ADH State Health Assessment

Health Disparities

A way to look at the differences in health opportunities is to compare racial and ethnic groups about a particular health problem.  When one group has a much higher rate of disease compared to another, then we say that there is health disparity in that group.  

Health disparities can also be uncovered by comparing groups by using other traits, such as age, sex, income, or disability.  Improving opportunities for all Arkansans to make healthy choices will go a long way toward lowering health disparities in our state.

Why Is This Important?

To understand the health problems facing the state it is important to look at the people and how they live.  There are close to three million people living in Arkansas.  Children under the age of 18 make up 23 percent of the population.  Individuals over 65 make up 17 percent.  There are slightly more females than males in Arkansas.  Since women live longer than men, there are increasingly more females than males in the older age groups. 

There are more than 2,380,000 whites in Arkansas, which makes whites the largest racial group.  There are more than 471,000 blacks in Arkansas, which makes blacks the second largest group.  Blacks are 15.4 percent of the population.  The main minority ethnic group in Arkansas is the Latino group.  There are nearly 228,000 Latinos in Arkansas, which is about eight percent of the population.

There are 490,000 people in Arkansas who live with a disability, not including those who live in nursing homes.  This is 18 percent of the total population, which is much higher than the U.S. rate of 13 percent.  Many people with disabilities also live in poverty.

Health Disparities

All but one of the 75 counties in Arkansas had life expectancies lower than the national average. Benton County in northwest Arkansas had the longest life expectancy, which was 79.7 years. Monroe County had the shortest life expectancy of 70.6 years. This is a 9-year difference in life expectancy compared to Benton County. There were 15 counties with life expectancies that were 6 to 8 years shorter than Benton County. These were Chicot, Cleveland, Sharp, Ouachita, Bradley, Calhoun, Randolph, Jefferson, Cross, Jackson, Clay, Poinsett, Desha, Phillips, Mississippi, Monroe counties (in order of higher to lower life expectancies). Most of the counties with the lowest life expectancies are in the delta region along the eastern border of Arkansas, while many others are in the southwest part of the state.

Why Is This Important?

Life expectancy is defined as the average number of years a person is predicted to live, based on the death rates for the year being studied.  In 2016 the average life expectancy in Arkansas was 75.8 years. This was shorter than the U.S. life expectancy, which was 78.6 years. 

Measuring premature mortality, rather than overall mortality, focuses attention on deaths that could have been prevented. Measuring Years of Potential Life Lost (YPLL) allows communities to target resources to high-risk areas and further investigate the causes of premature death. YPLL is a widely used measure of the rate and distribution of premature mortality. The measure was introduced mainly because simple mortality rates do not fully address the issue of premature death, the impact of disease and death, and their costs to society.

Profile Measure Data Source: Arkansas Department of Health, Health Statistics Branch

Health Disparities

 https://www.healthy.arkansas.gov/images/uploads/pdf/2018_Cancer_Mortality_Disparity_Fact_Sheet.pdf

Why Is This Important?

Most of the leading causes of death in Arkansas are chronic diseases. Heart disease, cancer, chronic lung disease, stroke, Alzheimer’s disease, diabetes, and kidney disease are all chronic diseases. Arkansas has very high rates of chronic diseases compared to the United States as a whole. Within Arkansas, the counties with the shortest life expectancy tend to have the highest rates of chronic diseases. Chronic diseases are very common in Arkansas because many people in our state struggle with two common health problems that lead to chronic diseases: obesity and high blood pressure. Chronic diseases are also very common in Arkansas because many people in our state struggle with living a healthy lifestyle. The main lifestyle problems are tobacco use, poor diet, and lack of physical activity.

In Arkansas, unintentional injuries are the fourth leading cause of death overall, which is the same as in the United States. Unintentional injuries include motor vehicle crashes, falls, poisonings, fires and burns, and drowning. In 2017, almost 1,600 people in Arkansas died from unintentional injuries.

