This post is the second of a two-part series on the state of women in Oklahoma based on the Center for American Progress’s report “The State of Women in America: A 50-State Analysis of How Women are Faring Across the Nation. (Click here for Part 1). Oklahoma ranked 48th out of 50 overall based on three categories: economic security, leadership, and the health of women and families. The state’s scores for women’s economic security and leadership weren’t terrible, but Oklahoma’s ranking for health of women and families – 50th out of 50 – pushed the state’s overall ranking downward. This post discusses the health of women and families and posits options going forward.
It’s not that Oklahoma was the absolute worst by all of the health indicators – it typically wasn’t – but that no other state consistently did as badly as Oklahoma. While eight other states reported higher infant mortality statistics than Oklahoma (Mississippi, Alabama, Tennessee, Ohio, Delaware, Indiana, and Louisiana), none of those same states were the two who outranked Oklahoma for maternal mortality (Michigan and Georgia). And none of those ten states were the single state that had more women per OB-GYN (Pennsylvania).
Also taken into account was Oklahoma’s decision to not accept federal Medicaid expansion under the Affordable Care Act given the number of nonelderly uninsured women in the state. Only three states reported more uninsured nonelderly women than Oklahoma (20.7 percent): Texas (24.7 percent), Florida (23.0 percent) and Nevada (22.1 percent). And while the state was ranked ninth for uninsured elderly African American women (21.3 percent), it placed fourth for uninsured elderly Hispanic women (34.5 percent).
Furthermore, although Oklahoma isn’t one of the most difficult states in which to obtain abortion care, it’s still far from accessible, as this recent article about a young Oklahoma couple seeking abortion care illustrates. There are substantial barriers between women and comprehensive reproductive health. According to the Guttmacher Institute, in 2008, 96 percent of counties in Oklahoma had no abortion provider, and 56 percent of Oklahoma’s women lived in those counties. The national average is 86 percent and 33 percent, respectively.
So what can be done?
It is simultaneously reassuring and alarming that none of the problems identified by the Center for American Progress should be unexpected. Many of the contributors to poor health outcomes identified have been known for some time; we discussed some of them at a statewide leadership summit on infant mortality last year. As such, a variety of solutions are available. A few are described below:
Accepting Medicaid expansion would provide enormous good for Oklahoma’s women and families. At present, Medicaid only covers low-income women while pregnant and shortly after giving birth, although according to the Center on Budget and Policy Priorities, “when women have health coverage before becoming pregnant as well as between pregnancies, they are healthier during pregnancy and their babies are more likely to be healthy at birth.” Expanding Medicaid in Oklahoma will mean better continuity of care and healthier families.
Similarly, the access to care provided by programs like WIC can be a lifeline for women and children in Oklahoma. WIC (Women, Infants, & Children) provides new and expecting mothers and their very young children access to nutritious food, diapers and healthcare; half of all babies in born in Oklahoma are on WIC, and WIC is a proven tool for alleviating infant mortality. However, WIC is vulnerable. We reported last year on the cancellation of the state’s WIC contract with Planned Parenthood, leaving 3,000 women and their children per month seeking care elsewhere. This is bad for the health of women and families, and makes poor economic sense – every dollar spent on prenatal care for low-income women saves $3.38 on infant medical care during the first year of life. Particularly in the wake of recent SNAP cuts, there is no scenario in which cutting WIC or making WIC benefits more difficult to access provides sustainable benefit.
The state’s OB-GYN shortage may be somewhat alleviated in the near future. The Affordable Care Act (ACA) earmarked $1.5 billion to address physician shortages, and local medical schools are implementing new recruitment tactics to identify local potential medical students and keep them in Oklahoma.
There are also smaller policy options that would positive effects on the health of women and families. Almost 17 percent of pregnant women in Oklahoma smoke, compared to 13 percent nationally, and infants exposed to secondhand smoke are at a higher risk of death. Smoking bans are both simple and effective, and would have strong positive effects on the health of women and children in Oklahoma.
Although the Center for American Progress’s analysis indicates that women are not faring well in Oklahoma, that same analysis reveals that solutions are both ready and applicable. Implementing common-sense policy proposals that improve health and access to healthcare for women and children will contribute to building a stronger and more successful Oklahoma.