arkansas department of health - arkleg.state.ar.us forces... · january 14, 2010 arkansas...

January 14, 2010 Arkansas Legislative Taskforce on Reducing Poverty and Promoting Economic Opportunity Dear Task Force Member: It is with pleasure that we at the Arkansas Department of Health provide you with a copy of our Guide to Programs and Services. While it is the mission of the Health Department to protect and improve the health and well-being of all Arkansans, we are especially proud of our programs and services that are specially designed to serve Arkansans who live in poverty. I have listed many of them for you below and indicated the page number where specific information may be found. Program Page BreastCare 18 ConnectCare 20 Women’s Health 20 Women, Infants and Children (WIC) 23 Oral Health 24 Tobacco Prevention and Cessation 25 Immunizations 29 HIV/AIDS Prevention and Services 29 Sexually Transmitted Diseases 29 Tuberculosis 29 In-home Services 40 In addition to the programs that provide services directly to individuals, the ADH works to promote the health of Arkansans living in poverty through policy and systems change. For example, our Office of Rural Health and Primary Care promotes the development of community-based health care services and systems throughout Arkansas to ensure that well-managed, quality health services are available to all citizens regardless of ability to pay. Similarly, our office of Minority Health and Health Disparities works to ensure that health services are appropriate, accessible and sensitive to the needs of minority populations in Arkansas, many of which are the focus of the Task Force’s concern. As you read through the booklet, you will note additional Health Department programs and activities that address the needs of Arkansans living in poverty. I hope you will find this information helpful. Thank you for the invitation to provide you with an overview of the services that the Arkansas Department of Health provides to the many men, women and children in our great State, who deserve the best that we can give them. Please do not hesitate to contact me if I can provide additional information or may be of additional service to you. Sincerely, Jennifer Dillaha, MD Director, Center for Health Advancement

Arkansas Department of Health

4815 West Markham Street ● Little Rock, Arkansas 72205-3867 ● Telephone (501) 661-2000 Governor Mike Beebe

Paul K. Halverson, DrPH, FACHE, Director and State Health Officer

ARKANSAS DEPARTMENT OF HEALTH GUIDE TO PROGRAMS AND SERvIcES

July 1, 2007 - June 30, 2008

Cover photo: Our 80,000 square foot state-of-the art public health laboratory was dedicated in October 2006. The laboratory and its professional staff provide laboratory support for 93 local health units throughout the state. Each year the lab performs over 800,000 tests on nearly 500,000 specimens. Photo by Ed Barham

MISSIONTo protect and improve the health and well-being of all Arkansans

VISIONOptimal health for all Arkansans to achieve

maximum personal, economic and social impact

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TABLE OF cONTENTSMission and Vision Inside CoverHelpful Numbers 2 Local Health Unit Directory 3Message from the Director 4 Public Health Leadership in Arkansas 5Board of Health 6ADH Organizational Chart 7Our Department’s Core Services 8ADH Source and Use of Funds, FY 2008 10Public Health: What It Is And How It Works 11Public Health: Something So Important May Be Misunderstood 12Health Rankings 14Arkansas Rankings 15The Department’s Four Strategic Priority Areas 16 Our prOgrAMS ANd SerVIceS

chrONIc dISeASe 18Breast & Cervical Cancer Control (BreastCare) 18Comprehensive Cancer Control 18Diabetes Prevention & Control 18Heart Disease & Stroke Prevention 19

FAMIly heAlTh 20child and Adolescent health 20 Abstinence Education 20 Coordinated School Health 20 Infant Hearing 20 Newborn Screening 20health connections 20 ConnectCare 20 Healthy Baby/Happy Birthday Baby Book 20Women’s health 20 Lay Midwifery Licensure 20 Maternity Nurse Midwifery 21 Pregnancy Testing 21 Reproductive Health 21 Teenage Pregnancy/Unwed Birth Prevention 21

lIFeSTAge heAlTh 22Arkansas Healthy Employee Lifestyle Program 22Fruits & Veggies: More Matters 22Governor’s Council on Physical Fitness & Health 22

NuTrITION/WOMeN, INFANTS ANd chIldreN (WIc) 23Breastfeeding 23WIC Farmer’s Market 23

OrAl heAlTh 24Fluoridation Program 24

TObAccO preVeNTION & ceSSATION 25

heAlTh SySTeMS lIceNSINg ANd regulATION 26health Facility Services 26 Health Facilities Construction 26 Health Facilities Licensure 26 HMO Certification 26 Medicare Certification 26 Orthotics Prosthetics Perdorthics Licensure 26 Perfusion Licensure 26 Utilization Review 26emergency Medical Services 26 Emergency Medical Services & Trauma Systems 26 Emergency Response 27radiation control 27 Mammography Accreditation & Inspection 27 Radioactive Materials 27 Radiological Emergency Response 27 Radiologic Technology Licensure 27 Radon 27 X-Ray/Radiation Producing Equipment 27

INFecTIOuS dISeASe 29 Communicable Disease 29 Immunizations 29 Immunization Registry 29 HIV/AIDS Prevention & Services 29 Sexually Transmitted Diseases 29 Tuberculosis 29 Zoonotic Disease 29

INjury preVeNTION ANd cONTrOl 31Fire-Related Injury Prevention 31Traumatic Brain Injury 31

phArMAcy SerVIceS & drug cONTrOl 32Investigations & Drug Control 32

prepAredNeSS ANd eMergeNcy reSpONSe 33Emergency Communications Center 33Health Care Preparedness Program (formerly Hospital Preparedness) 33Nuclear Planning & Response 33Public Health Preparedness 33

eNVIrONMeNTAl heAlTh 35Clean Indoor Air Act Enforcement 35Engineering - Community Protection 35Engineering - Plan Review 35Food Services 35General Sanitation 35Heating, Ventilation, Air Conditioning & Refrigeration (HVAC/R) 35Lead Paint Testing 36Mammography Accreditation 36Marine Sanitation 36

Medical Waste 36Milk & Dairy 36Plumbing 36Public Water System Supervision 36 Cross Connection Control 37 Fluoride Analysis 37 Monitoring 37 Non-Community Systems 37 Source Water Protection 38Recreation 38Rodent & Vector Control 38Septic Tanks 38Swimming Pools & Related Facilities 38Tattoo, Body Art & Permanent Cosmetics 38Water Supplies, Private 39Well & Spring Drinking Water Fluoride Analysis 39

IN-hOMe SerVIceS 40Community-Based Case Management for the Elderly 40Home Health 40Hospice 40Mother/Infant Home Visiting Program 40Personal Care 40

epIdeMIOlOgy 42Chemical Materials 42Chronic Disease Epidemiology 42Foodborne Disease 42Medical Waste Program 42National Electronic Disease Surveillance System (NEDSS) 42Toxic Substances & Disease Registry 43West Nile Virus (WNV) Surveillance 43

heAlTh STATISTIcS 45Registries & Hospital Discharge 45 Cancer Registry 45 HIV/AIDS/STD Registry 45 Tuberculosis Registry 45 Surveys 45Vital Records 45

publIc heAlTh lAbOrATOry 46Laboratory Services 46

crOSS-cuTTINg SerVIceS 47 Arkansas Hometown Health Improvement 47 Minority Health & Health Disparities 47 Community Services 47

2006-08 SelecTed STATISTIcAl INdIcATOrS 48

AbbreVIATIONS, deFINITIONS & TerMS 49

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HELPFUL NUMBERS

Photo by Ed Barham

Adh Main Switchboard (little rock) 501-661-2000Adh Toll-Free Number 800-462-0599Emergency Assistance (toll-free number) 800-633-1735Director’s Office 501-661-2400Center for Health Advancement 501-661-2199 Center for Health Protection 501-661-2243 Center for Local Public Health 501-661-2574Center for Public Health Practice 501-661-2224Public Health Laboratory 501-661-2220Abstinence Education 501-280-4799Accounts Payables 501-280-4478Accounts Receivables 501-280-4638ADH Toll-Free Number 800-482-5850Alcohol Testing 501-661-2287Ambulance Licensing 501-661-2262Birth Certificates 501-661-2695BreastCare 501-661-2942Breastfeeding Services 501-280-4068Budget & Banking 501-280-4498Cancer Registry 501-661-2463Cardiovascular Health 501-661-2627Cemetary Permitting 501-331-2113Central Supply 501-661-2128Child & Adolescent Health 501-280-4799Children in Schools 501-661-2099Chronic Disease 501-661-2075Compliance 501-280-4633Comprehensive Cancer 501-661-2942ConnectCare 501-280-4828ConnectCare (Toll-Free) 800-275-1131Coordinated School Health 501-280-4799Courier Service 501-671-1418Death Certificates 501-661-2695Diabetes 501-280-4187Emergency Management/Russellville 479-968-7702Emergency Medical Services 501-661-2272EMT Certification 501-661-2262Engineering 501-661-2623Environmental Health 501-661-2171Epidemiology 501-661-2893Family Health 501-661-2480Farmer’s Market/WIC 501-661-2508Fire-Related Injury Prevention 501-280-4776Five-A-Day (Nutrition) 501-661-2099Fluoridation 501-661-2279Food Services 501-661-2171Governor’s Council on Fitness 501-661-2099Grants Management/Reporting 501-280-4557Happy Birthday Baby Book 800-275-1131

Health Care Preparedness Program 501-661-2375 Health Communications & Marketing 501-661-2186Health Facilities 501-661-2201Health Statistics 501-661-2368Hepatitis C Prevention 501-661-2408HIV/STD 501-661-2408Home Health 501-661-2614Hometown Health Support Services 501-280-4560Hospice 501-661-2698Hospital Discharge 501-661-2368Human Resources 501-661-2115HVAC/R Program 501-661-2307Immunization Registry 800-544-4040Immunizations 501-661-2169Infant Hearing 501-280-4799Infectious Diseases 501-661-2169Information Technology Services 501-661-2367In-Home Services 501-661-2969Injury Prevention & Control 501-280-4776Internal Audit 501-280-4477Lay & Nurse Midwifery 501-661-2480Lead Paint Testing 501-661-2220Legal Services 501-661-2878Life Stage Health 501-661-2099Mammography Accreditation 501-661-2107Marine Sanitation 501-661-2171Maternal Infant Program 501-661-2927Maternity 501-661-2480Milk Program 501-661-2171Minority Health & Health Disparities 501-661-2622Newborn Screenings 501-280-4799Obesity 501-661-2075Oral Health 501-661-2279Personal Care 501-661-2969Pharmacy Services & Drug Control 501-661-2325Physical Activity 501-661-2099Physical Plant (Maintenance) 501-661-2732Plumbing Program 501-661-2641Policies & Procedures 501-661-2122Preparedness & Response 501-661-2375Procurement/Support 501-280-4573Protective Health Codes 501-661-2642Public Health Preparedness 501-661-2482Public Water Systems 501-661-2623Radiation Control 501-661-2301Radiologic Technology Licensure 501-661-2166Registries 501-661-2971Reproductive Health 501-661-2480Rural Health & Primary Care 501-280-4560

Septic Tanks 501-661-2171Sexually Transmitted Diseases 501-661-2408SOS (Stamp Out Smoking) Quitline 501-661-2783SOS (Stamp Out Smoking) Toll-Free 866-669-7848Swimming Pools & Related Facilities 501-661-2171Tattoos & Body Piercings 501-661-2171Teenage Pregnancy/Unwed Birth Prevention 501-280-4799Tobacco Prevention & Cessation 501-661-2783Trauma Systems 501-661-2262Traumatic Brain Injury 501-280-4776Tuberculosis 501-661-2886Vaccines for Children 501-661-2169Vital Records 501-661-2695WIC (Women, Infants & Children) 501-661-2508Women’s Health 501-661-2480Workforce & Career Development 501-661-2351Worksite Wellness (Adults) 501-661-2099Zoonotic (Veterinary) Disease 501-280-4136

Our central office is located at:4815 W. Markham St.little rock, Ar 72205-3867

Visit our website www.healthyarkansas.com for information or to locate your nearest local health unit.

