Community Profile 2006
As part of its mission, the Arkansas Affiliate of the Susan G. Komen Breast Cancer Foundation produces a bi-annual Community Profile providing appropriate demographics, breast cancer statistics, and, at the same time, assessing breast health/breast cancer needs and services in the 63-county area served by the Affiliate.
Executive Summary
Physical Description of Service Area
The service area for the Arkansas Affiliate includes 63 of the 75 counties in Arkansas. Arkansas has been described as a small, rural state dependent upon an agrarian economy. The 63 counties in the Arkansas Affiliate service area range from the mountains of the west and north central regions to the low-lying farmlands of the east and southern Delta. Arkansas’ two million residents live primarily in rural areas, small communities, or small cities. The largest county, Pulaski County, which is home to the capital city of Little Rock, has a population of 272,839 residents.
Demographics
The largest population for ethnic minority women in Arkansas includes African American women (159,341). The largest population of women in Arkansas requiring breast cancer screening by age and ethnicity consists of Caucasian women, > 65 years (198,071) and 40-49 years (159,868); African American women, 40-49 years (30,991); Hispanic women, 40-49 years (3,517); and Asian women, 40-49 years (1,842). Counties in the Arkansas Affiliate service area with the largest population of African American, Hispanic, Asian, and Native American women include Crittenden, Faulkner, Jefferson, Pulaski, Sevier, and Yell Counties. Arkansas has a population of 203,634 with an income of > $15,000. Pulaski, Garland, and Craighead Counties in the Arkansas Affiliate service area have the largest population that have an income of < $15,000. The population in Arkansas with less than a high school education includes 437,464 residents. Counties in the Arkansas Affiliate service area with the largest population that have less than a high school education consist of Pulaski, Garland, and Jefferson Counties.
Breast Cancer Statistics
There are 396,902 residents in Arkansas who had no breast cancer screening. Counties in the Arkansas Affiliate service area with the highest number for no breast cancer screening and breast cancer screening frequency of 5+ years by all demographic variables include Pulaski, Garland, Saline, Faulkner, Jefferson, Craighead, and Crittenden Counties. Persons in Pulaski, Saline, Faulkner, Garland, and Craighead Counties with income levels of < $15,000 and $35,000-$50,000+ had a higher number for no breast cancer screening and breast cancer screening frequency of 5+ years, when compared to persons with other income levels in other Arkansas counties.
Counties in the Arkansas Affiliate service area that have the highest number of persons with less than a high school education who had no breast cancer screening and had breast cancer screening frequency of 5+ years include Pulaski, Garland, and Jefferson Counties. Persons with less than a high school education and a high school education in Pulaski, Saline, Garland, and Jefferson Counties had a higher number with no breast cancer screening and breast cancer screening frequency of 5+ years, when compared to persons with other education levels in other Arkansas counties. Garland, Saline, and Pulaski Counties have the highest number of cases for invasive incidences of breast cancer for Caucasians. Jefferson County has the highest number of cases for invasive incidences of breast cancer for African Americans; and Pulaski County has the highest number of cases for invasive incidences of breast cancer for Hispanics.
Programs and Services
The sample for the Programs and Services Survey included administrators and staff in 109 programs (23% response rate)This sample included breast cancer and breast health programs in hospitals; mammography facilities; rural health, Area Health Education Center (AHEC), and Health Department clinics; Community Health Centers; centers for older adults; battered women’s shelters; ethnic minority programs; and church ministry programs. Follow-up procedures for non-respondents included one follow-up with phone calls; and e-mailing, mailing, or faxing the survey instrument to non-respondents. The program services reported in this survey included 5-100 services for the following types of services: support groups; hospice; prosthetic; mammography; research; breast cancer treatment; breast cancer education with multilingual educational materials and staff; breast cancer screening; services for underserved, uninsured, low income, disabled, rural, ethnic minority, and lesbian groups. These programs and services are provided in all regions of Arkansas. The types of services that had a lower number of services reported in the Program Services Survey included: Research, support groups, hospice, prosthetic, breast cancer treatment, and mammography services.
Overview of Key Informants Survey: Issues and Themes for Breast Healthcare
The key informants for the Key Informants Survey (N = 11, response rate = 37%) included administrators in hospitals, mammography and radiology programs, health department and rural health clinics, Community Health Centers, and breast cancer support groups in Baxter, Bradley, Clay, Cleveland, Craighead, Hot Spring, Polk, Pulaski, Randolph, and Searcy Counties of Arkansas. Follow-up procedures for non-respondents included one follow-up with e-mailing or faxing the survey instrument to non-respondents.
The issues and common themes reported in the Key Informants Survey include needs for and barriers to breast healthcare regarding access, cost, fear, education, cultural and behavioral factors and social support. The key informants reported that the following populations have the greatest need for breast healthcare: African American, Caucasian, general population, Hispanic/Latina, low income, low literacy, rural, and uninsured/underinsured populations.
Access Issues/Themes
The common themes and needs reported for access to breast healthcare involved: Access barriers including no public transportation, rural area, location of services too far away, and lack of medical providers; needs regarding access to breast healthcare for low literacy, uninsured/underinsured, low income, and rural groups, Caucasians and ethnic minority groups; transportation assistance; problems with age limits for services; poor access to cancer treatment and mammography; and need for collaborating with community health programs and community agencies to reach the disabled, aging, and low income groups.
Cost Issues/Themes
Common themes and needs reported on the Key Informants Survey regarding cost for breast healthcare included: Cost barriers consisting of not being able to afford to take off work, uninsured/underinsured, cannot afford services, poverty, and cannot afford transportation; needs regarding payment for treatment and screening, problems with income limits for breast health services, financial assistance for mammograms, and financial burden of breast cancer.
Fear Issues/Themes
Common themes reported on the Key Informants Survey regarding fears barriers to breast healthcare include: Results of tests, having cancer, losing a breast, going to the doctor, procedures and pain.
Education Issues/Themes
Common themes and needs reported on the Key Informants Survey regarding education for breast healthcare included education barriers involving lack of education, literacy; myths, false information; not aware of risk; and not discussed or recommended by doctor; and needs for more breast health education, outreach for health promotion, and education for minority ethnic groups.
Cultural/Behavioral Issues/Themes
Common themes reported on the Key Informants Survey regarding cultural/behavioral barriers to breast healthcare include: Other health problems more urgent, procrastinates or forgets, embarrassment and modesty, family won’t allow it, fatalism and no faith in the medical system.
Social Support Issues/Themes
Common themes and needs reported on the Key Informants Survey regarding social support include needs for social and financial support and poor access to breast cancer support groups.
Prioritized Breast Health and Breast Cancer Gaps (Needs)
The prioritized breast health and breast cancer gaps (needs) were based on an evaluation of the demographic data, breast cancer statistics, Programs and Services Survey Report, and Key Informants Survey Report in the Online Report of the Community Profile for the Arkansas Affiliate.
Based on these findings, the gaps (needs) have been ranked and the following prioritized gaps (needs) have been identified:
- Cost
- Education
- Access
- Social Support
