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Health Officials Are Hopeful Medicaid Expansion, New Safe Syringe Program Will Curtail Oklahoma's Hepatitis C Deaths

Centers for Disease Control And Prevention

Oklahoma continues to rank top three in the nation for Hepatitis C deaths, but health officials are hopeful recent policy changes will help reverse the trend.

Hepatitis C — a viral liver infection — is a problem nationwide. It’s the most prominent chronic blood-borne infection and leading cause of liver transplants. It can cause many complications, including cancer.

Although the infection is a household name, it is significantly harder to track and study than other viral infections like HIV. Mostly because it can infect without causing symptoms.

Dr. Eric Hall is an Emory University professor working on HepVu. That’s a project compiling national data on Hepatitis and raising awareness about the infection.

“The CDC estimates, I think up to half of people who are infected don’t know that they’re actually infected,” he said. “So if they’re not sick, if they don’t know they’re infected, they’re probably not seeking care, and they’re probably not getting recorded in our surveillance system.”

The team compiles national data to help state and local jurisdictions craft policy. HepVu found that Oklahoma ranks third in the country for Hepatitis C deaths. The ranking is tragic, but not necessarily surprising. The state has long struggled with infections.

Hepatitis C researchers tend to group those who contract the virus into two groups: People over 40 and under 40. The former group tended to get sick from blood transfusions and transplants, which until a few decades ago, weren’t screened for infection.

Younger people tend to contract the virus elsewhere.

“What we’ve seen in recent years is there’s been an increase in transmission among younger adults, persons under 40, and that’s very much tied to the opioid epidemic and an increase in injection drug use related to the opioid epidemic.” Hall said. “So injection drug use now is the most common risk factor for transmitting Hepatitis C.”

Antonbara Sowemimo is the Prevention Programs Manager and viral Hepatitis prevention coordinator for the state department of health’s sexual health and harm reduction services. She says Oklahoma has long struggled with Hepatitis C and deaths resulting from it. There are obviously many factors involved, but two major contributors are IV drug use and lack of insurance.

“We do have high rates of injecting drug use, needle sharing, obviously, because there is no access to clean needles for an individual to use,” she said. “Think about it — if an individual who injects drugs, the feasibility of walking into a pharmacy or somewhere to go buy clean needles isn’t really there, wasn’t really there.”

So, a majority of Oklahoma’s Hepatitis C cases result from IV drug use. And Oklahoma ranks second in the nation for its uninsured rate.

“In general, if someone is uninsured, they’re less likely to visit a health care facility,” she said. “You know, to get screened for anything. Of some people who know they’ve had Hepatitis C for years, but they can’t treat it, so they just live one day at a time, hoping something will happen.”

If someone infected with Hepatitis C does manage to get diagnosed, treatment comes with obstacles. On average, without insurance, it costs $30,000.

This year marked two major health policy changes in Oklahoma. After the passage of State Question 802, Oklahoma expanded Medicaid, opening the health coverage program to an estimated 200,000 working adults.

And during the 2021 legislative session, Oklahoma created the legal framework for harm reduction services, including clean needle programs. It will allow the state department of health to oversee services such as clean needle and safe injection sites, which community partners like substance abuse services and churches can provide.

Sowemimo says syringe service programs do more than provide clean needles. They link residents with screenings, health education and even treatment programs.

StateImpact health reporter Catherine Sweeney will take a deeper look next week into Senate Bill 511, which created the legal framework for syringe services in Oklahoma, and report on the effect lawmakers and health officials anticipate from it.

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Catherine Sweeney was StateImpact Oklahoma's health reporter from 2020 to 2023.
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