Study Ranks Oklahoma Last in Health Indicators

Sept. 21-- Oklahoma has worse death and disease rates than the national average and has gotten worse in the majority of health indicators studied, according to the 2011 State of the State's Health Report released Tuesday.

Oklahoma is last in the nation in eating fruits and vegetables, chronic lower-respiratory-disease deaths and adult dental visits, according to the report, which was originally set to be released in 2010.

"Oklahoma's poor health status is not acceptable and improvement must occur," Oklahoma State Board of Health members wrote in a section of the report titled "Call to Action."

"Every Oklahoman has a stake and role in improving our state's health outcomes and we must work together to shape our future and assure the health of all Oklahomans -- both for this generation and generations to come."

The state received a grade of F for heart-disease deaths, stroke deaths, injury deaths, diabetes, physical activity and smoking.

Jenny Alexopulos, chairwoman of the board of health, said some of the indicators deal with personal responsibility. Patients must take care of their own health in addition to visiting a doctor, she said.

"Eat less. Move more. Don't smoke," she said. "Those are the main things."

With the exception of fruit and vegetable consumption, there were significant disparities in the state between those earning fewer than $25,000 a year and those earning more, as well as between those with a high-school education versus a college degree.

In Tulsa County, 17 percent more adults had diabetes, 16 percent more had asthma, 10 percent more were physically inactive and 14 percent more were obese than in the previous year studied.

The study used the latest available data, with the most recent years varying among categories.

Tulsa County residents were more likely to visit the dentist and had better diabetes and asthma rates than the state overall. The county ranks 31st in the state for age-adjusted total mortality, with the leading causes of death of heart disease, cancer and stroke.

Alicia Plati, division manager of health data and evaluation for the Tulsa Health Department, said the poor marks were not a surprise.

"There's nothing on this list that we don't know about and aren't actively trying to change," she said.

The Health Department has a program called Know Your Numbers that offers free diagnostic testing for residents in high-risk ZIP codes. It also has programs to encourage workplace wellness programs and school-based initiatives to encourage physical activity and better nutrition, she said.

The department tries to work within the community and to partner with other organizations to make positive lifestyle changes, Plati said.

"One agency working on it individually isn't going to get a lot done," she said.

The leading causes of death in Oklahoma are heart disease, stroke, chronic lower-respiratory disease, unintentional injury and diabetes.

The main chronic lower-respiratory disease is Chronic Obstructive Pulmonary Disease, which is a progressive disease of the lungs that restricts air flow, said Carmen Vesbianu, an internal medicine specialist with Omni Medical Group.

About 90 percent of COPD cases are caused by smoking. The damage is irreversible and the only effective treatment is a lung transplant, she said.

Most people seek treatment late in the stages of COPD. Symptoms include shortness of breath, coughing and wheezing, she said.

The disease does more than damage the lungs, Vesbianu said.

"When you lose oxygen your heart suffers," she said. "Your brain suffers. Your whole body can suffer from this."

There were a few small bright spots in the report. Oklahoma improved in vaccinating seniors against flu and pneumonia and in immunizing children younger than 3. The percentage of uninsured adults also decreased.

"We've got these incremental focused areas of improvement," Alexopulos said.

Oklahoma's total mortality rate and infant mortality rates were worse in 2007 -- the most recent year cited by the study -- than the year before and are well above the national averages. There were 8.6 deaths for every 1,000 live births in Oklahoma in 2007, a rate that is 26 percent higher than the U.S. average of 6.8 per 1,000.

The state also ranked poorly in preventable hospitalizations, such as a person who has recently been discharged from a hospital but didn't receive the follow-up care needed to stay healthy.

"Then we find these patients coming back through the emergency department," Alexopulos said.

By the numbers

Fruit and vegetable consumption:

U.S. -- 23.4 percent

OK -- 14.6 percent

No physical activity:

U.S. -- 23.8 percent

OK -- 31.4 percent

Current smoking prevalence:

U.S. -- 17.9 percent

OK -- 25.5 percent

Obesity:

U.S. -- 26.9 percent

OK -- 32 percent

Adult dental visits:

U.S. -- 71.3 percent

OK -- 57.9 percent

No insurance coverage:

U.S. -- 14.3 percent

OK -- 19.8 percent

Poverty:

U.S. -- 13.2 percent

OK -- 15.7 percent

Preventable hospitalizations (per 100,000):

U.S. -- 1,762.6

OK -- 2,120.9

Source: 2011 State of the State's Health Report

Shannon Muchmore 918-581-8378

shannon.muchmore@tulsaworld.com