1. MSFW Analysis - Oklahoma National Center for Farmworker Health

2. Presentation Controls Legend Next slidePrevious Slide Data County Information Return to presentation Only buttons in lower right hand corner are operational MSFW Analysis - Oklahoma

3. Purpose The purpose of this presentation is to conduct spatial data analysis of MSFW enumeration data to enable health planners to target limited resources to areas of greatest MSFW need. MSFW Analysis - Oklahoma

4. Presentation Outline Introduction State Overview Service Delivery Gaps Other Data MSFW Analysis - Oklahoma

5. Introduction Acronyms MSFW Enumeration Profiles Studies Rationale for State Selections Data Sources MSFW Population Categories Rationale for MSFW Population Categories MSFW Analysis - Oklahoma

6. Acronyms MSFW Analysis - Oklahoma BPHC – Bureau of Primary Health Care CHC – Community Health Center (Section 330 grantee) HRSA – Health Resources and Services Administration MHC – Migrant Health Center (Section 330 grantee) MSFW – Migrant and Seasonal Farmworker NCFH – National Center for Farmworker Health NP – Nurse Practitioner OK PCA – Oklahoma Primary Care Association PA – Physician Assistant UDS – Uniform Data System

7. MSFW Enumeration Profiles Studies In 1998, the Bureau of Primary Health Care (BPHC) and the Environmental Protection Agency jointly funded a study to estimate MSFW populations at the county level, and awarded a grant to the National Center for Farmworker Health (NCFH). NCFH subsequently contracted with Alice C. Larson, Ph.D., to research and develop state estimates for the MSFW population in ten states: Arkansas, California, Florida, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, and Texas. MSFW Analysis - Oklahoma

8. Rationale for State Selections Five states were chosen because they are home to the largest MSFW populations (California, Florida, North Carolina, Texas, and Washington). The other five states (Arkansas, Louisiana, Maryland, Mississippi, and Oklahoma) were selected because they were states for which minimal data was available, and they appeared to provide a broad sample of MSFW employment environments. MSFW Analysis - Oklahoma

9. Data Sources MSFW numbers are taken from the MSFW Enumeration Profiles Study - Oklahoma, September 2000. MHC and CHC grantee site locations were taken from the BPHC web site (http://ask.hrsa.gov/pc/) in May 2003, and updated by the Oklahoma Primary Care Association (OK PCA) in May 2003.http://ask.hrsa.gov/pc/ User data was provided by the Health Resources and Services Administration (HRSA) and BPHC. MSFW Analysis - Oklahoma

10. MSFW Population Categories In this analysis, there are four county MSFW population categories: 0 to 499 500 to 999 1,000 to 1,999 2,000 and over MSFW Analysis - Oklahoma

11. Rationale for MSFW Population Categories The four MSFW population categories were selected based on assumptions about deriving a potential clinic user population number from a target population estimate. Potential clinics include existing CHC service sites or a new access point. A new access point is a new delivery site for the provision of comprehensive primary and preventive health care services. The two types of new access points are (1) new starts and (2) satellites. We assume that a target population will produce a 75% clinic user rate and that a clinic site requires 750 to 1,500 users (based on an average ratio of 750 users per PA/NP and 1,500 per physician). MSFW Analysis - Oklahoma

12. MSFW Population Category 0 - 499 Counties that have an MSFW population from 0 to 499 are assumed to have an MSFW target population sufficient only to support a user population that would account for less than 25% of the users of an existing CHC service site or a new access point. MSFW Analysis - Oklahoma

13. MSFW Population Category 500 - 999 Counties that have an MSFW population from 500 to 999 are assumed to have an MSFW target population sufficient to support a user population that would account for 25% to 50% of the users of an existing CHC service site or a new access point. MSFW Analysis - Oklahoma

14. MSFW Population Category 1,000 – 1,999 Counties that have an MSFW population from 1,000 to 1,999 are assumed to have an MSFW target population sufficient to support a user population that would account for 50% to 100% of the users of an existing CHC service site or a new access point. MSFW Analysis - Oklahoma

15. MSFW Population Category Over 2,000 Counties that have an MSFW population over 2,000 are assumed to have an MSFW target population sufficient to support a user population that would justify a new access point. MSFW Analysis - Oklahoma

16. Presentation Outline Introduction State Overview Service Delivery Gaps Other Data MSFW Analysis - Oklahoma

17. State Overview State Data State Map with Counties Perspective: Oklahoma vs. Maryland MSFW Population MSFW Population – Data Map MSFW Population – Spatial Map MSFW Analysis - Oklahoma

