STATE HEALTH IMPROVEMENT PLAN 2021-2025
Eight Priority Areas (Click on the Links to view the Scorecards)
- Disease Transmission and Vaccination
- Access to Care
- Public Health Workforce Development
- Health Education
- Social Determinants of Health
- Addiction/Mental Health/Suicide
- Maternal and Infant Health
- Obesity
Result: Click on the 'note' icon to view detailed information.
Indicator: Click on the 'plus' sign to view detailed information.
Strategies and Measurable Objectives
In 2019-2020, the ADH recruited over 70 partners from within the Agency and outside to form an initial planning team to identify state health improvement areas and develop ideas for strategies and objectives within each area. During phase one, the planning team formed workgroups and determined eight priority areas for the state level health improvement. Each priority area is presented as a Result (R) in the Result section of this Scorecard.
Phase two had consisted of working on the ideas for strategies and objectives and later formalizing the ideas for approval. However, due to the COVID-19 pandemic, phase two was substantially delayed. In 2022, a new Planning and Implementation Team, with incumbent and new members, will convene to build on the ideas presented by the old team. The Planning Group will finalize strategies, objectives, activities, and collaborative partners within each area and implement the SHIP.
The Scorecard will be updated as these developments occur.
Policy Agenda
To be determined by the new Planning and Implementation Team.
Additional Data Needed/Potential Indicators
To be determined by the new Planning and Implementation Team.
Workgroup Members
In 2022, the new Planning and Implementation Team will form workgroup for each priority area for monitoring implementation and reporting.
Workgroup Action Plan
Will be developed by workgroups.
SHIP Partners
Only two partners were suggested by the planning team, state below.
- Arkansas Department of Health
- University of Arkansas Medical School
Why Is This Important?
Every year in the United States, many people get diseases that vaccines can prevent. Healthy People 2030 focuses on preventing infectious diseases by increasing vaccination rates. Infants and children need to get vaccinated to prevent diseases like hepatitis, measles, and pertussis. Though most children get recommended vaccines, some U.S. communities have low vaccination coverage that puts them at risk for outbreaks. Strategies to make sure more children get vaccinated — like requiring vaccination for children who are in school — are key to reducing rates of infectious diseases.
Adolescents, adults, and older adults also need vaccines. For example, adolescents need the HPV (human papillomavirus) vaccine, older adults need vaccines to help prevent pneumonia, and almost everyone age 6 months and older needs a yearly flu vaccine. Teaching people about the importance of vaccines, sending vaccination reminders, and making it easier to get vaccines can help increase vaccination rates in adolescents and adults.
Source: https://health.gov/healthypeople
Strategies and Measurable Objectives
In 2019-2020, the ADH recruited over 70 partners from within the Agency and outside to form an initial planning team to identify state health improvement areas and develop ideas for strategies and objectives within each area. During phase one, the planning team formed workgroups and determined eight priority areas for the state level health improvement. Each priority area is presented as a Result (R) in the Result section of this Scorecard.
Phase two had consisted of working on the ideas for strategies and objectives and later formalizing the ideas for approval. However, due to the COVID-19 pandemic, phase two was substantially delayed. In 2022, a new Planning and Implementation Team, with incumbent and new members, will convene to build on the ideas presented by the old team. The Planning Group will finalize strategies, objectives, activities, and collaborative partners within each area and implement the SHIP.
The Scorecard will be updated as these developments occur.
Policy Agenda
To be determined by the new Planning and Implementation Team.
Additional Data Needed/Potential Indicators
To be determined by the new Planning and Implementation Team.
Workgroup Members
In 2022, the new Planning and Implementation Team will form workgroup for each priority area for monitoring implementation and reporting.
Workgroup Action Plan
Will be developed by workgroups.
SHIP Partners
- AR American Association of Retired Persons (AARP)
- AR Center for Health Improvement (ACHI)
- AR Department of Health
- AR Emergency Medical Services Advisory Council
- AR Emergency Medical Technicians Association
- AR Hospital Association
- AR Rural Health Partnership
- AR State Dental Association
- AR Trauma Advisory Council
- Arkansas STEMI Advisory Council
- Chambers of Commerce
- Employers
- Faith-Based Organizations
- Healthcare Payors Rupa - not sure what is meant by this? Third Party Payers?
- Local Volunteer Fire Departments
- Public Safety Answering Points (911 Call Centers)
- Schools
Resources
Why Is This Important?
What is rural health?
According to U.S Census Data almost 44 percent of Arkansans live in rural areas. According to the definition for rural that the United States Office of Budget and Management uses, 53 of the 75 counties in Arkansas are considered rural. However, there are rural areas even in counties that are not defined as rural counties.
Why is rural health important to Arkansas?
In many ways people who live in Arkansas’s rural areas have the same barriers to good health as people who live in Arkansas’s cities. However, they may also experience barriers that people who live in cities may not. For example, people who live in rural counties have higher rates of chronic diseases and are more likely to be involved in serious accidents. Yet people who live in rural areas must travel greater distances to see a doctor or go to the hospital. In some rural counties, there are no hospitals. People who live in rural counties also tend to have shorter life expectancies. Babies in those counties tend to have higher infant death rates. And the people there are more likely to struggle with low health literacy.
Low Access to Health Care
People in rural Arkansas have greater difficulty getting the health care they need compared to those who live in the non-rural counties. One reason they have difficulty getting health care is because of the cost. In general, 15.3 percent of Arkansans report that they were not able to see a doctor in the past 12 months due to the cost, compared to 13 percent in the United States. However, in many rural counties, more than 20 percent of residents were not able to see a doctor due to cost. Lack of health insurance makes the cost of seeing a doctor hard, if not impossible to afford. In Arkansas 25 percent of working-age adults have no health insurance. In many rural counties it is even higher.
