1. Community Profile: tulsa County 2015
This presentation is an overview of key demographic, socio-economic, and health trends in Tulsa County, and in some cases, state and nation, and discussion about why these indicators matter. The most current data from the US Census Bureau, State Health Department and Health Care Authority, State Department of Education, and other sources are used in this community profile.
Prepared by the Community Service Council, with support from the Metropolitan Human Services Commission
July 2015

3. Overview Population shifting demographically
Well-being of children not so well
Many strive for “living wage”… and many must rely on public assistance to fill the gap
Continuing impact of social determinants of health
Much like the rest of the state and nation, the population in Tulsa County is going through a major demographic shift, both in terms of age and race/ethnicity. In many ways, children face many challenges today. Many families struggle to be self-sufficient, even while holding down jobs. Certain conditions tend to be associated with negative health outcomes.

4. Tulsa County, like much of the rest of the state and the nation, is going through major changes demographically. These shifts are occurring in age and race/ethnicity distribution. The changes in race/ethnicity are beginning with children and youth.
DEMOGRAPHIC TRENDS

5. Population Trends and Projections: Tulsa County, 1980 to 2050
As of July 1, 2014, the population of Oklahoma increased by 3.3% since 2010 (from 3,751,351 in 2010 to 3,878,051 in 2014). According to the Oklahoma Department of Commerce report, 2012 Demographic State of the State Report: Oklahoma State and County Population Projections through 2075, Oklahoma’s population will continue to rise. The state’s population is projected to reach 4 million by 2020, 5 million by the mid 2050’s, and by the year 2075, Oklahoma will have over 5.5 million residents.
Tulsa County is projected to grow at a slow but steady pace over the next several decades, increasing at an average of about 8% per decade. Projections indicate that the county will be home to 800,000 residents in 2050, and 900,000 by Just released population estimates for place a total of 629,598 residents in Tulsa County, 46,452 of whom are under age 5. Projections are not currently available by age for Oklahoma counties
projections
Source: Oklahoma Department of Commerce, “2012 Demographic State of the State Report: Oklahoma State and County Population Projections through 2075”; US Census Bureau, Decennial Censuses.

6. Population Trends and Projections by Age Group: Oklahoma, 1970-2030
The aging of the baby boom population, along with improvements in health care resulting in longer life expectancy, have led to a major shift in age demographics across the nation. Oklahoma is no exception. In 2010, 13.5% of the state’s population was aged 65 or older, up from 11.7% in By 2030, that share is projected to grow to 18.8%. Children under 18, on the other hand, have lost ground, from representing 32.8% of the population in 1970 and 24.7% in 2010, to projections of 23.2% in These demographic shifts have major implications for the nation as well as individual communities in terms of social services, health care, employment opportunities, etc.
Source: US Census Bureau, 1970, 1980, 1990, 2000, and 2010 Censuses; Oklahoma Department of Commerce, 2012 Demographic State of the State Report: Oklahoma State and County Population Projections through 2075.

7. Population Trends and Projections by Age Group: Tulsa County, 1970-2014
Tulsa County appears to be following the state and national trend of a declining share of young people (loss of 8% of the population share) and a growing proportion of the older population (gain of 4%). This evolving population age composition presents new challenges and opportunities for the community as a whole.
Source: US Census Bureau, 1970, 1980, 1990, 2000, and 2010 Censuses; US Census Bureau, Population Estimates Program.

8. Race Comparison for Total Population and Young Children: Tulsa County, 2014 Estimates
Under 5 Population = 46,452
Tulsa County’s overall population is becoming increasingly diverse racially, but the trend is most evident among children. Population estimates by race for children under 5 show a shifting demographic that can be seen in many parts of the country. The under 5 population is becoming more culturally diverse with Hispanic (19.3%), and 2 or more races (10.1%) beginning to represent greater proportions of the population than previous generations.
Source: Census Bureau, Population Estimates Program, “Annual Estimates of the Resident Population by Sex, Age, Race and Hispanic Origin for Counties, April 1, 2010 to July 1, 2014.”

9. FAMILY, CHILDREN AND YOUTH
Adequate resources, healthy and safe environments, and positive intellectual and emotional development of children are key to eventual transition into healthy and productive adulthood. Unfortunately, these are not guaranteed and many children in Oklahoma do not have the opportunity to benefit from such conditions.
FAMILY, CHILDREN AND YOUTH

10. Family

11. Family Type for Children under Age 5 by Race and Ethnicity, Tulsa County, 2009-13
Female headed families are most common among blacks (64.1%) in Tulsa County. The percent of female-headed families among Asians, whites and Hispanics were much lower at 5.4%, 21.4% and 23.3%, respectively. Single parent, female-headed families with young children are the most vulnerable to poverty.
Source: US Census Bureau, American Community Survey.

12. Children in Non-Traditional Settings: Tulsa County, 2009-13
Since 2000, children are increasingly living with grandparents, other relatives (excluding parents) and non-relatives. Oklahoma ranks 4th in grandparents raising grandchildren. One of the major reasons is our high rate of incarceration of women; we have ranked #1 in the incarceration of women for all but one of the past 10 years when we were outpaced by Texas.
Many of the children living with non-relatives are in foster care homes. Oklahoma is ranked in the top 10 in rate of children 0-17 in the foster care system with a rate of 8/1,000; the national average is 5/ Children in the foster care system tend to face some tough challenges. Forty to 50% of children in foster care will not finish high school; 66% will become homeless, go to jail or die within one year of leaving the foster care system at 18. Girls in foster care are 600% more likely than the general population to become pregnant before age 21. Foster care children are more likely to be on public assistance as adults. The number of children in foster care is commonly used as an indicator for the future prison population. Eighty percent of the prison population were once foster children.
The numbers shown as living in group quarters are those in both supervised facilities, such as correctional facilities, nursing facilities, mental hospitals, group homes for juveniles, and residential treatment centers for juveniles, and unsupervised facilities such as residence halls at college.
In Tulsa County, children not living with their parent(s) (and who are not living in their own independent households) account for 10% of all children under 18 in the county.
Source: US Census Bureau, American Community Survey, Tables B09018 and B09001.

13. Subfamilies by Type, Tulsa County, 2009-13
Number
Percent of all Subfamilies
Total:
6,122
100.0%
Married-couple subfamily:
1,518
24.8%
With own children under 18
568
9.3%
No own children under 18
950
15.5%
Mother-child subfamily
3,472
56.7%
Father-child subfamily
1,132
18.5%
Homelessness is measured in street people and in measures of subfamilies reported within households. An estimated 4% of families in Tulsa County are “subfamilies,” accounting for over 6,000 families. The majority of these subfamilies are single parent mothers with children.
Source: US Census Bureau, American Community Survey.

14. Living Arrangements of Persons 65 & Over, Tulsa County, 2009-2013
While most persons age 65 and older in Tulsa County live with family, nearly a third live alone, creating situations that may put them at greater risk of injury or accidents. About 3/4 of those living along are female. A smaller share of the 65 and older population live in group quarters or have other living arrangements.
Source: US Census Bureau, American Community Survey.

