Closing Health Gaps: The Oklahoma Example

Dec 7, 2015, 8:00 AM, Posted by Andrea Ducas

With the right data to inform priorities, and a powerful commitment to equity, places like Tulsa, Okla., are making progress to close health gaps.

What would your ideal future look like? For me and my colleagues at the Foundation, it would be one where everyone has the opportunity to live the healthiest life they can.

An unfortunate reality in this country, however, is that while we continue to realize substantial gains in health, the things that help people become and stay healthy are not evenly distributed across states or even metropolitan areas. Access to healthy foods, opportunities for exercise, good-paying jobs, good schools, and high quality health care services may be readily available in one area, and difficult to come by or nonexistent in another just a few miles away.

Sometimes the differences are particularly stark: In some communities, two children growing up just a short subway or car ride apart could be separated by a 10-year difference in life expectancy.

So how do we square this reality with the Culture of Health we’re working hard with others to build? An important first step is recognizing those disparities and what’s driving them, and ensuring that people in communities across America have strategies – and the data – they can use to proactively close health gaps.

Let’s use Oklahoma, and within it the city of Tulsa, as an example.

Aiming for a Fair Shot at Health
A County Health Rankings Health Gaps report that we released recently with our partners at the University of Wisconsin Population Health Institute shows that if all Oklahoma counties were as healthy as the state’s top counties and all Oklahomans had a fair shot at health, we’d expect to see 2,600 fewer premature deaths each year. One in a series on each of the 50 states, the report also finds there would be:

  • 187,000 fewer adults who smoke
  • 52,000 fewer obese adults
  • 49,000 more adults ages 25 to 44 with some higher education
  • 78,000 fewer children in poverty
  • 39,000 fewer people without jobs
  • 93,000 fewer households with severe housing problems

The need to close health gaps isn’t news to Oklahoma leaders, who have taken steps over the past 15 years or so to make health a shared value and foster cross-sector collaboration.

Since 1998, the state has offered universal pre-K to all 4-year-olds; a study of the program in Tulsa found phenomenal improvements in school readiness. The state is also reshaping how health care is delivered, starting with medical education. The University of Oklahoma – Tulsa’s School of Community Medicine forged a partnership between insurance companies, providers and health systems. The partners are working to transform primary care practices into patient-centered medical homes, exchange electronic medical data seamlessly, and transform medical education so that Oklahoma doctors understand the social underpinnings of health—and health disparities.

A City Builds Toward Change
But arguably the biggest Culture of Health story in the state has unfolded in Tulsa. More than a decade ago, city leaders learned of a 14-year disparity in life expectancy between the North Tulsa and South Tulsa — and decided they needed to close the gap.

Though their work is not done, the gap has narrowed — down to 11 years, according to an illuminating new map developed through the Foundation’s partnership with the Virginia Commonwealth University Center on Society and Health. [Note: check out the full series of zip code maps on 10 different cities – those gaps are striking, and they’re not unique to Tulsa.]

The city narrowed their health equity gap by taking a cross-sector approach to health — informed by a common understanding of the most important opportunities for health.

The George Kaiser Family Foundation took a leading role and invested in the city’s youngest residents by forming partnerships with both the private and public sectors to provide comprehensive health and educational support for children and families.

In 2013, the School of Community Medicine opened a $20 million clinic in North Tulsa to expand access to high quality health care. Since then, 27 new doctors are providing care to the community.

The Tulsa Regional Chamber of Commerce has joined the citywide effort to create a healthier, more equitable community and is promoting the important role employers play in ensuring good health. The Chamber’s “Partners in Education” program connects business leaders with the city’s public schools, and its “Tulsa’s Future” program aims to create 15,000 new jobs with salaries of at least $50,000.

Wide-reaching culture change takes time, cross-sector collaboration, and vision. It also takes good and useable data to identify priorities, track progress, and offer opportunities for course-correction—that’s where the state-by-state Health Gaps report and metropolitan life expectancy maps are valuable resources. We know that change doesn’t come easy. But the work in Oklahoma, as well as in many other beacons of progress across the country, also shows us that the change we’re building toward is closer than we may think.
 

Andrea Ducas is a program officer with the Robert Wood Johnson Foundation. Read her full bio.