Oklahoma is primarily a rural state with a population distinguished by multiple ethnicities, numerous tribal affiliations, and rich cultural traditions.
Although American Indians comprise just 7 percent of Oklahoma’s population, the state includes 38 federally recognized tribal nations, who share a proud and painful history that to this day exerts an influence on their relationship with the state and federal government. Some tribes handle their own health care and other service needs, while others receive direct services from the federal government’s Indian Health Service (IHS). Although tribes set their own laws, they have worked with federal and state governments on initiatives to improve community health.
Oil production has figured prominently in Oklahoma’s economic fortunes—and distress—since 1897, when oil was discovered in the state’s northeast corner. The state was one of the nation’s leaders in oil production until the mid-1940s, after which drilling slumped, rebounded, boomed again. Growth continued between 2002 and 2012, but in 2014, the bottom dropped from oil prices yet again. Since June 2014, plummeting oil prices have cost the state more than 12,500 jobs, created significant budget shortfalls, and limited funding for the Oklahoma State Department of Health (OSDH). Fiscal constraints on OSDH have far-reaching implications for the health and well-being of all Oklahoma residents.