15. Summary of Risk Factors for Infants: Tulsa County, 2013
Total births = 9,243
There were a total of 9,243 births to Tulsa County resident in Eight percent were to teens, 42% were to unmarried women. Both unmarried and teen mothers tend to face greater challenges financially than do women who give birth after age 19 and those that are married or live with a partner.
About one in five women who gave birth in 2013 have less than a high school education. Many, but not all, of these women are teens. The absence of a high school diploma significantly undermines a person’s ability to be financially independent.
Twelve percent of 2013 Tulsa County births were premature and just less than 10% were either low or very low birth weight. These are indicators for developmental delays.
Source: Oklahoma State Department of Health, Vital Statistics 2013, OK2SHARE, accessed on 2/3/15.

16. Characteristics of Births to Teens (age 15-19): Tulsa County, 2013
There were 729 births to teen mothers in Tulsa County in 2013, returning a teen birth rate of 37.3 per 1,000 females between ages 15 and 19, which is lower than the state average of 55 per 1, Research shows that teenagers who become pregnant are more likely to drop out of school and teenagers who drop out of school are also more likely to become pregnant.
Nearly 90% of teen births in Tulsa County were to unmarried teens. As will be illustrated later in this profile, being a single female parent adds to the difficulty of maintaining an economically self-sufficient household.
Over 10% of Tulsa County births to teens were premature. Adequate prenatal care can help to reduce the number of premature births. Most Tulsa County teens who gave birth started receiving prenatal care during the first or second trimesters, but 3.5% and 10.5%, respectively, either received no prenatal care or only entered care during the third trimester.
Almost one in five Tulsa County teens giving birth in 2013 had given birth previously, indicating that the economic strain will be even greater on these families.
The good news, though, is that births to teens in Tulsa County, as well as in the state as a whole, are declining, both in number and as a rate.
Tulsa County:
Total teen births = 729
Age-specific fertility rate = 37.3
/1,000 females age 15-19
Source: Oklahoma State Department of Health, Vital Statistics 2013, OK2SHARE, accessed on 2/3/15.

17. Resident Births to Women under Age 20, Tulsa County, 1980-2013
Number of births to women age 15 to 19 has been cut in half in Tulsa County since The number dropped from 1,444 in 1980 to 729 in This trend is being seen statewide and nationally.
Source: Oklahoma State Department of Health (OK2SHARE).

18. Age-specific birth rate for 15-19 =
Age-Specific Birth Rates for Women under Age 20, Tulsa County,
It’s not only number of teen births that have declined, but teen birth rates as well. Tulsa County’s rate fell 49% between 1980 and 2013, from 77.9 to Varying theories attempt to explain the decline, which is being seen statewide and nationally, including the recession, teen pregnancy prevention programs, and reality television focused on teen pregnancy and parenting.
Age-specific birth rate for =
number of births to women age 15 to 19 per 1,000 females age 15 to 19 in the population
Source: Oklahoma State Department of Health, Vital Statistics 2013, OK2SHARE, accessed on 6/26/15.

19. Births by Trimester of Entry into Prenatal Care: Tulsa County, 1980 to 2013
Early and consistent prenatal care is essential for a healthy pregnancy and delivery. First trimester entry into prenatal care peaked in 2000 at 75%, but has since declined, reaching 63% in Second trimester entry, in contrast, appears to be on the upswing, with 27% of the share in 2013.
Source: Oklahoma State Department of Health (OK2SHARE).

20. Births by Marital Status of Mother: Tulsa County, 1980 to 2013
Over 80% of all Tulsa County births were to married women in 1980 (83.6%). Every decade since has seen an increase in births to unmarried women – 25.4% in 1990, 33.3% in 2000, 42.1% in 2010.
The vast majority of Tulsa County births were to married women in 1980, leaving a much smaller share of births to unmarried women (16%). Since then, however, in Tulsa County, as in the rest of the state and nation, births to unmarried women have been increasing – 25% in 1990, 33% in 2000, 42% in 2013.
Source: Oklahoma State Department of Health (OK2SHARE).

21. Infant Mortality Rates (5-year averages): Tulsa County, and State of Oklahoma, 1980 to 2013
The 5-year average infant mortality rate in Tulsa County (7.2 per 1,000 live births) was a little lower than that of the state (7.4) for the period ending in The rates for both the state and the county have been steadily declining over the past 30 years, and are inching closer to the Healthy People 2020 goal of 6.0.
Healthy People 2020 goal: 6.0
Source: Oklahoma State Department of Health (OK2SHARE).

22. Housing Units by Occupancy Status and Tenure, Tulsa County, 2009-2013
60.9% of occupied housing units
Occupied housing units
A total of 241,915 (89%) Tulsa County housing units are occupied, leaving 28,693 (11%) vacant. In the state as a whole, the occupied housing unit rate is a bit lower at 87%. Of the county’s occupied housing units, 61% are owner-occupied and 39% are renter-occupied. The state averages 67% owner and 33% renter-occupied. So although Tulsa County has a slightly higher housing unit occupancy rate than the state, those occupied units are more likely to be rented than in the state as a whole.
39.1% of occupied housing units
Source: US Census Bureau, American Community Survey.

23. Children and youth

24. Oklahoma Rankings on Indicators of Child Well-being
Best State (#1)
Worst State (#50)
Overall child well-being 39
Massachusetts
Mississippi
Economic well-being 30
North Dakota
Education 41
Nevada
Health
Iowa
Montana
Family and Community 38
New Hampshire
Oklahoma ranks #36 in overall child well-being, with 1 being the best (New Hampshire) and 50 the worst (New Mexico). In particular, Oklahoma ranks relatively poorly in health, education, and family and community indicators, and about average in economic well-being.
Source: Annie E. Casey Foundation, “KIDS COUNT Data Book, 2014.” (

25. Oklahoma Rankings on Specific Child Indicators
U.S. rate
Oklahoma rate
Oklahoma rank
Best rank
Median family income
$60,700
$51,100 42 1
Children in poverty
22%
24% 35
Children below 200% poverty
45%
51% 43
Population in poverty
16%
17% 32
Children 3 & 4 not enrolled in preschool
54%
59%
Population not high school graduate
11%
13% 37
Children living in concentrated poverty
14% 31
Children in single parent families
35%
36% 29
Children living with neither parent 5% 6% 38
Low birth weight babies
8.0% 24
Children confirmed victims of maltreatment
9/1,000
10/1,000 25
Among specific indicators of child well-being, Oklahoma ranks in the worst half for every indicator except child maltreatment, for which the state ranks at number 19. We’re in the bottom 10 on two of these indicators: median family income and children living with neither parent. Oklahoma’s median family income is $49,400 compared to national average of $58,000. Six percent of Oklahoma’s children live with neither parent compared to 5% nationally.
Source: Annie E. Casey Foundation, “KIDS COUNT Data Book, 2014.”

