Community Profile 2007 Wagoner County and Broken Arrow Prepared by the Community Service Council of Greater Tulsa January, 2007

How Well do You Know Your Community? 1. How did Wagoner County’s population change between 2000 & 2005? a. down 8%b. no change c. up 12% 2. What percentage of Broken Arrow’s 65+ population live alone? a. 10% b. 22%c. 36% 3. What percentage of Wagoner County’s elementary school children participate in the school free & reduced lunch program? a. 28%b. 41%c. 55% 4. What percentage of Oklahoma’s working age population have no health insurance? a. 13%b. 25%c. 48% 5. What percentage of Broken Arrow’s population with disabilities are employed? a. 68%b.46% c. 29%

Community Profile 2007 Demographic Trends Human Development Panel Topics Best Practices

TAUW Service Area

Tulsa Metropolitan Statistical Area

Demographic Trends in Wagoner County & Broken Arrow (part 1) Wagoner County, Broken Arrow and Coweta have all experienced high rates of population growth since Growing cultural diversity, particularly among the population <25 Living arrangements are changing significantly with more children living with a single parent, especially the mother, and living with other relatives, especially grandparents

Wagoner County’s population 65+ projected to make up 22% of population by 2030 (up from 10% in 2000) Population <18 projected to account for 23% of population by 2030 (down from 28% in 2000) As working age population’s share declines, the 2030 projected dependency ratio climbs to 81 per 100, up from 61 per 100 in 2000 Demographic Trends in Wagoner County & Broken Arrow (part 2)

Larger number of people over 65 years of age are living alone, especially women Median family income varies by race Large population of mobile renters Demographic Trends in Wagoner County & Broken Arrow (part 3)

Tulsa Area Human Development Industry What is it? Independent and collective action of efforts to address the education, health, housing, family support, emergency financial, and transportation needs of families and individuals in the Tulsa area. Increasingly these efforts seek to prevent needs through promoting increased self-sufficiency among people in the Tulsa area while still intervening to respond to crises and other concerns.

The Roots of the Challenge Thirty Year of Economic and Social Changes Emergence of new persistent poor in late 1960's and early 1970's Massive loss of low skill/high pay jobs Sharp rise in working poor Decline in young male workers' wages Increase in female headed families Impact of substance abuse All trends disproportionately affected: ~African-Americans ~young children & young families

Human Development: Key Points Middle class is disappearing Many households lack adequate income Stress of inadequate income and related conditions is widespread Starting life in Wagoner County for many is risky business

Human Development: Key Points… continued Populations of aging and persons with disabilities are large and growing Health challenges are critical to individual and community well-being Poor human conditions impact crime and growing incarcerations Overall progress in human development is tied to educational success

The Middle Class is Disappearing ~Lower income groups greatly expand, middle shrinks, highest income group increases dramatically

Many Households Lack Adequate Income ~More and more households lack adequate income to meet living needs

The Self-Sufficiency Standard Customized by specific family composition Customized by geographic location Based on all expense categories Updated annually using consumer price index …The level of income required for a family to meet its own needs

Prepared by the Community Service Council of Greater Tulsa

Additional Indicators of Economic Distress Public assistance programs Free & reduced school lunch program Homeless shelters Helpline and Babyline referrals

Populations of Aging and Persons with Disabilities are Large and Growing ~These populations will significantly test the capacity of resources needed to enable them to be most self-sufficient

Health Challenges are Critical to Individual and Community Well-being ~Inadequate income, high risks of starting life and poor lifestyle choices contribute to major health concerns

OBESITY Trend: America’s weight gain epidemic – 25% of Americans are obese – more than doubled in 15 years. Benchmark: We must reverse this trend. Bad: Consequences – –high healthcare costs. –Increased heart disease, type II diabetes, osteoarthritis, hypertension, gallbladder disease, breast cancer, endometrial cancer and colon cancer. Bad: OK and Tulsa Co heart disease rates are higher than the rest of the nation – only one state ranks worse than OK. Lapolla, Health Policy Analysis of the Tulsa Metropolitan Area, Center for Health Policy Research and Development, OUCPH, 2005; NCHS, CDC; THD; Tulsa County Health Profile; NIH; United Health Foundation; BRFSS, CDC; St. Francis Health System FY 2004 Community Needs Assessment. OK US THD – Patel/Woodruff 9/05 Major Health Concern: Poor Lifestyle Choices -- Obesity