A second reason that people who live in rural Arkansas find it hard to get health care is that there is a shortage of health care on hand in their communities. For example, 39 counties in Arkansas have only one hospital and 19 counties have no hospital at all.
Many of the rural counties in Arkansas have been named as Medically Underserved Areas (MUA) by the Health Services and Resources Administration of the United States government. A Medically Underserved Area is a part of a county, a whole county or a group of nearby counties in which the residents have a shortage of personal health services. Here is a map that shows the Medically Underserved Areas in Arkansas.
There is also a general shortage of primary care doctors in Arkansas. This shortage can be especially great in the rural areas. Primary care doctors can be doctors who work in general practice medicine, family medicine, internal medicine, pediatrics, or obstetrics and gynecology. The rural areas in Arkansas have 73 primary care doctors for every 100,000 residents, while in the cities there are 133 primary care doctors for every 100,000 residents. Some of the rural areas have a more severe shortage than others. In the delta area of eastern Arkansas, there are only 61 primary care doctors for every 100,000 residents.
Source: Arkansas State Health Assessment, 2020
Strategies and Measurable Objectives
In 2019-2020, the ADH recruited over 70 partners from within the Agency and outside to form an initial planning team to identify state health improvement areas and develop ideas for strategies and objectives within each area. During phase one, the planning team formed workgroups and determined eight priority areas for the state level health improvement. Each priority area is presented as a Result (R) in the Result section of this Scorecard.
Phase two had consisted of working on the ideas for strategies and objectives and later formalizing the ideas for approval. However, due to the COVID-19 pandemic, phase two was substantially delayed. In 2022, a new Planning and Implementation Team, with incumbent and new members, will convene to build on the ideas presented by the old team. The Planning Group will finalize strategies, objectives, activities, and collaborative partners within each area and implement the SHIP.
The Scorecard will be updated as these developments occur.
Policy Agenda
To be determined by the new Planning and Implementation Team.
Additional Data Needed/Potential Indicators
The following performance and outcome indicators suggested by the 2019-2020 planning team will be considered by the new Planning and Implementation Team.
- Number of all public health degree programs through higher education institutions
- Number of all public health courses through higher education institutions
- Number of persons and demographics of who have completed public health programs and courses at a higher educational level
- Number of non-traditional, non-degreed related trainings in public health
- Number of traditional and non-traditional audiences to receive training in public health (school boards, faith-based, teachers, etc.) on topics such as careers, public health issues, resources, etc.
Workgroup Members
In 2022, the new Planning and Implementation Team will form workgroup for each priority area for monitoring implementation and reporting.
Workgroup Action Plan
Will be developed by workgroups.
SHIP Partners
- Arkansas Center for Health Improvement
- Arkansas Department of Education
- Arkansas Department of Health
- Arkansas Foundation for Medical Care
- Arkansas Hospital Association
- Arkansas Public Health Association
- Association of Schools & Programs of Public Health
- University of Akansas Medical School (UAMS) College of Public Health
Resources
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Data for Decisions: Collect needed data about workforce gaps and training needs to inform decisions about public health workforce development.
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Crosscutting Competencies: Promote essential crosscutting skills to complement public health workers’ discipline-specific skills.
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Quality Standards for Training: Use accepted education and training standards to guide investments towards high quality products.
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Training Decision Tools and Access: Provide tools for public health workers to define their training needs and locate high-quality trainings that address these needs.
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Funding Integration: Integrate workforce development into funding requirements to build workforce capacity and improve program outcomes.
The Division of Scientific Education and Professional Development (DSEPD) strengthens and develops the public health workforce, America’s first line of defense against disease outbreaks and other health threats. The DSEPD takes an evidence-based and collaborative approach to strengthening and developing the public health workforce. Our activities support COVID-19 and future emergency responses, data modernization, and diversity, equity, and inclusion in public health. We focus on proactive program planning and development so that we are ready to respond when new needs arise, building on our existing programs, experiences, and lessons learned.
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Recruit: Attract a More Diverse and Qualified Public Health Sciences Workforce
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Train: Build the Skills of the Current and Future Workforce
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Forecast: Plan for Tomorrow’s Workforce through Our Actions Today
Key outcomes from the Fifth Annual Report of Diversity in the Arkansas Health Care Workforce include:
- The majority of workers in health occupations are male including physicians, dentists, optometrists, chiropractors and podiatrists. Dental hygienists (99 percent female), dieticians (96 percent female), specialty surgeons (93 percent male), licensed practical nurses (93 percent female), and speech therapists (96 percent female) were occupations with less than 10 percent in a gender field. Pharmacists and physical therapists enjoyed the most equity in terms of gender.
- Each profession was predominately white. In fact, there were only six professions (i.e., general physicans, speciality physicians, nurses (LPN, RN and Specialty nurses), pharmacists, podiatrists and social workers) in which the proportion of white workers was less than 90 percent. Optometrists were 97 percent white, making them the least diverse profession with respect to race, whereas social workers were 77 percent white and 19 percent African American, making them the most diverse group in 2018. Race was not available for dental assistants at the time of reporting.
- Geographic distribution followed a similar pattern for most professions. The highest concentration of workers tended to be in the central, northwest and northeast regions of the state (i.e., the more urban areas of the state). Some professions were absent in a large number of counties. Specialty surgeons, for example, lacked active professionals in 45 counties, and general surgeons lacked professionals in 28 counties. Other professions enjoyed much greater dispersion. For example, pharmacists, physical therapists and social workers appeared to be active in all 75 counties.
- Despite the legislative mandate requiring licensing boards to capture and report data on demographic characteristics of those licensed in Arkansas, data were not consistently provided. Three of the seventeen healthcare professions covered in this report failed to report some or all of the required demographic data, compared to 3/17 in 2017, 4/17 in 2016 and 7/17 in 2015.