26. The Adverse Childhood Experiences (ACE) Study Pyramid
Early Death
Disease, Disability and Social Problems
Adoption of Health-risk Behaviors
Social, Emotional and Cognitive Impairment
Disrupted Neurodevelopment
Adverse Childhood Experiences
Death
The Adverse Childhood Experiences study – a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego, with lead researchers Robert Anda, MD and Vincent Felitti, MD, in the late 1990s – found correlations between childhood neglect, abuse and household dysfunction with later-life health and well-being. This is one of the largest investigations ever conducted to assess relationships between child maltreatment and later-life health and well-being. This study has received renewed interest in recent years as a conceptual model to examine the potential for changes in well-being through the life cycle of the child. The implications for our state are dramatic with the large number of children experiencing child abuse and neglect, incarcerated parents, single parenting, as well as other negative indicators.
The study found that children who experience adverse childhood trauma may have disrupted neurodevelopment which increases their risk for school failures and ultimately poorer well-being throughout the life span, including greater incidences of premature death. Risk for health problems increases as number of ACEs increases. Adolescent pregnancy, early initiation of sexual activity and long-term psychosocial consequences have been shown to correlate inversely with childhood family strengths – the greater the number of strengths, the lower the risk of these events occurring.
A child’s early years matter because early relationships and experiences help shape the architecture and wiring of the brain, creating either a sturdy or fragile foundation for a young child’s cognitive, emotional and behavioral development. Nurturing relationships with parents and other caregivers, as well as stimulating and educationally rich environments, help young children thrive. But the experience of poverty and related risk factors — such as poor parenting, inadequate nutrition, frequent moves and changes in nonparental caregivers, insufficient cognitive stimulation and unsafe environments — can actually suppress brain development and have lasting effects.
From even the youngest age, there are measurable differences in how children from lower-income families and their middle-class peers develop and learn. These differences persist after children enter school, where a lack of high-quality early childhood experiences is linked to failure to read at grade level by the end of third grade — a strong predictor of becoming a high school dropout.
The effects of poverty and inadequate early care extend beyond the school years. Children who are persistently poor are more likely to live in poverty between ages 25 and 30, become teen and/or unmarried parents and have inconsistent employment records.
A child’s earliest relationships and experiences matter. Early intervention can prevent, or at least reduce, some of the negative effects associated with living in poverty. Parents are their child’s first and primary teachers and caregivers, but some low income, new and expecting parents need support to succeed in these roles. Although we still have a lot to learn in this area, research suggests that high-quality early childhood programs can help reduce the stresses of poverty by providing better, more sensitive care and by teaching parents how to interact more positively with their young children. All children benefit from high-quality early care and education, but research indicates that the quality of care is most important for children at highest risk of poor developmental outcomes. According to Nobel Prize-winning economist James Heckman, although early childhood through the early years are critically important, we must continue to identify other key developmental moments when intervention pays off in the long term.
Early childhood strategies alone will not successfully reduce disparities among children; we must also assist their parents. Too often, low-income parents struggle to gain and retain employment. Evidence suggests that highly targeted income supports can help reduce the effects of poverty and improve children’s outcomes, particularly academic performance.
Interventions are some of the best investments we can make as a nation, with a return on investment at 7 to 10 percent annually by reducing crime, improving academic achievement and building a skilled workforce. Many strategies show evidence of high returns in child well-being and healthy development.
Conception
Mechanisms by which Adverse Childhood Experiences Influence Health and Well-being throughout the Lifespan
Source: The Adverse Childhood Experiences Study website: “About the Adverse Childhood Experiences Study.”

27. Adverse Childhood Experiences…
…growing up in a household with ADVERSE CHILDHOOD EXPERIENCES:
…DISEASE, DISABILITY AND SOCIAL PROBLEMS IN ADULTHOOD
…ADOPTION OF HEALTH RISK BEHAVIORS…
Nicotine addiction
Alcoholism
Drug addiction
Obesity
Depression
Suicide
Injuries
Unintentional pregnancy
Adolescent pregnancy
Heart disease
Cancer
Chronic lung and liver disease
Stroke
Diabetes
Fetal death
Sexually transmitted diseases
Recurrent physical abuse
Recurrent emotional abuse
Sexual abuse
An alcohol or drug abuser
An incarcerated household member
Someone who is chronically depressed, suicidal, institutionalized or mentally ill
Mother being treated violently
Living with one or neither parent
Emotional or physical neglect
Smoking
Overeating
Physical inactivity
Heavy alcohol use
Drug use
Promiscuity
Adverse childhood experiences include:
Recurrent physical abuse
Recurrent emotional abuse
Sexual abuse
An alcohol or drug abuser in the household
An incarcerated household member
Household member who is chronically depressed, suicidal, institutionalized or mentally ill
Mother being treated violently
One or neither parent living with child
Emotional or physical neglect
Any one of these experiences may be traumatic enough by itself to create changes in neurodevelopment, but the increase in the number of adverse childhood experiences increases the correlation with negative lifetime outcomes. According to the study, about 13% of average middle-class Americans experienced 4 or more of these conditions as a child (15% of women, 9% of men).
Some of the resulting conditions include drug, alcohol and nicotine addiction, obesity, depression and suicide, unintentional pregnancy, heart disease, cancer and premature death. Correlation has even been seen in people with frequent headaches, including migraines.
Source: The Adverse Childhood Experiences Study website: “What are Adverse Childhood Experiences (ACE’s).”

28. Adverse Childhood Experiences: Oklahoma
Parental divorce or separation
5.2 divorce and annulment/1,000 residents
Children in single parent families
36% of children
Children living with neither parent
6% of children
Incarcerated household member
47.7 index crimes/1,000 residents
Mentally ill household member
11.0% psychological distress rate
Substance abusing household member
5.1% substance abuse rate
Violence against mother
16.3 protective orders files/1,000 adult women
Psychological, physical & sexual abuse or neglect
8 child maltreatment confirmations/1,000 children
Oklahoma ranks as one of the top 10 most depressed states – highest rates of depression, psychological distress, and other indicators of poor mental health.
Other Oklahoma ranks include:
6th highest divorce rate
#30 (best = 1) in single parent families
#41 (best = 1) in children living with neither parent
4th largest per capita prison population
#1 in female incarceration
highest occurrence of mental illness
#19 (best = 1) in confirmed child maltreatment
Good news: ok is ranked #1 for standards and oversight of child care homes and centers.
Source: Oklahoma Institute for Child Advocacy, “Oklahoma KIDS COUNT Factbook, ;” Annie E. Casey Foundation,“KIDS COUNT Data Book, 2013.”

29. Adverse Childhood Experiences Tulsa County Rankings
Parental separation or divorce 49
Incarcerated household member 76
Mentally ill household member 77
Substance abusing household member
76*
Violence against mother 57
Psychological, physical & sexual abuse 12
Emotional & physical neglect 4
Overall ranking 31
Based on the Adverse Childhood Experiences risk factors, children in Tulsa County have a slightly lower than average likelihood (relative to other Oklahoma counties) of experiencing adversity and having increased risk for adult health and social problems, as ranked by the Oklahoma Institute for Child Advocacy (2006).
Tulsa County is ranked 31 of Oklahoma’s 77 counties in adverse childhood experiences. Looking at specific indicators, the county ranks especially poorly on mentally ill household member, incarcerated household member, substance abusing household member, and violence again mother. The county ranks more favorably on emotional and physical neglect, and psychological, physical and sexual abuse.
Rankings: 1 = best, 77 = worst
*Indicates a tie with at least one other county.
Source: Oklahoma KIDS COUNT Factbook, , Oklahoma Institute for Child Advocacy

30. DHS Licensed Child Care Services Provided to Children Under Age 5, by Age: Tulsa County, FY 2004 & 2014
Overall number of young children in subsidized child care in Tulsa County has declined more than 40% over the past ten years (-39.8). This is a trend occurring all across Oklahoma. For Tulsa County the loss is most prevalent among the youngest children – zero through one year olds. Many families are choosing to opt for family and friend care and sharing of child care with other families instead of formal licensed care.
Source: Oklahoma Department of Human Services, 2014 Annual Report.

