Consistent Primary Care

Put simply, primary care is overwhelmingly associated with improved health outcomes. Areas with more PCPs and more people regularly seeing them have lower all-cause mortality rates, better pregnancy outcomes, longer life expectancy, and higher self-rated health.²Barbara Starfield, Leiyu Shi, and James Macinko, “Contributions of Primary Care to Health Systems and Health,” The Milbank Quarterly 83, no. 3 (2005): 457-502.

Primary care has a unique role in women’s health and well-being. From puberty through her reproductive years and into menopause, a woman’s healthcare needs – and the specialists best equipped to address them – change.

Primary providers help identify and bridge these care gaps. As generalists, they track evolving health and well-being throughout life stages, assessing and addressing health risks proactively.

PCPs also serve as “care quarterbacks,” connecting women to other care or service providers as needed.

In Oklahoma’s restrictive reproductive health landscape, consistent healthcare interactions with PCPs are especially important for women during their reproductive years. Primary care practitioners are ideally suited to provide preconception care during routine visits. They can empower women to have children if and when they choose by providing contraceptive counseling, assessing pregnancy-related risks, and helping women enter pregnancy in optimal health.³Meredith G. Manze, Diana R. Romero, Annie Sumberg, Monica Gagnon, Lynn Roberts, Heidi Jones, “Women’s Perspectives on Reproductive Health Services in Primary Care,” Fam Med 52, no. 2 (February 2020):112-119.

During pregnancy, PCPs can connect women with OB/GYNs and other birth workers. Early prenatal care greatly improves health outcomes for mother and child (see Adequate Prenatal Care).

Unfortunately, access to primary care is far from a given in Oklahoma. Women may not have a regular provider for various reasons, the most common being the expense (see Unable to See a Doctor Due to Cost).

Regardless of socioeconomic status, however, women of color and those who speak a language other than English are less likely to receive preventive health services. When they do, it’s often lower quality due to language barriers and lack of cultural competency and racial/ethnic representation among providers.⁴Pilar Ortega, Tiffany M. Shin, “Language Is Not A Barrier—It Is An Opportunity To Improve Health Equity Through Education,” Health Affairs Blog, healthaffairs.org. July 30, 2021.

Another major barrier to primary care access is the lack of practitioners. Because they are paid less than specialists and burn out at higher rates, PCPs are in increasingly shorter supply.⁵“State of the Primary Care Workforce, 2023,” National Center for Health Workforce Analysis at the Bureau of Health Workforce, U.S. Health Resources and Services Administration, bhw.hrsa.gov. November 2023. The problem is especially apparent in Oklahoma where a majority of the state’s 77 counties are designated as Primary Care Health Professional Shortage Areas (HPSAs).⁶“Health Professional Shortage Areas Primary Care (Scores),” Office of Primary Care, Oklahoma State Department of Health. March 2022.

In line with national trends, the PCP shortage in Oklahoma is most extreme in rural parts of the state where transportation can further hinder women’s ability to attend regular check-ups (see Access to Care in Rural Areas).