Oklahoma’s health ranking: same song, another verse

graph 1The latest nationwide health ranking is out, and Oklahoma in its customary trailing position on national comparisons. United Health Foundation’s annual America’s Health Rankings report placed Oklahoma 46th in the US for the health of our people. This continues the state’s steady march downward since the group began compiling and releasing rankings. Since the rankings were first released in 1990, we’ve fallen to 46th from a solid 32.

So what’s going on? United Health Foundation bases the ranking on a wide range of variables, from prevalence of smoking to high school graduation rates. While Oklahoma’s indicators generally ranked badly, the report identified three primary areas of concern:

High rates of physical inactivity

While Oklahoma requires physical education (P.E.) in schools, we don’t require two important components necessary to make those classes effective: daily physical activity and health education. While physical education might be one or two classes in a high schooler’s career, a physical activity requirement would make sure students were active for a minimum amount of time every day. Some evidence even suggests it would boost students’ ability to learn.

Photo by  Mathieu Jarry used under a Creative Commons license.
Photo by Mathieu Jarry used under a Creative Commons license.

Similarly, a health education requirement would take the knowledge from the P.E. curriculum and apply that information to a broader understanding of a “culture of health,” including nutrition and preventive care. Oklahoma is one of only two states that don’t require health education. (The other is Colorado).

Low rates of childhood immunizations

Over one-third of Oklahoma children aged 19-35 months don’t receive all their recommended immunizations (DTaP, polio, MMR, Hib, Hepatitis B, chickenpox, PCV). Following a decade of steady progress, the immunization rate has cratered: the annual State of the State’s Health report awarded the state’s immunization rate a “D” in 2000, a “C” in 2005, a “B” in 2010, and an “F” in 2012.

It’s not clear why: whether parents are choosing not to vaccinate their children for medical, religious or philosophical reasons; because rising costs of vaccines mean parents have difficulty locating a doctor who provides immunizations; or because parents are simply unaware of the immunizations’ importance. But immunizations keep kids from catching, spreading, and dying of everything from the measles to pneumonia. Whatever the reason, increasing numbers of unvaccinated kids place many more at risk.

A shortage of primary care physicians

Oklahoma’s primary care shortage isn’t a new issue: we ran a guest post that made recommendations on the topic in 2012, and a research fellow took a swing at it last summer. Continuing to invest in the next generation of primary care physicians would build a better health care provider supply. More responsible fiscal planning could create a more stable state budget, which in turn would lessen the likelihood of further provider cuts. Finally, accepting federal funds to expand health coverage to low-income Oklahomans would be a net savings to the state and would inject billions in federal funds into our health care system. But policymakers haven’t instituted needed change, and so the problem persists.

All is not entirely gloomy: binge drinking and pertussis (whooping cough) are less prevalent here than in many other states, and the report noted the state’s relatively low prevalence of low birthweight babies (although the rate has worsened over the last decade). But by and large, America’s Health Rankings is a strong reminder that from smoking rates to preventable hospitalizations to high school graduation rates, Oklahomans are faring worse than most other Americans. We need to recognize that while our health rankings can’t get much worse, our health outcomes can – and without intervention, almost certainly will.


Carly Putnam joined OK Policy in 2013. As Policy Director, she supervises policy research and strategy. She previously worked as an OK Policy intern, and she was OK Policy's health care policy analyst through July 2020. She graduated from the University of Tulsa in 2013. As a student, she was a participant in the National Education for Women (N.E.W.) Leadership Institute and interned with Planned Parenthood. Carly is a graduate of the Oklahoma Center for Nonprofits Nonprofit Management Certification; the Oklahoma Developmental Disabilities Council’s Partners in Policymaking; The Mine, a social entrepreneurship fellowship in Tulsa; and Leadership Tulsa Class 62. She currently serves on the boards of Restore Hope Ministries and The Arc of Oklahoma. In her free time, she enjoys reading, cooking, and doing battle with her hundred year-old house.

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