31. DHS Child Care Licensed Facilities and Capacity, by Type: Tulsa County, FY 2014
Tulsa County has a total of 619 licensed child care facilities, including 259 centers and 360 homes, with a total capacity of 27,593. Of that total number of facilities, 386 accept subsidies – 184 centers and 202 homes – with a total subsidized capacity of 18,730.
Source: Oklahoma Department of Human Services, 2014 Annual Report.

32. Four Year Old Early Childhood (pre-k) Enrollment: Tulsa County School Districts, October 2013
School districts in Tulsa County have made great strides in providing and enrolling four year olds in pre-K programs. Over 5,300 four year olds are enrolled in full-day, and almost 700 in half-day public pre-k in these 14 districts.
When exploring the impact of pre-kindergarten on children and their communities, evidence shows that children who attend pre-kindergarten benefits from heightened vocabulary scores, improved attendance and high school graduation rates. Research on the long-term benefits of pre-kindergarten suggest that children who attend pre-kindergarten are more likely to avoid criminal behavior, be more resilient, have increased earnings, and better health. Research also shows that investing in pre-kindergarten as a community benefits the private citizen, as well as local, state, and federal government. (Source: Urban Child Institute.)
Source: Oklahoma State Department of Education.

33. Average Daily Membership Percent in Special Education
Average Daily Membership and Percentage of Students Enrolled in Special Education: Tulsa County by School District, School Year
Average Daily Membership
Percent in Special Education
Tulsa County total ADM = 116,817
Percent in special education = 14.0%
Average daily membership in Tulsa County public schools totaled 116,817 in school year Fourteen percent of these students receive special education services.
Source: Oklahoma Office of Educational Quality and Accountability, “Profiles 2014 District Reports.”

34. Educational Indicators, High School Class of 2014: Tulsa County School Districts
Tulsa County total
Berryhill
Bixby
Broken Arrow
Collinsville
Glenpool
Jenks
4-year dropout rate
13.4% 0%
.9%
9.6%
2.9%
3.8%
7.3%
Avg. freshman grad. rate (county)/cohort graduation rate
78.3%
>95%
93%
91%
89%
88%
Career Tech participation rate
46.9%
72.8%
51.3%
59.4%
37.4%
60.2%
58.2%
College-bound curriculum
81.1%
89.1%
88.0%
83.0%
71.0%
74.0%
91.9%
Out-of-state college rate
7.8%
2.2%
9.0%
5.0%
3.3%
1.3%
OK college going rate
56.6%
58.5%
59.6%
61.1%
48.7%
57.0%
64.1%
3rd grade reading proficiency ( )
80%
83%
95%
86%
87%
Educational indicators help predict school success. The four-year dropout rate represents an indicator of negative school success, while the others in this table indicate positive school success.
The dropout rate county-wide improved between 2013 and 2014 from 15% to 13.4%. Skiatook and Tulsa High Schools both report 4-year dropout rates above 10% for the class of 2014, 11.3% and 29.6%, respectively. Berryhill, Bixby, Collinsville, Glenpool, Jenks, Liberty, Owasso, Sand Springs, Sperry and Union all report dropout rates below the state average of The four-year dropout rate is calculated by dividing number of dropouts over the past four years for a particular cohort by the sum of those dropouts plus graduates from that same cohort.
The cohort graduation rates for Berryhill, Bixby, Broken Arrow, Glenpool, Liberty, Skiatook and Union High Schools are all at or above 90%. The rate for Tulsa Public Schools as a total is not released by the State Department of Education, but by individual high school, the rate ranges from lows of less than 5% at Rogers College High and 53% at Webster High Schools to highs of greater than 95% at Booker T. Washington and 80% at Edison Preparatory High Schools. “The four-year [cohort] graduation rate is defined by the U.S. Department of Education in 34 C.F.R. § (b)(i)(A) and 70 OS § as ‘the number of students who graduate in four years with a regular high school diploma divided by the number of students who form the adjusted cohort for that graduating class’ (i.e., entered high school four years earlier, adjusting for transfers in and out, émigrés and deceased students).” (Oklahoma State Department of Education, 2014 A to F Report Card Technical Guide)
Students participating in a career tech program range from 0% at Owasso to 93% at Liberty.
At least 90% of students at Sperry, Sand Springs, Skiatook, Union, Liberty, and Jenks High Schools completed a college-bound curriculum. All districts except Liberty and Sperry have a majority of students attending college, in or out of state.
In all districts except Liberty, Sand Springs, and Tulsa, at least 80% of 3rd graders scored proficient on the standardized reading test.
Source: Office of Educational Quality and Accountability, “Profiles 2014 State Report;” “Profiles 2014 District Report;” Oklahoma State Department of Education, “A-F Report Card, ”

35. Educational Indicators, High School Class of 2014: Tulsa County School Districts (Cont…)
Tulsa County total
Liberty
Owasso
Sand Springs
Skiatook
Sperry
Tulsa
Union
4-year dropout rate
13.4% 0%
1.3%
4.9%
11.3%
7.6%
29.6%
7.9%
Avg. freshman grad. rate (county)/cohort graduation rate
78.3%
>95%
84%
89%
91%
81% na
Career Tech participation rate
46.9%
92.6%
46.3%
53.1%
56.7%
47.8%
42%
College-bound curriculum
81.1%
94.2%
66.9%
96.0%
95%
100%
63.9%
94.6%
Out-of-state college rate
7.8%
24.6%
4.0%
2.1%
3.3%
8.6%
1.0%
OK college going rate
56.6%
49.2%
55.7%
50.7%
44.6%
54.8%
55.6%
3rd grade reading proficiency ( )
80%
44%
78%
87%
85%
65%
79%
(See previous slide for notes)
Source: Office of Educational Quality and Accountability, “Profiles 2014 State Report;” “Profiles 2014 District Report;” Oklahoma State Department of Education, “A-F Report Card, ”

36. Percentage of 4th graders not proficient in reading by race and Hispanic origin: United states: 2011
Reading proficiency in 4th grade is a crucial marker in a child’s educational development. Kids not proficient are more likely to drop out of high school, reducing earning potential and chances for success. High quality pre-k programs can improve school readiness, with the greatest gains for highest risk children. 54% of US children and 59% of Oklahoma children are NOT enrolled in pre-K programs.
Chronic economic hardship and low parental education correlate to lower school performance. There is a widening gap between low and high income students in standardized test scores – the gap is up 40% since 1960’s, while the racial gap has shrunk. This is because low income children tend to face multiple problems, including poverty, single-parent households, lack of access to quality early childhood programs and well-resourced public schools.
Overall society benefits when low income kids experience positive early development -- all children become healthy and productive adults, our economy becomes stronger because businesses can find skilled workers they need and more people are capable of higher levels of spending, and more taxes are being collected while less is being distributed as assistance.
Source: Annie E. Casey Foundation, “KIDS COUNT Data Book, 2013.”

