Archive for Wednesday, March 14, 2018

Douglas County falls from 7th to 23rd in health rankings; data shows stark racial and ethnic disparities

Some of Douglas County's best and worst categories in the 2018 County Health Rankings.

Some of Douglas County's best and worst categories in the 2018 County Health Rankings.

March 14, 2018

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Douglas County has fallen from the seventh healthiest county in Kansas last year to 23rd in 2018.

This is the first time since the annual County Health Rankings and Roadmap report was first published nine years ago that the county has not been included in the top 10. However, an expert with the Kansas Health Institute said it’s still impressive to be in the top quartile.

Dr. Gianfranco Pezzino, senior fellow and strategy team leader with the Kansas Health Institute

Dr. Gianfranco Pezzino, senior fellow and strategy team leader with the Kansas Health Institute

“I think that overall, Douglas County is still in good shape,” said Dr. Gianfranco Pezzino, senior fellow and strategy team leader with KHI. “I think most measures and indicators are going the right direction. There are a few areas of concern. ... I wouldn't put too much weight just on that change in ranking alone.”

Pezzino is concerned, however, about racial inequity.

New this year, the report shows racial and ethnic disparities for a few select categories — “that information is quite difficult to obtain,” Pezzino said.

For instance, the teen birth rate of 10 per 1,000 girls and women between ages 15 to 19 is significantly lower than the statewide average of 30 — however, the numbers for black and Hispanic teens in Douglas County are 26 and 18, respectively, and just 8 for white teens.

Also, the county’s percentage of children living in poverty has gradually declined each year from 17 percent in 2014 to 12 percent this year, and is now better than the statewide average of 14 percent. Broken down by race, though, the numbers show 27 percent of black children, 30 percent of Hispanic children and 11 percent of white children live in poverty in Douglas County.

“There are pockets of poverty and underprivileged populations, including sometimes maybe even the (University of Kansas) students,” Pezzino said. “They need to be taken care of. They need to be addressed. These are populations that remain vulnerable. If they live in poverty and adopt unhealthy behaviors, that can affect their entire community and not just their own personal health.”

Chris Tilden

Chris Tilden

Chris Tilden, community health director with the Lawrence-Douglas County Health Department, said the department has looked closely at these disparities but has had difficulty because of sample sizes.

“That's not to say that they don't exist, but we're a relatively small county, we have relatively small populations of racial and ethnic minorities, so we've got pretty limited data on local disparities,” he said.

LDCHD has, however, identified inequity in economic categories, many of which came up as concerns in last year’s Community Health Assessment. Those points, echoed in Wednesday’s report, include issues such as safe and affordable housing and income inequality.

Severe housing problems have stayed fairly flat between 20 and 22 percent for the past five years in Douglas County. Today’s report indicates housing with at least 1 of 4 problems: overcrowding, high housing costs, or lack of kitchen or plumbing facilities. This year’s 21 percent is 7 percent worse than the statewide average of 14 percent.

Also, the county has the second highest income inequality, or the ratio of household income at the 80th percentile to that at the 20th percentile, in the state. It is 5.2 for Douglas County and 4.4 statewide.

“As you look at this report and note that we really do not compare favorably with other communities around the country on things like safe and affordable housing, income inequality,” Tilden said. “I think we've targeted the issues that we know have been a challenge in Douglas County and have brought many, many partners to the table to try to address them in coming years.”

Quality of life factors also look worse for Douglas County this year — it fell to 68th from 28th last year. That measure includes the percentage reporting fair or poor health (13); the number of poor physical health days (3.4) and poor mental health days (3.6) in a 30-day period; and percentage of low birth weights (6.5).

The number of poor mental health days is heavily weighted — 10 percent — in the rankings, and Douglas County’s is the seventh worst statewide, based on responses to the Behavioral Risk Factor Surveillance System. The same weight is applied to poor physical health days, and Douglas County falls in the worst 20 in that category as well. The statewide averages are 3.3 and 3.1, respectively.

“It would even be dangerous, in most cases, I think, to say that these (latest numbers) represent a trend,” Tilden said. “... We'd love to be seeing downward trends for all of these numbers, and what we've seen over time is, again, they're hard numbers to move, and they've been pretty constant over time but not improving, and that's certainly something, at the end of the day, that concerns us.”

Related document

Douglas County Health Rankings data 2018 ( .PDF )

Another notable factor in the report is a continuous upward trend in sexually transmitted infections and alcohol-related behaviors. As the Journal-World has reported, both Douglas County and the University of Kansas campus have seen increased rates of STIs this year.

Pezzino said that’s somewhat to be expected in a college town, “but I think taking that for granted probably would be the wrong attitude. I think it's still something that needs to be addressed,” he said.

The percentage of adults reporting binge drinking or excessive drinking was 22 percent, compared to the statewide average of 17 percent. The percentage of driving deaths involving alcohol had been trending downward, from 33 percent in 2014 to 24 percent last year, but that number rose to 30 percent in the most recent report.

Overall, Tilden said this report each year gives the health department an opportunity to highlight challenging issues and face them in coming years.

“We're now working on the next five-year community health plan, and that plan will address disparities, with a real focus on disparities and health equity, doing that through the lens of behavioral health, safe and affordable housing, poverty and jobs as well as nutrition and physical activity,” Tilden said.

