Living well summer 2014

Page 12 — Sunday, July 27, 2014

Muskogee Phoenix

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Living Well July 27, 2014

muskogeephoenix.com

Checkup: Health care by county

Page 2 — Sunday, July 27, 2014

Muskogee Phoenix

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Report: Incidence of cancer high in county

By Anita Reding Phoenix Staff Writer

Prevention and education should be top priorities for the state regarding health care, said Dr. Michael Stratton, a Muskogee physician.

Stratton made those comments in reference to the recent State of the State’s Health Report, on which Muskogee County ranked very low in numerous categories.

The state needs to focus on preventative medicine and educate people on diet, health, smoking cessation, substance abuse and other areas, he said.

“Overall, they need to learn how to live a healthy life,” he said.

Muskogee County is ranked 69th in the state for total mortality, and the leading causes of death are heart disease, cancer and chronic lower respiratory disease, according to the State of the State’s Health Report.

The county’s cancer incidence rate was one of the worst in the state and is 20 percent higher than the national rate, the report states.

Muskogee County ranked 75th in the state for the rate of deaths attributed to chronic lower respiratory disease.

The report also states that 28 percent of the adults in the county were currently smokers, and ranked the county as the fourth highest in the state — 41 percent higher than the national rate.

The rates of death due to chronic lower respiratory disease and unintentional injury worsened by 31 percent and 36 percent respectively.

The county received low grades for several risk factors, including scores of

Staff photo by Anita Reding

Dr. Michael Stratton completes an office exam for Quaid Sikes, 15 months, as his mother, Lacy Sikes, holds him. Muskogee County received an A in the recent State of the State’s Health Report for immunizations of children 3 or younger.

“F” for minimal fruit and physical activity, the vegetable consumption. A report states. grade of “F” also was given The news was not all to the county for lack of bad for the county, howev-

er. The rate of deaths due fatality rate improved 28 to nephritis (kidney dis- percent. ease) improved 37 perThe county also saw a cent. The occupational decrease in the occurrence

Muskogee County Health Report Previous Current Grade MORTALITY Infant (rate per 1,000) 5.9 7.5 D Total (rate per 100,000) 963.7 1060.5 F LEADING CAUSES OF DEATH (Rate per 100,000) Heart disease 252.9 257.4 F Malignant neoplasm (cancer) 217.4 212.7 F Cerebrovascular disease (stroke) 54.7 53.1 F Chronic lower respiratory disease 76.2 99.8 F Unintentional injury 49.7 67.4 F Diabetes 29.8 18.7 A

Influenza/pneumonia 18.5 32.8 F Alzheimer’s disease 43.7 33.6 D Nephritis (kidney disease) 15.7 9.9 B Suicides 14.6 15.7 D DISEASE RATES Diabetes prevalence 12.5% 12.9% F Current asthma prevalence 10.6% 11.3% F Cancer incidence (Rate per 100,000) 545.3 553.8 F RISK FACTORS AND BEHAVIORS Minimal fruit consumption NA 51.7% F Minimal vegetable consumption

NA 28.6% F No physical activity 33.1% 30.1% F Current smoking prevalence 30.7% 27.6% F Obesity 32.2% 33.4% F Immunizations < 3 years 72.0% 79.8% A Seniors influenza vaccination 62.2% 67.7% B Seniors pneumonia vaccination 71.7% 73.9% A Limited activity days 19.0% 20.6% F Poor mental health days 28.2% 26..5% D Poor physical health days 25.8% 26.5% F Good or better health rating 74.3% 75.6% F Teen fertility (rate per 1,000)

35.5 29.9 F First trimester prenatal care 60.3% 63.2% F Low birth weight 8.6% 8.9% D Adult dental visits 49.7% 51.2% F Usual source of care 75.3% 75.4% C Occupational fatalities (Rate per 100,000 workers) 5.0 3.6 C Preventable hospitalizations (Rate per 100,000) 2486.3 2380.6 F SOCIOECONOMIC FACTORS No insurance 24.0% 19.9% D Poverty 19.7% 24.1% F Source: Oklahoma Department of Health

of diabetes, and received an “A.” The county received top scores for the number of seniors receiving influenza and pneumonia vaccinations.

Stratton said the recent decision to cut reimbursements for the state’s Medicaid and SoonerCare to physicians will affect health care.

“Why are we cutting health care when our state is ranked at the bottom as far as the health of our citizens?” he said.

“We’ve made very big strides in health care for children,” he said, adding that some specialists have been brought to the state.

With the decrease in reimbursement, Stratton said the state will see some of the doctors who were recruited leaving.

“That’s going to be a tragic thing for the state,” he said.

Stratton said there are several reasons for the infant mortality rate being worse than the previous year on the recent health report, including drug abuse by parents, lack of prenatal care, child abuse and lack of education.

Based on the information in the State of the State’s Health Report, Oklahoma overall is making progress, said William Pierson, the county health department’s acting director.

“We still have a ways to go, but we are seeing some improvement,” he said.

He said that the Oklahoma health improvement plan is focused on three key issues — children’s health, obesity and smoking cessation. If those areas can be improved “we are making progress.”

Reach Anita Reding at (918) 684-2903 or areding @muskogeephoenix.com.

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Muskogee Phoenix

Sunday, July 27, 2014 — Page 11

Wagoner County death rate lower than state’s

By D.E. Smoot Phoenix Staff Writer

A recent report released by the Oklahoma Department of Health shows the state continues to face ongoing challenges with regard to public health, but there are promising signs of improvement.

Total mortality rates for the state — Oklahoma has the fourth highest rate of deaths in the nation from all causes — earned a failing grade with 915.5 deaths for 100,000 residents. That compares to 747 deaths per capita for the nation as a whole.

Oklahoma performed slightly better — it earned a D in the 2014 State of the State’s Health Report — when it comes to infant mortalities, with 7.6 deaths for every 1,000 infants in the state.

Nationally, the per capita rate of infant mortality was 6.1 per 1,000.

Wagoner County fared somewhat better than the state as a whole, with state health officials assigning a score of D for total mortality rate.

Statistics for 2012, the base year for this year’s report, show there were 830.7 deaths per 100,000 residents — that is down from the 910.8 deaths reported previously.