37. Child Abuse and Neglect: Oklahoma and Tulsa County, FY2014
Alleged victims (reports accepted for investigation or assessment)
36,736
6,091
Confirmed victims
14,172
2,044
…of Abuse
2,328
402
…of Neglect
10,123
1,376
… of Both abuse & neglect
1,721
266
Child abuse/neglect rate per 1,000 children
15.0
12.9
In fiscal year 2014, 2,044 children in Hughes County were confirmed victims of child abuse and/or neglect (may be duplicated count). This number returns a rate of 12.9 victims of child abuse or neglect per 1,000 children, a rate a bit lower than that of the state – 15.0.
Notes: An “alleged victim” represents a report of child abuse and/or neglect accepted by OKDHS for investigation or assessment, and may include multiple children. Each “confirmed victim” of child abuse and/or neglect indicates one child. Since a child may be confirmed abused and/or neglected multiple times in a year, “confirmed victims” is not an unduplicated count of children.
Source: Oklahoma Department of Human Services, Fiscal Year 2014 Annual Report Tables.

38. Child Deaths due to Abuse and Neglect: Tulsa County, Fiscal Years 1991 through 2012
Number of child deaths due to abuse and neglect in Tulsa County has fluctuated over the past two decades from lows of one in 1993 and 2003 to a high of 11 in Most recently available data indicate two deaths in 2012.
Source: Oklahoma Department of Human Services, Division of Children and Family Services, Child Abuse and Neglect Statistics fiscal years

39. Child Deaths due to Abuse and Neglect: Oklahoma, Fiscal Years 1978 through 2012
Seventy five percent of all child abuse/neglect deaths are due to neglect rather than abuse. The challenge of child abuse and neglect in the state has been met with an increase in prevention programs (Children First, Healthy Families Oklahoma), and improved efforts at family interventions when risks are evident.
Source: Oklahoma Department of Human Services, Division of Children and Family Services, Child Abuse and Neglect Statistics fiscal years

40. Adverse childhood experiences of children are systematically assessed in the Youth Risk Behavior Survey conducted by the Oklahoma State Department of Health. This study assesses middle and high school students for risk behaviors. This and the next chart are synopsis of the Youth Risk Behavior Survey results from Oklahoma and the United States (US). County specific results are provided to area school superintendents. The sample population was 11th grade high school students. The results indicated “Methamphetamines ever used, smoked cigarettes during the past month and drove after drinking alcohol in the past month” to be higher than the US student population.
Source: Centers for Disease Control, Youth Risk Behavior Surveillance System; Oklahoma State Department of Health, OK2SHARE.

41. Questions regarding sexual behavior indicated Oklahoma youth were at risk in many areas compared to the US with more Oklahoma youth having had sexual intercourse, and not using a condom. Significantly more Oklahoma youth used birth control pills during their last sexual encounter than did the US population.
Risk factors regarding poor physical health were greater for at risk of overweight, and overweight as well as insufficient moderate physical activity.
Source: Centers for Disease Control, Youth Risk Behavior Surveillance System; Oklahoma State Department of Health, OK2SHARE.

42. Juvenile Arrests by Type of Crime: Tulsa County, 2001-13
A total of 2,586 juvenile arrests were made in Tulsa County in 2013, for a rate of 38.7 per 1,000 juveniles age 10-17, down from 5,954 arrests and a rate of 91.9 in 2001
The number of juvenile arrests in Tulsa County declined tremendously from 2001 to All categories of juvenile crime showed overall downward trends during this time period. A total of 2,586 juvenile arrests were made in the county in 2013 for a rate of 38.7 per 1,000 juveniles age 10-17, a 57% drop from 5,954 arrests and a rate of 91.9 in Juvenile arrests account for 11% of all arrests in Tulsa County.
Statewide, 35.9 per 1,000 juveniles were arrested in 2013.
Murder, Rape, Robbery, Aggravated Assault, Burglary, Larceny, and Motor Vehicle Theft
All drug arrests reported as Sale/Manufacturing and Possession
Driving Under the Influence, Liquor Law Violations, and Drunkenness
Other Assaults, Disorderly Conduct, Curfew & Loitering, Runaway, and all other non-traffic offenses
Source: Oklahoma State Bureau of Investigation, Uniform Crime Reports.

43. Economic indicators

44. Labor force participation
NEED PICTURE

45. Unemployment Rates: Oklahoma and Tulsa County, 1990 to 2014
Unemployment rates in 2000 for both Tulsa County and the state, 2.8 and 3.0, respectively, were the lowest seen in those geographies since before 1990, and ever since. That was followed by the first recession of the 21st century, which caused unemployment rates in both the county and the entire state to escalate, peaking in Rates then declined until 2009, when the Great Recession made its way into Oklahoma, and unemployment rates again rose, even higher than in Both the county’s and the state’s unemployment rates reached their highest point since the late 1980s in 2010 with 7.0 for the county and 6.8 for the state. Since then, rates have fallen fairly consistently, reaching 4.3 (county) and 4.5 (state) in 2014.
Source: Bureau of Labor Statistics.

46. Labor Force Participation for Persons Age 16 and over: Tulsa County, 2009-13
In labor force
Employed
Unemployed
Not in labor force
Number
Rate
Tulsa County
315,233
292,199
22,511
7.1
155,339
Oklahoma
1,834,366
1,686,404
127,842
7.0
1,116,417
United States
158,197,577
141,864,697
15,249,189
9.6
87,994,377
According to the US Census Bureau’s American Community Survey, for the five-year period from 2009 to 2013, the unemployment rate for Tulsa County was 7.1 per 100 people in the labor force, compared to a rate of 7.0 for the state. Because the state was still recovering from the recession during this time, these rates are higher than that shown in previous slide, which represents only 2013.
Source: US Census Bureau, American Community Survey.

47. Not enrolled in school, and either unemployed or not in labor force
School and Employment Status of Youth Age 16 to 19: Tulsa County,
Total population age 16 to 19 = 32,337
Not enrolled in school, and either unemployed or not in labor force
Of Tulsa County’s 32,337 youth aged 16 to 19, 80% are enrolled in school – some of these kids also work. Nine percent of the county’s youth are employed and not enrolled in school – most of these kids have graduated high school. Eleven percent are neither enrolled in school nor working. Eight of that 11% are not in the labor force, and the other 4% are unemployed (meaning they would like, and are looking for, employment).
Source: US Census Bureau, American Community Survey.

48. Employment Status of Youth Age 20 to 24, Tulsa County and Oklahoma, 2009-13
Over a fifth of Tulsa County’s young people age 20 to 24 are not in the labor force – some of them are undoubtedly enrolled in college or other training, but we currently have no way to measure that population. Seventy percent are employed, and 8% are unemployed.
Source: US Census Bureau, American Community Survey.