Why Is This Important?
Public health infrastructure provides communities, states, and the nation with the capacity to prevent disease, promote health, and prepare for and respond to both ongoing challenges and emerging threats to health. Essential public health services depend on the presence of a basic infrastructure, including a trained and competent workforce, strong data and information systems, and public health organizations that can assess and respond to community health needs. While a strong infrastructure depends on many partners, government public health agencies and health departments play a central role in a solid public health infrastructure.
Source: https://health.gov/healthypeople/about/workgroups/public-health-infrastructure-workgroup
The goal of SHIP is to advance health outcomes of Arkansans by providing a strong and diverse public health workforce. This will be accomplished by employing meaningful strategies by first ascertaining the strengths and gaps of the current workforce.
Strategies and Measurable Objectives
In 2019-2020, the ADH recruited over 70 partners from within the Agency and outside to form an initial planning team to identify state health improvement areas and develop ideas for strategies and objectives within each area. During phase one, the planning team formed workgroups and determined eight priority areas for the state level health improvement. Each priority area is presented as a Result (R) in the Result section of this Scorecard.
Phase two had consisted of working on the ideas for strategies and objectives and later formalizing the ideas for approval. However, due to the COVID-19 pandemic, phase two was substantially delayed. In 2022, a new Planning and Implementation Team, with incumbent and new members, will convene to build on the ideas presented by the old team. The Planning Group will finalize strategies, objectives, activities, and collaborative partners within each area and implement the SHIP.
The Scorecard will be updated as these developments occur.
Policy Agenda
To be determined by the new Planning and Implementation Team.
Additional Data Needed/Potential Indicators
The following performance and outcome indicators suggested by the 2019-2020 planning team will be considered by the new Planning and Implementation Team.
- Number of providers with health literacy training/competencies
- Percent of students K-12 aware of health topics
Workgroup Members
In 2022, the new Planning and Implementation Team will form workgroup for each priority area for monitoring implementation and reporting.
Workgroup Action Plan
Will be developed by workgroups.
SHIP Partners
- Arkasnas Coalition for Obesity Prevention (ArCOP)
- Arkansas Community Health Worker Association
- Arkansas Farm Bureau
- Arkansas Legislators
- Arkansas Department of Health
- Child Health Advisory Committee (CHAC)
- Churches
- Educational Cooperatives
- Foundations
- Health Ambassadors
- Healthy Active Arkansas
- Public Libraries
- Retired professionals
- School District Wellness Committees
- University of Arkansas Cooperative Extension Service
- University of Arkansas Medical School (UAMS) Center for Health Literacy
- University of Arkansas Medical School (UAMS) College of Public Health
Resources
From: https://health.gov/our-work/national-health-initiatives/healthy-people/healthy-people-2030/health-literacy-healthy-people-2030
Health literacy is a central focus of Healthy People 2030. One of the initiative’s overarching goals demonstrates this focus: “Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.”
Six Healthy People objectives — developed by the Health Communication and Health Information Technology Workgroup — are related to health literacy:
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Increase the proportion of adults whose health care provider checked their understanding
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Decrease the proportion of adults who report poor communication with their health care provider
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Increase the proportion of people who say their online medical record is easy to understand
How does Healthy People define health literacy?
Healthy People 2030 addresses both personal health literacy and organizational health literacy and provides the following definitions:
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Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
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Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
These definitions are a change from the health literacy definition used in Healthy People 2010 and Healthy People 2020: “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” The new definitions:
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Emphasize people’s ability to use health information rather than just understand it
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Focus on the ability to make “well-informed” decisions rather than “appropriate” ones
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Incorporate a public health perspective
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Acknowledge that organizations have a responsibility to address health literacy
Learn more about the history of Healthy People’s health literacy definitions.
Personal health literacy
Healthy People 2030’s definition of personal health literacy is aligned with the concept that people’s health literacy can be assessed at a given point in time. Such a definition is important for conducting both population studies and research on interventions aimed at ensuring equal access to information and services for people with limited literacy skills.
The new definition — with its emphasis on the use of health information and its public health perspective — may also prompt new ways of studying and promoting personal health literacy. In addition, it encourages efforts to address the skills that help people move from understanding to action and from a focus on their own health to a focus on the health of their communities.
Organizational health literacy
By adopting a definition for organizational health literacy, Healthy People acknowledges that personal health literacy is contextual and that producers of health information and services have a role in improving health literacy. The definition also emphasizes organizations’ responsibility to equitably address health literacy, in line with Healthy People 2030’s overarching goals.
In addition, including a definition for organizational health literacy in Healthy People aligns with the HHS National Action Plan to Improve Health Literacy.
From: https://health.gov/our-work/national-health-initiatives/health-literacy/national-action-plan-improve-health-literacy
National Action Plan to Improve Health Literacy
The National Action Plan to Improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked, multi-sector effort to improve health literacy. The Action Plan is based on 2 core principles:
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All people have the right to health information that helps them make informed decisions
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Health services should be delivered in ways that are easy to understand and that improve health, longevity, and quality of life
The Action Plan contains 7 goals that will improve health literacy and strategies for achieving them:
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Develop and disseminate health and safety information that is accurate, accessible, and actionable
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Promote changes in the health care system that improve health information, communication, informed decision-making, and access to health services
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Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level
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Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community
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Build partnerships, develop guidance, and change policies
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Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy
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Increase the dissemination and use of evidence-based health literacy practices and interventions
Many of the strategies highlight actions that particular organizations or professions can take to further these goals. It will take everyone working together in a linked and coordinated manner to improve access to accurate and actionable health information and usable health services. By focusing on health literacy issues and working together, we can improve the accessibility, quality, and safety of health care; reduce costs; and improve the health and quality of life of millions of people in the United States.