The annual report comes from the Robert Wood Johnson Foundation and the University of Wisconsin Public Health Institute. The Kansas report ranks 103 counties, and it can be found at countyhealthrankings.org.

Some other statistics:

• The percentage of obese adults rose from 24 percent last year to 26 percent, increasing for the third year in a row; it’s still better than the state average of 32 percent, however, and falls in the top 10th percentile nationwide.

• Douglas County ranks fifth overall for clinical care, which comprises the percent uninsured (10); ratio of primary care physicians, mental health providers and dentists to patients; diabetes monitoring and mammography screening.

• Though it’s a topic of concern for local government, the mental health provider-to-patient ratio is 370-to-1, exceeding the statewide ratio of 560-to-1.

• Riley County, home of Kansas State University, has a chlamydia rate of 617.5 per 100,000 people; Douglas County’s is 557.5; and the statewide average is 394.8.

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Comments

MerriAnnie Smith 1 month, 1 week ago

I don't live in Lawrence but I've always admired the city and Douglas County. I mean, just driving toward Lawrence from my city on a back road we go out of our county and into Douglas and immediately the highway is smoother. Very noticeable.

But this situation where the health of the citizens is concerned seems obvious to me... obvious that Douglas county must be gaining more poor people (generally black and Hispanic).

Even I, whom I consider wealthy compared to most people, at 75 years old, will consider the cost vesus the symptoms before going to a doctor or the ER. Thankfully, I've been a lucky white person who has had some opportunities others may not have and therefore I can afford health insurance.

There is someone I know quite well who is in her late 40's and no longer has children at home. Both her children are very smart and went/go to college and live elsewhere now.

She suddenly developed a major mental illness. She now has something called Schizo-affective disease. She hears voices that tell her to kill herself or they're going to kill her. She is unintelligible when she talks. She is unable to concentrate on anything that requires concentration to do it well. Therefore she is unable to get or hold a job. But can she get on Medicaid for that?

No.

Not in Kansas.

She tried to get on Social Security disability and was turned down.

She began trying to get on Medicaid months ago and no answer yet.

How does she live? Off her parents who are retired and living on a small pension and social security.

Is this right? Why are Kansans so uncaring? Why is Kansas so different from other states on this?

I know people in Georgia, white people, btw, Christians.... who had no problem getting on disability AND Medicaid there for things like this: One of them is not as smart as most other people. She calls the check she gets each month her "stupid" check. Her daughter suffers from much the same thing, a lack of intelligence, and is very overweight and could not do most jobs. She's on disability and Medicaid.

This woman in Kansas is seriously suffering. The meds she gets from Valeo do not do a good job. They just make her feel a bit better. They don't make her whole again so she can work. It is far worse than not being a genius or being overweight. And yet, Kansas does not care.

What is it with this state?

At any rate, folks, if you have poor people who are unable to get help in Kansas so they can go to the doctor when they need to.... it's the fault of the attitude in Kansas that, if you're poor, you're not worth helping. It must be YOUR fault.

Aaron McGrogor 1 month, 1 week ago

The attitude that health insurance is a privilege is still very prevalent here. Unfortunately, the point that is missed is that health insurance very often equates to health care.

Sharilyn Wells 1 month, 1 week ago

She should try Sunshine connection in Topeka.

Richard Heckler 1 month, 1 week ago

Voters should know by now after 70 years politicians have never provided health insurance for the people. Too many on both sides of the aisle take health care $$$$$ from the insurance industry and from health care providers for their campaign cookie jars. In addition to Wall Street investments.

WE voters need the last word aka WE voters need to be on the ballot even a special election if necessary.

Voters = democrats,moderate republicans, Green Party thinkers and sensible voters in general. Washington DC needs a big push to put choice on the table and on the ballot and lock it in for a lifetime.

To be fair to all in America there is only one way to satisfy the demand for ethical medical insurance coverage. That is by way of leaving the choice to consumers.

In fact a package of choices consisting of three choices is a most exciting package.

The estimated $3.4 trillion in existing tax dollars that is being inefficiently spent on health care will most likely cover the cost of Single Payer after all of the savings come into play which are significant.

Why not put choices on the table? And show veterans and business a little more respect in the process.

LET THE VOTERS DECIDE ON THE 2018 BALLOT NATION WIDE = voting on this entire package thus providing consumers 3 options for the rest of their lives.

Which one works best for YOU?

=== ObamaCare which retains the health insurance industry for those who fear the word Medicare or phrase Single Payer after all it is their dollar. This needs stiff federal regulations that cannot be superceded by the states. Offer a fair tax dollar rebate at the end of every year. Sooner or later this group will enroll in single payer.

=== Single Payer Medicare for ALL = excellent coverage for those who wish to enroll. The absolute best choice on planet earth. https://www.healthcare-now.org/docs/spreport.pdf

=== Self financed health care for those able to do so aka opt out. Offer a fair tax dollar rebate at the end of every year.

=== ALL Disabled vets should receive Medicare with a 100% benefit so they and their families can receive medical care immediately upon discharge. Make it retroactive.

=== Business should not be forced to provide health insurance.

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