State of the state's health : a report from the Oklahoma State Board of Health.

              O K L A H OMA S TAT E D E PA R TME N T O F H E A LT H 2 0 1 1 S TAT E O F T H E S TAT E ’ S H E A LT H R E P O R T
2 Foreword
4 Summary
7 State Report Card
9 Board of Health
Call To Action
10 Board of Health
12 Indicator Report Cards
Mortality
13 Infant Mortality
14 Total Mortality
Leading Causes of Death
15 Heart Disease Deaths
16 Malignant Neoplasm
(Cancer) Deaths
17 Cerebrovascular Disease
(Stroke) Deaths
18 Chronic Lower Respiratory
Disease Deaths
19 Unintentional Injury
Deaths
20 Diabetes Deaths
21 Influenza/Pneumonia
Deaths
22 Alzheimer’s Disease
Deaths
23 Nephritis (Kidney Disease)
Deaths
24 Suicides
Disease Rates
25 Diabetes Prevalence
26 Current Asthma
Prevalence
27 Cancer Incidence
Risk Factors & Behaviors
28 Fruit and Vegetable
Consumption
29 No Physical Activity
30 Current Smoking
31 Obesity
32 Immunization < 3 Years
(4:3:1:3:3:1 series)
33 Seniors Influenza
Vaccination
34 Seniors Pneumonia
Vaccination
35 Limited Activity Days
36 Poor Mental Health Days
37 Poor Physical Health
Days
38 Good or Better Health
Rating
39 Teen Fertility
40 First Trimester Prenatal
Care
41 Low Birth Weight
42 Dental Visits (Adults)
43 Usual Source of Care
Socioeconomic Factors
44 No Insurance Coverage
45 Poverty
New Indicators
46 Occupational Fatalities
47 Preventable
Hospitalizations
48 County Report Cards
49 Adair County
50 Alfalfa County
51 Atoka County
52 Beaver County
53 Beckham County
54 Blaine County
55 Bryan County
56 Caddo County
57 Canadian County
58 Carter County
59 Cherokee County
60 Choctaw County
61 Cimarron County
62 Cleveland County
63 Coal County
64 Comanche County
65 Cotton County
66 Craig County
67 Creek County
68 Custer County
69 Delaware County
70 Dewey County
71 Ellis County
72 Garfield County
73 Garvin County
74 Grady County
75 Grant County
76 Greer County
77 Harmon County
78 Harper County
79 Haskell County
80 Hughes County
81 Jackson County
82 Jefferson County
83 Johnston County
84 Kay County
85 Kingfisher County
86 Kiowa County
87 Latimer County
88 LeFlore County
89 Lincoln County
90 Logan County
91 Love County
92 Major County
93 Marshall County
94 Mayes County
95 McClain County
96 McCurtain County
97 McIntosh County
98 Murray County
99 Muskogee County
100 Noble County
101 Nowata County
102 Okfuskee County
103 Oklahoma County
104 Okmulgee County
105 Osage County
106 Ottawa County
107 Pawnee County
108 Payne County
109 Pittsburg County
110 Pontotoc County
111 Pottawatomie County
112 Pushmataha County
113 Roger Mills County
114 Rogers County
115 Seminole County
116 Sequoyah County
117 Stephens County
118 Texas County
119 Tillman County
120 Tulsa County
121 Wagoner County
122 Washington County
123 Washita County
124 Woods County
125 Woodward County
126 County Rankings
138 Technical Notes
2 0 1 1 S TAT E O F T H E S TAT E ’ S H E A LT H R E P O R T 2
Thank you for taking time to read through our 2011 State of the State’s
Health Report. This report provides useful information about how our
state and counties are doing in regard to the health status of our residents.
Even though our health ranking has improved from 49th to 46th in the Nation,
Oklahoma’s health status indicators are among the worst in the United States.
We have a high prevalence of smoking and obesity, limited access to prenatal
care and availability of primary care physicians, and high rates of preventable
hospitalizations and cardiovascular disease. As a State, we have fewer babies
that survive their first birthday and a life expectancy for our residents that is
shorter than almost every other state in the country.
Based upon these findings, it is essential for us to strive together to improve
the health of the residents of our state. Oklahoma’s poor health status is not
acceptable and improvement must occur. 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.
Sincerely,
Jenny Alexopulos, DO, President Terry L. Cline, PhD
Oklahoma State Board of Health Commissioner
Secretary of Health and Human Services
foreword
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The 2011 State of the State’s Health Report maintains the new format
that began in 2008. As before, rather than highlight a single theme
or issue, the 2011 report reviews multiple indicators that contribute
to Oklahoma’s overall health status. The indicators have been updated using
the most current available data. Readers will be able to look at the state as a
whole and identify county-specific trends by reviewing summaries for each of
Oklahoma’s 77 counties.
Major shifts in health status indicators rarely occur within a span of two or
three years. In addition, it is difficult to show current trends due to the lag in
data collection and reporting. As expected, the indicators summarized in the
2011 report are similar to those seen in 2008, and there are several areas
that continue to give us pause for concern. Oklahoma still leads much of the
nation with deaths due to heart disease. Likewise, Oklahoma’s cerebrovascular
disease deaths (strokes) are much higher than much of the nation. Of particu-lar
concern is the disproportionate burden of heart disease and cerebrovascu-lar
disease deaths among African Americans, with higher rates than any other
ethnic group in Oklahoma.
Chronic lower respiratory diseases continue to plague Oklahoma at higher than
national average rates, primarily because of Oklahomans’ continued depen-dency
on tobacco. Another chronic condition where Oklahoma ranks among
the 10 worst states is diabetes, with significant disparities seen among Native
Americans and African Americans.
Taken in sum, these conditions result in a much higher total mortality rate
for Oklahoma than the rest of the nation. But more disturbing than our over-all
mortality rate is Oklahoma’s infant mortality, again higher than the U.S.
rate, with rates among African American infants nearly twice as high as white
infants.
Many factors contribute to our poor health outcomes, higher rates of disease,
and overall higher total mortality. Certainly, the data indicate that we need to
increase our physical activity, eat more fruits and vegetables, and expand our
tobacco use prevention and cessation efforts. The good news is that progress
has been made in several areas over the past few years. The Tobacco Settle-ment
Endowment Trust (TSET) continues to support tobacco use prevention
summary
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2 0 1 1 S TAT E O F T H E S TAT E ’ S H E A LT H R E P O R T 5
and cessation efforts through community-based initiatives and the
1-800-QUIT-NOW line. Results have been fewer youth using tobacco, more
Oklahomans quitting tobacco use, and the implementation of effective policies
such as 24/7 tobacco-free policies in Oklahoma schools, universities, and busi-nesses.
Additionally, TSET is entering into a new and exciting phase of com-munity-
based funding initiatives that will focus on nutrition and fitness best
practices. As these efforts are implemented in community partnerships across
the state, models for effective fitness and nutrition interventions will begin to
emerge, just as they have for tobacco use prevention and cessation.
Another bright spot continues to be in the area of childhood immunizations.
The data show and the United Health Foundation recognizes Oklahoma as
being in the top 20 states for children immunized between the ages of 19
and 35 months.
When looking at health care coverage, progress is also noted. Thanks to the
Oklahoma Health Care Authority’s “Insure Oklahoma” program, Oklahoma’s
rate of uninsured adults ages 18-64 continues to decrease. This is good news,
and many more Oklahomans who previously could not afford coverage now
have access to health care.
Still, much work needs to be done. Significant disparities exist between those
who earn $25,000 per year or less and those on the other end of the spec-trum.
We see similar disparities between those with a high school education or
less and those with higher levels of education. Although not traditional focus
areas of public health, these and other social determinants of health are abso-lutely
critical to address if we ever hope to improve Oklahoma’s overall health
status to even average levels when compared to the rest of the United States.
How do we address these issues and other risk factors that contribute to Okla-homa’s
health outcomes? Certainly, the Oklahoma State Department of Health
cannot work in isolation. It will take the collaboration of many partners, like
local Turning Point partnerships, the faith community, schools, businesses, and
our policymakers. Working together through long-term commitments, sustained
efforts, and continued focus on the Oklahoma Health Improvement Plan, our
key health status indicators will move in positive directions, Creating a State
of Health.
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2 0 1 1 S TAT E O F T H E S TAT E ’ S H E A LT H R E P O R T 7
state report card
Indicator U.S. OK Grade
Mortality
Infant Mortality (per 1,000) 6.8 8.6 D
Total Mortality (per 100,000) 760.2 933.0 F
Leading Causes of Death (per 100,000)
Heart Disease Deaths 190.9 242.1 F
Malignant Neoplasm (Cancer) Deaths 178.4 198.3 D
Cerebrovascular Disease (Stroke) Deaths 42.2 53.8 F
Chronic Lower Respiratory Disease Deaths 43.3 61.3 F
Unintentional Injury Deaths 40.0 58.5 F
Diabetes Deaths 22.5 29.4 F
Influenza/Pneumonia Deaths 16.2 20.1 D
Alzheimer’s Disease Deaths 22.7 23.1 C
Nephritis (Kidney Disease) Deaths 14.5 15.7 C
Suicides 11.3 14.7 D
Disease Rates
Diabetes Prevalence 8.3% 11.0% F
Current Asthma Prevalence 8.8% 10.0% D
Cancer Incidence (per 100,000) 481.7 498.9 C
Risk Factors
Fruit & Vegetable Consumption 23.4% 14.6% F
No Physical Activity 23.8% 31.4% F
Current Smoking Prevalence 17.9% 25.5% F
Obesity 26.9% 32.0% D
Immunizations < 3 69.9% 70.2% C
Seniors Influenza Vaccination 70.1% 72.3% B
Seniors Pneumonia Vaccination 68.5% 72.1% B
Limited Activity Days (average) 4.3 5.2 D
Poor Mental Health Days (average) 3.5 4.2 D
Poor Physical Health Days (average) 3.6 4.3 D
Good or Better Health Rating (average) 85.5 80.4 D
Teen Fertility (per 1,000) 22.1 30.4 D
First Trimester Prenatal Care 83.2% 76.3%
Low Birth Weight 8.2% 8.2% C
Dental Visits - Adults 71.3% 57.9% F
Usual Source of Care 81.0% 77.6% C
Socioeconomic Factors
No Insurance Coverage 14.3% 19.8% D
Poverty 13.2% 15.7% D
New Indicators (per 100,000)
Occupational Fatalities 2.1 3.6 D
Preventable Hospitalizations 1762.6 2120.9 D
2 0 1 1 S TAT E O F T H E S TAT E ’ S H E A LT H R E P O R T 8
There has never been a more critical time to invest in prevention than
today. As this State of the State’s Health Report shows, Oklahoma con-tinues
to face enormous challenges with our health status indicators.
While we have seen improvements in some areas such as immunization rates
and health insurance coverage, other health concerns continue to plague our
state including high rates of heart disease, obesity, diabetes, and stroke.
Even in the face of these challenges, the Oklahoma State Board of Health and
the Oklahoma State Department of Health will not be deterred. As all of us deal
with the realities of funding prevention priorities, we also seek new partner-ships
which will leverage available resources, sustain our public health work-force,
and protect the health of all Oklahomans. Now is not the time to retreat.
Now is the time to act.
Literally thousands of lives would be saved each year if Oklahoma’s health
status was just at the national average. Those lives represent mothers, fathers,
brothers, sisters, our children and our future. But, we need your help to protect
those lives. It will take all of us working together — faith partners, businesses,
individuals, schools, local Turning Point partnerships, city councils, families
and our state policymakers — to turn the tide and make a difference in our chil-dren’s
health, our obesity rates, and our tobacco use. Together, we can Create
a State of Health.
The Oklahoma State Board of Health
2 0 1 1 S TAT E O F T H E S TAT E ’ S H E A LT H R E P O R T 9
call to action
Jenny Alexopulos, DO, President · Dr. Alexopulos is board-certified by the American
Osteopathic Board of Family Physicians. She is also the Associate Dean of Clinical
Services and Professor of Family Medicine with the Oklahoma State University
College of Osteopathic Medicine. Dr. Alexopulos represents Ottawa, Delaware,
Craig, Mayes, Nowata, Rogers, Washington, Tulsa, Pawnee, and Osage counties.
R Murali Krishna, MD, Vice President · Dr. Krishna is president and chief operat-ing
officer of INTEGRIS Mental Health; co-founder, president and chief operating
officer of INTEGRIS Health James L. Hall, Jr. Center for Mind, Body and Spirit;
founding chair, past-president, and current board member of the Health Alliance
for the Uninsured; a clinical professor of Psychiatry at the University of Oklahoma
Health Sciences Center Department of Psychiatry and Behavioral Science; past
president of the Oklahoma County Medical Society; past president of the Okla-homa
Psychiatric Association; and a distinguished life fellow of the American
Psychiatric Association. Dr. Krishna represents Logan, Oklahoma, Cleveland,
McClain, Garvin, Murray and Payne counties.
Cris Hart-Wolfe, Secretary-Treasurer · Ms. Hart-Wolfe is a board-certified orthope-dic
physical therapist and director of Human Performance Centers in Clinton. She
is also a certified athletic trainer. Ms Hart-Wolfe represents Ellis, Dewey, Custer,
Roger Mills, Beckham, Washita, Kiowa, Greer, Jackson, Harmon, and Tillman
counties.
Alfred Baldwin, Jr · Rev. Baldwin is pastor of the First Missionary Baptist Church
in Enid and is a retired science teacher with Enid Public Schools. He also serves
as state director and state congress dean for the Oklahoma Baptist State Con-gress
of Christian Education. Rev. Baldwin represents Cimarron, Texas, Beaver,
Harper, Woodward, Woods, Major, Alfalfa, Grant, Garfield, Kay and Noble counties.
board of health
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2 0 1 1 S TAT E O F T H E S TAT E ’ S H E A LT H R E P O R T 11
Martha A Burger · Ms. Burger is senior vice president, Human & Corporate
Resources, Chesapeake Energy. She is also chair for the United Way of Central
Oklahoma Campaign Cabinet. Additionally, she is on the Board of Directors for
the Greater Oklahoma City Chamber, the Board of Trustees for the Oklahoma
City University, the Board of Trustees for the University of Central Oklahoma, the
Board of Trustees for the Oklahoma City Boathouse Foundation and the Central
Oklahoma Humane Society, and is a member of the MAPS 3 Citizen’s Advisory
Board’s Oklahoma River Subcommittee. Ms. Burger represents the state at large.
Richard G Davis, DDS · Dr. Davis has been practicing dentistry in Shawnee since
1978 and is a member of the American Dental Association and the Oklahoma
Dental Association. He represents Creek, Lincoln, Okfuskee, Seminole, Pottawat-omie,
Pontotoc, Hughes, Johnston, and Coal counties.
Kenneth Miller, MD · Dr. Miller is board-certified with the American Board of
Internal Medicine and practices in McAlester. He represents LeFlore, Latimer,
Pittsburg, Atoka, Pushmataha, McCurtain, Choctaw, Bryan, Marshall, Carter, and
Love counties.
Barry L Smith, JD · Mr. Smith is an attorney in private practice specializing in
health care law, litigation, and advocacy. He has served as general counsel for
Saint Francis Health System and continues to represent multiple health care
entities. Mr. Smith represents Adair, Sequoyah, Cherokee, Wagoner, Muskogee,
Haskell, McIntosh, and Okmulgee counties.
