Oklahoma’s Health Ranking Declines

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An annual study shows that Oklahoma’s health ranking has declined.

The United Health Foundation ranks the state 48th in the nation when it comes to overall health in 2011. Last year, the state ranked 46th. Mississippi and Louisiana ranked 50th and 49th, respectively, in the study. Arkansas, the state’s eastern neighbor, was 47th. The number one ranking went to Vermont, a state that has been a forerunner in establishing a single-payer health care system.

It’s easy to dismiss such rankings, which always paint a dismal picture of Oklahoma. The years and the bad health reports go by, and not much ever gets done. Why even acknowledge the obvious? What’s the point?

But it remains important to remind ourselves of the factors that lead to poor health rankings. Even small incremental, positive change is good, though the United Health Foundation ranking shows Oklahoma is going in the wrong direction.

Here are some of the reasons Oklahoma ranks so low:

  • It ranks 49th in the nation in the number of primary care physicians compared to population. This has been a chronic dilemma for the state, which has a rural population that is underserved medically.

  • It ranks 47th in the nation in premature deals, defined as the “loss of years of life lost due to death before age 75.” The study notes, “… cancer, unintentional injury, heart disease, suicide and deaths occurring during the perinatal period are the top five causes of premature death . . .”

  • It ranks 48th in the number of people who smoke on a per capita basis. The overall smoking rate has decreased somewhat over the last two decades, but it still remains a major problem here. Smoking can lead to severe health problems, including cancer and emphysema.

  • It ranks 42nd in the number of children living in poverty, perhaps the most important statistic. When children grow up without adequate health care because their parents are too poor to afford it, they are more likely to develop chronic illness.

The state also has poor rankings in early prenatal care, infant mortality and cardiovascular deaths.

All of this means that Oklahoma is simply not a healthy place to live on a general basis. Obviously, people can choose to live healthier lives—this is the right-wing slogan when it comes to studies like this one—but the state’s infrastructure, from its lack of sidewalks to its automobile-dependent lifestyle, means healthy routines are not built easily into day-to-day living. Poverty also contributes to the poor ranking.

It’s also important to note that the poor health rankings are regional in nature, with states like Mississippi, Louisiana, Oklahoma and Arkansas leading the pack. Texas is ranked 44th. Perhaps, there should be a broader and extensive regional approach to the health care dilemma of all these states.

Many Oklahomans are probably tired of hearing about the state’s poor medical outcomes, but we shouldn’t risk falling into the trap of indifference over an important issue that affects the quality of life for everyone.

Is Individual Mandate Ruling Significant?

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In a celebratory statement about a federal appeals court ruling striking down the individual mandate in the Affordable Care Act, state Rep. Mike Ritze argued that so-called Obamacare “takes us away from a healthy and efficient free market health care system.”

But surely Ritze, a doctor, doesn’t believe the current health care system in this country and especially in Oklahoma is “healthy and efficient” or that focusing on insurance company profits will improve medical outcomes. If anything, the United State has demonstrated how much an unfettered free-market system that places profits above human suffering leads to wasteful spending and poor medical outcomes.

Yet one can understand Ritze’s political posturing here. He was the author, for example, of the state constitutional amendment recently passed here that would supposedly allow Oklahoma to opt out of the new federal law. Ritze, a Republican from Broken Arrow, must feel validated by the decision of the Appeals Court of the 11th Circuit, though he said he was disappointed “the ruling only extends to the individual insurance mandate rather than the entire bill.”

Under the individual mandate, people would be required to purchase health insurance. The government would also provide subsidies for low-income individuals and families.

But here are some facts Ritze surely has encountered in one frame or another: The United States ranks 37th in the world among countries in medical outcomes but spends more money that any other country on health care, according to the World Health Organization. In 2006, the country ranked 39th in the world for infant mortality. On a local level, Oklahoma’s infant mortality rate is the sixth highest in the nation. The black infant mortality rate here is second highest in the country.

I could go on and fill this space with even more gloomy statistics from simple Google searches about the declining health care system in this country and Oklahoma, but the facts will never trump right-wing ideology. The truth is that the great health care divide in the country breaks down this way. Some of us, myself included, believe medical care should be a human right; others believe it shouldn’t be a human right.

Some pundits have even argued the recent ruling is not as significant as Ritze and others claim.. The respected Firedoglake blog makes this point about the ruling:

. . . Despite what some on the left and right are saying, the individual mandate is not essential to the overall function of the law.

It is both possible and legal to expand Medicaid, require guaranteed issue, establish new insurance regulations, and provide people with subsidies to buy insurance without a mandate. These policies can and have been put into effect in states without a mandate.

The U.S. Supreme Court will probably decide the fate of the new health care program, but it seems unlikely the court would invalidate the entire law. What would solve the issue is some type of public option for health coverage, which many other countries offer, but that’s not likely to happen anytime soon given the current political milieu.

Does Health Philosophy Determine Planning?

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A recent editorial in The Oklahoman shows just how intractable and narrow minded some city leaders are when it comes to significantly improving the quality of life here.

The headline says it all: “More bad news on obesity, but government isn't the solution.”

Published July 12, the editorial cites a national report that shows Oklahoma is ranked at seventh in the nation with an obesity rate of 31.4 percent. The editorial goes through the report, says “no thanks” to a recommendation that everyone get screened for obesity and diabetes as part of a preventative medical effort and then ends with this typical caveat:

Getting out of it will take another generation, or more. But it will result from individuals making better choices about diet and exercise, not from government fiat.

Individual responsibility over community. Survival of the fittest—literally—over advocating common sense planning choices.

The Oklahoman doesn’t speak for all leaders here, but I think it’s fair to argue this particular, hands-off philosophy when it comes to health issues has contributed to some dubious distinctions for the state. Just recently, for example, the Oklahoma City area was named the most unfit metropolitan area among the nation’s largest 50 cities.

Obesity is not just an Oklahoma problem, of course, and these never-ending reports about our collective weight should not be used as a cudgel to embarrass anyone.

But the state, and especially the Oklahoma City area, needs more sidewalks, bike lanes, ball diamonds, soccer facilities and parks. It needs more swimming pools and jogging trails. People need to walk more and drive less. People need better access to medical care. These arguments are not part of some “government fiat.” They simple argue for better planning to improve the quality of life for everyone, even those in the best physical shape. Obviously, this has an impact on overall economic development as well, but it’s primarily small-business focused and doesn’t necessarily affect the area’s high rollers. That’s a major problem given the leadership dynamics in Oklahoma City.

Meanwhile, the editorial exposes a crass attitude that makes it terribly unsurprising the Oklahoma City Council has voted to move up the timeline in building the new convention center under the MAPS 3 project. The convention center will primarily benefit a segment of the business community here, though some city leaders dispute that, and will do nothing to improve the collective health here. When do we get the urban park, the biking and walking trails and the new street-car system, which are all part of MAPS 3 and would improve the collective health here? Let’s hope all city leaders, not just the handful who opposed moving up the timeline on the convention center, can get as enthusiastic about those life-affirming aspects of MAPS 3 as they can about hotel profits.

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