Comparisons of health data across three Southwest Arkansas counties compiled in a report by the Robert Wood Johnson Foundation show marked disparities in health conditions in some cases despite similarities in ranking on one hand, but significant differences in ranking, in some instances, where factors involved favored the county with the poorer ranking.
Comparisons of health data across three Southwest Arkansas counties compiled in a report by the Robert Wood Johnson Foundation show marked disparities in health conditions in some cases despite similarities in ranking on one hand, but significant differences in ranking, in some instances, where factors involved favored the county with the poorer ranking. The annual rankings report has been relied upon by the Arkansas Department of Health to characterize Benton, Washington, Fulkner, Saline and Boone counties as the healthiest in Arkansas; and, Ouachita, Phillips, Mississippi, Poinsett and Lafayette counties as the unhealthiest in the state. “Since their inception in 2009, the County Health Rankings have provided Arkansas counties with some powerful tools to help guide local efforts as they improve our overall health and well-being,” ADH Director/State Health Officer Dr. Paul K. Halverson said in an ADH statement on the release of the data. “The County Health Rankings provide a clear picture of our strengths as well as our opportunities for improvement.” Halverson said the data will be used to introduce Hometown Health Improvement initiatives across the state. Yet, in comparing data for Hempstead, Howard and Nevada counties, the study puts Howard County at 68th and Hempstead County at 61st in “clinical care” factors, both counties having staffed and operating hospitals, while Nevada County, which has no hospital, is ranked at 41st statewide in “clinical care” factors. The survey makes no distinction as to the proximity of the population to the clinical care factors; therefore, not factoring in the overlapping numbers of residents from Hempstead and Nevada counties which use hospital facilities in Hope. 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. Clinical care data includes the number of primary care physicians per 1,000 population and the number of “preventable hospital stays” per 1,000 population. The data concerning primary care physicians shows that in 2011-12, there were 3,765 residents in Hempstead County per primary care physician, compared with a ratio of 1,974 to 1 in Howard County and 2,995 to 1 in Nevada County. “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.” Yet the rate of “preventable hospital stays” in Nevada County is 102 per 1,000 in base year 2010, compared to 114 in Hempstead County during the same period, and 90 per 1,000 in the same period in Howard County. While the survey notes that, “The measure may also represent a tendency to overuse hospitals as a main source of care,” it makes no distinction as to the origin of hospital stays in a county, whether from local referrals or out of county referrals. Consequently, there is no distinction regarding whether Nevada County physicians used Hope hospital facilities more than Arkadelphia, the only other facility nearly proximate to the county. Specific disease comparisons between the three counties are remarkably similar, including those for diabetes and HIV, ranging from 13-14 percent across all three for diabetes and 103-132 cases of HIV across the three counties. Here, again, the study ranks diabetes cases based upon the number of respondents who have been told by a doctor they have the disease, as compared to the prevalence of HIV across the three counties. While the survey does not make any general statement as to the comparability of the data from county to county, it does comment on the limitations of each category in the study. But, it notes that “preventable hospital stays” represent data taken primarily from Medicare claims data, and “...therefore, may potentially miss trends and disparities among younger age groups.” Consequently, in comparing the demographic data from all three counties, that factor shows up clearly, since 85 percent of the population in both Hempstead and Howard counties is below age 65, and 82 percent of the population in Nevada County is below age 65. Still, other demographic factors across the three counties are remarkably similar, despite disparities in ranking. For instance, median household incomes in Hempstead County at $30,922, in Howard County at $33,079, and in Nevada County at $31,590, accounting for total population in each county. That similarity is in contrast to the data showing Nevada County to have the lowest health care costs among the three at $9,503; while Howard County stands at $9,633 and Hempstead County at $10,568. Here, again, the data is based upon Medicare costs, as opposed to household costs, and does not represent the entire population of each county.