A: Only about 10 percent of our overall health is attributable to access to health care; 40 percent is attributable to behaviors.
Public health is at the front end of that. Prevention is better than cure. I'm all for cure, but I'm more enthusiastic about prevention. Prevention will help someone avoid having to deal with an illness altogether.
For example, if we can drive down obesity rates, we're going to be able to drive down the diabetes rate.
With this Oklahoma plan, we have an opportunity to actually create and improve our current system so it really becomes a health care system that's focused on promoting wellness.
Q: Why does Oklahoma rank so low on many health indexes?
A: One of the primary drivers is our use of tobacco. It's the No. 1 preventable cause of death, and we rank 47th. That's a bad place to start.
Many other states have more aggressively protected their citizens. They're ensuring that they have places to go in public that are free of tobacco smoke. Oklahoma has been very reluctant as a state to do that. We actually have a state law on the books that prohibits communities from getting tougher on tobacco ordinances than the state law.
Most state law is meant as a floor … But with smoking, it's actually a ceiling. For example, Oklahoma City cannot decide that it wants to go smoke-free for all indoor public facilities. It's prohibited by law. We're one of only two states left in the nation that has this level of prohibition or pre-emption. Tennessee is the other state.
Q: Have you asked the Legislature to change that?
A: We have. Two years ago, we couldn't even get it heard in committee. Last year, it passed out of the House committee, passed off the House floor, and was sent to the Senate, where it was killed. It didn't receive a hearing in committee, so it wasn't even debated on the Senate side.
There were 12 paid tobacco lobbyists that were working vigorously to kill this bill. Their interest, of course, was keeping the tobacco use rates high in Oklahoma.
Q: What about Oklahoma's high rate of prescription drug abuse?
A: Every year we have between 600 and 700 deaths from the misuse of prescription drugs. We have one of the highest prescription rates for narcotic drugs in the country.
That's a serious issue in our state, and it's something that we can do something about. A task force has been formed. The governor is going to give that a push to really drive some solutions. We really need to have a comprehensive approach to be successful in battling this.
The data shows that the majority of those drugs are actually obtained from other people's medicine cabinets. The No. 1 source is our neighbors and our friends and our own medicine cabinets.
Q: What can the Legislature do?
A: They can make sure there are opportunities for appropriate disposal. If you find that you have a large prescription rate that seems out of keeping with the number of people in the population, the Legislature could limit that either by dose or by quantity. But that gets tricky because you probably don't want the Legislature dictating the scope of medical practices.
We also have a Prescription Monitoring Program that is one of the best in the country … but it's not mandatory. They could make that mandatory.
About Oklahoma Watch
Oklahoma Watch is a nonprofit investigative team established to report on public policy issues in Oklahoma. It is funded by the Ethics and Excellence in Journalism Foundation, the George Kaiser Family Foundation, the John S. and James L. Knight Foundation and the Tulsa Community Foundation.