Download Full PDF [617KB] Download Summary PDF [251KB]
Suggested Citation
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). National Action Plan to Improve Health Literacy. Washington, DC: Author.
Footnotes
1 Nielsen-Bohlman, L., Panzer, A. M., & Kindig, D. A. (Eds.). (2004). Health literacy: A prescription to end confusion.Washington, DC: National Academies Press.
2 Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America's adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006-483). Washington, DC: U.S. Department of Education, National Center for Education Statistics.
3 Rudd, R. E., Anderson, J. E., Oppenheimer, S., & Nath, C. (2007). Health literacy: An update of public health and medical literature. In J. P. Comings, B. Garner, & C. Smith. (Eds.), Review of adult learning and literacy (vol. 7) (pp 175–204). Mahwah, NJ: Lawrence Erlbaum Associates.
4 U.S. Department of Health and Human Services. (2000). Healthy People 2010 (2nd ed.) [with Understanding and Improving Health (vol. 1) and Objectives for Improving Health (vol. 2)]. Washington, DC: U.S. Government Printing Office.
5 Berkman, N. D., DeWalt, D. A., Pignone, M. P., Sheridan, S. L., Lohr, K. N., Lux, L., et al. (2004). Literacy and health outcomes(AHRQ Publication No. 04-E007-2). Rockville, MD: Agency for Healthcare Research and Quality.
Why Is This Important?
Addressing health literacy by improving skills among current and future health professionals as well as consumers will position ADH to make progress in its range of strategic health priorities.
Low health literacy is a problem because it can lead to poor health and poor quality of life. People who struggle to understand and use health information are more likely to have less knowledge about diseases and conditions and to have serious health problems. This is because people with low health literacy are less likely to understand and follow their doctors’ orders. They are less likely to take their medicine the right way and less likely to get the preventive health services they need before they get sick. So, they are more likely to have serious complications from chronic diseases, such as obesity, asthma, diabetes, or heart failure. They are likely to have more emergency room visits, more (or longer) hospital stays, a shorter life expectancy, and higher medical costs. Source: 2019-2020 Planning Team.
Only 1 in 10 adults in the U.S. has proficient health literacy skills. Efforts must be undertaken to improve individual patient and consumer skills and to lessen the demands placed on patients and consumers by health care systems and other communicators of health information. Source: https://health.gov/our-work/national-health-initiatives/healthy-people/healthy-people-2030/health-literacy-healthy-people-2030
Further, health literacy is a central focus of Healthy People 2030. One of the initiative’s overarching goals demonstrates this focus: “Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.” Healthy People 2030 addresses both personal health literacy and organizational health literacy and provides the following definitions:
-
Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
-
Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
These definitions are a change from the health literacy definition used in Healthy People 2010 and Healthy People 2020: “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” The new definitions follows: Emphasize people’s ability to use health information rather than just understand it; focus on the ability to make “well-informed” decisions rather than “appropriate” ones; incorporate a public health perspective; and acknowledge that organizations have a responsibility to address health literacy
Strategies and Measurable Objectives
In 2019-2020, the ADH recruited over 70 partners from within the Agency and outside to form an initial planning team to identify state health improvement areas and develop ideas for strategies and objectives within each area. During phase one, the planning team formed workgroups and determined eight priority areas for the state level health improvement. Each priority area is presented as a Result (R) in the Result section of this Scorecard.
Phase two had consisted of working on the ideas for strategies and objectives and later formalizing the ideas for approval. However, due to the COVID-19 pandemic, phase two was substantially delayed. In 2022, a new Planning and Implementation Team, with incumbent and new members, will convene to build on the ideas presented by the old team. The Planning Group will finalize strategies, objectives, activities, and collaborative partners within each area and implement the SHIP.
The Scorecard will be updated as these developments occur.
Policy Agenda
To be determined by the new Planning and Implementation Group.
Additional Data Needed/Potential Indicators
The following performance and outcome indicators suggested by the 2019-2020 planning team will be considered by the new Planning and Implementation Team.
- Number of communities involved in planning for healthier environments
- Number of programs/initiatives/services that address health equity explicitly
- Percent of students with healthy habits/behaviors throughout school
- Percent of adults with healthy habits/behaviors throughout life
Workgroup Members
In 2022, the new Planning and Implementation Team will form workgroup for each priority area for monitoring implementation and reporting.
Workgroup Action Plan
Will be developed by workgroups.
SHIP Partners
- Arkansas Department of Education
- Arkansas Department of Finance
- Arkansas Department of Health
- Arkansas Department of Human Services
- Arkansas Equal Employment Opportunity Commission
- Arkansas Foundation for Medical Care
- Arkansas Minority Health Commission
- Board of Health Members
- County Health Officers
- Current identified city and county health community champions
- Local faith-based leaders
Resources
Why Is This Important?
Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
SDOH can be grouped into 5 domains:
- Economic Stability
- Education Access and Quality
- Health Care Access and Quality
- Neighborhood and Built Environment
- Social and Community Context
Social determinants of health (SDOH) have a major impact on people’s health, well-being, and quality of life. Examples of SDOH include:
- Safe housing, transportation, and neighborhoods
- Racism, discrimination, and violence
- Education, job opportunities, and income
- Access to nutritious foods and physical activity opportunities
- Polluted air and water
- Language and literacy skills
SDOH also contribute to wide health disparities and inequities. For example, people who don't have access to grocery stores with healthy foods are less likely to have good nutrition. That raises their risk of health conditions like heart disease, diabetes, and obesity — and even lowers life expectancy relative to people who do have access to healthy foods.
