KANSAS CITY, Mo. – The city has a legitimate and historic role to play in helping poor people gain access to health-care services. On that much, Kansas City’s Mayor Mark Funkhouser and most of the men and women vying to replace him in the Feb. 22 primary election agree.

However, they told KHI News Service they have slightly varying ideas on just what the city should do in pursuit of that goal.

“We ought to use the money from the health levy to reduce health disparities, and the city’s Health Department ought to be part of that strategy,” Funkhouser said.

When people speak of Kansas City’s “health levy,” they are generally referring to two separate, voter-approved property tax levies that Jackson County administers on behalf of the city. One of the taxes supports general health and the other mental health.

Funkhouser, who is the former city auditor, said the levies bring in about $45 million a year, “with well more than half going to Truman Medical Center.”

The mayor said the remainder goes directly to other “safety-net providers” such as the Kansas City Free Health Clinic and Samuel U. Rogers Health Center, and to fund the city’s Health Department.

“It’s unusual for a city to have a major health department,” Funkhouser said. “That is usually a county function. And we have a substantial property tax dedicated to health, which is unusual, too. So Kansas City is unique in several respects. … And since we have a health levy, the purpose should be to reduce disparities between minorities and non-minorities.”

That, in fact, was the recommendation of a 2008 report given to the mayor by a city health commission.

That panel recommended that between 2009 and 2011, the city focus on the following areas:

• Clean indoor air – smoking cessation
• Wellness for women and infants to reduce infant mortality
• Mental health disease management
• Improved health care access and quality assurance
• Violence, crime and other social determinants of health.

Real progress

When discussing the goals, the mayor and most of his opponents noted the voter-approved ban on smoking in public places, which took effect in 2008.

“We have made real progress in several areas,” Funkhouser said, “certainly with regard to smoking and healthy food. But if you look at why the Health Commission was created, the main job is reducing health disparities.”

The mayor and others also noted that the City Council last year passed a so-called “urban agriculture” ordinance, aimed at making it easier for residents to grow and sell fresh vegetables on their own land.

“We ought to be 150 percent behind urban gardening,” said mayoral candidate Sly James, an attorney. “The next step is to help groups of people create cooperatives so that produce from urban gardens can be aggregated and sold. Number one, it helps to reclaim land that is lying fallow as vacant lots. Number two, it makes fresh foods more available to people. And number three, it circulates more money in the urban core. The city … doesn’t need to fund it, but we could lend legal or technical expertise to get these cooperatives started.

“We need to bring people together,” James said. “When I was growing up in the African-American neighborhoods, gardening was almost competitive. We need to bring that back.”

New use for old schools

A couple of candidates mentioned efforts to promote exercise.

Former Councilman Jim Rowland cited his volunteer work to help establish the city’s walking-trail system, and Councilwoman Deb Hermann looks longingly at the dozens of schools that have been abandoned by the Kansas City, Mo. School District.

“If you have the income, you can buy a treadmill or go to the gym,” Hermann said. “Lower-income folks don’t have as many options. But about 30 schools have been abandoned by the district, and some opportunities may lie there. We need partners.”

Attorney and former Councilman Mike Burke’s professional expertise is in development matters, so perhaps it comes as no surprise that he focused on tax incentives that could help make healthier food more available in the so-called “food deserts” in the center city.

For instance, Burke said, Kansas City could require a company that wants tax breaks for a suburban development that includes a grocery store or restaurant “to build another store in the inner city.”

Burke, like the others contacted for this story – including businessman Henry Klein (only former Mayor Dr. Charles B. Wheeler could not be reached for comment) – said they expected the city’s 1 percent earnings tax to be retained when it comes up for a vote in April.

That retention vote – and one every five years hereafter -- was necessitated by the statewide passage of Proposition A on Nov. 2.

Even if the earnings tax is voted out, “it will not touch the health levy,” said Hermann. “It would impact things like the number of community centers and how long they are open and what programs they provide.”

And those institutions have an indirect impact on public health, she said.

The top two finishers in the mayoral primary will face off in the general election March 22.