Ronald Woodson, MD · Dr. Woodson is an interventional cardiologist, practicing
in Lawton since 1982. He is also a fellow of the American College of Cardiology,
board-certified by the American Board of Internal Medicine and Cardiovascular
Diseases, and a member of the American State Medical Association and Okla-homa
State Medical Association. Dr. Woodson is the co-founder and president of
The Heart and Vascular Center of Lawton, the chief of staff-elect at Comanche
County Memorial Hospital, and an associate professor of OU Family Practice
Residency Program in Lawton. He represents Blaine, Kingfisher, Canadian,
Caddo, Grady, Comanche, Jefferson, Stephens, and Cotton counties.
indicator report cards
2 0 1 1 S TAT E O F T H E S TAT E ’ S H E A LT H R E P O R T 1 2
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
infant mortality
(RATE PER 1,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 6.9 6.8 C
WASHINGTON (best) 4.7 4.8 B
OKLAHOMA 8.2 8.6 D
DC (worst) 14.6 13.1 F
MOTHER’S AGE IN YEARS
18 - 24 8.1 10.2 F
25 - 34 6.9 6.8 C
35 - 44 6.4 10.7 F
45 - 54 - -
55 - 64 NA NA
65 + NA NA
CHILD’S GENDER
MALE 9.0 8.9 D
FEMALE 7.0 8.2 D
RACE/ETHNICITY
WHITE (NH) 6.9 7.8 D
BLACK (NH) 14.6 18.0 F
AMER INDIAN (NH) 9.9 8.6 D
HISPANIC 5.2 6.7 C
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
MOTHER’S EDUCATION
< HS 11.1 12.1 F
HS 8.9 8.9 D
HS+ 6.3 8.5 D
COLLEGE GRADUATE 4.1 5.4 B
HISTORIC
OK 1990 9.0 D
OK 1995 8.3 D
OK 2000 8.4 D
OK 2005 8.1 D
OK 2007 8.6 D
STATE REGION
CENTRAL 7.7 7.8 D
NE 6.9 8.1 D
NW 7.9 8.8 D
SE 7.6 9.1 F
SW 10.2 8.9 D
TULSA 8.7 9.4 F
In 2007, Oklahoma’s infant mortality rate (IMR) was 30 percent higher than
the U.S. rate.
• Infant mortality rate measures the incidence of deaths for infants less than 1
year of age.
• In Oklahoma, there were 8.6 infant deaths for every 1,000 live births in 2007.
This was 26 percent higher than the U.S. rate of 6.8 per 1,000.
• Since 1990, Oklahoma has consistently received a grade of D for its high
infant mortality rate.
• Hispanics received the best grade (C) and have the lowest IMR (6.7) of any
racial/ethnic group.
• The IMR for non-Hispanic blacks (18.0) was 2.3 times the rate of non-Hispanic
whites (7.8).
• Mothers who were college graduates had the best IMR (5.4) and received a B.
• Mothers with less than a high school education received an F (12.1). Their IMR
was more than two times that of college graduates (5.4).
• Mothers aged 25-34 years had a better IMR than either younger mothers aged
18-24 years or older mothers aged 35-44 years.
• Custer was Oklahoma’s only county to receive an A with an IMR of 3.6.
• Seventeen counties in Oklahoma were given a failing grade with IMRs ranging
from 9.2 to 17.1.
• Oklahoma’s two largest counties, Oklahoma and Tulsa, received a D.
• In 2007, Oklahoma ranked 46th nationally for IMR. Only four states — South
Carolina, Louisiana, Alabama, and Mississippi — were ranked lower.1
• The IMR worsened from the previous year in all regions of the state except for
the southwest.
1 Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final data for 2007. National Vital Statistics
Reports; vol 58 no 19. Hyattsville, MD: National Center for Health Statistics. 2010.
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 1 3
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 1 4
total mortality
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 799.4 760.2 C
HAWAII (best) 628.2 607.4 A
OKLAHOMA 920.9 933.0 F
WEST VIRGINIA (worst) 943.2 951.7 F
AGE IN YEARS
18 - 24 113.5 115.0 A
25 - 34 144.5 143.7 A
35 - 44 256.4 254.5 A
45 - 54 560.4 580.1 A
55 - 64 1147.6 1148.0 F
65 + 5306.4 5303.1 F
GENDER
MALE 1093.3 1094.0 F
FEMALE 780.6 786.4 D
RACE/ETHNICITY
WHITE (NH) 913.8 922.6 F
BLACK (NH) 1110.0 1094.9 F
AMER INDIAN (NH) 913.0 907.8 F
HISPANIC 471.6 475.2 A
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 958.3 F
OK 1995 958.8 F
OK 2000 968.3 F
OK 2005 956.4 F
OK 2007 922.3 F
STATE REGION
CENTRAL 871.3 873.2 D
NE 919.2 930.5 F
NW 856.3 844.1 D
SE 1007.5 999.4 F
SW 988.7 989.3 F
TULSA 910.7 916.1 F
Oklahoma’s death rate is one of the highest in the United States.
• Unhealthy lifestyles and behaviors contribute to most of today’s leading
causes of death.1
• In 2007, more than 36,000 Oklahomans died, resulting in a mortality rate that
was 23 percent higher than the national rate.2
• While the U.S. mortality rate dropped 22 percent over the last 20 years,
Oklahoma’s rate only decreased 4 percent.3,4
• Oklahoma had the fifth highest rate of death from all causes in the U.S.2
• In Oklahoma, men had a significantly higher death rate (52 percent) than
women.
• Hispanics had a death rate that was half that of other racial/ethnic groups in
Oklahoma.
• The mortality rate was lowest in the northwest region of the state.
• There are several programs throughout the state focusing on improving
behaviors that contribute to high mortality rates, such as the Shape Your
Future initiative.
1 National Center for Health Statistics. Health, United States, 2009: With Special Feature on Medical
Technology. Hyattsville, MD. 2010.
2 Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final data for 2007. National Vital Statistics
Reports; vol 58 no 19. Hyattsville, MD: National Center for Health Statistics. 2010.
3 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1999-2007. CDC WONDER On-line Database. Accessed at <http://wonder.cdc.gov/cmf-icd10.html>.
4 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1979-1998. CDC WONDER On-line Database. Accessed at <http://wonder.cdc.gov/cmf-icd9.html>.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 1 5
heart disease
deaths
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 211.4 190.9 C
MINNESOTA (best) 143.5 129.8 A
OKLAHOMA 251.0 242.1 F
MISSISSIPPI (worst) 293.3 266.5 F
AGE IN YEARS
18 - 24 2.7 1.6 A
25 - 34 13.0 10.8 A
35 - 44 40.4 40.2 A
45 - 54 123.5 132.3 A
55 - 64 299.7 293.1 F
65 + 1633.9 1563.9 F
GENDER
MALE 315.1 296.8 F
FEMALE 200.5 198.9 C
RACE/ETHNICITY
WHITE (NH) 250.6 243.5 F
BLACK (NH) 302.9 312.2 F
AMER INDIAN (NH) 237.0 208.9 D
HISPANIC 103.1 94.1 A
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 345.7 F
OK 1995 325.1 F
OK 2000 309.5 F
OK 2005 262.3 F
OK 2007 242.1 F
STATE REGION
CENTRAL 232.3 218.9 D
NE 249.1 244.9 F
NW 236.4 229.6 D
SE 281.6 281.8 F
SW 277.7 267.0 F
TULSA 238.9 223.2 D
• Oklahoma had the second highest rate of death due to heart disease in the
nation and was 27 percent above the U.S. rate.
• In 2007, more than 9,600 Oklahomans died from heart disease.
• The rate of death due to heart disease dropped by 41 percent since 1990 in
the U.S., but only 31 percent in Oklahoma.1,2
• The rate of death due to heart disease was 49 percent higher among men
than women in Oklahoma.
• In Oklahoma, the rate of heart disease deaths among non-Hispanic blacks
was 28 percent higher than the rate among non-Hispanic whites, and more
than 230 percent higher than the rate among Hispanics.
• High blood pressure, high cholesterol, smoking, physical inactivity, obesity,
poor diet, and diabetes are the leading causes of cardiovascular disease.3
• Smoke-free environments, better food choices, improved labeling, and
decreased salt content of foods can help prevent heart disease.3
• The Oklahoma Heart Disease and Stroke Prevention Program focuses on
policy, environmental factors, and systems changes to promote heart health
and moderate unhealthy behaviors.
• The Oklahoma Heart Disease and Stroke Prevention Program works with
healthcare systems on secondary prevention efforts, such as improving blood
pressure control, within the adult population.
1 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1979-1998. CDC WONDER Online Database, compiled from Compressed Mortality File (CMF) 1968-
1988 Series 20 No. 2A, 2000 and CMF 1989-1998 Series 20 No. 2E, 2003.
2 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1999-2007. CDC WONDER Online Database, compiled from Compressed Mortality File 1999-2007
Series 20 No. 2M, 2010.
3 Newschaffer, C.J., Longjian, L., and Sim, A. (2010). Cardiovascular Disease. Remington, P., Brownson, R.,
and Wegner, M. Chronic Disease Epidemiology and Control (pp.383-428). Washington, DC: American
Public Health Association.
Heart disease is the leading cause of death in Oklahoma and the U.S.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 1 6
• Cancer is responsible for nearly one out of every four deaths in the U.S.1
• Oklahoma had the seventh highest rate of cancer deaths in the U.S.2
• The rate of cancer deaths increased steadily with age. The highest rates
occured after age 55.
• Cancer death rates were 53 percent higher among men than women.
• While the rate of cancer deaths among men is higher than among women,
they have slowly dropped over time. Conversely, the cancer death rate among
women has changed very little.
• The U.S. rate of death due to cancer has dropped 11 percent since 1999.
Oklahoma is only three percent lower than the 1999 rate.1
• Cancer death rates were highest among whites and black non-Hispanics.
These rates were more than twice as high as the rate for Hispanics.
• Central Oklahoma had the lowest death rate. This may be due to better access
to care in the Oklahoma City metropolitan area.
• The rate of cancer deaths is strongly influenced by the stage of cancer when
diagnosed, the ability to treat it, and how well an individual is able to access
standard care treatments.
• For most types of cancer, the later the stage at diagnosis, the lower the
probability of survival.2
1 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1999-2007. CDC WONDER Online Database, compiled from Compressed Mortality File 1999-2007
Series 20 No. 2M, 2010. Accessed at <http://wonder.cdc.gov/cmf-icd10.html>.
2 American Cancer Society. Cancer Facts & Figures 2010. Atlanta: American Cancer Society; 2010.
Cancer was the second leading cause of death in 2007.
malignant neoplasm
(cancer) deaths
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 183.9 178.4 C
UTAH (best) 136.9 128.8 A
OKLAHOMA 195.0 198.3 D
KENTUCKY (worst) 218.2 213.5 F
AGE IN YEARS
18 - 24 4.3 4.6 A
25 - 34 10.9 7.8 A
35 - 44 36.4 32.4 A
45 - 54 134.1 142.3 A
55 - 64 377.4 371.0 F
65 + 1075.7 1103.4 F
GENDER
MALE 236.3 248.6 F
FEMALE 165.9 162.9 B
RACE/ETHNICITY
WHITE (NH) 195.9 201.6 D
BLACK (NH) 234.3 223.6 F
AMER INDIAN (NH) 177.3 175.8 C
HISPANIC 89.4 90.6 A
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 209.0 F
OK 1995 208.1 F
OK 2000 204.0 F
OK 2005 196.8 D
OK 2007 198.3 D
STATE REGION
CENTRAL 182.4 180.1 C
NE 199.8 205.4 F
NW 176.2 183.7 C
SE 210.2 218.4 F
SW 211.1 206.0 F
TULSA 192.5 200.6 D
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 1 7
cerebrovascular
disease (stroke) deaths
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 46.6 42.2 C
NEW YORK (best) 31.1 28.2 A
OKLAHOMA 53.4 53.8 F
ARKANSAS (worst) 58.9 57.4 F
AGE IN YEARS
18 - 24 - -
25 - 34 - 2.7 A
35 - 44 4.9 6.9 A
45 - 54 19.2 19.5 A
55 - 64 42.3 38.8 B
65 + 377.5 378.6 F
GENDER
MALE 53.1 53.2 F
FEMALE 52.5 53.4 F
RACE/ETHNICITY
WHITE (NH) 52.3 53.2 F
BLACK (NH) 79.2 74.5 F
AMER INDIAN (NH) 38.5 44.5 C
HISPANIC 36.1 27.7 A
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 70.8 F
OK 1995 68.9 F
OK 2000 68.6 F
OK 2005 58.4 F
OK 2007 53.8 F
STATE REGION
CENTRAL 53.3 51.5 D
NE 51.7 52.6 F
NW 49.4 47.9 D
SE 53.5 50.2 D
SW 55.1 59.1 F
TULSA 57.1 61.6 F
• Stroke was the fifth leading cause of death in Oklahoma in 2007, resulting in
more than 2,100 deaths.
• The stroke mortality rate decreased by 36 percent since 1990 in the U.S. but
only decreased 24 percent in Oklahoma.1,2
• Seniors (age 65+) had a rate much higher than other age groups.
• The stroke death rate was similar among Oklahoma men and women.
• In Oklahoma, the stroke death rate for non-Hispanic blacks was 40 percent
higher than non-Hispanic whites and almost 170 percent higher than
Hispanics.
• About 87 percent of strokes are ischemic (blockages) and about 13 percent
are hemorrhagic (bleeding).3
• Stroke is a leading cause of long-term disability in the United States.3
• High blood pressure, smoking, diabetes, high cholesterol, obesity, and physical
inactivity are risk factors for stroke that can be changed.4
• In order to reduce stroke deaths, the Oklahoma Heart Disease and Stroke
Prevention Program works with many partners through the Oklahoma State
Stroke System Advisory Committee (OSSSAC) to provide stroke education and
advocate for policy change.
1 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1979-1998. CDC WONDER Online Database, compiled from Compressed Mortality File (CMF) 1968-
1988 Series 20 No. 2A, 2000 and CMF 1989-1998 Series 20 No. 2E, 2003.
2 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1999-2007. CDC WONDER Online Database, compiled from Compressed Mortality File 1999-2007
Series 20 No. 2M, 2010.
3 American Heart Association. Heart Disease and Stroke Statistics - 2010 Update. Dallas, Texas.
4 Newschaffer, C.J., Longjian, L., and Sim, A. (2010). Cardiovascular Disease. In Remington, P., Brownson,
R., and Wegner, M. Chronic Disease Epidemiology and Control (pp.383-428). Washington, DC: American
Public Health Association.
Oklahoma has one of the five highest rates of death due to stroke in the U.S.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
chronic lower
respiratory disease
deaths
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 43.3 40.8 C
HAWAII (best) 19.5 19.4 A
OKLAHOMA (worst) 57.2 61.3 F
AGE IN YEARS
18 - 24 - -
25 - 34 - -
35 - 44 3.8 3.7 A
45 - 54 16.6 20.1 A
55 - 64 75.7 76.1 F
65 + 376.7 407.4 F
GENDER
MALE 69.3 75.3 F
FEMALE 49.4 52.5 F
RACE/ETHNICITY
WHITE (NH) 60.0 65.0 F
BLACK (NH) 35.1 38.3 C
AMER INDIAN (NH) 43.9 45.1 D
HISPANIC 12.0 20.3 A
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 41.0 C
OK 1995 45.1 D
OK 2000 54.2 F
OK 2005 62.5 F
OK 2007 61.3 F
STATE REGION
CENTRAL 55.7 58.6 F
NE 55.9 63.2 F
NW 52.8 55.6 F
SE 66.3 69.4 F
SW 57.8 62.9 F
TULSA 56.1 57.5 F
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 1 8
• Chronic lower respiratory diseases, e.g., COPD, emphysema, chronic
bronchitis, and asthma, are the third leading cause of death in Oklahoma.1
• COPD is responsible for 98 percent of deaths from chronic lower respiratory
diseases in Oklahoma.1
• COPD is a major cause of disability. People with COPD over the age of 50 years
are more likely to be considered disabled.2
• Cigarette smoking is the leading cause of COPD, and secondhand smoke is
associated with a 10-43 percent increase in risk of COPD in adults.2
• COPD has no cure, however patients can take steps to manage symptoms and
slow the progress of the disease. Quitting smoking is the most important step
to treat COPD.2
• Men had much higher death rates due to chronic lower respiratory diseases
than women.
• The rate of death due to chronic lower respiratory disease was higher among
whites than minority groups.
1 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1999-2007. CDC WONDER On-line Database, compiled from Compressed Mortality File 1999-2007
Series 20 No. 2M, 2010. Accessed at <http://wonder.cdc.gov/cmf-icd10.html>
2 American Lung Association, Trends in COPD (Chronic bronchitis and emphysema) Morbidity and Mortality.
American Lung Association, Washington, DC. 2007.
