Four-County Community Health Needs Assessment 2004

Summary of Findings

Madison County Demographic Profile

A demographic analysis of Madison County residents who participated in the Four-County Community Health Needs Assessment was compared to the 2002 US Census Bureau Data for Madison County. This demographic profile analysis is designed to assess whether Madison County residents who participated in the Health Needs Assessment were representative of the larger population within Madison County. Demographic variables that were assessed included: gender, age, ethnicity, socioeconomic status, educational level, and employment status.

Results of the demographic profile analysis for Madison County suggested that significant differences existed between survey respondents and key demographic variables obtained from the 2002 US Census Bureau Data. Survey participants were more likely to be female, somewhat younger in age, over representative of Hispanic/Latinos and Native Americans, less likely to be below the poverty line for a family of 4, and more highly educated, as compared to the 2002 Census Bureau Data, for Madison County.

Approximately 66% of the survey participants were female and nearly 34% were male, as compared to the 2002 Census Bureau data; which indicated that 50% of Madison County residents were female, and 50% were male. Survey respondents were more likely to be younger, as a group, as compared to the overall Madison County population. Slightly more than 51% of the survey respondents were 18-44 years of age, as compared to 45.9% of younger adults, based on the 2002 US Census Bureau data. The percentage of middle age adults who participated in the Four-county Community Health Needs Assessment (35.62%) was comparable to same aged adults according to the 2002 Census Bureau data (34.65%). Older adults (65 years of age or older) were under represented in the Health Needs Assessment, as compared to the 2002 Census Bureau data (13.13% to19.45 respectively).

Multicultural residents within Madison County were over represented among survey respondents. Approximately 8% of survey respondents were of Hispanic/Latino origin and slightly over 4% of participants identified themselves as Native Americans, in 2002. These findings are not consistent with the 2002 Census Bureau data. Results obtained from the Census Bureau data revealed that only 3% of Madison County residents were of Hispanic/Latino decent and 1% was Native American.

Considerable caution needs to be exercised in the analysis and interpretation of data obtained from the socioeconomic status (household income), section of the Four-County Community Health Needs Assessment. The percentage of households which were 200% or more below the poverty line, was an estimate extrapolated from the demographic data contained within the survey. Given this caveat, it appears that survey respondents were somewhat less likely to be 200% or below the poverty level for a family of 4, as compared to the 2002 US Census Bureau Data.

Significant differences were also observed in the educational obtained level of survey respondents, as compared to the overall population of Madison County. Nearly 83% of survey respondents reported to be a high school graduate or greater, and 14.73% of the Four-County Community Health Needs Assessment participants stated they had a college degree or greater. This compares to 67.8% of CarrollCounty residents who had a high school diploma or greater, and 10.15% with a Bachelor's Degree or greater, based upon the 2002 Census Bureau data.


Medical Care Costs

The costs associated with medical care were a significant concern for Madison County residents who participated in the Northwest Arkansas Health Needs Assessment. Over 70% of survey respondents identified money for prescriptions as the most significant cost related health care concern. Slightly over 67% of survey respondents cited money for emergency medical care as a significant concern and nearly 65% of individuals who participated in the Health Needs Assessment identified money for ongoing medical care, as a significant problem.


The ethnicity, educational level, household composition, and insurance status, of Madison County survey respondents, emerged as significant demographic variables, affecting their perceptions, in regard to the costs associated with medical care services. Survey participants who were Caucasian expressed significantly greater concern in regard to the costs for prescriptions, as compared to Hispanic/Latino respondents. Madison County residents who had attended "some college", cited significantly greater concern about the following medical care costs, as compared to survey respondents who had a high school diploma or less education:

Madison County residents that participated in the Health Needs Assessment and resided in households with dependents were significantly more concerned about dentists who will not accept ARKids First Insurance, as compared to no-dependent residences. Insurance status was also a factor, which affected Madison County citizen's opinions in regard to health care costs. Individuals with health insurance reported significantly greater concern in regard to medical doctors who will not accept my insurance as compared to survey respondents who did not have health insurance. The lack of compatibility between an individual or families health insurance policy and the insurance requirement of a PCP or health clinic, represents a daunting challenge, even in the best of circumstances. This conundrum however, is greatly exacerbated in a rural setting, like Madison County, where there may be limited choices for health care services due to the unavailability, or limited access to health care clinics and/or primary care physicians.

Access to Health Care Services

Access to the following health care services were rated by Madison County survey respondents, as their highest rated concerns:

Access to hospital services, was cited by survey participants as the most pressing health care problem within Madison County. Nearly 76% of survey respondents identified the need for hospital services, as the most important health care issue confronting Madison County.  A little over 47% of survey participants cited access to tests and diagnostic services as a significant problem, and approximately 43% of respondents identified the need for adequate and timely access to a physician as a major concern.