Just promoting healthy choices won't eliminate these and other health disparities. Instead, public health organizations and their partners in sectors like education, transportation, and housing need to take action to improve the conditions in people's environments.
Souce: https://health.gov/healthypeople/objectives-and-data/social-determinants-health and https://health.gov/healthypeople/about/workgroups/social-determinants-health-workgroup
Strategies and Measurable Objectives
Plan for Development of Final Strategies and SMART* Objectives
The COVID-19 pandemic has delayed the work on the action plans for each of the priority areas of the SHIP. Initial work was done by a planning team for this priority area that met in 2019-2020 to come up with initial strategy ideas and potentail measures for the work to be done both at a statewide level and by the Arkansas Department of Health. A workgroup that will be created in 2022 will build on the work of the planning team and formulate an action plan for this priority area that will include statewide strategies and performance measures. The workgroup will identify and communicate with relevant partners, oversee implementation, monitor progress. and provide regular reports. .
*A SMART objective is one that is SPECIFIC, MEASURABLE, ACHIEVABLE, RELEVANT, AND TIME-BOUND.
The strategies, performance measures, and action plan will be added to the Scorecard once developed by the workgroup.
Policy Agenda
Additional Data Needed/Potential Indicators
Workgroup Members
Workgroup Action Plan
SHIP Partners
- American Heart Association - AR chapters
- AR American Association of Retired Persons (AARP) Rupa, they did not have these 3 that I have highlighted listed for this priority area but I wondered if they should be here - you can decided.
- AR Center for Health Improvement (ACHI)
- AR Department of Health
- AR Rural Health Partnership
- AR State Dental Association
- Chambers of Commerce
- Employers
- Faith-Based Organizations
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Healthcare Payors
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Schools
Rupa, they also had these below listed, but I wasn't sure they made sense given the topic so you can decide if they should be included:
- AR Ambulance Association
- AR Emergency Medical Services Advisory Council
- AR Trauma Advisory Council
- Local Volunteer Fire Departments
- Public Safety Answering Points (911 Call Centers)
Resources
Why Is This Important?
What is rural health?
According to U.S Census Data almost 44 percent of Arkansans live in rural areas. According to the definition for rural that the United States Office of Budget and Management uses, 53 of the 75 counties in Arkansas are considered rural. However, there are rural areas even in counties that are not defined as rural counties.
Why is rural health important to Arkansas?
In many ways people who live in Arkansas’s rural areas have the same barriers to good health as people who live in Arkansas’s cities. However, they may also experience barriers that people who live in cities may not. For example, people who live in rural counties have higher rates of chronic diseases and are more likely to be involved in serious accidents. Yet people who live in rural areas must travel greater distances to see a doctor or go to the hospital. In some rural counties, there are no hospitals. People who live in rural counties also tend to have shorter life expectancies. Babies in those counties tend to have higher infant death rates. And the people there are more likely to struggle with low health literacy.
Low Access to Health Care
People in rural Arkansas have greater difficulty getting the health care they need compared to those who live in the non-rural counties. One reason they have difficulty getting health care is because of the cost. In general, 15.3 percent of Arkansans report that they were not able to see a doctor in the past 12 months due to the cost, compared to 13 percent in the United States. However, in many rural counties, more than 20 percent of residents were not able to see a doctor due to cost. Lack of health insurance makes the cost of seeing a doctor hard, if not impossible to afford. In Arkansas 25 percent of working-age adults have no health insurance. In many rural counties it is even higher.
A second reason that people who live in rural Arkansas find it hard to get health care is that there is a shortage of health care on hand in their communities. For example, 39 counties in Arkansas have only one hospital and 19 counties have no hospital at all.
Many of the rural counties in Arkansas have been named as Medically Underserved Areas (MUA) by the Health Services and Resources Administration of the United States government. A Medically Underserved Area is a part of a county, a whole county or a group of nearby counties in which the residents have a shortage of personal health services. Here is a map that shows the Medically Underserved Areas in Arkansas.
There is also a general shortage of primary care doctors in Arkansas. This shortage can be especially great in the rural areas. Primary care doctors can be doctors who work in general practice medicine, family medicine, internal medicine, pediatrics, or obstetrics and gynecology. The rural areas in Arkansas have 73 primary care doctors for every 100,000 residents, while in the cities there are 133 primary care doctors for every 100,000 residents. Some of the rural areas have a more severe shortage than others. In the delta area of eastern Arkansas, there are only 61 primary care doctors for every 100,000 residents.
Source: Arkansas State Health Assessment, 2020
Strategies and Measurable Objectives
In 2019-2020, the ADH recruited over 70 partners from within the Agency and outside to form an initial planning team to identify state health improvement areas and develop ideas for strategies and objectives within each area. During phase one, the planning team formed workgroups and determined eight priority areas for the state level health improvement. Each priority area is presented as a Result (R) in the Result section of this Scorecard.
Phase two had consisted of working on the ideas for strategies and objectives and later formalizing the ideas for approval. However, due to the COVID-19 pandemic, phase two was substantially delayed. In 2022, a new Planning and Implementation Team, with incumbent and new members, will convene to build on the ideas presented by the old team. The Planning Group will finalize strategies, objectives, activities, and collaborative partners within each area and implement the SHIP.
The Scorecard will be updated as these developments occur.
Policy Agenda
To be determined by the new Planning and Implementation Team.
Additional Data Needed/Potential Indicators
To be determined by the new Planning and Implementation Team.
Workgroup Members
In 2022, the new Planning and Implementation Team will form workgroup for each priority area for monitoring implementation and reporting.
Workgroup Action Plan
Will be developed by workgroups.
