FAYETTEVILLE — Northwest Arkansas residents are among the healthiest in the state, but all of Arkansas has slipped in several measures of public health in the past few years, according to an annual report released last week.
The 2018 county health rankings from the Robert Wood Johnson Foundation and University of Wisconsin found Benton County ranked No. 1 out of 75 Arkansas counties in factors that affect health, such as how common smoking or teen births are, and in health outcomes like lifespan.
The county has held that spot since at least 2010, the earliest year with detailed data. Washington County ranked second in health outcomes and fifth in health factors.
The Northwest Arkansas counties do well compared with other counties in their numbers of mental health care providers and years of life, according to the report, which uses measurements from the federal Centers for Disease Control and Prevention and other sources. Most of the region’s population is also within reach of opportunities to exercise, such as the Razorback Greenway and the ever-growing network of smaller trails connecting to it from Fayetteville to Bella Vista.
The greenway let Grant Holcomb go without a parking pass and ride his bicycle daily to the University of Arkansas, Fayetteville as a student. He now manages the Phat Tire Bike Shop a few feet from the greenway in downtown Springdale and said he probably wouldn’t be as avid a cyclist without the trail.
“I think it inspires a lot of people to get out and ride,” said Holcomb, who sees a mix of experienced cyclists and new riders go into the shop. “It’s awesome. We’re very lucky.”
Benton and Washington counties still struggle with more excessive drinking than others in the state, along with growing problems with sexually transmitted infections and obesity, the rankings show.
The picture is mixed across the state, too. Arkansans have slightly longer lives and fewer teen births than in 2010 but are more often obese and have grown in number faster than the primary care physicians looking after them. The proportion of adults smoking tobacco has stayed about 24 percent.
Health measures tend to be best in the northwest and middle parts of the state, deteriorating in a roughly southeast direction to the worst health findings in the Arkansas Delta along its eastern border. Pulaski County ranked 11th in health factors but 21st in outcomes.
The rankings don’t compare entire states with each other, but annual reports from the United Health Foundation typically find Arkansas near the bottom of the country thanks to deaths from cancer, cardiovascular disease and other factors. Even Benton County scores lower than many of the country’s healthiest counties.
“There’s a lot that’s helping us, but there’s also a lot that’s working against us,” said Dr. Namvar Zohoori, chief science officer for the Arkansas Department of Health.
Most of Arkansas is rural, making it hard to reach health care services, for instance. Many of those services react to health problems rather than trying to prevent them. And Zohoori said most of the state lacks enough nurses, physicians and other providers for its population.
The county rankings show Arkansas is falling further behind. The state had a primary care doctor for every 1,300 or so residents in 2011; that ratio is now one for more than 1,500.
“We’re not getting enough new doctors that are necessarily staying in Arkansas,” Zohoori said. “And those that are staying are not necessarily going to the places that are needed.”
Health care administrators and educators have pointed to a shortage of residencies, temporary training positions for doctors after medical school. The National Resident Matching Program matches medical school graduates with compatible slots and regularly reports thousands more applicants than openings.
The University of Arkansas for Medical Sciences in recent years has worked with local health systems to start new residencies. An internal medicine program at White River Health System northeast of Little Rock will welcome its second class of 10 residents this summer, for example. System spokesman Sheila Mace said a family medicine program should start in 2019.
Mercy Northwest Arkansas, UAMS and Veterans Health Care System of the Ozarks partnered for an internal medicine program that began in 2016 and is about to welcome its third group of eight, said Dr. Thomas Schulz, who directs the residency.
Schulz said the program will have three classes with a fourth-year position for chief resident, but a program for family medicine could come next year. Others in pediatrics or geriatric care could follow, or the internal medicine program might eventually take on more than eight residents each year.
“We’ve had really good luck,” Schulz said of the residents, who come from around the country. People often think more medical schools will help the doctor shortage, he added, but “they aren’t the answer. This is the answer.”
The general pattern of county rankings around the state has held steady for years, though some counties have moved up or down the list. Craighead County in northeast Arkansas, home of Jonesboro and several hospitals, stands out in its region with relatively high ranks — seventh in health factors and 14th for outcomes.
Phillips County in the middle of the Delta is last in both measures. It and many of the other lowest-ranked counties roughly correspond to places that are losing population.
Jerome Turner grew up on a farm in Phillips County and is pastor at New Mount Everett and New Hope of Coffee Creek Baptist churches there. He sees several obstacles to healthy living around the area, such as few options for buying healthful foods or general stress and anxiety that can make family meals with rich foods a rare source of comfort.
He and other area churches have worked with UAMS for years on church-based programs to encourage healthier choices among church members such as tweaking diets, walking together more and providing emotional support. Turner said he has seen the interventions make a difference, even if it’s a small one, as when people stop drinking soda or eat smaller portions.
“One of the most important things that they relate to me is that they are aware of the food they eat,” Turner said. “It was a lot of optimism — it was something they could do.”
Karen Yeary, an associate professor with UAMS’ College of Public Health, said the church program focusing on weight loss seemed to help people lose several pounds, though keeping them off is more of a struggle.
But she said she’s not discouraged and has online health training for church laypeople and other projects planned. Tiffany Haynes, an assistant professor at the college, is working with some of the same Delta churches to recruit members into a similar program to encourage emotional wellness and chip away the longstanding stigma surrounding mental health needs that can, in turn, affect diet and physical health.
“We have to go back and look at the cultural underpinnings of some of those things. Those norms have been there for generations,” Haynes said.
Adult obesity in Phillips County ticked down slightly from last year, falling from 46 percent to 44 percent. It could be unrelated to weight-loss programs or a yearly fluke, but it followed at least seven straight years of increases.
UAMS works with Marshall Islander churches in Northwest Arkansas in similar ways to lower the prevalence of diabetes. Collaborating with communities like theirs and the Delta, which have long been underserved because of poverty and racial bias, can make the state healthier as whole, Yeary said.
“We’re realizing for sustainable changes in communities to take place, those communities need to have a voice in how those interventions are implemented,” she said.
Zohoori at the Health Department also saw reason to be optimistic for Arkansas’s overall health. Though the smoking rate has changed little in recent years, those who smoke bought half as many packs of cigarettes in 2016 as they did in 2001, he said. He added that stronger laws against smoking indoors or bumping the legal age to buy them to 21 could lower the rate further.
“No matter how much we improve, there’s still a lot more to be done,” he said.
“We’re not getting enough new doctors that are necessarily staying in Arkansas. And those that are staying are not necessarily going to the places that are needed.”
— Dr. Namvar Zohoori, chief science officer for the Arkansas Department of Health
Print Headline: NW counties score high on health