Seventeen years ago, Dr. Rex Archer returned to his hometown of Kansas City to lead its health department. He started reviewing the city’s vital statistics to get a handle on its pressing needs.
“When you have 480,000 patients, you can’t do histories and physicals on every single one of them,” he says wryly.
The inequities he found shocked him. Life expectancy for white residents was 6.5 years longer than the life expectancy of African-American residents. Gathering more data, he found about half the city’s annual deaths could be attributed to social factors such as segregation, poverty, violence and a lack of education. The homicide rates for African-Americans and Hispanics were 9.5 and 4 times higher, respectively, than the homicide rate for whites.
Archer knew his departament had to tackle these disparities, but without careful planning it would be “like throwing gasoline on a fire.” With support from the mayor, he convened the Mayor’s Minority Health Improvement Task Force. In 2001, the health department shared the statistics and initial task force recommendations in the report, “Is it Good for the Children? Minority Health Indicators 2000.”
That report has served as the central focus for the community’s work over the past 15 years. Health equity outcomes are built into the city’s business plan, with goals formed for primary prevention, tobacco reduction, environmental health and violence reduction, mental health and addictive disorders, and women’s, infants’ and children’s health. The overarching goal: Increase overall life expectancy and reduce health inequities across the city.
The mayor and City Council moved quickly after the release of the report, accepting its recommendations for minority racial/ethnic health improvements and then, in April 2001, passing a resolution to establish the Kansas City Health Commission (KCHC) and launch the Community Health Improvement Plan (CHIP). The KCHC, a mayoral-appointed advisory board, became permanent in 2006.
These actions created a model for change informed by hard data and actionable plans rather than anecdotes and broad suggestions. CHIP is now a community-driven document that serves as a blueprint to improve the health of residents. Some of the sources guiding this work:
Citizen Satisfaction Surveys, conducted quarterly, are shared annually via Open Data KC, a public data platform.
With input from citizens, KC Stat provides qualitative and quantitative data to measure progress on the City Council’s strategic priorities.
The city’s five-year financial plan factors in life expectancy, crime and other indicators.
RWJF County Health Rankings, along with Kansas City Community Health Assessment data, are used to help identify trends and needs.
With data and statistics lighting the way, Kansas City leaders across sectors can see connections that would have been only dimly visible just a generation earlier.
Progress is already becoming apparent: Archer said life expectancy is increasing for everyone, and the difference between life expectancy for whites and African-Americans was reduced from 6.5 years to 5 years. With time and effort, the hope and expectation is that the health inequity gap will continue to shrink.
“We have a 149-year history of protecting the population’s health. That’s when the city first hired a city physician and began its public health functions,” Archer says. “Then it was to prevent the spread of communicable disease and to look at the social problems that were causing problems in our community. We haven’t lost that heritage.”
Kansas City, MO: 2015 Prize Winner
Kansas City is creating a safe, healthy environment for all its residents by addressing what impacts health. Over the past decade, life expectancy improved for all. The gap between white and African-American residents was reduced from 6.5 to 5 years.