Benton County topped a list ranking the health of Arkansas’ 75 counties, and Ouachita County fared the poorest in the report, released Wednesday by the Robert Wood Johnson Foundation.
The counties with the poorest health outcomes rankings are largely clustered in the Delta and other areas with large uninsured and low-income populations.
Conversely, counties with the highest health outcomes rankings are clustered in central and Northwest Arkansas - parts of the state with larger insured populations and greater access to hospitals and health-care facilities.
Arkansas public-health officials said the report reinforces calls for greater preventive care and public-health education.
Click on the county to see its ranking. An expanded view is available here.
“Changing behavior is what we must do to improve the health of the people of this state,” said Dr. Joe Bates, deputy director and chief science officer at the Arkansas Department of Health.
The list determined a county’s health rankings by combining 2010 data from the National Center for Health Statistics related to deaths before age 75 and babies with low birth weights with 2011 survey data from the Behavior Risk Factor Surveillance System related to respondents’s perception of their physical and mental health.
The five highest-ranked counties in this year’s report were Benton, Washington, Faulkner, Saline and Boone. Counties at the bottom of the list were Ouachita, Phillips, Mississippi, Poinsett and Lafayette.
In a separate health-factors list, the report ranked states using data related to factors such as access to primary-care physicians and hospitals, tobacco use, percentage of residents without health insurance, rates of sexually transmitted disease and obesity. Benton County also topped that list. Phillips County ranked at the bottom.
Pulaski County ranked 22nd for health outcomes and 12th for health factors. The state’s largest county - home to the University of Arkansas for Medical Sciences and Arkansas Children’s Hospital - ranked No. 1 for access to clinical care but fared poorly compared with other counties in factors such as violent-crime rates. In addition, 18 percent, or 60,673, of the county’s residents under age 65 areuninsured, according to the report.
County uninsured rates ranged from the least - 16 percent in Saline County- to the most - 32 percent in Sevier County, the report said.
Health insurance and more health-care professionals would help residents in poorly ranked counties improve their health outcomes by providing greater access to preventive care, said Bates, an advocate for expanding the state’s Medicaid program to all residents below 138 percent of the federal poverty level under the Patient Protection and Affordable Care Act. State lawmakers are now debating that issue.
“Medicaid expansion will be the first step,” Bates said. “Then we have to have some people that will provide [treatment].”
The state’s private insurers and health-care providers are gradually replacing a “fee-forservice” model, which compensates providers for individual services and tests, with a system that compensates providers for all treatments associated with a “health episode,” such as a pregnancy or a stroke, to provide incentives for efficient care and cooperation among providers.
The state’s public-health leaders have also called for increased use of physician assistants and nurse practitioners to fill a gap in primary care.
A study by the Arkansas Center for Rural Health estimates that there is shortage of 1,000 primary-care physicians in the state, a number that grows as older physicians retire. And more than 500,000 Arkansans live in areas with shortages of primary-care professionals, according tothe U.S. Department of Health and Human Services.
Recently, UAMS has added a physician-assistant program and four universities - UAMS, the University of Central Arkansas, the University of Arkansas at Fayetteville and Arkansas State University-Jonesboro - have added doctorate programs in nursing.
That will help remedy an “upside down situation” that leads poor Arkansans to avoid healthful behaviors, such as exercise and health screenings, until they are forced toconfront resulting chronic illnesses, such as diabetes and heart disease, Bates said.
In addition to greater clinical-access rates, the counties with the highest health-outcome rankings scored well in quality-of-life indicators, such as access to recreational facilities and healthful foods, the report said. They also had higher rates of post-secondary education.
Residents in top-ranked Benton County benefit from thriving parks and walking trails, said Loy Bailey, the county’s health district administrator.
Rapid population growth in Northwest Arkansas has helped bolster its city sales-tax collections, providing funding for projects that make physical activity convenient. Growth has also drawn new organizations to the area that cooperate to educate residents and find creative ways to address health concerns, Bailey said, citing anti-tobacco campaigns that have purchased time for advertisements in movie theaters and placed them at community farmers markets.
“There’s just so many neat things going on,” Bailey said.
The county health rankings will help residents around the state easily understand the issues that affect their neighbors, Bailey said.
“It helps to galvanize support to address an issue,” he said.
Along with the rankings, the Robert Wood Johnson Foundation provided County Health Roadmaps, which are strategies communities can use to improve the health of their residents.
Arkansas Health Director Paul Halverson said the rankings report, which has been released annually since 2009, has helped fuel efforts to address smoking, obesity and other issues in the state.
“Over the last four years, when local policymakers have gotten together with tools like these, real discussions about how we can change for the better have been happening around the state,” Halverson said in a prepared statement.
Arkansas, Pages 9 on 03/21/2013