The infant mortality rate in Wagoner County also fared better than the state as a whole, with just 5.6 deaths of children

Wagoner County Health Report Previous Current Grade MORTALITY Infant (rate per 1,000) 5.4 5.6 C Total (rate per 100,000) 910.8 830.7 D LEADING CAUSES OF DEATH (Rate per 100,000) Heart disease 249.4 208.5 D Malignant neoplasm (cancer) 206.0 188.6 D Cerebrovascular disease (stroke) 59.1 41.2 C Chronic lower respiratory disease 68.8 67.1 F Unintentional injury 55.0 56.5 F Diabetes 36.1 22.4 C

younger than 12 months of 1,000 reported for the study year. While scoring a C with regard to infant mortality, the rate crept upward from the previous rate of 5.4 infant deaths per 1,000.

Stacey Jones, extension educator for family and consumer sciences with the Oklahoma State University Extension Office in Coweta, credited public awareness and access for recent public health improvements in Wagoner County. She also attributed some of the better-than-average numbers on lower poverty levels and a more educated population.

“Here in Wagoner County, we do have a higher number of people who have attended col-

Influenza/pneumonia 21.8 11.4 B Alzheimer’s disease 28.3 26.3 C Nephritis (kidney disease) 5.9 14.1 C Suicides 10.2 17.0 D DISEASE RATES Diabetes prevalence 11.8% 12.2% F Current asthma prevalence 8.1% 8.5% C Cancer incidence (rate per 100,000) 300.7 384.8 A RISK FACTORS AND BEHAVIORS Minimal fruit consumption NA 51.3% F Minimal vegetable consumption

lege, more people with master’s degrees and doctorate-level education,” said Jones, who also is a member of Wagoner County Family Service Council.

“Wagoner County is somewhat rural but semi-urbanized, so we do have access to several colleges and universities.”

Louise Micolites, a regional consultant for Oklahoma Turning Point Coalition, credited an increased focus on environmental factors that can impact public health.

She said the coalition works with communities and local organization to find solutions to local public health needs.

“It’s a good and worthy thing to educate people, but the fact is most people already know what they

NA 25.9% D No physical activity 30.7% 27.9% D Current smoking prevalence 25.1% 22.2% D Obesity 31.9% 33.0% F Immunizations < 3 years 60.1% 73.0% C Seniors influenza vaccination 64.7% 70.1% A Seniors pneumonia vaccination 74.1% 76.2% A Limited activity days 16.3% 17.6% C Poor mental health days 26.1% 24.4% C Poor physical health days 22.4% 23.0% C Good or better health rating 81.7% 82.8% C Teen fertility (rate per 1,000)

need to do to be healthy,” Micolites said. “What we are really trying to do now — the big push during the past five years — is try to change the environment people live in a way that supports proper eating and exercise.”

Micolites said the focus in public health initiatives now tends to focus more on providing opportunities to live a healthy lifestyle. Some factors include efforts to make sure there are safe, lighted sidewalks, and parks to promote active lifestyles.

While being proactive on that end, Micolites said the No. 1 health concern in most of Oklahoma continues to be tobacco cessation. She said programs made possible by an

14.9 13.8 C First trimester prenatal care 62.5% 64.2% F Low birth weight 8.1% 7.3% B Adult dental visits 60.7% 62.5% D Usual source of care 81.5% 81.8% B Occupational fatalities (Rate per 100,000) 2.0 4.8 C Preventable hospitalizations (Rate per 100,000) 1831.7 1747.8 D SOCIOECONOMIC FACTORS No insurance 17.3% 13.6% B Poverty 11.0% 12.8% B Source: Oklahoma Department of Health

endowment fund set up with settlement proceeds from tobacco lawsuits has resulted with a 10 percent drop in tobacco use, but more can be done.

The leading causes of death in Wagoner County, which ranks as the 13th best of the 77 counties in Oklahoma, were heart disease, cancer, stroke and chronic lower respiratory disease. Even with cancer being the second leading cause of death there, Wagoner County had one of the lowest incidences of cancer in the state and, 16 percent lower than the national rate with just 188.6 deaths of 100,000 attributable to cancer.

Wagoner County outshined most other Oklahoma counties in a number of public health-

related areas, according the state report. The county had the 10th best selfhealth rating and the eighth lowest rate of residents who live below the poverty level.

Other risk data related to behavioral or socioeconomic factors show Wagoner County tied for the third lowest rate for teenagers giving birth — with 13.8 teen pregnancies per 1,000 teens, it ranked 40 percent lower than the state rate per capita.

Even while the number of teen pregnancies in Wagoner County trended downward, the county received a failing grade for prenatal care during the first trimester of all pregnancies. Jones said there could be a couple reasons to explain the phenomenon: Some women may not know they are pregnant until they reach the end of the first trimester, and others may be opting for alternative care.

With regard to future improvements, both Jones and Micolites said there is a greater emphasis on childhood obesity and diabetes. Jones said she is working with state officials on a program focusing on students ranging from third- to eighthgrade to improve fitness through better eating habits and more active lifestyles.

Reach D.E. Smoot at (918) 684-2901 or dsmoot @muskogeephoenix.com.å

“What we are really trying to do now — the big push during the past five years — is try to change the environment people live in a way that supports proper eating and exercise.”

— Louise Micolites, a regional consultant for Oklahoma Turning Point Coalition

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McIntosh Continued from Page 5

dren who completed the primary immunization series improved by 29 percent. The infant mortality rate saw a slight improvement and the low birthweight rate dropped by 15 percent.

“There has been a real concentrated effort to talk about tobacco prevention,” Ables said.

Current smoking prevalence dropped from 26.9 percent to 23.8 percent.

Ables said a push from the health departments, especially in schools, may have accounted for the decrease.

Other positive percentages from McIntosh

Muskogee Phoenix County include an improved mortality rate and senior vaccination rates.

The overall mortality rate improved 6 percent, and the rate of deaths due to kidney disease improved by 27 percent.

Seniors’ influenza and pneumonia vaccinations ranked better than the national average.

Ables said the health

report is an important indicator for the state.

Risk behavior surveys and hospital data is used to gather the information.

“This is something that gives us a snapshot of what’s goin˚g on in the county,” Ables said. “We use the most consistent data sources that are available.”

Reach E.I. Hillin at (918) 684-2926 or ehillin@ muskogeephoenix.com.

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Cherokee Continued from Page 8

Adams, who is taking the class, said she has learned a lot about caring for herself and her baby.

She said she also learned a lot visiting Champlain and Craig at Tahlequah Medical Center.

