Health Status & Disparities

Health Disparities

By and large, the latest health data for the region shows positive trends. Mortality rates and disease incidence rates are down in most cases, with obesity and diabetes being the principle exceptions. Also, preventable hospitalizations are on the decline. However, these regional trends mask some important disparities. Health outcomes and health trends vary significantly by location and across income, race and ethnicity. For the region to be truly healthy, everyone must be able to benefit from positive health trends.

Geographic Disparities — Residents of the most rural and the most urban counties often experience poorer health outcomes.

Health outcomes are unevenly distributed across the region. This reflects an uneven distribution of those who are poor, less educated, older or are racial and ethnic minorities. It also reflects an uneven distribution of health resources, such as physicians or dentists. A review of regional health data shows a familiar pattern across health issues, with the most urban counties (Wyandotte and Jackson) and the most rural counties (Allen, Miami, Lafayette and Ray) typically faring worse than the suburban counties.

Residents of urban counties often have poorer access to health care resources due to low incomes or lack of insurance. They may also live in less healthy environments, with higher exposure to toxins, more stressful lifestyles and a lack of community assets such as safe places for outdoor recreation. Rural residents may have limited access to health care, and rural counties often have more older residents.

One example of the uneven distribution of health outcomes is Years of Potential Life Lost (YPLL), a measure of premature death. The chart below shows how counties compared for this measure in four time ranges: 2004–2006; 2010–2012, 2011–2013 and 2012–2014. The YPLL numbers are highest in the most urban counties (Wyandotte and Jackson) and the most rural (Allen and Ray). There is a small, but measurable, decline in YPLL from the 2004–2006 range to the 2012-2014 range in every county but Ray.

Preventable hospitalizations for Medicare recipients is significantly higher for Blacks than for Whites.

The county distribution of preventable hospitalizations for Medicare recipients, although not as strong as for YPLL, demonstrates a similar distribution, with urban areas and particular rural areas showing the highest rates.

It should be noted that between 2010 and 2014 there have been significant declines in these rates across all counties. However, with the exception of Johnson and Platte Counties, the rates are above the national rate.

Preventable hospitalizations for Medicare recipients is significantly higher for Blacks than for Whites. Although rates have declined between 2010 and 2014, the disparity has remained, despite the fact that both Blacks and Whites have Medicare insurance and thus presumably equal access to health care.


Discharges for ambulatory care sensitive conditions (Preventable Hospitalizations) per 1,000 Medicare enrollees

  2014 2010 % Change 2010 to 2014
  All Black White All Black White All Black White
United States 49.9 64.9 48.7 66.6 88.3 64.8 -25% -26% -25%
Kansas 51.9 62.6 50.8 66.8 75.4 65.4 -22% -17% -22%
Missouri 56.6 67.0 55.6 73.0 90.4 71.5 -22% -26% -22%
Allen 61.2     95.2     -36%    
Johnson 45.6 57.0 44.5 55.6 90.6 53.8 -18% -37% -17%
Leavenworth 58.7 72.6 57.4 73.3 85.2 72.0 -20% -15% -20%
Miami 55.7     60.4     -8%    
Wyandotte 61.1 76.3 60.7 69.0 79.6 71.2 -12% -4% -15%
Cass 64.7     70.2     -8%    
Clay 57.9 79.8 56.4 83.1 85.8 81.2 -30% -7% -31%
Jackson 55.1 64.9 55.0 64.0 73.9 64.4 -14% -12% -15%
Lafayette 69.7     98.1     -29%    
Platte 47.4     60.9     -22%    
Ray 82.3     125.5     -34%    

Source: The data was obtained from The Dartmouth Atlas, which is funded by the Robert Wood Johnson Foundation and the Dartmouth Clinical and Translational Science Institute, under award number UL1TR001086 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH).

 

Data for the nation and the two states shows significantly higher death rates from diabetes for Hispanics, and especially Blacks, when compared to Whites. These rates have held relatively constant from 2013 to 2015.

 






Blacks experience a higher rate of diabetes prevalence than do Whites at the national level and in both states. Nationally, Hispanics have diabetes prevalence at a slightly higher rate than Whites, but that is not the case in Kansas. There was insufficient responses from Hispanics in Missouri.







