A national study of health conditions in virtually every county in the nation puts Hempstead County almost precisely in the middle of the 75 counties in Arkansas in overall health outcomes, but drops the county to 52nd in lifestyle choices connected to overall health, and 61st in access to healthcare statewide. The 2013 County Health Rankings published by the Robert Wood Johnson Foundation, in conjunction with the University of Wisconsin Population Health Institute, is in its fourth year, and has begun to establish some national trends from the data collected nationwide. The survey is divided into two subgroups, including “health outcomes” and “health factors.” Health outcomes include data on mortality rates and morbidity rates, while health factors include data on health behaviors, clinical care, social/economic factors, and physical environment. Hempstead County ranks 27th in “mortality” rates, which measures premature death among adults; and, the county ranks 45th in “morbidity” rates, which measures the relationship between mental and physical health in adults and birthweight in infants. The survey ranks Hempstead County 33rd in overall health outcomes and 52nd in health factors. Significant among the survey findings this year is that, “The counties where people don't live as long and don't feel as well mentally or physically have the highest rates of smoking, teen births, and physical inactivity, as well as more preventable hospital stays.” That trend is reflected in some data for Hempstead County. Among adult smokers, 21 percent of the adult population of Hempstead County smokes regularly, compared with 23 percent statewide; while, 78 females per 1,000 between ages 15-19 gave birth in the period from 2004-2010, compared with 59 per 1,000 statewide; 32 percent of the population had no regular physical regimen, compared with 31 percent statewide; and, 114 of every 1,000 ambulatory care-sensitive hospital discharges in the base year 2010 were preventable, compared with 79 per 1,000 statewide. Significant in connection with the clinical care data on “preventable hospital stays” is a correlation to the accessibility of outpatient services locally and hospital overuse, the study says. Here, Hempstead County ranks 61st statewide. “Hospitalization for diagnoses treatable in outpatient services suggests that the quality of care provided in the outpatient setting was less than ideal,” the survey notes. “The measure may also represent a tendency to overuse hospitals as a main source of care.” A related factor in the survey examines access to primary care physicians, which shows that in 2011-12, there were 3,765 residents in Hempstead County per primary care physician, compared with a ratio of 1,613 to 1 statewide. “Primary care physicians include practicing physicians (M.D.s and D.O.s) under age 75 specializing in general practice medicine, family medicine, internal medicine, and pediatrics,” according to the survey. “The measurement represents the population per physician.” In that period, according to information provided at the time by the former Medical Park Hospital, there were two family practice M.D.s and three pediatric M.D.s practicing in Hempstead County in 2011, and three family practice M.D.s and three pediatric M.D.s practicing in Hempstead County in 2012. The population of Hempstead County in that period was 22,541 residents. The ratio, based upon those figures, represents 4,508 residents per doctor in 2012, and 3,757 per doctor in 2011. Compared to the 1,613 to 1 ratio statewide, Hempstead County was statistically underserved in medical access in those two years by 4.0 to 4.5 times the statewide ratio. The survey also shows that 24 percent of the population in Hempstead County has no health insurance, compared with 21 percent statewide. “Access to care requires not only financial coverage, but also, access to providers,” according to the survey. “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 speciality care.” A second significant relationship in the data is the connection between teen births and sexually transmitted infections. While the teen birth rate in Hempstead County from 2004-2010 was measured at 78 per 1,000, compared with 59 per 1,000 statewide, the sexually transmitted infection rate in Hempstead County in 2010 was 1,106 incidents per 100,000 population, compared with 529 per 100,000 statewide. That translates into 1,106 specific incidents over a population countywide of 16,681 residents over the age of 18, and 5,860 residents under the age of 18, more than twice the state average and 12 times the national average of 92 incidents per 100,000 population.