Executive Summary
The Community Profile service area consists of eight counties in Northwest Arkansas: Benton, Boone, Carroll, Crawford, Madison, Newton, Sebastian and Washington.
Demographics
The following information was provided by Komen National based on demographics for persons 18+ years old living in the Affiliate service area. Total population for the eight county service area is 457,923. Washington and Benton counties continue to be two of the fastest growing areas in the U.S. due to the home offices of Wal-Mart, Inc., Tyson Foods and J.B. Hunt residing in these counties.
Ethnicity
The ethnic mix of those residing in the Ozark Affiliate area consist of the following:
- Caucasians: 394,093 (86% of the population)
- African Americans: 9,634 (2% of the population)
- Hispanics: 33,322 (7% of the population)
- Asians: 8,927 (2% of the population)
- Native Americans: 5,093 (1% of the population)
- Multiracial: 6,710 (1% of the population)
- Others*: 134 (less than 1%)
*Northwest Arkansas has a large population of Pacific Islanders, specifically Marshallese—the largest population of Marshallese outside of the Marshall Islands. This represents 969 individuals living in Benton and Washington counties.
Based on those surveyed in each of the eight counties, 22% of the population had less than a high school education; 32% had a high school diploma or GED; 26% had some post high school education while 19% of the population was college graduates. The urban counties of Benton and Washington had the highest college graduate rates—21% and 25%, respectively. The rural counties of Carroll, Madison and Newton had the greatest percentage of those with less than a high school degree at 29%, 32% and 30%, respectively.
Income breakdown in the Affiliate service area presented as follows: those making less than $15,000 represented 16% of the population; $15,000-$24,999, 14%; $25,000-$34,999, 14%; $35,000-$50,000, 18% and income of $50,000 + was 38% of the surveyed population. The more urbanized counties of Benton and Washington had income levels over $50,000 while the more rural counties incomes were less than $50,000.
Being uninsured or underinsured in the Ozark Affiliate service area is a substantial problem. In addition approximately 60% of companies in the Northwest Arkansas area are self-funded—some of which do not pay for mammography or other imaging services; a gap in breast health service for many of those residing in our service area. The following chart lists each county's percentage of individuals that do not have healthcare coverage:
County Estimates based on State BRFSS 2004 data |
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County Name |
Do not have any kind of healthcare coverage |
2004 Arkansas state Prevalence (average) |
Nationwide Median |
Benton |
19.30% |
18.60% |
14.80% |
Boone |
26.80% |
18.60% |
14.80% |
Carroll |
19.40% |
18.60% |
14.80% |
Crawford |
16.50% |
18.60% |
14.80% |
Madison |
18.60% |
18.60% |
14.80% |
Newton |
22.30% |
18.60% |
14.80% |
Sebastian |
14.10% |
18.60% |
14.80% |
Washington |
19.00% |
18.60% |
14.80% |
Area Average |
19.50% |
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* Note: Higher standard errors are generated due to small sample size from that county. |
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It is not advised to use the percentage for counties who have high standard errors. |
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Boone and Newton counties are two new counties recently annexed into the Ozark Affiliate service area in December 2005. These two counties have the highest percent of uninsured individuals out of the eight counties within the service area. Statewide, the number of individuals without healthcare coverage is higher at 18.6% than the national average of 14.8%. The Affiliate service area uninsured average is 19.5%
Breast Cancer Statistics
The total number of new invasive breast cancer incidences for 2004 within the Affiliate service area for all races was 432 while statewide the total number of incidences was 1,910. Benton and Washington counties had the highest incidence rate with 29% and 28% of all cases diagnosed in the eight county service area. In addition, the Ozark Affiliate service area had 23% of all breast cancer cases diagnosed in the state of Arkansas. In 2004 there were 397 cases of breast cancer diagnosed in Caucasian women which constitutes 92% of all cases diagnosed in the eight county area. The number of women that reported a diagnosis among other ethnicities included: African American, 7; Hispanic, 11 and others, 17. We believe a possible explanation for more Caucasian women being diagnosed than any other ethnic group is three-fold: typically higher educational levels—which could mean greater awareness, higher incomes and more accessibility to care.
There were 80 breast cancer mortalities in the Affiliate service area while statewide there were 380 mortalities. Breast cancer mortality in he Affiliate service area represents 21% of all mortalities in the state. Benton and Washington counties had 23 breast cancer mortalities each—greatest number of mortalities in our service area. Ethnic breakdown of reported cancer mortalities: Caucasian, 72; African American, 2; Hispanic, 3; Others, 3.