Chronic Obstructive Pulmonary Disease (COPD) is the major cause of chronic
lower respiratory disease deaths in Oklahoma.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
unintentional injury
deaths
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 39.1 40.0 C
NEW YORK (best) 23.0 25.3 B
OKLAHOMA 56.3 58.5 F
NEW MEXICO (worst) 67.3 66.7 F
AGE IN YEARS
18 - 24 58.3 65.1 F
25 - 34 56.8 58.8 F
35 - 44 62.9 67.0 F
45 - 54 68.6 67.4 F
55 - 64 46.7 58.5 F
65 + 119.2 122.0 F
GENDER
MALE 75.2 75.9 F
FEMALE 38.3 42.1 C
RACE/ETHNICITY
WHITE (NH) 56.8 59.8 F
BLACK (NH) 44.3 47.3 D
AMER INDIAN (NH) 77.6 76.0 F
HISPANIC 35.9 43.7 C
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 41.6 C
OK 1995 41.4 C
OK 2000 40.6 C
OK 2005 56.4 F
OK 2007 58.5 F
STATE REGION
CENTRAL 42.5 47.3 D
NE 62.1 58.5 F
NW 54.7 50.6 D
SE 72.1 74.0 F
SW 65.7 75.5 F
TULSA 52.3 56.3 F
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 1 9
• Unintentional injuries accounted for more premature deaths before age 65
than heart disease, stroke, and diabetes combined.1
• Approximately 2,100 Oklahomans die every year from an unintentional injury.1
• Oklahoma’s death rates due to motor vehicle crashes, drowning, and fire/
burns were higher than the national average.1
• Unintentional injuries accounted for 1 of every 17 deaths.1
• Males were almost two times more likely to die from unintentional injuries
than females.1 The unintentional injury death rate was highest among
American Indians.
• The average medical cost for a non-fatal injury hospitalization was $22,000.1
• The leading cause of unintentional injury death in Oklahoma was traffic
crashes, followed by poisonings and falls.2
• Drowning was the leading cause of injury deaths among children ages 1 to 4.2
• Poisoning was the leading cause of unintentional injury death among persons
25 to 54 years of age,2 largely due to the misuse of prescription drugs.
• Falls were the leading cause of unintentional injury death among persons aged
65 and older.2
• Current prevention efforts include child safety seat programs, smoke alarm
installations, poisoning education, and Tai Chi classes to prevent falls among
older adults.
1 Oklahoma State Department of Health, Injury Prevention Service. Injuries in Oklahoma, 2004-2008.
Retrieved from <http://www.ok.gov/health/documents/Injuries_in_OK_2004-2008.pdf>.
2 Centers for Disease Control and Prevention. WISQARS, 2007 data. Retrieved from <http://www.cdc.gov/
injury/wisqars/index.html>.
Injuries are the leading cause of death among Oklahomans ages 1 to 44.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
diabetes deaths
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 24.6 22.5 C
NEVADA (best) 12.8 12.9 A
OKLAHOMA 30.3 29.4 F
WEST VIRGINIA (worst) 33.2 35.5 F
AGE IN YEARS
18 - 24 - -
25 - 34 4.6 1.8 A
35 - 44 8.1 8.2 A
45 - 54 20.9 17.0 B
55 - 64 54.7 51.4 F
65 + 165.7 168.1 F
GENDER
MALE 34.0 34.2 F
FEMALE 27.5 25.8 D
RACE/ETHNICITY
WHITE (NH) 26.5 25.8 D
BLACK (NH) 60.8 55.8 F
AMER INDIAN (NH) 58.9 60.4 F
HISPANIC 22.4 27.3 D
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 16.0 B
OK 1995 18.6 B
OK 2000 26.8 D
OK 2005 32.1 F
OK 2007 29.4 F
STATE REGION
CENTRAL 23.9 26.7 D
NE 31.5 31.7 F
NW 29.1 30.7 F
SE 35.5 30.9 F
SW 36.9 34.7 F
TULSA 28.9 23.1 C
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 0
• Diabetes is the sixth leading cause of death in Oklahoma.1
• Oklahoma had the fourth highest diabetes death rate in the nation.1
• Men had higher diabetes mortality than women.
• Seniors (age 65+) had much higher rates of death due to diabetes.
• Non-Hispanic blacks and non-Hispanic American Indians had higher diabetes
mortality rates than non-Hispanic whites.
• Diabetes death rates were highest in the southwest region of Oklahoma.
• The risk for death among those with diabetes is double that of people without
diabetes regardless of age.2
• Cardiovascular disease is the major complication and the leading cause of
premature death among people with diabetes.2
• Diabetes-related health expenditures were estimated at $3.28 billion in
Oklahoma.2
1 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1999-2007. CDC WONDER On-line Database, compiled from Compressed Mortality File 1999-2007
Series 20 No. 2M, 2010. Accessed at <http://wonder.cdc.gov/cmf-icd10.html>.
2 Oklahoma State Department of Health, Chronic Disease Service. Diabetes Surveillance Report, Oklahoma
2008.
The diabetes mortality rate in Oklahoma was significantly higher than the
national average.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
influenza/pneumonia
deaths
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 17.8 16.2 C
FLORIDA (best) 9.7 8.6 A
OKLAHOMA 22.7 20.1 D
TENNESSEE (worst) 24.8 22.5 F
AGE IN YEARS
18 - 24 - -
25 - 34 - -
35 - 44 4.9 3.9 A
45 - 54 8.4 6.3 A
55 - 64 15.3 17.4 C
65 + 156.8 139.8 F
GENDER
MALE 26.4 24.2 F
FEMALE 20.5 17.5 D
RACE/ETHNICITY
WHITE (NH) 23.1 20.5 D
BLACK (NH) 22.8 15.9 C
AMER INDIAN (NH) 16.0 19.5 D
HISPANIC 12.1 15.4 C
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 41.0 F
OK 1995 39.3 F
OK 2000 24.3 F
OK 2005 24.8 F
OK 2007 20.1 D
STATE REGION
CENTRAL 21.7 17.2 C
NE 22.0 21.9 F
NW 26.0 17.4 C
SE 24.2 25.1 F
SW 22.1 22.6 F
TULSA 21.9 16.9 C
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 1
• Influenza (“flu”) is a highly contagious respiratory viral infection that usually
occurs seasonally.
• Flu causes more than 200,000 people to be hospitalized and roughly 36,000
deaths each year in the U.S. due to flu complications.
• Pneumonia can be a complication of the flu, especially among infants, persons
age 65+, or persons with other chronic conditions, such as asthma, chronic
obstructive pulmonary disease (COPD), diabetes, cancer, or heart disease.
• Everyone over 6 months of age are recommended to receive an annual “flu”
vaccination to provide protection against three different strains of the virus.
• Only one dose of the “pneumonia shot” is recommended for persons age 19+
with chronic medical conditions or for all persons age 65+. Those who
received the pneumonia shot before age 65 should receive a second dose
when they reach age 65 or wait until at least five years have passed since the
first dose.1
• Children younger than 2 years should receive four doses of pneumococcal
conjugate vaccine. An additional dose is recommended before age 5 or for
children age 6-18 who are at higher risk of developing invasive pneumococcal
disease.2
• Immunization outreach is working to vaccinate 90 percent of Oklahoma
seniors (65+) against influenza and pneumonia,3 which will help to lower our
state’s mortality rate from these diseases.
1 Centers for Disease Control and Prevention. Updated Recommendations for Prevention of Invasive
Pneumococcal Disease among Adults Using the 23-Valent Pneumococcal Polysaccharide Vaccine
(PPSV 23). MMWR 2010;59(34):1102-1106.
2 Centers for Disease Control and Prevention. Licensure of a 13 – Valent Pneumococcal Conjugate Vaccine
(PCV13) and Recommendations for Use Among Children – Advisory Committee on Immunization Practices
(ACIP), 2010. MMWR 2010; 59(09):258-261.
3 U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and
Improving Health and Objectives for Improving Health. 2 vols. Washington, D.C.: U.S. Government Printing
Office, November 2000.
Influenza and pneumonia are the eighth leading cause of death in the U.S.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
alzheimer’s disease
deaths
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 22.9 22.7 C
NEW YORK (best) 9.4 8.8 A
OKLAHOMA 23.5 23.1 C
WASHINGTON (worst) 37.1 40.7 F
AGE IN YEARS
18 - 24 - -
25 - 34 - -
35 - 44 - -
45 - 54 - -
55 - 64 2.6 2.8 A
65 + 194.0 191.0 F
GENDER
MALE 18.9 17.7 B
FEMALE 26.2 26.3 D
RACE/ETHNICITY
WHITE (NH) 24.2 24.0 C
BLACK (NH) 28.3 23.0 C
AMER INDIAN (NH) 11.4 11.5 A
HISPANIC - 10.3 A
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 5.1 A
OK 1995 6.0 A
OK 2000 17.4 B
OK 2005 26.0 D
OK 2007 23.1 C
STATE REGION
CENTRAL 18.9 21.1 C
NE 25.5 24.3 C
NW 19.5 18.1 B
SE 24.8 23.1 C
SW 26.0 26.8 D
TULSA 26.4 23.7 C
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 2
• Alzheimer’s Disease was the seventh leading cause of deaths among
Oklahomans. In 2007, it was the sixth leading cause of death in the U.S.1
• Alzheimer’s disease is a progressively debilitating disease of the brain that
results in the eventual loss of cognitive function.2
• Though there is no known cause of Alzheimer’s disease, age and family history
are two primary risk factors.2
• The rate of deaths in Oklahoma due to Alzheimer’s Disease was close to the
national average.
• Oklahoma’s death rate due to Alzheimer’s Disease peaked in 2005 and
declined 11 percent by 2007.
• Because the disease occurs most commonly among older adults, the mortality
rate is highest among those aged 65+. Few deaths occurred to those in the
55-64 age group and none occurred in people less than 55 years.
• The rate of deaths due to Alzheimer’s Disease was 49 percent higher among
women compared to men in Oklahoma, and more than twice as high among
non-Hispanic whites and blacks compared to American Indians and Hispanics.
• The rate of deaths due to Alzheimer’s Disease was lowest in the northwest
region of the state and highest in Oklahoma’s southwest region.
1 National Institute on Aging. Alzheimer’s Information. Retrieved from <http://www.nia.nih.gov/Alzheimers/
Alzheimer6sInformation>.
2 Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final data for 2007. National Vital Statistics
Reports; vol 58 no 19. Hyattsville, MD: National Center for Health Statistics. 2010.
Alzheimer’s Disease deaths occur almost exclusively among seniors.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
nephritis (kidney
disease) deaths
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 14.3 14.5 C
NORTH DAKOTA (best) 6.5 6.2 A
OKLAHOMA 15.4 15.7 C
LOUISIANA (worst) 27.3 26.9 F
AGE IN YEARS
18 - 24 - -
25 - 34 1.7 -
35 - 44 2.8 1.5 A
45 - 54 5.6 5.3 A
55 - 64 15.3 13.9 C
65 + 101.7 108.5 F
GENDER
MALE 18.6 16.8 C
FEMALE 13.3 15.2 C
RACE/ETHNICITY
WHITE (NH) 13.3 14.7 C
BLACK (NH) 37.3 31.6 F
AMER INDIAN (NH) 21.9 23.4 F
HISPANIC - -
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 12.1 C
OK 1995 11.9 B
OK 2000 14.7 C
OK 2005 14.9 C
OK 2007 15.7 C
STATE REGION
CENTRAL 12.5 14.0 C
NE 13.6 18.4 D
NW 18.4 15.0 C
SE 16.7 17.0 D
SW 18.5 15.9 C
TULSA 16.2 13.5 C
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 3
• Chronic renal failure and end-stage kidney disease accounted for 82.1 percent
of deaths from renal failure in Oklahoma.2
• Diabetes is the leading cause of renal failure, and responsible for 44 percent
of new cases in Oklahoma.2
• About half of people who began treatment for end-stage kidney disease in
Oklahoma had diabetes.2
• One percent of hospital admissions for people with diabetes also had chronic
kidney disease.2
• Men had significantly higher prevalence of chronic kidney disease than
women.
• Non-Hispanic blacks and American Indians had significantly higher prevalence
of chronic kidney disease than whites.
1 Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality
File 1999-2007. CDC WONDER Online Database, compiled from Compressed Mortality File 1999-2007
Series 20 No. 2M, 2010. Accessed at <http://wonder.cdc.gov/cmf-icd10.html>.
2 Oklahoma State Department of Health, Chronic Disease Service. Diabetes Surveillance Report, Oklahoma
2008.
Kidney diseases (nephritis, nephrotic syndrome and nephrosis) were the
ninth leading cause of death in Oklahoma.2
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
suicides
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 10.9 11.3 C
DC (best) 5.2 5.8 A
OKLAHOMA 14.9 14.7 D
ALASKA (worst) 20.0 22.1 F
AGE IN YEARS
18 - 24 15.6 12.5 C
25 - 34 18.0 18.4 F
35 - 44 23.8 21.3 F
45 - 54 21.9 26.0 F
55 - 64 20.0 14.4 D
65 + 15.4 18.7 F
GENDER
MALE 24.5 23.5 F
FEMALE 6.1 6.8 B
RACE/ETHNICITY
WHITE (NH) 16.0 15.8 D
BLACK (NH) 5.6 6.5 B
AMER INDIAN (NH) 13.1 13.2 C
HISPANIC 8.7 9.4 B
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 13.2 D
OK 1995 14.5 D
OK 2000 13.6 D
OK 2005 14.5 D
OK 2007 14.7 D
STATE REGION
CENTRAL 13.7 11.9 C
NE 16.0 16.0 D
NW 13.0 12.9 C
SE 20.0 17.3 F
SW 13.0 14.8 D
TULSA 14.3 16.3 D
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 4
• Suicide deaths outnumber homicides by more than two-to-one.1
• The suicide rate in Oklahoma was 30 percent higher than the U.S. rate.
• Suicide rates tended to be higher in the southeast area of Oklahoma.
• Men were three times more likely than women to kill themselves.
• Non-Hispanic whites and American Indians had higher rates of suicide than
blacks or Hispanics.
• One in 5 suicide victims had a history of suicide attempts and 30 percent had
shared their intent/feelings with another person.2
• Firearms were the most common means of suicide, followed by hanging and
poisoning.2
• Men used firearms more often than women to kill themselves, while women
used poison more often.2
• For every suicide death, there were approximately 4.5 people hospitalized for a
suicide attempt or non-fatal, self-inflicted injury.3
• Women had higher rates of non-fatal self-inflicted injuries than men, and
poisoning was the leading cause of hospitalized non-fatal self-inflicted
injuries.3
• Issues that are most likely to increase a person’s risk for suicide are mental
illness, intimate partner problems, and physical health problems.2
1 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based
Injury Statistics Query and Reporting System (WISQARS) [online]. (2007) [cited 2010Dec 17]. Available at
<www.cdc.gov/ncipc/wisqars>.
2 Oklahoma State Department of Health, Injury Prevention Service. (2010). Summary of Violent Deaths in
Oklahoma, Oklahoma Violent Death Reporting System, 2004-2007. Available at <http://www.ok.gov/
health/documents/Violent percent20Deaths percent202004-2007.pdf>.
3 Oklahoma State Department of Health, Injury Prevention Service. (2006). Fatal and Nonfatal Self-Inflicted
Injuries in Oklahoma, 2002-2004. Available at <http://www.ok.gov/health/documents/Suicide_2002-
2004.pdf>.