The ethnicity, employment level, and health insurance status were important demographic variables that impacted survey respondent's perceptions in accessing needed health care services. Caucasian respondents identified significantly greater concern in regard to the following health access issues as compared to Hispanic survey participants: adequate and timely access to a physician, access to hospital services, access to available and affordable assisted living for the elderly. Madison County residents that are employed were significantly more concerned about access to private transportation, access to health care clinics, and access to affordable and adequate assisted living for the elderly, as compared to unemployed adults. The insurance status of Madison County survey respondents also emerged as an important factor in terms of their opinions in regard to accessing health care services. Insured adults acknowledged significantly greater concerns in regard to the access to the adequate and timely access to a physician, access to health care clinics, and access to affordable and adequate assisted living for the elderly, as compared to uninsured adults.

Physical Health Care Concerns

Cancer was identified by 64.5% of Madison County residents participating in the Northwest Arkansas Health Needs Assessment, as the most challenging physical health care issue currently affecting their community. Cigarette smoking and/or second hand smoke and weight problems were also rated by survey respondents as major physical health care concerns.


The age, ethnicity, household income, educational level, and insurance status of survey respondents, differently affected their perceptions in terms of physical health care issues. In general, younger and middle aged adults displayed significantly greater concern about a variety of physical health care issues, than did older adults (65 years of age or older). Adults aged 18-44 and 45-64 years of age, cited significantly greater concern about sexually transmitted diseases, HIV, smokeless tobacco, and Alzheimer's disease than did older adults. Middle-aged adults were significantly more concerned than younger or older adults in regard to diabetes, heart disease, stroke and cancer. The lack of any significant findings in terms of physical health care issues for older adults is somewhat surprising.   It is uncertain whether this lack of comparative concern (as contrasted with younger and middle aged adults), is simply representative of the opinions of older adults who participated in the Four-County Community Health Needs Assessment, or is reflective of the views and perceptions of senior citizens in Madison County. Conversely, this finding may be simply an artifact of the research design utilized in this survey and may not accurately portray the level of concern that seniors residing in Madison County actually experience in regard to physical health care issues.

Caucasians who participated in the survey expressed significantly greater concern about asthma and other lung diseases, heart disease, weight problems, stroke, and cancer, as compared to Hispanic survey respondents.

Household income exerted a significant impact upon the perceptions of survey respondents.   Survey participants with an annual household income between $29,000 and $99,000 per year expressed significantly greater concern than did households with less than $29,000 per year, in regard to the following health issues: cigarette smoking and/or second hand smoke, heart disease, weight problems, and sexually transmitted diseases.

Survey respondents with some college education exhibited significantly greater concern than did participants with a high school degree or less, involving the following physical health care issues: heart disease, weight problems, sexually transmitted diseases, HIV, stroke and cancer. Survey participants with some college education also expressed greater concern about HIV than did respondents with a bachelor's degree or greater educational obtainment.

Madison County residents with health insurance identified the following health care issues of significant concern as compared to uninsured adults: diabetes, heart disease, STD's, HIV, stroke, and cancer.

Mental Health Concerns

Illegal drugs in Northwest Arkansas (e.g. , methamphetamines) and alcohol abuse, affected survey respondent's opinions in terms of mental health care issues. Madison County residents identified substance abuse, available and affordable substance abuse treatment services, and alcoholism, as the most salient mental health care issues affecting their community. Over 65% of survey participants identified substance abuse as the most significant mental health care issue that impacts Madison County. The need for available and affordable substance abuse treatment services was cited by 56% of participants, and nearly 46% of surveyed adults reported that alcoholism was a serious mental health concern.

The age of the survey respondents emerged as the only demographic variable which affected participant's opinions in regard to mental health care issues. Younger and middle aged adults consistently cited significantly greater concerns in terms of mental health care issues, as compared to older adults. Adults aged 18 - 44, and 45 - 64 years of age, demonstrated significantly greater concerns about the following mental health care issues as compared to senior citizens: alcoholism, access to affordable and available alcohol treatment programs, anxiety disorders, substance abuse, and available and affordable substance abuse services. Middle-aged adults (44 - 64 years of age) cited significantly greater concern in regard to available and affordable counseling services, emergency mental health services, and depression, than did younger and older adults.

Madison County Qualitative Summary

Madison County survey respondents were asked to identify the top 3 health care concerns for their community. 154 completed surveys were obtained in Madison County. Consistent with the rural nature of this county, survey participants identified the following 3 health care concerns as the most important in the community:

 
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