New health rankings show Kansas stuck at No. 27 among the 50 states, the same slot 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.
The annual United Health Foundation rankings are 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 advisor, says there’s no mistaking the trend.
“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,” Randall says.
That’s a far cry from the state’s 1991 ranking as the eighth healthiest state in the nation. Kansas’ slide from the top 10 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 a trend that we need to reverse quickly, or Kansas will slip to the bottom of the pack,” Willett says.
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 that without an investment in programs designed to keep Kansans healthier, the state won’t raise immunization rates or make more progress against preventable causes of death like obesity and smoking.
Kansas Department of Health and Environment spokeswoman Sara Belfry takes issue with that view.
“I would completely disagree with that,” she says.
Belfry concedes that Kansas ranks near the bottom in public health funding but 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.
Belfry insists the state is nonetheless making progress.
“In the past two years, we have seen the rate of smoking decrease by nine per cent, and that’s a huge improvement,” Belfry 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, head of a coalition of anti-smoking organizations called Kansans for a Healthy Future, 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.
“You know, if you look at it in terms of the whole nation, we rank 31 out of 50 states,” Russell says. “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 Centers for Disease Control and Prevention says the state needs to spend at least $28 million if it wants to 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 Gov. Sam Brownback to order emergency spending cuts.
Russell’s coalition 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.
“More than 22 per cent of Missouri adults smoke, putting (Missouri’s) ranking at 41st,” says Dr. Tony Sun, medical director for UnitedHealthcare in Kansas, Missouri and Nebraska. “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, an improvement of three spots over last year.
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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