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LOcAL HEALTH UNIT DIREcTORYArkansas County/ Stuttgart 870-673-1609

Arkansas County/ DeWitt 870-946-2934

Ashley County/ Crossett 870-364-2115

Ashley County/ Hamburg 870-853-5525

Baxter County 870-425-3072

Benton County 479-271-1055

Boone County 870-743-5244

Bradley County 870-226-8440

Calhoun County 870-798-2808

Carroll County 870-423-2923

Chicot County/ Lake Village 870-265-2236

Chicot County/ Dermott 870-538-3336

Chicot County/ Eudora 870-355-2278

Clark County 870-246-4471

Clay County/ Piggott 870-598-3390

Clay County/ Corning 870-857-6281

Cleburne County 501-362-7581

Cleveland County 870-325-6311

Columbia County 870-235-3798

Conway County 501-354-4652

Craighead County 870-933-4585

Crawford County 479-474-6391

Crittenden County/ West Memphis 870-735-4334

Crittenden County/ Earle 870-792-7393

Cross County 870-238-2101

Dallas County 870-352-7197

Desha County/ Dumas 870-382-2377

Desha County/ McGehee 870-222-3910

Drew County 870-367-6234

Faulkner County 501-450-4941

Independence County 870-793-8847

Izard County 870-368-7790

Jackson County 870-523-8968

Jefferson County 870-535-2142

Johnson County 479-754-2949

Lafayette County 870-921-5744

Lawrence County 870-886-3201

Lee County 870-295-2400

Lincoln County 870-628-5121

Little River County 870-898-3831

Logan County/ Paris 479-963-6126

Logan County/ Booneville 479-675-2593

Lonoke County/ Cabot 501-843-7561

Lonoke County/ Lonoke 501-676-2268

Madison County 479-738-2612

Marion County 870-449-4259

Miller County 870-773-2108

Mississippi County/ Blytheville 870-763-7064

Mississippi County/ Osceola 870-563-2521

Monroe County 870-734-1461

Montgomery County 870-867-2331

Nevada County 870-887-2004

Newton County 870-446-2216

Ouachita County 870-836-5033

Perry County 501-889-5156

Phillips County 870-572-9028

Poinsett County/ Trumann 870-483-5761

Polk County 479-394-2707

Pope County 479-968-6004

Prairie County 870-256-4430

Pulaski County/ Jacksonville 501-982-7477

Pulaski County/ North Little Rock 501-791-8551

Pulaski County/ Pulaski Central 501-280-3100

Pulaski County/ SW Little Rock 501-565-9311

Randolph County 870-892-5239

Saline County 501-303-5650

Scott County 479-637-2165

Searcy County 870-448-3374

Sebastian County 479-452-8600

Sevier County 870-642-2535

Sharp County 870-994-7364

St. Francis County/ Forrest City 870-633-1340

St. Francis County/ Hughes 870-339-3206

Stone County 870-269-3308

Union County 870-863-5101

Van Buren County 501-745-2485

Washington County 479-521-8181

White County/ Searcy 501-268-6102

White County/ Beebe 501-882-5128

Woodruff County 870-347-5061

Yell County/ Dardanelle 479-229-3509

Yell County/ Danville 479-495-3750

Franklin County 479-667-2555

Fulton County 870-895-3300

Garland County 501-624-3394

Grant County 870-942-3157

Greene County 870-236-7782

Hempstead County 870-777-2191

Hot Spring County 501-332-6972

Howard County 870-845-2208

Pike County 870-285-3154

Poinsett County/ Marked Tree 870-358-3615

Poinsett County/ Harrisburg 870-578-4480

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Greetings!

On behalf of the Arkansas Department of Health, I welcome and encourage you to review our 2008 Guide to Programs and Services as an introduction to what we do best – protecting and improving the health of all Arkansans.

One of the major challenges facing our Great State is the individual behavior change modification needed to affect our overall health status. Arkansas is so rich in natural beauty, culture and in quality citizens; however, we have some of the worst health status in the country. Arkansans deserve better – we are better! Our agency is highly committed to strengthening community capacity to address the health of our home towns and individual communities. We recognize that by strengthening communities, we strengthen the state as a whole. The future of the state’s health is bright. The Department of Health is looking forward to enabling every Arkansas citizen to realize his or her fullest potential in health and longevity!

In order to focus our public health efforts in the most effective manner, the Department of Health has developed a strategic plan that emphasizes our priorities. In addition to maintaining our core services, our efforts will center around making progress in improving health outcomes and reducing health disparities in Arkansas. Specifically, we will work statewide and in our local communities to strengthen injury prevention and control, reduce infant mortality, increase physical activity and improve oral health.

We hope that your review of this Guide provides you with a snapshot of the many resources and opportunities Arkansas enjoys for partnership and community involvement. We encourage you to be an active member in your home town to better improve the state’s public health. We look forward to your comments and questions. Thank you,

Message from theDirector

Paul K. Halverson, DrPH, FACHEDirector and State Health Officer

Paul K. Halverson, DrPH, FACHe

5 adh GUIdE 2007-08

joe Thompson, Md, MphArkansas Surgeon General

Dr. Joe Thompson has the distinction of serving as the first Surgeon General for Arkansas. By law, the Surgeon General role was created in 2007, although Dr. Thompson has served in a similar capacity since 2005. As Surgeon General, he is responsible for identifying strategies and shaping policies to improve the health of Arkansans. Dr. Thompson also serves as an Associate Professor in the University of Arkansas for Medical Sciences (UAMS) Colleges of Medicine and Public Health.

governor Mike beebe

Governor Beebe is head of the Executive Branch of Arkansas state government. Both Dr. Halverson and Dr. Thompson report directly to Governor Beebe.

paul K. halverson, drph, FAche Director and State Health Officer

Dr. Paul K. Halverson has served as the Director and State Health Officer for the Arkansas Department of Health for more than three years. Previously, he served on the senior scientific staff at the Centers for Disease Control and Prevention (CDC). Dr. Halverson has an extensive background in the area of public health systems development and research. He is a Professor of Health Policy and Management in the UAMS Fay W. Boozman College of Public Health.

Mary leathDeputy Director for Administration

Mary Leath oversees all aspects of financial management, human resources, workforce development, information technology and internal audits. She works in coordination with the Chief Operating Officer to provide a strong and stable administrative base to ensure smooth delivery of programs and services. Ms. Leath has more than 30 years experience in state government.

joseph bates, Md, MSDeputy State Health Officer and Chief Science Officer Dr. Joseph Bates serves as the Deputy State Health Officer, Chief Science Officer and Science Advisory Committee Chair. He is the principal advisor for medical and public health science issues and facilitates the development and implementation of public health policy. Dr. Bates serves as Associate Dean for Public Health Practice and Professor of Epidemiology at the UAMS Fay W. Boozman College of Public Health. He helps to facilitate coordination between the Department and the College to ensure that the best public health science guides the Department. Dr. Bates is also a Professor in the UAMS College of Medicine.

charles Mcgrew, Mph Deputy Director and Chief Operating Officer

Charles McGrew works in coordination with the Department Director to set policy direction for the Department and assure that fiduciary and programmatic responsibilities are met. He has a 39- year career in public health and serves as the Department’s liaison to the Governor’s Office and governmental affairs. Mr. McGrew is an Assistant Professor of Health Policy and Management in the UAMS Fay W. Boozman College of Public Health.

Public HealtH leadersHiP in arkansas

6 adh GUIdE 2007-08

BOARD OF HEALTH

Lawrence Braden, MDGlenn Davis, MDAlan Fortenberry, PELarry Fritchman, DVMGeorge Harper, JDRichard Hughes, IVAnthony N. Hui, MDSusan Jones, MDThomas Jones, RSKaren Konarski-Hart, DCWilliam Lagaly, DO

The Arkansas State board of health was established by Act 96 of 1913, which serves as the charter or constitution for this board. The board has the general supervision and control of all matters pertaining to the health of the citizens of Arkansas. It is empowered to make all necessary and reasonable rules and regulations of a general nature for:

protection of the public health and safety• general improvement of the sanitary and • hygienic conditions within the statesuppression and prevention of infectious, • contagious and communicable diseasesproper enforcement of quarantine, isolation • and control of such diseasesproper control of chemical exposures that may • result in adverse health effects to the public.

The Department of Health is the state agency responsible for implementing the Board’s regulations.

Officers

Jack Porter, DDSPresident

Glen “Eddie” Bryant, MDPresident-elect

Paul K. Halverson, DrPH, FACHE Secretary/Director

Lynda M. Lehing, RN, MBAMarvin Leibovich, MDJohn Richard Page, PDDonald Paul PhelanRuss Sword, FACHEJoe Thompson, MD, MPHPeggy Walker, RN, MSNPatricia Westfall, ODAnika Whitfield, DPMTerry Yamauchi, MD

Members

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ARKANSAS DEPARTMENT OF HEALTH

FinanceBob Bennett,

Chief Financial Officer

center for health AdvancementDr. Jennifer Dillaha, Director

Maria Jones, Associate Director for Management & Operations

Dr. Namvar Zohoori, Associate Director for Science

Director and State Health OfficerDr. Paul K. Halverson

Deputy State Health Officer & Chief Science OfficerDr. Joe Bates

Chronic Disease Branch

Family Health Branch

Lifestage Health Branch

Oral Health Branch

Tobacco Prevention& Cessation Branch

Health Systems Licensing & Regulation Branch

AdministrationMary Leath,

Deputy Director for Administration

health communications & MarketingAnn Wright, Director

Environmental Chemistry Branch

Facilities Support ServicesTerry Brumbelow,

Building/Supply Manager

human resources & professional development

Xavier Heard, Director

health Information, protection & Security

Vacant, Program Consultant

Internal AuditSteve McClellan,

Internal Audit Manager

Information Technology ServicesJerry Pack,

Chief Information Officer

community SupportJodiane Tritt, Director

legal ServicesRick Hogan, Chief Legal Counsel

policies & proceduresCassie Frazier, Coordinator

Minority health & health disparitiesChristine Patterson, Director

Local Public Health Offices Branch

Deputy Director & Chief Operating OfficerCharles McGrew

CDC Senior Management OfficialSteve Boedigheimer

Nutrition/Women, Infants & Children (WIC) Branch

Infectious Disease Branch

Injury Prevention & Control Branch

Pharmacy Services & Drug Control Branch

Preparedness & Emergency Response Branch

center for health protectionDonnie Smith, Director

Ron Stark, Associate Director for Management & OperationsDr. William Mason, Associate

Director for Science

center for local public healthRandy Lee, Director

Rick Sanders, Associate Director for Management & Operations

Dr. Richard Nugent, Associate Director for Science

center for public health practiceDr. Glen Baker, Director

Mischelle Priebe, Associate Director for Management & Operations

Dr. John Senner, Associate Director for Science

public health laboratoryDr. Glen Baker, Director

Ed Just, Associate Director for Management & Operations

Environmental Health Branch

Hometown Health Branch

In-Home Services Branch

Epidemiology Branch

Health Statistics Branch

Alcohol Testing Branch

Clinical/Biological Sciences Branch

8 adh GUIdE 2007-08

In-home ServicesIn-Home Services encompass an array of health care programs and services provided under physicians’ orders to patients in their homes and other settings.

Home Health allows patients recovering from a • serious illness or living with a chronic disease to receive skilled nursing; physical, occupational and speech therapy; nurse aide and social work services.

Personal Care/Elderchoices provide assistance • with activities of daily living such as hygiene, diet (including meal preparation), household chores, respite for caregivers and other services that promote independent living at home and

clinical ServicesLocal health units provide clinical services that prevent disease, illness and injury; protect against health threats and share knowledge with the community. These services are an essential and cost-effective public investment.

Infectious Disease Prevention and Control • services identify and treat tuberculosis and sexually transmitted infections; provide testing, counseling and prevention education for HIV; maintain surveillance for infectious diseases and intervene to prevent or manage outbreaks.

Our department’s core ServicesThe work of the Arkansas department of health affects the state’s entire population every day. In urban areas and throughout the most rural parts of the state, our employees provide a wide range of services. each year, we see more than 80,000 family planning clients and ensure that more than 20,000 food service establishments are sanitary and that our water systems and swimming pools are safe. Our employees investigate public health diseases and threats, provide preventive health services in clinical and in-home settings and educate and monitor sites that impact the public’s health. The following describes services that can be accessed through our local health units.

delay or prevent the need to go to a nursing home.

Hospice is a special caring service for terminally • ill patients who wish to remain with family at home.

Maternal Infant is a short-term program • designed to get expectant mothers and infants off to a good start.

Community-based Case Management for the • Elderly assists older Arkansans who have difficulty with daily living activities and need multiple services that require coordination at the community level.

The goal of In-Home Services is to offer all eligible Arkansans an opportunity to receive safe, effective and cost-efficient health care services at home. All of these services can be accessed through local health units.

Immunizations services include childhood • and adult immunizations for diseases such as influenza, tetanus, diphtheria, pertussis, measles and polio.

Breast and Cervical Cancer Prevention and • Control provides breast and cervical cancer screenings, diagnosis and treatment to women over age 40 that are uninsured or underinsured.

Women, Infants and Children (WIC) program • provides vouchers to purchase nutritious foods to supplement diets, nutrition counseling and breastfeeding education and support to low-income eligible pregnant women, new mothers and children up to age five.

Women’s Health Services provide, for • women of childbearing age, access to family planning, pregnancy testing, prenatal care and other services designed to avoid unwanted pregnancy, improve birth outcomes and maintain health.

Photo by Ed Barham

Photo by Ed Barham

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community ServicesCommunity Services assists in improving the health of citizens by promoting healthy behaviors and providing assistance with the development of health services and systems of care.

