z Four-County Community Health Needs Assessment 2004

Four-County Community Health Needs Assessment 2004

summary of findings

Benton County Demographic Profile

A demographic profile of respondents who participated in the Four-County Community Health Needs Assessment was compared to the 2002 Census Bureau data for Benton County. This comparison enabled SWRC to assess how well the Benton County survey respondents can be said to represent the total Benton County Population. Toward this end, SWRC examined the gender, age, ethnicity, SES status, educational attainment, and employment status of Benton County respondents.

Benton County Age Breakdown

Benton County Ethnic Breakdown

Benton County Socio-Economic Status Indicator

Benton County Employment Status

Sex by County (Benton County)

Benton County Educational Status

The demographic analysis revealed that Benton County survey respondents were disproportionately female compared to U.S. Census data for the area. Beyond that, respondents tended to occupy a lower socioeconomic status and demonstrated a higher concentration of college graduates and persons with post bachelor-level educations compared to 2002 Census Bureau data.

survey findings - benton county

Medical Care Costs

The cost of medical services is a major concern for the residents of Benton County. Survey respondents tended to rate medical care costs as their greatest concern. Benton County respondents tended to list the following items as their highest concerns over medical care costs:

Benton County Medical Care Costs

Demographic factors also influenced Benton County residents' perception regarding medical care costs. The age of the respondent, employment status, socioeconomic level, the presence of dependents in the respondent's household and insurance status affected survey respondents' opinions of medical care costs.

Money for ongoing medical care was a significantly greater concern for 45-64 year olds than it was for survey respondents aged 18-44 and 65 years of age and older. This same age cohort rated money for ongoing dental care, finding a doctor who accepts Medicaid, Medicare health insurance and ARKids First as significantly greater issues than for senior citizens (65 years of age or older).

The 18-44 year old cohort of Benton County respondents tended to be more concerned over medical doctors not accepting their insurance than the cohort of Benton County respondents 65 years old or older. Not surprisingly, senior citizens rated finding a doctor who accepts Medicare as a significantly greater issue compared to Benton County's young adults (18-44 years of age).

Employment Status

Employment status emerged as a salient finding when considering medical care costs. Employed Benton County residents were significantly more concerned about medical care costs compared to unemployed respondents. While it is somewhat difficult to fully account for these findings, part of the explanation may be attributed to the manner in which this item was worded. This item required respondents to reply within the confines of a forced choice format. respondents were asked, "Are you currently employed?" As a result of the manner in which this item was presented, three distinct "unemployed" subgroups (unemployed, not in the work force, retired), may have all answered this item with a no response. Since it was not possible to discern the relative contribution of each "unemployed" subgroup, one or more of these unemployed groups may have disproportionately affected this response set. It is possible that persons who are unemployed are not as concerned about medical care costs because of their eligibility for state and federal health insurance (Medicaid), or due to their use of emergency room services for medical care. It is also possible, since over 14% of respondents were 65 years of age and older, issues associated with the availability of health insurance for elders may have affected the direction of this response set. Conversely, since there was not an analysis of the socioeconomic status of employed Benton County respondents, nor any analysis of the health insurance status of this group, it is difficult to discern how these factors may have affected respondents concern about medical care costs. Further analysis is needed in order to clarify this issue.

Benton County Resdeints who are Employed have a Greater Concern for Medical Care Costs 

Household Income

Household income emerged as an important factor affecting Benton County residents' perceptions about medical care costs. Money for emergency medical care emerged as a significantly greater concern for residents with household incomes of $29,000 or less and those households who earned $29,000-$99,000, than it was for the highest income households ($99,000 and greater).

In addition, money for ongoing medical care was a significantly greater concern for the least affluent households than it was for the wealthiest residents. Clearly, household income is a significant variable affecting residents' abilities to afford emergency and ongoing medical care.

The presence of dependents within respondents' households emerged as a salient factor regarding the affordability of emergency medical care. Survey respondents with dependents were significantly more concerned about their ability to pay for emergency services as compared to respondents without dependents.

