New health rankings show Kansas stuck at 27 – the same slot that it occupied last year. But there was a time – not that long ago – when the state ranked much higher than the middle of the pack.
2014 America's Health Rankings
The America's Health Rankings from the United Health Foundation provide a snapshot of 30 health measures ranging from clinical care to behavior and environment to state policy.
Dr. Rhonda Randall, the foundation’s chief health adviser, said there’s no mistaking the trend for Kansas.
“Kansas has had a steady decline, from about 10 or 11 in that initial 1990 rank to rank 27th in this most recent year’s report,” Randall said.
That’s a far cry from its 1991 ranking as the eighth-healthiest state in the nation. The state’s slide from the top 10 to the bottom half of the rankings recently caught the attention of officials at the Kansas Health Foundation. Alarmed, the foundation convened a statewide meeting in June to discuss the rankings slide that the foundation’s vice president of programs, Jeff Willett, calls “heartbreaking.”
“We’re concerned that this is a trend that we need to reverse quickly, or Kansas will slip to the bottom of the pack,” he said.
Willett said much of the drop can be linked to one key statistic: Kansas ranks 42nd in the nation in public health funding.
“That’s a key driver of many of the drops we’ve seen in our ranking," he said. "Kansas has underfunded public health for decades, and I think today we’re just starting to see the consequences of that.”
Willett said without an investment in programs designed to keep Kansans healthier, the state won’t improve immunization rates or make more progress against preventable causes of death, like obesity and smoking.
But Kansas Department of Health and Environment spokeswoman Sara Belfry takes issue with that view.
“I would completely disagree with that,” said Belfry.
Belfry concedes that Kansas ranks near the bottom in public health funding, but she said the state has made some progress closing the gap in the past two years. That said, the top states are spending about four times as many dollars per person on public health programs as Kansas is. But Belfry said the state is making progress.
“In the past two years, we have seen the rate of smoking decrease by 9 percent, and that’s a huge improvement,” she said. “We have a ways to go, and we’re still above the national average, but we continue to work to make sure that people are living healthier lives here in Kansas.”
When it comes to the smoking rate, Tracy Russell said Kansas doesn’t have much to celebrate. While the number of Kansans who smoke is going down, states with comprehensive tobacco prevention programs are reducing their rates faster. Russell heads a coalition of anti-smoking organizations called Kansans for a Healthy Future.
“You know, if you look at it in terms of the whole nation, we rank 31 out of 50 states,” Russell said. “And so, to me, that just shows we have a lot of work to do.”
Kansas spends a little less than $1 million a year on programs to reduce tobacco use. The CDC says the state should spend at least $28 million if it wants to really make progress. Even if legislators could be convinced to spend that much, budget issues make that unlikely. Plummeting revenues have created a budget crisis and forced Gov. Sam Brownback to order emergency spending cuts.
But if there is the will, Russell insists there’s a way. The coalition she leads is preparing to push an increase in the state’s cigarette tax, which now stands at 79 cents a pack. That’s likely to be a tough sell for a lot of reasons. For one thing, neighboring Missouri has the nation’s lowest tax at 17 cents a pack. Probably not coincidentally, it also has a high smoking rate.
Dr. Tony Sun is the medical director for UnitedHealthcare in Kansas, Missouri and Nebraska.
“More than 22 percent of Missouri adults smoke, putting their ranking at 41st,” Sun said. “That has heavily weighted what some of the Missouri rankings has been.”
Overall, Missouri comes in behind Kansas at 36th in this year’s rankings. In addition to relatively high rates of tobacco use and low rates of public health spending, the report says low immunization coverage among teenagers is another factor keeping both Kansas and Missouri from making more progress.
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