Death from influenza and pneumonia is the ninth most common cause of death in Arkansas. In 2017, over 700 people died from influenza and pneumonia. Over the past several years Arkansas has had a higher death rate from influenza and pneumonia when compared to the United States.

Health Disparities

Diabetes: In 2011, an estimated 26 million persons aged ≥20 years (11.3% of the U.S. population) had diabetes. Both the prevalence and incidence of diabetes have increased rapidly since the mid-1990s, with minority racial/ethnic groups and socioeconomically disadvantaged groups experiencing the steepest increases and most substantial effects from the disease. https://www.cdc.gov/mmwr/pdf/other/su6203.pdf

HIV Infections: At the end of 2009, approximately 1.1 million persons in the United States were living with human immunodeficiency virus (HIV) infection, with approximately 50,000 new infections annually. The prevalence of HIV continues to be greatest among gay, bisexual, and other men who have sex with men (MSM), who comprised approximately half of all persons with new infections in 2009. Disparities also exist among racial/ ethnic minority populations, with blacks/African Americans and Hispanics/Latinos accounting for approximately half of all new infections and deaths among persons who received an HIV diagnosis in 2009. https://www.cdc.gov/mmwr/pdf/other/su6203.pdf

Tuberculosis: From 1993 to 2010, the number of TB cases reported in the United States decreased from 25,103 to 11,182. Despite the decrease, TB continues to affect many communities in the United States disproportionately and unequally, especially racial/ethnic minorities and foreign-born persons. TB remains one of many diseases and health conditions with large disparities and inequalities by income, race/ethnicity, educational attainment, and other sociodemographic characteristics. https://www.cdc.gov/mmwr/pdf/other/su6203.pdf

Teen Births: In 2010, birth rates for females aged 15–19 years varied considerably by race and Hispanic origin. The rates for Hispanics (55.7 births per 1,000 females aged 15–19 years) and non-Hispanic blacks (51.5 births) were approximately five times the rate for A/PIs (10.9 births) and approximately twice the rate for non-Hispanic whites (23.5 births). The rate for AI/ ANs aged 15–19 years was intermediate (38.7 births per 1,000 females aged 15–19 years). Rates varied considerably across specified Hispanic groups. The rate in 2010 was highest for "other" Hispanics aged 15–19 years (65.4 births per 1,000), followed by Mexican (55.5 births), Puerto Rican (43.7 births), and Cuban (24.4 births). https://www.cdc.gov/mmwr/pdf/other/su6203.pdf

Infant Mortality: The infant mortality rate among blacks is highest and rates among white and blacks have increased in recent years.  The infant mortality rate among Latinos is lowest overall. Higher infant mortality reates are associated with babies whose mothers are:

• Less than 20 years old or greater than 40 years old
• Less than a 12th grade education
• Not married
• Smoked cigarettes
• Received no medical care while pregnant
• Had at least one health problem while pregnant

Some counties in Arkansas are more rural, have higher rates of poverty, and have fewer adults who have graduated from high school or college. These counties have higher infant mortality rates.

Why Is This Important?

Fewer people in Arkansas report having excellent or very good health compared to the country as a whole. In the United States, 19 percent of adults have excellent health and 34 percent have very good health. Conversely, more people in Arkansas report having good, fair or poor health compared to the United States. In the United States, 31 percent of adults report having good health, 12 percent having fair health, and four percent having poor health. Arkansas is ranked very low in terms of overall health. We are ranked 46th out of 50 states. Only Louisiana, Mississippi, Alabama, and Oklahoma have lower rankings. Arkansas ranks low for many reasons. These reasons include high rates of early death, infant death, and death from chronic diseases.