 Trend: Percent of adult smokers (2003): 22.7(Tulsa Co), 25.1(OK), 22.0(US), state rank=36.  Benchmark: Smoking bans in public venues, smoking cessation programs, and increasing cigarette taxes = curtailed adult smoking and youth take-up rate.  Good: OK youth smoking percent is below the national average— 26.5(OK) and 27.5(US); adult smokers declining locally, statewide and nationally (2003).  Bad: Smoking is a major cause of premature death, cardiovascular and pulmonary system disease including heart attack, stroke and cancer. THD – Patel/Woodruff 9/05 NCHS, CDC; THD;Tulsa County Health Profile; NIH; BRFSS, CDC Major Health Concern: Poor Lifestyle Choices -- Smoking

 Tulsa’s uninsured and Medicaid beneficiaries seek primary care in Tulsa hospital ERs. ER visits by Medicaid recipients actually exceeded uninsured visits by 25%.  Tulsa hospital ER patient survey found that 73% were not true emergencies: 30% treated for non-emergency conditions – another 43% could have been treated in non-emergency facilities within 48 hours.  Using hospital ERs for non-emergency care is a costly and inefficient.  Non-emergency ER use is a major contributor to overload and frequent divert status of Tulsa hospital ERs — especially in the last 2 years. THD – Patel/Woodruff 9/05 Lapolla, Health Policy Analysis of the Tulsa Metropolitan Area, Center for Health Policy Research and Development, OUCPH, 2005; THD CAP Poor health conditions create huge inefficient demand on resources - Misuse of Hospitals and Emergency Rooms

 Of the 80 largest US metro areas, only Tulsa and Wichita lack ALL the components of a traditional public healthcare safety net infrastructure for indigent care. No public or university hospital. No comprehensive sponsorship of specialties/sub- specialties at medical schools. No hospital receiving Medicaid Disproportionate Share Hospital (DSH) funds for indigent care served. No hospital specifically organized and tasked to provide indigent care. No statewide support of Federally Qualified Health Centers (FQHCs); only one fully functional FQHC in Tulsa. Lapolla, Health Policy Analysis of the Tulsa Metropolitan Area, OU Center for Health Policy, 2005 THD – Patel/Woodruff 9/05 Overall lack of health care resources for indigent care No Local Traditional Safety Net

Higher poverty correlates closely with higher percentages of uninsured and Medicaid recipients. Oklahoma ranks 40 th in the United Health Foundation’s state index rankings, but we are right on the average for states with similar levels of poverty. Poverty may be the greatest single determining factor in a state’s health rank accounting for almost 55% of the variance explanation. Generally, states with low poverty levels can expect to achieve higher health ranking without regard to other public health measures. THD, 2005; United Health Foundation State Health Rankings, 2004 OK The Influence of Poverty on Health Rankings

Poor Human Conditions Impact Crime and Growing Incarcerations ~Trends greatly affected by substance abuse

Oklahoma’s prison population was relatively stable until 1980 when laws passed to curb illegal drug use came into effect Oklahoma’s Prison Population Source: Oklahoma State Department of Corrections, Prepared by the Community Service Council of Greater Tulsa for the Metropolitan Human Services Commission in Tulsa. Note: Number of inmates in Oklahoma prisons, data as of June 30 of each year

Overall Progress in Human Development is Tied to Educational Success ~From preschool through post secondary education

Education Success: Preschool

Education Success: Kindergarten – 12 th Grade

Source: Oklahoma State Department of Education. THD – Patel/Woodruff 9/05

Source: Oklahoma State Department of Education. THD – Patel/Woodruff 9/05

Education Success: Post-Secondary-Higher Education

Growing importance of coordination among higher education institutions to promote system efficiency System Overview The State Regents prescribe academic standards of higher education, determine functions and courses of study at state colleges and universities, grant degrees, recommend to the state Legislature budget allocations for each college and university, and recommend proposed fees within limits set by the Legislature. A primary goal for the State Regents is “System Efficiency” especially focused on reduced program duplication. Tulsa Community College provides the lower level (Freshman & Sophomore) courses in Tulsa County and articulates agreements with all state supported four-year colleges and universities in Oklahoma for students wishing to pursue a bachelor’s degree. Tulsa Community College provides educational opportunities that can lead to Associate Degrees in Arts, Science, or Applied Science and to Certificates of Achievement.

