Hello and welcome to Arkansas Week.

I'm Karen Walker.

For 25 years, the Arkansas Center for Health Improvement has been collecting and converting data into resource useful information to help improve the health of Arkansans.

The new president and CEO joins us later in the program to share their latest assessment on health care in Arkansas.

But first, coming up on July 4th, the nation will be celebrating the 250th anniversary of the signing of the Declaration of Independence.

Over the past two years, the Arkansas 250 Commission has been busy at work preparing for this commemorative celebration.

Please welcome Secretary Shay Lewis for the Arkansas Department of Parks, Heritage and Tourism.

And Doctor Marty Amin, Director Marty Ryle for Arkansas Heritage, to talk about how Arkansas is playing an important role in this occasion.

Welcome, gentlemen.

Secretary Lewis.

Yes, I'm excited to have you guys.

We're going to talk about some fun stuff today.

That's right.

I know.

Governor Sanders in 2024 put this commission together.

And Secretary Lewis, you are the chair for that.

Can you tell us what you've what the committee has been doing to really prepare for this commemorative event?

Sure.

We saw multiple years ago that the Sumiko Centennial was coming our way.

So centennial is the the 250th anniversary of our country.

And so it's one of those words that we're getting a lot of practice in saying.

And by the end of this year, I think everybody will have it down pat.

But Governor Sanders assembled a great team of commissioners that have been working hard, to look at what the opportunities were for our state.

You know, how do we celebrate?

How do we join in?

And what is taking place on the national level, on the state level?

On the state level, but also what's happening in our classrooms and through education as well.

And so we've seen really great opportunities to partnership with, America 250 in the events that are happening on the national level.

We've been working on a time capsule, inclusion into what, what the state will contribute to the, America's time capsule.

There's the America Gives program, our American story.

A lot of things happening on the national level, but we're seeing a tremendous amount of work here on the state level.

The partnering with the Department of Education and higher ed, curriculum, around Arkansas 250 has been created and implemented across our state schools and doing a tremendous job of getting out to the students.

This year.

This spring and also the fall semester as well.

Across the state level, we're seeing a tremendous amount of work with the Historic Marker Program, an oral history program that we worked with the University of Arkansas at the Pryor Center that would that helped collect oral histories, capturing Arkansas stories specifically.

We're partnering with our DoD on signage and a flag program.

We even will be later on this year unveiling a unique piece of commemorative art by artist Barry Thomas.

That will represent the state of Arkansas.

In this this year long celebration that some good information sounds like there's lots of work has gone into making this really special.

And I know you, Marty.

You are the vice chair.

How have the leaders around the state stepped in to help make this a just a really special event for Arkansas?

Well, you know, this isn't just a, a statewide effort with the commission.

We want this to be a community led effort as well.

And so our commission, our commissioners have traveled around the state, all the four corners of the state.

We've met with community leaders, mayors and, and, museum, directors and all kinds of people from the community that are putting together their own events because just like, in America 250 it's a collection.

It's not just one story is a collection of all 50 stories.

All 50 states have a story of something to contribute.

Or is it the commission we're trying to help tell Arkansas story with some of the programs that she mentioned.

But then collectively, there's 75 stories out there from all 75 counties that collectively make up our state story as well.

And so there's unique exhibits around the state where some communities have been exhibits that that highlight some of the special features of their counties.

And, then also there's, special events are being planned around the state, that are locally based.

And so we're excited for the local community to tell their stories and be a part of it.

As we're telling the state story for the Arkansas 2050.

That's wonderful.

I love to hear that.

You know, you mentioned, Secretary Lewis, the Arkansas 250 marker Initiative.

What is that?

Can you tell us about it?

So if you think about the historical markers that you see throughout the state, if you're on a road trip and traveling, you know, backroads of Arkansas, you often see historical markers there, in this states back, celebrating, an anniversary dates back to even the, the state's centennial, in 1936, historical marker program was created for that centennial.

So we wanted to follow that same approach, and find locations, find people, find stories, to tell that have impacted not only the state of Arkansas history, but also our nation's history.

And so we, the commission work to identify a list of potential places.

11 markers have been identified, that will tell the story of Arkansas and the role of Arkansas in American history.

That's wonderful.

When you've had some, dedication events already, like the in Park side and Daisy Bates, Buffalo River.

Talk a little bit about that.

First of all, I will say it is, become really apparent how important these, markers are.

Invaluable.

They are to the communities the communities love.

As Marty mentioned earlier, love to tell their stories and and their connection to history and and so, just for instance, the first sign we installed was at bauxite.

And the role that bauxite played, in America's fight during World War two.