Hometown Health Initiatives (HHI) support community-related health development efforts in all 75 counties in the • state and provide support for 73 coalitions. These initiatives do critical and essential work to improve the health of those in their communities. HHI mobilizes community partnerships to identify and solve health problems by promoting and encouraging healthy behaviors and lifestyles. This support includes coalition development, community assessments and program planning. Hometown Health celebrates its 10th birthday in 2008. Rural Health and Primary Care works with numerous organizations to coordinate rural health resources and • activities statewide. This office administers several grant programs for small hospitals and committees seeking to improve or enhance health services in rural areas of our state. Rural Health and Primary Care provides technical assistance to organizations and communities wishing to expand access to primary care for underserved populations. They work to recruit and retain health care professionals in rural areas and underserved areas of Arkansas and provide technical assistance to the 28 Critical Access Hospitals in the state.

environmental health ServicesEnvironmental Health Services work to prevent premature death and avoidable illness and disability that may result from interactions between people and the environment.

Food and milk programs ensure the safety • of consumer products at the manufacturing, wholesale and retail levels.

On-site wastewater programs help ensure the • safety of water resources by regulating basic sewage systems, responding to environmental complaints and approving individual sewage systems.

Pool and swim beach safety programs review • plans for recreational facilities and test water quality to prevent waterborne diseases.

Tattoo and body art programs inspect tattoo • facilities and license artists.

Engineering programs enforce the federal laws • for public water systems, inspect facilities and train and certify public water system workers to ensure the safety of drinking water.

Heating, ventilation, air conditioning and • refrigeration (HVAC/R) programs train and license HVAC/R professionals.

Plumbing programs train and license plumbing • professionals. Photo by Ed Barham

Photo by Ed Barham

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capital equipment$2,934,480

(0.9%)

Operationalexpenses

$52,950,104(16.5%)

Total Source of Funds $321,156,905 Total expenditure of Funds $321,156,905

Arkansas department of healthSource and Use of Funds, FY 2008

Source of Funds use of Funds

Tobacco Settlement Funds$15,089,681

(4.7%)

MedicaidMatch* & Other

$1,017,785(0.3%)

Federally Funded programs

$219,448,681(68.3%)

State Tax dollars(general revenue)

$54,988,930(17.1%)

Fees/reimbursable Services

$31,629,613(9.9%)

personnel$144,713,036

(45.1%)

grants andcontracts

$49,398,417(15.4%)

Food for Women, Infants and children (WIc)

$70,142,083(21.8%)

*Medicaid provides states with a federal financial match for state dollars.


Public HealtH: WhAT IT IS ANd hOW IT WOrKSPublic health is commonly understood as being a variety of clinical services and a collection of important programs. However, it is emerging into a more expanded role of assuring improved health outcomes for a population. Since the Institute of Medicine (IOM) published its landmark report The Future of Public health1 in 1988, there has been support to strengthen the framework of public health within levels of government and to organize public health around the primary functions and services that people most need to be healthy.

Definition of Public Health’s Mission, Substance and Organizational FrameworkAs cited in the IOM Report: Public health is the science and the art of (1) preventing disease, (2) prolonging life and (3) organized community efforts for (a) the sanitation of the environment, (b) the control of communicable infections, (c) the education of the individual in personal hygiene, (d) the organization of medical and nursing services for the early diagnosis and preventive treatment of disease and (e) the development of the social machinery to ensure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to realize his birthright of health and longevity.1

Within the same report, the substance of public health is defined as organized community efforts aimed at the prevention of disease and promotion of health. It links many disciplines and rests upon the scientific core of epidemiology.1 The organizational framework of public health is to encompass both activities undertaken within the formal structure of government and the associated efforts of private and voluntary organizations and individuals. 1

In more understandable language, public health works to improve the health of the community or population as a whole, rather than individual patients. The mission, or goal, is to address conditions so that people can be healthy. This is accomplished through monitoring communities and their people so that health problems and priorities are identified and addressed. Public

health develops public policies that will help to solve and address local or national health problems and issues. Another role of public health is to make sure that people of all races and walks of life are able to get and can afford to pay for any needed prevention and health services.

differences between public health and Medical health ServicesA key factor in being able to define public health is to know the difference between public health services and what doctors and hospitals do. First, public health services direct their efforts to the health of the whole population, while doctors and hospitals address the health of individual patients within their care, one-on-one or as patients in the institution. Second, public health services tend to focus on prevention (doing what is needed for all citizens to enhance their health and avoid illness), while doctors and hospitals focus more on diagnosing and healing illnesses. Third, public health looks at the whole community in order to 1) identify causes and risk factors underlying the spread of disease, 2) develop and promote practices to improve the population’s health and 3) develop and implement health policy with the same intention. Fortunately many doctors and hospitals, while doing one-on-one and institutional care, also address these goals.

The 10 essential public health ServicesSince the release of the IOM Report, there has been significant strengthening of practice in governmental public health agencies and other settings. State and local health departments, often viewed only as providing basic clinic services to the poor, actually do much more. They assure clean water, clear air and safe food, among other environmental and home health services. State health departments also operate licensing programs for health facilities, assuring quality of care. The IOM lists the services considered to be “public health,” that should be undertaken by communities called the “10 Essential Services.”2 These 10 essential services provide a working definition of public health and a guiding framework for the responsibilities of local public health systems. The following show how the essential services align with the three core functions of public health (assessment, policy development and assurance):

Assessment1) Monitor health status.2) diagnose and investigate health problems and hazards.

policy development3) Inform, educate and empower people.4) Mobilize partnerships and actions.5) develop policies and plans.

Assurance6) enforce laws and regulations.7) link people to needed personal health services.8) Assure competent health care workforce.9) evaluate health services.10) research for solutions to health problems.

how all the Services Work TogetherThrough these 10 essential services, public health agencies work to promote and protect the health of populations. However, public health agencies alone cannot assure the nation’s health. The population-based approach to improved health requires the work of many different health professionals. Health improvement requires the combination of management, science and local public health, in coordination with medical care providers, educational systems and other public health and government agencies.

1Source: Institute of Medicine, The Future of Public health Report, 1988 2These services represent Essential Public Health Services, defined and supported by the Institute of Medicine, the Core Public health Functions Steering Committee and the National Public health Performance Standards Program, 1994.


Public HealtH: SOMeThINg SO IMpOrTANT MAy be MISuNderSTOOdPublic health has made immeasurable improvements in areas that protect and preserve our quality of life. In fact, we address a wide range of physical, mental and social factors that influence the well-being of our citizens and communities. Despite this, surveys have found that, while citizens know public health is important, they aren’t exactly sure what it is or how it has touched their lives.

Part of the difficulty is because the role of public health has evolved from its beginnings over 100 years ago. In the early days, public health efforts were focused on controlling the spread of infectious diseases. Public health interventions like immunizations and regulations governing safe drinking water, were at the forefront of these efforts. Later, many public health agencies assumed the responsibility of providing care to indigent populations. This effort was largely the reason for the public’s perception of public health as being a provider of services for only the poor populations in our state.

Public health perception has also been impacted by its high visibility of emergency care. In recent years, public health has been most visible during disease outbreaks like West Nile Virus or disasters such as Hurricane Katrina. In actuality, public health services touch each and every Arkansan every day, but these services are generally out of sight and mind of the general public.

Another challenge is that public health is often confused with medical care. To clarify, a health care provider diagnoses and treats individual patients. Public health professionals have a broader responsibility to diagnose whole communities and develop plans of action to improve the health status of entire populations.

The role of public health has expanded to include clinical services such as providing maternity care, community efforts such as local emergency response, environmental efforts like restaurant inspections and in-home services in which our nurses provide direct care to the sick and homebound. All the while, public health employees have continued to do their jobs professionally and quietly. We don’t “toot our own horns” as loudly as we should and, as a result, we have done ourselves a disservice.

Since our inception more than 100 years ago, our public health system has strived to address our populations’ changing needs, providing more than 100 services to our various populations. In the 21st century, public health is facing many new challenges such as emerging infectious diseases, high rates of unintentional injuries, increased obesity rates in children and adults and the threat of bioterrorism. Added to that, the Department is facing workforce challenges, including large numbers of workers who are retiring, shortages of skilled and trained professionals and the need for ongoing education to assure that emerging diseases and new threats can be effectively addressed.

In Arkansas, we score at the bottom among the states for many health rankings. We can, and we must do better. Our rates for cancer, stroke and heart disease, physical activity, obesity and unintentional injuries are some of the poorest in the country.

Added to that, we have huge disparities in rates for minorities. However, we are making progress – a little at a time – and the future looks hopeful. Due to efforts in tobacco prevention and clean indoor air policies, we have seen decreases in smoking among youth and adults. Arkansas has been a leader in the development of tuberculosis and other infectious disease policies and procedures. Currently, we rank 27th in the U.S. in infectious disease rates. Arkansas ranks next to last in public health spending (dollars) per person. Despite the lack of funding, we are doing more with less, and our employees work harder with fewer resources.

So what are some of the future steps being taken to better the health status of Arkansans? The Department will continue to work to strengthen the focus of our core services. We have also identified four health priority areas to be addressed through a behavior change initiative over the next three to five years. These priorities are discussed in detail within this guide. It will take more than increased funding alone to see substantial improvements. Both individual behavior and systems-level changes will have to occur for us to be successful and to see better health outcomes. There will have to be expanded and aggressive partnerships to make a real and lasting impact.

We need to work harder to communicate the value and contribution of public health services so that there is better understanding and increased support from our citizens and policy makers. A strengthened understanding of public health in Arkansas will help us demonstrate how the good health of our children and adults is necessary in order to have better education and improved economic development.

So, come and share with us the story of public health in Arkansas. This Guide will explain who we are and what we do. You will see where we rank as a state in terms of disease rates, services provided and overall health status. You’ll see what interventions are in place to protect and improve the overall health status in your county. And most importantly, you’ll learn what you can do to be part of the statewide team of professionals working Toward a healthier arkansas.

“Public health services touch each and every Arkansan every day, but are generally out of sight and mind of the general public.”


Children at the State Capitol Photo by Ed Barham Clinton Library and Pedestrian Bridge Photo by Ed Barham

“Every day, the work of the Department affects the state’s entire population, including our visitors.”

Paul K. Halverson, DrPH, FACHE, Director & State Health Officer

Trolley at the River Market Courtesy of arkansas department of Parks & Tourism


Each year, the United Health Foundation partners with the American Public Health Association and Partnership for Prevention to produce the America’s Health Rankings, an assessment of the relative healthiness of our nation based on a set of factors. The rankings are comprised of two types of measurements - health determinants and health outcomes. Health determinants are those items that can affect future health of the population; whereas, health outcomes are those items that measure what has already occurred, either through death or missed days due to illness. For a state to improve the health of its population, efforts must focus on changing the determinants of health.

Unfortunately, Arkansas ranks poorly among the states and our rank for each perimeter is set out in the table on the following page. America’s Health Rankings – 2007 shows Arkansas as 48th in the state health rankings, down from 46th in 2006. Some of these problems can be corrected over a short period of time and some will take much longer. Some short-term solutions include decreasing the prevalence of tobacco use, providing optimal fluoride concentrations in community drinking water, promoting better nutrition to lessen obesity, requiring the use of seat belts when driving, providing excellent prenatal care for all expectant mothers soon after pregnancy begins and making sure that all women of reproductive age are in the best health possible.

We have shown progress and strength in a number of areas. We have a low prevalence of binge drinking, ranking 9th in the nation, and a moderate high school graduation rate, ranking 26th in the nation. Over the past year, we have seen improvements in both the prevalence of obesity and immunization coverage. Since 1990, we have seen a remarkable 24% decrease in smoking among youth and adults.

With the support of continued health initiatives and the implementation of evidence-based interventions, we look forward to seeing additional improvements in our state’s health outcomes.

Photo by Ed Barham

AMERIcA’S HEALTH RANKINGS™ - 2007 EDITION

HEALTH RANKINGS

15 adh GUIdE 2007-08Source: AHR = America’s Health Rankings (United Health Foundation) 2007 www.unitedhealthfoundation.org/↑ and ↓ indicate major increases and decreases in the last year. --- indicates data not available. *Data may not be comparable. Ranking out of 50 states, where 1 = best and 50 = worst.