SHIP Partners
- American Cancer Society, Arkansas
- American Lung Association, Arkansas
- Arkansas American Association of Retired Persons (AARP)
- Arkansas Center for Health Improvement (ACHI)
- Arkansas Children's
- Arkansas Department of Health
- Arkansas Department of Human Services
- Arkansas Foundation for Medical Care
- Arkansas Medical Society
- Arkansas Pharmacists Association
- Arkansas Rural Health Partnership
- Arkansas State Board of Nursing
- Arkansas State Board of Pharmacy
- Arkansas State Crime Laboratory
- Arkansas State Dental Association
- Arkansas State Medical Board
- Arkansas State Police
- Attorney General's Office
- Blue Cross/Blue Shield
- County fairs
- Drug Courts
- Grocery stores/Pharmacies
- Healthcare Payors
- Local Volunteer Fire Departments
- Public Safety Answering Points (911 Call Centers)
- Schools
- State Drug Director's Office
- Tobacco Coalitions
- University of Arkansas at Little Rock - Midsouth
- University of Arkansas Medical School (UAMS)
- US Drug Enforcement Agency - Arkansas
- Pine Bluff VA church projects
Resources
Why Is This Important?
Tobacco
The use of tobacco is the most preventable cause of death in Arkansas. Tobacco use kills close to 5,000 people in Arkansas each year, which makes it one of the biggest causes of short life expectancy in our state. By tobacco use, we mean smoking cigarettes, cigars, pipes, e-cigarettes, or using any form of smokeless tobacco.
Smoking damages nearly every organ of the body and can affect non-smokers as well. Exposure to secondhand smoke is responsible for 41,000 deaths among U.S. adults every year.
While the use of cigarettes, cigars, pipe tobacco and smokeless tobacco has declined among youth in recent years, this decline has been countered with increases in the use of other emerging tobacco products, especially electronic cigarettes. Commonly known as e-cigs or vape pens, electronic cigarettes are now the most commonly used tobacco product among youth, surpassing cigarettes in 2014.
Youth are particularly vulnerable to peer pressure and tobacco companies’ strategies to get tobacco users hooked early, such as flavored tobacco products. Nearly 9 in 10 cigarette smokers have their first cigarette by age 18. Each day in the U.S., about 1,600 youth smoke their first cigarette, and 200 youth become everyday smokers. An estimated 5.6 million youth under age 18 today will die prematurely from diseases caused by long-term tobacco use later in life. Further, smoking is responsible for approximately $170 billion in health care expenditures and an additional $156 billion in lost productivity annually in the U.S.
Alcohol
Excessive drinking comes with short- and long-term risks. Short-term risks include:
- Unintentional injuries such as falls, drownings, burns and motor vehicle accidents.
- Violence such as homicide, suicide and sexual assault.
- Alcohol poisoning.
- Poor decision-making and engagement in risky behaviors such as unprotected sex.
Long-term risks include:
- Hypertension, heart disease, stroke and liver disease.
- Cancer of the breasts, mouth, throat, esophagus, liver or colon.
- Alcohol dependence.
- Memory and learning problems.
Death rates from excessive drinking increased significantly between 2000 and 2019. An estimated 95,000 people die every year from alcohol-attributable causes, making it the third-leading preventable cause of death in the United States, behind tobacco and poor diet/physical inactivity. Excessive drinking is responsible for an average of 261 deaths per day, which is equal to 2.8 million years of potential life lost per year.
Drug Dependency
Drug misuse and addiction have become serious public health issues for the United States over the past twenty years. The misuse of prescription drugs means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a medical complaint such as pain; or taking a medication to get high. Addiction is a brain disease that causes a person to continuously uses drugs even though this may create life problem like keeping relationships, or managing their social and professional responsibilities. A person with the disease of addiction is often described as having a substance use disorder. Both misuse and addiction carry the risk of overdose and death. Over 500,000 people have died as a result of drug overdoses since 1999. In 2016, over 60,000 Americans died from drug overdoses making overdoses cause more deaths than motor vehicle crashes. This is more than any other previous year on record. Multiple types of drugs are creating the overall problem with drug misuse and addiction. Prescription opioids and illicit opioids (like heroin and illicit fentanyl) are the most common and potentially most deadly. In 2016, 66% of all drug overdose deaths in the United States were due to an opioid.
Just like the United States, Arkansas has also seen a rise in drug overdoses in recent years. In 2018, 426 Arkansans died from a drug overdose and opioids were the most widely identified drug. Methamphetamine (“Meth”), benzodiazepines (“Benzos”), and antidepressants are other commonly misused drugs in our state. In 2017, the prescribing rate for opioids in Arkansas was the second highest in the nation. There were more prescriptions for opioids in the state than there were people. High levels of prescription opioids available create more opportunities for misuse and addiction among those at risk.
The biggest danger of drug use is the likelihood of drug overdose or death, but there are also other dangers. Using drugs can spread infections. Infections happen when harmful germs get into your body and make you sick. Infections like Hepatitis C virus (HCV, a liver infection), human immunodeficiency virus (HIV), endocarditis (heart valve infection), osteomyelitis (bone infection), and many others are spread by drug use. There are many known ways to use drugs. Injecting drugs with needles into the vein (“shooting up”) is becoming more frequent. Shooting up drugs and sharing injection equipment (needles, cottons, and/or cookers) is a common way to get these infections. It also can put someone at risk for an overdose or death. These infections can kill and they are on the rise in Arkansas and in the United States.
Strategies and Measurable Objectives
Plan for Development of Final Strategies and SMART* Objectives
The COVID-19 pandemic has delayed the work on the action plans for each of the priority areas of the SHIP. Initial work was done by a planning team for this priority area that met in 2019-2020 to come up with initial strategy ideas and potentail measures for the work to be done both at a statewide level and by the Arkansas Department of Health. A workgroup that will be created in 2022 will build on the work of the planning team and formulate an action plan for this priority area that will include statewide strategies and performance measures. The workgroup will identify and communicate with relevant partners, oversee implementation, monitor progress. and provide regular reports. .
