Obviously there is still much to be done. The rate among Indians is significantly higher than for the general population. Throughout the Indian Health Service, diabetes is the second leading cause of outpatient visits and the eighth leading cause of death. Within the Oklahoma City Area it is the fifth leading cause of death, with a mortality rate of 24.6 per 1,000.
Accidents are the second leading cause of Indian deaths nation- wide.
But in Oklahoma, accidents are in third place as a cause of death, with a mortality rate lower than that of the general population. Although alcoholism remains at a higher level nationally, the rate among Oklahoma Indians is much lower, as is the incidence of suicide, depression. A possible explanation is that the social disorganization historically so commonplace in states with reservation systems is less prevalent in the Oklahoma area. With no boundaries to impede them, Oklahoma's Indians have evolved biculturally, with most of them maintaining their traditions while simultaneously adapting to the socioeconomic demands of the general population. Still, the 37 tribes served by the Oklahoma City Area of IHS have had their share of problems.