ARKANSAS RANKINGS

2007 2006 2000 1990VAlue rANK VAlue rANK VAlue rANK VAlue rANK

perSONAl behAVIOrSPrevalence of Smoking (Percent of population) 23.7 44 23.5 41 27.2 46 31.3 35

Prevalence of Binge Drinking (Percent of population) 12.4 9 10.4* 5* 10.3* 7* — —Prevalence of Obesity (Percent of population) 26.9↓ 36 28 44 22.7 47 13.2 41

High School Graduation (Percent of incoming ninth graders) 76.8 26 76.6 21 73.2* 22* 78.6* 18cOMMuNITy eNVIrONMeNT

Violent Crime (Offenses per 100,000 population) 552 40 529 39 490 29 413 23Occupational Fatalities (Deaths per 100,000 workers) 10.1 45 11.1 44 7.2 37 14* 41

Infectious Disease (Cases per 100,000 population) 16.4 27 15.8 27 24.1 21 37 35Children in Poverty (Percent of persons under age 18) 26.6↑ 49 18.6 35 18.5 35 25.2 43

publIc & heAlTh pOlIcIeSLack of Health Insurance (Percent without health insurance) 18.9↑ 42 17.5 42 13.6 32 19.1 45

Per Capita Public Health Spending (Dollars per person) $64 49 $64 49 — — — —Immunization Coverage (Percent of children ages 19 to 35 months) 75.0↑ 45 67.8 49 70.4 36 — —

clINIcAl cAreAdequacy of Prenatal Care (Percent of pregnant women) 69 41 69 41 69.7* 45* 61.4* 46*

Primary Care Physicians (Number per 100,000 population) 98.7 41 97.9 41 — — — —Preventable Hospitalizations (Number per 1,000 Medicare enrollees) 92.7 43 92.3 43 — — — —

All deTerMINANTS -11.4 48 -9.4 44 -7.2 45 -5.4 44HEALTH OUTCOMES

Poor Mental Health Days (Days in previous 30 days) 3.8 43 3.7 45 3.2 35 — —Poor Physical Health Days (Days in previous 30 days) 4.1 45 4.1 44 4 48 — —

Infant Mortality (Deaths per 1,000 live births) 7.9 38 8.1 41 8.8 44 10.3 30Cardiovascular Deaths (Deaths per 100,000 population) 367.6 44 376.4 44 391.2 45 425.3 38

Cancer Deaths (Deaths per 100,000 population) 219.2 46 215.6 43 220.4 41 198 24Premature Death (Years lost per 100,000 population) 9,763↑ 47 9,587 46 9,476 48 9,523 44

All heAlTh OuTcOMeS -4.9 44 -6.6 45 -5.3 44 -3.9 45OVerall rank -16.3 48 -16.1 46 -12.5 46 -9.3 45

HealtH OutcOMes

deterMinants


Infant mortality is the 15th leading cause of death in Arkansas. The overall rate in Arkansas is among the highest in the nation: 7.9 deaths per 1,000 live births. Blacks are more than twice as likely to die in infancy as whites. Costs in dollars are high and costs in terms of potential life lost can never be recouped. Because women with low incomes are more likely to give birth to low birth-weight babies, Medicaid bears a large portion of the financial burden of caring for these children.

The best intervention against infant mortality is prevention. Several evidence-based interventions can be implemented to affect change in three to five years. These include:

Promoting good health before becoming • pregnant

Working towards all women receiving prenatal • care in the first trimester

Increasing folic acid • supplementation

Promoting smoking • cessation

Reducing teen • pregnancies

Preventing sudden • infant death syndrome (SIDS)

Performing infant • cardiopulmonary resuscitation (CPR)

Physical activity is a health behavior that, when performed as recommended, can improve outcomes of serious health problems. Heart disease, cancer, stroke and diabetes accounted for 59 percent of deaths in Arkansas in 2005. Treatment costs for the survivors, as well as costs to society for lost

Compared to other states, Arkansas continues to rank toward the bottom in favorable health outcomes and at the top of serious health concerns. Overall, Arkansas ranks 48th out of 50 states according to America’s Health RankingsTM - 2007 published by United Health Foundation. In order to address some of our most serious health concerns, the Department of Health has established a new comprehensive initiative. The ideal targets considered for intervention were diseases, conditions or risk behaviors that:

Are serious health threats for our state • Have a range of evidence-based intervention • opportunities that include individual/family, community and policy approachesAre amenable to change within a three-to-five- • year windowWill further our efforts to eliminate health • disparitiesWill be acceptable to communities•

Initially, six primary health conditions and four risk behaviors were identified and considered further. Advantages and disadvantages of each target option, as well as the following factors were considered:

Mortality• Hospital costs• Years of potential life lost• Medicaid burden (in hospital charges)•

The following four strategic priority areas were selected based on the above considerations and because the likelihood of seeing measureable improvements within three to five years is high.

Injury is an important health concern within the state. Unintentional injury, including falls, fires and motor vehicle accidents, is the fifth leading cause of death for the population overall but is the leading cause of death for every age group under the age of 45. Costs to the state are high in terms of years of potential life lost, inpatient and outpatient

treatment costs and short-term and long-term treatment expenses. Intervention opportunities are widespread and comprehensive, ranging from

policy initiatives to individual behavior change, throughout the lifespan and through the schools, workplaces and community settings.

Injuries impose a substantial cost on the citizens, health care systems and health care payment systems within the state - a cost that is preventable in large part. A wide range of intervention

opportunities exist that are likely to be attractive to communities, including:

Policies: laws, ordinances, building codes, • statewide trauma system

Individual/Family Interventions: education, • safety checks, smoke detectors, driving under the influence (DUI) programs

Environmental Interventions: modifying the • home to prevent falls, establishing safety and equipment inspection programs, modifying the built environment to remove safety hazards

Access to Treatment: ensuring that the • appropriate medical care is available for all trauma victims

Worksites: worksite wellness and occupational • injury prevention programs

Employing these evidence-based interventions, in whole or in part, across Arkansas has the potential to reduce both the rate of injuries and their economic impact within three to five years.

The department’s Four Strategic priority Areas

Photo by Ed BarhamStrategic Priority: INJURY PREVENTION

Strategic Priority: PHYSICAL ACTIVITY

Strategic Priority: INFANT MORTALITY


chewing surfaces of first and second permanent molar (back) teeth. The dental sealants are thin plastic coatings which are applied to the chewing surfaces of the molars. Most tooth decay in children and teens occurs in these surfaces. Schools traditionally have been a setting for both dental disease prevention programs and for oral health status assessment. However, sealants remain underused, particularly among children from low-income families and from racial/ethnic minority groups. Studies have shown that targeted, school-based dental sealant programs can substantially increase prevalence of dental sealants and can reduce or eliminate racial and economic disparities in the prevalence of dental sealants. Appropriate use of sealants can save time, money and the discomfort associated with dental treatment procedures.

While fluoride works best on the smooth surfaces of teeth, sealants protect the chewing surfaces on the back teeth which have tiny grooves where decay often begins. Sealants and fluorides work together to prevent tooth decay. With optimal fluoride in drinking water and use of sealants, children can expect to reach adulthood having no cavities.

Alongside our core services, these four areas are overarching priorities within the Department. With the implementation of evidence-based interventions in these priority areas over the next three to five years, we look forward to seeing measureable improvements in our state’s health outcomes.

productivity, are high. Blacks are almost twice as likely to die from stroke as whites and more than twice as likely to die from diabetes as whites. Obesity resulting from poor eating habits and low participation in physical activity is a primary reason why Arkansas leads the nation in deaths from these conditions.

More than one quarter of America’s health care costs are related to obesity. Across the nation, adult obesity rates have doubled since 1980 and childhood obesity rates have tripled. In fact, the childhood obesity epidemic is putting today’s youth on a course to become the first generation to live shorter, less healthy lives than their parents.

Increasing opportunities for physical activity is an effective, low-cost strategy for improving quality of life for Arkansans of all ages. Several evidence-based physical activity interventions are available with the potential to affect change in three to five years, among them:

Policies/Environmental Interventions: laws, • ordinances, codes and policies supporting safe walking/biking routes; community exercise facilities; third-party reimbursement for exercise programs; sidewalks and walking/bike trails in housing developments

Individual/Family Interventions: exercise • programs, walking clubs, support groups, awareness campaigns, health education

Schools: increased opportunities for and • varieties of physical activity, walk-to-school initiatives, bike clubs, secure parking for bicycles

Worksites: wellness facilities that encourage • employees to exercise during the day and offer incentives for participation in wellness programs.

Oral health is an integral part of overall health. In children, tooth decay has been associated with difficulty eating, sleeping and learning, and in maintaining proper nutrition. In Arkansas, 61 percent of children under age nine have already experienced tooth decay.

Although it is preventable, tooth decay is the most common chronic condition of childhood. Left untreated, tooth decay can cause pain and tooth loss.

Among adults, untreated decay and the resulting tooth loss causes negative effects on self-esteem and employability. In Arkansas, 29 percent of adults 65 and older have lost all of their teeth. The burden of tooth decay is far worse for Arkansans with low socioeconomic status and for those who live in rural areas. In both cases, access to prevention and treatment services is limited.

This priority has two main areas of emphasis:

Water Fluoridation: Adjusting the fluoride levels in community drinking water to a concentration of 0.7 to 1.2 parts per million has repeatedly been shown to be a safe, inexpensive and effective method to prevent tooth decay. Fluoridation benefits whole communities, especially those populations with limited access to dental services. On average, for every dollar spent on fluoridation, $38 is saved in treating tooth decay. Studies of community water fluoridation confirm that positive effects may be seen in three to five years. A 30 percent decrease in childhood tooth decay has been documented in communities that fluoridate their water supplies.

Dental Sealants: Dental sealants are almost 100 percent effective in preventing tooth decay on the Photo by Ed Barham

The department’s Four Strategic priority Areas

Strategic Priority: ORAL HEALTH

Summary


cHRONIc DISEASE

Breast and cervical cancer control (Breastcare)Our Purpose:Reduce mortality by increasing the rate of early detection of breast and cervical cancer through public and professional education, provision of free mammograms, clinical breast exams, pelvic exams, Pap smears, diagnosis and follow-up cancer treatment if needed.

Target Population:Low-income women 40 years and older who are uninsured and under-insured residents of the State of Arkansas.

Advisory boardsAdvisory Board - Breast Cancer Control • Program (Breast Cancer Control Act 434 of 1997) Cervical Cancer Task Force (Act 1414 • of 2005) - BreastCare Program provides administrative support.

comprehensive cancer controlOur Purpose:Develop strategies to reduce overall cancer incidence and mortality and to provide an improved quality of life for those affected by cancer in Arkansas.

Target Population:Under-served residents of the state, decision and health policy-makers and youth.

Advisory boardArkansas Cancer Coalition•

Diabetes Prevention and controlOur Purpose:Conduct activities to assess and reduce the burden of diabetes and its complications in Arkansas.

Target Population:Arkansans 18 years of age and older at risk for diabetes, with an emphasis on disparate populations.

Advisory boardDiabetes Advisory Council•

THROUGHOUT THIS GUIDE: Target population is all

Arkansans unless otherwise noted. Advisory boards are

included only when applicable.

WHAT WE DOFy08 Fy07 Fy06

Clinical Breast Exams 10,703 14,386 12,646

Pap Tests 8,482 9,460* 8,149*

Screening Mammograms 9,891 10,949 9,840

*The Electronic Data System’s (EDS) Pap test data was changed in February 2008 to report more accurate Pap test information.

Photo by Ed Barham


Heart Disease and Stroke PreventionOur Purpose:Provide public and professional education to promote policy, environmental and systems changes to prevent and reduce disability and death from heart disease and stroke.

Target Population:Adult Arkansans.

Advisory boardsHeart Disease & Stroke Task Force• Acute Stroke Care Task Force (Act 663 of • 2005) – Provides administrative support.

WHERE WE STAND Ar7 u.S.7 rANK1

Cervical Cancer Deaths, 20043 56 3.5 2.4 +45.8% N/A

Cervical Cancer Incidence, 20042, 3 139 9.9 7.9 +25.3% 48

Colorectal Cancer Deaths, 20043 617 20.6 17.9 +15.1% 46

Colorectal Cancer Incidence,20042, 4 1,543 50.0 49.5 +1.0% 24

Diabetes Deaths, 20054 824 26.6 24.6 +8.1% 34 Diabetes Prevalence, 20075, 6 -- 9.2% 8.0% +15.0% --

Female Breast Cancer Deaths, 20043 418 24.9 24.4 +2.0% 36

Female Breast Cancer Incidence, 20042 1,713 106.1 117.7 -9.9% 3 Ischemic Heart Disease Deaths, 20054 5,304 169.4 144.4 +17.3% 45

Lung Cancer Deaths, 20044 2,099 68.9 53.3 +29.3% 49 Lung Cancer Incidence, 20042, 4 2,513 79.7 67.4 +18.2% 44 Obesity Prevalence, 20075, 6 -- 29.3% 26.3% +11.4% 46

Prostate Cancer Deaths, 20044 316 28.3 25.4 +11.4% 38

Prostate Cancer Incidence, 20042, 4 2,062 148.2 145.3 +2.0% 23 Stroke Deaths, 20054 1,847 58.6 46.6 +25.8% 48 Tobacco Use Prevalence, 20075, 6 -- 22.4% 19.8% +13.1% --

1 - State rankings: 1 = best and 50 = worst 2 - Incidence = Number of new cases3 - Source: U.S. Cancer Statistics, 2004 data4 - Source: Centers for Disease Control and Prevention (CDC) Wonder, 2005 data5 - Prevalence = Estimated number of persons living with the disease 6 - Source: Behavioral Risk Factor Surveillance System (BRFSS), 2007 data7 - Case rates per 100,000 populationPercent difference was calculated by dividing the difference of the United States rate from the arkansas rate by the United States rate.