Bauxite was one of the largest contributors of aluminum, to the airplane industry.

That was vital, to our success during that war.

And so without Arkansas, our nation, would have struggled, perhaps, you know, through that conflict.

And so, really, really a unique opportunity to honor that.

But the community responded and was so excited to have us there, with that sign.

But we've placed signs.

Yeah, we had locations.

I mean, just this week we're up at, ASC campus up in Jonesborough, and and Hattie Caraway from Jonesborough is the first united female United States senator anywhere in America.

And we wanted to tell that story about, Senator Hattie Caraway, because, again, as she mentioned, that some of these markers, they're all very significant to Arkansas, but many are significant to our nation as well.

Whereas boxer contribution to winning World War Two and Heady Caraway is the first United States Senator from the United States.

Senator where I have won going at Crater Diamonds, the only public diamond mined in the United States.

So, of course, the Buffalo River, the first national river ever designated in our nation in 1972.

It became the first National River.

So it is the first.

And of course, its natural beauty is so significant to our state for tourism and recreation, those kind of things.

And so, a lot of these again, they're they're very significant to Arkansas.

And, Daisy Bates, of course, her home, where the little Rock nine gathered every day before they went to school.

We want to recognize that, her home, there's so many markers that, designate the desegregation center here at Central High School, which is very important, but a Daisy Bates home where so much of this took place.

And it was such a huge, event for our nation as far as future opportunities.

And so, we put a marker, Daisy Bates is home.

And so, it's really been a segment is fun.

The community gets involved with it and really significant national events as well as state events.

And a lot of them.

Yeah, yeah, we'll even have one at Walmart.

How can you not be in Arkansas and talk about the role that Walmart and the impact Walmart has had across, our country and around the world.

But, the first Walmart in in Arkansas as well.

Arkansas's history is so rich and so glad that we're going to be able to tell our story.

Arkansans and visitors will be able to take a look at this new exhibit at the old statehouse.

Tell us about that.

Sure.

So, the Allstate House Museum, is one of, four of our state museums that are in the heritage division.

We have the Mosaic Templars cultural center, we the Delta Cultural Center, of course, the state House museum and then Historic Arkansas Museum.

And then we have the Arkansas State Archives, and they collaborated along with some other agencies, the parks, service and, and, the Natural Heritage Commission.

And we brought all the curators together because each one has their own collection of artifacts and archives and treasures that are that are really, important to our state.

And, you know, from the, Bowie knife to, that was made down at, Washington, now Washington State Park.

I mean, there's so many artifacts they have that they could draw on to make this a collection that tells the story through the course of the 250 years, of our nation, of what is Arkansas Territory.

And it's, at the old state House Museum.

We, it's been open now for a couple of weeks.

It's closed on Monday, but Tuesday through Sunday, you can go see it.

And, it's free to the public.

Wow.

That's wonderful.

So.

And it's now people can start going now.

Oh, I don't have to wait for the celebration.

That's exactly right.

With Secretary Lewis.

I'm curious, how do you expect all of the events to impact tourism here in Arkansas?

What's your expectations?

One thing that we've always known is that in-state travel is a large contributor to the tourism economy.

The tourism economy in the state of Arkansas is the second largest industry.

And so we you know, we see this as an opportunity.

And we've always had a strong in-state travel market, where people love to travel in-state, whether that's visiting, perhaps they live in rural areas or coming to little Rock or visiting Northwest Arkansas or, or coming to different places for events and activities.

We see the centennial as an opportunity to drive people to specific places maybe they haven't been to before.

Perhaps it is that state park, or that museum, or that historic site that they haven't been, but but also, it's just a good reminder that, perhaps I should go out and I haven't floated the Buffalo River in a long period of time.

Let's let's experience that again and do that.

So we know that that's a large part of our, our travel impact, in our state.

And it's opportunities for us to celebrate.

We see Arkansas as being really well positioned for, for this celebration because of the stories we have to tell, but also because of the natural resources that whether it's the natural resources for outdoor recreation or that's for, the historic sites or the cultural stories that we can tell here as well.

So we're excited about this, and we're seeing an impact of this already, whether that's, exhibits that are coming up or people just getting out and staying local.

Traveling local, I love it.

Yay for Arkansas, right?

That's right, that's right.

Well, as we're wrapping up, can you tell me what's going to happen in the next few weeks, few months?

What type of events can we see throughout the year?

I think a few things just, to have on your list is we know that Hot Springs is a got a weeklong celebration in April.

So keeping that in mind, there's a brand new exhibit at, at Crystal Bridges Museum of American Art celebrating America 250, a brand new exhibit, the exhibit at the Clinton, Presidential Library.