HEALTH OUTCOMES

Diabetes is an important marker for a range of health behaviors. Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States.7

Profile Measure Data Source: Arkansas Department of Health, Health Statistics Branch, BRFSS County Estimates

Human Immunodeficiency Virus (HIV) is also an important marker for a range of risky health behaviors and it can put significant burden on the population and the health care system. Through the surveillance of HIV, a data system can be developed that combines information on HIV infection, disease progression, and behaviors and characteristics of people at high risk. With this system, CDC can direct HIV prevention funding to where it is needed the most.8

Profile Measure Data Source: Arkansas eHARS (enhanced HIV/AIDS Reporting System)

Chlamydia is the most common bacterial Sexually Transmitted Infection (STI) in North America and is one of the major causes of tubal infertility, ectopic pregnancy, pelvic inflammatory disease, and chronic pelvic pain. STIs are associated with a significantly increased risk of morbidity and mortality, including increased risk of cervical cancer, involuntary infertility, and premature death. STIs also have a high economic burden on society. For example, the direct medical cost of managing STIs and the complications in the U.S. was approximately 15.6 billion dollars in 2008.9

Profile Measure Data Source: Arkansas PRISM (Patient Reporting Investigating Surveillance Manager)

Low birth weight (LBW) represents two factors: maternal exposure to health risks and an infant’s current and future morbidity, as well as premature mortality risk. From the perspective of maternal health outcomes, LBW indicates maternal exposure to health risks in all categories of health factors, including her health behaviors, access to health care, the social and economic environment she inhabits, and environmental risks to which she is exposed. In terms of the infant’s health outcomes, LBW serves as a predictor of premature mortality and/or morbidity over the life course and for potential cognitive development problems.

Profile Measure Data Source: Arkansas Department of Health, Health Statistics Branch Query System

Teen Births are the number of births per 1,000 female population, ages 15-19. Evidence suggests teen pregnancy significantly increases the risk of repeat pregnancy and of contracting a STI, both of which can result in adverse health outcomes for mothers, children, families, and communities. A systematic review of the sexual risk among pregnant and mothering teens concludes that pregnancy is a marker for current and future sexual risk behaviors and adverse outcomes. Pregnant teens are more likely than older women to receive late or no prenatal care, have gestational hypertension and anemia, and achieve poor maternal weight gain. Teens are also more likely than older women to have a pre-term delivery and LBW baby, increasing the risk of child developmental delay, illness, and mortality.

Profile Measure Data Source: Arkansas Department of Health, Health Statistics Branch Query System

Infant mortality represents the health of the most vulnerable age group (those under 365 days). This measure can help to interpret the YPLL rate in a county.

Profile Measure Data Source: Arkansas Department of Health, Health Statistics Branch Query System

Health Disparities

Smoking: Some progress in reducing smoking prevalence among certain racial/ethnic groups was observed; however, disparities among persons with low-SES persisted. For both youth and adults, little to no changes in smoking prevalence for those below FPL was observed from 2006–2008 to 2009–2010; however, decreases were observed for youth and adults who were above FPL. During 2009–2010, the prevalence of smoking was 46.4% among 12th-grade–aged youth who had dropped out of school compared with 21.9% among youth who were still in the 12th grade. Among adults, smoking prevalence was 34.6% for those who did not graduate from high school compared with 13.2% among those with a college degree. From 2006–2008 to 2009–2010, smoking declined from 44.7% to 40.9% among adults who were unemployed. Among racial/ethnic groups, smoking prevalence was lowest among black and Asian youth aged 12–17 years during both survey cycles. Although smoking prevalence remained highest among American Indian/Alaska Native youth and adults, smoking declined from 17.2% to 13.6% in youth and from 42.2% to 34.4% in adults. https://www.cdc.gov/mmwr/pdf/other/su6203.pdf

Obesity: Between 1999–2002 and 2007–2010, the age-adjusted prevalence of obesity among adults aged ≥18 years increased from 26.5% to 33.0% among men and from 32.4% to 34.9% among women. The prevalence of obesity differed substantially across categories of various demographic characteristics. Among men, there was little difference in the prevalence of obesity by race/ethnicity, but among women, the overall (1999–2010) prevalence among non-Hispanic blacks (51%) was 10 percentage points higher than that among Mexican- Americans and 20 percentage points higher than that among non-Hispanic white women. https://www.cdc.gov/mmwr/pdf/other/su6203.pdf