Human Development: Key Points Middle class is disappearing Many households lack adequate income Stress of inadequate income and related conditions is widespread

Human Development: Key Points… continued Populations of aging and persons with disabilities are large and growing Health challenges are critical to individual and community well-being Poor human conditions impact crime and growing incarcerations Overall progress in human development is tied to educational success

Special Topics Adults and Families at Risk

Adults and Families at Risk…

Top Risk Factors for Adults and Families Single-parent households Low educational attainment Illiteracy Childhood abuse and other adverse childhood experiences Substance abuse/addiction Lack of health insurance/poor health care Poor diet & lack of exercise Tobacco use & excessive alcohol use

Lapolla, Health Policy Analysis of the Tulsa Metropolitan Area, OU Center for Health Policy, 2005;. THD – Patel/Woodruff 9/05 Major Health Concern: Uninsured – Tulsa to Comparable Cities

Risk Factors Increase Likelihood of Adverse Health and Social Outcomes ~ Adverse Outcomes for Adults and Families: Lower earnings/lack of economic self-sufficiency Domestic violence Crime/gang violence/incarceration Disease or disability Suicide Premature death

Adult Literacy Levels and Income Over 20% of American adults read at or below a 5th grade level - far below the level needed to earn a living wage. 43% of people with the lowest literacy skills live in poverty. Workers who lack a high school diploma earned an average hourly wage of $9.50 in 2001, compared to $12.81 for high school graduates and $22.58 for those with a college degree. Source: Oklahoma Literacy Resource Office; Economic Policy Institute website.

Impact of Adult Literacy & Education Levels on Children As the educational level of adults improves, so does their children's success in school; helping low-literate adults improve their basic skills has a direct and measurable impact on both the education and quality of life of their children. Children of adults who participate in literacy programs improve their grades and test scores, improve their reading skills and are less likely to drop out. Children's literacy levels are strongly linked to educational level of their parents, especially their mothers. Children of parents who are unemployed and have not completed high school are five times more likely to drop out than children of employed parents. Source: Oklahoma Literacy Resource Office.

Oklahoma’s prison population was relatively stable until 1980 when laws passed to curb illegal drug use came into effect Oklahoma’s Prison Population Source: Oklahoma State Department of Corrections, Prepared by the Community Service Council of Greater Tulsa for the Metropolitan Human Services Commission in Tulsa Note: Number of inmates in Oklahoma prisons, data as of June 30 of each year

Department of Corrections Receptions from Tulsa County by Gender Source: Oklahoma State Department of Corrections Prepared by the Community Service Council of Greater Tulsa for the Metropolitan Human Services Commission in Tulsa.

 Good:  Tulsa Co death rates parallel those of OK  Tulsa rates below the OK rate for most years;  2002 Tulsa rate lower than some metro areas of similar size and scope, including Oklahoma City.  Bad: By 2002 Tulsa County rate was 14.5% higher than the nation. THD – Patel/Woodruff 9/05 Major Health Concern: Tulsa’s high age-adjusted death rate compared to other areas Age-Adjusted Deaths Rates for Tulsa and Comparable Areas, 2002

Best Practices… A Research Based Approach Doing What Works

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

How Well do You Know Your Community? 1. How did Wagoner County’s population change between 2000 & 2005? a. down 8%b. no change c. up 12% 2. What percentage of Broken Arrow’s 65+ population live alone? a. 10% b. 22%c. 36% 3. What percentage of Wagoner County’s elementary school children participate in the school free & reduced lunch program? a. 28%b. 41%c. 55% 4. What percentage of Oklahoma’s working age population have no health insurance? a. 13%b. 25%c. 48% 5. What percentage of Broken Arrow’s population with disabilities are employed? a. 68%b.46% c. 29%

TAUW Community Investments Strategy Mission Statement To take a leadership role in community building by investing TAUW's community resources in the most efficient and effective delivery systems for health and human services.

Community Profile 2007 Wagoner County and Broken Arrow …is available on our website: Prepared by the Community Service Council of Greater Tulsa January, 2007