Kansas City is known for lots of things: barbecue, the Country Club Plaza, broad boulevards, the place where Walt Disney grew up.
Less flatteringly, Kansas Citians are fatter, exercise less and smoke more than most of the rest of the country.
As leader of the Mid-America Regional Coalition’s Regional Health Care Initiative, Scott Lakin works to address those unhealthy distinctions. Lakin is a former Missouri state representative and one-time director of the Missouri Department of Insurance.
He answered five questions as part of our monthly series, KC Checkup:
What is the Regional Health Care Initiative?
The Regional Health Care Initiative is a division of Mid-America Regional Council, started based on a report in 2006 by Health Management Associates to do a study of the Kansas City metropolitan area regarding health care. And they found that there was a real need for safety net clinics – those that treat the uninsured and the medically underserved – to come together and start developing collaborative approaches to delivering health care and access to health care for those that are uninsured and medically underserved.
How does the initiative promote access to health care?
We get the groups together to problem solve on a regional basis, and no one’s forced to come. It’s people of the willing that come to these meetings, and they start brainstorming and collectively solve the problems that they can’t solve on their own. Or they collectively solve the problem and have a bigger impact. When we started with the safety net clinics, we did things like an after-hours program. Many of the people that do not have health insurance, they work all day. And so we did a program of some specific clinics in this area that would make sure that there were clinics open at all times in the evenings and on weekends, so that you’d have better access if you were working a full-time job and needed health services.
A 2013 regional health assessment by the Regional Health Care Initiative said the incidence of obesity and diabetes increased in all 11 counties in the metropolitan area between 2004 and 2009. What accounts for that?
Well, that was actually an update of a 2010 report. And I think that is a national trend, not just a regional trend, but something that we’ve had to deal with. How we’ve dealt with it is we’ve done everything from looking at what vending machines are in high schools to encouraging people to walk, and encouraging people to be active in their lives and looking at ways that we can start having an effect on the obesity problem. Particularly, the obesity problem is one in children – and we saw very significant increases in the increase of weight for children and the obesity of children. So we’re looking at a number of programs: healthy eating, education with parents, and we work with community neighborhoods on providing healthy foods in those areas. And that’s again what MARC is designed to do and the Regional Health Care Initiative - is we bring the groups together and work on it from a regional basis rather than having multiple programs working on it and not being quite as effective.
The assessment also said there were considerable disparities across the counties and across race and income groups. What were some of the most glaring disparities?
It basically said that poverty is on the move, and that brings up a lot of interesting policy discussions and a lot of needed policy changes. Because in the past if you wanted to get to the high uninsured areas or you wanted to get to areas of high disparities in access to care, you’d go to the central city or urban core. It’s not that simple anymore. Those areas continue to be a problem but you’ve’ also got pockets of economic disparities as well as healthcare access and pockets of poor moving out to the suburbs. And we see it in our schools with the free and reduced lunch programs. We see it in the schools, we see it a lot in housing and those types of issues as well.
Going back to the assessment, it also said that suicide rates have increased 50 percent since 2008. Why do you think that’s so?
I think there’s multiple reasons. Quite frankly, I think the economy has a part in that. Mental health services have been underfunded both in Missouri and Kansas for a number of years, and I think that has played a role in it. And I think that we see it nationally with a lot of the shootings and things coming from high schools and happening in the high schools that we need to look at that and address it. Unfortunately, on a national basis they’ve not addressed it. We’re hopeful that, as we go forward in Missouri and Kansas, people will understand that, again, primary care, particularly in mental health, is a good investment.