Champlain said women need prenatal care early in their pregnancy to help identify potential problems and risk factors. The Tahlequah Medical Center, part of the Northeastern Oklahoma Community Health Centers system, offers ultrasound and free pregnancy testing.

“We are striving to eliminate any barriers women would have to prenatal care,” Champlain said.

“Financial barriers are always a factor. Prenatal care would be a low priority for people who are struggling financially. We have a lot of patients with transportation issues.”

Poverty continues to be a major health issue in

Cherokee County.

According to the state report, nearly one in four Cherokee County residents — 24.6 percent — live in poverty.

Statewide, 18 percent of Oklahomans live in poverty.

Gahn said low economic status has been associated with several health risk factors.

“A lot of factors tie directly into education,” Gahn said.

For example, the state report also gave Cherokee County an “F” for a high teen fertility rate — 38.1 per thousand.

“One of the root causes for low economic status is having children as a teenager,” Gahn said. “If a woman has a child as a teenager, she is not as likely to finish school.”

Cherokee County also had a high rate of deaths caused by heart disease, cancer, lower respiratory disease, influenza/pneumonia and suicide, according to the 2014 report.

Reach Cathy Spaulding at (918) 684-2928 or cspaulding@muskogee phoenix.com.

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Muskogee Phoenix

Sunday, July 27, 2014 — Page 3

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Muskogee Phoenix

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State health facts Specific leading causes of death that contribute to Oklahoma’s high mortality rate include the following:

• Oklahoma has the 12th highest rate of death due to cancer in the nation.

• Oklahoma has the third

highest rate of death due to heart disease in the nation.

• Oklahoma has the fourth highest rate of death due to stroke in the nation.

• Oklahoma has the highest rate of death due to chronic lower respiratory disease in the nation.

• Oklahoma has the fourth highest rate of death due to diabetes in the nation.

Contributing to our high mortality rates are behavioral risk factors that disproportionately overburden Oklahomans. Areas of concern include the following: • Oklahoma is the 44th least physically active state in the nation.

• Oklahoma has the sixth highest rate of obesity in the nation.

• Oklahoma’s adult smoking rate in 2012, while better than the 26.1 percent in 2011, was 23.3 percent compared to 19.6 percent nationally.

Source: Oklahoma State Department of Health’s “State of the State’s Health Report”

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Muskogee Phoenix

Sunday, July 27, 2014 — Page 9

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Muskogee Phoenix

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Cherokee County gets F in prenatal care

Phoenix Staff Writer

Phoenix Staff Writer

“We are striving to eliminate any barriers women would have to prenatal care.”

While the numbers of uninsured adults and smokers decreased in McIntosh County, there’s definitely room for improvement, said Tressia Ables.

“We have made improvements,” Ables said. “We are very aware there are things we want to work on.”

McIntosh County’s leading causes of death are heart disease, cancer, and unintentional injury.

According to the Oklahoma State Department of Health’s “State of the State’s Health Report,” one in seven adults in McIntosh County had been diagnosed with diabetes, making it the second worse in the state and 46 percent higher than the national

— Dr. Wallace Champlain, ob/gyn at Tahlequah Medical Center

Sunday, July 27, 2014 — Page 5

rate.

Ables, public information officer for McIntosh County Health Department, said the three flagship issues the state health department is concentrating on are tobacco use prevention, obesity, and children’s health.

Inside the health report, data collected from 2012 is compiled to show risk factors, disease rates, and leading causes of death for each county.

Ables said there is a connection between the high percentages of heart disease and stroke and the lifestylˇˇes of residents in the county.

“McIntosh County is considered a poverty county,” Ables said. “There’s not a lot of economic development, and people are job hunting.”

The report states that

one in four residents in the county live in poverty.

The poverty rate increased from 20.8 percent to 24.5 percent since the previous year.

“When you’re living in a poverty county there’s not a whole lot of activities,” Ables said. “Type two diabetes directly tied into lack of exercise and poor eating habits.”

Teen fertility rates have increased from 21 percent to 27.3 percent. McIntosh ranked 27th in the state for teen fertility rates and is 77 percent higher than the national average.

While poverty and diabetes plague the county, the improvements in the amount of tobacco use and child immunizations are good signs, Ables said.

The percentage of chil(See MCINTOSH, Page 10)

McIntosh County Health Report Staff photo by Cathy Spaulding

Hulbert resident Rachel Adams rests on a pillow during a birthing class at Tahlequah City Hospital. The hosa certified nurse practipital offers the three-week class about four times a year. tioner and seven certified nurse midwives, said Dr. David Gahn, an ob/gyn Cherokee County Health Report and surveillance coordiPrevious Current grade Influenza/pneumonia NA 27.6% D 33.7 31.8 F nator for Cherokee MORTALITY 24.4 26.0 F No physical activity First trimester prenatal care Nation Public Health.

Infant (rate per 1,000) Alzheimer’s disease 30.5% 27.7% D 56.1% 59.6% F Tahlequah City 8.9 7.2 D 15.5 20.5 B Current smoking prevalence Low birth weight Hospital has three Total (rate per 100,000) Nephritis (kidney disease) 26.5% 23.7% D 7.7% 8.7% C 1053 9 955.2 F 20.7 8.7 B Obesity Adult dental visits ob/gyns and one nurse Suicides 31.3% 32.6% D 58.4% 60.1% D midwife, said Megan LEADING CAUSES 14.0 25.2 F Immunizations < 3 years Usual source of care Grogan, RN. Grogan OF DEATH 74.8% 76.9% B 72.6% 72.7% D helps teach a three-week (Rate per 100,000) DISEASE RATES Seniors influenza Occupational fatalities Heart disease Diabetes prevalence vaccination (Rate per 100,000 workers) birthing class at the hos291.8 257.7 F 10.7% 11.1% D 63.5% 68.9% A * 5.6 D pital, which is changing Malignant neoplasm (cancer) Current asthma prevalence Seniors pneumonia Preventable hospitalizations its name to Northeast 194.4 215.6 F 9.7% 10.3% D vaccination (Rate per 100,000) Health System.

