Assessing Our Health and Social Services Structures
Human, health and social services provide the safety net that is essential to our society. Most Oklahomans agree that government has an essential role in ensuring that vulnerable individuals and families can meet their basic needs and are taken care of if they cannot care for themselves. Most also believe that government should promote healthy lifestyles and support a public health infrastructure that can reduce public and private costs.
Like all public institutions, health and social services have a long history. Limited efforts to care for the least fortunate were provided by local governments starting in the 18th century. In the 1800s, states became more involved in social services, particularly in caring for those with mental illness and veterans. Federal involvement grew through this period as well, providing pensions for war veterans and their widows. All of these programs evolved in the 20th century. Pensions expanded into the Social Security system. Relief efforts for the poor were expanded at every level of government in the 1920s and 1930s. At the same time, public investments in research, vaccinations, and public health campaigns were essential in fighting and eliminating some diseases, which contributed to the 20th century’s dramatic gains in average life expectancy.
Health and social services are accepted as an essential focus of government. At the state level we expect government to provide access to physical and mental health care, operate hospitals, promote health and regulate health care, investigate and combat disease outbreaks, and help look after those with disabilities, seniors, veterans, children, and others who cannot meet their basic needs without help.
Health and social services are essential to a healthy community and economy. By most measures, however, the United States falls short of other developed nations and Oklahoma struggles to keep up with the rest of the nation. We have made progress, though. Oklahoma has successfully invested to increase the number of children with health insurance and we have developed a statewide nursing home visitation program. We rank high in investments in public health to prevent and control infectious diseases, which have become less prevalent over the last two decades.
Overall health has improved recently, though not as quickly as elsewhere. Drug abuse and addiction rates are high, as are child abuse, domestic violence, accidental death, and smoking. Obesity is increasing dramatically. Overall, our health status ranks near the bottom of the 50 states. Our health and social services shortfalls hit the lower-income population hardest. A higher proportion of Oklahomans are poor than the American average and access to health insurance is among the worst in the nation.
These indicators give a snapshot of where Oklahoma health and social services stand today.
16.1 percent – of Oklahomans are poor in 2015, according to the federal definition. The U.S. average is 14.7 percent. Oklahoma has the 14th highest rate of poverty. According to the U.S. Census Bureau, 22.2 percent of Oklahoma children are poor, compared to 20.7 percent.
45th — Oklahoma ranked 45th in overall health in 2015, according to the United Health Foundation. While this was a slight improvement from 46th the previous year, Oklahoma continues to rank in the bottom ten in smoking, obesity, job-related deaths, access to health insurance, and days lost to physical illness.
$53 — per person spent by Oklahoma for mental health purposes in 2013. This ranked 45th in the nation and was less than one-half the national average of $120 per person, according to the National Association of State Mental Health Program Directors.
13.9 percent – of Oklahomans did not have health insurance in 2015. This ranked Oklahoma 3rd highest in uninsured population, according to the U.S. Census Bureau. The national average was 9.4 percent uninsured. Oklahoma continues to lag behind on this measure. While the national average has decreased by 8 percentage points over the last five years, Oklahoma’s decrease was only 5 percentage points, due in large part to the state’s refusal to expand health insurance to low-income adults through the Affordable Care Act.
2nd — Oklahoma had the second highest rate of death by accidents in the nation in 2013, according to National Center for Health Statistics of the US Department of Health and Human Services . Our rate of 62.7 deaths per 100,000 people compares to the national average of 39.4 deaths. Rates are adjusted for age of the population. Oklahoma also exceeds the national average for death rates from cancer, cerebrovascular diseases, heart disease, Alzheimer’s disease, hypertension, suicide, and virtually every other category.
12.2 — Of every 1,000 children, 12.2 were victims of maltreatment in 2013, according to the U.S. Department of Health and Human Services. Oklahoma’s rate of maltreatment was well over the national average of 9.1 per 1,000. The Oklahoma rate was up from 7.7 per 1,000 in 2010, while national statistics have been stable in the same time period.