Suicide is the leading cause of intentional deaths in Oklahoma.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
(PERCENT) 2007 2009 2009 GRADE
STATE COMPARISON
US 8.0 8.3 C
AK & CO (best) 6.1/5.3 5.8 B
OKLAHOMA 10.2 11.0 F
WEST VIRGINIA (worst) 10.8 12.4 F
AGE IN YEARS
18 - 24 2.1 1.8 A
25 - 34 3.1 3.6 A
35 - 44 5.0 6.1 B
45 - 54 11.1 12.0 F
55 - 64 18.3 18.3 F
65 + 20.7 22.1 F
GENDER
MALE 10.6 11.1 F
FEMALE 9.8 10.9 F
RACE/ETHNICITY
WHITE (NH) 9.2 9.9 D
BLACK (NH) 12.7 15.1 F
AMER INDIAN (NH) 18.5 14.7 F
HISPANIC 8.5 12.5 F
INCOME
< $15k 17.5 19.0 F
$15k - 25k 13.2 14.5 F
$25k - 49k 9.2 11.3 F
$50k - 75k 9.4 8.2 C
$75k + 7.3 5.9 B
EDUCATION
< HS 14.7 13.0 F
HS 10.9 12.6 F
HS+ 9.6 11.1 F
COLLEGE GRADUATE 7.7 8.2 C
HISTORIC
OK 1990 5.2 A
OK 1995 2.9 A
OK 2000 5.5 A
OK 2005 8.7 C
OK 2009 11.0 F
STATE REGION
CENTRAL 8.5 9.9 D
NE 12.9 12.2 F
NW 9.9 10.4 D
SE 10.7 12.6 F
SW 10.2 10.9 F
TULSA 9.2 10.1 D
diabetes prevalence
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 5
• Approximately 304,500 Oklahomans age 18+ have been diagnosed with
diabetes.1
• Oklahoma ranked seventh highest in the nation for the prevalence of people
living with diabetes in 2009. Oklahoma has been consistently in the top ten for
several years.1
• Minority populations reported higher prevalence of diabetes than whites.
• Adults with older age, lower annual household incomes, or less education
tended to report higher prevalence of diabetes.
• The prevalence of diabetes was higher among people living in the eastern part
of the state.
• Adults who have ever been diagnosed with diabetes are more likely to report
having cardiovascular diseases.2
• One in 5 hospital admissions in Oklahoma include a diagnosis of diabetes.2
• Lack of physical activity is one of the major risk factors of diabetes. Oklahoma
adults who participated in leisure-time physical activity reported significantly
lower prevalence of diabetes.2
• Obesity (Body Mass Index, BMI>=30) and overweight (25<=BMI<30) are risk
factors of diabetes. Diabetes is more common among persons with higher
BMI.2
• Health expenditures of diabetes in Oklahoma were estimated at $3.28 billion.2
• Cardiovascular disease is the major complication and the leading cause of
premature death among people with diabetes.2
1 Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey
Data. Atlanta, Georgia: US. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
2 Oklahoma State Department of Health, Chronic Disease Service. Diabetes Surveillance Report, Oklahoma
2008.
The number of Oklahomans with diabetes has grown steadily over the last
ten years.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 6
• 429,500 Oklahomans age 18+ (15.5 percent) reported having been
diagnosed with asthma at some time during their lives by a health
professional.1
• 274,700 Oklahomans aged 18+ (9.9 percent) reported that they have asthma
now.1
• Women in Oklahoma had significantly higher prevalence of asthma than men.
• Non-Hispanic American Indians and blacks had a slightly higher rate of asthma
than non-Hispanic whites.
• About 1 in 10 Oklahoma children aged 0-17 currently has asthma (~100,000
children).2
• Asthma affects nearly one in 13 school-aged children and was the leading
cause of school absenteeism due to chronic disease.2
• In 2008, there were 4,367 hospital admissions with asthma as the principal
diagnosis, and 66.3 percent of them were admitted from the emergency
room.2
• Most asthma hospital admissions came from Oklahoma City and Tulsa,
however some counties in western Oklahoma had higher rates of
hospitalization.
• Thirty-nine people died from asthma in 2007 in Oklahoma; five (12.5 percent)
were less than age 25.2
• Asthma mortality rates were much higher among people aged 65+. Blacks had
twice the mortality rate compared to whites.2
1 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: US. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
2 Oklahoma State Department of Health, Chronic Disease Service. Asthma Surveillance Report, Oklahoma
2008.
One in 10 Oklahoma children currently has asthma.
current asthma
prevalence
(PERCENT) 2007 2009 2009 GRADE
STATE COMPARISON
US 8.4 8.8 C
LOUISIANA (best) 6.3 6.3 A
OKLAHOMA 8.6 10.0 D
OREGON (worst) 9.7 11.1 F
AGE IN YEARS
18 - 24 9.6 13.4 F
25 - 34 7.9 11.1 F
35 - 44 8.1 8.8 C
45 - 54 9.0 10.1 D
55 - 64 9.5 8.5 C
65 + 8.2 9.3 C
GENDER
MALE 5.7 7.9 B
FEMALE 11.4 12.0 F
RACE/ETHNICITY
WHITE (NH) 8.5 9.8 D
BLACK (NH) 9.5 8.9 C
AMER INDIAN (NH) 11.4 16.8 F
HISPANIC 4.7 5.3 A
INCOME
< $15k 15.7 18.9 F
$15k - 25k 9.1 12.8 F
$25k - 49k 6.5 9.5 D
$50k - 75k 8.7 8.2 B
$75k + 6.7 5.9 A
EDUCATION
< HS 9.4 13.1 F
HS 8.8 10.0 D
HS+ 8.3 10.1 D
COLLEGE GRADUATE 8.5 8.5 C
HISTORIC
OK 1990 NA
OK 1995 NA
OK 2000 6.3 A
OK 2005 8.6 C
OK 2009 10.0 D
STATE REGION
CENTRAL 9.0 9.6 D
NE 8.0 11.9 F
NW 7.3 8.0 B
SE 9.9 11.7 F
SW 10.8 9.1 C
TULSA 7.3 8.2 B
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 7
• Cancer is a group of diseases characterized by uncontrolled growth and the
spread of abnormal cells. If the spread is not controlled, it can result in death.
• Oklahoma had the 17th highest rate of new cases of cancer in the U.S.
• The U.S. rate declined by three percent while Oklahoma’s rate increased by
seven percent in the past eight years.
• The incidence of new cancer cases increased with age, with the highest rates
occurring after age 50.
• Higher rates occurred in urban regions, possibly as a result of better access
to screening, such as mammograms and colonoscopies.
• Rates of cancer diagnosis increased among all races, but remained the
highest among American Indians.
• Rates of cancer diagnosis were much higher among men than women.
• Many cancers could be prevented through lifestyle changes such as eating
better, moving more, and being tobacco free.2
• The Take Charge! program currently provides no cost breast and cervical
cancer screening tests for eligible women throughout the state. Call
1-888-669-5934 for more information.
• The Oklahoma Colorectal Cancer screening program provides no cost
colonoscopies for eligible men and women throughout the state. Call
1-888-669-5934 for more information.
1 American Cancer Society. Cancer Facts & Figures 2010.
2 Brownson, R.C. and Joshu, C. (2010). Cancer. In Remington, P., Brownson, R., and Wegner, M. Chronic
Disease Epidemiology and Control (pp.429-468). Washington, DC: American Public Health Association.
One in 2 men and 1 in 3 women will develop cancer some time in their
lives.1
cancer incidence
(RATE PER 100,000) 2005 2006 2006 GRADE
STATE COMPARISON
US 481.7 481.7 C
NEW MEXICO (best) 417.6 403.4 A
OKLAHOMA 481.9 498.9 C
MAINE (worst) 544.4 556.4 F
AGE IN YEARS
0 - 19 18.0 22.7 A
20 - 29 40.5 52.6 A
30 - 39 120.9 136.6 A
40 - 49 327.2 340.3 A
50 - 64 919.8 967.9 F
65 - 79 2315.0 2372.5 F
GENDER
MALE 573.3 601.7 F
FEMALE 466.5 485.2 C
RACE/ETHNICITY
WHITE (NH) 505.5 529.0 D
BLACK (NH) 512.9 541.4 F
AMER INDIAN (NH) 592.3 604.6 F
HISPANIC 387.7 396.5 A
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 NA
OK 1995 NA
OK 2000 475.9 C
OK 2005 507.6 D
OK 2006 530.3 D
STATE REGION
CENTRAL 510.2 553.5 F
NE 487.4 493.7 C
NW 494.7 508.9 D
SE 503.6 524.9 D
SW 504.0 533.7 D
TULSA 552.0 566.3 F
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
• Eating more fruits and vegetables can lower the risk of chronic disease,
including some cancers, diabetes, heart disease, and obesity.1
• Only 1 in 7 (14.6 percent) Oklahoma adults reported eating fruits and
vegetables five times or more per day, ranking Oklahoma 51st in the nation.2
• Only 15 percent of Oklahoma youth ate fruits and vegetables fives times or
more per day.3
• Fruit and vegetable consumption did not widely differ by income.2
• Food industry marketing, many fast food restaurants, and few grocery stores
are community factors that influence unhealthy food choices. 1
• Only 57.4 percent of Oklahoma census tracts had healthy food retailers in or
within half of a mile of tract boundaries.4
• Only 0.3 percent of cropland acreage was harvested for fruits and vegetables.4
• Worksites, schools, and faith-based organizations can help increase fruit and
vegetable consumption through education, availability, and social support.1
• Oklahoma was 1 of 21 states with a state-level policy for Farm-to-School
programs and 1 of 20 with a state-level Food Policy Council.4
• Implementation of Get Fit, Eat Smart, the state plan to reduce obesity, is a
priority of the Oklahoma Health Improvement Plan (OHIP).
• The Oklahoma State Department of Health has begun a four-year pilot utilizing
evidenced-based physical activity and nutrition curricula in multiple school
districts.
1 Malas, N., Tharp, K.M., and Foerster, S.B. (2010). Diet and Nutrition. In Remington, P., Brownson, R., and
Wegner, M. Chronic Disease Epidemiology and Control (pp.159-197). Washington, DC: American Public
Health Association.
2 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, CDC, 2009.
3 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance – United States 2009.
MMWR Surveillance Summaries 59, no. SS05 (2010). Available at <http://www.cdc.gov/mmwr/pdf/ss/
ss5905.pdf>.
4 Centers for Disease Control and Prevention. State indicator report on fruits and vegetables, 2009. US
Department of Health and Human Services, CDC; 2009. Available at <http:www.fruitsandveggiesmatter.
gov/indicatorreport>.
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 8
Oklahomans report they are the least likely to eat fruits and vegetables.
fruit and vegetable
consumption
(PERCENT) 2007 2009 2009 GRADE
STATE COMPARISON
US 24.4 23.4 C
DC (best) 32.5 31.5 A
OKLAHOMA (worst) 16.3 14.6 F
AGE IN YEARS
18 - 24 18.3 10.3 F
25 - 34 13.9 15.1 F
35 - 44 13.8 13.3 F
45 - 54 16.3 13.5 F
55 - 64 15.7 14.6 F
65 + 20.3 18.4 D
GENDER
MALE 12.7 12.4 F
FEMALE 19.6 16.7 F
RACE/ETHNICITY
WHITE (NH) 16.4 13.8 F
BLACK (NH) 15.4 16.5 F
AMER INDIAN (NH) 15.5 15.7 F
HISPANIC 13.4 13.8 F
INCOME
< $15k 16.0 14.3 F
$15k - 25k 13.9 13.2 F
$25k - 49k 13.8 15.3 F
$50k - 75k 18.0 14.9 F
$75k + 19.6 14.7 F
EDUCATION
< HS 12.5 11.5 F
HS 14.8 12.7 F
HS+ 14.9 14.5 F
COLLEGE GRADUATE 21.5 18.3 D
HISTORIC
OK 1990 NA
OK 1995 17.2 F
OK 2000 18.2 D
OK 2005 15.6 F
OK 2009 14.6 F
STATE REGION
CENTRAL 17.4 16.0 F
NE 14.8 13.2 F
NW 15.8 14.5 F
SE 13.6 15.3 F
SW 16.9 12.9 F
TULSA 18.7 15.0 F
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
no physical activity
(PERCENT) 2007 2009 2009 GRADE
STATE COMPARISON
US 22.6 23.8 C
MINNESOTA (best) 16.7 15.8 A
OKLAHOMA 29.6 31.4 F
WEST VIRGINIA (worst) 28.2 33.2 F
AGE IN YEARS
18 - 24 23.7 23.9 C
25 - 34 22.5 26.9 D
35 - 44 26.2 25.9 D
45 - 54 28.1 32.3 F
55 - 64 36.9 37.5 F
65 + 40.0 39.4 F
GENDER
MALE 27.8 28.7 D
FEMALE 31.3 33.9 F
RACE/ETHNICITY
WHITE (NH) 28.2 30.2 F
BLACK (NH) 34.2 36.5 F
AMER INDIAN (NH) 32.1 31.2 F
HISPANIC 36.6 39.9 F
INCOME
< $15k 44.8 47.9 F
$15k - 25k 41.0 42.0 F
$25k - 49k 30.8 32.1 F
$50k - 75k 19.3 24.8 C
$75k + 15.9 16.8 A
EDUCATION
< HS 46.7 45.1 F
HS 35.9 37.6 F
HS+ 27.5 30.2 F
COLLEGE GRADUATE 15.5 19.1 B
HISTORIC
OK 1990 41.1 F
OK 1995 40.6 F
OK 2000 34.4 F
OK 2005 30.2 F
OK 2009 31.4 F
STATE REGION
CENTRAL 27.3 29.0 D
NE 31.1 36.0 F
NW 28.3 29.6 D
SE 35.7 31.1 F
SW 29.8 33.2 F
TULSA 27.0 27.8 D
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 2 9
• Thirty percent of Oklahoma adults report not being physically active.
• Physical activity has a role in reversing or preventing health problems1 and
reduces the risk of premature death.2
• The World Health Organization estimates that 1.9 million deaths worldwide are
attributable to physical inactivity.3
• College graduates were twice as likely to be physically active as those with only
a HS education.1,4
• Physical inactivity was higher among Hispanics than non-Hispanic whites.4
• Oklahomans with less income were less physically active.4
• The Partnership for a Strong and Healthy Oklahoma is supporting programs
that adopt the physical activity state plan.
• The Oklahoma Action for Healthy Kids state team has embraced “screen time
reduction” as their focus area.
• The Oklahoma Safe Routes to School program provides schools with
opportunities to encourage walking and bicycling to school.
• The Oklahoma State Department of Health has begun a four-year pilot utilizing
an evidence-based physical activity and nutrition curricula in multiple school
districts.
• Implementation of Get Fit, Eat Smart, the state plan to reduce obesity, is a
priority of the Oklahoma Health Improvement Plan (OHIP).
1 U.S. Department of Health and Human Services, 2008 Physical Activity Guidelines for Americans. Available
at <http://www.health.gov/paguidelines/guidelines/chapter2.aspx>.
2 Ainsworth, B.E. and Macera, C.A. (2010). Physical Activity. In Remington, P., Brownson, R., and Wegner, M.
Chronic Disease Epidemiology and Control (pp.199-227). Washington, DC: American Public Health
Association.
3 World Health Organization. Risk Factor: Physical Inactivity. Available at <http://www.who.int/
cardiovascular_diseases/en/cvd_atlas_08_physical_inactivity.pdf>.
4 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U. S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
Oklahoma ranks 49th worst in the nation for lack of physical activity.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 0
• Smoking kills more Oklahomans than alcohol, auto accidents, AIDS, suicides,
murders and illegal drugs combined.1
• Smoking costs Oklahomans an estimated $2.7 billion in medical expenses and
lost productivity each year.2
• Smokers miss an average of 50 percent more work days than nonsmokers.3
• Twenty-six percent of Oklahoma adults smoked, compared to about 18
percent nationally.4
• About 60 percent of adult smokers in Oklahoma made at least one serious
attempt to quit within the last year.4
• Each year, about 5,400 Oklahoma children become new daily smokers.5
• Each year, about $213 million is spent by tobacco companies to promote their
products to Oklahomans.6
• Effective programs and policies are needed to decrease smoking initiation,
increase cessation, and reduce exposure to secondhand smoke.7
• Oklahoma is one of only two states that prohibits communities from adopting
any policy on tobacco that’s stronger than state law.8
1 Centers for Disease Control and Prevention. State-Specific Smoking-Attributable Mortality and Years of
Potential Life Lost – United States, 2000-2004. Jan. 22, 2009.
2 Centers for Disease Control and Prevention. Data Highlights 2006 [and underlying CDC data/estimates;
CDC's State System average annual smoking attributable productivity losses from 1997-2001 (1999
estimates updated to 2004 dollars).
3 Halpern, M.T., et al, Impact of smoking status on workplace absenteeism and productivity. Tobacco Control
10(3): 233-238, Sept. 2001.
4 Behavioral Risk Factor Surveillance System. 2009.
5 U.S. Department of Health and Human Services (HHS). Results from the 2009 National Survey on Drug Use
and Health.