Cerebrovascular disease Cancer incidence 73.5% 75.7% A 1775.7 1328.7 B “We have a class every (stroke) (rate per 100,000) Limited activity days SOCIOECONOMIC 73.2 43.8 D 447.3 489.2 D 17.5% 19.1% D FACTORS three months,” Grogan Chronic lower respiratory Poor mental health days No insurance said, adding that the disease RISK FACTORS 26.0% 24.4% C 21.5% 17.5% C class is $35 for women 63.9 65.4 F AND BEHAVIORS Poor physical health days Poverty delivering at TCH or $50 Unintentional injury Minimal fruit consumption 24.6% 25.3% D 25.3% 24.6% F for women delivering at 74.7 48.1 D NA 51.8% F Good or better health rating * Denotes <5 events in morDiabetes Minimal vegetable 79.2% 80.2% D tality fields. other hospitals.

35.7

(See CHEROKEE, Page 10)

Muskogee Phoenix

Diabetes incidence high in McIntosh County

By E.I. Hillin

By Cathy Spaulding TAHLEQUAH — With a baby due in three weeks, Hulbert resident Rachel Adams said she appreciates the prenatal care she receives at Tahlequah Medical Center.

“Dr. Champlain is great,” Adams said, referring to Dr. Wallace Champlain, ob/gyn at the center. “And I go to Sarah Craig, the nurse midwife.

I love her to pieces. She is a miracle worker. She is there every step of the way.”

Adams, 28, is fortunate to receive such care.

According to the Oklahoma State Department of Health, most Cherokee County mothers-to-be do not receive adequate prenatal care in their first trimester. The department’s 2014 State of the State’s Health Report gave Cherokee County an F letter grade for first trimester prenatal care, noting that 59.6 percent of women in the county receive such care, compared with 65.5 percent of women statewide.

Even at 65.5 percent, the state of Oklahoma received an F in that category.

The 2014 report showed a slight improvement from the state’s 2011 report, which indicated 56.1 percent of Cherokee County women receiving first trimester prenatal care.

Area health care providers are working to help women get through their pregnancy.

Cherokee Nation’s W.W. Hastings Hospital has six certified ob/gyns,

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24.2

D

consumption

Teen fertility (rate per 1,000)

Source: Oklahoma Department of Health

Previous Current grade MORTALITY Infant (rate per 1,000) 12.8 11.4 F Total (rate per 100,000) 965.5 1027.5 F LEADING CAUSES OF DEATH (Rate per 100,000) Heart disease 277.9 255.4 F Malignant neoplasm (cancer) 205.1 210.8 F Cerebrovascular disease (stroke) 55.9 49.0 F Chronic lower respiratory disease 77.3 83.8 F Unintentional injury 83.4 87.3 F Diabetes 28.6 18.6 A Influenza/pneumonia 15.0 35.4 F Alzheimer’s disease 12.6 24.0 C Nephritis (kidney disease) 11.9 8.7 B Suicides 18.0 17.9 F

DISEASE RATES Diabetes prevalence 13.4 14.0% F Current asthma prevalence 8.3 8.8% C Cancer incidence (rate per 100,000) 484.8 496.1 D RISK FACTORS AND BEHAVIORS Minimal fruit consumption NA 52.2% F Minimal vegetable consumption NA 28.6% F No physical activity 35.8% 32.9% F Current smoking prevalence 26.9% 23.8% D Obesity 32.4% 33.5% F Immunizations < 3 years 62.5% 80.6% A Seniors influenza vaccination 63.3% 68.7% A Seniors pneumonia vaccination 72.4% 74.6% A Limited activity days 18.5% 20.0% D

Poor mental health days 26.5% 24.7% C Poor physical health days 26.0% 26.8% F Good or better health rating 73.8% 75.0% F Teen fertility (rate per 1,000) 21.0 27.3 F First trimester prenatal care 54.7% 58.3% F Low birth weight 9.4% 7.9% C Adult dental visits 50.5% 52.1% F Usual source of care 77.6% 78.1% C Occupational fatalities (Rate per 100,000 workers) * * Preventable hospitalizations (Rate per 100,000) 1733.0 1763.9 D SOCIOECONOMIC FACTORS No insurance 20.5% 16.3% C Poverty 20.8% 24.5% F * Denotes <5 events in mortality fields.

Source: Oklahoma Department of Health

Staff photo by E.I. Hillin

Teryy Acuff, 38, stands smoking a cigarette on West Gentry Avenue in Checotah.

Acuff said he has been smoking most of his life and has no home. Poverty is one of the leading factors in health issues in McIntosh County according to health officials.

Page 6 — Sunday, July 27, 2014

Muskogee Phoenix

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Sunday, July 27, 2014 — Page 7

Oklahoma Health Report U.S.

Okla. Grade MORTALITY Infant (rate per 1,000) 6.1 7.6 D Total (rate per 100,000) 747.0 915.5 F LEADING CAUSES OF DEATH (Rate per 100,000) Heart disease 179.1 235.2 F Malignant neoplasm (cancer) 172.8 191.3 D Cerebrovascular disease (stroke) 39.1 50.0 F Chronic lower respiratory disease 42.2 67.4 F Unintentional injury 38.1 60.5 F Diabetes 20.8 26.9 D Influenza/pneumonia 15.1 19.7 D Alzheimer’s disease 25.1 26.1 C Nephritis (kidney disease) 15.3 15.0 C Suicides 12.1 16.5 D

DISEASE RATES Diabetes prevalence 9.7% 11.5% D Current asthma prevalence 8.9% 10.2% D Cancer incidence (rate per 100,000) 460.5 456.9 C RISK FACTORS AND BEHAVIORS Minimal fruit consumption 37.7% 50.2% F Minimal vegetable consumption 22.6% 26.8% D No physical activity 22.9% 28.3% D Current smoking prevalence 19.6% 23.3% D Obesity 27.6% 32.2% D Immunizations < 3 years 71.9% 64.7% D Seniors influenza vaccination 60.1% 67.8% B Seniors pneumonia vaccination 68.8% 74.9% A Limited activity days (avg.)

2.6 3.0 D

Poor mental health days (avg.)

3.9 4.2 C Poor physical health days (avg.)

4.0 4.4 D Good or better health rating 83.1% 81.0% D Teen fertility (rate per 1,000) 15.4 22.9 D First trimester prenatal care 73.1% 65.5% F Low birth weight 8.1% 8.4% C Adult dental visits 67.2% 58.9% F Usual source of care 77.8% 75.9% C Occupational fatalities (Rate per 100,000 workers) 4.1 7.0 F Preventable hospitalizations (Rate per 100,000) 1562.1 1815.8 D SOCIOECONOMIC FACTORS No insurance 17.1% 18.0% C Poverty 15.9% 17.2% C Source: Oklahoma Dept. of Health

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Muskogee Phoenix

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Muskogee Phoenix

Sunday, July 27, 2014 — Page 7

Oklahoma Health Report U.S.

