Oklahoma epidemiological profile.

              2010 Oklahoma Epidemiological Profile
Epidemiology, the science of public health, provides vital information about disorders that threaten the
health and well‐being of populations. Epidemiological data identify problems, help determine what
areas and who are affected by the problems—knowledge that is essential for effective intervention—
and measure the success of interventions aimed at preventing or reducing these problems. Engagement
in a thoughtful planning process that includes careful assessments of needs, resources, capacity,
readiness, and contextual conditions—prior to selecting strategies—is essential to successful prevention
efforts.
This data focus—collection, analysis, and use—is entrenched in each step of the SPF and continually
informs the process. The formal assessment of contextual conditions, needs, resources, readiness, and
capacity is used to identify priority issues in Step 1. In Step 2, data are shared to generate awareness,
spur mobilization, and leverage resources. In Step 3, assessment data are used to drive the development
of a strategic plan and guide the selection of evidence‐based strategies. Data are used in Step 4 to
inform (and, if necessary, revise) the implementation plan. And finally, data are collected to monitor
progress toward outcomes, and findings are used to make adjustments and develop sustainable
prevention efforts.
The Oklahoma State Epidemiological Outcomes Workgroup (SEOW) is a multidisciplinary workgroup
whose members are connected to key decision‐making and resource allocation bodies in the state. This
workgroup, funded through a Federal grant from SAMHSA/CSAP, was established by ODMHSAS in 2006
and is patterned after the National Institute on Drug Abuse (NIDA) community epidemiological
workgroup. Oklahoma’s SEOW is charged with improving prevention assessment, planning,
implementation, and monitoring efforts through data collection and analysis that accurately assesses
the causes and consequences of the use of alcohol, tobacco, and other drugs and drives decisions
concerning the effective and efficient use of prevention resources throughout the state.
To study the nature and extent of the problem of alcohol, tobacco, and other drug use in Oklahoma, the
state’s SEOW utilized the CSAP model of consumption and consequence constructs and indicators. Table
1 provides a complete listing of alcohol, tobacco, and illicit and prescription drug consumption and
consequence constructs. For each construct, one or more identifiable indicators (measures) were used
to quantify consumption and substance‐related consequences. Unlike the underlying constructs, these
indicators are precisely defined and determined by specific data sources. Thus, while “alcohol‐related
mortality” is a relevant construct for monitoring trends of an important consequence of use, it does not
provide a precise definition of how this construct can be measured. However, a number of indicators do
provide specific measures of this construct (e.g., annual incidence rate of deaths attributable to alcohol‐related
chronic liver disease, suicide, homicide, or crash fatalities). A list of constructs and indicators for
alcohol and illicit drug consumption and consequences appear in the epidemiological data tables on
pages 54–59.
CSAP recommendations were not available for prescription drugs, so Oklahoma used the same data
sources CSAP recommended for the other constructs and indicators.
Table 1. Alcohol, Tobacco, Illicit Drugs, and Prescription Drug Consumption and Consequence Constructs
Alcohol Tobacco Illicit Drugs Prescription Drugs
Consumption • Current use •Current use • Current use
• Age of initial use •Lifetime use
•Age of initial use
• Drinking and driving
Consequence •Alcohol‐related mortality
• Alcohol‐related Crime
•Dependence or abuse
•Total cigarette use
consumption per
capita
• Apparent per capita alcohol
• Alcohol‐related motor vehicle
crashes
•Tobacco‐related
mortality
•Illicit drug‐related
mortality
•Illicit drug‐related
crime
•Dependence or
abuse
•Prescription opiate‐related
mortality
• Current use
• Heavy drinking
• Age of initial use
• Current binge drinking
• Alcohol use during pregnancy
•Tobacco use during
pregnancy
The SEOW required data indicators for each substance to be readily available and accessible, with the
measure available in disaggregated form at the State or lower geographic level. The method or means of
collecting and organizing the data also had to be consistent over time; if for any reason the method of
measurement had changed, reliable data had to be available to allow adjustment for differences
resulting from data collection changes. In addition, research‐based evidence had to support that the
indicator accurately measured the specific construct and yielded a true representation of the
phenomenon at the time of assessment, with data collected—preferably on an annual, or at minimum, a
biennial basis—for the preceding 3 to 5 years. And each indicator had to be sufficiently sensitive to
detect change over time that might be associated with changes in alcohol, tobacco, or illicit drug use.