Binge Drinking: In general, Hispanics and Blacks have higher rates of complete abstinence from alcohol than non-Hispanic whites and other groups.  But those who do drink consume more alcohol and often have higher rates of binge drinking. https://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/diversity-health-disparities

Drug & Opioid-involved Overdose: American Indians/Alaska Natives and non-Hispanic whites had the highest drug-induced death rates overall. This finding is consistent with the previous report for rates during 2003–2007. However, it does reflect a change from the 1980s and 1990s, when drug-induced mortality rates were higher among blacks than whites. Prescribed drugs have replaced illicit drugs as a leading cause of drug-related overdose deaths. Non-Hispanic blacks are less likely than non-Hispanic whites to use prescription drugs, and therefore might be less likely to misuse such drugs. https://www.cdc.gov/mmwr/pdf/other/su6203.pdf

Why Is This Important?

Chronic diseases are also very common in Arkansas because many people in our state struggle with living a healthy lifestyle. The main lifestyle problems are tobacco use, poor diet, and lack of physical activity.

Tobacco use is a leading cause of the chronic diseases, particularly heart disease, cancer, chronic lung disease, and stroke. It is the single most preventable cause of death in Arkansas. Tobacco use kills close to 5,000 people in Arkansas each year, which makes it one of the biggest causes of short life expectancy in our state.

Poor diet is another big cause of chronic diseases. A diet high in fruits and vegetables can lower the risk of dying from the chronic diseases. A diet with lots of fruits and vegetables also helps to control high blood pressure and keep a healthy weight.

Lack of physical activity is also a top cause of chronic diseases. Regular physical activity can lower a person’s chance of dying from the chronic diseases. Physical activity is also important for managing high blood pressure and keeping a healthy weight.

Just like the U.S., Arkansas has also seen a rise in drug overdoses in recent years. In 2016, 385 Arkansans died from a drug overdose and opioids were the most widely abused and misused drug. Methamphetamine (Meth), benzodiazepines (Benzos) and antidepressants are other commonly abused and misused drugs in our state.

Health Disparities

There is also a general shortage of primary care doctors in Arkansas. This shortage can be especially great in the rural areas. Primary care doctors can be doctors who work in general practice medicine, family medicine, internal medicine, pediatrics or obstetrics and gynecology. The rural areas in Arkansas have 73 primary care doctors for every 100,000 residents, while in the cities there are 133 primary care doctors for every 100,000 residents. Some of the rural areas have a more severe shortage than others. In the delta area of eastern Arkansas, there are only 61 primary care doctors for every 100,000 residents.

While high rates of specialist physicians have been shown to be associated with higher, and perhaps unnecessary utilization, sufficient availability of primary care physicians is essential for preventive and primary care, and when needed, referrals to appropriate specialty care.

Profile Measure Data Source: Arkansas Department of Health, Health Statistics Branch

Untreated dental disease can lead to serious health effects including pain, infection, and tooth loss. Although lack of sufficient dental providers is only one barrier to accessing oral health care, much of the country suffers from shortages. According to the Health Resources and Services Administration, as of December 2012, there were 4,585 Dental Health Professional Shortage Areas (HPSAs) with 45 million people living in them.

Profile Measure Data Source: Arkansas Department of Health, Health Statistics Branch

Why Is This Important?

People who live in rural Arkansas find it hard to get health care because there is a shortage of health care on hand in their communities. For example, 39 counties in Arkansas have only one hospital and 19 counties have no hospital at all. Many of the rural counties in Arkansas have been named as Medically Underserved Areas (MUA) by the Health Services and Resources Administration of the U.S. government.  A Medically Underserved Area is a part of a county, a whole county or a group of nearby counties in which the residents have a shortage of personal health services. 

Health Disparities

Health care costs are an important measure of the efficiency of a health care system. Health care costs are the price-adjusted Medicare reimbursements (Parts A and B) per enrollee. However, in order to rank a measure, an ideal value must be known. Research shows that ‘too little’ or ‘too much’ health care spending is not good for health care outcomes. However, it is not yet known what the ‘ideal’ level of spending on patients should be.