Okla. Grade MORTALITY Infant (rate per 1,000) 6.1 7.6 D Total (rate per 100,000) 747.0 915.5 F LEADING CAUSES OF DEATH (Rate per 100,000) Heart disease 179.1 235.2 F Malignant neoplasm (cancer) 172.8 191.3 D Cerebrovascular disease (stroke) 39.1 50.0 F Chronic lower respiratory disease 42.2 67.4 F Unintentional injury 38.1 60.5 F Diabetes 20.8 26.9 D Influenza/pneumonia 15.1 19.7 D Alzheimer’s disease 25.1 26.1 C Nephritis (kidney disease) 15.3 15.0 C Suicides 12.1 16.5 D

DISEASE RATES Diabetes prevalence 9.7% 11.5% D Current asthma prevalence 8.9% 10.2% D Cancer incidence (rate per 100,000) 460.5 456.9 C RISK FACTORS AND BEHAVIORS Minimal fruit consumption 37.7% 50.2% F Minimal vegetable consumption 22.6% 26.8% D No physical activity 22.9% 28.3% D Current smoking prevalence 19.6% 23.3% D Obesity 27.6% 32.2% D Immunizations < 3 years 71.9% 64.7% D Seniors influenza vaccination 60.1% 67.8% B Seniors pneumonia vaccination 68.8% 74.9% A Limited activity days (avg.)

2.6 3.0 D

Poor mental health days (avg.)

3.9 4.2 C Poor physical health days (avg.)

4.0 4.4 D Good or better health rating 83.1% 81.0% D Teen fertility (rate per 1,000) 15.4 22.9 D First trimester prenatal care 73.1% 65.5% F Low birth weight 8.1% 8.4% C Adult dental visits 67.2% 58.9% F Usual source of care 77.8% 75.9% C Occupational fatalities (Rate per 100,000 workers) 4.1 7.0 F Preventable hospitalizations (Rate per 100,000) 1562.1 1815.8 D SOCIOECONOMIC FACTORS No insurance 17.1% 18.0% C Poverty 15.9% 17.2% C Source: Oklahoma Dept. of Health

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Muskogee Phoenix

Living Well

Cherokee County gets F in prenatal care

Phoenix Staff Writer

Phoenix Staff Writer

“We are striving to eliminate any barriers women would have to prenatal care.”

While the numbers of uninsured adults and smokers decreased in McIntosh County, there’s definitely room for improvement, said Tressia Ables.

“We have made improvements,” Ables said. “We are very aware there are things we want to work on.”

McIntosh County’s leading causes of death are heart disease, cancer, and unintentional injury.

According to the Oklahoma State Department of Health’s “State of the State’s Health Report,” one in seven adults in McIntosh County had been diagnosed with diabetes, making it the second worse in the state and 46 percent higher than the national

— Dr. Wallace Champlain, ob/gyn at Tahlequah Medical Center

Sunday, July 27, 2014 — Page 5

rate.

Ables, public information officer for McIntosh County Health Department, said the three flagship issues the state health department is concentrating on are tobacco use prevention, obesity, and children’s health.

Inside the health report, data collected from 2012 is compiled to show risk factors, disease rates, and leading causes of death for each county.

Ables said there is a connection between the high percentages of heart disease and stroke and the lifestylˇˇes of residents in the county.

“McIntosh County is considered a poverty county,” Ables said. “There’s not a lot of economic development, and people are job hunting.”

The report states that

one in four residents in the county live in poverty.

The poverty rate increased from 20.8 percent to 24.5 percent since the previous year.

“When you’re living in a poverty county there’s not a whole lot of activities,” Ables said. “Type two diabetes directly tied into lack of exercise and poor eating habits.”

Teen fertility rates have increased from 21 percent to 27.3 percent. McIntosh ranked 27th in the state for teen fertility rates and is 77 percent higher than the national average.

While poverty and diabetes plague the county, the improvements in the amount of tobacco use and child immunizations are good signs, Ables said.

The percentage of chil(See MCINTOSH, Page 10)

McIntosh County Health Report Staff photo by Cathy Spaulding

Hulbert resident Rachel Adams rests on a pillow during a birthing class at Tahlequah City Hospital. The hosa certified nurse practipital offers the three-week class about four times a year. tioner and seven certified nurse midwives, said Dr. David Gahn, an ob/gyn Cherokee County Health Report and surveillance coordiPrevious Current grade Influenza/pneumonia NA 27.6% D 33.7 31.8 F nator for Cherokee MORTALITY 24.4 26.0 F No physical activity First trimester prenatal care Nation Public Health.

Infant (rate per 1,000) Alzheimer’s disease 30.5% 27.7% D 56.1% 59.6% F Tahlequah City 8.9 7.2 D 15.5 20.5 B Current smoking prevalence Low birth weight Hospital has three Total (rate per 100,000) Nephritis (kidney disease) 26.5% 23.7% D 7.7% 8.7% C 1053 9 955.2 F 20.7 8.7 B Obesity Adult dental visits ob/gyns and one nurse Suicides 31.3% 32.6% D 58.4% 60.1% D midwife, said Megan LEADING CAUSES 14.0 25.2 F Immunizations < 3 years Usual source of care Grogan, RN. Grogan OF DEATH 74.8% 76.9% B 72.6% 72.7% D helps teach a three-week (Rate per 100,000) DISEASE RATES Seniors influenza Occupational fatalities Heart disease Diabetes prevalence vaccination (Rate per 100,000 workers) birthing class at the hos291.8 257.7 F 10.7% 11.1% D 63.5% 68.9% A * 5.6 D pital, which is changing Malignant neoplasm (cancer) Current asthma prevalence Seniors pneumonia Preventable hospitalizations its name to Northeast 194.4 215.6 F 9.7% 10.3% D vaccination (Rate per 100,000) Health System.

