Report Publish Date: October 2022
This report summarizes Oklahoma’s health, wellbeing, and equity journey from 2016 to 2021, as part of RWJF’s Sentinel Communities Surveillance project.
“Oklahoma has a strong capacity for addressing issues of health and well being at the state level through its health department and well-established anchor organizations,” the authors write. External grants, cross-sector collaboration, and federal funding also played a role during the period studied. Several long-term initiatives, including ones focused on early childhood, healthy eating, and access to care, had grown and educational institutions were incorporating health and equity.
The state’s approach to healthcare remained focused on individual responsibility and the governor was taking a “business-minded” approach, the researchers say. Even so, the state’s department of health was increasingly acknowledging the importance of social determinants of health.
Begun in 2016, RWJF’s Sentinel Communities Surveillance project tracks how a Culture of Health is developing in 29 communities across the country. The authors wanted to describe key challenges, opportunities, and insights in Oklahoma.
The authors gathered information from phone interviews with Sentinel Community leaders; online, published, and local materials and media about the communities; and data sources including the Census Bureau’s American Community Survey, the CDC’s Behavioral Risk Factor Surveillance System, County Health Rankings, and state and local data collection systems.
For this report, the authors conducted 46 hourlong, semi-structured interviews between early 2018 and spring 2022. Interviewees came from several different types of organizations and sectors.
“Future research should examine if and how the increased focus on social determinants of health in the state can spur a broader, systems-level approach to health equity and how communities in the state navigate tensions with state leadership in terms of health policies and investment choices.”
—RAND Corporation
“With the recent passage of Oklahoma’s law to limit access to abortion care, there are new questions about citizen voice in health policy and concerns about negative impacts on maternal and child inequities,” the authors write. “Other communities can learn from Oklahoma’s approaches to building support for health activities outside of government.”
Oklahoma is a largely rural state, bolstered by the energy, agriculture, and aerospace industries. The uncertainty in the energy sector has contributed to some economic volatility in the state, thus placing maintaining economic viability as the state’s top priority. Oklahoma has grappled with high rates of chronic disease, placing the state at the bottom of lists for most health outcomes, such as obesity and cancer. While the state and its political leadership have been characterized by an individualistic mindset about health—which has influenced the level of investment in public health—there have been efforts to address health that have favored government engagement, such as the vote to expand Medicaid in 2021. However, while the state has made investments in expanding healthcare capacity, difficulties in access to healthcare—particularly for rural populations—remain an issue.
Despite these challenges, Oklahoma has pursued several efforts that are having an impact on the state, including initiatives to address early childhood development, mental health and opioid use, homelessness, and healthcare capacity through telehealth and provider incentive programs. While the State Department of Health is leading significant efforts to build data capacity around social determinants of health, significant action for health in Oklahoma has been supported by philanthropies, nonprofits, and universities as well as federal grants and other external resources. Oklahoma is starting to discuss health equity, but there are questions about whether this new dialogue will lead to demonstrable structural changes to address longstanding inequities.
Robert Wood Johnson Foundation, October 2022
This study and report was conducted and created by:
A library of research and perspectives about Sentinel Communities, 30 diverse communities around the country.