Profile Measure Data Source: University of Wisconsin Population Health Institute, 2017 County Health Rankings

Preventable hospital stays is the hospital discharge rate for ambulatory care-sensitive conditions per 1,000 fee-for-service Medicare enrollees. Ambulatory care-sensitive conditions include: convulsions, chronic obstructive pulmonary disease, bacterial pneumonia, asthma, congestive heart failure, hypertension, angina, cellulitis, diabetes, gastroenteritis, kidney/urinary infection, and dehydration. Hospitalization for diagnoses treatable in outpatient services suggests that the quality of care provided in the outpatient setting was less than ideal. The measure may also represent a tendency to overuse hospitals as a main source of care.

Profile Measure Data Source: University of Wisconsin Population Health Institute, 2017 County Health Rankings

Why Is This Important?

People in rural Arkansas have greater difficulty getting the health care they need compared to those who live in the non-rural counties.  One reason they have difficulty getting health care is because of the cost; in general, 15.3 percent of Arkansans report that they were not able to see a doctor in the past 12 months due to the cost, compared to 13 percent in the U.S.   However, in many rural counties, more than 20 percent of residents were not able to see a doctor due to cost.  Lack of health insurance makes the cost of seeing a doctor hard, if not impossible to afford. In Arkansas 25 percent of working-age adults have no health insurance. In many rural counties it is even higher.

Health Disparities

Adults and children in single parent households are at risk for adverse health outcomes such as mental health problems (including substance abuse, depression, and suicide) and unhealthy behaviors such as smoking and excessive alcohol use. Self-reported health has been shown to be worse among lone parents (male and female) than for parents living as couples, even when controlling for socioeconomic characteristics. Mortality risk is also higher among lone parents. Children in single parent households are at greater risk of severe morbidity and all-cause mortality then their peers in two-parent households.

Profile Measure Data Source: United States Census Bureau, American Community Survey

Not only does one’s education level affect his or her health, education can have multi-generational implications that make it an important measure for the health of future generations. Evidence links maternal education with the health of her offspring. Parents’ level of education affects their children’s health directly through resources available to the children, and also indirectly through the quality of schools that the children attend.

Profile Measure Data Source: United States Census Bureau, American Community Survey

The relationship between higher education and improved health outcomes is well known, with years of formal education correlating strongly with improved work and economic opportunities, reduced psychosocial stress, and healthier lifestyles.

Profile Measure Data Source: United States Census Bureau, American Community Survey

Homicides are the number of deaths from assaults. Homicide has been ranked as one of the top five leading causes of death each year for persons aged 1-45 years living in the United States. Homicide is an extreme outcome of the broader public health problem of interpersonal violence. Despite the promising decrease in certain homicide rates, primary prevention efforts against violence should be increased, particularly among young racial/ethnic minority males.

Profile Measure Data Source: Arkansas Department of Health, Health Statistics Branch Query System

High levels of violent crime compromise physical safety and psychological well-being. High crime rates can also deter residents from pursuing healthy behaviors such as exercising outdoors. Exposure to crime and violence has been shown to increase stress, which may exacerbate hypertension and other stress-related disorders and may contribute to obesity prevalence.

Profile Measure Data Source: University of Wisconsin Population Health Institute, 2017 County Health Rankings

Injuries are one of the leading causes of death. Unintentional injuries were the 4th leading cause and intentional injuries the 10th leading cause of U.S. mortality in 2015. The leading causes of death among unintentional injuries, respectively were: poisoning, motor vehicle traffic, and falls. Among intentional injuries the leading causes of death are: suicide by firearm, suicide by suffocation, and homicide by firearm, respectively. Unintentional injuries are a substantial contributor to premature death as the leading cause of death for persons under age 45.

Profile Measure Data Source: Arkansas Department of Health, Health Statistics Branch Query System

Why Is This Important?