Both of those exhibits have artifacts on display of national significance that they've brought in from collections all across the nation.

And on display that you can only see in Arkansas right now.

Really, really special.

Arkansas Museum of Fine Arts will have an exhibit later on.

We mentioned the old state House specifically, but also each community has got their own 4th of July events.

Little Rock, of course, has a large, July for celebration.

Jonesborough and the region in northeast Arkansas is planning a large scale event.

That's going to include lots of things, as well as Northwest Arkansas, too.

And then one other event coming up, that we would mention.

So you mentioned earlier that we partnered with Arkansas Arts Council, would, have a official artwork of the Arkansas 1050 commemoration, and we made an appeal to all Arkansas artists to send us their thoughts and, and, diagrams of what they would create for this piece of art.

And the commission selected, a winning artist, Barry Thomas, who was selected and, he is now, completed his artwork and is going to be unveiled in the next within the next 3 or 4 weeks.

And it will be the official, artwork and, of the Arkansas 250 commission and it will hang in one of our state museums.

And we're very excited to share that with the state coming up, I love it.

Thank you so much for joining us today, Secretary Lewis and director Marty Rael.

It's going to be a great time for Arkansans to celebrate.

So stay tuned.

Coming up, we're going to hear an assessment from the Arkansas Center for Health Improvement on our state of health.

Welcome back.

The Arkansas Center for Health Improvement, also referred to as Acci, has been serving the state as a catalyst to improve the health of Arkansans through research, health policy and innovation.

Craig Wilson serves as the president and CEO, and joins us now to provide an assessment on the state's current health care status.

Welcome.

Welcome to the program to be here.

Thanks for inviting me.

Yes, and I know, Craig, you've been with Ecai for over a decade, but in a different capacity, I think.

Was it, over health policy?

Yeah.

Yeah.

Can you talk a little bit about your previous work?

Yeah, we, you know, we've seen a lot of changes currently.

I'm now in the organizational strategy and oversight role.

But, you know, at our core and, you know, both individually and organizationally, we are a health policy shop, you know, independent, nonpartisan.

Our goal is to really turn data into information and insights that inform policymakers, to make good decisions about the health of Arkansans.

And that can be governmental.

For example, you know, the development of, of a trauma system in Arkansas.

It can be institutional, to help, hospitals, for example, or other providers do quality improvement activities, or even individuals, for example, creating awareness about the impact of social media on teens, health and well-being.

You know, we just want to be a resource to be first, right?

And credible in this space.

That's wonderful.

But, you know, rural health is an issue, right now in our state.

Tell us a little bit about the, Rural Health Transportation Program.

Yeah, the rural health transformation.

It was a provision that was included in the budget bill, the federal budget bill last year.

H.R.

one is is the budget bill.

And it was $50 billion nationally.

Arkansas, at least, in its first year, is slated to get $209 million for transformation.

That's quite a few dollars.

You know, we have, I think, in Arkansas, I've been fortunate to not see, very many of our rural hospitals close, rural Arkansas and rural America, frankly, experiences challenges generally with outmigration of populations, particularly younger populations.

So that makes it more challenging for our hospitals and our providers, to have the volume that they need to survive.

But not only that, when younger populations move out of those areas, what's left is older, sicker populations who are more, likely to be on public programs like Medicare and Medicaid, which provide reimbursement that is typically lower than private reimbursement.

So they're trying to survive on smaller and smaller margins that are just disappearing.

And, and ultimately, those margins go away and they have to, you know, cut facility costs, they have to cut personnel, they have to cut service lines like we've seen in the maternal health space with labor and delivery.

And ultimately, they are at risk of closing.

And we've got about, half of our rural hospitals at risk of closing.

We have challenges with recruiting providers, into rural spaces.

So this funding hopefully will help with regionalization, of providing of services and really rightsizing, those facilities to, to be able to survive.

Yes.

That's interesting because we continue to have a shortage of physicians and nurses, not just in Arkansas but across the nation.

So what are some of those challenges as well as opportunities for health care workforce?

Yeah, nationally we have a supply shortage.

You know, primary care physicians, specialty physicians, nurses, mental health providers, dentists.

And relative to that shortage nationally, Arkansas has a an even bigger shortage.

Probably our bigger issue is the mal distribution of providers.

In our urban areas, we have a per capita rate of primary care physicians of about 57 per 10,000 residents.

And in in rural areas, it's about three per 10,000 residents.

So if you do the math there, that's one physician serving about 3000 patients.

And that's just not a it's not good for, rural populations.

We've got an aging workforce.

With about a quarter of our primary care physicians older than 60.

