2. Priority Area: Access to Care

State Health Improvement Plan (SHIP) 2021-2025 

ACCESS TO CARE

About 1 in 10 people in the United States don’t have health insurance. People without insurance are less likely to have a primary care provider, and they may not be able to afford the health care services and medications they need. Strategies to increase insurance coverage rates are critical for making sure more people get important health care services, like preventive care and treatment for chronic illnesses.

Sometimes people don’t get recommended health care services, like cancer screenings, because they don’t have a primary care provider. Other times, it’s because they live too far away from health care providers who offer them. Interventions to increase access to health care professionals and improve communication, in person or remotely, can help more people get the care they need (- Healthy People 2030).

The ADH and its community partners will focus on improving public health in Arkansas by helping people get timely and high-quality health care services.

 

Priority Area - Access to Care
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Why Is This Important?

What is rural health?
When talking about rural health, we mean the health of people living in the parts of the state that are away from cities – out in the country, so to speak. According to U.S Census Data almost 44 percent of Arkansans live in rural areas. But, defining exactly where a city ends and a rural area starts can be hard. So, we have used the definition for rural that the United States Office of Budget and Management has used. It defines a rural county as any county that is not part of a Metropolitan Statistical Area. A Metropolitan Statistical Area is a city that has a population of 50,000 people or more. By this definition, 53 of the 75 counties in Arkansas are considered rural. The map on page 84 shows the rural counties in Arkansas using this definition We realize, however, that there are rural areas even in counties that are not defined as rural counties.

Why is rural health important to Arkansas?
People who live in rural counties 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.

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 communities may not have grocery stores where they can buy food for a healthy diet, such as fresh fruits or vegetables. Barriers such as these must be removed if we want all Arkansans to have the same chance to enjoy good health.

What are the key health issues in rural Arkansas?
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, 2019

SHIP Partners

Key Partners:

  • American Heart Association
  • Dental Association
  • Arkansas Ambulance Association
  • Emergency Medical Services Association
  • 911 PSAPs
  • Trauma Advisory
  • EMS Advisory
  • Acute Stroke Care Task Force
  • Arkansas STEMI Advisory Council
  • Local Volunteer Fire Departments
  • Chambers of Commerce
  • Schools
  • Healthcare Payors
  • Employers
  • Faith Based Organizations
  • AARP
  • ACHI
  • Hospital Association
  • Arkansas Transparency Initiative (APCD)
  • Rural Health Consortium
Resources
G
Time
Period
Current
Actual
Value
Current
Target
Value
Current
Trend
Baseline
% Change
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

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
  • Healthcare Payors

  • 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
Outcome Measures
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