Assignment 4 – Policy Analysis|
Oklahoma Rural Populations and Healthcare
Assignment 4 – Policy Analysis
The problem is not uncommon. In fact, a number of states throughout the country are facing the same and other similar issues. However, for Oklahoma, the shortage of healthcare providers has moved from bad to intolerable. Oklahoma has consistently been at the bottom of states in terms of the public’s access to healthcare and is likely to remain there without significant changes.1 The Problem and Affected Population
Oklahoma falls short of providing an adequate amount of physicians to its residents. Not only that, but with a mere fraction of the providers outside of city limits, residents in rural areas are particularly vulnerable to this shortage. The most recent report from the Census Bureau details that 58% of Oklahoma residents live within the state’s two largest metropolitan areas of Oklahoma City and Tulsa.2 This indicates that a significant number of Oklahoma’s residents are outside of urban and suburban territory, where physician and other health provider shortages are even more pronounced. The scope of this issue stretches beyond the shortage of physicians, and is related to number of other circumstances. Oklahomans, by comparison, are routinely among the least healthy in all of the United States.3 Though not the entire story, these rankings and studies showing high levels of heart attacks, diabetes, and low levels of physical activity certainly illustrate the lack of adequate health care provided throughout the state. With a population experiencing poor health at rates this high, an increase in physicians alone will not solve the problem. Public officials must determine the necessary steps to creating a culture change in the habits of Oklahoma’s residents that encourage healthy living. Although the physician shortage alone does not explain Oklahoma’s health woes, it is important to note its magnitude when assessing how public officials might address Oklahoma’s health issues. Looking across the state it is clear there are not enough providers to serve Oklahoma. In fact, when using a per capita basis, Oklahoma ranks last in the country for physician coverage.3 Wide ranges of land without specialists means that many people have to travel to either Tulsa or Oklahoma City in order to have individual needs met – a frightening prospect for a heart attack victim who is three hours from the nearest cardiologist.3 Unfortunately, this is not limited to specialists; primary care within the state is also declining. For rural populations, the problem is even greater, as nearly sixty percent of their physicians are over the age of 50 years old.4 The scope of this issue only increases when one considers the increase of newly insured residents in two years as a result of the passing of the Patient Protection and Affordable Care Act (PPACA). A growing number of people insured with declining numbers of physicians calls for more, not fewer primary care providers. Finally, one of the causes of the state’s shortage is that students and newly licensed health care providers are leaving the state for school and residencies without plans to return for employment. With two medical schools, including one of the premier schools of osteopathic medicine in Oklahoma State University, Oklahoma has a rich history of producing quality primary and rural health physicians. Though, with a growing need for physicians, the modest increases in class size is not enough to substantially impact the shortage, especially when one considers the 7 years of schooling/residency it takes for an increase in class size to impact a workforce. Compounding the problem, as students gain this training, they are increasingly seeking out residencies and job opportunities providing higher pay.3 Not only do these higher salaries lead students away from rural areas,...