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The State of Our Health in Oklahoma



Dr. Terry Cline, Oklahoma’s Commissioner of Health

 

First, The Good News:
 

When it comes to the state of Oklahoma’s health, studies show we are making progress. Just a few years ago Oklahoma ranked 49th out of 50 states in terms of how healthy we are.


Now the bad news:
 

although we are making some progress, it is slow. Very slow. Over the last five years Oklahoma has moved up only a couple of notches, now coming in at number 46.

According to “America’s Health Rankings” from the United Health Foundation, Oklahoma still has a long way to go.

“We have indeed improved our ranking over the past five years,” said Dr. Terry Cline, Oklahoma’s Commissioner of Health. “Our ranking is relative to other states, so as we are making advances, other states are as well. As you would expect in a race, it is not just about your own ‘best time,’ but how you are doing relative to others in the race.

“Much like a competitive race, none of us should be happy with and settle for any ranking that puts us in the 40s,” Cline continues. “With this particular race, people’s lives are at stake. As Oklahomans, we deserve better.”

Tackling our health issues is not easy. A few years ago the Oklahoma State Department of Health held a series of community chats across the state. As a result of those meetings, the “Oklahoma Health Improvement Plan” was drafted and outlined several key areas that needed improvement. Obesity and tobacco use were right up at the top. Using that as a blueprint, Cline and the OSDH went to work. Now Oklahoma is starting to see the benefits of those efforts, even though some in the state legislature have dug in their heels in resistance.


“The Tobacco Settlement Endowment Trust has done an awesome job of working with communities to advance what they can do on a local level. And coalitions like Students Working Against Tobacco have done everything within their power to bring those rates down, which is understandable given tobacco use is the number one preventable cause of death in Oklahoma."

- Dr. Terry Cline


“Our youth and adult tobacco rates have declined significantly over the last decade, although it is still much higher than the national average,” Cline said. “The Tobacco Settlement Endowment Trust has done an awesome job of working with communities to advance what they can do on a local level. And coalitions like Students Working Against Tobacco have done everything within their power to bring those rates down, which is understandable given tobacco use is the number one preventable cause of death in Oklahoma.

“Unfortunately our legislature has not demonstrated the willingness to allow communities to enact ordinances that would permit them to be smoke free. So, communities are prohibited by state law from doing so. We are one of only two states left in the country with this archaic pre-emption law on our books. The tobacco lobbyists here in Oklahoma have been very influential with the legislature.”

But Cline says a proposed bill during this legislative session may help change that.

“Senator A.J. Griffin has authored Senate Joint Resolution 24, which would send a ballot question to a vote of the people to see if they expect and want clean indoor air in public places across Oklahoma.


“Senator Griffin is a hero who is taking on the tobacco lobbyists and is doing what is right for Oklahoma. Public polls indicate the majority of people want this – even a large percentage of people who smoke,” Cline said. “Our legislature talks a lot about keeping government out of people’s lives. We will watch this vote very closely, which will indicate whether our state legislators think they know what is best or they have confidence and faith in the people of Oklahoma to decide for themselves.”

Another proposed bill would raise the tobacco tax and give that added money to education. State Representative Doug Cox has authored House Bill 1719, which would raise the tobacco tax by about $1 a pack on cigarettes and other tobacco products. According to statistics from the Centers for Disease Control, that $1 hike could mean 23,500 Oklahomans under 18 would be less likely to become adult smokers. The CDC data also suggests 24,000 adult smokers would quit.

And as an added incentive, HB 1719 would send that extra income to education, providing raises for teachers, cost-of-living adjustments for retired teachers and perhaps as much as $100 million for schools throughout the state.

For those individuals who seriously want to quit smoking, help is available. Experts say it may not be easy, but it can be done.
 


“We have all heard the phrase ‘kick the habit,’” said Joy Leuthard, Coordinator of the Tobacco Cessation Systems Initiative at the Oklahoma Hospital Association. “But smoking is more than a habit. It really is more along the lines of a psychological addiction.

“Nicotine stimulates more brain cells than even cocaine or heroin. And because tobacco is legal and easily acquired it is more addictive than illegal drugs, making quitting very difficult.”

 Nearly 700,000 adult Oklahomans smoke, Leuthard said, and about 42,000 young people under the age of 18 admit to smoking.

While smoking rates are declining somewhat, Leuthard says far too many people each year continue to die needless deaths.

“Nationally, about 500,000 people die from smoking-related deaths,” she said. “That is the equivalent of four or five jumbo jets crashing every day! Would we tolerate that? Of course not! So why do we tolerate tobacco use and the continued marketing and selling by the tobacco industry? It is the only legal substance that, when used as directed, kills people and has no positive health or social value. It is driven by money and profits – just the same as illegal drug use.”

Tobacco kills more people than alcohol, illegal drugs, car accidents, AIDS, homicides and suicides combined, Leuthard added. In Oklahoma, 6,200 people die each year, including hundreds more that don’t smoke but are exposed to second-hand smoke.

Trends show tobacco use is higher in certain groups than in others.

