MERRIAM, Kan. — Two-thirds of the residents in the region surrounding the Kansas City metropolitan area are part of at least one medically vulnerable population, according to a report issued Monday by the REACH Healthcare Foundation.
The Kansas City Regional Health Assessment Report is an analysis of data from an 11-county region that includes approximately 2 million residents on both sides of the Missouri-Kansas state line.
Categories contributing to medical vulnerability included poverty, disability, marital status, and health insurance coverage. The data came from a variety of sources, including the U.S. Census Bureau, state health departments in Missouri and Kansas, and the Missouri Hospital Association.
The report adds to a growing body of evidence that is “sort of sounding the alarm bell that we’ve got a growing population of medically vulnerable and economically disadvantaged persons throughout our region,” said William Moore, REACH’s vice president of program, policy and evaluation, “and each county is going to need to begin thinking more strategically about how our resources are going to be used to meet these growing needs.”
Prepared for REACH by the Mid-America Regional Council, the latest assessment updates a report the partners issued nearly three years ago.
The latest assessment found that:
- The percent of the regional population living below the federal poverty level rose from 8.5 percent in 2000 to about 13.5 percent in 2011. The rate for residents living under 200 percent of the federal poverty level grew from 22.3 percent to 30.2 percent in the same period.
- The greatest rates of increase in poverty between 2000 and 2011 occurred in the suburban counties of Cass in Missouri (146 percent) and Johnson in Kansas (135 percent).
- The percentage of residents without health insurance grew from 12.4 percent in 2008 to 13.6 percent in 2011, for a total of 265,938 individuals.
- The number of residents covered through employer-based health insurance decreased from 58.6 percent in 2008 to 54.2 percent in 2011.
There were some positive developments reported:
Between 2000 and 2010, the death rate from heart disease declined by 30 percent, from 224 per 100,000 residents to 187, while deaths from cancer declined 2 percent, from 185 to 180 per 100,000 residents.
Also, hospitalization data showed that most of the counties logged substantial decreases in preventable hospitalizations, including Lafayette in Missouri, which reduced hospitalizations due to chronic conditions by more than 30 percent between 2002 and 2009.
Some of the other notable findings, Moore said, included the fact that although the combined population in the study area increased by about 12 percent within the past decade, the number of people living in poverty grew by 75 percent.
He also found it noteworthy that, between 2008 and 2011, it was married couples that led the pack among households that lost health insurance.
“It wasn’t single people sort of on the economic bubble,” Moore said.
Many of the findings were not new to people who follow these trends closely, said Dean Katerndahl, government innovations forum director at MARC.
For instance, given the recession, he said it was not unexpected to see a drop in people covered by employer-sponsored health insurance. The growth of poverty in the suburbs was also something analysts have noted before.
“But I think (the report) is important because most people don’t understand this stuff,” Katerndahl said.
And by compiling a lot of data in one place, he said, “you are creating more of a story or a picture, so you can see, ‘Well, we are doing a little better in some health care outcomes … but there are some signs to worry about.’”
United Community Services of Johnson County is one organization that has highlighted the growing problem of poverty in the suburbs.
The REACH report reinforced the connection between income and health status, said Valorie Carson, community planning director at United Community Services.
Also, she said, “what’s important is that (REACH has) made the commitment to be watching and tracking these trends over time. That helps us anticipate the future and where problems are likely to be.”
In Allen County, health advocates have been celebrating an improvement in their health status compared with other counties in the state.
This year’s health rankings from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute placed Allen County 86th out of the 105 counties. Two years ago they were 94th.
But the REACH report was a mixed bag for Allen County.
For instance, it found that Allen County logged the largest population loss (8.9 percent) of any of the counties studied during the past two decades. It also had the highest death rate, 1,361 deaths per 100,000 residents in 2010, a 16 percent increase from 2000.
But in December 2012, according to the report, it had the second lowest unemployment rate.
The negative indicators highlighted in the REACH report were cause for concern, said David Toland, executive director of Thrive Allen County, an Iola-based nonprofit working to improve health in that area.
But, he said, the county health rankings indicated that health advocates were beginning to make a difference in reducing risky behaviors such as smoking, drinking, and teen pregnancy.
“We have been on a 100-year decline in population, economic conditions, and health conditions,” Toland said. “This doesn’t turn around overnight, but we are seeing signs of improvement that have been sustained over the last three to five years and that is more than I think most rural counties in Kansas can say.”