Oklahoma, Arkansas Hit in Health Care Analysis

Article excerpt

From Wire Reports

President-elect Bill Clinton's Arkansas is a public health pit and Hawaii a public health paradise, according to a state-by-state analysis of health care programs by the American Public Health Association.

Oklahomans, it said, smoke too much, and have health care habits among the worst in the nation.

The organization of public health experts issued a "report card" Monday ranking each state and the District of Columbia on a variety of medical issues. Arkansas was the only state to rank in the bottom quarter in all five major categories: Medical care access, healthy environment, healthy neighborhoods, healthy behaviors and community health service.

Hawaii, which has required that all businesses provide health insurance since 1974, came out at the top, ranking in the first or second quarter in all categories.

"We want to draw attention to the underlying determinants of health in this country," said Dr. Joyce Lashof, president of the American Public Health Association and former dean of the University of California at Berkeley's School of Public Health.

Instead of more traditional measures of public health such as disease statistics, life expectancies and rates of infant mortality, the report card rates states on qualities such as availability of medical care, childhood poverty and spending on sewer projects. Public health researchers say these "broad determinants" correlate closely with the health of a given population.

"Poverty is the No. 1 factor that influences health," Lashof said.

Dragging down the national averages were poor health conditions in Oklahoma, according to the report, which claimed 23 percent of the Sooner population is uninsured, doctors are scarce, and the amount of government money spent on public health care is nearly the lowest in the nation.

It stated only two states have fewer doctors per capita than Oklahoma, which also ranks 50th for government spending on community health programs, about $39 per person. The report found Oklahoma spends more than twice that on sanitation and sewage disposal, about $78.

Health habits in Oklahoma are a little worse than average, it said: nearly 30 percent of people smoke, 23 percent are obese, and 10 percent drink to excess, while more than 25 percent don't wear seat belts.

The report placed Oklahoma's environment near the national average because of a fewer-than-average number of work-related injury cases, a shortage of fluoridated water and moderate pollution levels. …