The education level in Arkansas is lower than the U.S. average for both high school and bachelor’s level degrees or higher.  Only 85 percent of Arkansans 25 years and over have finished high school or an equivalency exam.  In the U.S., 87 percent of adults 25 and over have completed high school. 

The U.S. has the largest prison population in the world. The number of people in prison in Arkansas is growing faster than any other state. Many states are trying to lower the number of people in prisons. This has caused the number of people that are in prisons to go down. But in Arkansas, the number of people in prisons keeps going up. If it continues at the current pace, the number of people in prison in Arkansas will be almost 23,000 in 10 years.

In Arkansas, accidents are the fifth leading cause of death overall, which is the same as in the U.S. Accidents, which are also called unintentional injuries, include suicide, accidental poisoning and motor vehicle accidents. The most common types of accident are motor vehicle crashes, falls, poisonings, fires and burns, and drowning. Adults age 75 and over have the highest death rates from accidents, while children and teens under the age of 20 have the lowest death rates.  However, the number one cause of death for older adults is chronic diseases, while the number one cause of death for children and teenagers is accidents. In fact, accidents are the number one killer of Arkansans between the ages of one and 44.

Health Disparities

Socioeconomic status can be determined by a family's income level, education level, and occupational status. In spite of the differences in definition between poverty and socioeconomic status, researchers agree that there is a clear and established relationship between poverty, socioeconomic status, and health outcomes—including increased risk for disease and premature death.

Many factors can contribute to inequitable access to resources and opportunities, which may result in poverty. Marital status, education, social class, social status, income level, and geographic location (e.g., urban vs. rural) can influence a household's risk of living in poverty. Racial and ethnic minorities are more likely than non-minority groups to experience poverty at some point in their lives. In addition, children from families that receive welfare assistance are 3 times more likely to use welfare benefits when they become adults than children from families who do not receive welfare. Studies also report that migrant status is a risk factor for poverty.

Residents of impoverished neighborhoods or communities are at increased risk for mental illness, chronic disease, higher mortality, and lower life expectancy. Some population groups living in poverty may have more adverse health outcomes than others. For example, the risk for chronic conditions such as heart disease, diabetes, and obesity is higher among those with the lowest income and education levels. In addition, older adults who are poor experience higher rates of disability and mortality. Finally, people with disabilities are more vulnerable to the effects of poverty than other groups.

The average family income in Arkansas is $53,000 per year.  This amount is lower than the average family income in the U.S., which is $68,000.  Family income takes into account every person in the family who works, so it may include more than one worker. Arkansas’s poverty rate is high.  At 19 percent, it is the fourth highest in the U.S.  This means there are 542,000 people in Arkansas who are living in poverty.  The counties in southeast Arkansas have the highest poverty rates.  The counties with the lowest poverty rates are in central and northwest Arkansas.

Why Is This Important?

Median household income is the income at which half the households earn more and half the households earn less. Median household income is a well-recognized indicator of income and poverty.

Profile Measure Data Source: United States Census Bureau, American Community Survey

The unemployed population experiences worse health and higher mortality rates than the employed population. Unemployment has been shown to lead to an increase in unhealthy behaviors related to alcohol and tobacco consumption, diet, exercise, and other health-related behaviors, which in turn can lead to increased risk for disease or mortality, especially suicide. Because employer-sponsored health insurance is the most common source of health insurance coverage, unemployment can also limit access to health care.

Profile Measure Data Source: University of Wisconsin Population Health Institute, 2017 County Health Rankings

Poverty can result in an increased risk of mortality, prevalence of medical conditions and disease incidence, depression, intimate partner violence, and poor health behaviors. A 1990 study found that if poverty were considered a cause of death in the U.S., it would rank among the top 10 causes. While negative health effects resulting from poverty are present at all ages, children in poverty experience greater morbidity and mortality than adults due to increased risk of accidental injury and lack of health care access.

