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March 28, 2011
KANSAS CITY, Kan. Mayor Joe Reardon said he understands why some people might be skeptical of the latest effort to improve the health and livability of Wyandotte County.
Through the years, the county has been the focus of many programs designed to raise people out of poverty, create jobs, lower crime rates and fix the schools. Some have been more effective others. But none really succeeded. Wyandotte County and its largest city – Kansas City, Kan., continue to rank among the state’s poorest and least healthy places to live.
But after a recent meeting of the steering committee for his new Wyandotte Healthy Community Task Force, Reardon said, “The focus here is very different than it’s been in the past.”
Previous efforts to move the needle on health, Reardon said, were concentrated on increasing peoples’ access to health care services. But this latest effort is different. It aims to get at the social problems that are at the root of the county’s health problems – poverty, violence, lack of education and poor health behaviors.
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“We certainly have an action group that’s going to be focused on access to health care and access to hospitals and doctors,” Reardon said. “But, we’re really holistically looking at the health in our community. And I think it’s the first time we’ve ever done that.”
At the urging of the task force, the Unified Government of Wyandotte County Board of Commissioners is considering a fundamental change to the way infrastructure improvements are designed and built. The “complete streets” initiative would require roadways to be built with lanes and crosswalks that make it easier and safer for people to bike and walk throughout the county.
That’s an example, Reardon said, of a new, more comprehensive approach to improving health.
“That’s the kind of thing that is different today,” he said. “I know it hasn’t happened in the past.”
Holistic approach critical
Two recent surveys ranked Wyandotte County among the least healthy counties in the state. The Kansas Health Institute’s Kansas County Health Rankings 2009 ranked it last. A 2010 national report from the Robert Wood Johnson Foundation ranked it 94th among the 99 counties studied.
The county’s back-of-the-pack ranking in the Robert Wood Johnson report wasn’t because its residents lacked access to health care. It ranked 18th in the state in that category, largely because of a strong network of safety-net clinics and the presence of the University of Kansas Medical Center. But it was ranked 99th for social and economic factors – poverty, education, employment, community safety and family support.
“These are complex, long-term issues,” said Julie Willems Van Dijk, a spokesperson for the University of Wisconsin Population Health Institute, which compiled the rankings for the Robert Wood Johnson report.
State Rep. Barbara Bollier, who also is a physician, represents Mission Hills, perhaps the most affluent community in prosperous Johnson County, which borders Wyandotte County to the south.
According to the Robert Wood Johnson report, Johnson County is the healthiest in the state.
Bollier said though it is striking that the states’ healthiest and least healthy counties are Kansas City-area neighbors, the reasons for their differences are clear: Johnson County is first in the social and economic factors, which correlates to healthier behaviors and the other factors that typically boost a county’s rank. Wyandotte County, though adjacent, is much poorer and its residents tend to be less educated.
“It is a huge, big picture,” Bollier said, reviewing a list of measures in which Wyandotte County ranked lower than Johnson County.
Bollier said two of the categories – Wyandotte County’s low high school graduation rate and its high teen birth rate – illustrated how problems are often closely linked.
“Why are kids not graduating from high school? Well, if they’re getting pregnant they’re much less likely to graduate from high school,” she said.
WyCo effort seen as model
The Wisconsin institute and the Robert Wood Johnson Foundation have noted how Wyandotte County responded to the rankings.
Reardon’s task force and steering committee have members from a broad cross section of the community, including school district superintendents, ministers, business people and the heads of social-service agencies.
Willems Van Dijk said the group appears capable of digging into the fundamental issues responsible for the county’s low health ranking.
“We really see that the work that is going on in this community is taking that comprehensive approach,” she said.
The response has made Wyandotte County a sort of poster child for how to mobilize response to a low health ranking. The foundation sent a film crew to document the work of the task force and other health-improvement initiatives underway in the county. The piece they produced will be featured on the Robert Wood Johnson Foundation website when the 2011 county rankings are released Wednesday.
Patience and small steps
Those involved in the Wyandotte County initiative acknowledge it likely always will be a work in progress and it might take years before the county’s overall ranking improves. So, they’re looking for indications that they’re on the right track.
For instance, Willems Van Dijk said, it may take a while to lower the percentage of county residents who are overweight or obese. But it would be a measure of progress, if there were an uptick in the percentage of people who are physically active. Likewise, substantially lowering the county’s unemployment rate likely will take time. But a tangible way to reach that objective could be focusing on raising the high school-graduation rate.
“What’s really important as they move forward in thinking about how they’re going to improve health is that they don’t say, ‘we want to see our county health ranking change by next year,’” Willems Van Dijk said. “But you can look at those interim measures in a shorter period of time and measure your progress and celebrate that.”
Reardon said economic activity associated with construction of the Kansas Speedway and The Legends shopping complex in the western part of the county combined with improvements in the county’s schools make it possible to imagine tackling some of the deep-seated social problems that before seemed beyond reach.
“We could identify them (the problems), but it would have been difficult for a community like ours to say, ‘let’s get after them,’” Reardon said. “But we can do that today because of the progress we’ve made. It puts us in a different place than we’ve been before.”