The Northwest Arkansas region remains healthier than most of the state, according to an annual report.
Officials said that’s largely because the region’s 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 as 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 10th County Health Rankings report, released today by the Robert Wood Johnson Foundation, contains 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 are broken into categories including behaviors such as smoking and physical inactivity; clinical care, including the number of health care providers; social and economic factors; and physical environment, such as severe housing problems and air pollution.
Pulaski County, the state’s m o s t- p o p u l o u s co u n ty, ranked worse in health outcomes than some of the areas surrounding it in central Arkansas.
The county ranked No. 21 in outcomes. Of the neighboring counties, Saline was No. 3, Faulkner was No. 4, Lonoke was No. 6 and Grant was No.
- (Perry County, No. 38, and Jefferson County, No. 62, also border the area.)
P u l a s k i C o u n t y wa s ranked highly in terms of clinical care — it was No. 2 in the state, with more clinicians available to its population compared with the state as a whole. For example, there was one mental health care provider for every 260 people in Pulaski County, compared with one for every 490 people in the state overall.
The county fell in the upper third of the rankings at No. 11 for health factors, reporting lower adult smoking and obesity rates than the state average, but with a higher-than-average incidence of sexually transmitted infections.
The violent crime rate was almost twice as high within the county as it was within the state, the report found.
STRUGGLING AREAS
Poor health outcomes were largely concentrated in Arkansas’ southern and eastern areas, particularly on its eastern border, which comprises the state’s Mississippi Delta region.
The area is a hot spot for many public-health issues tracked at the county level, and it forms the edge of the federal Centers for Disease Control and Prevention’s “diabetes belt.”
As in many rural areas, poverty, a limited number of providers and poor health literacy are all thought to contribute to the region’s health challenges.
The United Health Foundation continues to rank 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 variety 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 for 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 with 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.
COMMUNITY RESOURCES
Poorer counties generally are less healthy. Fifty-nine percent of children in Phillips County live in poverty, compared with 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 U.S. 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 also affects their ability to do well in school. It becomes a cycle 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, the group’s chief executive officer.
The clinics had more than 100,000 visits from patients 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 languages other than English, and staff members help them navigate the health insurance system and sign up for programs if they are eligible, she said.
Compared with 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.
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 mortgages.
“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 with 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 that stretches from Fayetteville to Bella Vista, and has worked with cities to construct other trails, said Elizabeth Bowen, project manager at the commission.
Bowen 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. The center has 6,500 members. About a fourth of them have scholarships, so they pay only 10 percent of the regular membership fees, said Jake Lane, a spokesman for the center.
“Accessibility is huge,” Lane said. “Our founder wanted this to be a place where everyone could come, despite how much money they make.”
Information for this article was contributed by Kat Stromquist of the Arkansas Democrat-Gazette.