*A SMART objective is one that is SPECIFIC, MEASURABLE, ACHIEVABLE, RELEVANT, AND TIME-BOUND.
The strategies, performance measures, and action plan will be added to the Scorecard once developed by the workgroup.
Policy Agenda
To be determined by the workgroup.
Workgroup Members
Workgroup Members
To be determined by the workgroup.
Workgroup Action Plan
To be determined by the workgroup.
SHIP Partners
- American Foundation for Suicide Prevention
- Arkansas Children’s
- AR Department of Health
- Arkansas Department of Veteran Affairs
- AR Minority Health Commission
- Central Arkansas Veterans Healthcare System
- Suicide Prevention Partners
- University of Arkansas at Little Rock-Midsouth
Resources
Why Is This Important?
A healthy mental state is essential to overall positive health and well-being. In some cases, poor mental health may lead to suicide. Frequent mental distress is associated with smoking, physical inactivity, housing insecurity, food insecurity and insufficient sleep.
Mental health disorders and substance use disorders are the most significant risk factors for suicidal behaviors. In addition, environmental factors such as stressful life events and access to lethal means such as firearms or drugs may increase the risk of suicide. Previous suicide attempts and a family history of suicide are also important risk factors.
Suicide is when someone dies by intentionally hurting themselves. Death from suicide is the leading injury-related cause of death in Arkansas. In 2017, more than 600 Arkansans died from suicide. The most common means of suicide are from firearms, suffocation, and poisoning. The chart below shows the rates of suicide in Arkansas are consistently higher when compared to the United States.
Unfortunately, the rates of suicide in Arkansas are increasing. Over the last 10 years, the number of people who died from suicide went from 447 in 2008 to 631 in 2017.
https://www.americashealthrankings.org/explore/annual/measure/Suicide/state/ALL
https://www.americashealthrankings.org/explore/annual/measure/mental_distress
SHA 2020
Strategies and Measurable Objectives
In 2019-2020, the ADH recruited over 70 partners from within the Agency and outside to form an initial planning team to identify state health improvement areas and develop ideas for strategies and objectives within each area. During phase one, the planning team formed workgroups and determined eight priority areas for the state level health improvement. Each priority area is presented as a Result (R) in the Result section of this Scorecard.
Phase two had consisted of working on the ideas for strategies and objectives and later formalizing the ideas for approval. However, due to the COVID-19 pandemic, phase two was substantially delayed. In 2022, a new Planning and Implementation Team, with incumbent and new members, will convene to build on the ideas presented by the old team. The Planning Group will finalize strategies, objectives, activities, and collaborative partners within each area and implement the SHIP.
The Scorecard will be updated as these developments occur.
Policy Agenda
To be determined by the new Planning and Implementation Team.
Additional Data Needed/Potential Indicators
To be determined by the workgroup.
Workgroup Members
In 2022, the new Planning and Implementation Team will form workgroup for each priority area for monitoring implementation and reporting.
Workgroup Action Plan
To be determined by the workgroup.
SHIP Partners
- American Cancer Society in Arkansas
- American Foundation for Suicide Prevention - AR Chapter
- American Lung Association - AR Chapter
- Arkansas Center for Health Improvement
- Arkansas Chapter American Academy of Pediatrics
- Arkansas Department of Health
- Arkansas Department of Human Services, Division of Children & Family Services
- Arkansas Medicaid
- Arkansas Attorney General
- Arkansas Children's
- Arkansas Department of Health (ADH)
- Arkansas Foundation for Medical Care (AFMC)
- Arkansas Hospital Association
- Arkansas Medical, Dental and Pharmaceutical Association, Inc. (AMDPA)
- Be Well Arkansas Smoking Cessation Call Center
- Brothers and Sisters United
- Community Mental Health Centers
- Federally Qualified Health Centers
- insurance providers
- Junior League
- LAMMICO Medical Malpractice Insurance Company
- Merck for Mothers
- State Drug Director
- Teen influencers
- University of Arkansas Little Rock (UALR) Midsouth
- University of Arkansas for Medical Sciences (UAMS)
- Walton Family Foundation
Resources
Why Is This Important?
Infant Mortality
Infant mortality is a way of looking at the number of babies who die each year before they reach their first birthday. It is usually defined as the number of babies who die out of every 1,000 babies who are born alive. Infant mortality can be divided into neonatal mortality and post-neonatal mortality. When a newborn baby dies less than 28 days after they are born, it is called neonatal mortality. When babies who are older than 27 days but younger than one year die, it is called post-neonatal mortality. Neonatal and post-neonatal mortality often have different causes, so it can be helpful to look at them one by one.
Why is infant mortality a public health problem?
The death of a baby is a tragedy for any family. High infant mortality also means that there are public health problems in the community that need to be addressed. So, it is important to see what problems cause a high infant mortality rate in a community so that people and organizations can work together to solve those problems and protect the health of the next generation.
How big is the problem of infant mortality?
In 2017, 304 babies died in Arkansas before their first birthdays. The infant mortality rate for that year was 8.1 deaths per 1,000 live births compared to the national infant mortality rate for the same year which was 5.8. Arkansas’s neonatal mortality rate was 4.6 per 1,000 live births. This was close to the United States neonatal mortality rate, which was 3.9. Arkansas’s post-neonatal mortality rate was 3.5 per 1,000 live births. This was much higher than the United States' post-neonatal mortality rate, which was 1.9.
The two most common causes of neonatal mortality are birth defects and prematurity.