Photo by Ed Barham

Ar perceNTdIFFereNce

Numberof cases

case rate


FAMILY HEALTH

cHILD AND ADOLEScENT HEALTHTarget Population:Arkansans from birth through adolescence.

connectcareOur Purpose:Connect Medicaid and ARKids recipients to the health care delivery system by ensuring primary care physician (PCP) and dental enrollment through a toll-free telephone help-line; educate and inform recipients on appropriate utilization of the health care system, connect recipients to local health services, discourage use of the emergency room for non-emergency care and promote health education and disease prevention.

Target Population:Medicaid-eligible families.

Abstinence EducationOur Purpose:Provide technical assistance and funding to community-based organizations that implement abstinence-only programs in order to reduce teenage pregnancy and unwed birth rates.

Healthy Baby/Happy Birthday Baby BookOur Purpose:Process requests through a toll-free helpline for Happy Birthday Baby Book that promotes and encourages all pregnant women to receive early prenatal care, includes a monthly planner to record doctor visits and important pregnancy-related events and provides money-saving coupons for mother and baby to use along with information on pregnancy, fetal development, WIC services and immunizations.

Target Population:Pregnant women.

Infant HearingOur Purpose:Collect and analyze data from all infants in Arkansas who are screened for hearing loss and make referrals to care providers for follow up; coordinate activities through all birthing hospitals in Arkansas.

coordinated School HealthOur Purpose:Develop policy and strategies; provide technical assistance and financial support to schools, following the Coordinated School Model, in order to prevent chronic disease and improve academic outcomes.

Newborn ScreeningOur Purpose:Collect and analyze specimens from all infants born in Arkansas, report test results and perform follow up on abnormal results; provide counseling and medical technical assistance for genetically transmitted diseases.

HEALTH cONNEcTIONS

Lay Midwifery LicensureOur Purpose:Issue licenses, monitor performance and practice of lay midwives; provide information on lay midwifery in Arkansas.

WOMEN’S HEALTHTarget Population:Women of childbearing age and men, primarily low-income clients who are uninsured or under-insured.

Photo by ed Barham


Teenage Pregnancy/Unwed Birth PreventionOur Purpose:Provide technical assistance and funding to community coalitions charged with reducing the number of teen pregnancies and unwed births.

Maternity Nurse MidwiferyOur Purpose:Provide prenatal and postpartum care, including medical, nutritional and social assessment, along with case management; educate clients on pregnancy, nutrition, labor/delivery, infant care, reproductive health and parenting and provide nutritional and social consultation for high-risk women.

Pregnancy TestingOur Purpose:Provides pregnancy testing and counseling.

Reproductive HealthOur Purpose:Provide services to both men and women, enabling them to choose the number and the spacing of their children in order to prevent unplanned pregnancies.

WHERE WE STANDAr u.S. rANK*

First trimester prenatal care, 2005 78.3% 83.9% -6.7% --

Infant mortality rate (deaths from birth to age one/1,000 live births), 2004 8.1 6.8 +19.1% 43

Low birth weight (< 2,500 g or 5.5 lbs), 2004 8.9% 8.2% +8.5% 41

Preterm births (born prior to 37th week of gestation), 2005 13.4% 12.7% +5.5% --

Teen birth rate (births/1,000 females aged 15 to 19 years), 2004 59.9 40.5 +47.9% 47

* - State rankings: 1 = best and 50 = worstPercent difference was calculated by dividing the difference of the United States value from the arkansas value by the United States value.


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Photo by ed Barham


Number of family planning patients 81,138 82,164 84,062

Number of maternity patients 8,163 10,146 12,170

Number of physiologic hearing screens for infants2 39,086 38,508 37,157

1 - Data by calendar years2 - Data are provided by hospitals up to three months after service delivery. As a result, data for all of FY08 are not available. Source = Infant Hearing Program


LIFESTAGEHEALTH

LIFESTAGE HEALTHOur Purpose:Promote activities around physical activity and nutrition throughout all lifestages including children in schools, adults in worksites and older adults in communities.

Arkansas Healthy Employee Lifestyle ProgramOur Purpose:Encourage state employees to live a healthy life by focusing on proper nutrition, diet, exercise and smoking cessation.

Fruits & veggies: More MattersOur Purpose:Promote public awareness of the health benefits of eating fruits and vegetables; educate the public to include more servings in their daily eating patterns.

Governor’s council on Physical Fitness & HealthOur Purpose:Coordinate activities to promote and support physical activity in collaboration with the Governor’s Office.

WHERE WE STANDAr u.S. rANK1

Obesity among adults (BRFSS, 2007)2 29.3% 26.3% +11.4% 46

Prevalence of adults who have consumed fruits and vegetables five or more times/day (BRFSS, 2007)2 21.8% 24.3% -10.3% 341 - State rankings: 1 = best and 50 = worst2 - Behavioral Risk Factor Surveillance SystemPercent difference was calculated by dividing the difference of the United States value from the arkansas value by the United States value.

Fy08 Fy07 Fy06 WHAT WE DO

Percentage of Department of Health employees who participated in the annual Fitness Challenge 33% 19% *

* No data collected

Fy08 Fy07 Fy06

Photo by Bruce Sharp

Photo by Ed Barham



NUTRITION / WIc

Nutrition / Women, Infants and children (WIc) Our Purpose:Improve the health of infants, children and childbearing women by directly supplementing their diets with foods rich in nutrients; provide nutrition education and counseling and referrals to other services.

Target Population:Low-income pregnant, breastfeeding and non-breastfeeding postpartum women, infants and children up to age 5 who are found to be at nutritional risk through clinical assessment by a health care professional.

BreastfeedingOur Purpose:Promote and support breastfeeding through public education and education of health professionals.

WIc Farmer’s MarketOur Purpose:Encourage the consumption of fresh fruits and vegetables by WIC participants and promote the development of farmer’s markets.

WHERE WE STANDAr u.S. rANK

Percentage of population participating 3.2% 2.9% +10.3% -- in WIC*

WHAT WE DO Fy08 Fy07 Fy06

WIC Participants (infants and children)* 110,867 107,827 107,123 WIC Participants (women)* 52,899 52,860 51,259 Pregnant 34,946 Postpartum 12,228 Breastfeeding 5,725

WIC Farmer’s Market 21,187

* - (June 07-Oct. 07)

* - Source: U.S. Department of Agriculture (USDA), May 2008Percent difference was calculated by dividing the difference of the United States value from the arkansas value by the United States value.

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Photo by Ed Barham

Ar perceNT dIFFereNce


ORALHEALTH

Oral HealthOur Purpose:Work toward optimum oral health for every Arkansan through primary prevention at the community, health care professional and family levels.

Advisory boardArkansas Oral Health Coalition•

Fluoridation ProgramOur Purpose:Provide education and promote awareness to communities concerning the benefits (reduce dental disease) of community water system fluoridation; provide funding to purchasing and install fluoridation and monitoring equipment.

WHERE WE STANDAr u.S. rANK1

Office of Oral Health


Population Receiving Fluoridated Water, 20022 62.1% 67.3% -7.7% 33

Students with Dental Sealants, 2003-2004 15%3 26%4 -42.3% --1 - State rankings: 1 = best and 50 = worst2 - Source = Centers for Disease Control and Prevention 2002 Water Fluoridation Reporting System 3 - Arkansas Oral Health Screening 2003-2004 4 - Centers for Disease Control and Prevention (CDC) Oral Health DataPercent difference was calculated by dividing the difference of the United States value from the arkansas value by the United States value.


TOBAccO PREvENTION & cESSATION

Tobacco Prevention and cessationOur Purpose:Reduce death and illness associated with tobacco use by developing, implementing, monitoring and evaluating a statewide comprehensive tobacco control program. Target Population:All Arkansans with particular attention to preventing the initiation of tobacco use among youth and promoting quitting among tobacco users.

Advisory boardsArkansas Tobacco Advisory Committee• Arkansas Tobacco Settlement Commission•


Adult tobacco users enrolled in tobacco cessation counseling, including free nicotine replacement therapy NA* 4,647 3,160

Compliance checks conducted to ensure that merchants are adhering to laws restricting youth access to tobacco 5,022 5,329 4,593

Paid health communication advertising (radio/TV/print) placed in local communities across the state 372 283 194

Number of school-based grants 21 30 19Number of community-based grants 16 19 19Number of Clean Air Act exemptions 49 50 359Number of Clean Air Act complaints 38 98 7

Prevalence of cigarette smoking among adults, BRFSS 20052, 4 22.4% 19.8% +13.1% --

Prevalence of cigarette smoking among high school students, YRBS ,20052, 3 20.7% 20.0% +3.5% --

Prevalence of smoking overall, BRFSS 20062, 4 23.7% 20.1% +17.9% 44

1 - State Ranking = All rankings represent status among the 50 states, where 1 = best and 50 = worst2 - Prevalence = Total estimated number of persons living with a disease or behavior3 - YRBS = Youth Risk Behavior Survey4 - BRFSS = Behavior Risk Factor Surveillance SystemPercent difference was calculated by dividing the difference of the United States value from the arkansas value by the United States value.

WHERE WE STAND Ar u.S. rANK1

* - Data not available


There were an estimated 84,000 fewer smokers in Arkansas in 2007, a decrease in smoking rates from 26.3% in 2002 to 22.4% in 2007 (National 2007 smoking rate is 19.8%) (behavioral risk Factor Surveillance Survey).

Since 2001 the rate of current cigarette smoking has dropped among Arkansas high school students from 34.7% to 20.7% in 2007, according to the Youth Risk Behavior Surveillance Survey (National 2007 smoking rate is 20.0%). In the last two years alone, the drop in the youth smoking rate translates into 6,234 fewer high school smokers in Arkansas, according to the Arkansas Youth Tobacco Survey (between 2005 and 2007).

perceNT OF curreNT SMOKerS IN ArKANSAS, 2002-2007

Source: Arkansas Behavioral Risk Factor Surveillance System


HEALTH SYSTEMS LIcENSING AND REGULATION

Health Facilities constructionOur Purpose:Conduct Life Safety Code surveys, conduct plan reviews on health facilities prior to construction and inspect facilities during the construction phase.

Health Facilities LicensureOur Purpose:Provide licensure and survey of hospitals, ambulatory surgery centers, outpatient psychiatric centers, abortion clinics, health maintenance organizations, recuperation centers, infirmaries, hospice facilities, home health agencies and freestanding birthing centers.

Medicare CertificationOur Purpose:Provide certification of hospitals, home health agencies, independent laboratories, ambulatory surgery centers, portable x-ray facilities, Clinical Lab Improvement Act (CLIA) facilities, hospices, swing beds, outpatient physical therapy facilities, independent practicing physical therapists, Prospective Payment Systems (PPS) rehabs, PPS psychiatric centers, alcohol/drug abuse treatment centers and Comprehensive Outpatient Rehabilitation Facilities (CORFs) to receive Medicare reimbursement.

Utilization ReviewOur Purpose:Regulate medical review activities of health insurers, health maintenance organizations, third-party administrators, managed care plans and any other entities offering health care utilization review, contracts or benefits.

Perfusion LicensureOur Purpose:Provide licensure of individuals engaged in the practice of perfusion.Note: Perfusion is the act of injecting fluid into a blood vessel in order to reach an organ or tissues, usually to supply nutrients and oxygen.

Orthotics Prosthetics Pedorthics LicensureOur Purpose:Provide licensure of individuals engaged in the practice of orthotic prosthetic and pedorthics and provide licensure of assistant orthotists and assistant prosthetists. Note: Orthotics and prosthetics is the production and fitting of artificial limbs and orthopedic braces. Certified pedorthists generally create foot orthotics.

HMO CertificationOur Purpose:Regulate health maintenance organizations for licensure and operational standards consistent with current patient care practices in coordination with the Arkansas Insurance Commission.

Emergency Medical Services & Trauma SystemsOur Purpose:Administer the emergency medical technician (EMT) written and practical certification examination, certify EMT instructors, inspect and license EMT training sites, license and regulate EMS personnel, investigate EMS complaints, collect pre-hospital data, compile and distribute summary results to EMS organizations and develop and lead efforts of a statewide trauma system.

HealtH FacilitY serVices

eMergencY Medical serVices


Emergency ResponseOur Purpose:Provide on-site response to hazardous and radioactive materials incidents, provide technical expertise and support to state and local government entities and to volunteer organizations in situations involving the release of nuclear or non-nuclear hazardous materials and coordinate the medical response to any technical or natural disaster.