Alcohol Consumption
According to Oklahoma’s Youth Risk Behavior Survey (YRBS), in 2009, 39.0 percent of students in grades
9–12 reported current alcohol consumption. That percentage is consistent with data collected by the
National Survey on Drug Use and Health (NSDUH) for the population aged 12 and older, which showed
42.5 percent of respondents were current drinkers in 2007. NSDUH and YRBS data also showed between
21 and 28 percent of adolescents were binge drinkers at the time of the surveys. Although youth binge
drinking is on the decline, with the exception of 2009, Oklahoma has been consistently above the
national average for this behavior according to the YRBS. NSDUH data from 2007 indicated 37.4 percent
of 18‐ to 25‐year‐olds and 9.0 percent of 12‐ to 17‐year‐olds were binge drinkers. The 2009 YRBS
showed 19.4 percent of Oklahoma students in grades 9–12 reported early initiation of alcohol; a
continued indication of a steady decline in that behavior since the 2003 YRBS report of 26.8 percent.
While adolescent drinking and driving is trending downward, Oklahoma continues to have percentages
higher than the national average. In 2003, Oklahoma’s percentage of adolescent drunk driving was 17.5
percent, which was 45 percent higher than the national average. This dropped to 11.0 percent in 2009,
which was 13 percent higher than the national average of 9.7 percent.[1]
Figure 1.YRBS 2003–2007 Percentage of Students in Grades 9–12 Who Reported
Driving When They Had Been Drinking
Indicators from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) show Oklahoma is lower
than the national average in current alcohol consumption, heavy consumption, and binge drinking
among adults. In 2009, 42.6 percent of Oklahoma adults reported current alcohol consumption, which
was 27 percent lower than the national average of 54.3 percent.[2]
Although lower than the national average, NSDUH data indicates Oklahoma’s percentage of binge
drinking among persons 12 and older has increased from 2003‐2007. The percentage was 19.01 in 2003
and 21.2 in 2007.[3]
Figure 2. BRFSS 2009 Alcohol Consumption Categories
Data from the Pregnancy Risk Assessment Monitoring Survey (PRAMS) show that alcohol use among
pregnant women has been climbing in Oklahoma since 2003, when 2.5 percent of pregnant women had
consumed alcohol during the last 3 months of their pregnancy. In 2007, the percentage had increased to
4.8 percent of pregnant women.[4]
Alcohol Consequences
Oklahoma is consistently above the national average in alcohol‐related mortality. Long‐term alcohol
consumption is associated with chronic liver disease. The relationship between alcohol use and suicide is
also well documented, according to CSAP. Both chronic liver deaths and suicide deaths have been on the
rise in Oklahoma since 2003.[5,6,7]
17.5
12.3 13.3
11.00
12.1
9.9 10.5 9.7
0
5
10
15
20
2003 2005 2007 2009
Oklahoma
Nation
42.6
12.9
3.4
54.3
15.7
5.1
0
10
20
30
40
50
60
Current
Drinker
Binge Drinker Heavy Drinker
Oklahoma
Nation
Figure 3. 2003–2006 National Vital Statistics System (NVSS)
Oklahoma Chronic Liver Disease and Suicide Mortality
Data Deaths per 100,000
According to the Uniform Crime Reports (UCR), Oklahoma has also been consistently above the national
average in crimes related to alcohol use which include aggravated assaults, sexual assaults, and
robberies. Since 2003, there has been an 18.1 percent increase.[8]
Figure 4. 2005–2008 UCR Number of Violent Crimes Reported to Police Per 100,000
Population
Fatality Analysis Reporting System (FARS) data show that Oklahoma has maintained a steady rate of
fatal crashes involving an alcohol‐impaired driver. In 2003, Oklahoma’s alcohol‐impaired driver fatality
percent was 31.3, and in 2008, that figure remained relatively stable at 31.6 percent. National
percentages for those years were 30.3 and 31.4, respectively.[9]
Tobacco Consumption
According to the 2007 NSDUH, 30.6 percent of Oklahomans aged 12 and older were current cigarette
smokers, which was above the national average of 24.2 percent. Data from the 2009 BRFSS also showed
Oklahomans’ daily cigarette smoking exceeding that of the United States population as a whole, at 25.4
percent vs. 17.9 percent, respectively.[2,3]
The YRBS shows indicators in tobacco use among adolescents have been falling in Oklahoma since 2003,
with students who smoked their first cigarette before the age of 13 decreasing by half since that year.[1]
9.413.6 10.314.4 11.314.7 12.415.0
0
5
10
15
20
2003 2004 2005 2006
Chronic Liver
Disease
Suicide
508.6
497.4 499.6
526.7
469.0 473.6 466.9
454.5
400.0
420.0
440.0
460.0
480.0
500.0
520.0
540.0
2005 2006 2007 2008
Oklahoma
Nation
Figure 5. YRBS 2003–2009 Percentage of Students in Grades 9–12
Who Reported Smoking a Whole Cigarette for the First
Time Before the Age of 13.
