To ensure that Oklahoma is prepared for future public health emergencies like the COVID-19 pandemic, the Center for Public Health Practice at the Hudson College of Public Health at the OU Health Sciences Center convened stakeholders from across the state to study strengths and weaknesses in various sectors of society. Today, that group — known as the Achieving a Healthy Oklahoma initiative — is announcing recommendations aimed at improving preparedness and making Oklahomans less vulnerable to emerging diseases.
“While our state mounted a strong response to COVID-19, we wanted to bring people together in order to learn from our mistakes and build upon our resources,” said Dale Bratzler, DO, MPH, interim dean of the Hudson College of Public Health and the University of Oklahoma’s Chief COVID Officer. “Members of this initiative came from diverse sectors of our society, and they dedicated themselves to establishing actions we can take to improve and expand our public health infrastructure.”
The Achieving a Healthy Oklahoma initiative began nearly a year ago as a nonpartisan effort funded by private and philanthropic organizations. The group, with more than 100 members representing the sectors of public health/healthcare, business, education, and community organizations, held statewide listening sessions and workgroup meetings, conducted interviews and performed surveys.
From those efforts, the initiative’s four overarching recommendations are:
1. State and local health departments should optimize emergency response performance by:
* Identifying key public and private partnership capabilities to improve performance across Oklahoma; and
* Coordinating innovative responses and efforts across jurisdictional boundaries
2. Health leaders and policymakers should pursue sustainable funding for state and local health departments to strengthen public-private partnerships. Oklahoma State Department of Health workforce data indicates there are 316 unfilled public health positions — 193 of which are considered critical — across Oklahoma. The greatest shortage is among registered nurses.
3. The Center for Public Health Practice (at the Hudson College of Public Health) should serve as a hub for:
* Communications around public health preparedness
* Policy collaboration
* Workforce development data and evaluation
* Cross-sector collaboration to guide data modernization and grant opportunities
* Periodic review of the Achieving a Healthy Oklahoma recommendations and impacts
4. Data modernization must be a key driver for the next phase of preparedness and health improvement. Policymakers must pursue funding for sustainable, interconnected health data solutions, including cross-sector, statewide and national systems. The Center for Public Health Practice is uniquely positioned to serve as a central data modernization hub between public-private entities to pursue scalable and interoperable health data projects.
The Achieving a Healthy Oklahoma initiative made further recommendations specific to the sectors of public health/healthcare, business, education, and community engagement. Within each area, action items were designated to the Center for Public Health Practice, Oklahoma policymakers and public-private engagement.
The initiative also gleaned insight from different areas of Oklahoma through six regional listening sessions. Listening was key to understanding each area’s distinct needs, as one stakeholder said: “We really have to step away from planning for people without planning with people. What you do for me, without me, you do to me.”
Common themes emerged in each community. Participants identified strengths including a strong volunteer presence; flexibility among common and secondary schools; business engagement in the emergency response effort; and coordination of emergency response systems at the local and county level. Weaknesses included inadequate staffing at county health departments, hospitals and schools; politicization of strictly science and health issues; technology barriers; burnout among healthcare workers; and barriers to vaccine rollout.
Recommendations that developed from listening sessions include: developing real-time actionable communication strategies; additional investment in the healthcare workforce and ensuring staff work at the highest level of licensure; making real-time, decentralized and transparent data accessible; and training policymakers and political leaders on disaster response and health emergency management.
The regional outreach of the Achieving a Healthy Oklahoma initiative also identified several successes unique to each area’s response to COVID-19. In Duncan, for example, urgent care clinics played a critical role in diverting non-emergency care from hospitals. Duncan Regional Hospital retained its employees and cross-trained staff to adapt to changing needs. In Muskogee, the city sent masks to every resident, and businesses were proactive in encouraging masking in stores. In Miami, first responders and leaders from schools and county health departments facilitated an increase in public trust and communication. In addition, the local hospital system, operated by Integris, partnered with Indian Health Services to manage the influx of COVID-19 cases.
In McAlester, hospitals diverted care to federally qualified health centers, which played a critical role in relieving local healthcare facilities that were overburdened by COVID-19. In addition, the Choctaw Nation was a key partner in the local vaccination effort. In Lawton, libraries served as central hubs to deliver IT access and community resource catalogs to community members. The vaccination effort was quickly organized, and volunteers and community partners delivered up to 1,500 vaccinations a day.
The Southern Plains Tribal Health Board, which provides a unified voice on tribal public health needs and policy for the 43 federally recognized tributes in Oklahoma, Kansas and Texas, extended tribal resources to all residents in local communities regardless of tribal status. Tribes also took a population-level approach to addressing COVID-19 health needs rather than an individual approach. Contact tracers with tribes served as comprehensive case managers and public health allies.
The Achieving a Healthy Oklahoma initiative is one of the first of its kind in the nation, and it establishes the foundation for Oklahoma to serve as a leading agent of change for public health, said Gary Cox, J.D., Associate Dean for Public Health Practice in the Hudson College of Public Health and Community Partnerships Director for the college’s Center for Public Health.
“The work accomplished this past year by our committees provides actionable steps for Oklahoma to be better poised across healthcare, business, education, and community sectors to prepare for — and respond to — public health crises in the future,” Cox said. “The Center for Public Health Practice is prepared to turn these action steps into sustainable, effective programs that can be implemented throughout Oklahoma and serve as a template for the rest of the nation.”
To read the entire report from the Achieving a Healthy Oklahoma initiative, visit