This is the third of a seven part series by Oklahoma Policy Institute to propose public policy action items for the state of Oklahoma. These recommendations are aimed at improving the shared prosperity of all Oklahomans while maintaining a fiscally responsible state budget. The first installment made recommendations for tax reform, while the second installment addressed criminal justice reform. Future installments will focus on education, energy, financial security, and jobs.

Download the full issue brief here

Oklahomans are some of the unhealthiest people in America, now ranking 43^th overall in a national ranking of health indicators and outcomes. The latest rankings from the United Health Foundation shows that we’re on pace to have the highest rate of obesity in the nation within the next decade, our residents smoke at higher rates than most other states, and only Alabama and Mississippi have higher rates of cardiovascular disease deaths.  Persistent health disparities exist as well, with non-Hispanic blacks having a higher prevalence of tobacco use, sedentary lifestyles, and obesity. Over the past 10 years the infant mortality rate has declined in Oklahoma but black babies are still dying at more than double the rate of white babies.     

Our most pressing challenge is a gaping shortfall in primary care providers (PCPs), with just 80 PCPs for every 100,000 residents, 49^th worst in the country.  Without enough doctors, nurses, and other health care professionals at the frontlines delivering treatment, Oklahomans cannot improve, or even maintain, their health.  Access to affordable health care is another major barrier.  More than 600,000 residents are uninsured, about 19 percent of the state. 

Back in 2008, state leaders seemed serious about addressing the health crisis occurring in Oklahoma. The Oklahoma legislature passed Senate Joint Resolution 41, which charged the State Board of Health with preparing an improvement plan to address the “general improvement of the physical, social, and mental well-being of all people in Oklahoma through a high functioning public health system.”

The State Board of Health produced the Oklahoma Health Improvement Plan, which was a comprehensive plan to improve the health of all Oklahomans between 2010 and 2014. The plan envisioned that “Oklahomans will achieve optimal physical, mental, and social health and the state health status will be in the top quartile of states by 2014.

The improvement plan identified three priority areas which included flagship goals, infrastructure goals, and societal and policy integration. Flagship goals focus on tobacco use prevention, obesity reduction, and children’s health, while infrastructure goals calls attention to public health finance, access to care, and health system effectiveness. Lastly, societal and policy integration address policies and legislation as well as social determinants of health and health equity.

 This report identifies areas in which action can be taken to address Oklahoma’s health crisis.

Action Items

• Grow the supply of primary care providers: Specific measures to accomplish this include continuing the investments to primary care provider (PCP) programs and expand scope of practice and training programs  for non-physician PCPs to address the lack of access to PCPs in rural and underserved areas. The state could also take advantage of funding from Title V of the Affordable Care Act to increase the health care workforce and address quality of care issues that result from the workforce shortage.
• Invest in prevention of public health epidemics: The state can tackle unhealthy outcomes head on by supporting social and public programs that promote healthy lifestyles and by shifting the focus of the health care delivery system.
• Expand access to affordable health insurance: With the passage of the Patient Protection and Affordable Care Act (ACA), uninsured Oklahomans will now have access to affordable health insurance. The state of Oklahoma can contribute to the reduction in uninsured Oklahomans by redefining Medicaid eligibility guidelines to cover all Oklahomans with incomes less than 138 percent of the federal poverty level and creating an awareness campaign to ensure all Oklahomans eligible for Advanced Premium Tax Credits are knowledgeable of the health insurance marketplace in Oklahoma.

By implementing these policy reforms, Oklahoma will be moving forward towards improving health outcomes in our state. We already have the infrastructure in place, it’s now time to build upon that infrastructure through adequate funding and smart reforms.

To read the entire brief click here.

For more information and OK Policy publications about health care issues in Oklahoma click here.