Smoking among pregnant women is climbing in Oklahoma according to PRAMS. In 2003, 16.2 percent of
pregnant women reported they had smoked during the last 3 months of their pregnancy; in 2007, the
most recent PRAMS for which data are currently available, the percentage of pregnant women who
smoked during the last 3 months of pregnancy had jumped to 21.3.[4]
Tobacco Consequences
National Vital Statistics System (NVSS) data show deaths from both chronic obstructive pulmonary
disease (COPD) and emphysema for Oklahoma are above the national average.[10]
Figure 6. NVSS 2006 COPD/Emphysema and Lung Cancer Deaths Per 100,000
Illicit Drug Consumption
The YRBS shows daily marijuana use for high school students in grades 9–12 is decreasing; 22.0 percent
were daily users in 2003, while just 15.9 percent reported this behavior in 2007.[1]
According to NSDUH, Oklahoma has been consistently above the national average among persons aged
12 and older reporting the use of any illicit drug other than marijuana. The percentages were 4.1 in 2004
and 4.6 in 2007. The national percentages for those same years were 3.4 and 3.7, respectively.[3]
23.7
20.2
15.6
11.5
0
5
10
15
20
25
2003 2005 2007 2009
Oklahoma
60.0
68.2
40.5
53.1
0.0
20.0
40.0
60.0
80.0
COPD/Emphysema Lung Cancer
Cause of Death
Oklahoma
Nation
Although still above the national average, youth methamphetamine use continues to decline in
Oklahoma according to the YRBS. Since 2003, the percentage of youth methamphetamine users has
dropped by half.[1]
Figure 7. YRBS 2003‐2009 Percentage of Oklahoma Students in Grades 9–
12 Who Reported Ever Using Methamphetamines
The YRBS also shows Oklahoma exceeds the national average in cocaine, ecstasy, steroid, and inhalant
use. Although above the national average, cocaine use in Oklahoma has dropped from 9.2 percent in
2003 to 7.4 percent in 2009.[1]
Although initially below the national average in years 2003–2007, adolescent use of inhalants is on a
steady ascent. In 2009, 12.7 percent of Oklahoma adolescents reported inhalant use, surpassing the
national average of 11.7 percent.[1]
Figure 8. 2003‐2009 YRBS Percent of Students in Grades 9–12 Who Reported
Ever Using Any Form of Inhalant
Illicit Drug Consequences
The latest NVSS data show that Oklahoma exceeds the Nation in number of deaths due to drug‐related
behavior. In 2006, the rate per 100,000 was 17.3 for Oklahoma and 12.8 for the United States as a
whole.[5]
9.9
7.1
5.5
4.8
0
2
4
6
8
10
12
2003 2005 2007 2009
9.9
12.0 11.7
12.1 12.4 12.7
13.3
11.7
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
2003 2005 2007 2009
Oklahoma
Nation
The number of drug‐related crimes (larceny, burglary, motor vehicle theft) in Oklahoma also outstrips
that of the Nation; in 2008, Oklahoma reported 3,442.4 per 100,000 compared to the national rate of
3,212.5 per 100,000. However, Oklahoma’s 2008 rate does represent a decline for the state, which
reported drug‐related crimes of 4042.0 per 100,000 in 2005.[8]
Prescription Drug Consumption
According to data from the 2007 NSDUH, Oklahomans aged 12 and older exceeded the national average
for the consumption of painkillers for nonmedical use by 232 percent. This is a 22 percent increase since
2004.[3]
Prescription Drug Consequences
Although hospital inpatient discharge data were not indicators used in scoring, they were presented to
the State Epidemiological Outcomes Workgroup (SEOW) due to the paucity of indicators regarding
prescription drugs. Oklahoma hospital data associated with opiates have shown a 91 percent increase
since 2003. Although this is a general category for opiates, for all practical purposes, heroin is the only
illicit opiate taken into account.[11]
NVSS data show there has been a 328 percent increase in opiate‐related deaths in Oklahoma since 1999.
In 2006, Oklahoma ranked 4th in the Nation for opiate overdose deaths, exceeding the national average
by 123 percent.[12]
Figure 9. NVSS 1999‐2006 Opioid Overdose Deaths Per 100,000 Population
Mental and Emotional Disorders
The Oklahoma SEOW intends to expand its scope to collect and analyze epidemiological data on the
nature and extent of mental illness and related indicators in the state. The broadening of the SEOW’s
scope of work is critical for Oklahoma to gain more understanding about opportunities for mental illness
prevention and mental health promotion within the state. In addition, developing research supports the
connection between mental and emotional disorders, their causal factors, and other behavioral health
problems, including substance abuse. Therefore, it is imperative that Oklahoma apply the same
0
2
4
6
8
10
12
1999 2000 2001 2002 2003 2004 2005 2006
Rate
Oklahoma
US
.
assessment standards integral to the SPF process for the prevention of mental and emotional disorders
as has been done for substance abuse.