18. Oklahoma Data AREA - 70,003 square miles POPULATION (2000) – 3,460,097 TOTAL MSFW POPULATION – 14,202 COUNTIES – 77 counties (ranging in size from 416 to 2,271 square miles) CHC/MHC SITES – 2 Grantees and 2 sites CHC ONLY SITES – 5 Grantees and 8 sites MSFW Analysis - Oklahoma

19. Oklahoma Counties Cimarron Dewey Texas BeaverHarper Woods Alfalfa Grant Woodward Ellis Roger Mills Beckham Custer Washita Kiowa Greer Harmon Kay Osage Major Blaine Jackson Tillman Comanche Cotton Garfield King- fisher Canadian Caddo Ottawa Delaware McCurtain Le Flore Jefferson Grady Stephens Noble Pawnee Logan Okla- homa LoveMarshall Carter Adair Sequoyah Washington Nowata Craig Payne Lincoln Creek Johnston ChoctawBryan Garvin McClain Cleveland Rogers Mayes Cherokee Tulsa Pushmat- sha Latimer Haskell Muskogee Wagoner Okmulgee Atoka Murray Okfuskee McIntosh Pittsburg Coal Hughes Seminole Pottawa- tomie Pontotoc MSFW Analysis - Oklahoma

20. Area Perspective: Oklahoma vs. Maryland MSFW Analysis - Oklahoma

21. MSFW Population The migrant and seasonal farmworker population is estimated at 14,202. This number includes workers and their dependents. The largest concentrations of farmworkers and their families are located in the southwest and east central parts of the state. The next slide will present this data as an overlay on the county. Data source: MSFW Enumeration Profiles Study – OK, Larson, 9/2000 MSFW Analysis - Oklahoma

22. MSFW Total Population 14,202 2 0 00 00 0 0 0 0 33164 166 0 131 137 510 401 33 69 643 86 423 112 1,910 48 730 0 1 119 84 162 13 24119 183 124 18 50 251 137 66 79 390 83 594 93 60 107 50 292 432 41 1,008 191 211 277 704 444 180 126 146 264 155 73 233 380 0 239 231 86 215 66 237 20 MSFW Analysis - Oklahoma

23. MSFW Population The next slide will depict the state’s counties organized into four categories, based on the county’s MSFW population. In addition to the three categories already described, there is a category for counties with an MSFW population below 500. MSFW Analysis - Oklahoma

24. MSFW Total Population - 14,202 Data source: MSFW Enumeration Profiles Study – OK, Larson, 9/2000 MSFW Analysis - Oklahoma

25. Presentation Outline Introduction State Overview Service Delivery Gaps Other Data MSFW Analysis - Oklahoma

26. Service Delivery Gaps Analysis Process MHC Grantees CHC Grantees Grantee Delivery Area vs MSFW Population County Analysis by MSFW Population Category MSFW Analysis - Oklahoma

27. Analysis Process Service potential will be evaluated in the following order: MHC grantee in county CHC grantee in county MHC grantee in adjoining county CHC grantee in adjoining county MSFW Analysis - Oklahoma

28. MHC Grantees There is one Migrant Health Center grantee in the state. This grantee provides services at 2 sites in 2 counties. Data source: BPHC web site, 10/2002; OK PCA Updates 5/2003 MSFW Analysis - Oklahoma

29. MHC Grantee Sites and Service Counties Data source: BPHC web site, 10/2002; OK PCA Updates 5/2003 MSFW Analysis - Oklahoma

30. MHC Delivery Sites Coverage Data source: BPHC web site, 10/2002; OK PCA Updates 5/2003 MSFW Analysis - Oklahoma

31. CHC Grantees There are seven Community Health Center grantees in the state. The two MHC grantees are also CHC grantees. The five additional CHC grantees provide health services at eight sites in six counties (one of which has an MHC grantee site). Data source: BPHC web site, 10/2002; OK PCA Updates 5/2003 MSFW Analysis - Oklahoma

32. CHC Grantee Delivery Areas Data source: BPHC web site, 10/2002; OK PCA Update 5/2003 MSFW Analysis - Oklahoma

33. MHC/CHC Grantee Delivery Areas Data source: BPHC web site, 10/2002; OK PCA Update 5/2003 MSFW Analysis - Oklahoma

34. MHC/CHC Grantee Delivery Areas & MSFW Population Jackson Data source: BPHC web site, 10/2002; OK PCA Update 5/2003 Jefferson Bryan MSFW Analysis - Oklahoma