6 U.S. Federal Trade Commission. 2009. Estimate based on state cigarette pack sales.
7 Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs -
2007.
8 Centers for Disease Control and Prevention. State Tobacco Activities Tracking & Evaluation System; States
Preemption Summary, updated Dec. 31, 2009.
Smoking is Oklahoma’s leading cause of preventable death.
current smoking
prevalence
(PERCENT) 2007 2009 2009 GRADE
STATE COMPARISON
US 19.8 17.9 C
UTAH (best) 11.7 9.8 A
OKLAHOMA 25.8 25.5 F
KY & WV (worst) 28/27 25.6 F
AGE IN YEARS
18 - 24 29.4 32.6 F
25 - 34 31.4 30.9 F
35 - 44 26.0 24.5 F
45 - 54 31.7 31.6 F
55 - 64 24.6 22.5 D
65 + 11.6 12.1 A
GENDER
MALE 27.9 27.1 F
FEMALE 23.7 24.0 F
RACE/ETHNICITY
WHITE (NH) 24.6 24.1 F
BLACK (NH) 30.3 31.7 F
AMER INDIAN (NH) 36.1 31.9 F
HISPANIC 16.9 24.2 F
INCOME
< $15k 43.6 40.5 F
$15k - 25k 34.9 36.9 F
$25k - 49k 27.3 24.8 F
$50k - 75k 26.4 18.6 C
$75k + 16.5 13.6 B
EDUCATION
< HS 38.1 41.1 F
HS 31.5 31.8 F
HS+ 26.3 26.2 F
COLLEGE GRADUATE 11.5 10.4 A
HISTORIC
OK 1990 26.5 F
OK 1995 21.7 D
OK 2000 23.3 F
OK 2005 25.0 F
OK 2009 25.5 F
STATE REGION
CENTRAL 22.6 22.0 D
NE 26.5 28.4 F
NW 25.7 20.9 D
SE 30.9 26.1 F
SW 27.8 29.4 F
TULSA 24.8 26.1 F
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
obesity
(PERCENT) 2007 2009 2009 GRADE
STATE COMPARISON
US 26.3 26.9 C
COLORADO (best) 19.3 19.0 A
OKLAHOMA 28.8 32.0 D
MISSISSIPPI (worst) 32.6 35.4 F
AGE IN YEARS
18 - 24 19.9 23.5 B
25 - 34 27.9 30.0 D
35 - 44 29.4 37.2 F
45 - 54 32.4 39.0 F
55 - 64 36.6 35.5 F
65 + 24.4 23.9 B
GENDER
MALE 28.9 32.8 F
FEMALE 28.5 31.2 D
RACE/ETHNICITY
WHITE (NH) 27.5 30.5 D
BLACK (NH) 28.7 43.9 F
AMER INDIAN (NH) 36.3 41.9 F
HISPANIC 32.3 27.3 C
INCOME
< $15k 34.5 36.1 F
$15k - 25k 30.9 34.4 F
$25k - 49k 30.7 34.9 F
$50k - 75k 29.2 32.7 F
$75k + 26.2 27.7 C
EDUCATION
< HS 33.9 31.5 D
HS 29.5 33.9 F
HS+ 30.5 36.0 F
COLLEGE GRADUATE 23.2 25.9 C
HISTORIC
OK 1990 11.6 A
OK 1995 13.5 A
OK 2000 19.7 A
OK 2005 26.5 C
OK 2009 32.0 D
STATE REGION
CENTRAL 28.0 28.4 C
NE 31.0 35.2 F
NW 27.2 31.7 D
SE 29.3 37.5 F
SW 29.7 32.5 F
TULSA 26.9 28.4 C
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 1
Oklahoma’s adult obesity rate has nearly quadrupled since 1988.
• Obesity is associated with increased mortality.1
• Excess weight increases the risk of developing chronic disease, such as heart
disease, stroke, diabetes, and some cancers.1
• Oklahoma ranked 47th in the nation for obesity (or fifth most obese) and two-thirds
of Oklahoma adults had a Body Mass Index (BMI) of 25+ (overweight
and obese).2
• Fourteen percent of Oklahoma youth were obese and 16 percent were
overweight.3
• Implementation of Get Fit, Eat Smart, the state plan to reduce obesity, is a
priority of the Oklahoma Health Improvement Plan (OHIP).
• As an individual’s BMI increases, so do the number of sick days, medical
claims, and health care costs.4
• Obesity increases a child’s risk for a range of health problems and negatively
impacts mental health and school performance.5,6
• Twenty-nine percent of Oklahoma high school students watch three or more
hours of TV daily.
• Only 36.4 percent of high school students had a physical education class at
least once a week, and only 31.4 percent had daily physical education.3
1 Galuska, D.A. and Dietz, W.H. (2010). Obesity and Overweight. In Remington, P., Brownson, R., and
Wegner, M. Chronic Disease Epidemiology and Control (pp.269-290). Washington, DC: American Public
Health Association.
2 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
3 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance - United States 2009.
MMWR Surveillance Summaries 59, no.SS05 (2010). Available at <http://www.cdc.gov/mmwr/pdf/ss/
ss5905.pdf>.
4 The Robert Wood Johnson Foundation, the American Stroke Association, and the American Heart
Association. A Nation at Risk: Obesity in the United States, A Statistical Sourcebook. Dallas, TX: American
Heart Association, 2005.
5 W.H. Dietz. Health Consequences of Obesity in Youth: Childhood Predictors of Adult Disease. Pediatrics
101, no. 3 (1998): 518-525.
6 A. Datar and R. Strum. Childhood Overweight and Elementary School Outcomes. International Journal of
Obesity 30, (2006): 1449-1460.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 2
• Oklahoma children continued to be among the nation’s best vaccinated
despite a nationwide shortage of Haemophilus Influenzae Type b (Hib)
vaccine.1
• In 2009, Oklahoma ranked 16th in the percent of 19-35 month-old children
completing the primary vaccination series for ten dangerous diseases.1
• About 70 percent of Oklahoma children completed the 15 doses of the primary
series covering diphtheria, tetanus, pertussis, measles, mumps, rubella, polio,
Hib, hepatitis B and varicella.1 [U.S. 69.9 percent.1]
• According to the Oklahoma Two-Year-Old Survey, Hispanics had the highest
coverage rate (73.1 percent) for any race/ethnicity followed by Native
Americans (68.8 percent), whites (66.4 percent), and blacks (60.9 percent).2
• Children of college graduates (70.7 percent) had better rates compared to
children of parents with some college (68.3 percent), high school graduates
(67.4 percent), and those who have not completed high school (67.2
percent).2
• The largest differences in county rates were due to incompletion of the fourth
dose of DTaP vaccine (diphtheria, tetanus and pertussis) and the third dose of
Hib vaccine, and were due primarily to the national vaccine shortage.2
• Oklahoma continues to focus on efforts to improve vaccine coverage rates by
following-up on 21 month-old children who lack only one dose in completing
the primary immunization series.2
Data for childhood immunization rates were drawn from the Oklahoma State Immunization Information
System’s (OSIIS) 2007 Birth Cohort Survey and the 2009 National Immunization Survey (NIS). The OSIIS is a
voluntary immunization registry and the Birth Cohort Survey includes age, race/ethnicity, education, region
and county level data. These data represent the proportion of children 24 months old that are up-to-date for
the 4:3:1:3:3:1 immunization series.
1 Centers for Disease Control and Prevention.2009 National Immunization Survey. Unpublished table.
Available at <http://www.cdc.gov/vaccines/stats-surv/nis/default.htm#nis>.
2 Oklahoma State Department of Health Immunization Survey. 2010 Oklahoma Two-Year-Old Survey.
Unpublished.
Immunizations help prevent many disabling and life-threatening diseases.
immunization < 3 years
(4:3:1:3:3:1 series)
(PERCENT) 2006 2009 2009 GRADE
STATE COMPARISON
US 76.9 69.9 C
MASSACHUSETTS (best) 83.6 81.1 B
OKLAHOMA 77.6 70.2 C
CONNECTICUT (worst) 81.8 46.5 F
MOTHER’S AGE IN YEARS
18 - 24 78.0 67.3 C
25 - 34 79.6 68.2 C
35 - 44 82.8 69.0 C
45 - 54 100.0 72.6 C
55 - 64 NA NA
65 + NA NA
CHILD’S GENDER
MALE NA 67.6 C
FEMALE NA 68.2 C
RACE/ETHNICITY
WHITE (NH) 76.8 66.4 C
BLACK (NH) 72.3 60.9 D
AMER INDIAN (NH) 78.1 68.8 C
HISPANIC 84.1 73.1 C
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
MOTHER’S EDUCATION
< HS 77.9 67.2 C
HS 78.8 67.4 C
HS+ 78.7 68.3 C
COLLEGE GRADUATE 83.8 70.7 C
HISTORIC
OK 1990 NA
OK 1995 NA
OK 2000 60.3 D
OK 2005 72.3 C
OK 2009 70.2 C
STATE REGION
CENTRAL 80.5 69.1 C
NE 77.4 67.8 C
NW 81.4 68.5 C
SE 80.2 72.2 C
SW 78.3 70.3 C
TULSA 76.1 60.0 D
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
seniors influenza
vaccination
(PERCENT) 2006 2009 2009 GRADE
STATE COMPARISON
US 69.6 70.1 C
MINNESOTA (best) 73.8 76.8 A
OKLAHOMA 76.1 72.3 B
ALASKA (worst) 62.5 62.1 F
AGE IN YEARS
18 - 24 NA NA
25 - 34 NA NA
35 - 44 NA NA
45 - 54 NA NA
55 - 64 NA NA
65 + 76.1 72.3 B
GENDER
MALE 69.8 71.7 C
FEMALE 71.2 72.7 B
RACE/ETHNICITY
WHITE (NH) 71.9 74.2 B
BLACK (NH) 49.2 58.3 F
AMER INDIAN (NH) 71.9 68.5 C
HISPANIC - -
INCOME
< $15k 62.4 69.6 C
$15k - 25k 73.0 71.6 C
$25k - 49k 73.3 70.6 C
$50k - 75k 71.5 75.4 A
$75k + 72.3 72.9 B
EDUCATION
< HS 67.0 66.6 D
HS 70.3 72.4 B
HS+ 70.1 72.5 B
COLLEGE GRADUATE 75.7 75.5 A
HISTORIC
OK 1993 58.5 F
OK 1995 61.1 F
OK 2001 72.7 B
OK 2005 73.2 B
OK 2009 72.3 B
STATE REGION
CENTRAL 68.8 72.3 B
NE 69.8 73.2 B
NW 69.8 73.8 B
SE 73.0 71.7 C
SW 70.1 70.3 C
TULSA 74.0 71.7 C
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 3
• Influenza (“flu”) is a highly contagious seasonal respiratory viral infection
causing 200,000+ people to be hospitalized nationally and approximately
36,000 deaths each year due to complications.
• Oklahoma’s adult flu vaccination rate (72.3) ranked 13th best in the U.S.1
• The Healthy People 2010 goal is to vaccinate 90 percent of adults aged
65+ against both influenza and pneumococcal pneumonia.2
• Immunization outreach among Oklahoma seniors must be increased to
achieve the Healthy People 2010 goal and lower our state’s mortality rate
from this disease.
• The flu rate for black adults age 65+ (58.3 percent) remained lower than
whites (74.2 percent) and American Indians (68.5 percent) in 2009.
• Flu vaccination is available at all county health departments, healthcare
providers, and some pharmacies.
• Healthcare providers are encouraged to review patients’ medical records for
immunization history and promote influenza and pneumococcal vaccination.
1 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
2 U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and
Improving Health and Objectives for Improving Health. 2 vols. Washington, D.C., U.S. Government Printing
Office, November 2000.
Oklahoma’s senior vaccination rates are higher than the national rate.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 4
• Oklahoma ranked third in the nation in 2009 for the percent of adults age 65+
who have ever had a pneumococcal vaccination.1 (OK 72.1 percent, U.S. 68.5
percent)
• Pneumonia can be a complication of influenza, especially among infants,
persons age 65+, or persons with underlying chronic medical conditions, such
as asthma, chronic obstructive pulmonary disease (COPD), diabetes, cancer,
or heart disease.
• Only one dose of pneumococcal polysaccharide vaccine (commonly known as
the “pneumonia shot”) is recommended for persons age 19+ with chronic
medical conditions or for all persons age 65+. Those who received a
pneumonia shot before age 65 should receive a second dose when they reach
age 65 or wait until at least five years have passed since the first dose.2
• The Healthy People 2010 goal is to vaccinate 90 percent of seniors against
both influenza and pneumococcal pneumonia.3
• Oklahoma senior women were more likely to be immunized (74.4 percent)
than senior men (69 percent).
• Pneumococcal vaccination rates were 19 percent lower among black
Oklahomans compared to whites.
1 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
2 Centers for Disease Control and Prevention. Updated Recommendations for Prevention of Invasive
Pneumococcal Disease among Adults Using the 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV
23). MMWR 2010;59(34):1102-1106.
3 U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and
Improving Health and Objectives for Improving Health. 2 vols. Washington, D.C., U.S. Government Printing
Office, November 2000.
Oklahoma’s pneumococcal vaccination rate for seniors (age 65+) was
better than the national average.
seniors pneumonia
vaccination
(PERCENT) 2006 2009 2009 GRADE
STATE COMPARISON
US 66.9 68.5 C
COLORADO (best) 72.9 73.9 A
OKLAHOMA 71.7 72.1 B
CALIFORNIA (worst) 60.0 59.9 F
AGE IN YEARS
18 - 24 NA NA
25 - 34 NA NA
35 - 44 NA NA
45 - 54 NA NA
55 - 64 NA NA
65 + 71.7 72.1 B
GENDER
MALE 68.5 69.0 C
FEMALE 71.4 74.4 A
RACE/ETHNICITY
WHITE (NH) 71.0 73.8 A
BLACK (NH) 59.9 61.9 F
AMER INDIAN (NH) 69.4 71.7 B
HISPANIC - -
INCOME
< $15k 66.6 72.1 B
$15k - 25k 72.1 73.7 A
$25k - 49k 74.1 70.4 B
$50k - 75k 76.3 71.7 B
$75k + 65.3 75.5 A
EDUCATION
< HS 66.7 62.2 F
HS 70.7 72.2 B
HS+ 71.5 75.0 A
COLLEGE GRADUATE 71.1 74.7 A
HISTORIC
OK 1993 29.6 F
OK 1995 37.2 F
OK 2001 66.1 D
OK 2005 70.5 B
OK 2009 72.1 B
STATE REGION
CENTRAL 74.0 74.0 A
NE 68.2 70.9 B
NW 70.8 72.2 B
SE 71.2 72.9 B
SW 67.7 72.0 B
TULSA 68.6 70.7 B
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 5
• Poor physical and/or mental health can impact an individual’s ability to
perform usual activities.1
• Oklahoma adults ranked 45th worst in the U.S. in the average number of
limited activity days (18+) in 2009.2
• Compared to the nation, Oklahomans experienced 21 percent more time in
which their activities were limited due to poor physical and/or mental health.2
• Average number of limited activity days were highest among Oklahoma’s
adults age 45+, and among blacks and American Indians.
• The average number of limited activity days declined as income increased, and
were consistently higher for all education levels except college graduates.
• Oklahoma’s northwest region experienced the fewest number of limited activity
days, while the southeast region experienced the most.
• Compared to 2007, Oklahoma’s average number of limited activity days
declined 12 percent in 2009.
• The rate of limited activity days increased 45 percent among blacks, 21 per-cent
among American Indians, and 62 percent among 18-24 year-olds.
• The rate of limited activity days declined 29 percent for Hispanics.
1 Centers for Disease Control and Prevention. Measuring Health Days. Atlanta, Georgia: CDC, November
2000.