Cerebrovascular disease Cancer incidence 73.5% 75.7% A 1775.7 1328.7 B “We have a class every (stroke) (rate per 100,000) Limited activity days SOCIOECONOMIC 73.2 43.8 D 447.3 489.2 D 17.5% 19.1% D FACTORS three months,” Grogan Chronic lower respiratory Poor mental health days No insurance said, adding that the disease RISK FACTORS 26.0% 24.4% C 21.5% 17.5% C class is $35 for women 63.9 65.4 F AND BEHAVIORS Poor physical health days Poverty delivering at TCH or $50 Unintentional injury Minimal fruit consumption 24.6% 25.3% D 25.3% 24.6% F for women delivering at 74.7 48.1 D NA 51.8% F Good or better health rating * Denotes <5 events in morDiabetes Minimal vegetable 79.2% 80.2% D tality fields. other hospitals.

35.7

(See CHEROKEE, Page 10)

Muskogee Phoenix

Diabetes incidence high in McIntosh County

By E.I. Hillin

By Cathy Spaulding TAHLEQUAH — With a baby due in three weeks, Hulbert resident Rachel Adams said she appreciates the prenatal care she receives at Tahlequah Medical Center.

“Dr. Champlain is great,” Adams said, referring to Dr. Wallace Champlain, ob/gyn at the center. “And I go to Sarah Craig, the nurse midwife.

I love her to pieces. She is a miracle worker. She is there every step of the way.”

Adams, 28, is fortunate to receive such care.

According to the Oklahoma State Department of Health, most Cherokee County mothers-to-be do not receive adequate prenatal care in their first trimester. The department’s 2014 State of the State’s Health Report gave Cherokee County an F letter grade for first trimester prenatal care, noting that 59.6 percent of women in the county receive such care, compared with 65.5 percent of women statewide.

Even at 65.5 percent, the state of Oklahoma received an F in that category.

The 2014 report showed a slight improvement from the state’s 2011 report, which indicated 56.1 percent of Cherokee County women receiving first trimester prenatal care.

Area health care providers are working to help women get through their pregnancy.

Cherokee Nation’s W.W. Hastings Hospital has six certified ob/gyns,

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24.2

D

consumption

Teen fertility (rate per 1,000)

Source: Oklahoma Department of Health

Previous Current grade MORTALITY Infant (rate per 1,000) 12.8 11.4 F Total (rate per 100,000) 965.5 1027.5 F LEADING CAUSES OF DEATH (Rate per 100,000) Heart disease 277.9 255.4 F Malignant neoplasm (cancer) 205.1 210.8 F Cerebrovascular disease (stroke) 55.9 49.0 F Chronic lower respiratory disease 77.3 83.8 F Unintentional injury 83.4 87.3 F Diabetes 28.6 18.6 A Influenza/pneumonia 15.0 35.4 F Alzheimer’s disease 12.6 24.0 C Nephritis (kidney disease) 11.9 8.7 B Suicides 18.0 17.9 F

DISEASE RATES Diabetes prevalence 13.4 14.0% F Current asthma prevalence 8.3 8.8% C Cancer incidence (rate per 100,000) 484.8 496.1 D RISK FACTORS AND BEHAVIORS Minimal fruit consumption NA 52.2% F Minimal vegetable consumption NA 28.6% F No physical activity 35.8% 32.9% F Current smoking prevalence 26.9% 23.8% D Obesity 32.4% 33.5% F Immunizations < 3 years 62.5% 80.6% A Seniors influenza vaccination 63.3% 68.7% A Seniors pneumonia vaccination 72.4% 74.6% A Limited activity days 18.5% 20.0% D

Poor mental health days 26.5% 24.7% C Poor physical health days 26.0% 26.8% F Good or better health rating 73.8% 75.0% F Teen fertility (rate per 1,000) 21.0 27.3 F First trimester prenatal care 54.7% 58.3% F Low birth weight 9.4% 7.9% C Adult dental visits 50.5% 52.1% F Usual source of care 77.6% 78.1% C Occupational fatalities (Rate per 100,000 workers) * * Preventable hospitalizations (Rate per 100,000) 1733.0 1763.9 D SOCIOECONOMIC FACTORS No insurance 20.5% 16.3% C Poverty 20.8% 24.5% F * Denotes <5 events in mortality fields.

Source: Oklahoma Department of Health

Staff photo by E.I. Hillin

Teryy Acuff, 38, stands smoking a cigarette on West Gentry Avenue in Checotah.

Acuff said he has been smoking most of his life and has no home. Poverty is one of the leading factors in health issues in McIntosh County according to health officials.

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Muskogee Phoenix

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State health facts Specific leading causes of death that contribute to Oklahoma’s high mortality rate include the following:

• Oklahoma has the 12th highest rate of death due to cancer in the nation.

• Oklahoma has the third

highest rate of death due to heart disease in the nation.

• Oklahoma has the fourth highest rate of death due to stroke in the nation.

• Oklahoma has the highest rate of death due to chronic lower respiratory disease in the nation.

• Oklahoma has the fourth highest rate of death due to diabetes in the nation.

Contributing to our high mortality rates are behavioral risk factors that disproportionately overburden Oklahomans. Areas of concern include the following: • Oklahoma is the 44th least physically active state in the nation.

• Oklahoma has the sixth highest rate of obesity in the nation.

• Oklahoma’s adult smoking rate in 2012, while better than the 26.1 percent in 2011, was 23.3 percent compared to 19.6 percent nationally.

Source: Oklahoma State Department of Health’s “State of the State’s Health Report”

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Muskogee Phoenix

Sunday, July 27, 2014 — Page 9

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McIntosh Continued from Page 5

dren who completed the primary immunization series improved by 29 percent. The infant mortality rate saw a slight improvement and the low birthweight rate dropped by 15 percent.

“There has been a real concentrated effort to talk about tobacco prevention,” Ables said.

Current smoking prevalence dropped from 26.9 percent to 23.8 percent.

Ables said a push from the health departments, especially in schools, may have accounted for the decrease.

Other positive percentages from McIntosh

Muskogee Phoenix County include an improved mortality rate and senior vaccination rates.

The overall mortality rate improved 6 percent, and the rate of deaths due to kidney disease improved by 27 percent.

Seniors’ influenza and pneumonia vaccinations ranked better than the national average.

Ables said the health

report is an important indicator for the state.

Risk behavior surveys and hospital data is used to gather the information.

“This is something that gives us a snapshot of what’s goin˚g on in the county,” Ables said. “We use the most consistent data sources that are available.”

Reach E.I. Hillin at (918) 684-2926 or ehillin@ muskogeephoenix.com.

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Cherokee Continued from Page 8

Adams, who is taking the class, said she has learned a lot about caring for herself and her baby.