Mental disorders (brain dysfunction disorders) account for 25 percent of disability in the United States.
About 22 percent of the U.S. adult population has one or more diagnosable disorders in a given year.
Oklahoma currently ranks number one in the Nation for the prevalence of these disorders in adults.[13]
Mental illness can influence the onset, progression, and outcome of other illnesses. Anxiety, impulse
control, and mood disorders often correlate with health risk behaviors such as substance abuse, tobacco
use, and physical injury. Depression is a risk factor for such chronic illnesses as hypertension,
cardiovascular disease, and diabetes. Mental illness and depression also increase the risk for suicide.
Oklahoma has consistently had a higher number of suicide deaths compared to the rest of the Nation. In
Oklahoma, suicide is the most common manner of violent death. The first quarter of 2010 has yielded a
sharp increase in calls to Oklahoma’s suicide prevention hotline. In 2009, for example, there were 833
calls during the first quarter. In the first quarter of 2010 there has been a 53.0 percent increase, with
1,272 clients having called the hotline.[14]
From 2004–2007, the rate of suicide was 14.4 per 100,000 according to the Oklahoma Violent Death
Reporting System (OVDRS). Data from OVDRS also show that suicide was the third‐leading cause of
death among 15‐ to 24‐year‐olds in 2007. The suicide rate reported by Oklahoma for this population was
13.5 percent higher than the national rate among the corresponding age group. And in fact, among all
ages, Oklahoma’s reported suicide rate is higher than the national average. In 2006, Oklahoma’s rate per
100,000 was 15.0, compared to the national average of 10.9. Seventy‐eight percent of suicides were
males. Depression was the leading circumstance associated with suicide. Forty‐six percent of suicides
were the result of a depressed mood. Substance use also played a role in suicides according to OVDRS.
Thirty percent of persons tested had a positive blood alcohol test, and 88 percent tested positive for
other drugs.[15]
In 2007, NSDUH reported that 14.0 percent of Oklahomans aged 18 and older suffered from serious
psychological distress. Table 2 shows several mental health indicators for which Oklahoma had some of
the highest percentages in the Nation in 2006–2007. In addition, results from the 2009 BRFSS show 20.7
percent of Oklahoma adults had between 1 and 13 mentally unhealthy days in the last month, and 13.7
percent had between 14 and 30 such days.[3]
Table 2. NSDUH, 2006–2007 Annual Averages
Mental Health Indicator Percent
Serious psychological distress in the past year (age 18 and older) 14.0
Serious psychological distress in the past year (age 26 and older) 13.2
Persons having at least one major depressive episode in the past year (age 18 and older) 9.1
Persons having at least one major depressive episode in the past year (age 18–25) 10.5
Persons having at least one major depressive episode in the past year (age 26 and older) 8.9
ODMHSAS reported 34,132 persons received ODMHSAS‐funded mental health services for fiscal year
2004. In 2009, that number increased to 52,226. In 2009, the top three reasons clients sought services
were emotional maladjustment/disturbance (38.9 percent), substance abuse disorders (29.0 percent),
and depressive disorders (7.0 percent). The top drug of choice was alcohol. The age groups of clients
that had the highest percentages of service were 25–34 (23.5 percent) and 35–44 (21.0 percent). The
gender breakdown of clientele was virtually the same. Of the clients who were given a substance abuse
screening, 57.0 percent tested positive.[16]
The number of children with serious emotional disturbance (SED) receiving ODMHSAS‐funded mental
health services increased 76 percent over a 5‐year period, from 2,254 in 2004 to 3,959 in 2009. Persons
with serious mental illness (SMI) receiving ODMHSAS‐funded mental health services increased from
25,492 in 2004 to 38,222 in 2009—an increase of approximately 50 percent.[16]
Data from the YRBS show that, in 2009, 28.2 percent of students felt sad or hopeless everyday day for 2
weeks or more in a row to the extent that they stopped doing some usual activities during the past 12
months; this was slightly higher than the national average of 26.1 percent.[1] Oklahoma Systems of Care,
a comprehensive spectrum of mental health and other support services for adolescents and their
families with a serious emotional disturbance, has experienced a 73 percent increase in enrolled clients
since fiscal year 2006—jumping from 456 in 2006 to 787 in 2010. The majority of clients are white, male,
and diagnosed with conduct disorders.[17]
Populations of Note
American Indian
In 2000, the American Indian and Alaska Native (AI/AN) population in Oklahoma was 266,801, comprising 8
percent of the state’s total population and ranking Oklahoma second among all states for AI/AN population.