Insurance status, not surprisingly, was a significant variable affecting respondents' perceptions about the affordability of health care. Uninsured adults cited a significantly greater concern over their ability to pay for dental care and in finding a doctor who accepts ARKids First Insurance, as compared to adults with health insurance. Insured adults were more concerned about finding a doctor who would accept their insurance as compared to adults without health insurance.

 

Access to Health Care Services

In terms of access to health care services, Benton County respondents cited the following items as their greatest concern:

Benton County Residents Greatest Concern Involving Access to Health Care

Over 35% of Benton County respondents rated access to tests and diagnostics as a major issue. Slightly more than 33% of those surveyed considered adequate and timely access to a physician and access to health care services as major concerns.

Several demographic variables appear to significantly affect Benton County residents' perceptions of access to health care services. In particular, the age of the survey participant, employment status and the presence of dependents in respondents' households impacted their opinions on access to health care services. In general, survey participants aged 18-44 and 45-64 years old reported significantly more concern over access to health care services than did older respondents (65 years of age or greater).

Middle-aged adults were significantly more concerned over access to prenatal care, public transportation, health care services, adequate and timely access to a physician, tests and diagnostics, pharmacy services, hospital services, access to dental care and access to affordable and available assisted living for the elderly than younger or older adults.

Adults 45-64 years of age were significantly more likely to identify access to private transportation and health care clinics as major concerns compared to older adults.

Employed adults expressed a significantly greater concern over access to prenatal care, private transportation, access to health care clinics and adequate and timely access to a physician, as contrasted with unemployed adults.

Adults with dependents were significantly more concerned about their access to prenatal care and dental services than were adults without dependents.

Overall, middle aged adults residing in Benton County exhibited significantly greater concerns regarding access to health care services, as compared to younger and older adults.

Physical Health Care Issues

Survey respondents in Benton County rated the following health care issues as major issues:

The high percentage of respondents who identified these health care issues as major concerns parallels recent health data findings, which consistently rank weight problems, cigarette smoking, second hand smoke, and heart disease as the leading causes of premature morbidity in this county.

Major Health Care Issues for Benton County Residents

The age, employment status, socioeconomic level, the presence of dependents in the respondents' households, and the availability of health insurance, exerted a significant influence on Benton County respondents' perceptions of physical health care issues. Adults 45-64 years of age reported significantly greater concern about asthma or other lung diseases, cigarette smoking, second hand smoke, diabetes, heart disease and HIV, than did younger and older adults. Middle aged adults also considered weight problems, smokeless tobacco, and sexually transmitted diseases as being of significantly greater concern, compared to older adults. Contrasted with younger adults, middle-aged adults identified osteoporosis, stroke, Alzheimer's disease and cancer as being more problematic. Older adults cited stroke and Alzheimer's disease as their greatest concern, compared to the younger aged respondents. Finally, smokeless tobacco was cited more frequently as a problem by younger adults, than it was by older adults.

Factors that Effected Benton Counties Perception of Physical Health Care Issues

Employed Benton County respondents identified cigarette smoking, second hand smoke, heart disease, weight problems, sexually transmitted diseases, HIV and smokeless tobacco as a greater concern than did unemployed Benton County respondents.

respondents from households with the largest incomes ($99,000 or greater per year), identified weight problems and the use of smokeless tobacco as significantly more problematic as compared to respondents from lower income households. respondents from middle-income households ($29,000-$99.000 per year) cited Alzheimer's disease and cancer as being of significantly greater concern compared to respondents from the least wealthy households (less than $29,000 per year).

Residents of Benton County with Larger Incomes had Greater Concern for Problematic Items

Interestingly, respondents from households without dependents indicated significantly greater concern over diabetes, heart disease, stroke, Alzheimer's disease and cancer than did respondents from households with dependents. This trend may be partially explained by the association of these diseases and old age, wherein elderly respondents may not have dependents living in their households.

