DEFINITIONS
DEMOGRAPHIC FACTORS Return to sectional headings page Return to main page
Demographic data are from the U.S. Census Bureau's web page, www.census.gov/
population/estimates/county/casrh/casrh05.txt, released after December,2002. These
data are estimates of the number of persons by age, race, and sex for the state, health
management area, or county . In addition, the "Overall Percent" shows the proportion of
all the persons in the state, health management area, or county. For example, persons
45-54 years of age represents 12.4 percent of all persons in the state of Arkansas.
Percent Change reflects the growth or decline in the total and age-specific population of
the state, health management area, or county from 2000 to the current year. An increase or
decrease in the population may be a factor in decisions to expand or consolidate services
and facilities.
HEALTH MANAGEMENT AREA RANK AND COUNTY RANK - Rank for any health
management area or county for the given indicator. Health management areas and
counties are ranked in descending order by percent or rate with "1" being the highest and
"75" being the lowest. In case of a tie, two or more health management areas or
counties will be assigned the average rank of all health management areas or counties
with the same value.
RURAL/URBAN DISTRIBUTIONS Return to sectional headings page Return to main page
Data are based on July 2000 named-place and county estimates prepared by the Census
State Data Center at the University of Arkansas at Little Rock. Urbanized areas refer to
the number and percent of people who live in areas (cities, towns, and Census-designated
places) with a population of 2,500 or greater or, alternately, 10,000 or greater. (Note:
any area not "urban" is considered rural.) Population density (persons per square mile) is
also reported as an alternative (and sometimes superior) method of measuring
urbanization.
ECONOMIC FACTORS Return to sectional headings page Return to main page
POPULATION LESS THAN 100% POVERTY and
POPULATION OF PEOPLE AGE 0 TO 17 YEARS LESS THAN 100% POVERTY - Poverty
status is defined by the U.S. Census and varies with income and household size. In
2000, the average poverty threshold for a family of four persons was $18,267. Larger
households, with more persons to support, may have higher incomes while the poverty
threshold is lower for smaller households. The poverty threshold is from the U.S. Census
Bureau's web page, www.census.gov/hhes/ poverty/ thresh01.html. The poverty
estimates are from the U.S. Census Bureau's web page,
www.census.gov/hhes/www/saipe.html, and is entitled "Small Area Income and Poverty
Estimates Intercensal Estimates for States and Counties." The data were last revised in
December, 2001. The data file is est98_AR.dat.
1990 FEDERAL ESTIMATE OF PERSONS LESS THAN 200% POVERTY AND:
UNINSURED - Income less than 200 percent of poverty and insured
MEDICARE - Income less than 200 percent of poverty and receiving Medicare
UNDER AGE 65 AND MEDICAID - Income less than 200 percent of poverty,
under age 65, and receiving Medicaid.
(CAUTION: Data concerning those Persons with Income less than 200 Percent of Poverty
and Uninsured, Medicare, or Under Age 65 and Medicaid were provided by the U.S.
Health Resources and Services Administration (HRSA). They are estimates based on
1990 data from a national survey and, so, are subject to considerable error when applied
to specific counties. These data are included because they are used by federal agencies
in designating counties as Medically Under Served Areas or Health Professional Shortage
Areas.)
UNINSURED - STATE SURVEY (1998 - 2000) - The number and percent of adults age 18
and older who report not having any health insurance. These data are obtained from the
Behavioral Risk Factor Survey (BRFS), and is an ongoing random-digit dialing telephone
survey of randomly selected adults throughout Arkansas. The uninsured results are based
on 7,799 interviews conducted in 1998 through 2000. Using standard statistical
techniques, data are weighted by age, gender, and race to compensate for underreporting
and telephone non-coverage. A model-based estimate was computed using a weighting
technique that gave 1999 data more emphasis than 1998 and 2000. For counties whose
sample sizes are less than 50, results are adjusted to reflect percent uninsured assuming
a sample of size 50. These data are probably more accurate than the federal estimates
previously discussed. However, the reader should keep in mind that the state data are
limited to adults only while the federal estimates apply to all persons. Persons presently
enrolled in Medicaid and Medicare are considered insured.
UNEMPLOYMENT RATE - Data are from the State of Arkansas Labor Market Information
Section of the Employment Security Department of the State of Arkansas. Released in
March 2001, these data give the average percent of persons in the civilian labor force
who were unemployed and actively seeking work in 2002.
PER CAPITA INCOME - Data are taken from Arkansas Personal Income Handbook prepared
by the Institute for Economic Advancement at the University of Arkansas at Little Rock.
