Public Health

in the City of Tulsa

Public health in Tulsa is inextricably linked to socioeconomic status and social determinants of health. Regular preventative check-ups and healthy lifestyles can be considered luxury expenses to disadvantaged Tulsans without health insurance who struggle to keep food on their table or a roof over their heads. Without good health or the ability to pay medical expenses, individual quality of life suffers. When whole communities of Tulsans fail to receive adequate health care, social progress stalls.

The Public Health theme analyzes inequalities by race, geography, and veteran status. These groups experience disparities in health care access, health conditions, and health outcomes.

The topics for the Public Health theme are Healthcare Access, Mortality, and Well-being.

You can see a snapshot of the indicators averaged in this theme in the chart to your right and then visit the sections below for more detail.

Read our recent blogs about Public Health…

Healthcare Access

The indicators in the Healthcare Access topic are:
  • Race & Health Insurance
  • Geography & Emergency Room Use
  • Veterans & Veterans Affairs Appointment Wait Time
Even as health care has become more accessible through the implementation of the federal Affordable Care Act, many obstacles remain for some of the more disadvantaged groups in Tulsa, due in part to the fact that Oklahoma has not expanded Medicaid eligibility to cover a particular set of low income households – those earning between 45% and 138% of the poverty level. Disparities exist in health insurance coverage, as well as in emergency room use. As of this year’s report, however, Tulsa veterans’ appointment wait time improved enough to drop below the national average. Look at the chart to your right for an overall picture of this topic, and then look at each indicator and the scores in context for more detail and additional findings.

Indicators within Healthcare Access

  • Race & Health Insurance

    What is Measured?
    Ratio of White to Hispanic/Latinx rates of health insurance coverage

    What are the Results?
    White: 89.7%; Hispanic/Latinx: 68.8%

    What is the Indicator-Level Ratio?
    1.304

    What is the Indicator-Level Score?
    70

    What Did We Find?
    Individuals without health insurance face not only health issues, but also economic and educational issues as a result of poor healthcare. Insurance coverage disparities are apparent by race. White adults age 18-64 (89.7%) are more likely to be insured as Hispanic/Latinx (68.8%).

    What Data Source(s) were Used?
    U.S. Census Bureau, 2016 & 2017 American Community Survey, 1-Year Estimates

  • Geography & Emergency Room Use

    What is Measured?
    Ratio of rates of emergency room visits for residents of north to south Tulsa per 1,000 population

    What are the Results?
    North Tulsa: 474.7; South Tulsa: 233.5

    What is the Indicator-Level Ratio?
     2.033

    What is the Indicator-Level Score?
    40

    What Did We Find?
    There are a number of reasons that a person may choose to use the emergency room instead of scheduling a visit with a primary care physician. Often, it is due to things like proximity to a healthcare center, clinic times, or affordability of health insurance. Residents of North Tulsa are around twice as likely (474.7) to use the emergency room as South Tulsa residents (233.5).

    What Data Source(s) were Used?
    Tulsa Health Department, Health Data & Evaluation, 2017 & 2018 (by request); U.S. Census Bureau, 2016 & 2017 American Community Survey, 5-Year Estimates

  • Veterans & Veterans Affairs Appointment Wait Time

    What is Measured?
    Ratio of percentages of appointments completed in over 30 days at Tulsa Veterans Affairs (VA) clinics to national average of all VA clinics

    What are the Results?
    Tulsa VA clinics: 3.1%; National average: 5.0%

    What is the Indicator-Level Ratio?
    0.619

    What is the Indicator-Level Score?
    100

    What Did We Find?
    Tulsa is now performing in veterans being able to complete appointments within a month of scheduling better than the national average. About 3.1% of appointments are completed in over 30 days of scheduling, compared to the national average of 5.0%. Additionally, the average wait time for mental health services in the two Tulsa VA clinics are 2.02 days and 8.53 days. The national average wait time for mental health services is 2.97 days.

    What Data Source(s) were Used?
    U.S. Department of Veterans Affairs (VA.gov), Completed Appointment Wait Times National, Facility, and Division Level Summaries, Wait Time Measured from Preferred Date for the Reporting Periods Ending: October 2017 & October 2018

Mortality

The indicators in the Mortality topic are:
  • Race & Infant Mortality
  • Geography & Life Expectancy Past Age of Retirement
  • Race & Cardiovascular Disease Mortality
Infant mortality rate (IMR) is often used as an indicator of the overall health of a community. While the overall IMR in Tulsa County has been declining over the last 30 years, racial disparities persist. Infant mortality continues to affect African American communities at significantly higher levels than other populations across the United States, even when education level, income, and neighborhood conditions are held constant. Many researchers believe this disparity is the result of racism and discrimination, either directly in the health care system or epigenetically in the transfer of trauma from one generation to the next. Cardiovascular disease mortality incidence patterns also exhibit racial disparities. Related to these and other disparities is the substantial difference in life expectancy by geographic region of Tulsa. Look at the chart to your right for an overall picture of this topic, and then look at each indicator and the scores in context for more detail and additional findings.

Indicators within Mortality

  • Race & Infant Mortality

    What is Measured?
    Ratio of Black to White rates of infant mortality per 1,000 live births

    What are the Results?
    Black: 18.7; White: 4.6

    What is the Indicator-Level Ratio?
     4.108

    What is the Indicator-Level Score?
    26

    What Did We Find?
    The infant mortality rate (IMR), often used as an indicator of overall health, represents the number of deaths of infants under one year of age per 1,000 live births in the same year. In Tulsa County, the Black IMR is around four times higher than the White IMR. Even when healthcare or socioeconomic factors are accounted for and found to be equal, the Black infant mortality rate (IMR) is still found to be substantially higher than that of other races.