Alcohol and tobacco consumption is a significant problem in this population.
According to data from the 2009 BRFSS, 14.2 percent of AI/AN adults reported binge drinking, and 4.0 percent
reported heavy drinking; both percentages exceed those reported by any other race. Smoking consumption was
also highest among this group according to the BRFSS. In 2009, 31.9 percent AI/ANs reported current smoking
compared to all other races (25.0 percent).
Data from the Oklahoma State Bureau of Investigation (OSBI) show Oklahoma’s AI/AN population had substantially
greater alcohol‐related arrests (i.e., driving under the influence, liquor law violations and drunkenness) at 44
percent; lower drug law violation arrests (i.e., all drug arrests reported as sale/manufacturing and possession) at 8
percent; and lower index crime arrests (i.e., murder, rape, robbery, aggravated assault, burglary, larceny, and
motor vehicle theft) at 10 percent, compared to all races combined (29 percent, 14 percent, and 13 percent,
respectively).
From fiscal years (FYs) 2001–2008, Oklahoma’s AI/AN population had consistently high rates of persons served in
substance abuse treatment facilities compared to Whites and people of all races combined.[18]
Older Adults
Older Oklahomans, aged 65 and above, are the fastest growing segment of the state’s population. In
2006, Oklahoma had the 19th‐highest number of persons aged 65 and over, with 475,637 individuals
falling into this category (U.S. Census Bureau, 2006). The population ages 60 and older increased by 18.2
percent from 1980 to 2000. This is substantially higher than the national average of 12.4 percent. In
2000, Oklahoma ranked 13th in terms of the percentage of the total population 60 years and older .This
high growth rate among senior citizens outpaced Oklahoma’s overall growth rate of 14 percent for the
same period. The very old (85 years and older) experienced the most notable growth rate of 61 percent
from 1980 to 2000. It is estimated that while Oklahoma’s total population will grow at a relatively slow
pace (10.2 percent), those 65 years and over will increase by over 60 percent between 2007 and 2030.
Further, the state’s population ages 85 years and older is expected to increase by 50 percent during the
same time period (U.S. Census Bureau, 2006).[13]
Figure 10.
According to Oklahoma’s 2009 BRFSS, 78.8 percent of persons aged 65–74 said that they always or
usually received social and emotional support. This was down from 2005, when the percent was 83.1.
Conversely, this among persons aged 75 and older, 77.6 percent always or usually received support in
2005 and 78.4 percent did in 2009.[3]
Another significant characteristic within the state’s older populations is grandparents raising
grandchildren. Approximately 43,000 older Oklahomans are responsible for their grandchildren; of
these, 16,200 have been responsible for the care of their grandchildren 5 years or longer. Grandparents
living with grandchildren under 18 years of age for the population 30 years and over households are
shown in the following table.[13]
Household types United States Oklahoma
0
10
20
30
40
50
60
70
80
1980-90 1980-2000
Percent growth 1980–1990, 1980–2000
Total OK pop
60 +
85 +
Total households 30+ years 158,881,037 1,915,455
Grandparents living with grandchildren under 18 5,771,671 67,194
Grandparents responsible for their grandchildren 2,426,730 39,279
Grandparents responsible for their grandchildren 5 years or more 933,408 14,714
Source: U.S. Census 2000
Veterans and Military Families
In Oklahoma, 12.5 percent (333,358) of the state’s citizens are veterans, with 20.7 percent having served
in the Gulf War, 35.1 percent having served in Vietnam Conflict, 12.7 percent having served in the
Korean War, and 13 percent having served in World War II. The American Forces News Services reports
that over 47,000 individuals based in Oklahoma are active in military operations and 24,500 have been
deployed since American troops entered Afghanistan (www.usmilitary.about.com. 2008). In addition to
other mental health disorders, 20 percent of returning veterans suffer posttraumatic stress disorder.[13]
According to the OVDRS, 23 percent of suicide deaths between 2004 and 2007 were veterans, which
represented 76 percent of all violent deaths among veterans.[15] In addition, a comparison of mortality
between Operation Enduring Freedom/Operation Iraqi Freedom Veterans and the general U.S.
population (adjusted for age, sex, race, and calendar year) showed evidence of a 21 percent excess of
suicides among veterans through 2007. Although the evidence is preliminary, it suggests decreased
suicide rates since 2006 among veterans of both sexes aged 18–29 who have used Veterans Health
Administration (VHA) health care services relative to veterans in the same age group who have not. This
decrease in rates translates to approximately 250 lives per year. Finally, more than 60 percent of
suicides among users of VHA services include patients with a known diagnosis of a mental health
condition.[19]
Incarcerated Women
According to the Oklahoma Department of Corrections (ODOC), Oklahoma leads the Nation in the rate of female
offender incarceration at 131 per 100,000 population, a significant departure from the national average of 69 per
100,000 population. As of 2006, 2,213 women were incarcerated in the State of Oklahoma, and the state’s female
inmate population is growing more rapidly than its male inmate population. Analogous to this rise in incarcerated
females is a rise in incarcerated female drug use (i.e., both personal use and drug‐related crimes).