Released in September, 2001, these data give per capita income by county. Per Capita
income is the average income of every person in the county, including children. It is
derived by dividing the total income of a county by the total population of that county.
In 2001, Pulaski County had the highest per capita income in the state ($30,124) and
Newton County had the lowest ($13,850).
MEDICAID ELIGIBLE - Data are taken from the "2001 Statistical Report" prepared by the
Arkansas Department of Human Services. These data give the average number of
Medicaid eligible people for any given month (not the unduplicated count) in State Fiscal
Year 2000. The population data used to compute the percent Medicaid eligible are from
the U.S. Census Bureau's web page, www.census.gov/
population/estimates/county/casrh/casrh05.txt.
MEDICAID ELIGIBLE CHILDREN - Data are taken from a report prepared by the Arkansas
Department of Human Services. These data give the unduplicated count of people under
age 21 who are Medicaid eligible anytime during State Fiscal Year 2000. These results
are not comparable to MEDICAID ELIGIBLE. The population data used to compute the
percent of children eligible for Medicaid are people in the United States under age 21. The
data are from the U.S. Census Bureau's web page
www.census.gov/population/estimates/county/casrh/casrh05.txt.
EPSDT PARTICIPATION - Data are prepared by the Arkansas Department of Health. The
data provide the percent of Medicaid eligible children who received at least one EPSDT
(Early Periodic Screening, Detection, and Treatment) screening during the State Fiscal Year
2000. Thirty-five percent of the 331,229 children eligible for Medicaid in 2000
received EPSDT. It should be noted that the year of these data differ from the remaining
factors in the "Economic Factors" section of this book.
TEA (AFDC) AVERAGE CASELOAD - Data are taken from the "2000 Statistical Report"
prepared by the Arkansas Department of Human Services. These data give the number
of adults and children that are receiving Transitional Employment Assistance (formerly Aid
to Families with Dependent Children) in June 2000. The population data used to
compute the percent receiving TEA are from the U.S. Census Bureau's web page
www.census.gov/population/estimates/county/casrh/ casrh05.txt.
WIC AVERAGE CASELOAD - Data are prepared by the Arkansas Department of Health.
These data provide the average caseloads for the Women, Infants, and Children nutritional
supplement program. In 2001 the average monthly WIC caseload for the state was
81,386.
FERTILITY Return to sectional headings page Return to main page
Data are taken from "2000 Arkansas Vital Statistics" and "1996-2000 County Trends in
Maternal and Child Health." Both sources, released in April 2002, are prepared by the
Arkansas Department of Health.
LIVE BIRTHS - Crude Birth Rate is the number of resident live births per 1000 in the total
resident population. The rate is "crude" because it relates to the total population without
regard to age or sex. In 2000, 37,790 infants were born by women who were Arkansas
residents. The crude birth rate was 15.9 births per 1,000 in the population.
LOW BIRTH WEIGHT - Any live-born infant whose birth weight is less than 2,500 grams
(5« pounds). This is calculated as a percent of all live births.
BIRTHS TO ADOLESCENTS (10 - 17 YEARS) - The number of live births to women under
the age of 18. "Percent" refers to that proportion of births to women less than 18 years
of age are of all births in the county. In 2000, the 2,153 births to adolescents 10 - 17
years old were six percent of the 37,790 births to residents of the state.
PRENATAL CARE (NO FIRST TRIMESTER CARE) - Number and percent of live births to
mothers who did not receive prenatal care in the first three months of the pregnancy.
LIVE BIRTHS (1996 - 2000) - The number of live births to Arkansas residents during 1996
through 2000.
LOW BIRTH WEIGHT (1996 - 2000) - The percent of resident births that were less than
2,500 grams during 1996 - 2000.
GENERAL FERTILITY RATE (2000) - The General Fertility Rate is calculated by dividing the
total number of births in a given year by the population of women age 15 through 44, and
multiplying by 1,000.
TEEN FERTILITY RATE (2000) - The Teen Fertility Rate is calculated by dividing the
number of births occurring to women aged 15 through 19 in a given year by the
population of women aged 15 through 19, and multiplying by 1,000.
MORBIDITY Return to sectional headings page Return to main page
Data are taken from the "2000 Communicable Disease Summary" prepared by the
Arkansas Department of Health. These data give the number of cases and rates
associated with various diseases. The rates are calculated by dividing the number of
reported cases by the total population, and multiplying by 100,000. Note that many
diseases are epidemic in nature and that their numbers may vary considerably from one
year or county to the next. Vaccine preventable diseases are Haemophilus influenzae type
b, hepatitis B, diphtheria, measles, mumps, pertussis, poliomyelitis, rubella, and tetanus.