49. Employees by Job Type and Demographic and Socioeconomic Characteristics, Tulsa County, 2011
This infographic displays characteristics about people who are employed in Tulsa County. The circles on the map represent job locations, and employment size is represented by size of the circle. A total of 345,906 job positions existed in the county in 2011, of which a quarter earned $1,250 or less per month. Almost a third of the positions are held by persons with a high school diploma or less. Healthcare and social assistance (14.3%), retail trade (11.4%), and manufacturing (10.7%) account for over a third of Tulsa County’s occupations. Workers age 30 to 54 make up over half of the total labor force.
Source: U.S. Census Bureau, OnTheMap Application and LEHD Origin-Destination
Employment Statistics (Beginning of Quarter Employment, 2nd Quarter of ).

50. Living wage and poverty

51. Comparison of Self-Sufficiency Wage to Poverty Guidelines, by Size of Family: Tulsa County, 2015
Family Size
Self-Sufficiency Wage (annual)
Poverty Guidelines (annual)
Dollar Difference
Self-Sufficiency Percent of Poverty
One person
$21,658
($10.25/hour)
$11,770
($5.57/hour)
$9,888
184%
Two persons
$38,806
($18.37/hour)
$15,930
($7.54hour)
$22,876
244%
Three persons
$44,410
($21.03/hour)
$20,090
($9.51/hour)
$24,320
221%
Four persons
$52,064
($24.65/hour)
$24,250
($11.48/hour)
$27,814
215%
The Self Sufficiency Standard is a new approach to express the income levels of families. It is a more sensitive measurement of the financial needs of a family to be self-sufficient from public and private support than is the traditional indicator known as the federal poverty level (FPL). The FPL has been a national standard since the Roosevelt Administration to determine family income levels to qualify for public support. The FPL is generated annually based on the family composition and the family income. It is the same across the United States. The Self Sufficiency Standard is based on family composition, family income, geographic location, and is updated annually using the consumer price index.
Comparison of the self-sufficiency wage to the poverty guidelines, by the size of family is presented in the following table. These numbers are representative of the federal poverty level for 2015 and the Self-Sufficiency Standard for Tulsa County in This table reports that the self-sufficiency income level in Tulsa County ranges from 184% to 244%, depending on family size.
A family of three will be followed through next series of charts and graphs. This family is composed of an adult and two children, of which one is pre-school and one is school age.
Notes: For the self-sufficiency wages shown in table, family of two consists of one adult and one preschooler; family of three consists of one adult, one preschooler and one schoolage child; family of four consists of two adults, one preschooler and one schoolage child. Hourly wages given assume full-time, year-round employment.
Source: Oklahoma Association of Community Action Agencies and the Oklahoma Asset Building Coalition, December 2009, The Self-Sufficiency Standard for Oklahoma 2009; Federal Register Notice, 01/22/2015, Annual Update of the HHS Poverty Guidelines; Bureau of Labor Statistics, Consumer Price Index, May 51

52. Self-sufficiency wage: $44,410 ($21.03 hourly)
Wage Comparison: Self-Sufficiency, Welfare, Minimum, Poverty and 185% of Poverty, and Median Family Income: Family of Three, Tulsa County 2015
Annual wage
Self-sufficiency wage: $44,410 ($21.03 hourly)
Married couple families
($36.74/hr.)
All families
($25.59/hr.)
Male-headed families
($17.60/hr.)
($18.33/hr.)
Female-headed families
($9.51/hr.)
($10.10/hr.)
In examining the comparison of wages, it is necessary to look at the enormity of the gap between attained income and self-sufficiency. The bar graph demonstrates the comparison of welfare wage (TANF support and food stamps), minimum wage, poverty wage, 185% of poverty which is the most generous federal program (Medicaid), and the “gap” between these supports and the self-sufficiency wage for a three person family in Tulsa County. This “gap” has been growing since The median family income for different family types are also displayed to illustrate how average Tulsa County families fare in terms of the self-sufficiency wage.
Minimum wage was the federal government’s legislative effort to close the gap between a self-sufficient income and need for public and private assistance in Working poor employed at minimum wage was intended to be the threshold of livable income was the last year that minimum wage annual income and self-sufficiency were the same threshold. As a result, families have had to determine priorities for personal expenditures and seek public and private support to meet expenses that their personal income could not afford (Bureau of Labor Statistics, 2002).
($7.25/hr.)
($5.11/hr.)
Notes: For self-sufficiency wage, family of three consists of one adult, one preschooler and one school-age child. Hourly wages given assume full-time, year-round employment. Welfare wage is the combined value of TANF, SNAP, & WIC. Median family income represents families with children under age 18.
Source: Oklahoma Association of Community Action Agencies and the Oklahoma Asset Building Coalition, December 2009, The Self-Sufficiency Standard for Oklahoma 2009; Federal Register Notice, 01/22/2015, Annual Update of the HHS Poverty Guidelines; Bureau of Labor Statistics, May. 2015; Oklahoma State Dept. of Human Services; US Census Bureau, American Community Survey.

53. Monthly Budget Distribution for 2 Adults + 1 Preschooler, and 1 School Age Child, Self-Sufficiency Wage: Tulsa County, 2015
Self-sufficiency wage = $3,701 per month
Oklahoma is one of 37 states and the District of Columbia with a Self-Sufficiency Standard by which to measure the gap between what families earn and what it takes to be self-sufficient. The self-sufficiency standard is the amount of income needed for either one or two adults to adequately take care of themselves or their family, without the need for assistance.
The 2009 Oklahoma Self-Sufficiency Standard, second edition is the most current release. The first edition was published in This budget is based on the 2009 distribution, updated for inflation with current consumer price index. More information on the Self-Sufficiency standard is available online at www. selfsufficiencystandard.org/
An average Tulsa County family of three earning a self-sufficient wage spends 25% of their earnings on child care, 23% on housing, and 14% on food. The remaining income goes to pay for health care, transportation, taxes and other miscellaneous expenses.
Source: Oklahoma Association of Community Action Agencies and the Oklahoma Asset Building Coalition, December 2009, The Self-Sufficiency Standard for Oklahoma 2009; Bureau of Labor Statistics, May 2015.

54. Median Family Income by Family Type and Presence of Children: Tulsa County, 2009-13
Typically, unmarried families with children earn less than married couples and unmarried families without children. In Tulsa County, female-headed families with children have the lowest median family income ($21,332), followed by male-headed families with children ($38,712), and then female-headed families with no children ($41,144). Married-couple families both with and without children have the highest median family incomes in the county ($77,599, and $73,554 respectively).
Source: US Census Bureau, American Community Survey.

55. Ratio of Income to Poverty by Age: Tulsa County, 2009-13
One out of six people in Tulsa County live below 100% of poverty and one out of three live below 200% of poverty. For children less than 18 years of age, one out of four live below 100% of poverty and nearly half live below 200% of poverty. For children under 6, over a quarter live below 100% of poverty and over half live below 200% of poverty. One out of twelve people age 65 and over live below 100% of poverty and nearly a third live below 200% of poverty.
Source: US Census Bureau, American Community Survey.