She said she also learned a lot visiting Champlain and Craig at Tahlequah Medical Center.

Champlain said women need prenatal care early in their pregnancy to help identify potential problems and risk factors. The Tahlequah Medical Center, part of the Northeastern Oklahoma Community Health Centers system, offers ultrasound and free pregnancy testing.

“We are striving to eliminate any barriers women would have to prenatal care,” Champlain said.

“Financial barriers are always a factor. Prenatal care would be a low priority for people who are struggling financially. We have a lot of patients with transportation issues.”

Poverty continues to be a major health issue in

Cherokee County.

According to the state report, nearly one in four Cherokee County residents — 24.6 percent — live in poverty.

Statewide, 18 percent of Oklahomans live in poverty.

Gahn said low economic status has been associated with several health risk factors.

“A lot of factors tie directly into education,” Gahn said.

For example, the state report also gave Cherokee County an “F” for a high teen fertility rate — 38.1 per thousand.

“One of the root causes for low economic status is having children as a teenager,” Gahn said. “If a woman has a child as a teenager, she is not as likely to finish school.”

Cherokee County also had a high rate of deaths caused by heart disease, cancer, lower respiratory disease, influenza/pneumonia and suicide, according to the 2014 report.

Reach Cathy Spaulding at (918) 684-2928 or cspaulding@muskogee phoenix.com.

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Muskogee Phoenix

Sunday, July 27, 2014 — Page 3

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Muskogee Phoenix

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Report: Incidence of cancer high in county

By Anita Reding Phoenix Staff Writer

Prevention and education should be top priorities for the state regarding health care, said Dr. Michael Stratton, a Muskogee physician.

Stratton made those comments in reference to the recent State of the State’s Health Report, on which Muskogee County ranked very low in numerous categories.

The state needs to focus on preventative medicine and educate people on diet, health, smoking cessation, substance abuse and other areas, he said.

“Overall, they need to learn how to live a healthy life,” he said.

Muskogee County is ranked 69th in the state for total mortality, and the leading causes of death are heart disease, cancer and chronic lower respiratory disease, according to the State of the State’s Health Report.

The county’s cancer incidence rate was one of the worst in the state and is 20 percent higher than the national rate, the report states.

Muskogee County ranked 75th in the state for the rate of deaths attributed to chronic lower respiratory disease.

The report also states that 28 percent of the adults in the county were currently smokers, and ranked the county as the fourth highest in the state — 41 percent higher than the national rate.

The rates of death due to chronic lower respiratory disease and unintentional injury worsened by 31 percent and 36 percent respectively.

The county received low grades for several risk factors, including scores of

Staff photo by Anita Reding

Dr. Michael Stratton completes an office exam for Quaid Sikes, 15 months, as his mother, Lacy Sikes, holds him. Muskogee County received an A in the recent State of the State’s Health Report for immunizations of children 3 or younger.

“F” for minimal fruit and physical activity, the vegetable consumption. A report states. grade of “F” also was given The news was not all to the county for lack of bad for the county, howev-

er. The rate of deaths due fatality rate improved 28 to nephritis (kidney dis- percent. ease) improved 37 perThe county also saw a cent. The occupational decrease in the occurrence

Muskogee County Health Report Previous Current Grade MORTALITY Infant (rate per 1,000) 5.9 7.5 D Total (rate per 100,000) 963.7 1060.5 F LEADING CAUSES OF DEATH (Rate per 100,000) Heart disease 252.9 257.4 F Malignant neoplasm (cancer) 217.4 212.7 F Cerebrovascular disease (stroke) 54.7 53.1 F Chronic lower respiratory disease 76.2 99.8 F Unintentional injury 49.7 67.4 F Diabetes 29.8 18.7 A

Influenza/pneumonia 18.5 32.8 F Alzheimer’s disease 43.7 33.6 D Nephritis (kidney disease) 15.7 9.9 B Suicides 14.6 15.7 D DISEASE RATES Diabetes prevalence 12.5% 12.9% F Current asthma prevalence 10.6% 11.3% F Cancer incidence (Rate per 100,000) 545.3 553.8 F RISK FACTORS AND BEHAVIORS Minimal fruit consumption NA 51.7% F Minimal vegetable consumption

NA 28.6% F No physical activity 33.1% 30.1% F Current smoking prevalence 30.7% 27.6% F Obesity 32.2% 33.4% F Immunizations < 3 years 72.0% 79.8% A Seniors influenza vaccination 62.2% 67.7% B Seniors pneumonia vaccination 71.7% 73.9% A Limited activity days 19.0% 20.6% F Poor mental health days 28.2% 26..5% D Poor physical health days 25.8% 26.5% F Good or better health rating 74.3% 75.6% F Teen fertility (rate per 1,000)

35.5 29.9 F First trimester prenatal care 60.3% 63.2% F Low birth weight 8.6% 8.9% D Adult dental visits 49.7% 51.2% F Usual source of care 75.3% 75.4% C Occupational fatalities (Rate per 100,000 workers) 5.0 3.6 C Preventable hospitalizations (Rate per 100,000) 2486.3 2380.6 F SOCIOECONOMIC FACTORS No insurance 24.0% 19.9% D Poverty 19.7% 24.1% F Source: Oklahoma Department of Health

of diabetes, and received an “A.” The county received top scores for the number of seniors receiving influenza and pneumonia vaccinations.

Stratton said the recent decision to cut reimbursements for the state’s Medicaid and SoonerCare to physicians will affect health care.

“Why are we cutting health care when our state is ranked at the bottom as far as the health of our citizens?” he said.

“We’ve made very big strides in health care for children,” he said, adding that some specialists have been brought to the state.

With the decrease in reimbursement, Stratton said the state will see some of the doctors who were recruited leaving.

“That’s going to be a tragic thing for the state,” he said.

Stratton said there are several reasons for the infant mortality rate being worse than the previous year on the recent health report, including drug abuse by parents, lack of prenatal care, child abuse and lack of education.

Based on the information in the State of the State’s Health Report, Oklahoma overall is making progress, said William Pierson, the county health department’s acting director.

“We still have a ways to go, but we are seeing some improvement,” he said.

He said that the Oklahoma health improvement plan is focused on three key issues — children’s health, obesity and smoking cessation. If those areas can be improved “we are making progress.”

Reach Anita Reding at (918) 684-2903 or areding @muskogeephoenix.com.