Radioactive MaterialsOur Purpose:Regulate the use of radioactive material through the licensure of radioactive material users, registration of “in vitro” uses of radioactive material, registration of Generally Licensed (GL) Radioactive Material Devices and licensure of individuals remediating Naturally Occurring Radioactive Material (NORM) contaminated sites; perform compliance inspections of licensed radioactive material users and monitor NORM remediation sites.

Radiological Emergency ResponseOur Purpose:Provide on-site response to radioactive materials incidents and provide technical expertise and support to state and local government entities and to volunteer organizations in situations involving the release of nuclear materials.

RadonOur Purpose:Provide general information to the public concerning radon, including guidance on testing and mitigation activities.

X-Ray/Radiation Producing EquipmentOur Purpose:Provide registration and recertification of all radiation-producing equipment (other than particle accelerators); provide registration and recertification of all individuals or firms that provide radiation-related services; evaluate shielding proposals for radiation facilities; license users of particle accelerators and perform compliance inspections of all x-ray facilities or other registrants.

RADIATION cONTROLMammography Accreditation & InspectionOur Purpose:Regulate the use of mammography equipment through the accreditation of mammography facilities in accordance with the Federal Mammography Quality Standard Act (MQSA) and through the conduction of annual MQSA facility inspections.

Radiologic Technology LicensureOur Purpose:Conduct regulation and licensure of individuals administering ionizing radiation to human beings with the exemptions of licensed practitioners.


WHAT WE DO Fy08

health Facility Services

Health Facility Inspections/ Evaluation/Plan Reviews 1,243 1,692 1,602

emergency Medical Services

EMS2: EMTs3 Certified/ Recertified 2,993 2,828 1,582EMS2: Licensed/Relicensed 221 219 208EMS2: Vehicles (including aircraft) Registered 656 708 610

radiation control

Radiation Control: MQSA 4

Inspections 93 94 94Radiological Equipment Inspections 340 676 484Radioactive Material User Inspections 109 82 82

1 - Decrease due to reduction in Centers for Medicare & Medicaid Services (CMS) budgeted funding2 - Emergency Medical Services3 - Emergency Medical Technicians4 - Federal Mammography Quality Standard Act

WHAT WE DO continuedFy08 Fy07 Fy06

health Facility Services

Health Facility Inspections/Evaluations/Plan Reviews 1,243Health Maintenance Organizations (HMO Certifications) 5Orthotists, Prosthetists, Pedorthists and Assistants Licensed 187Perfusionists Licensed 66Utilization Review (UR) Certifications 55

health care Facilities regulated

Abortion Clinics 1Alcohol and Drug Facilities 3Ambulatory Surgery Centers 64CLIA* Laboratories 1,992Comprehensive Rehabilitation Facilities 6End Stage Renal Disease Units 63Freestanding Birthing Centers 0Home Health Agencies 221Hospice Facilities 57Hospitals 112Infirmaries 12In Vitro Fertilization Facilities 0Outpatient Physical Speech Therapy Centers 23Outpatient Psychiatric Centers 6Portable X-ray Units 10Private Care Agencies 15Rehabilitation Units 20Recuperative Care Units 11Rural Health Clinics 65Psychiatric Units 25Swing Bed Facilities 39

Courtesy of Children’s hospital

* - Clinical Lab Improvement Act


INFEcTIOUS DISEASE

communicable DiseaseOur Purpose:Oversee disease surveillance, epidemiology and control of outbreaks of communicable diseases and provide information to private and public health care providers and to the public regarding communicable diseases.

ImmunizationsOur Purpose:Provide immunizations (particularly to children and adolescents) against varicella, diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B, Haemophilus influenza type B, hepatitis A, meningococcal disease, pneumococcal disease, rotavirus, influenza and human papillomavirus and inform and educate public on all vaccine-preventable diseases, including information concerning adult immunization.

Immunization RegistryOur Purpose:Maintain registry of all immunizations given to Arkansas children.

HIv / AIDS Prevention and ServicesOur Purpose:Conduct testing and counseling, provide referral and partner notification services, provide funding to community-based organizations for case management, partner with health care providers for provision of medical services and provide prevention education.

Sexually Transmitted DiseasesOur Purpose:Conduct testing, diagnosis and referral for treatment of patients with sexually transmitted diseases, perform case management (interviewing and partner notification of patients and their partners) and provide prevention education.

TuberculosisOur Purpose:Conduct screening, diagnosis and treatment of tuberculosis and provide prevention education.

Zoonotic DiseaseOur Purpose:Conduct identification and control or elimination of animal diseases which are of public health significance and transmissible to humans, provide direct technical assistance or consultation to communities or individuals on zoonotic diseases and, when indicated, provide consultation with Arkansas physicians regarding post-exposure treatment of individuals bitten by a rabid or suspect rabid animal.

Advisory boardsArkansas Community Planning Group for • HIV PreventionTransition Advisory Group for HIV Services•

Photo by Ed Barham


Chlamydia, 20062 8,259 297.2 347.8 -14.5% 19

Gonorrhea, 20062 4,306 154.9 120.9 +28.1% 38 National Immunization Survey 2007 Mid-year Age Appropriate (19-36 months) Vaccination Rate2 -- 76.3 80.4 -5.1% 43

Primary and Secondary Syphilis, 20062 77 2.8 3.3 -15.2% 32

1 - State Ranking = status among the 50 states, where 1 = best and 50 = worst2 - Source = Centers for Disease Control and Prevention - Based on calendar year3 - Rates per 100,000 population

Percent difference was calculated by dividing the difference of the United States value from the arkansasvalue by the United States value.

WHERE WE STAND Ar3 u.S.3 rANK1


Chlamydia Cases 12,692 8,985 7,877Childhood Immunizations 383,909 309,216 321,972 Confirmed and Probable Cases of Communicable Diseases Reported to the Department of Health 3,364 3,828 3,218Doses of Flu Vaccine Administered in Mass Flu Clinics 103,5332 35,3483 ---Doses of Flu Vaccine Administered 503,185 414,941 420,359Early Syphilis Cases 240 195 105HIV (including AIDS) Cases Reported 335 325 375HIV Testing and Counseling 56,101 56,060 58,546Individuals Trained by HIV/STD/Hepatitis C Programs 1,1371 2,272 3,760Gonorrhea Cases 4,405 4,294 4,294Perinatal HIV Reports 18 13 13Sexually Transmitted Disease Investigations 14,125 14,732 12,478Training/Presentations: HIV/STD/Hepatitis C Programs4 11,321 11,280 11,760Tuberculosis Cases 84 114 109

1 - Decline is due to fewer new hires and more staff already certified in required CDC HIV counseling course. 2 - November 2007 (87 clinics)3 - November 2006 (26 clinics)4 - Health Public InformationNote: Sexually transmitted disease cases in this table are based on fiscal years rather than calendar years as reflected in previous table.Photo by ed Barham

Pho

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arha

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Numberof cases

case rate


INjURY PREvENTION AND cONTROL

Fire-Related Injury PreventionOur Purpose:Encourage community-driven public health by promoting safer and healthier communities through smoke alarm installations and fire prevention education for at-risk populations.

Traumatic Brain InjuryOur Purpose:Enhance the quality of life for traumatic brain injury survivors and their families by developing a comprehensive, multidisciplinary and easily accessible system of care.

Advisory boardTraumatic Brain Injury Advisory Board•

WHERE WE STAND Ar u.S.

FIre-relATed

Fire Fatality Rate (per 100,000 population)1 2.44 1.61 +51.6%

Number of households enrolled to receive smoke alarm installation.2, 3 6,393 5,350 +19.5%

Number of households with fire escape plan at initial contact.2, 3 1,903 -- --

Number of households with fire escape plan at follow-up.2, 3 3,671 -- --

Percent of enrolled households 99.8% 99.8% 0.0% with functional smoke alarm at follow-up4

OTher INjury

Motor Vehicle Crash Fatality Rate5 23.66 14.24 +66.15%

Traumatic Brain Injury Deaths6 (Motor vehicle accidents for all ages) 23.98 14.90 +60.94%

Unintentional Injury Death Rate6 71.20 54.18 +31.4%

1 - Source: Centers for Disease Control and Prevention Smoke Alarm Installation and Fire Safety Education Program, Stevenson & Lee, 20042 - Source: Centers for Disease Control and Prevention Division of Unintentional Injury Prevention, Community-based Smoke Alarm Installation & Education Report, 2002-073 - Number of households initially contacted = 21,9304 - Centers for Disease Control and Prevention Division of Unintentional Injury Prevention, Community-based Smoke Alarm Installation & Education Report, 20075 - Fatal Accident Reporting System (FARS) 2006, National Highway Traffic Safety Administration (NHTSA)

6 - Source: National Center for Health Statistics - 2005, average case rates per 100,000 population for years 1998-2002 Percent difference was calculated by dividing the difference of the United States value from the arkansas value by the United States value.



PHARMAcY SERvIcES & DRUG cONTROL

Pharmacy Services/Investigations & Drug controlOur Purpose:Provide information and assistance regarding drug recalls from the Food and Drug Administration, perform drug destruction, regulate and investigate legitimate drug handlers to ensure accountability, oversee scheduling of controlled drugs according to Arkansas law, provide investigation services for Arkansas health professional licensing boards and provide on-site investigation of drug storage areas in preparation for man-made or natural disasters.


Controlled Substance Registrations 109 * *Dose Units of Drugs Destroyed 2,327,796 2,417,887 1,880,966 Educational Presentations 6 5 2Legitimate Drug Handler Investigations 64 48 85Pharmacists in Local Health Units and Charitable Clinics 84 * * *Unavailable

Photo by Jerry Jones


PREPAREDNESS AND EMERGENcY RESPONSE

Emergency communications centerOur Purpose:Provide on-site telecommunications monitoring during major emergency situations, operate ambulance dispatch and maintain day-to-day radio communications within the Department.

Nuclear Planning and ResponseOur Purpose:Provide technical assistance to local governments in the development and implementation of radiological emergency response planning for incidents involving Arkansas Nuclear One, train emergency workers in a five county area and perform environmental monitoring activities.

Public Health PreparednessOur Purpose:Coordinate public health preparation and response to bioterrorism, other infectious disease outbreaks and other public health emergencies through program components such as preparedness planning, surveillance and epidemiology, laboratory capacity, health alert network, risk communication and education and training.

Health care Preparedness Program (formerly Hospital Preparedness) Our Purpose:Enhance the ability of hospitals and health care systems to prepare for and respond to bioterrorism and other public health emergencies, utilizing interoperable communications systems, bed tracking systems, fatality management plans, hospital evacuation plans and volunteer programs.

Arkansas Nuclear One in RussellvilleCourtesy of Entergy

Note: The Emergency Communications Center is operated 24 hours a day, 7 days a week to respond to media and public inquiry in the event of an emergency.


WHAT WE DOFy08

emergency communications

Aircraft Ambulance Assistance 1,033 867 744Ambulance Assistance 3,049 3,289 2,907

Emergency Operations Center

Participated in and coordinated a two-day federally evaluated • radiological emergency preparedness exercise (REX’08) at Arkansas Nuclear One with several state agencies and five local governments.

Purchased ham radios for 84 hospitals.•

Provided training and licensed 165 new ham radio operators.•

Purchased Arkansas Wireless Information Network (AWIN) radios for • 105 local health units and 84 hospitals.

Participated in seven monthly regional video conferences with hospitals • across the state.

Hosted monthly Medical Reserve Corps videoconferencing calls.•

Provided regular training on videoconferencing equipment and Hospital • Bedtracking System to hospitals.

Conducted Emergency Systems for Advanced Registration of • Volunteer Health Professionals (ESAR-VHP) Program - now registering volunteers.

Implemented a strong fatality management plan – Arkansas Rapid• Mortuary Response (ARMoR) plan.

Implemented an Antiviral Drug Distribution Plan.•

Partnered with the Arkansas Army National Guard, Arkansas State • Police, Arkansas State Highway and Transportation Department and Arkansas Highway Police to conduct a mass vaccination exercise to distribute vaccine to all 75 counties in the state. Vaccines were distributed to all 75 counties in six hours.

Partnered with Arkansas Department of Emergency Management • (ADEM), Emergency Medical Services (EMS), Centers for Disease Control and Prevention (CDC), Arkansas State Police, Arkansas Army National Guard and Arkansas hospitals to conduct more than 100 dispensing exercises across the state.

Completed Pandemic (Pan) Flu Operations Plan.•

Conducted monthly tests in the Health Alert Network• .

Photo by Ed Barham

WHAT WE DO continuedFy08 Fy07 Fy06


ENvIRONMENTAL HEALTH

clean Indoor Air Act EnforcementOur Purpose:Process exemptions, monitor complaints and investigate establishments for compliance with the Clean Indoor Air Act of 2006.