56. Number of Persons Living Below 100%, and 200% of Poverty Level, by Age: Tulsa County, 2009-13
Population Cohort
All income levels
100% of poverty level
200% of poverty level
Tulsa County
Total population
599,603
95,328
216,900
Under 18
152,949
36,402
73,256
Under 6
53,171
14,608
28,352
65 and older
72,693
6,009
21,787
This table represents the numerical values for the data in the previous slide.
Close to 100,000 Tulsa County residents live below the federal poverty level. An additional 120,000 fall between 100 and 200% of the federal poverty level. Self-sufficiency level in Tulsa County falls between 184 and 244% of poverty, depending on family size and composition.
Source: US Census Bureau, American Community Survey.

57. Trends in Ratio of Income to Poverty: Tulsa County, 1989, 1999, and 2009-13
The shares of Tulsa County residents living below poverty, below 185% of poverty, and below 200% of poverty have all grown substantially over the past couple of decades. The share living in poverty has risen from 13.2% in 1989 to 15.9% based on the most recent survey. Likewise, the proportion of those living below 185% of poverty has jumped from 28.6% to 33.1%, and that of those below 200% of poverty rose from 31.5% to 36.2%. %. The current ratios of income to poverty for Tulsa County are slightly lower than state averages of 16.9% for 100% of poverty, 35.7% for 185%, and 38.8% for 200% of poverty.
It is important to remember also that the time period covered in this graphic includes the recent recession; upcoming census data releases will shed light on how the county is recovering.
Source: US Census Bureau, 1990 and 2000 Censuses; US Census Bureau, American Community Survey.

58. Number of Persons Living Below 100%, 185% and 200% of Poverty Level: Tulsa County, 1989, 1999, and
Year
All income levels
100% of poverty level
185% of poverty level
200% of poverty level
Tulsa County
1989
492,941
64,959
141,074
155,184
1999
551,650
64,062
152,656
167,765
599,603
95,328
198,664
216,900
This table represents the numerical values for the data in the previous slide. While the total population in Tulsa County rose 22% between 1989 and time period, the number in poverty increased 47%, and the number below 200% of poverty grew by 40%. Over 200,000 Tulsa County residents earn a level of income which makes economic self-sufficiency a struggle.
Source: US Census Bureau, 1990 and 2000 Censuses; US Census Bureau, American Community Survey.

59. Poverty Rates by Family Type: Tulsa County, 2009-13
Overall, female-headed families in Tulsa County have the highest poverty rates, including a rate of 61.6% for families with both pre-school and school-aged children. In general, married-couple families have the lowest rates of poverty, especially those with no related children (2.8%). Twelve percent of all families fall below the poverty level (19,000 out of a total of 154,000 families) in the county.
Source: US Census Bureau, American Community Survey.

60. Role of education

61. Educational Attainment for Persons Age 25 & over: Tulsa County, 2009-13
Just over a tenth of the population 25 and older in Tulsa County have less than a high school education. A quarter have only a high school diploma. More than a third have some type of college degree. Educational attainment is directly correlated with earnings – less educated adults are more likely to live in poverty than those with higher levels of education.
Source: US Census Bureau, American Community Survey.

62. Real Hourly Wage by Educational Attainment: United States, 1973-2012
$37.34
$29.56
$28.28
$24.46
$17.30
$18.06
$16.77
$15.78
$14.63
As discussed in previous slide, as a general rule, the higher the educational attainment, the higher the average earnings. Only college and advanced degree holders have seen increase in wages since 1973 nationally. A person with an advanced degree earns an average of over 200% more than a person with less than a high school education.
Higher levels of parental education are strongly associated with better outcomes for children. Children with parents without a high school diploma are at greater risk of low birth weight and other health issues, of poorer levels of school readiness and overall school success, and smoking and binge drinking in adulthood.
$11.75
Source: Economic Policy Institute, The State of Working America, 12th Edition, table 4.14.

63. Real Hourly Wage by Educational Attainment among Women: United States, 1973-2012
$31.55
$25.30
$24.21
$19.10
$15.53
$13.79
$13.70
$12.76
The gender difference in real hourly wage by education attainment has shown improvement in the last four years. The female makes 76.5 cents to the dollar for less than high school education, 78.5 cents for high school graduates, 74.5 cents for college graduates, and 75.5 cents for the advanced degrees.
Since 1979 woman have experienced increases in real hourly wage with the exception of a -0.6% drop between 1989 and Unfortunately, between 2007 and 2011 the real hourly wage for women fell across each education level except for those with advanced degrees. Women with less than a high school education had their real hourly wage cut by -0.5%. Those with a high school education, some college, or a college degree also saw a decline in real hourly wage. The only category that reported an increase in real hourly wage between 2007 and 2011 was those with an advanced degree (+0.3%).
Source: Authors' analysis of Current Population Survey Outgoing Rotation Group microdata
$10.31
$10.06
Source: Economic Policy Institute, The State of Working America, 12th Edition, table 4.14.

64. Real Hourly Wage by Educational Attainment among Men: United States, 1973-2012
$43.42
$31.07
$32.54
$27.97
$20.73
$19.20
$20.27
$17.41
$17.10
$12.75
Similar to women, men in the United States also saw a decline in real hourly wage across 4 out of 5 education levels. The only category that had an increase in real hourly wage were those with an advance degree (+0.1%). Since 2000, women have surpassed men in the share of the workforce with a degree or an advanced degree.
Source: Authors' analysis of Current Population Survey Outgoing Rotation Group microdata
Source: Economic Policy Institute, The State of Working America, 12th Edition, table 4.14.

65. Program participation

66. Unduplicated Participation in Public Assistance Programs: Tulsa County
26.4%
FY2014
51.8%
2/2015
41.2%
1/2015
17.8%
1/2015
11.9%
6/2015
13.9%
6/2015
2.1%
As previous slides have illustrated, many Oklahoma families are unable to make ends meet with their current earnings. Fortunately, many programs exist to help fill the gap between what families can afford and what they need to survive. A quarter of Tulsa County residents – 164,327 people -- received benefits from SoonerCare in FY Over half of children – 89,584 – are on SoonerCare. Four out of ten of the county’s infants receive WIC benefits, and over 86,000 residents receive SNAP (formerly Food Stamps). Over half of the county’s elementary school students participate in the school free lunch program, and an additional 10% qualify for reduced price lunches. Many Tulsa County families, children, and individuals rely on public assistance programs to meet their basic needs.
6/2015
55.6%
SY2013/14
9.5%
SY2013/14
Source: Oklahoma Dept. of Human Services, Fiscal Year 2013 Annual Report Tables; Oklahoma State Dept. of Education, Low Income Report for ; US Census Bureau, 2013 Population Estimates; Oklahoma State Dept of Health-WIC service, Caseload Report, Jan. 2015; Oklahoma Health Care Authority, Fast Facts, Feb. 2015, and 2014 Annual Report.

