FAYETTEVILLE — Northwest Arkansas remains healthier than most of the state, according to an annual report, and officials said the reason is largely because its residents have more money and more access to health care and community resources.
Benton County ranked No. 1 in the state for both health outcomes and factors, while Washington County ranked No. 2 in health outcomes and No. 5 in health factors. The two counties held the same spots last year, as did Phillips County in eastern Arkansas at No. 75 — the worst for both outcomes and factors.
“If there’s one thing these rankings show, it’s that it matters where you live,” said Dr. Namvar Zohoori, chief science officer for the Arkansas Department of Health.
The County Health Rankings report released today by the Robert Wood Johnson Foundation includes two rankings — health outcomes and health factors. Health outcomes take into account statistics such as the rate of premature death and the percentage of the population in poor health. Health factors is broken into categories including behaviors such as smoking and physical inactivity, clinical care that includes the number of health care providers, social and economic factors, and physical environment such as severe housing problems and air pollution.
This is the 10th County Health Rankings report. Pulaski County moved up from 2018 in both rankings, from 21 to 18 in outcomes and 11 to 7 in factors.
Crawford County ranked 19 in health outcomes and 23 in factors, and Sebastian County ranked 16 in health outcomes and 19 in factors. Boone County ranked 5 in health outcomes and 6 in factors.
The United Health Foundation still ranks Arkansas residents as some of the least healthy in the country. Arkansas was named the 46th-healthiest state in 2018.
The Arkansas Department of Health has a unit in each county that provides a range of services including basic preventive health care, immunizations and prenatal care. The units offer information on the department’s Women, Infants and Children program, which helps cover the cost of food needed for development for low-income pregnant, breastfeeding and postpartum women and children under 5.
Zohoori said the health units have nurse practitioners, but no doctors, and cannot meet all of the health care needs of the population.
“There are some counties that only have one primary health care provider,” he said.
In Phillips County, there is one primary care physician for every 2,710 people compared to one primary care physician for every 1,220 residents in Washington County, according to the report. The state on average has one primary care physician for every 1,500 residents.
Poorer counties generally are less healthy. Fifty-nine percent of children in Phillips County live in poverty, compared to 12 percent in Benton County.
Laura Kellams, Northwest Arkansas director of Arkansas Advocates for Children and Families, said it’s important to remember that, although a smaller percentage of children live in poverty, the region has a larger population so there are still many children in poverty.
Benton and Washington counties had populations of about 266,000 and 232,000, respectively, in 2017, according to the United States Census Bureau. Phillips County had about 18,500 residents.
Black and Hispanic children are twice as likely to live in poverty as white children, Kellams said. Poverty not only affects children’s access to health care and nutritious food, but affects their ability to do well in school. The cycle starts over because they are more likely to stay in poverty if they do not do well in school or don’t graduate.
Kellams said community resources help bridge the gap in Northwest Arkansas, but more early childhood education and after-school programs are needed.
While there are some community resources such as free clinics in the eastern part of the state, Northwest Arkansas tends to offer more to people who struggle to afford health care, Zohoori said.
Community Clinic, for example, is a nonprofit organization with 13 offices in Northwest Arkansas, said Kathy Grisham, chief executive officer.
The clinics had more than 100,000 patient visits in 2018 and treat anyone who walks through the door, she said.
Six of the clinics are at schools, where they can serve students, faculty or community members.
“We see students who would fall through the cracks,” Grisham said.
More than half of Community Clinic patients speak a language other than English, and staff members help them navigate the health insurance system and sign up for programs if they are eligible, she said.
WelcomeHealth in Fayetteville serves people who live more than 200 percent below the federal poverty level, said Monika Fischer-Massie, executive director. More than 90 percent of its patients do not have health insurance.
Compared to the state’s teen birth rate of 41 births per 1,000 teenage girls, the rate in Benton and Washington counties was 30 births, according to the report. The rate in Phillips County was more than double with 78 births per 1,000 teenage girls.
Arkansas has two Planned Parenthood offices, and one of them is in Fayetteville. The other is in Little Rock. The Fayetteville office offers primary care, birth control, medication abortions for patients up to 10 weeks pregnant, transgender services, sexually transmitted infection testing, emergency contraception and general gynecological care, said Margaret Kenny, the health center manager.
“The majority of our patients are coming for birth control,” Kenny said.
Patients younger than 18 can get birth control without a parent’s consent, but payment is due at the time of service, she said. Some services, such as abortion or hormone therapy for transgender patients, require parental consent.
Planned Parenthood in Fayetteville doesn’t receive any federal money, so the costs are left to the patients and their insurance. The office had more than 3,400 patient visits in 2018, said Jess Kelsey, spokeswoman.
County Health Rankings looked at how housing costs affect health, said Ali Havrilla of the organization. About 12 percent of households in Arkansas spend more than half their income on rent or a mortgage.
“Black residents are the most affected by severe housing costs,” she said.
Housing costs affect health because when residents spend more money on housing, they have less money to spend on health care and healthy food, she said.
The lower-ranked counties also had higher rates of obesity and physical inactivity.
Zohoori said 98 percent of people in Benton County have easy access to a safe sidewalk, trail or park, compared to 7 percent in Phillips County.
The Northwest Arkansas Regional Planning Commission has supported the Razorback Greenway, a more than 37-mile walking and cycling trail from Fayetteville to Bella Vista, and worked with cities to construct other trails, said Elizabeth Bowen, project manager at the commission.
Bone sees people using the trails for both recreation and exercise. Part of the reason for the Razorback Greenway is to improve public health, said Tim Conklin of the commission.
The Jones Center in Springdale has a fitness center, pools, fitness classes, an ice rink and a bike park, among other amenities, and membership prices range from $8 to $25 a month for individuals and $16 to $35 a month for families.
“Accessibility is huge. Our founder wanted this to be a place where everyone could come, despite how much money they make,” said Jake Lane, spokesman.
The center has 6,500 members, and about a fourth of them have scholarships so they pay only 10 percent of the regular membership fees, he said.