Oklahoma health systems and policy overview

Nursing

Oklahoma Health

Demographics

When looking at the demographics for the state of Oklahoma there are some interesting things that can be seen. In 2009 the median household income in the state was $41,716 compared to $50, 221 for the entire country. 19.4% of the population was uninsured compared with 16.7% across the U.S. And there 13.5% of the population was over the age of 65 compared to 12.9% for the country (U.S. Census Bureau, 2009). This data shows that the population of the state of Oklahoma is older, has less insurance and is poorer than the average across the country. All of these factors have been shown to affect the health of a population as a whole in that people with no money and no insurance often do not seek preventative care and therefore tend to be sicker as well as do those people who are over the age of 65.

Mortality -- Leading Cause of Death

In 2006 the leading cause of death in the state of Oklahoma and the United States as a whole was heart disease (State of the State Health Report, 2008). The state ranked 3rd in heart disease related deaths across the country (NCHS State Profiles 2009, 2009). There are many modifiable risk factors that lead to the high incidence of heart disease in Oklahoma. Smokers are two to four times more likely to develop coronary heart disease (CHD) than those who don't smoke. Presently one in four, or about 650,000, Oklahoma adults smoke. Heart disease death rates among adults with diabetes are two to four times higher than the rates for adults without diabetes. The incidence of adults with diagnosed diabetes in 2009 was 11.0%. Studies have shown that for every 20 mmHg systolic or 10 mmHg diastolic increase in blood pressure, there is a doubling of mortality from ischemic heart disease. The prevalence of Oklahoma adults with diagnosed high blood pressure in 2009 was 34.4%. Studies have found a direct association between levels of LDL cholesterol and the rate of heart disease in men and women. The incidence of Oklahoma adults with diagnosed high blood cholesterol in 2009 was 40.3%. Studies have shown that overweight and obesity are connected with increased risk for cardiovascular disease. The prevalence of obesity among Oklahoma adults in 2009 was 32% (Heart Disease in Oklahoma, 2010).

There are many factors that contribute to the inaptly high heart disease mortality rate in Oklahoma. A lot of people do not know the signs or symptoms of a heart attack and thus do not respond properly by calling emergency services. Oklahoma is largely rural which increases travel time to healthcare facilities therefore causing a delay in treatment (State of the State Health Report, 2008).

Morbidity -- Risk Factors/Behaviors Related to Disease

3. Among adult Oklahomans, approximately 304,500 people (11.0%) reported being diagnosed with diabetes by health professionals in 2009. Including those undiagnosed, the total number of adults who have diabetes is about 428,900 (15.5%) in Oklahoma. The modifiable risk factors relating to diabetes in Oklahoma include exercise and obesity. In 2009, 31.3% of Oklahoma adults did not participate in any leisure-time physical activity and the incidence of obesity among Oklahoma adults was 32.0% (Diabetes in Oklahoma, 2010).

Diabetes is among the top ten leading causes of death in Oklahoma. Diabetes mortality rates are increasing in Oklahoma as well as nationwide. In 1999, Oklahoma ranked 15th among all states in diabetes deaths. Additionally, each year about 1,800 Oklahomans die of diabetes. Diabetes-related deaths are impacting Oklahoma minority groups at a disproportionate rate. For instance, the age-adjusted death rates are over 200% higher for Native Americans and over 130% higher for blacks compared to whites. Because diabetes is a risk factor for other chronic diseases especially cardiovascular disease, the total impact of diabetes on the longevity of Oklahoma citizens is even greater than what present data shows (Oklahoma Diabetes State Plan, n.d.).

In the United States, diabetes represents $491.8 billion in direct medical costs and $39.8 billion in indirect medical costs. The per capita yearly costs are about $10,882. Applying this figure to the anticipated number of persons with diagnosed diabetes in Oklahoma, the cost attributable to diabetes in Oklahoma is thought to be $1.8 billion. The economic burden of diabetes in Oklahoma is widespread (Oklahoma Diabetes State Plan, n.d.). Diabetes affects an estimated 23.6 million people in the United States and is the 7th leading cause of death (Diabetes, 2011).

The State of Oklahoma has put into place a diabetes state plan in order to help fight the incidence of diabetes in the state. The plan includes:

the prevention of diabetes by endorsing healthy eating and augmented physical activity among all Oklahoma citizens the prevention of diabetes complications by promoting appropriate diabetes care, management and follow-up.

Increasing the use of ADA/IHS guidelines for standards of care

Providing more venues for health provider education

Identifying diabetes earlier

Increasing the focus on the 5 national objectives as identified by CDC (Oklahoma Diabetes State Plan, n.d.).

Healthy People 2020

4. When looking at the latest State of the State Health Report (2008), for Oklahoma there are several areas in which the health of the state is ranked with a grade of "D." Three of these areas are Cancer, Heart Disease and Obesity. All of these areas are of great concern to the state because they all lead to death. Obesity is of specific concern since it often leads to cancer and heart disease.