Benton County Households without Dependents had Greater Concerns about Health Care Conditions

Insurance Status

Insurance status also emerged as saliently factor, which is linked to physical health issues. Similar to the items endorsed by non-dependent households, insured adults identified heart disease, osteoporosis, stroke, Alzheimer's disease and cancer as being significantly more concerning, than uninsured adults. As this list is almost identical to the physical health conditions cited by non-dependent households (with the exception of osteoporosis), it is presumed that a unique combination of demographic variables is responsible for these findings.

Mental Health Care Issues

Mental health care issues exert a significant influence on the overall well being of a community. Results from the Northwest Arkansas Health Needs Assessment revealed that Benton County residents perceived the following as the most significant mental health concerns affecting their community:

Nearly 46% of surveyed Benton County residents identified substance abuse, as the most pressing mental health care issue impacting their community. Close to 40% of respondents cited depression, and nearly 37% of respondents identified alcoholism, as the second and third highest rated mental health care issues in their communities.

Perceived as the Most Significant Mental Health Concers by Benton County Residents 

Middle-aged adults acknowledged significantly greater concerns over mental health care issues than younger and older adults did. Adults 45-64 years of age expressed the greatest concern over available and affordable psychiatric services, available and affordable counseling services, emergency mental health services, housing or residential services for the severely and persistently mentally ill, alcoholism, anxiety disorders, depression, available and affordable substance abuse services and suicide. Substance abuse was cited more frequently as being problematic by 45-64 year olds, than it was by older adults.

Middle Age Adults in Benton County had a Greater Concern for Mental Health Care Issues

Employment status emerged as an important variable affecting respondent's opinions on mental health care issues. When compared to unemployed Benton County respondents, employed respondents more often cited available and affordable psychiatric services, available and affordable counseling services, emergency mental health services, housing or residential services for the severely and persistently mentally ill, alcoholism, access to available and affordable alcohol treatment programs, anxiety disorders, depression, substance abuse, available and affordable substance abuse services and suicide, as major mental health care concerns.

 

Multicultural Health Care Concerns

Since 1990, Northwest Arkansas has experienced a significant increase in its overall population. While rapid population growth, in general, exerts significant pressure on a region's infrastructure and ability to meet the needs of its growing population, the advent of an unprecedented number of multicultural people into Northwest Arkansas has created unique challenges in the region's ability to meet the needs of its growing population. While this challenge extends into all facets of life for newcomers to this area, no need is more critical than providing accessible and affordable health care services to the region's growing multicultural population.

respondents identified cultural and/or language barriers and access to affordable and available health care services as the two greatest challenges facing Benton County.

Two Greatest Challanges Facing Benton County

The age of the survey participants, their employment status, education level and health insurance status all affected respondents' perceptions of multicultural health care issues. Compared to younger and older adults in BentonCounty, middle-aged adults were significantly more likely to identify the adequacy of health care services and awareness of health care services as major issues. Compared to senior citizens, adults 45-64 years of age identified access to affordable and available health care services as a significant concern. Compared to older adults, younger adults (18-44 years of age), believed that cultural and/or language barriers to accessing health care services was a significant concern.

The employment status of the survey respondents appeared to be an important variable, in their responses to the items on the Multicultural Health Care Section of the Health Care Needs Assessment.

Benton County residents who were employed consistently rated the items within the multicultural health care section of the survey, as being of significantly greater concern, as compared to unemployed adults.

Educational Level

Benton County Educational LevelThe educational level of the survey respondents emerged as an important variable affecting participant's responses in regard to multicultural health care issues. Upon reviewing the pattern of participant's responses, increased educational achievement was consistently related to significantly greater concern, in regard to all of the multicultural health care items, within the survey. It appears that increased educational achievement is positively correlated with a survey respondent's propensity to identify multicultural health issues as being of major concern.

Benton County residents with health insurance were more likely than uninsured citizens, to endorse the following items as being of significant concern; awareness of health care services, cultural and/or language barriers to accessing health care services.

benton county Qualitative Summary

Benton County survey respondents were asked to list the top three health concerns for their community. Out of the 374 surveys collected in Benton County, the top three health care concerns identified were:

 
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