carroll county Health Care Profile
Carroll County respondents rated the cost of medical care services as the most significant health care problem confronting their community. Nearly 73% of survey participants identified the cost of prescriptions as a major issue. Sixty-seven percent of respondents selected money for ongoing medical care as a significant challenge, while 62% of Carroll County respondents identified the cost of prescriptions as a significant problem.
Compared to men, women were significantly more likely to identify the costs associated with medical care services as being of significant concern. These findings are consistent with the disproportiately higher number of women respondents who participated in the Four-County Community Health Needs Assessment and providers support of women's traditional role as caregivers and gatekeepers for their families in accessing health care services.
Socioeconomic and demographic factors, in part, also help to explain the heightened level of concern associated with medical care costs in Carroll County. Carroll County contains a significant percentage of adults who do not have medical insurance. Nearly 23% of Carroll County residents (22.7%), age 18 and over, do not have health insurance. Out of the 75 counties in Arkansas , Carroll County ranked 19 th, in terms of the number of uninsured adults (22.7%). According to the 2002 Arkansas Department of Health Data, Carroll County also had the highest unemployment rate in Northwest Arkansas (4.3%). A significant percentage of its' citizens met the federal criteria for poverty (15.4%), and Carroll County residents had the lowest median income, for full time male and female workers in the region (U.S. Census, 2002). These socioeconomic and demographic factors over a partial explanation for the high percentage of Carroll County residents who cited the cost of medical care services, as the most significant health care issue within their county.
Forty-two and a half percent (42.5%) of Carroll County respondents rated access to affordable and adequate assisted living for the elderly, as the most significant issue involving the access of health care services within their community. Thirty-nine percent (39%) of Carroll County respondents listed adequate and timely access to a physician, while 29.8% listed access to hospital services, as the most significant barriers in accessing needed health care services.
A multivariate analysis of selected demographic factors derived from survey respondents (e.g. , gender, age, ethnicity, employment status, socieoeconomic status, educational level, household composition, and insurance status), did not provide any significant findings related to any of the health care access items contained within this survey. While the analysis of survey responses is limited by the methodology, sample methods, and level of analysis employed in this study, several speculative areas of inquiry require further exploration.
Carroll County is primarily a rural county. The urban/rural population distribution for Carroll County in the year 2000 indicates that 72.1% of the population was considered to be rural, while only 27.8% was considered to be in an urban cluster (American Fact Finder, 2000). The relatively undeveloped nature of the county limits the access to medical services. Not only are needed services generally unavailable, but transportation costs and the response time for needed health care services have proven problematic. According to the Arkansas Department of Health in 2002, there were 6.1 primary care physicians for every 10,000 persons in Carroll County. This finding places Carroll County 34 th out of 75 counties in Arkansas in terms of the number of primary care physicians. In addition, there is currently only one general hospital in Carroll County , which has a limited number of specialized medical services. As a result, Carroll County residents often need to travel to larger urban areas in order to access vital medical specialists or services.
Carroll County respondents also identified the need for access to affordable and adequate assisted living facilities for the elderly as one of the most important issues associated with accessing health care services in Carroll County. The need for accessible and affordable retirement facilities, assisted living, and nursing homes is a natural health care concern, due to the increased longevity of the population. Northwest Arkansas has experienced a significant increase in the number of retirees who have relocated into this area. According to a number of different national surveys (AARP) , Northwest Arkansas has earned the reputation as one of the top 25 retiree destinations in the nation. This issue is especially salient in Carroll County , which not only boasts the highest percentage of citizens age 65 and over within the region (US Census Bureau Data, 2000), but also had the highest percentage of older survey respondents (27.78%). Accessible and affordable health care services for the general population, particularly for the elderly, represent a significant challenge for Carroll County residents.
Sixty-one percent (61%) of Carroll County respondents identified cancer as the most significant physical health care issue within the region. Nearly sixty percent of respondents identified cigarette smoking and/or second hand smoke as the most significant physical health care issue for the region, and 58.93% identified weight problems as a significant physical health care concern. In terms of overall mortality, cancer is the second leading cause of death in Carroll County (Arkansas Department of Health, 2002), with an age adjusted mortality rate of 193.1 deaths per 100,000. Heart Disease is the leading cause of death in Carroll County , with an age adjustment modality rate of 293.3 deaths per 100,000 (Arkansas Department of Health, 2002). While cancer represents a significant public health concern in Carroll County , health education and prevention services will need to focus upon the risk factors associated with heart disease, which is the leading cause of death within the county.
Based upon recent national data (National Center for Health Statistics, 2002), cigarette smoking, second hand smoke and weight problems are the leading behavioral risk factors associated with premature mortality in the United States. Within Carroll County , 33.5% of adults are smokers (Arkansas Department of Health, 2002). This finding places Carroll County 4 th out of 75 counties in Arkansas , in terms of the percentage of adults who are smokers. While Carroll County is only ranked 72 nd out of 75 counties in terms of the percentage of the adults who are overweight, this issue still represents a significant health concern for the citizens of Carroll County, as 51.6% of the local population has been assessed as being overweight (Arkansas Department of Health, 2002). Consistent with recent health care initiatives promoted by the Arkansas Health Department and the Governor's Office, concentrated efforts need to be undertaken to reduce the percentage of Arkansans, including Carroll County residents, with significant modifiable behavioral health risk factors. Given the significance of these behavioral health risk factors, and the large percentage of Carroll County residents who manifest these behaviors, comprehensive and systematic efforts to ameliorate these behavioral risk factors need to be developed and implemented within Carroll County.
Sixty-five and a half percent (65.5%) of Carroll County respondents cited substance abuse as a major mental health concern for the region. Fifty-two and a half percent of Carroll County respondents chose available and affordable substance abuse services as a major issue, while 46.55% listed alcoholism. While no reliable prevalence rates for substance abuse and alcoholism exist at the county level, anecdotal reports and arrest records for methamphetamine distribution and usage, as well as DUIs for the last several years, reflect the increasing significance of this problem, within Carroll County , (Office of Applied Studies 2003). To compound this problem, there are a limited number of alcohol and substance abuse facilities in Carroll County. A coordinated and systematic effort involving law enforcement, health education, and health care policy, along with a greater availability of affordable and accessible mental health and substance abuse/alcohol treatment programs, is needed in order to reduce the prevalence of substance abuse and alcohol problems within Carroll County.
Forty and a half percent (40.5%) of Carroll County respondents selected cultural and/or language barriers to accessing health care services as the region's most significant multicultural health care issue. Nearly 38% of survey respondents (37.75%) identified access to affordable and available health care services, as a major multicultural health care concern. According to recent demographic information provided by the Arkansas Department of Health (2002), Carroll County has the largest relative percentage of Hispanic residents living within Northwest Arkansas. With the rapid growth of the Hispanic community within Carroll County , there is a need for increased awareness of the cultural and language barriers that reduce access to health care services for Hispanic citizens and immigrants. There is also a need for culturally sensitive, easily accessible and affordable health care services, and education and outreach efforts, which specifically target the health care needs of the Hispanic community. There is also the need for culturally and language sensitive liaisons in order to more effectively serve the needs of the Hispanic community. These recommendations are designed to assist Hispanic residents successfully navigate the health care system within Northwest Arkansas.