From 2001 to 2007, the number of female prison admissions per year increased by 136 (12 percent). Of the total
female prison admissions during this time, 5,308 (61 percent) were White; 2,141 (24 percent) were Black; 998 (11
percent) were American Indian or Alaska Native; and 274 (3 percent) were Hispanic.
According to the Bureau of Justice Statistics (2002), 52 percent of the Nation’s female inmates were dependent on
drugs or alcohol. Of all the offenses listed for incarcerated women between 2001 and 2007 in Oklahoma, ap‐proximately
70 percent were associated with a controlled substance (i.e., a drug or chemical substance whose
possession and use are controlled by law), alcohol, or both.[18]
Epidemiological Data Sources
Alcohol Epidemiologic Data System (AEDS) • AEDS is responsible for maintaining, and extending an
alcohol‐related epidemiologic databank. AEDS also compiles the Alcohol Epidemiologic Data Directory
which is a current listing of surveys and other relevant data suitable for epidemiologic research on
alcohol.
Behavioral Risk Factor Surveillance Survey (BRFSS) • Established in 1984 by the Centers for Disease
Control and Prevention (CDC), the Behavioral Risk Factor Surveillance System (BRFSS) is a state‐based
system of health surveys that collects information on health risk behaviors, preventive health practices,
and health care access primarily related to chronic disease and injury. For many states, the BRFSS is the
only available source of timely, accurate data on health‐related behaviors. Oklahoma has participated in
BRFSS since 1995. This report focused on 2007 BRFSS data to give a current picture of substance
use/abuse in Oklahoma. http://www.cdc.gov/brfss/about.htm
Bureau of Justice • The Bureau of Justice Statistics was first established on December 27, 1979 under
the Justice Systems Improvement Act of 1979. The Bureau of Justice Statistics (BJS) is a component of
the Office of Justice Programs in the U.S. Department of Justice.
Center for Disease Control and Prevention (CDC) • The CDC, a part of the U.S. Department of Health
and Human Services, is the primary Federal agency for conducting and supporting public health activities
in the United States. CDC’s focus is not only on scientific excellence but also on the essential spirit that is
CDC – to protect the health of all people. CDC keeps humanity at the forefront of its mission to ensure
health protection through promotion, prevention, and preparedness.
Fatal Analysis Reporting System (FARS) • FARS contains data on all fatal traffic crashes within the 50
states, the District of Columbia, and Puerto Rico. The data system was conceived, designed, and
developed by the National Center for Statistics and Analysis (NCSA) to assist the traffic safety
community in identifying traffic safety problems, developing and implementing vehicle and driver
countermeasures, and evaluating motor vehicle safety standards and highway safety initiatives.
National Survey on Drug Use and Health (NSDUH) • The National Survey on Drug Use and Health
(NSDUH) provides annual data on drug use in the United States. The NSDUH is sponsored by the
Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the U.S. Public
Health Service and a part of the Department of Health and Human Services (DHHS). The survey provides
yearly national and state‐level estimates of alcohol, tobacco, illicit drug, and non‐medical prescription
drug use. Other health‐related questions also appear from year to year, including questions about
mental health. The NSDUH findings were used to evaluate substance use/abuse from the age of 12. This
survey is not a school based survey so it provides a different perspective than the YRBS for youth.
https://nsduhweb.rti.org
National Vital Statistics System (NVSS) • The National Vital Statistics System is the oldest and most
successful example of inter‐governmental data sharing in Public Health and the shared relationships,
standards, and procedures form the mechanism by which NCHS collects and disseminates the Nation's
official vital statistics. These data are provided through contracts between NCHS and vital registration
systems operated in the various jurisdictions legally responsible for the registration of vital events –
births, deaths, marriages, divorces, and fetal deaths.
Oklahoma Bureau of Narcotics and Dangerous Drugs (OBN) • The Oklahoma State Bureau of Narcotics
and Dangerous Drugs Control is a law enforcement agency with a goal of minimizing the abuse of
controlled substances through law enforcement measures directed primarily at drug trafficking, illicit
drug manufacturing, and major suppliers of illicit drugs.