Small numbers of HIV and AIDS cases are suppressed to preserve confidentiality.
MORTALITY Return to sectional headings page Return to main page
Data are taken from " Mortality in Arkansas: 2000" prepared by the Arkansas
Department of Health.
INFANT MORTALITY - Death of an individual less than one year of age. The infant
mortality rate is calculated by dividing the number of infant deaths occurring in a
given year by the number of live births, and multiplying by 1,000. In 2000, the 315
resident infant deaths in Arkansas and 37,790 live births result in an infant death rate of
8.3.
MORTALITY RATE - Rate is age adjusted to U.S. 2000 population. Age adjustment is a
statistical technique for calculating mortality rates, enabling the direct comparison of
mortality rates between populations with different age distributions. Consequently, a
county with a very young population has no statistical advantage in the calculation of its
mortality rate over a county with many elderly. This report uses the Direct Method of age
standardization and the 2000 standard population. In 2000 the Arkansas Age Adjusted
Mortality Rate was 975.4 deaths per 100,000 standard population.
"CAUSE OF DEATH" in the MORTALITY SECTION is defined by the following ICD-9
codes:
Cause of Death ICD-10 Code(s)
HEART DISEASE I00-I109, I11, I13, I20-I51 - 429
CARDIOVASCULAR DISEASE I00-I78
CANCER C00-C97
LUNG CANCER C34
BREAST CANCER C50
CEREBROVASCULAR DISEASE I60-I69
MOTOR VEHICLE ACCIDENTS V02-V04, V09.0,V09.2,V12-V14,V19.0-V19.2,V19.4-V19.6
V20-V79,V80.3-V80.5,V81.0-V81.1,V82.0-V82.1,V83-V86,
V87.0-V87.8,V88.0-V89.0,V89.2
WORK RELATED INJURIES* NO ICD CODE
SUICIDE X60-X84,X87.0
HOMICIDE X85-Y09,Y87.1
* age > 16 and a death certificate specified injury at work
HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA Return to sectional headings page Return to main page
Data are taken from "Annual Review for Primary Medical Care" prepared by BHCDANET
Information System. As defined by the U.S. Health Resources and Services
Administration (HRSA), the definition of a HPSA consists of three major elements: 1) the
ratio of population to primary care physicians, 2) the distance to contiguous area medical
resources, and 3) areas of high need; this latter category is subdivided into whether or not
the geographic area has: i) 20 percent or more of the population living below the poverty
line, ii) a general fertility rate (number of live births divided by the number of women 15-
44 years of age) greater than 100, and iii) an infant mortality rate of 20.0 or greater.
HRSA recognizes three types of HPSAs (geographic, population group, and facility) for the
purpose of administering its programs. The number and percent of the county population
residing within the HPSA are reported.
MEDICALLY UNDERSERVED AREAS (MUA Return to sectional headings page Return to main page
In designating a Medically Underserved Area (MUA), the U.S. Health Resources and
Services Administration uses a weighted combination of four factors: 1) the percent of
the population living below the poverty line, 2) the percent of the population that is 65
years of age or older, 3) the infant mortality rate, and 4) the ratio of population to primary
care physicians (MDs). HRSA may designate an entire county or only part of a county to
be a Medically Underserved Area. The number and percent of the county population
residing within the MUA is reported.
HEALTH PROFESSIONALS Return to sectional headings page Return to main page
Data, released in 2001, are from the Health Professions Licensing Survey, 2001 prepared
by the Arkansas Department of Health in cooperation with the Arkansas Chiropractic
Board, Arkansas Dental Examiners, Arkansas medical Board, Arkansas Nursing board,
Arkansas Optometry Board, and Arkansas Social Work Board.
TOTAL PHYSICIANS - All medical doctors and osteopathic physicianslicensed to practice
in the state of Arkansas in 2001, who are not retired and are not residents or interns.
PRIMARY CARE PHYSICIANS - medical doctors and osteopathic physicians participating in
family practice, general practice, obstetrics/gynecology, or internal medicine.
TOTAL CHIROPRACTORS - All chiropractors licensed to practice in Arkansas in 2001.
TOTAL DENTAL - All dental professions are counted, including endodontics, general
dentistry, oral surgery, orthodontics, pediatric dentists, periodontics, prosthodontics,
dental assistants, and dental hygienists.
TOTAL OPTOMETRY - All optometrists licensed to practice in Arkansas in 2001.
TOTAL SOCIAL WORK - All social workers are counted, including social worker, certified
social worker, and master of social work.
