Tackling the diabetes epidemic in Oklahoma (Guest Post: Breanca Thomas)

breanca thomasBreanca Thomas is a PhD student in Health Promotion Sciences in the College of Public Health at the University of Oklahoma Health Sciences Center and a 2013-14 OK Policy Research Fellow. She intends to pursue a research career focusing on effective methods of reducing health disparities among at-risk groups.

Diabetes is one of Oklahoma’s most serious health epidemics. Oklahoma has the seventh highest Type 2 diabetes rate in the country, and between  1995 and 2010, rates of diabetes rose by 226 percent. Diabetes develops when one’s body becomes insulin resistant, and cannot effectively regulate its blood sugar. If diabetes is not managed properly, it can lead to serious medical complications with poor circulation, vision, and kidney function. Oklahoma has a diabetes rate of about 11 percent, and the state has the fourth highest death rate from diabetes in the U.S. In 2011, $185 million was spent on diabetes-related hospital admissions in Oklahoma.

Though Oklahoma’s problem with diabetes is both financially and physically costly, solutions to this issue can be relatively complex. First, a major cause of diabetes is obesity;  80 percent of Type 2 diabetics are obese at the time of their diagnosis. About 30 percent of Oklahoma adults are obese, while 66 percent of Oklahoma adults are overweight or obese. Second, Oklahoma has a large population of low-income individuals. This group is at particular risk for diabetes because they often live in areas that lack access to affordable and healthy foods, and also have higher obesity rates than higher income groups.

Finally, Oklahoma has among the largest American Indian populations in the nation. This group tends to have a strong family history of diabetes, and to live in rural areas with low food security. The diabetes rate among American Indians in Oklahoma is 16.4 percent, compared to 10.3 percent for non-Hispanic Whites. African-Americans (13.5 percent) and multiracial individuals (16.2 percent) also experience high diabetes rates in Oklahoma. Combating diabetes in Oklahoma involves addressing these key groups—the obese and overweight, low-income, and racial/ethnic minorities— which often overlap with one another.

Reducing diabetes is simple in theory: studies show the cheapest and most effective methods for both preventing and managing diabetes are physical activity and healthy eating habits. However, diabetes is a population-wide issue in Oklahoma, and individual-level approaches may not suffice for Oklahoma’s widespread diabetes and obesity problems. Most Oklahoma adults and adolescents do not participate in recommended amounts of physical activity or fruit and vegetable consumption. Promoting these individual-level health behaviors involves developing interventions for small groups of at-risk individuals, or educating people about the importance of healthy eating. Even though these interventions often target the at-risk groups mentioned above, these interventions usually last for a limited amount of time, and do not involve most of the Oklahomans who need it.

Oklahoma has taken more widespread steps to both manage and prevent diabetes in the state. World Diabetes Day takes place annually at the State Capitol, and involves free diabetes screening and advice for healthy living. Through the Oklahoma State Department of Health, Oklahoma participates in programs supported by the Centers for Disease Control and Prevention (CDC), such as the Oklahoma Diabetes Control and Prevention Program and the CATCH Kids Club. Even though these programs support reduced rates of diabetes and obesity, similar programs are contingent on continued CDC funding.  

Since 2001, 29 different pieces of state legislation related to physical activity and nutrition have been passed in Oklahoma. They mostly involve resolutions that encourage healthy behaviors in Oklahoma communities and school districts. Some, like Safe Routes to School, require schools and districts to apply for grant funding or to develop their own program to participate in given programs, which may be problematic for rural areas with low capacity.

Oklahoma may consider more population-based methods to reduce diabetes. OK Policy has previously discussed issues of food security in Oklahoma. Healthier eating may be improved by increasing access to quality and healthy foods through programs like SNAP (Supplemental Nutrition Assistance Program, formerly food stamps), and encouraging grocery stores in low-income and rural areas to lower the pricing on fruits and vegetables. In terms of physical activity, studies have shown that individuals in low-SES neighborhoods are less likely to participate in physical activity and perceive more neighborhood crime and uncleanliness than high-SES areas. Low-income neighborhoods often lack recreational facilities, consistently placed sidewalks, so residents lack the ability to be physically active.

Oklahoma has taken steps to reduce the prevalence of these diabetes and obesity. However, solutions that remove barriers to the behaviors that lead to obesity and diabetes may be more effective than individual-level education alone, especially for at-risk groups.

The opinions stated above are not necessarily those of OK Policy, its staff, or its board. This blog is a venue to help promote the discussion of ideas from various points of view and we invite your comments and contributions. To see our guidelines for blog submissions, click here.


Former Executive Director David Blatt joined OK Policy in 2008 and served as its Executive Director from 2010 to 2019. He previously served as Director of Public Policy for Community Action Project of Tulsa County and as a budget analyst for the Oklahoma State Senate. He has a Ph.D. in political science from Cornell University and a B.A. from the University of Alberta. David has been selected as Political Scientist of the Year by the Oklahoma Political Science Association, Local Social Justice Champion by the Dan Allen Center for Social Justice, and Public Citizen of the Year by the National Association of Social Workers.

One thought on “Tackling the diabetes epidemic in Oklahoma (Guest Post: Breanca Thomas)

  1. I am a Type 2 diabetic who is sick of support groups, events and classes that cost money. Type 2 diabetics – especially newly diagnosed – need support and information, and not all can afford $100 or more for visits with professional nutritionists/dieticians. I am not a healthcare professional, but I figure there are enough of us to be able to share information, support each other, and perhaps even arrange (probably at cost, but with enough people cost would be minimal) to have a healthcare professional visit such a group. At any rate, we all have the same issues – some more than others: Encouragement, need to lose weight, concerns about meds, diet, exercise – the list goes on. So – does anyone know of such a free support group in OKC or Edmond? This group should not take the place of doctor visits, of course. And – thank you for all your good work, Breanca!

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