt recommended health policies within businesses, schools, congregations and communities.
Adopt recommended healthy lifestyle changes and encourage your friends and family.
Get connected with a local Turning Point or other community partnership
to plan and implement local community health improvement efforts.
Visit www.health.ok.gov for a complete listing of Turning Point Coalitions in Oklahoma.
Encourage local businesses, schools, communities, and congregations
to apply for and achieve Certified Healthy Oklahoma recognition.
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