Dr. Rex Archer is the director of the Kansas City, Mo., Health Department, which administers everything from flu shots to restaurant inspections. Archer says he is responsible for 480,000 patients and that social equity is the key to the city's future.
He answered five questions as part of our monthly series, KC Checkup.
What do you see as the biggest priority for health right now?
“We need to change our narrative of how we view or think about health. Some folks think about health as we’re a consumer and we purchase health from an illness care provider and we need to make enough money to buy insurance and/or to pay for that care, as opposed to understanding that – no, health is largely determined by the social conditions in which we’re living.”
“If I had to prioritize, it would probably be that voters need to understand that all these policies – whether or not we have a livable wage for folks, whether or not there are predatory lenders out there – you know, how we treat other folks in these policies impacts our health day-to-day.”
What is holding Kansas City back in health?
“Some of our long, unfortunate traditions that started back decades ago in regards to the blockbusting and redlining and various things that occurred in regards to make neighborhoods unstable.”
“Nationally, we should be changing how we fund education. It shouldn’t be based solely on property taxes so that the wealthy areas of the city have resources and the poorer areas don’t.”
How do you see politics affecting health right now?
“One of the biggest impacts of a population’s health is the disparity between those that have and those that don’t.”
“An infant born in a zip code in Kansas City, Missouri where the average family income in that entire ZIP code is under 40,000 is five times [more] likely to not make it to age one than an infant that’s born in a ZIP code where the average income is over 80,000.”
In Missouri right now, the debate over Medicaid expansion is ramping up again. What’s your take?
“There is almost no reason that I can think of to not expand Medicaid. There are reasons that are given, but most of those fall pretty hollow.”
“All of us that have private insurance of some form or another are paying more for that private insurance because of cost shifting. The hospitals, the doctors have to find resources to pay for the folks that aren’t able to pay.”
“We’re even paying the federal taxes, but they’re not coming back to the state for our own folks to benefit and to create jobs.”
Obesity continues to be a big problem in both Kansas and Missouri, along with the rest of the Midwest and the rest of the country. What can we do to change that?
“When we falsely subsidize production of corn and sugar and keep those prices low, but aren’t doing that with fruits and vegetables; when the lobbyists fight to keep out school menus unhealthy and aren’t pushing for healthier products; when we don’t differentially tax higher-sugar-concentration beverages or those kinds of things, we’re playing for this through the policies we implement. There are ways we could turn this around. Are we gonna do it or not and in enough time?”