And you've got younger, clinicians who otherwise might want to go into these areas, but they're looking at quality of life issues, their their work life balance.

You know, opinions are different.

So it creates a challenge to go into rural areas.

Now, you know, the state has, invested in some training programs, for physicians.

You know, our investment as a state is, well below what some of our comparable states are.

So I do think that the rural health transformation funds can be, an opportunity there.

We've got accelerated programs by UAMs and other, institutions, for physicians, the development of certified nurse midwife programs, new programs, for doulas and community health workers, interstate licensure compacts that help providers in other states to streamline the process, to be able to provide care here.

And I do think that technology can, can assist, in reducing the burden on providers, and assisting them to be able to provide care locally.

But there's going to be a lot of education, that's associated with that, for both for providers and for patients.

I think really what's important is before we get into, this five years of funding through the Rural Health Transformation Fund, that we invest in some really good data collection about what our providers are doing, how active they are in their professions, what types of services they're providing so that at the end of five years, we know whether we've hit the mark.

That's smart, very smart.

But, you know, we tend to pay attention to overall health.

But for some reason, oral health is not talked about as much.

Can you tell us the vital role that it plays in our health?

Yeah.

You know, I, my mom worked in a dentist office when I was young, so I grew up in dentist office.

So I have a real heart for this.

You know, we've we've talked a lot about we've begun to talk a lot about whole health.

Right.

And, you know, the nutrition aspects and the mental health aspects have become, you know, more naturally integrated into the medical space.

But oral health, you know, simply has not.

And there are a couple of reasons for that.

You know, they have a different training pathway for dentists.

There's a different insurance system typically, for oral health.

And so that makes it a challenge.

But I think we're going to have to realize that oral health, should be integrated into whole health, as as natural as we can, because we know that it impacts not just your overall medical health, but your mental health, as well as your, opportunity in life to succeed.

You know, if you if you look better and you feel better, I think you can perform better.

And and so we've got to make those linkages.

And really, I think investing in oral health, I love it, but, you know, we have to have a conversation about the importance of screenings, right?

Because March is National Colorectal Awareness Month.

And according to your website, it is the most, diagnosed and deadliest cancer among women and men in the U.S.

So talk to us about the importance of screenings.

Yeah, I, I turned 45 several years ago.

And I wrote a column that 45 is the new 50.

Right.

Colorectal cancer screening recommendations in 2021 changed, from 50 to 45.

And it was at about that time that I turned 45.

So, with a history, in my family, I made sure to get my colorectal cancer screening.

It is highly survivable if detected and treated early.

And, you know, we've we've seen, the news stories about, you know, actors, Chadwick Boseman, and James Vanderbeek recently, bringing attention to this issue.

And just really this week, there's an article in the Journal of the American Medical Association that noted that colorectal cancer is now the leading cause of cancer related deaths for people under 50.

So we got to make sure that that people are getting screened and that they understand the importance of screening and that there are there are less, invasive forms of screening that can be done than a colonoscopy.

And so getting those types of screenings in folks hands and getting them educated about this is extremely important.

Yes, that's real important.

You know, can you just touch, quickly on, you know, opioid abuse is big.

And unfortunately it's leading to a lot of overdoses.

Are there any new stats you can share with us?

Yeah, we've got some good news.

You know, opioid overdose deaths are are down, nationally and certainly in Arkansas.

Our opioid, prescription rates are down.

We've invested a lot of funds from, the settlements with the manufacturers and the distributors here in the state on a, on a statewide basis and locally into prevention, into harm reduction, into treatment and recovery.

And I think we're we're finally, seeing some success.

We've got a long way to go.

But that's that's a good story that I'm happy to share.

Wonderful.

Now you must tell us about your podcast if we want to stay up to date on wonderful health issues, how do we connect with you on your podcast?

I believe it's called Wonks at Work called Long at Work.

And, we're now nearing about 100 episodes.

I started this through, archive, right at the beginning of, of the pandemic, which, which made it very challenging, being in the same room with someone and doing a podcast.

But what I really wanted to do was, was demystify some of the very complex issues that we see in the health care space.

And not only that, but, you know, the dehumanizing of public health experts and health care providers that occurred early in the pandemic.

I wanted to really, humanize them.

And so a little bit of it is, is talking with them and breaking down the barriers personally about who they are as a person.

And I think we just need to we need to take a step back.

And there are there are faces and there are human beings behind public health experts and health care providers.

And I think the more that we do that, the better interaction is, that we're going to have between patients and providers.

Thank you.

Craig Wilson, president and CEO of AEI, for joining us today.

Such a great conversation.

I'm Karen Walker for Arkansas Week and that concludes our program.

See you next time.