“These groups include low socio-economic individuals, minorities including African Americans and Native Americans, as well as LGBT individuals,” according to Leuthard. “Tobacco companies still target these specific groups through their various marketing strategies. And for those who die, they target ‘replacement smokers’ with the same advertising concepts to ensure a steady stream of new customers.”

While Leuthard and Cline both agree the state legislature has been dragging its feet, a number of Oklahoma initiatives are helping people stop smoking.


“Nicotine stimulates more brain cells than even cocaine or heroin.
And because tobacco is legal and easily acquired it is more addictive than illegal drugs, making quitting very difficult.”

- Joy Leuthard


“Many resources are available to help those who seriously want to quit,” Leuthard said. “The Oklahoma Tobacco Helpline is a free service that is available 24/7 and has coaches who speak many languages. Since 2003, the Helpline has served more than 250,000 Oklahomans and was ranked as the top ‘quitline’ in the nation.”

One of the new smoking guns, no pun intended, is the electronic cigarette, or “e-cig.” They are battery-powered vaporizers that do not use tobacco, yet use nicotine from tobacco plants. Currently there is no government oversight of these products, and the FDA has not approved any e-cigarette as a safe or effective way to help smokers quit.

Commissioner Cline says those who use e-cigs should do so with caution.

“At the Oklahoma State Department of Health, we issued a public health advisory with a cautionary note about e-cig use,” Cline explains. There is a fair amount of ongoing research but not enough to establish a body of research yet that tells us definitely about the potential risks/benefits.

“The rate of use by youth has doubled across the nation in a very short time, and the prevalence of youth using e-cigs is higher in Oklahoma than across the nation. Historically, millions of people became addicted to nicotine before we realized what a deadly killer it is. I am worried about people who begin using this nicotine delivery system, who have never smoked tobacco, and who then start down a path of addiction,” Cline said.

Another area identified as significant in the Oklahoma Health Improvement Plan is obesity, and Oklahoma has a definite problem with its weight. The United Health Foundation lists obesity as one of the greatest health threats in the United States, affecting one in four adults. Since 1990, Oklahoma has become increasingly fatter.
 

Mayor Mick Cornett


In Oklahoma City, Mayor Mick Cornett helped start a city-wide conversation about obesity.

“We had an awareness campaign we called ‘This City Is Going on a Diet,’” Cornett said. “That led to a discussion about Oklahoma City’s built environment.

“Through the years we built a great city – if you happen to be a car. Our sprawling land mass had resulted in an automobile-centric culture. We built wide streets, without sidewalks, that had fast food restaurants at every intersection. From a public health standpoint, that was a recipe for disaster.”

And once discussions started, it was time to get busy redesigning Oklahoma City.

“The citizen input for MAPS 3 emphasized infrastructure projects that got people out of their cars and moving again,” Cornett smiled. “Hundreds of miles of new trails and sidewalks. A new 70-acre central park. A whitewater rafting course. Senior wellness centers. A modern streetcar transit system. It’s not a coincidence that most of the MAPS 3 projects encourage a healthier and more active lifestyle.

“At the same time, we began redesigning our urban streets to make them more pedestrian friendly,” Cornett continued. “We’ve added bike lanes and wider, more landscaped sidewalks. We spend a lot of time working with developers to create a more walkable and, in urban areas, dense built environment.”


“Through the years we built a great city – if you happen to be a car. Our sprawling land mass had resulted in an automobile-centric culture. We built wide streets, without sidewalks, that had fast food restaurants at every intersection. From a public health standpoint, that was a recipe for disaster.”

- Mayor Mick Cornett


On a personal level, the mayor says he helped set an example with the “This City Is Going on a Diet” campaign, and in the process lost 40 pounds.

“We had nearly 50,000 residents take part in that campaign,” he said. “It makes sense at every level – health, happiness, financial – to eat better and maintain a healthier lifestyle. I did it mostly by watching what I ate and eating less. Everyone should exercise. We heard so many motivating stories during the campaign. In almost all those cases, the individual simply decided they could do better and that their health mattered.”

Throwing away that sack of potato chips and getting up off the sofa is half the battle, making a simple effort to get healthy. The Mayor says his own personal routine helps keep him fit.

“I live downtown, so I walk a lot,” Cornett said. “I try to take the stairs when I can. There is a fitness facility where I live, so I’m able to use that from time to time. I play a little golf and I do 50 push-ups a day.

“Besides that, here are my words of wisdom,” he added. “If you smoke, stop. If we could cut smoking statewide, it would have a huge outcome on our health. But there are simple things everyone can do. Watch what you eat and how much you eat. Get outside and take a walk through your neighborhood. You’ll meet wonderful people in Oklahoma City and also get some fresh air and exercise.”
 


At the state level, the Health Department considers weight gain one of the most significant health hazards for its citizens.

“We have communities all over our state which are tackling obesity at the local level,” Cline said. “People today are more sedentary and spending significant amounts of time in front of their TVs, computers and hand-held devices. They are eating out more and relinquishing control over portion control and quality of food. People are consuming more sugary drinks and empty calories.

“This is a national trend,” Cline said, “but Oklahoma is far out in front. Just a few years ago we were expected to be the most obese state in the country by 2018.”