    What Data Source(s) were Used?
    Oklahoma State Department of Health (OSDH), Center for Health Statistics, Health Care Information, Vital Statistics 2016 & 2017 (OK2SHARE)

    Note: Data for this indicator are for Tulsa County.

  • Geography & Life Expectancy Past Age of Retirement

    What is Measured?
    Ratio of life expectancy in years past age of retirement in south to north Tulsa

    What are the Results?
    South Tulsa: 13.0; North Tulsa: 4.6

    What is the Indicator-Level Ratio?
    2.828

    What is the Indicator-Level Score?
    35

    What Did We Find?
    Many factors impact life expectancy, such as access to healthcare and environmental factors serving as social determinants of health. Individuals living in South Tulsa are expected to outlive individuals in North Tulsa by 8.4 years.

    What Data Source(s) were Used?
    Tulsa Health Department, Health Data & Evaluation, Life Expectancy by Zip Code, 2013-15 & 2014-16 (by request); U.S. Census Bureau, 2016 & 2017 American Community Survey, 5-Year Estimates; U.S. Social Security Administration, 2016 & 2017

    Note
    Age of retirement as defined by the U.S Social Security Administration at the time of reporting is 66.

  • Race & Cardiovascular Disease Mortality

    What is Measured?
    Ratio of Black to Hispanic/Latinx age-adjusted mortality rates for cardiovascular disease per 100,000 population

    What are the Results?
    Black: 345.6; Hispanic/Latinx: 127.8

    What is the Indicator-Level Ratio?
    2.704

    What is the Indicator-Level Score?
    36

    What Did We Find?
    Heart disease is one of the leading causes of death in the United States. Many factors contribute to high blood pressure and high cholesterol, like: smoking, lack of physical exercise, diet, and weight. In Tulsa County, Blacks have the highest rate of heart disease mortality (345.6).

    What Data Source(s) were Used?
    Oklahoma State Department of Health (OSDH), Center for Health Statistics, Health Care Information, Vital Statistics 2016 & 2017 (OK2SHARE)

    Note: Data for this indicator are for Tulsa County.

Well-being

The indicators in the Well-being topic are:
  • Race & Teen Births
  • Race & Preterm Births
  • Geography & Smoking
Teen moms are more likely to be unmarried and have lower levels of education than other mothers, both of which can negatively impact economic well-being. Babies born before 37 weeks’ gestation are considered preterm and are more likely to experience health problems and developmental delays. Smoking is one of the most preventable causes of death as it increases the risk of lung and other cancers, heart attack, stroke and chronic lung disease. Look at the chart to your right for an overall picture of this topic, and then look at each indicator and the scores in context for more detail and additional findings.

Indicators within Well-being

  • Race & Teen Births

    What is Measured?
    Ratio of birth rates for Black to White teens, per 1,000 females age 15 -19

    What are the Results?
    Black: 42.9; White: 19.3

    What is the Indicator-Level Ratio?
    Ratio: 2.225

    What is the Indicator-Level Score?
    39

    What Did We Find?
    Births to teen moms have a great effect on economic well-being. The teen birth rate per 1,000 for Blacks (42.9) is over twice that of Whites (19.3).

    What Data Source(s) were Used?
    Oklahoma State Department of Health (OSDH), Center for Health Statistics, Health Care Information, Vital Statistics 2016 & 2017 (OK2SHARE)

    Note
    Data for this indicator are for Tulsa County.

  • Race & Preterm Births

    What is Measured?
    Ratio of rates of Black to White preterm births

    What are the Results?
    Black: 15.3%; White: 10.9%

    What is the Indicator-Level Ratio?
     1.404

    What is the Indicator-Level Score?
    65

    What Did We Find?
    In Tulsa County, Blacks have a higher incidence of preterm births (15.3%) than Whites (10.9%).

    What Data Source(s) were Used?
    Oklahoma State Department of Health (OSDH), Center for Health Statistics, Health Care Information, Vital Statistics 2015, on Oklahoma Statistics on Health Available for Everyone (OK2SHARE)

    Note
    Data for this indicator are for Tulsa County. A preterm (or premature) birth is the delivery of a baby at fewer than 37 weeks’ gestational age.

  • Geography & Smoking

    What is Measured?
    Ratio of percentages of current smokers age 18 and over in north to south Tulsa

    What are the Results?
    North Tulsa: 33.9%; South Tulsa: 17.7%

    What is the Indicator-Level Ratio?
    1.915

    What is the Indicator-Level Score?
    44

    What Did We Find?
    Smoking can have severe impacts on a person’s health, including heart disease and cancer. Even though smoking is on the decline, there is still a geographic disparity regarding where smokers live. North Tulsa residents smoke at a higher rate (33.9%) than do south Tulsa residents (17.7%).

    What Data Source(s) were Used?
    Centers for Disease Control and Prevention (CDC), 500 Cities: Local Data for Better Health, Model-based estimates for current smoking among adults aged >=18 years, 2015 & 2016; Behavioral Risk Factor Surveillance System (BRFSS); U.S. Census Bureau, 2016 & 2017 American Community Survey, 5-Year Estimates