State falls again in health rankings
Infants are the only Oklahomans whose health showed much progress in the 2018 state rankings, and they still are near the bottom of the pack.
Oklahoma’s overall health ranking fell from 43rd in 2017 to 47th in 2018, as residents continued to do worse on most measures of behavior and health outcomes.
Measures related to babies were a rare bright spot, as fewer were born too small or died in the first year of life. It’s too early to get excited, though: Oklahoma still ranks 43rd in infant deaths, though that’s an improvement from 47th in 2017.
Joyce Marshall, director of maternal and child services at the Oklahoma State Department of Health, said the department needs more data to be sure that infant mortality will continue to fall. The rate of some risk factors, like unintended pregnancies, teen pregnancies and smoking while pregnant, are down, which gives babies a better chance of a healthy start, she said.
The work needs to continue, especially when it comes to encouraging providers to follow best practices in caring for women at high risk of preterm births and promoting safe sleep, Marshall said. The state has partnered with hospitals to offer sleep sacks, so babies won’t suffocate in a blanket, and is trying to expand a project to give out portable cribs to mothers who don’t have a safe place to lay their babies down, she said.
“It’s all well and good to receive the education, but if they don’t have the means to provide a crib, that doesn’t really help,” she said.
Children and teens
Children and teens were slightly less likely to live in poverty, but Oklahoma still fell from 41st to 42nd because other states made more progress. At the same time, the high school graduation rate went down, with fewer than 82 percent of teens getting a diploma. Childhood poverty and lack of education both raise the odds of poor health as an adult.
The data on vaccinations were mixed. Rates improved for human papillomavirus and the sequence of shots children get by age 3, but were down for tetanus and meningococcal disease.
Dr. Thomas Kuhls, president of Vaccinate Oklahoma, said vaccination rates typically have wide margins of error, which means it’s difficult to be sure if a drop is just statistical noise. More concerning is that Oklahoma consistently ranks low on uptake for some vaccines, he said.
“It’s not good, especially if it does that for a few years, but one year doesn’t mean much,” he said. “We’ve got to do better as a state, there’s no doubt about that.”
Adults
For adults, the good news was that deaths on the job decreased, and cancer deaths dropped a smidge.
Deaths from heart disease increased, however, as did the percentage of people reporting they had diabetes or poor mental health.
Rates of smoking, physical inactivity, obesity and excessive drinking all went up. Drug deaths also increased, but Oklahoma actually improved in the rankings, because deaths increased so much faster in states ravaged by illicit fentanyl.
Gary Cox, executive director of the Oklahoma City-County Health Department, said Oklahoma may not be investing enough in programs to target people who are at higher risk of poor health. Oklahoma has a good system for “sickcare” — providing treatment when someone is ill — but hasn’t done enough to prevent chronic health conditions, he said.
“Certainly, being 47th in health in Oklahoma, or even 43rd, like we were last year, is unacceptable,” he said.
Lack of stable housing, transportation and education all increase the odds of bad health outcomes, for both adults and kids, Cox said. So do food insecurity and domestic violence. Groups interested in improving health need to work with others who are targeting people who have the greatest needs, such as nonprofit organizations and schools, he said.
“Those issues that happen outside the doctor’s office have a big impact and, I think, could give us the biggest return,” he said. “We’re going to have to recognize the interdependence of education, health care and jobs and the economy.”