Arkansas Department of Health 100 Years of Service 1913 - 2013

1. Arkansas Department of Health100 Years of Service1913 - 2013

2. The mission of the Health Department is to protect and improve the health and well-being of all Arkansans.

3. Life Expectancy • Disease Control • Immunizations • Sanitation • Maternal/Child Health • Safer Food • Safe Drinking Water 100 years of public health advancements have added more than 25 years to our life expectancy in the United States.

4. Early Threats of Infectious Diseases • Early focus was response to infectious diseases • Yellow Fever • Hookworm • Malaria • Smallpox • Tuberculosis • Polio Kickapoo Medicine Company Products

5. Site of First Boards of Health • 1832 – the first city • Board of Health • 1913 – the first permanent State Board of Health The Old State House Museum 300 W Markham, LR. AR 72201

6. Permanent Board Created The Rockefeller Foundation awarded a $1 million grant to 11 southern states & the Sanitary Commission for the Eradication of Hookworm Disease Three conditions to qualify: Publicly funded Board of Health Public Health Laboratory Bureau of Vital Statistics John D. Rockefeller By John Singer Sargent 1917 PD-US

7. Vital Records The first recorded death certificate in Arkansas

8. Malaria From 1915 to 1917 A campaign to rid Crossett, Ark. of malaria by eliminating or controlling the breeding sites of mosquitoes led to a drop in physicians’ calls for malaria from a high of 2,500 to only 200 – a 92 % decrease.

9. Influenza The Great Pandemic of 1918 • More than 675,000 Americans and 40 million people worldwide died from influenza • 7,000 Arkansans died from the flu and its complications • Only the Black Death killed more people (14th Century)

10. Tuberculosis By the 1960s, Arkansasled the nation in tuberculosis treatment innovations. Drs. Paul Reagan, Joseph Bates & William Stead

11. HIV/AIDS • First diagnosed in 1981, HIV/AIDS has taken the lives of more than 2,800 Arkansans • CDC has estimated that approximately 55,000 – 58,500 (U.S.) persons become infected with HIV each year The AIDS Quilt

12. Sexually Transmitted Diseases • Before World War II, syphilis was the 4th leading cause of death in the U.S., behind tuberculosis, pneumonia and cancer . • By the beginning of WWII, Arkansas had a rate of syphilis twice the national rate.

13. Immunizations Vaccines work really well

14. Environmental Health • 1911-12 – Nearly half of the 7,500 rural Arkansas homes had outhouses without protection from flies, insects, fowl and animals. • 1935-42 – Works Progress Administration & the Health Department built 51,418 free privies.

15. Environmental Health • After WWII, as more people moved into rural areas without sewer systems, septic tanks were the method for waste disposal. • Septic tank malfunctions led to the need for installation requirements and regulation.

16. Safe Drinking Water Only in the past 100 years has safe drinking water been a true reality to the vast majority of people in the United States.

17. Safer Food • 1893 – Arkansas’s 1st law on safe foods • 1906– U.S. Meat Inspection Act authorized Secretary of Agriculture to require meat inspections • 1917–Legislation required inspections of all food establishments

18. Oral Health Tooth decay has long been one of the most widespread health conditions in Arkansas. Not having enough teeth was a leading cause of military rejection during both World Wars.

19. Oral Health Every $1 invested in water fluoridation saves approximately $38 in unnecessary dental treatment costs Super Tooth says: Give tooth decay the one-two punch – water fluoridation and dental sealants!

20. Local Public Health It was the absence of, and insufficient access to, physicians in rural Arkansas that helped solidify the importance of local nurses in the minds of rural Arkansans. Ruth Anderson, one of the first two nurses hired by the Board of Health in 1925

21. Hometown Health Improvement • HHI Coalitions • Identify local health challenges & develop solutions • Facilitate planning • Provide technical assistance to communities • Connect communities with resources

22. Family Health • Early 1900s – For every 1,000 live births, 100 infants died before age five. One in nine women died of pregnancy-related complications. • Several federal programs were created for women and children including: • Sheppard-Towner Maternity and Infancy Act - 1921 • Title V of the Social Security Act – 1935 • Title X Family Planning Services • and Population Research Act - 1970

