benton county Health Care Profile
Benton county respondents consistently rated the costs of medical care services as their greatest concern. Over 50% of respondents from Benton County cited money needed for ongoing medical care, prescriptions, and for emergency medical care as a major problem. The concerns of Benton County residents regarding medical care costs are consistent with US data (CDC, 2003). This data chronicles the increase in expenditures for health care and prescription costs (out of pocket expenses), for the years 1987 and 1997-1999. The annual out of pocket expenses for prescriptions for individuals 65 years of age or older was $212.00 in 1987. In 1999, senior citizens were paying $614.00 annually out of pocket, for prescription medications. Similarly, the mean annual health care costs for senior citizens increased from $5,947 a year in 1997, to $6,299 a year by 1999.
Survey respondents in Benton County are clearly experiencing similar increases in out of pocket expenses for health care costs and prescription medications, consistent with national trends. General demographic factors that appeared to be the most salient for survey respondents in terms of medical care costs include: age (45-64 years of age), employment status (employed), household income (less than $99,000 per year), household composition (dependents), and health insurance status (no health insurance). While the sampling procedures utilized in this study precluded the ability to conduct a more sophisticated multivariate analysis of the demographic variables utilized in this study, future studies would need to ascertain which combination of demographic factors would be predictive of residents' concerns, in regard to medical care costs in Benton County.
Over a third of Benton County survey respondents identified access to tests and diagnostics, adequate and timely access to a physician and access to health care services as significant issues, which affect their community. Younger and middle aged respondents (as compared to senior citizens), being employed, and having dependents within their household, emerged as significant demographic factors affecting respondents' perceptions concerning access to health care services.
While survey respondents identified a variety of different issues relevant to accessing health care services, several notable health care access concerns will be highlighted in this section.
Access to private transportation was cited as a significant concern by survey respondents who were middle aged and employed. While there was no way to discern the percentage of survey participants who were middle aged, employed, and who endorsed this item, this concern is notable as it appears to represent an important barrier for accessing health care services for a significant segment of the survey sample (e.g. , employed, middle aged).
Middle-aged adults also expressed significant concerns regarding access to affordable and available assisted living for the elderly. This finding is of significant interest for the following reasons:
- Benton County is not only the fastest growing county in Arkansas (on a percentage basis), but also is experiencing a rapid increase in the number of senior citizens who reside within its' confines.
- Middle aged adults (aged 45-64), have been described as the "sandwich generation" by researchers, due to the simultaneous care taking responsibilities this age group experiences in taking care of dependent children and aging parents.
It is reasonable to presume that the concerns faced by middle-aged survey respondents are related to demographic patterns within the county. The combination of sociocultural shifts and role changes, along with longer life expectancies, may be contributing to the perceived and actual lack of affordable and available assisted living facilities for the elderly in Benton County.
Access to dental care was cited as a significant problem by middle aged and older adults as well as for households with dependents. Access to prenatal care was identified as a significant health issues by employed survey respondents and in households with dependents. While it is axiomatic that available and affordable health care services remain a challenge for a significant percentage of the population, it is of considerable interest that a substantial percentage of survey respondents noted the need for accessible and specialized health care services (e.g. , dental services, prenatal care).
Weight problems, cigarette smoking and second hand smoke, and heart disease, were rated the most significant physical health care issues by survey respondents. Almost 53% of Benton County residents cited weight problems as the county's most pressing health problem, and approximately 45-49% of survey participants identified cigarette smoking and second hand smoke, and heart disease as the second and third most significant health care concerns in Benton County.
Recent data, disseminated by the Arkansas Department of Health (2004), for 2002, appears to corroborate the importance of the physical health concerns, cited by survey respondents. Heart disease is not only the leading cause of death in Benton County (287.5 deaths per 100,000 age adjusted mortality rate), but it also represents the leading cause of premature mortality (years of potential life lost before age 75, per 100,000 population). Weight problems and cigarette smoking and/or exposure to second hand smoke have been consistently listed as the leading behavioral or modifiable risk factors associated with premature mortality. The percent of adults 18 years of age or older that were smokers during 2000-2002 in Benton County comprised 22.2% of the population. Even more alarming, approximately 60.3% of adults aged 18 years or older were considered to be overweight as measured by the Body Mass Index (2000-2002). These findings suggest that the health perceptions of Benton County respondents accurately reflect the significance of the top rated physical health concerns identified in the survey.