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Muskogee Phoenix

Sunday, July 27, 2014 — Page 11

Wagoner County death rate lower than state’s

By D.E. Smoot Phoenix Staff Writer

A recent report released by the Oklahoma Department of Health shows the state continues to face ongoing challenges with regard to public health, but there are promising signs of improvement.

Total mortality rates for the state — Oklahoma has the fourth highest rate of deaths in the nation from all causes — earned a failing grade with 915.5 deaths for 100,000 residents. That compares to 747 deaths per capita for the nation as a whole.

Oklahoma performed slightly better — it earned a D in the 2014 State of the State’s Health Report — when it comes to infant mortalities, with 7.6 deaths for every 1,000 infants in the state.

Nationally, the per capita rate of infant mortality was 6.1 per 1,000.

Wagoner County fared somewhat better than the state as a whole, with state health officials assigning a score of D for total mortality rate.

Statistics for 2012, the base year for this year’s report, show there were 830.7 deaths per 100,000 residents — that is down from the 910.8 deaths reported previously.

The infant mortality rate in Wagoner County also fared better than the state as a whole, with just 5.6 deaths of children

Wagoner County Health Report Previous Current Grade MORTALITY Infant (rate per 1,000) 5.4 5.6 C Total (rate per 100,000) 910.8 830.7 D LEADING CAUSES OF DEATH (Rate per 100,000) Heart disease 249.4 208.5 D Malignant neoplasm (cancer) 206.0 188.6 D Cerebrovascular disease (stroke) 59.1 41.2 C Chronic lower respiratory disease 68.8 67.1 F Unintentional injury 55.0 56.5 F Diabetes 36.1 22.4 C

younger than 12 months of 1,000 reported for the study year. While scoring a C with regard to infant mortality, the rate crept upward from the previous rate of 5.4 infant deaths per 1,000.

Stacey Jones, extension educator for family and consumer sciences with the Oklahoma State University Extension Office in Coweta, credited public awareness and access for recent public health improvements in Wagoner County. She also attributed some of the better-than-average numbers on lower poverty levels and a more educated population.

“Here in Wagoner County, we do have a higher number of people who have attended col-

Influenza/pneumonia 21.8 11.4 B Alzheimer’s disease 28.3 26.3 C Nephritis (kidney disease) 5.9 14.1 C Suicides 10.2 17.0 D DISEASE RATES Diabetes prevalence 11.8% 12.2% F Current asthma prevalence 8.1% 8.5% C Cancer incidence (rate per 100,000) 300.7 384.8 A RISK FACTORS AND BEHAVIORS Minimal fruit consumption NA 51.3% F Minimal vegetable consumption

lege, more people with master’s degrees and doctorate-level education,” said Jones, who also is a member of Wagoner County Family Service Council.

“Wagoner County is somewhat rural but semi-urbanized, so we do have access to several colleges and universities.”

Louise Micolites, a regional consultant for Oklahoma Turning Point Coalition, credited an increased focus on environmental factors that can impact public health.

She said the coalition works with communities and local organization to find solutions to local public health needs.

“It’s a good and worthy thing to educate people, but the fact is most people already know what they

NA 25.9% D No physical activity 30.7% 27.9% D Current smoking prevalence 25.1% 22.2% D Obesity 31.9% 33.0% F Immunizations < 3 years 60.1% 73.0% C Seniors influenza vaccination 64.7% 70.1% A Seniors pneumonia vaccination 74.1% 76.2% A Limited activity days 16.3% 17.6% C Poor mental health days 26.1% 24.4% C Poor physical health days 22.4% 23.0% C Good or better health rating 81.7% 82.8% C Teen fertility (rate per 1,000)

need to do to be healthy,” Micolites said. “What we are really trying to do now — the big push during the past five years — is try to change the environment people live in a way that supports proper eating and exercise.”

Micolites said the focus in public health initiatives now tends to focus more on providing opportunities to live a healthy lifestyle. Some factors include efforts to make sure there are safe, lighted sidewalks, and parks to promote active lifestyles.

While being proactive on that end, Micolites said the No. 1 health concern in most of Oklahoma continues to be tobacco cessation. She said programs made possible by an

14.9 13.8 C First trimester prenatal care 62.5% 64.2% F Low birth weight 8.1% 7.3% B Adult dental visits 60.7% 62.5% D Usual source of care 81.5% 81.8% B Occupational fatalities (Rate per 100,000) 2.0 4.8 C Preventable hospitalizations (Rate per 100,000) 1831.7 1747.8 D SOCIOECONOMIC FACTORS No insurance 17.3% 13.6% B Poverty 11.0% 12.8% B Source: Oklahoma Department of Health

endowment fund set up with settlement proceeds from tobacco lawsuits has resulted with a 10 percent drop in tobacco use, but more can be done.

The leading causes of death in Wagoner County, which ranks as the 13th best of the 77 counties in Oklahoma, were heart disease, cancer, stroke and chronic lower respiratory disease. Even with cancer being the second leading cause of death there, Wagoner County had one of the lowest incidences of cancer in the state and, 16 percent lower than the national rate with just 188.6 deaths of 100,000 attributable to cancer.

Wagoner County outshined most other Oklahoma counties in a number of public health-

related areas, according the state report. The county had the 10th best selfhealth rating and the eighth lowest rate of residents who live below the poverty level.

Other risk data related to behavioral or socioeconomic factors show Wagoner County tied for the third lowest rate for teenagers giving birth — with 13.8 teen pregnancies per 1,000 teens, it ranked 40 percent lower than the state rate per capita.

Even while the number of teen pregnancies in Wagoner County trended downward, the county received a failing grade for prenatal care during the first trimester of all pregnancies. Jones said there could be a couple reasons to explain the phenomenon: Some women may not know they are pregnant until they reach the end of the first trimester, and others may be opting for alternative care.

With regard to future improvements, both Jones and Micolites said there is a greater emphasis on childhood obesity and diabetes. Jones said she is working with state officials on a program focusing on students ranging from third- to eighthgrade to improve fitness through better eating habits and more active lifestyles.

Reach D.E. Smoot at (918) 684-2901 or dsmoot @muskogeephoenix.com.å

“What we are really trying to do now — the big push during the past five years — is try to change the environment people live in a way that supports proper eating and exercise.”

— Louise Micolites, a regional consultant for Oklahoma Turning Point Coalition

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Checkup: Health care by county