Oklahoma Department of Corrections (ODOC) • Following the enacting of the Oklahoma Corrections
Act of 1967, the new Department of Corrections was created on July 1, 1967. The ODOC is a network of
facilities comprised of 17 institutions, seven Community Corrections Centers, and 15 Community Work
Centers. The incarcerated women data was obtained from the ODOC.
Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) • The ODMHSAS
was established in 1953 and continues to evolve to meet the needs of all Oklahomans. Collaborating
with leaders from multiple state agencies, advocacy organizations, consumers and family members,
providers, community leaders and elected officials, the way has been paved for meaningful mental
health and substance abuse services transformation in Oklahoma. The ODMHSAS is responsible for
providing services to Oklahomans who are affected by mental illness and substance abuse.
Oklahoma Prevention Needs Assessment Survey (OPNA) • The Oklahoma Prevention Needs As‐sessment
is a paper/pencil survey administered in opposite years of the YRBS in schools to 6th, 8th, 10th
and 12th grade students. The survey is designed to assess students’ involvement in a specific set of
problem behaviors, as well as their exposure to a set of scientifically validated risk and protective
factors. In 2008, 60,720 students were surveyed from 686 schools across 74 of Oklahoma’s 77 counties.*
The major limitation of this survey is that it is not a random sample; schools choose whether or not they
participate, making it a convenience sample.
Oklahoma State Bureau of Investigation (OSBI) • The Oklahoma State Bureau of Investigation Uniform
Crime Reporting (UCR) Program is part of a nationwide, cooperative statistical effort.
Oklahoma State Department of Health (OSDH) • The OSDH is a department of the government of
Oklahoma responsible for protecting the health of all Oklahomans and providing other essential human
services and through its system of local health services delivery, is ultimately responsible for protecting
and improving the public’s health status through strategies that focus on preventing disease. The OSDH
serves as the primary public health protection agency in the state.
Oklahoma Tax Commission • Since 1931, the Oklahoma Tax Commission has held the responsibility of
the collection and administration of taxes, licenses and fees that impact every Oklahoman. Under the
direction of the state legislature, the Tax Commission manages not only the collection of taxes and fees,
but also the distribution and apportionment of revenues to various state funds. The collected revenues
fuel such state projects as education, transportation, recreation, social welfare and a myriad of other
services.
Oklahoma Violent Death Reporting System (OKVDRS) • Oklahoma and 16 other states (Massachusetts,
Maryland, New Jersey, Oregon, South Carolina, North Carolina, Virginia, Alaska, Colorado, Georgia,
Wisconsin, Rhode Island, Kentucky, Utah, New Mexico and California) participate in the National Violent
Death Reporting System. Violent deaths include homicides, suicides, deaths from legal intervention,
unintentional firearm deaths, deaths of undetermined manner and deaths from acts of terrorism. Data
for OKVDRS are collected from death certificates, medical examiner reports, police reports, supple‐mental
homicide reports and crime labs. Standardized methodology and coding are used to collect the
data and enter into a database that is housed at the Oklahoma State Department of Health (OSDH). The
OSDH partners with the Oklahoma State Bureau of Investigation and the Oklahoma Medical Examiner’s
Office to collect the data.
Oklahoma Youth Tobacco Survey (OYTS) • Designed to provide comprehensive data for planning and
evaluating progress toward reducing tobacco use among youth. Items measured as part of the OYTS
survey include correlates of tobacco use such as demographics, minors’ access to tobacco, and exposure
to secondhand smoke. It provides data representative of Oklahoma middle school and high school
youth’s tobacco‐related beliefs, attitudes and behaviors, and exposure to pro‐ and anti‐tobacco
influences such as curricula and media. The data can be compared to results from the National Youth
Tobacco Survey and results from other states.
Pacific Institute for Research and Evaluation (PIRE) • PIRE is one of the Nation’s preeminent inde‐pendent,
nonprofit organizations focusing on individual and social problems associated with the use of
alcohol and other drugs. PIRE is dedicated to merging scientific knowledge and proven practice to create
solutions that improve the health, safety, and well‐being of individuals, communities, nations, and the
world.
Pregnancy Risk Assessment Monitoring System (PRAMS) • PRAMS was initiated in 1987 with a goal to
improve the health of mothers and infants by reducing adverse outcomes such as low birth weight,
infant mortality and morbidity, and maternal morbidity. PRAMS provides state‐specific data for planning
and assessing health programs and for describing maternal experiences that may contribute to maternal
and infant health.
Smoking Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) • SAMMEC is an internet‐based,
computational application. SAMMEC calculates annual state‐ and national‐level smoking‐attributable
deaths and years of potential life lost for adults and infants in the United States. The Adult
application also calculates medical expenditures and productivity costs among adults. Likewise,
Maternal and Child Health (MCH) SAMMEC estimates annual state‐ and national‐level smoking‐attributable
deaths and years of potential life lost for infants.