Obtaining reliable estimates at the county level for mental health problems, substance abuse, and alcoholism is a daunting task. While prevalence rates per 100,000, prediction rates, and mortality data associated with mental illness, substance abuse, and alcoholism are available for the United States and selected states; this information is not typically available at the county level. Survey and public health data has provided credible evidence of a general increase in the prevalence of mental health and substance related disorders (CDC, SAMSHA, 2002), however, this body of accumulated information provides only trend or pattern information, particularly as it is applied at the community or county level.
SAMHSA reported that 7.41% of Americans and 8.24% of Arkansans suffered from a serious mental illness in 2001(SAMHSA, 2001). Data obtained for the National Institute of Mental Health suggests that in any given year, approximately 11.0% of the population suffers from a depressive or Bipolar disorder, and 13% of the population aged 18-54 is affected with an anxiety disorder (note; comorbidity exists between depressive and anxiety disorders, so prevalence rates for these disorders should not be considered as being mutually exclusive). In addition, approximately 1% of the United States population suffers from a Schizophrenic disorder.
Substance abuse and alcohol disorders also afflict a significant number of Americans. It has been estimated that approximately 386,000 Americans aged 18 or older binge drink alcohol per month (SAMHSA, 2003). Approximately 118,000 adults use illicit drugs each month (SAMHSA, Office of Applied Studies 2003).
In the year 2000, 23,350 people died from suicide within the United States (Minino 2000). Ninety percent (90%) of these individuals suffered from a diagnosable mental health disorder (typically depression) or from a substance related disorder. (Conwell 1995)
Similar to the information obtained from national and state data sources, Benton County residents who participated in the Four-County Community Health Needs Assessment expressed concerns over substance abuse and alcohol related problems, as well as for affective disorders (depression). In particular, middle aged and employed adults not only cited concern in regard to a number of mental health problems (depression, anxiety, substance abuse, alcoholism, suicide), they also identified problems with the affordability and availability of psychiatric, mental health and substance abuse services. Results obtained from the Four-County Community Health Needs Assessment strongly indicate the need for affordable and available mental health, substance abuse, and alcohol treatment services, in order to effectively meet the mental health needs of Benton County citizens.
The demographic composition of Northwest Arkansas has changed dramatically since 1990. Northwest Arkansas has evolved from a largely rural, agrarian, and predominately Caucasian community, into a rapidly growing, economically vibrant, and culturally diverse region. Within Northwest Arkansas, Benton County is not only experiencing a dramatic increase in its population base, it is also witnessing burgeoning growth within its multicultural population. Based on Census Bureau Data, Benton County has experienced an 8.8% increase in its Hispanic/Latino population and a.1% increase in the number of Asian/Pacific Islanders over the 1990-2000 decade (US Census, Quickfacts). The rapid rate of growth and dramatic influx of multicultural populations within this region has created a significant amount of pressure on the health care infrastructure within Northwest Arkansas.
Relocating is often fraught with a variety of challenges. However, language barriers, unfamiliar customs and little knowledge of available health care services may compound these challenges. It is no surprise, then, that nearly 45% of Benton County respondents identified cultural and/or language barriers as a significant health problem, especially given the rapid increase in the overall and multicultural population.
Similarly, access to affordable and available health care service was cited as a major concern by almost 44% of survey participants.
Based upon responses to the Health Needs Assessment, there is a need for enhanced educational and outreach services, in order to meet the health care needs of the residents of Benton County. Furthermore, Benton County needs accessible and affordable health care services, which specifically addresses the health care concerns of the multicultural members of the Northwest Arkansas community.