New health rankings show Kansas stuck at 27--the same slot that it occupied last year. But KPR’s Bryan Thompson reports there was a time--not that long ago--when the state ranked much higher than the middle of the pack.
The United Health Foundation rankings are a snapshot of 30 health measures ranging from clinical care to behavior and environment to state policy.
“Kansas has had a steady decline, from about ten or eleven in that initial 1990 rank to rank 27th in this most recent year’s report,” says Dr. Rhonda Randall, the foundations chief health advisor.
That’s a far cry from its 1991 ranking as the 8th healthiest state in the nation. The state’s slide from the top ten to the bottom half of the rankings recently caught the attention of officials at the Kansas Health Foundation. Alarmed, they convened a statewide meeting last summer to talk about how to reverse a trend that the foundation’s Jeff Willett calls “heartbreaking."
“We’re concerned that this is, you know, a trend that we need to reverse quickly, or Kansas will slip to the bottom of the pack,” says Willett.
Willett says much of the slippage can be linked to one key statistic: Kansas ranks 42nd in the nation in public health funding.
“I think that’s a key driver of many of the drops we’ve seen in our ranking," he says. "Kansas has under-funded public health for decades, and I think today we’re just starting to see the consequences of that.”
Willett says without an investment in programs designed to keep us all healthier, we won’t raise immunization rates or make more progress against preventable causes of death, like obesity and smoking.
“I would completely disagree with that,” says Sara Belfry, a spokeswoman for the Kansas Department of Health and Environment. She concedes that Kansas ranks near the bottom in public health funding, but she says 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 insists the state is making progress nonetheless.
“In the past two years, we have seen the rate of smoking decrease by 9%, and that’s a huge improvement," she says. "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.”
But when it comes to the smoking rate, Tracy Russell says Kansas doesn’t have much to celebrate. While the number of Kansans who smoke is going down, states with comprehensive tobacco control 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, says Russell. "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 it needs to spend at least $28 million if it wants to really make progress. Even if legislators could be convinced to spend that much, there’s no money. Plummeting revenues have created a budget crisis and forced Governor 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% of Missouri adults smoke, putting their ranking at 41st," says Sun. "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.