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PubMed2002

Prevalence of current cigarette smoking among American Indians in Oklahoma: a comparison.

Tobacco use among American Indians in the US is higher compared to the overall population. Little is known, however, about tobacco use among Native Americans in Oklahoma. The objective of this paper is to report the prevalence of current cigarette smoking among the Native American population in Oklahoma and compare these rates to Oklahoma general adult population rates and United States median rates. The REACH 2010 Native American Behavioral Risk Factor Survey, a random telephone survey, was conducted in 2000 as a part of larger national REACH initiative. It was designed to over-sample Native Americans in Oklahoma, and collect information related to diabetes, cardiovascular disease, overweight and obesity, physical activity, tobacco use, and other behavioral risk factors of interest. The prevalence of current cigarette smoking was significantly higher among Native American adults in Oklahoma (33%) as compared to the Oklahoma general adult population current smoking rate (23%), and U.S. median rate (23%). It was also greater than smoking rates for other racial and/or ethnic groups in Oklahoma. For Native Americans in Oklahoma as well as for Oklahoma and U.S. general populations, highest cigarette smoking rates were among men, younger age groups, and those of lower socioeconomic status, all following the same trend. These findings are urging for more interventions targeting groups with higher smoking rates.

Adult↗
PubMedDate not supplied

Incidence of Rocky Mountain spotted fever among American Indians in Oklahoma.

OBJECTIVE: Although the state of Oklahoma has traditionally reported very high incidence rates of Rocky Mountain spotted fever (RMSF) cases, the incidence of RMSF among the American Indian population of the state has not been studied. The authors used data from several sources to estimate the incidence of RMSF among American Indians in Oklahoma. METHODS: The authors retrospectively reviewed an Indian Health Service (IHS) hospital discharge database for 1980-1996 and available medical charts from four IHS hospitals. The authors also reviewed RMSF case report forms submitted to the Centers for Disease Control and Prevention (CDC) for 1981-1996. RESULTS: The study data show that American Indians in the IHS Oklahoma City Area were hospitalized with RMSF at an annual rate of 48.2 per million population, compared with an estimated hospitalization rate of 16.9 per million Oklahoma residents. The majority of cases in the IHS database (69%) were diagnosed based on clinical suspicion rather than laboratory confirmation. The incidence of RMSF for Oklahoma American Indians as reported to the CDC was 37.4 cases per million, compared with 21.6 per million for all Oklahoma residents (RR 1.7, 95% confidence interval [CI] 1.5, 2.1). CONCLUSIONS: Rates derived from the IHS database may not be comparable to state and national rates because of differences in case inclusion criteria. However, an analysis of case report forms indicates that American Indians n Oklahoma have a significantly higher incidence of RMSF than that of the overall Oklahoma population. Oklahoma American Indians may benefit from educationa campaigns emphasizing prevention of tick bites and exposure to tick habitats.

Centers for Disease Control and Prevention, U.S.↗
PubMed1999

Oklahoma physician needs.

State policy makers, healthcare professionals, and advocates have been asking various iterations of the question, Do we have too many or too few physicians? In order to address this question, a relative-needs analysis was conducted for the state of Oklahoma. Six projection-needs studies were used for comparison with Oklahoma's supply of practicing physicians. This analysis found that Oklahoma did not have a surplus of primary care physicians. While the national average for primary care physicians per 100,000 was 79, Oklahoma's ratio was 68. This analysis also compares not only the number of physicians in Oklahoma per 100,000 population, it also discusses the proportion of primary care physicians in the physician workforce. Primary care physicians were found to be neither oversupplied nor undersupplied in Oklahoma. Oklahoma was found to be closer to national planning model goals than most states in the United States. Because this study combines both allopathic and osteopathic physicians and includes only those physicians in active practice, it is unique in comparison to many other studies concerning physician workforce needs.

Family Practice↗
PubMed1991

The descriptive epidemiology of Lyme disease in Oklahoma.