Blacks and Hispanics have slightly higher rates of obesity than do Whites. These rates have increased slightly 2014 to 2015.







Hospital discharge rates for several diagnoses show a similar pattern across both states and both sides of the metro area. Blacks have the highest discharge rates, Whites have rates somewhat less than Blacks, and Hispanics have significantly lower discharge rates. The low discharge rates for Hispanics may reflect their reluctance to access health care and/or their difficulty in accessing such care. It may also reflect a somewhat younger population than Blacks and Whites.

Discharge rates are generally declining for all populations and all geographies. However, the rate of decline varies based on race and diagnoses. Discharge rates for heart and circulation diagnoses are declining faster for Whites than Blacks as is the case for respiratory diagnoses. On the other hand, rates are declining faster for Blacks than Whites for mental disorder diagnoses and cancer diagnoses. Diagnoses related to pregnancy have declined the most for Hispanics.

Hospitalization Discharges for Selected Diagnoses by Race and Ethnicity

Black Population
           
Rate per
10,000 population
Heart and Circulation Mental Disorders Neoplasms - malignant
(Cancer)
Pregnancy -
Childbirth - Reproduction
Respiratory
(throat and lung)
2014 2010 Percent Change 2014 2010 Percent Change 2014 2010 Percent Change 2014 2010 Percent Change 2014 2010 Percent Change
State of Kansas 255 232 -2.8% 76 90 -16.0% 37 54 -30.7% 121 138 -12.5% 115 122 -5.5%
State of Missouri 261 311 -16.2% 185 171 8.3% 37 43 -14.4% 158 164 -4.1% 150 164 -8.5%
Kansas Side of Metro Area 262 260 0.8% 57 71 -19.7% 43 59 -26.7% 148 152 -2.3% 148 123 -2.0%
Missouri Side of Metro Area 262 158 -5.9% 135 158 -19.5% 35 41 -12.7% 166 177 -6.7% 166 146 1.5%

 

Hispanic Population
           
Rate per
10,000 population
Heart and Circulation Mental Disorders Neoplasms - malignant
(Cancer)
Pregnancy -
Childbirth - Reproduction
Respiratory
(throat and lung)
2014 2010 Percent Change 2014 2010 Percent Change 2014 2010 Percent Change 2014 2010 Percent Change 2014 2010 Percent Change
State of Kansas 61 61 0.3% 21 19 11.7% 19 18 5.0% 96 121 -20.5% 37 43 -12.7%
State of Missouri 72 84 -14.9% 36 32 12.1% 12 14 -10.4% 80 94 -15.2% 43 45 -3.4%
Kansas Side of Metro Area 71 59 21.2% 14 17 -17.4% 19 20 -7.0% 97 102 -4.4% 44 42 5.2%
Missouri Side of Metro Area 38 44 -14.8% 23 28 -17.6% 10 8 13.6% 82 114 -27.9% 37 37 1.2%

nicity

White Population
           
Rate per
10,000 population
Heart and Circulation Mental Disorders Neoplasms - malignant
(Cancer)
Pregnancy -
Childbirth - Reproduction
Respiratory
(throat and lung)
2014 2010 Percent Change 2014 2010 Percent Change 2014 2010 Percent Change 2014 2010 Percent Change 2014 2010 Percent Change
State of Kansas 106 119 -11.1% 57 60 -4.0% 28 33 -13.9% 106 109 -2.8% 75 84 -11.1%
State of Missouri 140 180 -21.8% 125 121 3.4% 27 33 -19.0% 122 130 -5.8% 96 110 -12.8%
Kansas Side of Metro Area 120 124 -3.4% 50 58 -13.6% 32 34 -5.9% 114 110 4.0% 67 67 -0.4%
Missouri Side of Metro Area 140 180 -21.8% 125 121 3.4% 27 33 -19.0% 122 130 -5.8% 96 110 -12.8%

Source: Kansas Information for Communities and Missouri Information for Community Assessment

 


Data is the most current available as of September 2017.

Produced by the Mid-America Regional Council for the REACH Healthcare Foundation | www.marc2.org/healthdata ©