Engineering-community ProtectionOur Purpose:Conduct investigations of complaints by citizens relating to the public health impact of cemeteries, overflows and discharges from community sewage collection and treatment facilities and hazards not covered by other programs within the Department.

Engineering-Plan ReviewOur Purpose:Review plans and specifications for new or expanded wastewater treatment facilities, collection systems and discharge locations for compliance with state regulations, accepted engineering practice and public health considerations.

Food ServicesOur Purpose:Inspect all food service, food processing and food storage facilities; review all plans for food service establishments, food stores and markets and other food-related establishments; issue annual food permits and collect samples of food products to ensure bacteriological standards are met.

General SanitationOur Purpose:Respond to environmental complaints involving vectors, sewage and other basic sanitation regulations; provide technical training for professional staff and industry personnel and investigate indoor air pollution complaints.

Heating, ventilation, Air conditioning & Refrigeration (HvAc/R)Our Purpose:Provide consultation to local public health officials, architects, engineers and other construction-related offices regarding heating, ventilation, air conditioning and refrigeration; supervise inspection program for newly constructed public and private facilities throughout the state for compliance with the State Mechanical Code; provide testing for the HVAC/R contractors and the issuance of four different types of HVAC/R licenses and publish license codes, rules and regulations.

*environmental health Services address public health-related environmental issues, complementary to Arkansas department of environmental Quality (AdeQ) services.

Photo by Ed Barham

Photo by Ed Barham

Note: Vectors are rodents, flies, mosquitoes or other organisms capable of transporting infectious disease.


Lead Paint TestingOur Purpose:Conduct inspection and testing for lead paint in single-family dwellings.

Mammography AccreditationOur Purpose:Conduct accreditation of mammography facilities in accordance with the Federal Mammography Quality Standards Act of 1992.

Marine SanitationOur Purpose:Inspect all vessels on the waters of the State of Arkansas to ensure compliance with Act 1774 of 2003 – the Marine Sanitation Act – and manage and coordinate construction of marine pump-out stations and pump-out boats.

Medical WasteOur Purpose:Regulate generation, handling, transport and disposal of medical waste and consult with health-related facilities, hospitals, physicians’ offices, private homes, industry and other agencies to determine proper control and disposal of medical waste.

Milk & DairyOur Purpose:Conduct monthly inspection of dairy farms, milk plants, single service plants and ice cream plants; issue various permits annually and perform milk sampling and lab analysis.

PlumbingOur Purpose:Provide consultation to local public health officials, architects, engineers and other construction-related professions regarding sanitary plumbing and natural gas systems; supervise inspection program for newly constructed public and private facilities throughout the state for compliance with Plumbing and Gas Codes; test and certify plumbers and city plumbing inspectors and issue various plumber and city inspector licenses; publish codes, rules and regulations for licensing and conduct plumber and gas-related training programs.

Public Water System SupervisionOur Purpose:Provide surveillance, inspection, technical assistance, training and analytical services (more than 100 potential contaminants) to ensure that public water systems are safe for public consumption and to comply with the National Primary Drinking Water Regulations; investigate water quality complaints and provide training, examination and certification of water operators.

Photo by Ed Barham


Public Water System Supervision: cross- connection controlOur Purpose:Provide assistance to public water systems in developing and implementing cross-connection control programs within their service areas to safeguard customers’ drinking water.

Public Water System Supervision:Fluoride AnalysisOur Purpose:Provide routine monthly analyses for fluoride for all community public water systems artificially fluoridating or containing significant amounts of naturally occurring fluoride and notify system if fluoride results deviate from optimal amount for prevention of tooth decay.

Public Water System Supervision: MonitoringOur Purpose:Conduct collection and analysis of water system specimens to ensure safe public drinking water supplies and to determine water quality compliance with Safe Drinking Water Act.

Public Water System Supervision: Non-community SystemsOur Purpose:Provide oversight of sampling and laboratory testing of water for non-community water systems and evaluate systems to ensure safe drinking water supply and for compliance with regulations.

Note: Non-community systems service an average of 25 or more non-residential customers with more than 15 service connections for at least 60 days out of the year. Photo by Ed Barham

Photo by Sherrie Shepherd


Rodent & vector controlOur Purpose:Provide technical assistance to county and local officials in eliminating rodents and controlling vectors and related organisms.

Septic TanksOur Purpose:Inspect and approve/disapprove individual disposal systems; evaluate, review and approve/disapprove alternate and experimental sewage system applications and subdivisions; issue annual licenses for septic tank manufacturers, installers and pumpers; conduct Arkansas Industrial Developers Commission (AIDC) sewage surveys and train professional staff and industry personnel.

Swimming Pools & Related FacilitiesOur Purpose:Conduct inspections of public or semi-public swimming pools, spas and related facilities.

Tattoo, Body Art & Permanent cosmeticsOur Purpose:Inspect facilities and issue license for artists; consult with tattoo and permanent cosmetic artists regarding new establishments, apprenticeship program and testing of apprentices; conduct inspections of tattoo and permanent cosmetic establishments for compliance with regulations; respond to public inquiries concerning tattooing and the application of permanent cosmetics; coordinate training for artists; review plans of new or renovation of existing establishments and develop revisions of regulations pertaining

to tattoo and permanent cosmetic establishments to reflect compliance with National Environmental Health Association, Center for Disease Control and FDA recommendations.

Public Water System Supervision: Source Water ProtectionOur Purpose:Provide oversight of a comprehensive, statewide source water assessment program to identify the areas that supply public drinking water, inventory contaminants, assess water system source susceptibility to contamination and inform the public of the results; provide technical assistance to public water systems to implement local source water protection programs.

RecreationOur Purpose:Conduct periodic inspections of summer camps, parks and outdoor swimming beaches.

Courtesy of arkansas department of Parks & Tourism

Note: Vectors are rodents, flies, mosquitoes or other organisms capable of transporting infectious disease.

Photo by S

herrie Shepherd


Water Supplies, PrivateOur Purpose:Conduct sampling of private water supplies for bacteriological content.

Well & Spring Drinking Water Fluoride AnalysisOur Purpose:Provide fluoride analysis kits to the public to test well or spring drinking water for fluoride concentration analysis so that dentists and physicians can prescribe appropriate supplemental fluoride dosages to help prevent tooth decay.


Active Water Operators Licensed 2,200 2,222 2,339Body Art Establishment Inspections 280 275 273Community Public Water Compliance with Safe Drinking Water Act Health Based Standards 95.4% 99.3% 96.2%Food Establishment Inspections 27,957 29,350 27,600Food Establishment Plan Reviews 1,021 1,008 1,064Heating, Ventilation, Air Conditioning and Refrigeration Licenses Issued 8,579 8,665 8,497Milk Plant and Dairy Farm Inspections 1,278 1,263 716Plumbing Licenses Issued 7,336 7,330 7,368Plumbing Plans Reviewed 2,369 2,508 2,587Public Swimming Pool Inspections 5,194 5,330 5,384Septic Tank Permits 6,076 7,818 9,695Water and Wastewater Inspections 1,200 1,127 1,215Water and Wastewater Plans Reviewed 2,954 3,264 3,735

Photo by ed Barham

Photo by ed Barham


IN-HOMESERvIcES

community-Based case Management for the ElderlyOur Purpose:Provide physician-ordered assistance through nurses who work with the patient and patient’s family to evaluate the patient’s needs and secure local resources and services to promote independent living at home.

HospiceOur Purpose:Provide in-home hospice services to terminally ill patients and their families through a Medicare-certified, state-licensed program and a physician-guided interdisciplinary group of nurses, home health aides, social workers, counselors and volunteers.

Note: hospice is on call 24 hours a day, 7 days a week. Bereavement services are available for families and caregivers.

Mother/Infant Home visiting ProgramOur Purpose:Provide physician-ordered prenatal services for postpartum and infant home visits by skilled nurses, including assessment and education to meet the medical, social and nutritional needs of the mother and infant.

Personal careOur Purpose:Provide physician-ordered services to persons who need help with daily living activities and are at risk of nursing home placement, to enable individuals to remain at home independently and avoid expensive institutional care; includes assessment and patient care supervision by a registered nurse and nurse aide services.

Home HealthOur Purpose:Provide in-home, physician-ordered health services through a Medicare-certified, state-licensed program to persons recovering from a serious illness.

Photo by Ed Barham



Case Management Units 156,760 148,644 225,245Elderchoice Hours 639,000 577,650 644,388Home Health Visits 315,115 317,507 315,340Hospice Days 47,446 58,027 58,624Maternal/Infant Visits 20,146 14,686 20,879Patients Served 26,393 26,732 27,374Personal Care Hours 1,208,050 1,315,159 1,522,185

Photo by Ed Barham


EPIDEMIOLOGY

chemical Materials Our Purpose:Respond to requests from the Arkansas Department of Environmental Quality (ADEQ) to independently evaluate trial burn information submitted by the Chemical Materials Agency (CMA) to determine any potential impacts on human health.

Note: CMa operates the facilities at the Pine Bluff arsenal that are responsible for the elimination of the chemical weapons stockpiles that are stored on that site. The program responsibility of the adEQ is to oversee the safe storage and the safe and timely destruction of the chemical weapons at the arsenal.

chronic Disease Epidemiology Our Purpose:Assist with the chronic disease surveillance and evaluation activities.

Note: Chronic disease Epidemiologists in this section work with the Chronic disease Branch staff to provide assistance with federally funded grants, monitor the trends of chronic diseases in the state, analyze data and disseminate results to health care professionals, legislators and the general public. They also assist with evaluation of the Chronic disease activities.

Foodborne Disease Our Purpose:Monitor reports from health care facilities and health care providers, as well as laboratory test reports, for indications of foodborne disease, commonly seen in persons experiencing gastroenteritis, vomiting, diarrhea, etc.

Note: The program maintains a database of these cases and looks for evidence of outbreaks. All confirmed and probable cases of these and other nationally notifiable communicable diseases are collected and reported to the Centers for disease Control and Prevention. Outbreaks of foodborne illness are reported separately to the CdC. Sources of foodborne disease, when identified, receive appropriate corrective action.

Medical Waste Program Our Purpose:Regulate all aspects of commercial medical waste management (i.e., accumulation, separation, storage, transportation, treatment and disposal) with respect to health care related facilities, commercial medical waste transporters and commercial medical waste

National Electronic Disease Surveillance System (NEDSS) Our Purpose:Provide electronic surveillance of communicable disease.

Note: Improvements in electronic lab reporting, coupled with the electronic transmission of initial case reports to local health units, have reduced the time to get critical communicable disease information to those in the field who conduct the first level of investigations.

treatment, storage and/or disposal facilities, as mandated by Arkansas Code Annotated, Volume 20, Chapter 32 (Disposal of Commercial Medical Waste).

Note: The purpose of these mandated regulatory requirements is to ensure proper treatment, handling and disposal of medical waste in arkansas, thereby preventing any potential transmission of infectious disease to the public from these medical waste-related activities.

Advisory Boards:Arkansas State Board of Health•

Advisory Boards:Arkansas State Board of Health•


Toxic Substances and Disease Registry Our Purpose:Conduct activities for the Agency for Toxic Substances and Disease Registry (ATSDR), the lead federal public health agency responsible for determining human health effects associated with toxic exposures, preventing continued exposures and mitigating associated human health risks at hazardous waste sites throughout the country.

West Nile virus (WNv) Surveillance Our Purpose:Develop and conduct enhanced bird, mosquito, human and equine surveillance activities, focusing on transmission of West Nile Virus, but including transmission of other medically important arboviruses; document human cases; document human cases with new routes of virus transmission and educate the public about the causes of arboviral diseases, notify the public of viral activities throughout the state and provide information to help protect the public.

Photo by Ed Barham


WHAT WE DOFy08

chemical Materials Completed independent evaluations of human health risk analysis for trial burns 2

Medical Waste program Administrative Enforcement Actions Taken 3Alternative Medical Waste Treatment Technologies Reviewed and Approved 3Applications for a Commercial Medical Waste Treatment Facility Permit Reviewed 4Commercial Medical Waste Transporter Fees Collected $37,784Commercial Medical Waste Transporter Permits Issued 4Commercial Medical Waste Treatment/Storage or Disposal Facilities 0Education/Guidance/Outreach Activities Provided to Community Leaders Regarding Collection and Disposal of Household Generated Contaminated Sharps and Syringes 12Medical Waste Clean-ups Conducted/Coordinated 3Medical Waste Complaints Investigated and Resolved 8Medical Waste Inquiries from the Public Addressed 36Medical Waste Inquiries from the Private Sector Addressed 29Medical Waste Generators Regulated 3,918Medical Waste Management Surveys from Hospitals Collected and Reviewed 111

NedSS Number of communicable disease nurses trained in NEDSS; will participate in a five-county pilot 15Percentage of NEDSS electronic reporting implemented 30%

Toxic Substances and disease registry Educational Activities Completed* 161Health Consultation Documents Completed 9Technical Assist Documents Completed 8

West Nile Virus Number of Birds Tested 75Number of Birds Positive 40Number of Chicken Flocks Tested 134Number of Chicken Flocks Positive 8Number of Human Positives 20Number of Human Deaths Due to WNV 1Number of Mosquito Pools Tested 169Number of Mosquito Pools Positive 32

* - Includes: site visits, public/community meetings, presentations, trainings, fact sheet development and distribution, etc.