Lyme disease is a tick-borne illness that primarily occurs in the United States in three endemic areas: the northeast, upper midwest, and pacific coastal regions. Although Oklahoma is considered a non-endemic area of Lyme disease, other tick-borne infections such as Rocky Mountain spotted fever, ehrlichiosis, and tularemia occur at endemic levels. In order to determine the extent of Lyme disease in Oklahoma, the Oklahoma State Department of Health collected information on all possible cases of Lyme disease. The first reported Oklahoma case occurred in 1985. In 1988, and 1989, 8 and 25 cases, respectively, of Lyme disease were reported in Oklahoma residents who acquired their infection indigenously. The mean age of case-patients was 38 years. Twenty-eight of 33 (85%) case-patients were white, and 4 of 33 (12%) were American Indian (race was unknown for 1 case-patient). The female/male ratio was 2.3. Most case-patients had onset of illness between May and September. Twenty-two counties reported cases, with Oklahoma County accounting for 4 of 33 (12%). Only 21 of 33 (64%) recalled a tick bite, and only 19 of 33 (58%) had erythema migrans. Continued active case-finding and passive reporting (as now mandated by state law) will further increase our knowledge of the epidemiology, ecology, and prevention of Lyme disease in Oklahoma.

Adult↗
PubMed1980

Cryptococcus neoformans serotype groups encountered in Oklahoma.

Eighty clinical and 28 soil isolates of C. neoformans obtained in Oklahoma were separated into A-D and B-C serotype groups utilizing creatinine-dextrose agar with bromthymol blue. Previously, serotype B-C clinical isolates have been frequent only in patients from Southern California where as many as 50% of the isolates are of this type. In contrast, in patients from the rest of the United States the B-C frequency has been only 6%. Of the 80 C. neoformans isolates from Oklahoma patients, 12 (15%) were serotype B-C. One-half of these 12 Oklahoma patients with serotype B-C isolates had no history of any travel to California, and were long-time residents of Oklahoma. All 28 soil isolates of C. neformans from Oklahoma in this study were serotype A-D. Since serotype B-C recovery from a soil sample has never been reported, attempts are in progress to isolate serotype B-C from the environments of these patients from Oklahoma.

Adult↗
PubMed2001

Early and periodic screening, diagnosis, and treatment examination completion rates for Oklahoma Medicaid managed care: 1995-1998.

Although quality medical care is a goal of all health care providers, finding a means by which to take that idea from the abstract to the measurable is often an arduous task. The Oklahoma Health Care Authority and the Oklahoma Foundation for Medical Quality confronted that challenge when examining the state of Oklahoma's Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) examination completion rates. Focused on measuring processes of care, the Oklahoma Health Care Authority (OHCA) and the Oklahoma Foundation for Medical Quality (OFMQ) used chart abstraction to track EPSDT examination rates for SoonerCare Plus Medicaid managed care recipients from 1995 through 1998. During the abstractions, an examination was interpreted as an EPSDT screen if a comprehensive health and development history plus a comprehensive unclothed physical examination were recorded. Examination rates have improved from 1995 when there was a documented 17.6% completion rate. The 1998 documented rate of completion was 60.0%. Trend analysis shows significant improvement over the four-year period. The results also suggest the necessity for continued improvement in the provision of documented EPSDT examinations to individuals in Medicaid managed care plans in Oklahoma.

Adolescent↗
PubMed2004

The magnitude of major trauma in Oklahoma.

BACKGROUND: Injuries are the third leading cause of death in Oklahoma and the leading cause of death and disability among persons 1-44 years. In 2001, participation in the Oklahoma trauma system became mandatory, and all licensed acute care hospitals were required to submit data to the Oklahoma Trauma Registry (OTR). The objective of this study was to describe the magnitude of major trauma occurring in Oklahoma from 2001-2002. METHODS: Data were collected from all licensed acute care hospitals in Oklahoma. Only patients meeting the major trauma criteria were included in the study. Mortality was used as the main outcome measure. RESULTS: A total of 5760 major trauma patients were reported. The mean age was 38 years (range: 5 days-100 years). Over two-thirds of major trauma cases were male. Blacks had the highest rate of injury (89.5/100,000 population). The leading cause of injury was motor vehicle crashes among persons < 65 years and falls among persons 65 years or older. Overall mortality was 16%; after controlling for age, males were significantly more likely to die than females (O.R 1.3; CI 1.1-1.5). Persons injured by firearms were nearly 5 times more likely to die (CFR=42%) than persons injured by all other causes (CFR=14%) (Odds Ratio 4.5; CI 3.6, 5.5). Excluding deaths in the emergency department (ED), patients were hospitalized an average of 9 days (median: 5 days; range 1-204 days). Over two-thirds (69%) of survivors were discharged home and 14% were discharged to a rehabilitation facility. CONCLUSION: There are noted demographic and etiological differences in the burden of major trauma. Understanding these differences may be useful in enhancing existing prevention practices in Oklahoma and for generating new research to lower this burden. The OTR is relatively new and still maturing; hence, further studies will be required to increase understanding of other factors that influence the incidence and outcome of trauma.

Adult↗