- A birth defect occurs when a baby is born with an abnormality that needs medical care. Some birth defects are easy for doctors to diagnose, while others call for special medical tests. Examples of special medical tests are the newborn screening tests that all Arkansas babies get at birth using a drop of blood from the baby’s heel. Newborn screening is able to find babies with rare defects in the way their bodies use the nutrition in their food. Often the problem can be solved with a special diet. Other types of birth defects are more obvious. They include abnormalities that require surgery to fix, such as congenital heart defects. Congenital means it was there when the baby was born. Congenital heart defects are the most common cause of fatal birth defects.
- Prematurity occurs when a baby is born before the 37th week of the pregnancy. A normal pregnancy lasts for 40 weeks. Premature babies are more likely to have serious health problems, because their internal organs, such as their lungs or brains, have not fully developed. So, they may have problems breathing or have bleeding in their brains, which is like a stroke. Premature babies are often very small and have low birth weight.
Some of the top causes of post-neonatal death:
- Sudden infant death syndrome (SIDS):
- Sudden unexpected infant death (SUID) is when a baby less than 1 year old dies unexpectedly. This includes accidental deaths (strangulation or suffocation in bed), sudden infant death syndrome (SIDS), and deaths with unknown causes. SIDS is the sudden, unexpected death of a baby younger than 1 year of age that doesn’t have a known cause even after a complete investigation. SIDS is one type of SUID. Most SUID deaths are preventable and often happen during sleep or in the baby’s sleep environment. SUID rates in the United States have been going down since 1992, when parents were first taught to put babies to sleep on their backs. Sadly, SUID still remains a leading cause of infant death in Arkansas. Other things that raise the risk of SUID include being around cigarette smoke either before or after being born, sleeping in the same bed with other people, soft bedding or toys where baby sleeps, and not being breastfe
- Birth defects
- Unintentional injuries
- Murder
Maternal Mortality
Women in the United States are more likely to die from childbirth than women living in other developed countries.1 Healthy People 2030 focuses on preventing pregnancy complications and maternal deaths and helping women stay healthy before, during, and after pregnancy.
Some women have health problems that start during pregnancy, and others have health problems before they get pregnant that could lead to complications during pregnancy. Strategies to help women adopt healthy habits and get health care before and during pregnancy can help prevent pregnancy complications. In addition, interventions to prevent unintended pregnancies can help reduce negative outcomes for women and infants.
Women’s health before, during, and after pregnancy can have a major impact on infants’ health and well-being. Women who get recommended health care services before they get pregnant are more likely to be healthy during pregnancy and to have healthy babies. Strategies to help pregnant women get medical care and avoid risky behaviors like smoking or drinking alcohol can also improve health outcomes for infants.
Source: Healthy People 2030
Strategies and Measurable Objectives
In 2019-2020, the ADH recruited over 70 partners from within the Agency and outside to form an initial planning team to identify state health improvement areas and develop ideas for strategies and objectives within each area. During phase one, the planning team formed workgroups and determined eight priority areas for the state level health improvement. Each priority area is presented as a Result (R) in the Result section of this Scorecard.
Phase two had consisted of working on the ideas for strategies and objectives and later formalizing the ideas for approval. However, due to the COVID-19 pandemic, phase two was substantially delayed. In 2022, a new Planning and Implementation Team, with incumbent and new members, will convene to build on the ideas presented by the old team. The Planning Group will finalize strategies, objectives, activities, and collaborative partners within each area and implement the SHIP.
The Scorecard will be updated as these developments occur.
Policy Agenda
To be determined by the new Planning and Implementation Team.
Additional Data Needed/Potential Indicators
To be determined by the new Planning and Implementation Team.
Workgroup Members
In 2022, the new Planning and Implementation Team will form workgroup for each priority area for monitoring implementation and reporting.
Workgroup Action Plan
Will be developed by workgroups.
SHIP Partners
-
Alliance for a Healthier Generation - Arkansas
-
Arkansas Academy of Nutrition & Dietetics
-
Arkansas Center for Health Improvement (ACHI)
-
Arkansas Coalition for Obesity Prevention (ArCOP)
-
Arkansas Coalition of Marshallese
-
Arkansas Department of Agriculture
-
Arkansas Department of Education, Division of Elementary and Secondary Education (DESE)
-
Arkansas Department of Health
-
Arkansas Department of Human Services, Division of Childcare and Early Childhood Education (DCCESE)
-
Arkansas Department of Human Services, SNAP
-
Arkansas Deptartment of Transportation
-
Arkansas Farm to School
-
Arkansas Heart Hospital
-
Arkansas Hunger Relief Alliance (AHRA)
-
Arkansas Minority Health Commission
-
ArCare
-
Boys and Girls Clubs
-
Center for Childhood Obesity Prevention - AR Children’s
-
Consulate of Mexico in Little Rock
-
Culinary Institutes
-
Growing Healthy Communities (GHC)/mayors
-
Healthy Active Arkansas
-
Hometown Health Improvement Coalitions
-
Hospitals
-
Library System
-
Metroplan
-
Natural Wonders, AR Children's
-
Univ of AR Cooperative Extension Services
-
University of Arkansas Medical School College of Public Health
Resources
Why Is This Important?
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Choose minimally processed whole foods with a variety of fresh fruits and vegetables and whole grains
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Drink water or other beverages that are naturally calorie-free
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Limit sugar-sweetened beverages, processed meats, refined and highly processed foods
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Avoid overeating by choosing small portions and eating slowly, eat at home, and eat mindfully, enjoying your food
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Stay active. If there was a "magic bullet" for good health, physical activity would be it
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Limit screen time
-
Get enough sleep
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Relax. Control stress with regular physical activity
Clear Impact Suite is an easy-to-use, web-based software platform that helps your staff collaborate with external stakeholders and community partners by utilizing the combination of data collection, performance reporting, and program planning.