Substance Abuse and Mental Health Services Administration (SAMHSA) • The Substance Abuse and
Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human
Services (HHS), focuses attention, programs and funding on promoting a life in the community with jobs,
homes and meaningful relationships with family and friends for people with or at risk for mental or
substance use disorders. The Agency is achieving that vision through an action‐oriented, measurable
mission of building resilience and facilitating recovery.
The Uniform Crime Report (UCR) • The UCR was conceived, developed, and implemented by law en‐forcement
for the express purpose of serving as a tool for operational and administrative purposes.
Under the auspices of the International Association of Chiefs of Police, the UCR Program was developed
in 1930. Prior to that date, no comprehensive system of crime information on a national scale existed.
The Oklahoma State Bureau of Investigation assumed the statewide administration of the UCR Program
on September 1, 1973. Statistical information was collected and compiled through the year 2007 with a
comparative analysis of the years 2006 and 2005.
United States Census Bureau • The Census Bureau serves as the leading source of quality data about
the Nation’s people and economy. The bureau of the Commerce Department, responsible for taking the
census, provides demographic information and analyses about the population of the United States.
Census data was used for all Oklahoma demographics.
http://www.census.gov/main/www/aboutus.html
Youth Risk Factor Behavioral Survey (YRBS) • The Youth Risk Behavior Surveillance System (YRBSS)
monitors six categories of priority health‐risk behaviors among youth and young adults, including
behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug
use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs),
including human immunodeficiency virus (HIV) infections; unhealthy dietary behaviors; and physical
inactivity. YRBSS includes a national school‐based survey conducted by CDC and state and local school‐based
surveys conducted by state and local education and health agencies. Oklahoma has participated
in the YRBS since 2003.
References
1. Centers for Disease Control and Prevention (CDC). 2003–2009 Youth Risk Behavior Survey. Access:
www.cdc.gov/yrbss
2. CDC. Behavioral Risk Factor Surveillance System Survey Data [2003‐2009]. Atlanta, Georgia: CDC.
3. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. National
Survey on Drug Use and Health,[2003–2007]. Rockville, MD: SAMHSA/OAS.
4. CDC. Pregnancy Risk Assessment Monitoring System [2003–2007]. Access:
http://www.cdc.gov/prams/CPONDER.htm
5. Hoyert, D. L., Heron, M. P., Murphy, S. L., et.al. (2006). “Deaths: Final Causes for 2003.” Division of
Vital Statistics Reports, 54(13).
6. Kung, H. C., Hoyert, D. L., Xu, J., et.al. (2008). “Deaths: Final Causes for 2005.” Division of Vital
Statistics Reports, 56(10).
7. Minino, A. M., Heron, M. P., Murphy, S. L., et al. (2007). “Deaths: Final Causes for 2004.” Division of
Vital Statistics Reports, (55)19.
8. U.S. Department of Justice, Federal Bureau of Investigation. Uniform Crime Reporting Program
Data, 2003–2009.
9. National Highway Traffic Safety Administration. Fatality Analysis Reporting System 2003–2008.
Washington, D.C.: Department of Transportation, National Highway Traffic Safety Administration.
10. Heron, M. P. “Deaths; Leading Causes for 2006.” (2009). National Vital Statistics Reports, 57(14).
11. Oklahoma State Department of Health, Health Care Information Division. Oklahoma Hospital
Inpatient Data 2003–2008. Hospitalizations associated with Opiates ICD9 Code 965.0.
12. Warner, M., Chen, L. H., Makuc, D. M. (2009). “Increase in fatal poisonings involving opioid
analgesics in the United States, 1999–2006.” NCHS Data Brief, Number 22. Hyattsville, MD: National
Center for Health Statistics.
13. Oklahoma Department of Mental Health and Substance Abuse Services. Oklahoma’s State Plan on
Aging, 2007–2010.
14. Oklahoma City Heartline. Call Volume Quarter 1, 2008–2010.
15. Oklahoma State Department of Health. Injury Prevention Service. Summary of Violent Deaths in
Oklahoma: Oklahoma Violent Death Reporting System, 2004–2007.
16. Oklahoma Department of Mental Health and Substance Abuse Services. Statistics. Access:
http://www.ok.gov/odmhsas/Statistics_and_Data/Statistics/
17. Oklahoma Systems of Care Wraparound Initiative. Youth Enrolled. Fiscal Years 2006–2010.
18. Oklahoma Department of Mental Health and Substance Abuse Services. Oklahoma State
Epidemiological Outcomes Workgroup. 2009 Epidemiological Profile Update.
19. Department of Veterans Affairs. VA Suicide Prevention Program. (2010). Facts About Veteran
Suicide.