2 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
Oklahomans report having an average of five limited activity days every
four weeks due to poor health.
limited activity days
(AVERAGE) 2007 2009 2009 GRADE
STATE COMPARISON
US 4.9 4.3 C
NORTH DAKOTA (best) 3.6 3.1 B
OKLAHOMA 5.9 5.2 D
TENNESSEE (worst) 8.2 6.2 F
AGE IN YEARS
18 - 24 2.1 3.4 B
25 - 34 3.9 3.1 B
35 - 44 4.6 4.3 C
45 - 54 6.2 6.9 F
55 - 64 7.5 7.1 F
65 + 6.9 6.5 F
GENDER
MALE 5.4 5.5 D
FEMALE 5.0 5.1 D
RACE/ETHNICITY
WHITE (NH) 5.0 4.8 D
BLACK (NH) 4.9 7.1 F
AMER INDIAN (NH) 5.7 6.9 F
HISPANIC 5.1 3.6 B
INCOME
< $15k 10.7 10.4 F
$15k - 25k 6.8 6.8 F
$25k - 49k 3.8 4.1 C
$50k - 75k 3.6 3.4 B
$75k + 2.5 2.3 A
EDUCATION
< HS 7.3 7.4 F
HS 5.7 5.7 F
HS+ 5.0 5.6 F
COLLEGE GRADUATE 3.3 3.3 B
HISTORIC
OK 1990 NA
OK 1995 4.3 C
OK 2000 4.6 C
OK 2005 5.0 D
OK 2009 5.2 D
STATE REGION
CENTRAL 4.1 4.4 C
NE 6.3 5.5 D
NW 4.3 3.9 B
SE 6.4 7.4 F
SW 5.5 5.0 D
TULSA 4.6 5.6 F
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
poor mental health
days
(AVERAGE) 2007 2009 2009 GRADE
STATE COMPARISON
US 3.3 3.5 C
ND & SD (best) 2.4/2.5 2.4 A
OKLAHOMA 3.9 4.2 D
KENTUCKY (worst) 4.3 4.6 F
AGE IN YEARS
18 - 24 4.8 4.4 F
25 - 34 4.0 4.8 F
35 - 44 3.8 3.6 C
45 - 54 4.8 5.2 F
55 - 64 3.8 4.7 F
65 + 2.5 2.5 A
GENDER
MALE 3.2 3.3 B
FEMALE 4.6 5.1 F
RACE/ETHNICITY
WHITE (NH) 3.6 4.0 D
BLACK (NH) 4.6 5.6 F
AMER INDIAN (NH) 5.3 5.5 F
HISPANIC 3.3 2.4 A
INCOME
< $15k 8.1 8.7 F
$15k - 25k 5.5 6.1 F
$25k - 49k 3.4 4.0 D
$50k - 75k 2.9 2.5 A
$75k + 1.9 2.2 A
EDUCATION
< HS 6.1 5.6 F
HS 4.1 4.2 D
HS+ 4.1 5.1 F
COLLEGE GRADUATE 2.4 2.7 A
HISTORIC
OK 1990 NA
OK 1995 1.8 A
OK 2000 2.2 A
OK 2005 3.7 C
OK 2009 4.2 D
STATE REGION
CENTRAL 3.8 4.2 D
NE 4.0 4.5 F
NW 3.2 3.5 C
SE 4.8 4.5 F
SW 4.5 4.1 D
TULSA 3.5 4.1 D
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 6
Oklahoma adults ranked 49th worst in the U.S. in the average number of
poor mental health days compared to other states.
• Mental illness is a significant contributor to the burden of disease in the
United States, negatively impacting health and productivity.1
• Mental illness is the leading cause of disability for U.S. adults aged 18-44
years.2
• Compared to the nation, Oklahomans experienced 20 percent more time
during which their mental health was not good.3
• The average number of poor mental health days was 55 percent higher among
women than men.
• Seniors, Hispanics, and college graduates reported the fewest number of poor
mental health days.
• The average number of poor mental health days declined as income
increased; those with an income of $75,000+ averaged 75 percent fewer
mentally unhealthy days compared to those with less than $15,000 yearly.
• Oklahoma’s northwest region experienced the fewest number of poor mental
health days.
• In 2009, Oklahoma’s overall average number of poor mental health days
increased 7.7 percent from 2007.
• The average number of poor mental health days increased 20 percent for 25-
34 year-olds, 24 percent for 55-64 year olds, 22 percent for blacks, and 24
percent for those with some college education. In contrast, the average
number of poor mental health days decreased 27 percent for Hispanics.
1 U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General.
Rockville, MD: U.S. Department of Health and Human Services. 1999.
2 Centers for Disease Control and Prevention. Measuring Health Days. Atlanta, Georgia: CDC, November
2000.
3 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
poor physical health
days
(AVERAGE) 2007 2009 2009 GRADE
STATE COMPARISON
US 4.3 3.6 C
DC (best) 3.0 2.6 A
OKLAHOMA 4.9 4.3 D
KY & WV (worst) 4.9/5.1 5.2 F
AGE IN YEARS
18 - 24 2.6 2.5 A
25 - 34 2.8 2.7 A
35 - 44 3.2 2.8 B
45 - 54 4.6 5.2 F
55 - 64 6.3 6.4 F
65 + 5.7 5.8 F
GENDER
MALE 3.8 3.7 C
FEMALE 4.6 4.8 F
RACE/ETHNICITY
WHITE (NH) 4.1 4.1 D
BLACK (NH) 4.2 5.1 F
AMER INDIAN (NH) 5.0 5.4 F
HISPANIC 2.8 2.4 A
INCOME
< $15k 9.2 8.9 F
$15k - 25k 6.0 6.3 F
$25k - 49k 3.7 3.7 C
$50k - 75k 2.9 2.3 A
$75k + 1.8 2.3 A
EDUCATION
< HS 6.1 5.8 F
HS 4.5 4.7 F
HS+ 4.5 4.7 F
COLLEGE GRADUATE 2.6 2.7 A
HISTORIC
OK 1990 NA
OK 1995 2.5 A
OK 2000 3.1 B
OK 2005 4.1 D
OK 2009 4.3 D
STATE REGION
CENTRAL 3.5 3.6 C
NE 4.9 4.6 F
NW 3.7 3.3 B
SE 5.6 5.9 F
SW 4.8 4.2 D
TULSA 3.3 4.3 D
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 7
• Physical symptoms such as illness, injury, and pain may interfere with an
individual’s ability to enjoy a good quality of life and may negatively impact the
ability to perform normal activities.1
• Oklahoma adults ranked 47th worst in the U.S. in the average number of poor
physical health days in 2009.2
• Compared to the nation, Oklahomans experienced 19 percent more time
during which their physical health was not good.2
• The average number of poor physical health days was 30 percent higher
among women than men.
• The youngest adults, Hispanics, and college graduates experienced the fewest
number of poor physical health days.
• The average number of poor physical health days declined as income
increased, such that those with an income of $50,000 or more averaged 74
percent fewer physically unhealthy days compared to those with an income
less than $15,000 yearly.
• Oklahoma’s northwest and central regions experienced the fewest number of
poor physical health days.
• Compared to 2007, Oklahoma’s overall average number of poor physical
health days decreased 12 percent in 2009.
• Poor physical health days increased 21 percent for blacks, 28 percent for
those with an income of $75,000 or greater, and 30 percent for those living in
the Tulsa region.
• Poor physical health days decreased by 21 percent for those with a household
income of $50,000-$74,999.
1 Centers for Disease Control and Prevention. Measuring Health Days. Atlanta, Georgia: CDC, November
2000.
2 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
Oklahomans report an average of one physically unhealthy day each week.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 8
• Oklahoma ranked 43rd in the U.S. with the percentage of the population
perceiving their health as good or excellent.1
• In 1998, Oklahoma’s self-health rating peaked and was similar to the nation.
Oklahoma’s rate declined 8 percent in the decade since.
• Perceptions of good or better health were most common among 18-24 year
olds, followed closely by 25-34 and 35-44 year olds.
• Positive perceptions of health were also most common among those with a
household income of $50,000+ and college graduates.
• Non-Hispanic whites had more positive perceptions of their health compared
to other racial/ethnic groups.
• An individual’s perception of their health is used as an alternative measure to
assess the perceived burden of acute and chronic health conditions.2
• Self-health ratings may independently predict mortality.3
• In 2009, there were few changes in perceptions of health in Oklahoma
compared to 2007. The rate worsened among those with less than a high
school education and in the Tulsa and northeast regions.
1 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
2 Centers for Disease Control and Prevention. Measuring Health Days. Atlanta, Georgia: CDC, November
2000.
3 Idler, E.L. and Benyamini Y. (1997). Self-rated health and mortality: A review of twenty-seven community
studies. J Health Soc Beh, 38:21-37.
Oklahomans rate their health among the poorest in the U.S.
good or better health
rating
(PERCENT) 2007 2009 2009 GRADE
STATE COMPARISON
US 84.6 85.5 C
MINNESOTA (best) 89.0 89.9 B
OKLAHOMA 80.8 80.4 D
WEST VIRGINIA (worst) 78.4 76.3 F
AGE IN YEARS
18 - 24 91.6 91.5 A
25 - 34 88.8 87.2 B
35 - 44 86.8 87.2 B
45 - 54 79.6 78.9 F
55 - 64 71.6 72.5 F
65 + 67.8 68.6 F
GENDER
MALE 82.2 81.5 D
FEMALE 79.5 79.5 F
RACE/ETHNICITY
WHITE (NH) 82.3 82.1 D
BLACK (NH) 79.4 76.2 F
AMER INDIAN (NH) 74.9 75.2 F
HISPANIC 75.3 78.5 F
INCOME
< $15k 55.7 55.9 F
$15k - 25k 72.2 68.8 F
$25k - 49k 83.0 82.2 D
$50k - 75k 90.2 90.8 A
$75k + 93.7 95.0 A
EDUCATION
< HS 59.1 64.8 F
HS 79.9 77.2 F
HS+ 82.2 80.6 D
COLLEGE GRADUATE 91.2 90.9 A
HISTORIC
OK 1993 82.9 D
OK 1995 86.9 C
OK 2000 84.7 C
OK 2005 81.4 D
OK 2009 80.4 D
STATE REGION
CENTRAL 82.4 84.4 C
NE 80.0 77.0 F
NW 82.7 84.3 C
SE 73.9 76.1 F
SW 79.1 79.1 F
TULSA 85.5 81.6 D
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
teen fertility
(age 15-17)
(RATE PER 1,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 21.4 22.1 C
NEW HAMPSHIRE (best) 7.0 7.6 A
OKLAHOMA 27.8 30.4 D
MISSISSIPPI (worst) 39.6 40.5 F
AGE IN YEARS
18 - 24 NA NA
25 - 34 NA NA
35 - 44 NA NA
45 - 54 NA NA
55 - 64 NA NA
65 + NA NA
GENDER
MALE NA NA
FEMALE NA NA
RACE/ETHNICITY
WHITE (NH) 22.3 21.5 C
BLACK (NH) 42.9 42.3 F
AMER INDIAN (NH) 39.7 45.8 F
HISPANIC 69.1 65.9 F
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 37.8 F
OK 1995 38.9 F
OK 2000 32.1 D
OK 2005 27.1 D
OK 2007 30.4 D
STATE REGION
CENTRAL 31.0 32.3 D
NE 27.8 27.5 D
NW 24.5 25.0 C
SE 38.9 37.4 F
SW 27.7 31.2 D
TULSA 32.3 28.9 D
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 3 9
• There were 2,293 births to Oklahoma teens aged 15-17 years in 2007.2
• Hispanic females had the highest teen birth rate (age 15-17) at 65.9 births per
1,000 females.2
• Non-Hispanic white females had the lowest teen birth rate (age 15-17) at 21.5
births per 1,000 females.2
• Fifty-five of Oklahoma’s 77 counties had a higher teen birth rate (age 15-17)
than the national average.2
• Grant and Woods Counties were Oklahoma’s only counties to receive an “A”
for their low teen birth rate (age 15-17).2
• The increase in teen birth rates in 2006-2007 ended a 15-year decline in teen
birth rates in Oklahoma.2
• Teen childbearing (less than age 20) cost Oklahoma taxpayers approximately
$149 million in 2004.3
• In Oklahoma, the average annual cost associated with a child born to a mother
less than age 18 was $3,807, which was higher than the surrounding states of
Arkansas, Louisiana, New Mexico, and Texas.3
• One in three teenage girls in the U.S. becomes pregnant at least once before
the age of 20.3
1 Martin JA, Hamilton BE, Sutton PD, et al. Births: Final data for 2007. National Vital Statistics Reports; vol
58 no 24. Hyattsville, MD: National Center for Health Statistics. 2010.
2 Oklahoma State Department of Health, Center for Health Statistics, Vital Records Division. OK2SHARE On-line
Database (access 12/28/10).
3 Hoffman, S. (2006). By the Numbers: The Public Costs of Teen Childbearing. Washington, DC: National
Campaign to Prevent Teen Pregnancy.
Oklahoma had the seventh highest (worst) teen birth rate in the nation
for teens aged 15-17 years in 2007.1
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
first trimester prenatal
care
(PERCENT) 2006 2007
STATE COMPARISON
US 83.2 83.2
OKLAHOMA 75.6 76.3
AGE IN YEARS
18 - 24 71.1 71.7
25 - 34 80.3 81.2
35 - 44 81.5 80.6
45 - 54 NA NA
55 - 64 NA NA
65 + NA NA
GENDER
MALE NA NA
FEMALE NA NA
RACE/ETHNICITY
WHITE (NH) 79.5 80.6
BLACK (NH) 69.8 70.7
AMER INDIAN (NH) 70.6 68.5
HISPANIC 64.6 65.5
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS 61.7 62.5
HS 74.3 74.1
HS+ 80.4 81.6
COLLEGE GRADUATE 90.1 90.9
HISTORIC
OK 1990 72.1
OK 1995 78.0
OK 2000 78.7
OK 2005 77.2
OK 2007 76.3
STATE REGION
CENTRAL 77.8 81.0
NE 75.0 74.0
NW 76.8 79.4
SE 78.1 75.2
SW 78.9 81.7
TULSA 68.9 67.0
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 4 0
Early prenatal care (PNC) is an important part of a healthy pregnancy.
• In Oklahoma, 75 percent of expecting mothers entered care during the first
trimester — well below the Healthy People 2010 objective of 90 percent.1
• First trimester PNC was most common among women age 25+.
• Young mothers (age 18-24) were 12 percent less likely than mothers age 25-
34 to receive early PNC.
• All racial/ethnic groups had substantially lower rates of first trimester PNC
than non-Hispanic whites with the greatest disparity occurring between non-
Hispanic whites (80.6 percent) and Hispanics (65.5 percent).
• First trimester PNC increased with a mother’s education; 91 percent of college
educated women entered prenatal care during the first trimester compared to
63 percent of women without a high school diploma.
• Eighty-one percent of pregnant women in the central and southwest regions
received first trimester PNC, compared to 67 percent in the Tulsa region.
• The percent of mothers receiving first trimester PNC increased from 72
percent in 1990 to 78 percent in 2000, but has since dropped slightly to 76
percent.
• Non-Hispanic American Indian women receiving first trimester PNC dropped 3
percent between 2006 and 2007.
• Between 2006 and 2007, women receiving first trimester PNC in the central
region increased 4 percent, whereas the southeast region dropped 4 percent.
1 U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and
Improving Health and Objectives for Improving Health. 2 vols. Washington, D.C.: U.S. Government Printing
Office, Nov. 2000.
NOTE: The Standard Live Birth Certificate has undergone a major revision which includes a change in how
Entry into PNC was collected. The new certificate is being gradually implemented across all states, and as
a result, the data is not comparable across states. In 2007, the National Center for Health Statistics only
reported rates for those 22 states that asked the new question and did not release a rate for the United
States. Oklahoma began data collection using the new question in April 2009.
For the purposes of this report Oklahoma data is available using the old question. National comparison/
ranking data is not available, so unfortunately grades could not be calculated.
Old: Month Pregnancy Prenatal Care began [First, Second, Third, etc. New: Date of First Prenatal Care visit
mm/dd/yy ].