23. Advances in Midwifery • 1926 –Arkansas reported 4,000 midwives living in the state • 1940– Arkansas was 3rd in the nation for midwife-attended births, nearly one-fourth of all births • Today– A Lay Midwife Advisory Board licenses Arkansas midwives Traveling Arkansas, midwives with their support van & driver; c. 1920s (Michael B. Dougan, Encyclopedia of Arkansas History & Culture)

24. Special Supplemental Nutrition Program for Women, Infants and Children (WIC) • 1974–The Arkansas WIC program began in 14 counties • 1979– Every county LHU provided WIC services • 2004 – ADH WIC served 89,113 participants • 2008 – Arkansas’s WIC Farmers Market began • 2013 – AR WIC is using social media such as Facebook™ & texting for outreach & education

25. Chronic Diseases Nutritional deficiencies early 1900s: • Pellagra • Rickets • Chronic diseases today: • Heart Disease and • Stroke • Diabetes • Hypertension

26. Cancer • Cancer is the second leading cause of death in the U.S. • About one-half of all men and one-third of all women in the U.S. will develop cancer during their lifetimes. • 1945 – Act 277 established a free-standing Cancer Commission with a hospital-based Statewide Cancer Registry • 1970s – Bureau of Cancer & Special Services • 1992 – Department received federal funding to create a breast and cervical cancer program • 1994 –New central cancer registry implemented by Health Department • 1999 –BreastCare program fully operational • 2001 –Arkansas Cancer Plan developed

27. Tobacco • In 1964 –U.S. Surgeon General issued report on dangers of smoking/lung cancer • 1993 – Tobacco Prevention and Education Program established • 1998 –Tobacco Master Settlement Agreement (MSA) reached • 2006 –Clean Indoor Air Act prohibited smoking in indoor workplaces and public areas A 1926 ad targeting women, an untapped market at the time (Leggett & Myers) • 1881 – Advent of a cigarette-making machine • WWI and WWII–Free cigarettes • provided to servicemen

28. Arkansas Trauma System • Injury is the #1 killer of Arkansans between the ages of one and 44 • In 2010 Arkansas’s injury death rate was 31% higher than the national average • Today Arkansas has 58 designated trauma centers • The ‘golden hour’ is the time period following traumatic injury when there is the highest likelihood that prompt medical treatment will prevent death.

29. Minority Health & Health Disparities • Arkansas’s history of slavery, segregation, and discrimination played a role in the health of minorities • In the last 30 years significant changes occurred to address health disparities • 1991– Arkansas Minority Health Commission and Office of Minority Health • 1997 to 1998– Study examining factors affecting Latino access to public health care • 2011– Acts 790 & 798 health equity • 2011– Joseph Bates Outreach clinic opened to serve Marshallese and Hispanics

30. Minority Health & Health Disparities Marshallese Consul General Carmen Chong Gum at home in Springdale Individuals living in red counties have an average life expectancy of 10 years less than individuals living in the green counties

31. Emergency Preparedness • 1945 – Cold War & Civil Defense • 1959 – Radiological monitoring activities • 1973 – Radiation surveillance at Arkansas Nuclear One • 1980 – Department’s nuclear planning and response program began • 1980 – Titan II missile explosion • 1985 – Chemical Stockpile and Emergency Preparedness program created Arkansas City, during the1927 flood.

32. All Hazards Preparedness • 2002 – Division of Bioterrorism started (now Public Health Preparedness and Emergency Response Branch) • September 2005 – Hurricane Katrina evacuee assistance AR 240 Bridge at Caddo Gap after flash floods swamped Albert Pike Campground • 2009– Ice storm, H1N1 influenza pandemic • 2010– The Albert Pike Campground flood

33. Arkansas Public Health Laboratory • 1913 – First public health laboratory located in Old State House Museum • 1969 –Laboratory opened in its current location • 2001-03 –Testing for possible anthrax demonstrated current laboratory was substandard for testing of bioterrorism agents. • 2006 – State-of-the-art public health laboratory - performs about 600,000 medical tests annually Arkansas Public Health Laboratory

34. Looking Ahead • Role of public health continues • to evolve • Today, a wide range of • physical, mental, and social • factors are being addressed • For more information, go to www.healthy.arkansas.gov