TOTAL NURSING - All nurses are counted, including licensed practical nurses, licensed
psychiatric technician nurses, and registered nurses.
COMMUNITY HEALTH CENTER Return to sectional headings page Return to main page
A federally funded nonprofit system of health care under the direction of a community
board that provides a full range of primary and preventive health care services to the
entire community, regardless of financial resources. CHCs operate independently of ADH
Local Health Units. The data are provided by the ADH Office of Primary Care. CHC
encounters are a count of single patient visits, during which more than one service may
be provided.
LOCAL HEALTH UNITS Return to sectional headings page Return to main page
Arkansas is one of five states in the nation with a unified public health department. All
local public health is provided by the Arkansas Department of Health through 98 Local
Health Units with at least one unit in each of the 75 counties. The city in which the Local
Health Unit is located is reported along with the number of full-time-equivalent Public
Health Nurses (PHN), Sanitarians, Licensed Practical Nurses (LPN), Public Health
Technicians (PHT), Clerks, and Other staff. Local Health Unit encounters are the number
of separate services ("Primary Service Categories") provided to the patient. At this time,
each patient visit involves about 1.2 encounters; however, this ratio is rising with the
increased emphasis on the "one-stop-shopping" model of efficient service delivery. Data
are prepared by the Arkansas Department of Health.
Note that Community Health Centers and ADH Local Health Units define encounters
differently. The same patient may visit either a Community Health Center or an ADH
Local Health Unit more than once in a given year. Encounters at the ADH Local health
Units do not include "motor-voter registrations."
MEDICAL FACILITIES AND PROVIDERS Return to sectional headings page Return to main page
Data are taken from "Hospitals and Related Institutions Licensed by the Arkansas
Department of Health, 2001" prepared by the Arkansas Department of Health.
Released in June, 2001, data are the names and number
of beds of all medical facilities licensed by the Department of Health in each county.
These may include hospitals, outpatient surgical or psychiatric centers, home health agencies,
recuperation and rehabilitation facilities, hospices, abortion facilities, etc.
Individual providers (e.g., physicians) and, most notably, nursing homes are not included.
Facilities are reported by their ususal business name where that differs from the
official corporate identification.
EMERGENCY MEDICAL SERVICES Return to sectional headings page Return to main page
Data are taken from "EMS Ambulance Services" prepared by the Arkansas Department
of Health and released in July, 2001. Under the statutory definition, "Emergency
Medical Services (EMS) means that transportation and medical care provided the critically
ill or injured prior to arrival at a medical facility by a certified EMT (Emergency Medical
Technician)...". Reflecting its most commonly accepted sense, this report provides the
name and type of service of every organization providing transportation (usually
ambulance) and medical services in each county. Levels of services are defined by the
ADH Division of Emergency Medical Services and Trauma Systems; categories 1 and 8
are classified as advanced; category 4 is intermediate; category 9 is air; the remaining
categories are designated basic.
MAPS Return to sectional headings page Return to main page
Two maps are presented for each of the 75 Arkansas counties. These maps depict health
service "catchment areas" for each county, as determined by data from the birth and
death certificate files. The concept of catchment area assumes that most people obtain
their health care near home rather than traveling long distances. Consequently, most of
the births and deaths in Arkansas take place in the county where the individual resides.
In those cases where the county may not have the health and medical services the
individual needs, that individual may leave the county. Each map shows the percentage
of births or deaths of residents that each county "sends" to the county identified in the
title of the map. A county with very limited medical services (e.g., no hospitals) will
typically see most of its residents go to neighboring counties with the requisite facilities.
Counties with modest facilities will keep many of their residents in the county; such
counties may also attract people from neighboring counties even while losing most of their
residents to other counties. Counties with large, sophisticated tertiary-care facilities will
have regional or even statewide catchment areas, drawing patients from beyond their own
county borders.
For the purposes of these maps, the data make no distinction regarding whether the event
occurred in a medical facility or not. However, more than 99 percent of all Arkansas
births occurred in hospitals. About 56 percent of all deaths occurred in hospitals, 18
percent in nursing homes, 23 percent at a private residence, and 3 percent "other."
In addition, a map is provided which shows the location of each of the 75 counties of the
state and the five Arkansas Department of Health Public Health Regions.
PUBLIC HEALTH REGIONS
To ease the delivery of health services to various regions of the state, the Arkansas
Department of Health has five Public Health Regions.
Public Health Regions are groups of counties defined by geographic contiguity, ease of
transportation, and similarity of demographic characteristics and health problems.
Return to main page