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
low birth weight
(PERCENT) 2006 2007 2007 GRADE
STATE COMPARISON
US 8.3 8.2 C
ALASKA (best) 6.0 5.7 A
OKLAHOMA 8.3 8.2 C
MISSISSIPPI (worst) 12.4 12.3 F
AGE IN YEARS
18 - 24 8.6 8.6 C
25 - 34 7.8 7.4 B
35 - 44 9.7 9.6 D
45 - 54 NA NA
55 - 64 NA NA
65 + NA NA
GENDER
MALE 7.8 7.5 B
FEMALE 9.0 8.8 C
RACE/ETHNICITY
WHITE (NH) 7.9 7.8 C
BLACK (NH) 15.5 14.8 F
AMER INDIAN (NH) 7.2 7.5 B
HISPANIC 6.6 6.2 B
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS 9.4 9.4 D
HS 8.7 8.6 C
HS+ 8.3 7.1 B
COLLEGE GRADUATE 6.6 6.8 B
HISTORIC
OK 1990 6.5 B
OK 1995 6.9 B
OK 2000 7.5 B
OK 2005 8.0 C
OK 2007 8.2 C
STATE REGION
CENTRAL 8.9 8.4 C
NE 7.4 8.1 C
NW 7.0 7.8 C
SE 8.4 8.0 C
SW 9.4 8.0 C
TULSA 8.5 8.3 C
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 4 1
• Babies are termed low birth weight (LBW) if they are born weighing less than
2500 grams (5.5 pounds).
• The percentage of LBW births has increased 26 percent since 1990.
• The prevalence of LBW was 17 percent higher for girls than for boys.
• Women age 35+ had the highest rate of LBW births.
• Newborns of Hispanic women (6.2 percent) were less likely to be born at LBW
than other racial/ethnic groups or any other demographic group.
• One in 7 non-Hispanic black infants was LBW — nearly two times the rate of all
other groups.
• All racial/ethnic groups except for non-Hispanic American Indians had a
decrease in their LBW rate since 2006. Non-Hispanic black women had the
greatest decrease (4.5 percent).
• College graduates were 27 percent less likely than those without a high school
education to have a LBW infant.
• The biggest change since 2006 was a decrease of LBW rates by 14 percent
among women with more than a high school education.
• Despite their grade being the same (C), LBW rates ranged from 7.8 percent in
the northwest region to 8.5 percent in the central region.
• The southwest region had the biggest decrease in LBW since 2007 (15
percent), while the largest increase was recorded for the northwest region
(11 percent).
Approximately eight percent of babies born in Oklahoma are low birth
weight, ranking Oklahoma 27th in the U.S.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
dental visits (adults)
(PERCENT) 2006 2008 2008 GRADE
STATE COMPARISON
US 70.3 71.3 C
CONNECTICUT (best) 80.5 80.3 A
OKLAHOMA (worst) 58.0 57.9 F
AGE IN YEARS
18 - 24 59.3 50.2 F
25 - 34 56.8 58.0 F
35 - 44 59.8 61.0 F
45 - 54 61.5 58.9 F
55 - 64 57.2 60.1 F
65 + 52.9 56.4 F
GENDER
MALE 56.7 54.3 F
FEMALE 59.2 61.4 F
RACE/ETHNICITY
WHITE (NH) 60.4 60.8 F
BLACK (NH) 48.2 49.0 F
AMER INDIAN (NH) 53.6 52.5 F
HISPANIC 52.1 52.1 F
INCOME
< $15k 30.6 35.9 F
$15k - 25k 42.3 38.9 F
$25k - 49k 60.9 57.2 F
$50k - 75k 70.3 73.1 C
$75k + 80.1 76.9 B
EDUCATION
< HS 34.4 37.0 F
HS 52.2 51.5 F
HS+ 61.4 59.8 F
COLLEGE GRADUATE 76.8 74.4 B
HISTORIC
OK 1990 NA
OK 1995 NA
OK 1999 62.3 F
OK 2004 61.3 F
OK 2008 57.9 F
STATE REGION
CENTRAL 61.7 60.5 F
NE 53.4 55.9 F
NW 58.1 61.5 F
SE 52.4 51.8 F
SW 59.7 60.7 F
TULSA 61.9 58.6 F
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 4 2
• Oklahoma ranked worst (51st) in the U.S. for the lowest percentage of adults
visiting a dentist in the past year.1
• Since 1999, the percentage of adults with a dental visit decreased 7 percent.
Most of this decline was since 2004.
• In 2008, women were 13 percent more likely than men to visit the dentist.
This gap has increased since 2006 when the gap was just 4 percent.
• Non-Hispanic whites were most likely to have visited the dentist compared
other race/ethnic groups.
• Higher levels of education and income were associated with being more likely
to have visited a dentist within the past year.
• Adults with incomes under $15,000 per year (36 percent) and without a high
school education (37 percent) were least likely to have had a dental visit.
• Young adults (age 18-24) were least likely to have had a routine dental visit
compared to other age groups. Only half of this age group saw a dentist in the
past year.
• The southeast region had the lowest rate (52 percent), followed by the
northwest region (56 percent).
1 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2008.
Fifty-eight percent of Oklahoma adults reported a dental visit in the
previous year.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
usual source of care
(PERCENT) 2007 2009 2009 GRADE
STATE COMPARISON
US 79.1 81.0 C
NEW HAMPSHIRE (best) 88.0 89.9 A
OKLAHOMA 79.1 77.6 D
ALASKA (worst) 72.1 67.6 F
AGE IN YEARS
18 - 24 60.8 53.6 F
25 - 34 67.3 64.8 F
35 - 44 77.2 76.2 D
45 - 54 83.1 82.0 C
55 - 64 87.9 88.1 B
65 + 93.8 93.3 A
GENDER
MALE 75.4 72.7 F
FEMALE 82.6 82.2 C
RACE/ETHNICITY
WHITE (NH) 82.3 81.2 C
BLACK (NH) 71.9 72.6 F
AMER INDIAN (NH) 82.5 78.1 D
HISPANIC 53.3 48.4 F
INCOME
< $15k 69.6 67.5 F
$15k - 25k 68.1 67.5 F
$25k - 49k 80.4 79.1 C
$50k - 75k 86.4 84.4 B
$75k + 88.7 85.9 B
EDUCATION
< HS 63.9 60.5 F
HS 75.1 73.9 D
HS+ 83.0 81.2 C
COLLEGE GRADUATE 87.8 85.7 B
HISTORIC
OK 1990 NA
OK 1995 NA
OK 2001 80.8 C
OK 2005 78.4 C
OK 2009 77.6 D
STATE REGION
CENTRAL 75.7 76.2 D
NE 80.5 78.0 D
NW 82.8 78.8 C
SE 78.2 78.2 D
SW 80.6 79.4 C
TULSA 80.0 77.0 D
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 4 3
• People with one or more personal health care providers are more likely to
receive routine preventive health care services.2
• Both the U.S. and state rates have remained relatively steady since 2001.1
The Oklahoma rate declined 4 percent since peaking at 80.2 percent in 2002.
• The percentage of Oklahoma adults with a usual source of care increased with
age and was higher among women and non-Hispanic whites.
• Less than half of Oklahoma’s Hispanic population had a usual source of health
care.
• Having a usual source of care was more common as income and education
increased.
• Overall, Oklahoma declined slightly since 2007 with the largest decline of 11.8
percent for 18-24 year olds followed by a decline of 9.2 percent for Hispanics.
Other drops were seen among American Indians and those without a high
school diploma.
1 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2001-2009.
2 Corbie-Smith G, Flagg EW, Doyle JP, and O’Brien MA. (2002). Influence of usual source of care on
differences by race/ethnicity in receipt of preventive services. Journal of General Internal Medicine.
17:458-464.
Oklahoma ranked 41st in the U.S. in the percentage of its population with a
usual source of health care.1
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
no insurance coverage
(RATE PER 100,000) 2007 2009 2009 GRADE
STATE COMPARISON
US 15.0 14.3 C
MASSACHUSETTS (best) 6.2 5.3 A
OKLAHOMA 20.1 19.8 D
TEXAS (worst) 25.7 25.2 F
AGE IN YEARS
18 - 24 36.4 43.7 F
25 - 34 29.7 30.6 F
35 - 44 23.6 21.7 F
45 - 54 18.2 16.8 D
55 - 64 15.1 13.5 C
65 + 2.5 1.6 A
GENDER
MALE 20.6 19.5 D
FEMALE 19.7 20.0 D
RACE/ETHNICITY
WHITE (NH) 16.3 16.6 D
BLACK (NH) 32.3 25.6 F
AMER INDIAN (NH) 18.2 20.4 D
HISPANIC 51.0 50.7 F
INCOME
< $15k 38.7 40.7 F
$15k - 25k 38.0 36.5 F
$25k - 49k 17.9 18.5 D
$50k - 75k 8.7 6.8 A
$75k + 3.2 4.9 A
EDUCATION
< HS 37.7 42.1 F
HS 25.8 22.9 F
HS+ 17.2 18.8 D
COLLEGE GRADUATE 7.2 7.6 A
HISTORIC
OK 1991 19.7 D
OK 1995 14.9 C
OK 2000 16.9 D
OK 2005 20.2 D
OK 2009 19.8 D
STATE REGION
CENTRAL 23.6 18.9 D
NE 18.7 19.9 D
NW 16.3 19.0 D
SE 23.3 23.0 F
SW 16.0 18.3 D
TULSA 18.8 20.0 D
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 4 4
• Oklahoma’s adult uninsured rate was almost 40 percent higher than the U.S
rate.1
• Not having health care coverage is a barrier to accessing medical care.2
• Individuals without health insurance are less likely to receive preventive care,
are more likely to delay treatment, and contribute to rising health care costs.2
• Oklahoma’s uninsured rates improved as age, income, and education levels
increased.
• Half of Oklahoma’s Hispanic population were uninsured in 2009.
• Oklahoma’s southeast region had the highest rate of uninsured in the state.
• The rate of uninsured had a relative increase of 20 percent among 18-24 year
olds, 53 percent for individuals with a household income of $75,000+, and 17
percent for those in the northwest region.
• The rate of uninsured decreased 21 percent among blacks, 22 percent for
individuals with a household income of $50,000-$74,999, and 20 percent for
those in the central region.
1 Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, 2009.
2 Kaiser Commission on Medicaid and the Uninsured. Sicker and Poorer: The Consequences of Being
Uninsured. Menlo Park, CA: The Henry J. Kaiser Family Foundation. May 2002. Available at <http://
www.kff.org/uninsured/upload/Full-Report.pdf>.
Oklahoma has the 48th highest rate of uninsured adults in the U.S.
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 4 5
• In 2008, Oklahoma ranked 41st worst in the U.S. in the percentage of
residents living in poverty.1
• The percentage of Oklahomans living in poverty was 19 percent worse than
the U.S. rate.1
• The U.S. Census Bureau establishes poverty thresholds which reflect the point
under which people lack the basic resources necessary to have a healthy
standard of living.2
• Those living in poverty are more likely to engage in unhealthy behaviors, be
exposed to environmental hazards, and have limited access to health care
services.3
• Oklahoma’s women, younger adults, and non-whites had the highest rates of
poverty in 2008.
• Oklahoma’s poverty rate improved as education levels increased.
• Oklahoma’s southeast region had the highest rate of poverty in the state.
• The percentage of those living in poverty improved 16 percent among
American Indians, 9 percent among Hispanics, and 12 percent among those in
the southwest region.
1 U.S. Census Bureau. 2008 American Community Survey. Available at <http://factfinder.census.gov/home/
saff/main.html?_lang=en>.
2 U.S. Census Bureau. How the Census Bureau Measures Poverty. Available at <http://www.census.gov/
hhes/www/poverty/methods/definitions.html>.
3 National Center for Health Statistics. Health, United States, 2009: With Special Feature on Medical
Technology. Hyattsville, MD. 2010.
One in 6 Oklahomans lives in poverty.
poverty
(RATE PER 100,000) 2007 2008 2008 GRADE
STATE COMPARISON
US 13.0 13.2 C
NEW HAMPSHIRE (best) 7.1 7.8 A
OKLAHOMA 15.9 15.7 D
MISSISSIPPI (worst) 20.6 20.8 F
AGE IN YEARS
18 - 24 25.1 24.5 F
25 - 34 16.6 16.6 D
35 - 44 12.2 12.6 C
45 - 54 10.9 10.3 B
55 - 64 9.8 9.9 B
65 + 10.1 10.9 B
GENDER
MALE 14.2 14.1 C
FEMALE 17.5 17.7 F
RACE/ETHNICITY
WHITE (NH) 12.5 12.7 C
BLACK 27.4 28.6 F
AMER INDIAN 23.6 19.8 F
HISPANIC 29.0 26.3 F
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS 26.7 25.8 F
HS 13.6 14.0 C
HS+ 9.1 9.6 B
COLLEGE GRADUATE 4.2 4.4 A
HISTORIC
OK 1990 16.7 D
OK 1995 16.7 D
OK 2000 14.7 C
OK 2005 16.5 D
OK 2008 15.9 D
STATE REGION
CENTRAL 14.6 14.9 D
NE 17.5 16.5 D
NW 14.0 12.9 C
SE 21.6 20.1 F
SW 18.9 16.6 D
TULSA 14.2 13.6 C
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH = Non-Hispanic
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 4 6
• Approximately 100 Oklahomans die every year from work-related injuries.2
• Deaths occurred most commonly among 35-54 year olds.3
• Almost all (93 percent) work-related deaths in Oklahoma were among males.3
• The leading causes of work-related deaths included motor vehicle crashes (37
percent), machinery (16 percent), and falls from elevation (12 percent).3
• Other common causes of work-related deaths included homicide/assault,
being struck/crushed by an object, electrocution, and fire/explosion.3
• Occupations resulting in the greatest number of fatalities were truck driving/
delivery (24 percent), followed by farming/ranching (17 percent) and
construction (10 percent).3
• Work-related incidents most commonly occurred in the summer months.3
• Incidents most commonly occurred between noon and 4:00 p.m.3
• Death rates were highest in western Oklahoma.
1 United Health Foundation. America’s Health Rankings - 2010 Edition. December 2010. Available at
<http://www.americashealthrankings.org/measure/2010/List percent20All/Occupational
percent20Fatalities.aspx>.
2 United States Department of Labor, Bureau of Labor Statistics. Census of Fatal Occupational Injuries -
Current and Revised Data. August 2010. Available at <http://www.bls.gov/iif/oshcfoi1.htm>.
3 Oklahoma State Department of Health, Injury Prevention Service. Work-Related Deaths in Oklahoma, 1998
- 2007. Retrieved from <http://www.ok.gov/health/documents/Work-related percent20Deaths
percent20color.pdf>.
Oklahoma ranks 44th in the U.S. in occupational fatalities.1
occupational fatalities
(RATE PER 100,000) 2006 2007 2007 GRADE
STATE COMPARISON
US 2.2 2.1 C
RHODE ISLAND (best) 1.2 0.6 B
OKLAHOMA 3.8 3.6 D
WYOMING (worst) 8.7 11.4 F
AGE IN YEARS
15 - 24 1.5 3.2 D
25 - 34 2.9 3.5 D
35 - 44 5.5 4.9 F
45 - 54 3.8 4.7 F
55 - 64 6.0 3.0 D
65 + 3.6 2.3 C
GENDER
MALE 6.9 6.8 F
FEMALE 0.8 0.6 B
RACE/ETHNICITY
WHITE (NH) 3.9 3.4 D
BLACK (NH) 1.9 2.8 C
AMER INDIAN (NH) 3.5 4.7 F
HISPANIC 4.3 5.8 F
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1991 2.5 C
OK 1995 7.0 F
OK 2000 2.9 C
OK 2005 4.2 D
OK 2007 3.6 D
STATE REGION
CENTRAL 2.3 2.7 C
NE 4.1 2.3 C
NW 7.5 5.9 F
SE 4.0 4.8 F
SW 4.3 6.5 F
TULSA 2.9 2.6 C
Note: A “-” is used to denote <5 events in mortality fields and
<5 observations or <50 in the sample population for BRFSS
data, which result in unstable rates. NH= Non-Hispanic
(RATE PER 100,000) 2007 2008
STATE COMPARISON
US 1878.5 1762.6
best NA
OKLAHOMA 2138.3 2120.9
worst NA
AGE IN YEARS
18 - 39 449.6 430.2
40 - 64 1595.9 1588.7
65 -74 4760.3 4634.6
75 + 9935.4 9917.8
GENDER
MALE 1782.6 1745.9
FEMALE 2475.6 2476.8
RACE/ETHNICITY
WHITE 2378.8 2368.2
BLACK 2654.0 2508.5
AMER INDIAN 1586.9 1570.3
HISPANIC 497.8 550.4
INCOME
< $15k NA NA
$15k - 25k NA NA
$25k - 49k NA NA
$50k - 75k NA NA
$75k + NA NA
EDUCATION
< HS NA NA
HS NA NA
HS+ NA NA
COLLEGE GRADUATE NA NA
HISTORIC
OK 1990 NA
OK 1995 NA
OK 2000 NA
OK 2005 NA
OK 2008 2120.9
STATE REGION
CENTRAL 1709.2 1716.7
NE 2101.9 2129.5
NW 2044.6 2100.6
SE 2766.3 2710.2
SW 2618.7 2499.0
TULSA 1862.6 1784.5
preventable
hospitalizations
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 4 7
• Preventable hospitalizations are hospital stays that may have been avoided
with timely and effective outpatient care and self-management.1
• The U.S. spent $30.8 billion in potentially avoidable hospital costs in 2006.2
• If low income area residents were hospitalized at the same rate as high
income area residents, the U.S. would have saved $4 billion in 2007.3
• Oklahoma and other southern U.S. states had the highest rates of
hospitalization for most of the preventable chronic and acute conditions.4
• Oklahoma had 57,512 preventable hospitalizations in 2008 — this translates
to more than $1 billion in hospital charges.
