Zip Code Analysis

Health and Wellness Score

Definition

As the two largest metropolitan areas in Oklahoma, Tulsa Health Department and the Oklahoma City-County Health Department partnered in the development of a health index formula to allow for comparisons within and between both City-County jurisdictions. This formula was adapted from both the County Health Rankings and Urban Hardship Index and finalized in collaboration with the City of Oklahoma City Planning Department and Oklahoma City-County Health Department.

The purpose of this index is to capture the multitude of factors that may be causing increased health burden at the zip code level. Data was evaluated from nine indicators: education, income, maternal and child health, mental health, mortality, healthcare access, crime, infectious disease, and the built environment.

Data is presented from 2013-2015 and will be updated annually.


How are we doing?

The map shows the ranking of Tulsa County zip codes for the health and wellness index (1- best; 40- worst). In general, the highest ranking zip codes were in south Tulsa and the south suburbs. The lowest ranking zip codes were in north and west Tulsa.

Top five zip codes:

1. 74037

2. 74114

3. 74008

4. 74012

5. 74137


Bottom five zip codes:

40. 74116

39. 74126

38. 74106

37. 74110

36. 74130

All individual data included in this analysis is presented in their respective Tulsa County Health Status Report chapters.


Methodology

The health index formula standardizes each of the category variables so that they are all given equal weight in the composite index. The index represents the average of the standardized ratios of all 9 category variables. The index ranges from 0 to 100 with a higher number indicating greater burden. The built environment portion of the index can also be separated out as an individual score, also ranging from 0 to 100, with a higher score indicating a higher burden.

All data used was from 2013 – 2015.


Formula: X= ((Y – Ymin)/(Ymax – Ymin))*100

X= Standardized value of category variable (for each zip to be computed)

Y= Unstandardized value of category variable for each zip

Ymin= Minimum value for Y across all zips

Ymax= Maximum value for Y across all zips

Ymin and Ymax were reversed for variables where a higher number indicates a more positive outcome (i.e., life expectancy).


Scale: 0 to 100 with a higher number indicating greater burden

There were nine categories included in the overall score:

• Education: % of population with less than a high school education

• Income: % of population below poverty

• Maternal and Child Health: Infant mortality rate (Infant deaths/1,000 live births)

• Mental Health: Age adjusted suicide deaths/100,000 population

• Mortality: Life expectancy at age 0-4

• Healthcare Access: ER visits for Medicaid population

• Crime: Gun related deaths/100,000 population

• Infectious Disease: Rates per respiratory , flu related hospitalizations, enteric , blood borne, mosquito borne, and sexually transmitted infections (all per 100,000 population)

• Built environment: Positive land use proximity—% of population within 1 mile of a supermarket, % of population within ½ mile of a park, % of population within ½ mile of a trail access point, % of population within ½ mile of a school (public preK – 12th, all colleges/universities); Negative land use proximity— % of population within ½ mile of an industrial land use, % of population within ¼ mile of an oil/gas site, % of population within ¼ mile of a highway; Transportation security—% of population with no vehicle access, % of population within ¼ mile of a transit stop; Housing security—% of population spending more than 30% of income on housing (mortgages and renters, separated), % of vacant units


Limitations

Missing values were removed. If a value was removed, any subsequent calculation was updated to show that there were less categories available for that zip code. For example, emergency department visits were not available for zip code 74063. Therefore, the final index score was calculated using the average of 8 standardized ratios as opposed to 9, thus eliminating the “emergency department visits” standardized ratio.

However, standardized ratios were collected using any number of cases/deaths. Generally, nothing is reported if it is less than five cases/deaths in a geographical region (in this case, zip code), but since this index does not show rates for separate or specific indicators, it was decided to use less than five cases to calculate standardized ratios.

Any zip code that had less than half of available data was removed from the calculation. Zip codes 74050, 74103, and 74117 were removed from the score.


Data sources

• American Community Survey 5-year estimates.

• Vital Statistics. Oklahoma State Department of Health.

• Medicaid Enrollment. Oklahoma Healthcare Authority.

• Acute Disease Services. Oklahoma State Department of Health.

• HIV/STD Service. Oklahoma State Department of Health.

• Indian Nations Council of Governments.