New data suggests the obesity trend may be flattening ever-so-slightly.

“We are seeing a significant decrease in adolescent obesity rates from 17 percent in 2011 to 11.8 percent in 2013! That is awesome! Hopefully we will see that trend continue,” Cline cheers.

A simple mantra is a good starting point for everyone to get healthy: “Eat better, move more and be tobacco free.”

“If you can do these three things, you are pretty much guaranteed to be healthier,” he says.
 


“Even as the state's Commissioner of Health, I often have difficulty following my own advice. I am sympathetic to the challenges because I experience them myself. Right now I am living off the benefits of a healthy lifestyle I have had for the vast majority of my life.

“My dad was the director of a YMCA and my mom was a nurse so I grew up in a healthy environment. I have been an avid swimmer most of my life – three, four, five times a week for several miles. Unfortunately, and this is the true confession part, I have only been in the pool a handful of times over the last year. Yikes! But I am confident I will get back in there, so check with me in six months,” Cline said with a laugh.

With spring in the air and summer just a few months away, Cline says getting outside is one of the things that helps keep him grounded.

“I love to work in the yard and get great immediate gratification in seeing a freshly-mowed lawn with fresh edging and knowing I did that,” he says. “I have the best neighbors in the world in Lincoln Terrace, and in warm weather it is not uncommon for three or four families to congregate on the front porch two or three times a week for food and company, with kids running around in the yard.

“I must admit I have spent more time thinking about my exercise routine and lifestyle in response to this article than I have in the last year,” Cline said. “I am good about taking the stairs instead of an elevator, and usually walk up an average of at least 15 floors a day, usually in three- or four- floor increments. I work with people I enjoy who I know share my passion for public health, and that helps in sharing the stress of the job.

“Family is also very important and I try to get to Ardmore at least once a month, if not more often, to connect with my extended family. I am incredibly fortunate to be surrounded by wonderful people who often pull me back from the brink,” he added.
 


Getting serious about health is not just limited to state and city leaders. A number of local businesses and non-profits are doing their part to get Oklahoma off its proverbial keister.

Just recently the Oklahoma City Community Foundation awarded $137,000 in Wellness Initiative grants to five organizations that are helping people get healthy.

The Foundation partnered with the YMCA of Greater Oklahoma City, encouraging folks to adopt a healthier way of living.

“Through our Wellness Initiative we want to support programs that motivate people of all ages to adopt a sustainable healthy lifestyle that will minimize the potential of future illness and disease,” said Cathy Nestlen, APR, Director of Communications for the Foundation. “We look forward to learning what works and sharing that information so like programs can be replicated elsewhere.”

Each of the funded projects is required to incorporate at least one of the four elements of the YMCA’s “ok5210” program.

“That program encourages people to eat five or more fruits and vegetables each day,” Nestlen explained. “It also requires two hours or less of screen time; one hour of physical activity and zero sugar-sweetened beverages. We are partnering with the YMCA to promote the program and encourage citizens to adopt these four elements.”

Organizations receiving the grants include the City of Oklahoma City Parks and Recreation Department, Metro Technology Centers, the Oklahoma City County Health Department, the Oklahoma City Indian Clinic and the Schools for Healthy Lifestyles.

Some metro-area companies are making it part of their overall business plan to offer not only the products they sell, but also health and fitness incentives to their customers.


“We could just sell shoes, but that did not fit with Red Coyote’s mission of actively promoting a healthy lifestyle in Oklahoma City and the surrounding areas.”

- Jon Beck


The owners of Red Coyote in Classen Curve say they founded their business with the goal of promoting an active lifestyle through community involvement and giving back.

“When Burke and I decided to open we wanted to be not just a retail store, but a resource for all things running and fitness,” said Red Coyote proprietor Jon Beck. “We opened in 2010 when Oklahoma City was consistently voted as one of the unhealthiest cities in the United States, and we wanted to help change that statistic.”

Beck says throughout their first year they met many people who were interested in getting in shape.

“We could just sell shoes, but that did not fit with Red Coyote’s mission of actively promoting a healthy lifestyle in Oklahoma City and the surrounding areas. We developed our ‘Newbie Program’ and it is offered in the spring and in the fall. Basically it is a beginner program designed for someone who has never run before or has taken a long break and wants to get back into running.
 


“From there, we began offering a 10k program to help Newbie graduates who want to go farther and gradually increase their distance,” Beck said. “And in the spring, Red Coyote offers our Half and Full Marathon Training Program that focuses on the Oklahoma City Memorial half and full marathon.

“Once a month we host a free Natural Running Form Clinic to teach better running form and to minimize the chance of injuries,” Beck added. “Then every Thursday night at 6 p.m. we have about 150 people gather at the store for the ‘Pack Pint Run.’ It is open to all abilities, and we have runners, walkers, strollers, and even dogs! It is truly a community event to promote fitness and fun.”

As spring ushers in longer days, lush green grass and golden sunshine, it is a time for new beginnings. Toss that pack of smokes, push away from the table and get outside. Better health and a better life are waiting. 




 

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March 2019

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