• The highest rate of preventable hospitalization occurred among patients 75
years of age and older.
• Counties in the Tulsa area and in central Oklahoma had the lowest rates of
preventable hospitalizations.
• Patients who actively participate in their care and adopt healthy lifestyle
behaviors may avoid some hospital admissions.1
• Comprehensive, coordinated outpatient care has been shown to reduce
preventable hospitalizations.4
1 Kruzikas, DT, Jiang, HJ, Remus, D, Barrett, ML, Coffey, RM, Andrews, R. (2004). Preventable
Hospitalizations: A Window Into Primary and Preventive Care, 2000. HCUP Fact Book No. 5; AHRQ
Publication No. 04-0056. U.S. Agency for Healthcare Research and Quality, Rockville, MD.
2 Jiang, HJ, Russo, CA, Barrett, ML.. (2009). Nationwide Frequency and Costs of Potentially Preventable
Hospitalizations, 2006. HCUP Statistical Brief #72. April 2009. U.S. Agency for Healthcare Research
Quality, Rockville, MD.
3 Moy, E, Barrett, M, Ho, K. (2011). Potentially Preventable Hospitalizations - United States, 2004-2007.
MMWR Supplements. January 14, 2011/60(01); 80-83.
4 Agency for Healthcare Research and Quality. (2009). Healthcare Innovations Exchange - U.S. Agency for
Healthcare Research Quality, Rockville, MD.
NOTE: Rates of preventable hospitalizations were calculated using procedures developed by the Agency for
Healthcare Research and Quality (AHRQ). The Healthcare Cost and Utilization Project (HCUP) creates a
Nationwide Inpatient Sample (NIS), which is the largest all-payer inpatient care database in the country. In
2008, the NIS consisted of approximately 8 million records from 1,056 hospitals located in 42 states. HCUP
publicly releases the data as a national estimate, but not on a state-by-state basis. National comparison/
ranking data is not available, so unfortunately grades could not be calculated.
Preventable hospitalizations give insight into primary and preventive care.
county report cards
2 0 1 1 S TAT E O F T H E S TAT E ’ S H E A LT H R E P O R T 4 8
Note: A “-” is used to denote <5 events in mortality fields and <5 observations
or <50 in the sample population for BRFSS data, which result in unstable rates.
Mortality and Leading Causes of Death
• Adair County’s infant mortality was the fifth lowest in the
state, about 40 percent lower than the state rate.
• Adair County ranked 73rd out of Oklahoma’s 77 counties in
age-adjusted total mortality.
• Heart disease was the leading cause of death in Adair
County, followed by cancer, diabetes, chronic lower
respiratory disease, and unintentional injury.
• Deaths from influenza/pneumonia and suicide were not as
common in Adair County, and rates were lower than the state
rate.
• Adair County ranked 75th out of 77 counties for deaths due
to diabetes and 75th for cancer deaths.
Disease Rates
• Adair County had a very high prevalence of diabetes, 53
percent higher than the state’s prevalence.
Risk Factors, Behaviors and Socioeconomic Factors
• Adair County had the worst ranking in the state for fruit/
vegetable consumption and senior flu vaccination.
• Adair County ranked second to last in the state for senior
pneumonia vaccination, and ranked near the bottom of the
counties for obesity, teen fertility, and percentage of
residents living in poverty.
Changes from Previous Report
• The infant mortality rate and mortality from influenza/
pneumonia each decreased 31 percent.
• The prevalence of diabetes and obesity among adults
increased 91 percent and 22 percent, respectively.
• Adults consuming the recommended servings of fruits and
vegetables decreased 47 percent.
• The prevalence of smoking and asthma decreased 23 and 20
percent, respectively.
• The number of poor mental and physical health days
decreased 32 percent and 25 percent, respectively.
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 4 9
Adair County
PREVIOUS CURRENT GRADE
MORTALITY
INFANT (RATE PER 1,000) 7.5 5.2 B
TOTAL (RATE PER 100,000) 1073.1 1102.4 F
LEADING CAUSES OF DEATH
(RATE PER 100,000)
HEART DISEASE 265.2 273.2 F
CANCER 233.0 246.6 F
STROKE 43.8 45.9 D
CHRONIC LOWER RESPIRATORY
DISEASE 69.3 71.2 F
UNINTENTIONAL INJURY 64.1 62.4 F
DIABETES 86.0 92.7 F
INFLUENZA/PNEUMONIA 16.4 11.4 B
ALZHEIMER’S DISEASE 29.3 26.4 D
NEPHRITIS (KIDNEY DISEASE) 28.0 31.4 F
SUICIDE 11.5 11.3 C
DISEASE RATES
DIABETES PREVALENCE 8.8% 16.8% F
ASTHMA PREVALENCE 11.8% 9.4% C
CANCER INCIDENCE 514.8 482.4 C
(RATE PER 100,000)
RISK FACTORS & BEHAVIORS
FRUIT/VEGETABLE CONSUMPTION 12.9% 6.9% F
NO PHYSICAL ACTIVITY 37.5% 32.6% F
SMOKING 32.8% 25.4% F
OBESITY 32.1% 39.1% F
IMMUNIZATIONS < 3 YEARS 79.8% 79.3% B
SENIORS FLU VACCINATION 64.0% 59.0% F
SENIORS PNEUMONIA VACCINATION 52.9% 54.8% F
LIMITED ACTIVITY DAYS (AVG) 6.9 6.0 F
POOR MENTAL HEALTH DAYS (AVG) 3.7 2.5 A
POOR PHYSICAL HEALTH DAYS (AVG) 5.2 3.9 C
GOOD OR BETTER HEALTH RATING 73.3% 81.4% D
TEEN FERTILITY (RATE PER 1,000) 47.8 43.5 F
FIRST TRIMESTER PRENATAL CARE 71.7% 72.0%
LOW BIRTHWEIGHT 8.1% 8.2% C
ADULT DENTAL VISITS 44.1% 51.2% F
USUAL SOURCE OF CARE 77.9% 73.6% D
SOCIOECONOMIC FACTORS
NO INSURANCE 18.9% 16.8% D
POVERTY 22.4% 22.9% F
Note: A “-” is used to denote <5 events in mortality fields and <5 observations
or <50 in the sample population for BRFSS data, which result in unstable rates.
Mortality and Leading Causes of Death
• Alfalfa County ranked second out of Oklahoma’s 77 counties
in age-adjusted total mortality.
• Alfalfa County’s leading cause of death was heart disease,
followed by cancer and unintentional injury.
• Alfalfa County had one of the lowest mortality rates for cancer
and chronic lower respiratory disease in the state.
• Alfalfa County had one of the state’s highest rates of mortality
due to influenza/pneumonia.
Disease Rates
• Alfalfa County’s cancer incidence was slightly higher than the
state and national rates.
Risk Factors, Behaviors and Socioeconomic Factors
• Because Alfalfa County is small, rates for most risk factors
and behaviors were unavailable.
• Alfalfa County had a low birth rate among teens aged 15-17
years, 52 percent lower than the state’s rate.
• The percent of Alfalfa County’s female residents seeking
prenatal care during their first trimester was similar to the
state’s rate.
• Alfalfa County’s poverty rate was 8 percent higher than the
state’s poverty rate.
Changes from Previous Report
• Mortality rates increased 13 percent for cancer and 32
percent for diabetes.
• The mortality rate for stroke decreased 19 percent.
• The rate of births to teens aged 15-17 years decreased
14 percent.
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 5 0
Alfalfa County
PREVIOUS CURRENT GRADE
MORTALITY
INFANT (RATE PER 1,000) - - A B D F
TOTAL (RATE PER 100,000) 758.4 764.7 C
LEADING CAUSES OF DEATH
(RATE PER 100,000)
HEART DISEASE 207.3 219.0 D
CANCER 138.4 156.4 B
STROKE 57.0 46.2 D
CHRONIC LOWER RESPIRATORY
DISEASE 38.5 40.5 C
UNINTENTIONAL INJURY 67.5 71.7 F
DIABETES 26.3 34.6 F
INFLUENZA/PNEUMONIA 36.2 40.0 F
ALZHEIMER’S DISEASE 7.2 -
NEPHRITIS (KIDNEY DISEASE) 20.1 20.4 D
SUICIDE 6.5 -
DISEASE RATES
DIABETES PREVALENCE - -
ASTHMA PREVALENCE - -
CANCER INCIDENCE 537.9 521.0 D
(RATE PER 100,000)
RISK FACTORS & BEHAVIORS
FRUIT/VEGETABLE CONSUMPTION - -
NO PHYSICAL ACTIVITY - -
SMOKING - -
OBESITY - -
IMMUNIZATIONS < 3 YEARS 70.0% 66.7% C
SENIORS FLU VACCINATION - -
SENIORS PNEUMONIA VACCINATION - -
LIMITED ACTIVITY DAYS (AVG) - -
POOR MENTAL HEALTH DAYS (AVG) 3.4 -
POOR PHYSICAL HEALTH DAYS (AVG) 6.1 -
GOOD OR BETTER HEALTH RATING - -
TEEN FERTILITY (RATE PER 1,000) 17.1 14.7 B
FIRST TRIMESTER PRENATAL CARE 72.8% 75.7%
LOW BIRTHWEIGHT 8.5% 8.5% C
ADULT DENTAL VISITS - -
USUAL SOURCE OF CARE - -
SOCIOECONOMIC FACTORS
NO INSURANCE - -
POVERTY 16.0% 17.0% D
Note: A “-” is used to denote <5 events in mortality fields and <5 observations
or <50 in the sample population for BRFSS data, which result in unstable rates.
Mortality and Leading Causes of Death
• Atoka County’s infant mortality rate was higher than the state
and national rates by 13 percent and 43 percent,
respectively.
• Atoka County had a mortality rate that was 11 percent higher
than the national rate but was low for the state, ranking tenth
out of Oklahoma’s 77 counties in age-adjusted total mortality.
• Atoka County’s leading causes of death were heart disease,
cancer, and unintentional injury.
• Atoka County had few deaths attributed to influenza/
pneumonia and Alzheimer’s disease.
Disease Rates
• Atoka County’s prevalence of diabetes was one of the highest
in the state, 76 percent higher than the state’s rate.
• Atoka County’s incidence of cancer was 17 percent lower
than the state rate, ranking the county sixth lowest (best) in
the state.
Risk Factors, Behaviors and Socioeconomic Factors
• Atoka County ranked as one of the worst counties in the state
for fruit/vegetable consumption, senior influenza vaccination,
number of poor mental health days, number of poor physical
health days, and self-health rating .
• More than 1 in 4 adult residents in Atoka did not have health
care coverage.
• One in 5 Atoka County residents lived in poverty.
Changes from Previous Report
• The diabetes mortality rate increased 43 percent.
• Mortality attributed to nephritis decreased 30 percent.
• The prevalence of diabetes among adults increased 128
percent.
• The average number of poor mental days and poor physical
health days increased 27 percent and 34 percent,
respectively.
• Adults without health care coverage declined 25 percent (i.e.,
more adults had coverage).
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 5 1
Atoka County
PREVIOUS CURRENT GRADE
MORTALITY
INFANT (RATE PER 1,000) 10.0 9.7 F
TOTAL (RATE PER 100,000) 890.4 844.6 D
LEADING CAUSES OF DEATH
(RATE PER 100,000)
HEART DISEASE 281.8 274.6 F
CANCER 180.6 178.4 C
STROKE 59.9 53.8 F
CHRONIC LOWER RESPIRATORY
DISEASE 62.2 55.7 F
UNINTENTIONAL INJURY 65.1 61.2 F
DIABETES 26.1 37.4 F
INFLUENZA/PNEUMONIA - -
ALZHEIMER’S DISEASE 10.2 -
NEPHRITIS (KIDNEY DISEASE) 23.3 16.2 C
SUICIDE 17.1 17.3 F
DISEASE RATES
DIABETES PREVALENCE 8.5% 19.4% F
ASTHMA PREVALENCE 10.1% -
CANCER INCIDENCE 390.4 414.0 A
(RATE PER 100,000)
RISK FACTORS & BEHAVIORS
FRUIT/VEGETABLE CONSUMPTION - 8.8% F
NO PHYSICAL ACTIVITY 32.3% 27.6% D
SMOKING 29.0% 21.1% D
OBESITY 30.2% 30.9% D
IMMUNIZATIONS < 3 YEARS 78.2% 75.5% B
SENIORS FLU VACCINATION - 64.5% F
SENIORS PNEUMONIA VACCINATION - 67.8% C
LIMITED ACTIVITY DAYS (AVG) 5.6 5.8 F
POOR MENTAL HEALTH DAYS (AVG) 5.2 6.6 F
POOR PHYSICAL HEALTH DAYS (AVG) 5.3 7.1 F
GOOD OR BETTER HEALTH RATING 77.8% 69.4% F
TEEN FERTILITY (RATE PER 1,000) 22.8 25.8 C
FIRST TRIMESTER PRENATAL CARE 78.4% 75.6%
LOW BIRTHWEIGHT 10.1% 10.1% D
ADULT DENTAL VISITS 51.4% 53.9% F
USUAL SOURCE OF CARE 87.7% 84.8% B
SOCIOECONOMIC FACTORS
NO INSURANCE 36.0% 27.1% F
POVERTY 22.8% 20.8% F
Note: A “-” is used to denote <5 events in mortality fields and <5 observations
or <50 in the sample population for BRFSS data, which result in unstable rates.
Mortality and Leading Causes of Death
• Beaver County ranked fourth out of Oklahoma’s 77 counties
in age-adjusted total mortality.
• Cancer was the leading cause of death in Beaver County,
followed heart disease, unintentional injury, and chronic
lower respiratory disease.
• Beaver County had the second lowest mortality rate for heart
disease and one of the highest rates for Alzheimer’s disease
deaths in the state.
• Beaver County had an unintentional injury mortality rate that
was more than double the national rate.
Disease Rates
• Beaver County’s prevalence of diabetes was higher than the
national rate, but lower than the state rate, ranking the
county 12th in the state.
• Beaver County’s incidence of cancer was 18 percent lower
than the state rate, ranking the county fifth lowest (best) in
the state.
Risk Factors, Behaviors and Socioeconomic Factors
• Beaver County had a low rate of current smoking, ranking the
county tenth in the state.
• Beaver County ranked fourth in the percentage of children
under 3 years of age that completed the primary
immunization series.
• Beaver County residents experienced few mentally and
physically unhealthy days.
• Beaver County’s rate of births to teens aged 15-17 years was
lower than both the state and national rates.
• Beaver County ranked sixth in the state for poverty, with
fewer than 11 percent of residents living in poverty. This rate
was better than the national rate.
Changes from Previous Report
• Mortality rates increased 44 percent for stroke and 39
percent for diabetes.
• The prevalence of diabetes and obesity increased 22 percent
and 43 percent, respectively.
• The prevalence of adult smokers declined 57 percent.
• Adults without health care coverage decreased 74 percent.
2 0 1 1 S T A T E O F T H E S T A T E ’ S H E A L T H R E P O R T l 5 2
Beaver County