WHAT WE DO continued

cy07* cy06* cy05*

Campylobacteriosis 246 189 226 Foodborne Outbreaks 2 5 4Hepatitis A 14 48 20Hepatitis B 72 90 75Hepatitis C 0 1 1 Meningococcal 9 11 18 Pertussis 173 112 321 Salmonellosis 847 917 735 Shigellosis 106 133 62 West Nile 20 29 28 * - Calendar years

cases of communicable diseases and conditions


HEALTH STATISTIcS

Health StatisticsOur Purpose:Collect, manage and analyze health-related data and statistics; conduct research and provide consultation and training and produce publications and reports.

Registries and Hospital DischargeOur Purpose:Collect, analyze and disseminate data on individuals with various diseases in Arkansas.

SurveysOur Purpose:Collect, analyze and disseminate data on health behaviors of Arkansans, using surveys such as the Behavioral Risk Factor Telephone Surveys and the County Adult Health Telephone Surveys.

vital RecordsOur Purpose:Register, file, store and preserve registration forms and issue certificates for birth, death and other vital records.

WHAT WE DOcy071 cy061 cy051

Behavioral Risk Factor Telephone Surveys Completed 5,732 5,596 5,280Cancer Cases Reported 14,405 14,392 14,393

County Adult Health Telephone Surveys Completed 3,445 3,431 6,383

County Youth Surveys Completed 722 7,073 1,691

Hospital Discharge Reports Collected 424,7142 408,458 408,340

Pregnancy Risk Factor Surveys Completed NA 2,094 2,238 1 - Based on calendar year

2 - Provisional data

Fy08 Fy07 Fy06

Births Registered 40,671 41,001 40,077

Deaths Registered 27,773 27,679 27,114

Vital Records: Certified Copies of Records Issued 371,953 363,667 346,322

HIv/AIDS/STD RegistryOur Purpose:Conduct Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS)and Sexually Transmitted Disease (STD) surveillance, maintain registry of diagnosed cases of HIV/AIDS and provide information on collective HIV/AIDS/STD cases reported to private and public health care providers and to the public.

Tuberculosis RegistryOur Purpose:Conduct tuberculosis surveillance activities and maintain registry of tuberculosis cases.

cancer RegistryOur Purpose:Conduct cancer surveillance activities and maintain registry of cancer incidence through collection, analysis, research and dissemination of cancer information; monitor cancer trends over time and determine cancer patterns in various populations.


LABORATORY

Laboratory Services(clinical/Biological, chemical & Alcohol Testing Labs)Our Purpose:Provide laboratory analysis and reporting of clinical and environmental samples, alcohol testing, microbiological testing of water for private individuals, neonatal screening of newborns, identification of organisms referred from clinical laboratories, certification of municipal water laboratories for microbiological testing, FDA compliance certification of milk industry dairy laboratories and unknown biological and chemical substance testing.


Alcohol Testing: Individuals Trained 742 746 582Alcohol Testing: Blood Tests Performed 1,205 1,404 1,560Alcohol Testing: Breath Tests Performed 26,000 19,562 19,261Alcohol Testing: Breath Instruments Repaired 243 231 234Environmental Samples Analyzed 84,447 86,324 90,992Environmental Tests Performed* 162,010 161,267 158,500Medical Samples Analyzed 276,037 272,819 246,029Medical Tests Performed* 531,058 524,721 415,792Newborn Screening for Genetic Diseases 169,055 167,392 163,831

* - Reflects multiple tests performed on samples.

Photo by Ed Barham

Photo by Ed Barham


cROSS-cUTTING SERvIcES

Arkansas Hometown Health ImprovementOur Purpose:Bring together a wide range of people and organizations, including consumers, business leaders, health care providers, elected officials, religious leaders and educators, to identify community health problems and to develop and implement solutions.

Hometown Health Improvement is a locally owned and locally controlled initiative that stresses:

collaboration• coalition building• community health assessment• prioritization of health issues• development and implementation of • community health strategies that are locally designed and sustained

department roleThe Department of Health provides support to help communities meet their needs for improving the health of their hometown by:

Minority Health and Health DisparitiesOur Purpose:Ensure that health services are appropriate, accessible and sensitive to the needs of minority populations. Health disparities, the difference in health and health care quality between races and ethnicities, address many topic areas including:

cancer • cardiovascular disease• stroke• diabetes• injury and violence• infant mortality• HIV/AIDS• access to health care•

community ServicesOur Purpose:Work collaboratively with each Center within the Department and a wide array of external partners to ensure that the services and support provided to communities are offered in an integrated manner, which promotes optimal utilization and efficiency of public health efforts at the local level.

Photo by Ed Barham

engaging interested individuals and • organizationsmobilizing the community to change• encouraging community dialogue to prioritize • health issues and develop effective solutionscollecting and interpreting local health data• identifying resources and coordinating • planning efforts

health professional development• improved data collection and analysis• cultural competency.•

Minority Health partners with many outside organizations including the Arkansas Minority Health Commission to maximize efforts and pool resources in order to expand the focus to eliminate health disparities.


Fy2006 Fy2007 Fy2008Alcohol TestingIndividuals Trained 582 746 742 Blood Tests Performed 1,560 1,404 1,205 Breath Tests Performed 19,261 19,562 26,000

disease prevention and control ServicesGonorrhea Cases 4,294 4,294 4,405Chlamydia Cases 7,877 8,985 12,692Early Syphilis Cases 105 195 240Sexually Transmitted Disease Investigations 12,478 14,732 14,125 HIV Testing and Counseling 58,546 56,060 56,101 Health Communication Public Information 11,760 11,280 11,321Perinatal HIV Reports 13 13 18HIV (including AIDS) Cases 375 325 335 ReportedTraining/Presentations: HIV/STD/Hepatitis C Programs 3,760 2,272 1,137Tuberculosis Cases 109 117 106Doses of Vaccine 420,359 414,941 503,185 Administered

emergency communicationsAmbulance Assistance 2,907 3,289 3,049 Aircraft Ambulance Assistance 744 867 1,033 emergency Medical ServicesAmbulance Services Licensed/Relicensed 208 219 221Emergency Medical Technicians Certified/Recertified 1,582 2,828 2,993Vehicles (Including Aircraft) 610 708 656 Registered

environmental health protectionFood Establishment Inspections 27,600 29,350 27,957 Food Establishment Plan 1,064 1,008 1,021 ReviewsMilk Plant and Dairy Farm 716 1,263 1,278 InspectionSeptic Tank Permits 9,695 7,818 6,076 Public Swimming Pool 5,384 5,330 5,194 InspectionsBody Art Establishment 273 275 280 Inspections

pharmacy Services and drug controlDose Units of Drugs Destroyed 1,880,966 2,417,887 2,327,796 Legitimate Drug Handler 85 48 64 Investigations Educational Presentations 2 5 6

protective health codesPlumbing Licenses Issued 7,368 7,330 7,336Plumbing Plans Reviewed 2,587 2,508 2,369HVACR Licenses Issued 8,497 8,665 8,579

public health laboratoriesMedical Samples Analyzed 246,029 272,819 276,037Medical Tests Performed4 415,792 524,721 531,058 Environmental Samples 90,992 86,324 84,447 AnalyzedEnvironmental Tests Performed4 158,500 161,267 162,010

public WaterWater and Wastewater 1,215 1,127 1,200 InspectionsWater and Wastewater Plans 3,735 3,264 2,954 Reviewed Community Public Water Compliance with Safe Drinking Water Act 96.2% 99.3% 95.4%

Fy2006 Fy2007 Fy2008epidemiologyCampylobacteriosis Cases 2261 1882 2463

Hepatitis A Cases 201 482 143

Hepatitis B Cases 751 902 723

Hepatitis C Cases (acute) 11 12 03

Meningococcal Disease Cases 181 112 93

Pertussis Cases 3211 1122 1733

Salmonellosis Cases 7351 9172 8473 Shigellosis Cases 621 1332 1063

West Nile Virus Human Cases 281 292 203

health Facility ServicesHealth Facility Inspections/ 1,602 1,692 1,001 Evaluations

In-home ServicesPatients Served 27,374 26,732 26,393Home Health Visits 315,340 317,507 315,115Maternal/Infant Visits 20,879 14,686 20,146Hospice Days 58,624 58,027 47,446Personal Care Hours 1,522,185 1,315,159 1,208,050 Elderchoice Hours 644,388 577,650 639,000Case Management Units 225,245 148,644 156,760

Fy2006 Fy2007 Fy2008public Water continuedActive Water Operators 2,339 2,222 2,200 Licensed

radiation control andemergency ManagementRadioactive Material User 82 82 109 Inspections Radiological Equipment 484 676 340 Inspections

Services for Infantsand childrenNewborn Screening for Genetic Diseases 163,831 167,392 169,055Physiologic Hearing Screening of Infants 37,1571 38,5082 39,0863 WIC Participants (Infants and Children) 107,123 107,827 110,867Childhood Immunizations 321,972 309,216 383,909 Services for WomenWIC Participants (Women) 51,259 52,860 52,899 Family Planning Patients 84,062 82,164 81,138 Maternity Patients 12,224 10,099 8,163

breast and cervical cancer controlScreening Mammograms 9,840 10,776 9,891Screening Pap Smears 8,401 9,573 8,482Clinical Breast Exams 12,619 14,334 10,703

Vital recordsCertified Copies of Records 346,322 363,667 371,953 Issued Births Registered 40,077 41,001 40,671 Deaths Registered 27,114 27,679 27,773

1 - Calendar Year 20052 - Calendar Year 20063 - Calendar Year 20074 - Reflects multiple tests performed on samples.

2006 - 08 Selected Statistical Indicators


ABBREvIATIONS, DEFINITIONS AND TERMS

ACHI: Arkansas Center for Health Improvement

ADEM: Arkansas Department of Emergency Management

ADEQ: Arkansas Department of Environmental Quality

ADH: Arkansas Department of Health

ADMO: Associate Director for Management and Operations

ADS: Associate Director for Science

AHELP: Arkansas Healthy Employee Lifestyle Program

AIDS: Acquired Immune Deficiency Syndrome

ATSDR: Agency for Toxic Substances and Disease Registry

BMI: Body Mass Index

CD: Communicable Disease

CDC: Centers for Disease Control and Prevention

CHPS: Community Health Promotion Specialist

CIO: Chief Information Officer

CLIA: Clinical Laboratory Improvement Act

COO: Chief Operating Officer

COPH: Fay W. Boozman College of Public Health

CY: Calendar Year (January - December)

EMS: Emergency Medical Services

EOC: Emergency Operations Center

EPA: Environmental Protection Agency

EPI: Epidemiology

FEMA: Federal Emergency Management Agency

FMNP: Farmers Market Nutrition Program

FY: Fiscal Year (July - June)

GIS: Geographic Information System

HazMat: Hazardous Materials

Health Disparities: The difference in health status and health care quality between races and ethnicities

HHI: Hometown Health Improvement

HIV: Human Immunodeficiency Virus

HVAC/R: Heating, Ventilation, Air Conditioning and Refrigeration

IHS: In-home Services

INCIDENCE: Incidence of a disease is the frequency at which new cases occur in a population during a specified period.

LHU: Local Health UnitCourtesy of arkansas department of Parks and Tourism

MCH: Maternal & Child Health

MORTALITY: Mortality is the incidence of death from a disease.

NEDSS: National Electronic Disease Surveillance System

OMHHD: Office of Minority Health & Health Disparities

PREVALENCE: Prevalence of a disease is the number of total cases in a population at a point in time.

SNS: Strategic National Stockpile

SOS: Stamp Out Smoking

STD: Sexually Transmitted Disease

TB: Tuberculosis

UAMS: University of Arkansas for Medical Sciences

WIC: Women, Infants and Children (special supplemental nutrition program)

arkansas dePartMent OF HealtHKeeping your Hometown Healthy

Office of Health Communications and Marketing

Arkansas Department of Health – 2008 Guide to Programs and Services Produced by Health Marketing Staff: Writers/Editors: Jan horton, amanda Fincher, ann Wright, Catherine TappGraphics/Layout: Sherrie ShepherdPhotos: Ed Barham, Sherrie Shepherd, Bruce Sharp, Jerry Jones

electronic copies are available on www.healthyarkansas.com