Profile Measure Data Source: United States Census Bureau, American Community Survey

Health Disparities

Food Insecurity: Persons who live in neighborhoods with better access to retailers such as supermarkets and large grocery stores that typically offer fruits and vegetables and other healthy foods might have healthier diets. However, in 2009, the U.S. Department of Agriculture estimated that 40% of all U.S. households do not have easy access (i.e., access within 1 mile of residence) to supermarkets and large grocery stores. Although few national studies examining disparities in access exist, research suggests that access is often lower among residents of rural, lower-income, and predominantly minority communities than among residents of other communities. https://www.cdc.gov/mmwr/pdf/other/su6203.pdf

Why Is This Important?

A rural county is any county that is not part of a city with a population of 50,000 people or more. By this definition, 54 of the 75 counties in Arkansas are considered rural. Arkansas is very rural compared to the U.S. as a whole. Only 19 percent of people in the U.S. live in rural areas, compared to 44 percent of the people in Arkansas. People who live in rural areas of Arkansas have higher rates of hunger, because they have limited access to healthy foods, lack of transportation to grocery stores, fewer job opportunities, and more unemployment and underemployment.  Children who live in rural areas of Arkansas have an even higher rate of hunger than adults.  These children are likely to struggle with school and have more health conditions like asthma. The overall food insecurity rate for Arkansas is 17.2%, but ranges from 10.8% in urban areas such as Benton County in far northwest Arkansas to 30.3% in rural counties such as Phillips County in east central Arkansas. 

The relationship between elevated air pollution, particularly fine particulate matter and ozone, and compromised health has been well documented. Negative consequences of ambient air pollution include decreased lung function, chronic bronchitis, asthma, and other adverse pulmonary effects.

Profile Measure Data Source: University of Wisconsin Population Health Institute, 2017 County Health Rankings

Recent studies estimate that contaminants in drinking water sicken 1.1 million people each year. Ensuring the safety of drinking water is important to prevent illness, birth defects, and death for those with compromised immune systems. A number of other health problems have been associated with contaminated water, including nausea, lung and skin irritation, cancer, kidney, liver, and nervous system damage.

Profile Measure Data Source: University of Wisconsin Population Health Institute, 2017 County Health Rankings

Good health depends on having homes that are safe and free from physical hazards. When adequate housing protects individuals and families from harmful exposures and provides them with a sense of privacy, security, stability and control, it can make important contributions to health. In contrast, poor quality and inadequate housing contributes to health problems such as infectious and chronic diseases, injuries and poor childhood development.

Profile Measure Data Source: University of Wisconsin Population Health Institute, 2017 County Health Rankings

More than half of all Arkansans fall into one of three groups that are reliant on public transit. These groups are seniors, people living in poverty and people with disabilities. People in rural areas who do not have their own personal cars have fewer choices when it comes to public transit. 

Food insecurity can negatively affect health, behavioral, and education outcomes for children. Inadequate nutrition can permanently alter a child's brain development causing learning difficulties and poor social skills. Women who are food insecure are more likely to have a low birth weight child. Food deserts are another way to look at the limited access to healthy foods. These are areas where people have limited access to affordable healthy foods such as fruits, vegetables, w hole grain products, and low-fat milk. These areas lack grocery stores, but may have many convenience and "dollar" stores that do not stock many healthy foods. Grocery stores are several miles away from many rural areas. Food deserts play a role in food insecurity and are a main cause of hunger in Arkansas. They can also influence the risk of obesity in both children and adults. The presence of grocery stores reduces the risk of obesity in low-income children and adults.

Before the Trauma System Act was passed by the Arkansas legislature in 2009, Arkansas had the worst system of emergency care in the U.S. At that point, Arkansas was one of only three states without a trauma system, and we were the only state without an official trauma center. Since 2009 Arkansas has made great progress in setting up the new trauma system and lowering the number of deaths due to injuries. Hospitals around the state have joined the trauma system as official trauma centers. The ambulance companies around the state have also joined the trauma system. Ambulance companies are also called emergency medical service providers or EMS providers, for short. The hospitals and EMS providers work together to get injured people to the best hospital for their type of injury in the shortest time possible.