Seft Hunter became chief operating officer last year of Communities Creating Opportunity, a faith-based organization that addresses poverty-related issues. As part of its campaign to promote health access and equity, CCO, working with the REACH Healthcare Foundation and other groups, has been mapping medical “hot spots” in the metropolitan area in an effort to better manage residents’ chronic conditions, improve access to health care and reduce emergency room visits.
Seft, who has a Ph.D. in communication and organizational management and serves on the Kansas City Health Commission, discussed CCO’s health initiatives with Heartland Health Monitor editor Dan Margolies. The transcript has been edited for length and clarity.
What are your organization’s top priorities when it comes to health care, health access?
CCO has been around for 38 years and … We were initially founded to address issues related to economic disparities in east-of-Troost communities. Since that time, we’ve branched out and are now working in five counties around the area, and our top priority as relates to health care is really to help individuals realize the dignity of what it means to live well. We know that when individuals are sick, they cannot take advantage of all that life has to offer. We know that there’s significant indignity that comes from folks that are facing medical bankruptcies because of the dramatic burden that comes from being uninsured.
As a result of these factors, we know that, when we talk to these folks and we encourage them to step up and share their stories, they do share immense pain, they share stories of immense shame that’s associated with some of the factors that come from being uninsured and having to basically live with a level of pain each day that no one in our country, no one in certainly one of the wealthiest countries in the world, should have to live with each year. So CCO as an organization is really committed to helping these individuals become advocates on their own behalf and become advocates for themselves and for their communities.
Why are the health outcomes in Wyandotte County so poor?
The core issue is the economic uncertainty. So the core issue is not having earnings that are adequate to meet the need. We know that when people earn a living wage, we know when people can actually provide for their families, those folks aren’t necessarily seeing life expectancy that’s 16 years or 13 to 16 years different than their neighbors. And so, at the core of this issue for us is really working on the factors that actually drive the personal and collective economy of individuals and families across Wyandotte County and the region.
So if I hear you correctly, you’re saying that jobs are really the biggest engine in driving health outcomes.
Jobs are one of the biggest engines in driving access to education and educational attainment, matriculation and everything related to educational success. And at the core of the diminished health outcomes, access to jobs, access to economic opportunities, not having some of those things that diminish the economic potential and reality of families, such as payday loans and things like that, so highly concentrated in urban centers. So all those things that actually address the personal economies of individuals and families really do affect life expectancy, affect health, affect educational attainment, and it certainly affects the general well-being of communities across the region.
What does ER use, emergency room use, tell us about health care outcomes, the state of health care, in a given area? Why is that important?
There are areas where there are individuals who are minority, individuals who are uninsured, individuals who have higher rates than normal unemployment. And these areas are also areas where people who could potentially benefit from the expansion of Medicaid reside. These folks tend to also have less than adequate access to transportation. And because of these factors, these individuals tend to choose going to the emergency room because they have no other outlets. For them, they’d much rather have a primary care doctor that they could see regularly, they’d much rather have a relationship with a health care provider that’s close to their house, they’d much rather not have to go to the emergency room. But what happens is they’re left with no other choice, and oftentimes what happens is the issues for which they present to the emergency room are issues that can actually be treated in a non-emergency setting…
It’s estimated about 40 percent of the folks who show up to the emergency room – the reason for which they show up are issues that can be better treated in a typical primary care environment. And so for those folks, what happens is they tend to let those issues fester and the issues get to such a critical level that they’re left with no other choice than to dial 911 and wait for transport and get to the emergency room.