Healthy Outlook: Kansas’ health ranking reveals some surprises, good and bad

photo by: Mackenzie Clark/Journal-World Graphic

Kansas hit its peak as the 8th healthiest U.S. state in 1991. In 2018, the state ranked No. 27 for the fifth time in seven years.

Breathe easy, Kansas, with the knowledge that the state has less dust in the wind — that is, relatively low air pollution — compared to other states.

Just make sure you brush and floss. The state only has 49.7 dentists per 100,000 population.

These numbers are according to America’s Health Rankings, an annual report from the United Health Foundation. The 2018 report, released on Thursday, shows Kansas positioned similarly to its geographic location — right about in the middle. The state ranks 27th healthiest — for the fifth time in the last seven years.

The state’s air pollution score, ranked No. 14, and dentist-to-population ratio, ranked No. 39, are the items with the most positive and most negative impacts on that ranking.

Report background

Since the first America’s Health Rankings report in 1990, Kansas has trended downward. The state peaked at 8th healthiest in 1991, but in the 27 rankings since, it has only seen improvement 10 times and has otherwise declined or stayed the same.

The biggest change was a jump from 22nd to 17th in 2006, but the state dropped again to 25th in 2007.

It’s interesting to see where Kansas falls within the states, and where Douglas falls among Kansas counties. In March, the Journal-World reported that Douglas County fell from the state’s 7th healthiest to 23rd. That annual report, the County Health Rankings & Roadmaps, offers several comparable statistics on a localized level. I’ll include some comparisons, where appropriate; bear in mind, though, that the ranking systems don’t use identical data sources in all cases.

Dr. Rhonda Randall, chief medical officer of UnitedHealthcare National Markets, expounded on the data in Kansas’ latest report card.

photo by: Contributed Photo

Dr. Rhonda Randall, chief medical officer of UnitedHealthcare National Markets

“There’s generally a combination of areas where Kansas is not keeping pace with improvements in the rest of the U.S.,” she said. “… We can look at areas where Kansas is most challenged, but being 27th, there certainly are areas of strength and areas where Kansas is doing particularly well, in addition.”

All of the reports are available at and

Here are some of the key takeaways from Thursday’s report:

• Cancer deaths increasing:

Although the nation’s rate of cancer deaths has seen a fairly steady decline, the state’s rate has increased over the past 28 years. Kansas’ rate was quite a bit below the national average — at its lowest, it ranked No. 9 in 1990, with a three-year average of 180.2 deaths per 100,000 population. Then the rates began to overlap in the late 2000s.

2013 was the last year Kansas’ rate was below the national average, and this year, the state ranks No. 31 with a rate of 195.5. That’s up 8.5 percent from 1990; the U.S. rate, on the other hand, has decreased 4.6 percent in that time frame.

The data also shows significant racial disparity: In Kansas, the American Indian/Alaska Native population has a rate of 241 cancer deaths per 100,000 — that’s among the highest in the country, and 62.7 percent higher than the nationwide rate of 126.

Randall said that in order to turn the cancer death numbers around, “we try to focus on things that are modifiable.”

She said the No. 1 behavior that is correlated with cancer deaths is smoking. On that front, Kansas has trended downward on par with the rest of the country — from 2012 to 2018, smoking decreased 20 percent — though Kansas actually saw a small uptick from 17.2 percent to 17.4 percent of adults who are smokers from 2017 to 2018. For reference, the 1990 number used a different methodology, but it was 30.2 percent. That’s a 42 percent decrease over the last 28 years in Kansas.

Randall also said obesity is a modifiable factor.

“Individuals who are carrying excessive weight, their body is in a constant state of inflammation because of that excessive weight,” she said, “and that inflammation has a tendency to turn cancer genes, cancer cells on, for example.”

• Drug deaths low:

Kansas has a relatively low number of drug-related deaths, ranking No. 7 in that category behind six other Midwest states. Nationwide, that number has increased 79.8 percent from 2007 through this year’s rate of 16.9 deaths per 100,000 population; in Kansas, it has increased 41.5 percent in that time, but it peaked at 11.8 last year and declined to 11.6 in 2018.

Randall said many other states are seeing a significant crisis. For comparison’s sake, West Virginia, ranked No. 50, had a rate of 41.4 — that’s 3.6 times Kansas’ rate. Douglas County’s rate of drug overdose deaths is 10 per 100,000.

“The states that are having real difficulty with increases in their drug death rate may want to understand some of the things that Kansas is doing to combat the drug death issue,” she said.

• Less frequent mental distress, with a caveat:

Kansas’ percentage of adults who reported that their mental health was not good 14 or more of the past 30 days is 11.4 percent for 2018 — lower than the national 12.0 percent, but it is a 16.3 percent increase since 2017. The state ranks No. 13 this year, but was No. 6 in 2017. Douglas County showed a small increase, too, from 10 percent to 11 percent.

Randall said frequent mental distress brings a range of effects.

“That causes the body to be in a state of constant feeling of fight or flight, which causes your body to produce stress hormones which have negative consequences, not only to your mental health but also to your physical health,” she said. “We also know that there’s higher correlations with things like depression, anxiety, and the one that we’re concerned about the most is that there’s a correlation with higher rates of suicide.”

• Clean air everywhere, but no one out to breathe it:

In a category in which Douglas County shines by comparison, Kansas ranks No. 32 nationwide for physical inactivity. 27.9 percent of adults in Kansas reported no physical activity other than their regular job in the last 30 days. Douglas County’s rate was 18 percent — that’s among the best in the state, and it tops No. 1-ranking Washington’s 19.2 percent.

“Remaining physically active is incredibly important, not only to your overall health and healthy weight and decreasing the risk of preventable diseases like diabetes and heart disease and cancer, but it’s also very important to maintain our independence as we age,” Randall said.

Turning it around

So, what can the average Kansan do to change the whole state’s numbers for the better? Randall said it starts with taking care of yourself.

“Find your own motivation, and hold yourself accountable to yourself,” she said.

She gave some example of small changes to improve overall health — eliminating all beverages besides water, or changing portion sizes — and emphasized sustainability.

“Those are little changes that you can stick with for a lifetime,” she said.

She suggested finding a way to get more physically active that will suit you — perhaps gardening, taking walks, picking up something you enjoyed as a kid or trying something new. There’s no one-size-fits-all approach, she said. Then, see if you can raise others up with you.

“Maybe you are an individual who is already taking a walk every morning,” Randall said. “Is there a neighbor who you can invite to join you on that walk and not only get to know them a little bit better, get some socialization, and help them live a healthier life?”

About Healthy Outlook

Healthy Outlook is a column written by Journal-World reporter and Health section editor Mackenzie Clark, in hopes of helping readers make their lives a little bit happier, healthier and more active.

Have questions about the world of health and wellness in Lawrence, or a health story idea? Contact Mackenzie:

Read more:


Welcome to the new Our old commenting system has been replaced with Facebook Comments. There is no longer a separate username and password login step. If you are already signed into Facebook within your browser, you will be able to comment. If you do not have a Facebook account and do not wish to create one, you will not be able to comment on stories.