67. Free and Reduced Lunch Participation in Elementary Schools: Tulsa County by School District, School Year
Tulsa Public Schools had the largest percentage of elementary school students eligible for free and reduced lunch in Tulsa County at over 90%. Bixby Public Schools had the lowest level of participation with a rate of 24%. It’s clear that many Tulsa County children depend upon the free and reduced lunch program for at least one meal every school day.
3-person household eligibility:
free lunch = 130% of poverty = $26,117
reduced lunch = 185% of poverty = $37,166
Source: Oklahoma State Dept of Education, Low Income Report for

68. Health Status

69. Overall Health Status Ranking: Oklahoma, 1990-2013
The 2013 United Health Foundation State Health Rankings Report paints a dire picture for Oklahoma with a ranking of 44 out of 50 in overall health.
Source: United Health Foundation, “America’s Health Rankings 2013.”

70. Oklahoma’s Rankings in Health Determinants, 2013
1=Healthiest state 50=Least healthy state
Behaviors
Community & Environment
The United Health Foundation State Health Rankings are used by industry in planning expansion and/or relocation to other states. The ranking is 1 for healthiest and 50 for least healthy. For health determinants, Oklahoma comes in at number 43, healthier than only seven states. Our state ranks in the bottom 25% on 9 out of the 13 total determinants, and in the bottom 10% in nearly half of them.
Oklahoma has made improvements in high school graduation, infectious disease control, and children in poverty over the last two decades.
Policy & Clinical Care
Source: United Health Foundation, “America’s Health Rankings 2013.”

71. Oklahoma’s Rankings in Health Outcomes, 2013
1=Healthiest state 50=Least healthy state
Oklahoma is ranked number 46 in the US in total health outcomes. Some of the states’ strengths include low prevalence of binge drinking, low incidence of pertussis, and low prevalence of low birthweight. Some of our challenges include high prevalence of physical inactivity, low immunization coverage among children, and limited availability of primary care physicians. Of the indicators shown on this graph, Oklahoma appears to be doing better in the area of disparity in health status based on education than we are in other indicator areas. For all other indicators, Oklahoma ranks among the unhealthiest ten states.
- See more at:
Source: United Health Foundation, “America’s Health Rankings 2013.”

72. Low Health Status: Oklahoma and United States, 1996-2013
According to the World Health Organization, health is defined as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Metrics used to determine health include the environment and community in which we live; behaviors; public health policies and practices of health care and prevention systems; and clinical care received. The overall health status for Oklahoma compared to the US indicates Oklahomans are in poor health. Oklahoma is ranked number 38 in low health status, with 19% of residents reporting fair or poor health.
Oklahoma is among the leaders in reducing air pollution and binge drinking. Some of the biggest health challenges facing the state are smoking, obesity, drug deaths, and physical inactivity.
Note: Data for 2011 and 2012 are not directly comparable to previous years because of changes in weighting and sampling.
Source: United Health Foundation, “America’s Health Rankings 2013.”

73. Obesity Prevalence: Oklahoma and United States, 1990-2013
State obesity prevalence is calculated by determining the percentage of adults who are obese, with a body mass index (BMI) of 30.0 or higher. (2011 BRFSS Methodology) - See more at: Obesity is one of the most prevalent threats facing the United States with over two-thirds of US citizens either overweight or obese. The direct medical costs for treating obesity and obesity-related, according to 2008 estimates, totaled over $147 billion. Compared to smoking, obesity is more prevalent. Similar to smoking, obesity is correlated with chronic conditions and poor overall health. Obesity has been rising since at least 1990 in Oklahoma and nationally. In 2013, Oklahoma ranked 45th in the share of population estimated to be obese – 32.2% compared to nation at 27.6%.
Source: Danaei G. The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Medicine. 2009;6(4). - See more at:
Note: Data for 2011 and 2012 are not directly comparable to previous years because of changes in weighting and sampling.
Source: United Health Foundation, “America’s Health Rankings 2013.”

74. Smoking Prevalence: Oklahoma and United States, 1990-2013
23.3% of adult Oklahomans and 19.6% of adult Americans are smokers (self-report smoking at least 100 cigarettes in their lifetime and currently smoke). Oklahoma currently ranks 39th in the United States in percent of adults who are smokers.
Nationally and statewide, the percentage of people who smoke has been declining since before Possibly due to changing the methodology (2011 BRFSS Methodology), the percentage of people in the United States who smoke rose significantly between 2011 and 2012 (after declining steadily since 2002). Since 2012, the national average has again been declining, falling from 21.2% in 2012, to 19.6% in (2011 BRFSS Methodology) - See more at:
Note: Data for 2011 and 2012 are not directly comparable to previous years because of changes in sampling methodology.
Source: United Health Foundation, “America’s Health Rankings 2013.”

75. Percent of Population Uninsured, by Age Group: Oklahoma, October 2014
Oklahomans aged 65 and over have an uninsured rate of less than 1.0%. For the under 19 population, 10% are uninsured; the 19 to 64 year old age group has the highest proportion of uninsured at 24%. Overall, 17.7% of Oklahomans lack health insurance. Those proportions should be declining with the impact of the Affordable Care Act.
Overall, 18% of Oklahomans lack health insurance. State residents aged 65 and over have an uninsured rate of less than 1%. For the under 19 population, 10% are uninsured; the 19 to 64 year old age group has the highest proportion of uninsured at 25%. Those proportions should be declining with the impact of the Affordable Care Act.
Source: Oklahoma Health Care Authority, “Oklahoma Uninsured Fast Facts,” October 2014.

76. Adult and Child Population by Health Insurance Status: Oklahoma, 2014
Over half a million Oklahoma adults and nearly 100,000 Oklahoma children do not have health care coverage in any form. Together, over a million adults and children are covered by SoonerCare – Oklahoma’s version of Medicaid. The majority of Oklahoma’s adult population are covered by “other insurance,” which is primarily private insurance.
Source: Oklahoma Health Care Authority, “Oklahoma Uninsured Fast Facts,” October 2014.

77. Percent of Population Uninsured, by Age Group: Tulsa County, 2009-13
Health insurance status by age reveals a large proportion of Tulsa County residents who are uninsured. Ten percent of children and a quarter of those age 18 to 64 self-report as uninsured. The lack of health insurance correlates with the lack of preventative and acute health care intervention leading to more significant health problems. The lack of health insurance is a factor in Oklahoma’s high premature death rate.
Source: US Census Bureau, American Community Survey.

78. …In Summary

79. Best Practices Strategies
Outcome performance measures
Community coalitions
Collaborative, public-private partnerships
Consumer/client investments
Successful outreach and recruitment
Case management/Care coordination
Strong social marketing
Risk reduction education
Access to services and care
Child care
Transportation
Translation
Research based strategies to make improvements in the conditions of infants and children are well documented and include all or a combination of the items listed on slide. The most successful community approaches address a continuum of prevention through maintenance.
Any plan for community improvement should include addressing the community, family, school and individual.

80. Community Profile 2015: tulsa county
Prepared by the Community Service Council, with support from the Metropolitan Human Services Commission
…is available on our website:
This presentation and report was prepared by Melanie Poulter, MA, Mike Witham, BS, and Jan Figart, DHA, RN.