35. Analysis of Counties with 1,000-1,999 MSFW Population There are two counties that have MSFW populations between 1,000 and 1,999, and one does not have an MHC grantee delivery site in the county. MSFW Analysis - Oklahoma

36. MSFW Population 1,000 – 1,999 Data source: MSFW Enumeration Profiles Study – OK, Larson, 9/2000 1,910 1,008 MSFW Analysis - Oklahoma

37. County Service Area with no MHC Adair Data source: BPHC web site, 10/2002; OK PCA Updates 5/2003 MSFW Analysis - Oklahoma

38. Adair County MSFW Population 1,008 Adair County adjoins a county with a CHC, but the site does not provide coverage to the MSFWs in the county. 1 MSFW Enumeration Profiles Study – OK, Larson, 9/2000 2 BPHC Web Site, 10/2002; OK PCA Update 5/2003 Adair MSFW Analysis - Oklahoma

39. Analysis of Counties 500-999 MSFW Population Of the four counties that have MSFW populations ranging from 500 to 999, none has an MHC or CHC grantee delivery site in the county, nor adjoin counties with MHC or CHC delivery sites. MSFW Analysis - Oklahoma

40. MSFW Population 500 – 1,000 Data source: MSFW Enumeration Profiles Study – OK, Larson, 9/2000 510 643 704 594 MSFW Analysis - Oklahoma

41. Jackson County MSFW Population 510 Jackson County adjoins a county with an MHC, but the site provides coverage to only a portion of the MSFWs in the county. 1 MSFW Enumeration Profiles Study – OK, Larson, 9/2000 2 BPHC Web Site, 10/2002; OK PCA Update 5/2003 Jackson MSFW Analysis - Oklahoma

42. Presentation Outline Introduction State Overview Service Delivery Gaps Other Data MSFW Analysis - Oklahoma

43. Other Data MHC Grantee Service Penetration MSFW Population Pockets – Southwest OK MSFW Population Pockets – South Central OK % Minority Population Population < 100% Poverty MSFW Analysis - Oklahoma

44. MHC Grantee Service Penetration The MHC grantee provided services to 359 users 1 during 2001, which represents 2.5% of the estimated statewide MSFW population. The estimated MSFW population in the counties where the grantee provided health services is 2,161 2. The reported users represent 16.6% penetration of this population. 1 UDS Reports - 2001, BPHC 2 MSFW Enumeration Profiles Study – OK, Larson, 9/2000 MSFW Analysis - Oklahoma

45. MSFW Population Pockets – Southwest Oklahoma Data source: MSFW Enumeration Profiles Study – OK, Larson, 9/2000 MSFW Population 1,889 BeckhamWashita KiowaGreer Harmon Jackson Tillman 401 112 423 166 131 137 510 MSFW Analysis - Oklahoma

46. MSFW Population Pockets – South Central Oklahoma Data source: MSFW Enumeration Profiles Study – OK, Larson, 9/2000 MSFW Population 2,129 Jefferson Love Marshall Bryan Johnston Carter 594 155 83 390 264 643 MSFW Analysis - Oklahoma

47. % Minority Population Data source: US Census 2000 MSFW Analysis - Oklahoma

48. Population < 100% Poverty Data source: US Census 2000 MSFW Analysis - Oklahoma

49. National Center for Farmworker Health

50. Oklahoma Counties Cimarron Dewey Texas BeaverHarper Woods Alfalfa Grant Woodward Ellis Roger Mills Beckham Custer Washita Kiowa Greer Harmon Kay Osage Major Blaine Jackson Tillman Comanche Cotton Garfield King- fisher Canadian Caddo Ottawa Delaware McCurtain Le Flore Jefferson Grady Stephens Noble Pawnee Logan Okla- homa LoveMarshall Carter Adair Sequoyah Washington Nowata Craig Payne Lincoln Creek Johnston ChoctawBryan Garvin McClain Cleveland Rogers Mayes Cherokee Tulsa Pushmat- sha Latimer Haskell Muskogee Wagoner Okmulgee Atoka Murray Okfuskee McIntosh Pittsburg Coal Hughes Seminole Pottawa- tomie Pontotoc MSFW Analysis - Oklahoma

51. Data source: MSFW Enumeration Profiles Study – OK, Larson, 9/2000 MSFW Analysis - Oklahoma