How low will we go?
BY JANET PEARSON Associate Editor
Sunday, December 11, 2011
12/11/11 at 3:28 AM
What will it take to get Oklahomans to get healthier? Obviously the risk of a horrible premature death that could bankrupt and devastate one's family isn't persuasive enough.
Yet again, a national report on health measures has given Oklahoma some of the most troubling marks in the country. In fact, the well-respected United Health Foundation's rankings, measured for the last 22 years, show Oklahoma's overall health ranking dropping by two points, to 48th place in the country in 2011.
Thank goodness for Mississippi and Louisiana, we sometimes joke in this business. If it weren't for that handful of states that regularly rounds out the bottom quintile on measures of well-being, Oklahoma would be last or next to the last even more often than we already are. Mississippi ranked 50th in America's Health Rankings' 2011 report, and Louisiana, 49th.
But this isn't funny. According to the State Department of Health's announcement of the latest rankings, the reasons Oklahoma scored lower this year included "the high percentage of Oklahoma children in poverty, an increase in the number of Oklahoma adults with diabetes, a high prevalence of Oklahoma adults who are obese, and the continued prevalence of smoking among Oklahoma adults."
Other factors bringing our ranking down were "the limited availability of primary care physicians ... the low use of pregnant women seeking prenatal care during their first trimester, and the high number of poor mental health days reported by Oklahomans."
Though the report overall paints an abysmal picture, there were a few bright spots. The report found that in the past five years, smoking has decreased 6 percent in the state, from 25.1 percent of the adult population to 23.7 percent. An estimated 669,000 adults still smoke in Oklahoma, the report concluded.
The drop in the smoking rate is no small accomplishment. Tobacco long has been one of the state's top health scourges, and the fact Oklahoma now has more ex-smokers than current smokers, as determined by a recent state survey, is encouraging. If Oklahomans can be persuaded little by little to abandon the tobacco habit, shouldn't it follow we can also be talked into taking up other healthy habits? Time will tell.
Another bright spot in the report was a reduction in the rate of preventable hospitalizations among Medicare enrollees, from 88.7 to 81.8 discharges per 1,000 participants. This finding suggests the older population is doing better for some reason or reasons at staying out of the hospital.
Daunting problems
But some of the most daunting problems facing the state only grew more serious. In the past five years, diabetes increased from 8.9 percent to 10.4 percent of adults, with an estimated 293,000 adults now trying to manage the disease.
In the past decade, obesity has increased from 19.7 percent to an astonishing 31.3 percent of adults. An estimated 883,000 Oklahoma adults are now considered obese.
The poverty rate - a major factor influencing health - among Oklahoma children skyrocketed in the past year, from 20.3 percent to 25 percent.
When the populations affected by these conditions are broken down along ethnic lines, the findings are even more alarming. An estimated 40 percent of the non-Hispanic American Indian population is obese, and 41.3 percent of the non-Hispanic black population. Similar trends are seen for diabetes: An estimated 15.1 percent of non-Hispanic American Indians are diabetic.
How do we compare with healthier states? We have a long, long way to go before we'll even make it to the mid-point. Vermont, deemed by the report to be America's healthiest state, boasted of a tobacco-use rate of only 15.4 percent of adults and an obesity rate of 23.9 percent among adults. Diabetes in Vermont affects only 6.8 percent of the population. And, 13.5 percent of the state's children live in poverty.
If it's any consolation - and it shouldn't be - measures of healthiness are showing declines in major categories elsewhere in America.
Even in healthy Vermont, the number of children living in poverty has nearly doubled in the last five years. Obesity among adults there has grown nearly 6 percent in the past decade, and diabetes has increased more than 2 percent in the last decade.
Is there the will?
Why should we care if fellow Oklahoma smoke or are overweight? Because it affects us all. Healthy children are better able to perform in school and pursue productive paths as adults. Adults who are healthy are more productive and less likely to foist health-care costs on employers and fellow taxpayers. Elderly people who stay healthy can remain independent longer, helping to hold down health-care costs for this population.
What's so exasperating about these reports is that the tools that can help improve health measures are well known and in fact readily available for those who want to get healthier. Detailed programs that offer health- improvement guidance for businesses, schools and communities are available through such sources as the health department. A new effort funded the state's Tobacco Settlement Endowment Trust is starting up to help communities develop local programs to deal with the obesity problem.
On the local front, new health partnerships and facilities are coming together, and should be especially helpful to those populations now unable to regularly access the right kind of care.
But even with progress occurring on some fronts, it still seems that good health is not an especially high priority around these parts. Oklahoma just doesn't have what's known as the "prevention culture." Even at leadership levels, important goals that could do much to advance healthy practices sometimes are given short shrift - or worse, spurned in favor of special interests.
State Health Commissioner Dr. Terry Cline, who said health leaders are "disappointed, but not surprised" by the report's findings, noted that existing state health policies don't always promote healthy living and healthy choices. The result is "progress is slower than it should be."
A couple of legislative objectives that will be pursued in the upcoming session are granting rights to local communities to adopt tobacco-use controls that are stricter than state laws, and health-education classes for middle-school students.
"These proposals are excellent examples of policies that endorse the concept of making the healthy choice the easy choice. Until these legislative priorities are passed, thousands of lives will needlessly be lost each year in Oklahoma," said Cline.
But such objectives have been pursued before without success. Will next year be any different? Will our state and local leaders, our business and civic stakeholders, and we as individuals make more choices that could make us healthier, saving lives and reducing costs? Or are we just going to throw up our hands and give up?
Janet Pearson 918-581-8328
janet.pearson@tulsaworld.com
