1. Adults and Families at Risk… From Community Service Council of Greater Tulsa’s Community Profile 2007

2. 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 Risk Factors

3. Single-Parent Households

4. Educational Attainment

5. Adult Literacy

6. Substance Abuse

7. Health Challenges

8. 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 Health Challenges

10. 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 Effects of adverse childhood experiences Disease or disability Suicide Premature death Adverse Outcomes

11. Inadequate Income

13. 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. Inadequate Income

14. Domestic Violence

16. Oklahoma’s prison population was relatively stable until 1980 when laws passed to curb illegal drug use came into effect Oklahoma’s Prison Population 1950-2005 Source: Oklahoma State Department of Corrections, Prepared by the Community Service Council of Greater Tulsa for the Metropolitan Human Services Commission in Tulsa. 1980 Note: Number of inmates in Oklahoma prisons, data as of June 30 of each year Crime & Incarceration

17. DOC Receptions Drug Crimes and Other Crimes FY1995 – FY 2005 Source: Oklahoma State Department of Corrections Prepared by the Community Service Council of Greater Tulsa for the Metropolitan Human Services Commission in Tulsa. Crime & Incarceration

20. Department of Corrections Receptions from Tulsa County by Gender 1998-2002 Source: Oklahoma State Department of Corrections Prepared by the Community Service Council of Greater Tulsa for the Metropolitan Human Services Commission in Tulsa. Crime & Incarceration

21. The Adverse Childhood Experiences (ACE) Study Major American research project that poses the question of whether and how childhood experiences affect adult health decades later Provides compelling evidence that: –Adverse childhood experiences are surprisingly common –ACE’s happen even in “the best of families” –ACE’s have long-term, damaging consequences Findings reveal powerful relationships between emotional experiences as children and physical and mental health as adults ACE Study Source: The Adverse Childhood Experiences Study website: www.acestudy.org, “About the Adverse Childhood Experiences Study.”

22. The Adverse Childhood Experiences (ACE) Study Pyramid Source: The Adverse Childhood Experiences Study website: www.acestudy.org, “About the Adverse Childhood Experiences Study.” ACE Study

23. Adverse Childhood Experiences… Recurrent physical abuse Recurrent emotional abuse Sexual abuse An alcohol or drug abuser An incarcerated household member Growing up in a household with: Someone who is chronically depressed, suicidal, institutionalized or mentally ill Mother being treated violently One or no parents Emotional or physical neglect Source: The Adverse Childhood Experiences Study website: www.acestudy.org, “What are Adverse Childhood Experieinces (ACE’s).” ACE Study

24. …Lead to Health-Risk Behaviors… Smoking Overeating Physical inactivity Heavy alcohol use Drug use Promiscuity Source: The Adverse Childhood Experiences Study website: www.acestudy.org ACE Study

25. …Which Cause Disease, Disability and Social Problems in Adulthood Heart disease Cancer Chronic lung and liver disease Stroke Diabetes Sexually transmitted diseases Nicotine addiction Alcoholism Drug addiction Obesity Depression Suicide Injuries Unintentional pregnancy Source: Felitti, Vincent J., “The Relationship of Adverse Childhood Experiences to Adult Health: Turning gold into lead;” CDC Media Relations, May 14, 1998, “Adult Health Problems Linked to Traumatic Childhood Experiences.” ACE Study

26. Health Challenges

27. Drug Addiction

28. Disease, Disability & Death

41.  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 Disease, Disability & Death