LAWRENCE — A team of public health researchers is finalizing a communitywide health plan for Wyandotte County, the county that encompasses Kansas City, Kansas. The University of Kansas Center for Community Health and Development began a comprehensive yearlong research process in November 2016 that involved stakeholders and policymakers from across the county.
“Wyandotte County is well-known for poorer health outcomes — historically, it has been at the very bottom of Kansas counties in terms of health rankings,” said Vicki Collie-Akers, assistant research professor and associate director of the Center for Community Health and Development at KU’s Life Span Institute. “A lot of our community partners have been focused on how we change that.”
The workgroup has compiled indicators from sources like the Centers for Disease Control and Prevention, the Kansas Department of Health & Environment, the Kansas Department of Labor as well as a large-scale survey of 2,300 residents regarding health issues.
“We also carried out focus groups to more deeply understand emerging health issues facing them,” Collie-Akers said. “One emerging issue was around hunger, so we talked with folks about conditions that contribute this locally. Our participatory model for assessment includes a mix of methods aimed at asking different questions about health and trying to put it together in a way that makes sense to local stakeholders.”
Additionally, to establish health priorities among residents and leaders Wyandotte County, the group held multiple public meetings with neighborhood groups.
“We asked them about their priorities and gave people two pennies to vote their priorities — we asked them, ‘Give us your two cents,’” said the KU researcher. “The local steering committee utilized that information applying a formula that weighted information, statistics and community perceptions. That helped optimize community input and also essential data.”
The final plan will address four health priorities: access to medical, dental and mental health care; housing; education and jobs; and violence. Each objective will include appropriate “SMART=C” objectives, which Collie-Akers said “are specific, measurable, relevant and time-challenging. Setting objectives helps hold a community accountable to its goals.”
Collie-Akers said access to medical, dental and mental health care is a complicated issue — one made more so by political fights in Washington, D.C., over the Affordable Care Act, commonly called “Obamacare.”
“One in 10 Wyandotte County residents don’t have insurance, and that is amplified in certain populations,” she said. “Wyandotte County residents experience lower rates of preventive care like mammograms and colonoscopies. We also know that of children in Wyandotte, one in four has obvious signs of dental decay. Overall, their ratio of providers for mental health and dental care is far worse than other places. The group is meeting right now about how to reduce barriers to care, including increasing the availability of providers.”
As for adequate housing, the KU researcher said that one in five residents in the county has severe housing problems. These problems include overcrowding, high costs where more than 30 percent of one’s income goes to mortgage or rent, lack of a kitchen or lack of plumbing.
“We’re looking at increasing affordable housing stock, and how to keep people — particularly seniors — in their homes,” Collie-Akers said. “We’re also looking at strategies to make residents’ housing safer, like reducing lead exposure.”
Another community health priority revolved around education and jobs, because in Wyandotte County only 78 percent of adults have a high school diploma compared with 90 percent for Kansas.
“Among African-Americans and Latinos, that gap gets wider,” said Collie-Akers. “About 50 percent of Latinos have a high school degree; only 5 percent have a college degree. We’re looking to reduce barriers to securing employment through child care and early-childhood education, addressing language barriers, increasing educational attainment and increasing availability of training to match jobs available in Wyandotte.”
The group identified violence as another community health priority, as violent crime rates included in their assessment showed 6.2 incidents per 1,000 residents, higher than the Kansas state average of 3.6 per 1000.
“There’s a concentration of violence in specific census tracts,” Collie-Akers said. “So, we’re focusing on certain areas to reduce violence where it’s more prevalent. Dr. Jomella Watson-Thompson (KU associate professor of applied behavioral science and associate director at the KU Center for Community Health and Development) has a grant to reduce violence, and she’s helping lead this part of planning effort.”
Collie-Akers said the Wyandotte County community is unique for its lack of a clear racial or ethnic majority since the early 2000s.
“Its population has changed dramatically,” she said. “There are parts of Wyandotte County where there’s a high population density of Latinos and African-Americans and recent immigrants from Asia and Africa.”
A major focus of the plan is on improving the health of Latinos residents, who make up 26-27 percent of Wyandotte County.
“We know the Latino population is at greater risk for chronic illnesses like diabetes and cardiovascular disease,” said Collie-Akers. “Through surveys, we know fewer Latinos engage in physical activity, or get enough fruits and vegetables, and overall in common question about heath — our health status answers go from ‘excellent,’ ‘good,’ ‘fair’ and ‘poor’ — by far Latinos are more likely to respond ‘poor’ than other groups overall.”
KU staff soon will present the community’s draft plan to the Wyandotte Health Foundation, the Unified Government of Wyandotte County, Kansas City, Kansas Public Health Department.