According to the CDC, in Arkansas 66.9% of women aged 40+ reported having a mammogram within the past two years. This number is up 8.2% in comparison to the 2004 Community Profile. In regards to ethnicity for all eight counties, Caucasian women had consistently higher screening rates than all other ethnic groups. Again, we believe that this could be due to greater accessibility that other ethnic groups may not have available to them. Based on income levels, residents in Boone, Carroll, Madison and Newton County who made less than $15,000 and were able to qualify for financial assistance programs and those who made $50,000+ (and were likely to have insurance that covered imaging service costs) were more likely to have received a mammogram in the previous two years than others who may have been between these two income levels. The screening rates for those in Benton, Crawford, Sebastian and Washington counties were highest among those who made over $35,000. According to statistics provided by Komen National, reports indicate that in all eight counties of the Affiliate service area, regardless of education, more women were NOT being screened as opposed to the number of women that were.
Program Services
One hundred seventy one service providers were surveyed. Mammography facilities are found in six of the eight counties with mobile units providing service in the remaining two counties. Digital mammography is available at six locations. A wide range of support services are available including breast prostheses and wigs, nutritional information/counseling, resources for lymphedema, genetic counseling and testing, individual counseling, prescription and emergency assistance, cancer support programs and rehabilitation services. Transportation programs are limited to certain areas and include: financial assistance with gasoline expenses, free or reduced lodging and transportation to and from certain facilities. An Arkansas Department of Health program called BreastCare provides funding for uninsured low income women aged 40 and above with screening mammograms and follow up services when needed. This program can also assist women younger than 40 who have been diagnosed with breast cancer before they enrolled in BreastCare. The Breast Center of Northwest Arkansas is the site of Arkansas's first dedicated breast magnetic resonance imaging system. This system, called Aurora, is an advanced MRI scanner designed specifically to image the breast. The Aurora is the only commercially available, FDA-cleared dedicated breast imaging system available today. Breast MRI is ideal for a wide range of indications in breast disease management. The MammoSite Radiation Therapy System is a form of partial breast irradiation that works by delivering radiation from inside the breast directly to the tissue where the cancer is most likely to recur. Radiation therapy with MammoSite can be completed in five days allowing the patient to get back to her life.
Within the Ozark Affiliate service area, a group of health care providers, survivors and other interested individuals have formed the Breast Health Initiative (BHI) committee. The purpose of this committee is to identify breast health issues that affect the citizens in Northwest Arkansas as well as the entire state. In addition, this committee is deeply committed to public policy regarding breast health issues. Through the efforts of the BHI committee insurance companies are now covering digital mammography.
The more rural counties of Boone, Carroll, Madison and Newton are not as fortunate to have all imaging services readily available to them. In particular, Madison and Newton counties do not have mammography facilities. Mobile mammography units must come to these counties in order for women to receive their imaging services or they have to travel outside of their community to receive such services.
Key Informant Responses
Sixteen key informants were interviewed for the Community Profile. These informants included survivors, co-survivors, area non-profits, a surgeon and Director of Radiology at a local hospital as well as staff from the Arkansas Department of Health. Recurrent themes about gaps in services included education/more public awareness, increased accessibility, transportation and cultural barriers.
Through input of our grant recipients as well as other key informants, we have had many success or changes since the last Community Profile. Some of those successes that have been addressed include accessibility, lack of financial resources, social workers/patient advocates and public policy issues.
Since 2004 accessibility issues and lack of financial resources have been a priority. Additional money has been granted to recipients to provide gas vouchers to and from treatment and emergency financial assistance. Reduced cost and free imaging services to those who are underinsured have increased in our area. Language barriers were identified and more translators have been utilized throughout this area. Rural and minority outreach issues have been identified and in response more focus has been given to those counties without services by offering BSE trainings, breast exam clinics and support groups for those from a different culture as well as in the more rural areas of the Ozark Affiliate. There are now two patient advocate programs for breast cancer survivors to use to help them navigate through the medical system and be their constant contact through this very challenging time. As mentioned earlier public policy issues have been addressed and digital mammography services are now covered by insurance companies in Arkansas.
While all of these gaps have not been fully eliminated, it is the desire of the Ozark Affiliate to continually improve access to care and meet the pressing needs of those individuals in our communities.
Identified and Prioritized Gaps
The Community Profile and Education Committee identified the following gaps and prioritized them based on the resources available.
1. Accessibility
- Lack of financial resources
- Availability of imaging services to rural areas
- Transportation
2. Education/Public Awareness
- Need for education for individuals to be responsible for one's own breast health care
- Educate the public about services available for those needing financial assistance
3. Cultural Barriers/Fears