The Journal of the Arkansas Medical Society Med Journal April 2019 Final 2 | Page 14

The State of Public Health in Arkansas in 2018
by NATHANIEL SMITH, MD, MPH, DIRECTOR AND STATE HEALTH OFFICER
T
he activities of the Arkansas
Department of Health (ADH) in
2018 were driven by its mission to protect
and improve the health and well-being of all Ar-
kansans and a strategic plan that focuses on six
health issues: childhood obesity, hypertension, to-
bacco, immunizations, teen pregnancy, and men-
tal and community wellness. In addition, the ADH
sought opportunities for innovation, efficiency, and
improvements in its operations and responded to
unexpected challenges. The 2018 Annual Report
of America’s Health Rankings ® by the United
Health Foundation showed that Arkansas had im-
proved from 48 th to 46 th in health ranking.
Healthy Active Arkansas (HAA), a public-
private partnership, promotes healthy weight
and an active, sustainable lifestyle. This year,
HAA received funding from the Delta Dental
Foundation to install water-bottle filling stations
in schools to encourage students to drink more
water. Breastfeeding is a primary activity to
reduce childhood obesity. In the past two years,
six Arkansas delivery hospitals have achieved
U.S. Breastfeeding Friendly status. The ADH also
partnered with private clinics, hospitals, and
the YMCA in implementing diabetes prevention
programs (DPPs), increasing the number of CDC-
recognized DPPs in Arkansas to 14.
Nationally, Arkansas ranks 1 st in heart attack
mortality and 7 th in stroke mortality. Progress in
addressing heart attack and stroke mortality
included increasing participation in the Arkansas
Stroke Registry, over 1,200 new Advanced Stroke
Life Support (ASLS) certified health care providers
across the state and certification of seven
hospitals as ASLS training centers, launching the
The 2018 Annual Report of
America’s Health Rankings ® by the
United Health Foundation showed
that Arkansas had improved from
48 th to 46 th in health ranking.
Arkansas Heart Attack Registry, and increasing
emergency medical service (EMS) access to 12-
lead ECG equipment in 15 counties. The “Dial
Don’t Drive” community-awareness campaign
was initiated to teach the signs and symptoms
of heart attack and stroke and the importance of
dialing 911.
Tobacco use is the leading cause of health
complications in Arkansas, causing huge
economic losses, and is preventable with proven
interventions. The ADH established an in-house
program, Be Well Arkansas, which provides
tobacco cessation counseling and resources for
diabetes and hypertension management. The ADH
also responded to inquiries about T-21 (raising the
age for sale of tobacco products from 18 to 21
years) and e-cigarette taxation, which reduces
use by youth. The use of e-cigarettes and vaping
products among youth now exceeds the use of
traditional cigarettes.
In response to an outbreak of over 250
cases of Hepatitis A, ADH local health units
reached out to populations at risk in northeast
Arkansas and vaccinated over 29,000 individuals.
Collaboration among state and local officials,
EMS, and businesses helped to expedite 43
special vaccination clinics. The ADH Tuberculosis
(TB) program collaborated with the CDC in Desha
County to investigate a cluster of TB cases among
African Americans and continues to work among
the Marshallese in northwest Arkansas through
screening and case identification. ADH staff also
traveled to the Marshall Islands to help public
health officials there reduce TB at its source,
resulting in fewer new cases in Arkansas.
The ADH continued to focus on reducing
unintended pregnancies, with a particular
emphasis on decreasing teen pregnancies. The
ADH provided a broad range of contraceptive
methods, including Long Acting Reversible
Contraception (LARC). The use of LARC provides
safe and more effective birth control than
traditional methods. In 2018, 3,861 women
seeking contraceptive services from local health
units received a LARC method.   
230 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY
The Prescription Drug Monitoring Program
began issuing quarterly Prescriber Comparison
Reports in April of 2018. Prescribers who write at
least one prescription for an opioid now receive
quarterly reports comparing their prescribing
habits to those in similarly self-identified
specialties. Close to 7,000 reports were issued
last quarter.
In 2017, Arkansas ranked 10 th in the nation
for the highest rate of suicide. During the 90th
General Assembly, Act 811 mandated that the
ADH create and maintain a statewide suicide-
prevention hotline. On December 11, 2017, the
Arkansas Lifeline Call Center began answering
calls, and Arkansas became the first state to have
a 24/7 suicide-prevention lifeline housed within
a state agency. The Arkansas Lifeline Call Center
averages 1,400 calls per month.
Children in Arkansas have the highest
prevalence of adverse childhood experiences
(ACEs) of all states as measured by the 2016
National Survey of Child Health. ACEs are
associated with subsequent adult health and
well-being but, if recognized, respond to targeted
interventions. In 2018, the ADH WIC Program
implemented the CDC “Learn the Signs, Act Early”
Developmental Milestone pilot. In another pilot
project, “Baby & Me,” parent-support mentors
provided interactive parent education to enrolled
WIC participants.
Innovation was a focus in 2018. The ADH
assumed management of the Office of Health
Information Technology (OHIT) to develop a func-
tional resource for clinicians and patients. Birth
and death certificates used to be available only
from the ADH main office in Little Rock but are
now available in every local health unit throughout
the state. In December, over 22,000 certificates
were provided locally. Our antibiotic stewardship
program was awarded a CDC grant to work with
outpatient facilities, and the health care-associ-
ated infections program increased its activities
in managing highly resistant bacteria, including
travel-associated infections.
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