It’s time to shape up, Kansas City.
The Greater Kansas City Chamber of Commerce and Blue Cross and Blue Shield of Kansas City today are announcing an ambitious initiative called Healthy KC aimed at improving health and well-being wherever people live, work or play.
Its many objectives, put together by more than 100 area health and environmental advocates, academics and business and political leaders, are at turns startling, politically difficult and potentially very expensive.
They include bumping up the age to buy tobacco from 18 to 21; raising money to build grocery stores in the region’s “food deserts”; making our auto-centric streets more friendly to pedestrians and cyclists; and improving social and mental health services to the region’s many homeless children, youth and families.
Much of the agenda would take years to accomplish, but at least two of the items will be ready to go relatively soon. To raise public awareness of the initiative, the chamber plans to challenge another city to a “Race to the Moon,” competing to see which city’s residents can be the first to walk 1 billion steps, roughly the distance to the moon and back.
And the initiative today is launching a regional workplace health and wellness certification program to recognize employers that have policies and programs in place that promote employees’ health and well-being. The chamber hopes to have 200 organizations certified by 2017.
The overall goal of Healthy KC is to make Kansas City “one of the healthiest cities in America,” said chamber president and CEO Jim Heeter. Community betterment is a chamber objective, he said. But the initiative also will benefit the chamber’s member businesses directly. “Healthy employees are better, more efficient employees,” he said.
The initiative’s organizers will have their work cut out for them. Kansas City has never had a reputation for healthy living.
Just 16.7 percent of area residents meet Centers for Disease Control and Prevention guidelines for both aerobic and strength exercise. One in five admits to not getting any exercise or physical activity at all in the past 30 days. And there are a lot more people here who smoke regularly — 21.7 percent — than who eat the recommended three servings of vegetables every day. A meager 12.6 percent are eating enough veggies.
Community health had always been a strong runner-up whenever the chamber discussed its “Big 5” list of projects for the metro area. About two years ago, the chamber and Blue Cross and Blue Shield began discussions of a regional health and wellness initiative, eventually inviting local experts onto teams to recommend the actions the initiative will take.
In addition to workplace wellness, these actions cover four general areas: active living, healthy eating, tobacco use cessation and prevention and behavioral health. Among the goals:
Active living: An interactive tool, such as a website or cellphone app, will be developed to connect the community to active living events and amenities, link to local parks and recreation department websites and highlight opportunities for recreation.
A second goal is to make Kansas City streets friendlier to pedestrians and cyclists by building more sidewalks and trails, bike lanes and safer street crossings. The initiative also calls for land use and economic development policies that encourage businesses to locate in walkable and bike-able neighborhoods and along mass transit routes.
“I think it’s a matter of changing people’s thinking,” said active living team chairwoman Mary Jane Judy, a marathon runner and Polsinelli attorney. “People in Kansas City are married to their cars.”
Healthy eating: To cut through the clutter of health advice, the initiative calls for an information campaign based on the Children’s Mercy Hospital 12345 Fit-tastic! program, which simplifies the daily message to one hour or more of physical activity, two hours or less of screen time, three servings of non- or low-fat milk or yogurt, four servings of water and five servings of fruits and vegetables.
“We think it’s a powerful message. It’s simple, straightforward and easy to remember,” said Beth Low of the Greater Kansas City Food Policy Coalition. “We would really like to amplify it at work sites, schools, community centers.”
The initiative also recommends that business leaders advocate to elected officials on behalf of food assistance and healthy eating programs.
But education will be just a first step, according to Low. “It’s great to teach people about their choices to eat healthier but it can be impossible to do if there aren’t healthy food options available.”
Goals include increasing the capacity of food pantries to carry fresh food, and advocating for the creation of fresh food funds to help finance the development of grocery stores in under-served neighborhoods.
Many food pantries don’t have refrigerated trucks or storage, which makes it a challenge to offer fresh food, Low said. Building grocery stores in so-called food deserts will be expensive; Low would like an initial investment of $5 million in a fresh food fund.
A final item on the healthy eating agenda is to encourage schools, parks and recreation centers and major sports and entertainment venues to add more healthy food choices to their menus.
“There are ‘once in a while foods.’ A hot dog at the ballpark may be a family tradition,” Low said. “The goal here is to make it possible for everyone to have the opportunity to make healthy choices, not to force them.”
Tobacco use cessation: Actions to prevent young people from starting to smoke are a key part of the initiative’s agenda. That includes raising tobacco taxes in both Kansas and Missouri and raising the age for buying tobacco products from 18 to 21.
Missouri has the lowest tobacco tax in the nation — just 17 cents per pack of cigarettes. The Kansas tax, 79 cents per pack, is well below the national average.
Research has found that every 10 percent increase in cigarette prices reduces youth smoking by 7 percent, said Jessica Hembree, chairwoman of the tobacco use team and a policy officer with the Health Care Foundation of Greater Kansas City. “What we’re finding is that Kansas and Missouri used to be in the forefront on tobacco taxes, but other states have been forging ahead.”
But raising the age for tobacco sales would put the Kansas City area back in a leadership position with such cities as Columbia and New York City that already have already taken the action, Hembree said.
“Young people will occasionally experiment with tobacco,” she said. “That critical time between 18 and 21 is when they become committed and addicted smokers.”
The initiative also calls for adding e-cigarettes to local laws that ban indoor smoking and looking into the feasibility of amending state laws to allow localities to levy their own tobacco taxes.
Hembree concedes that there is not much political support at the state level for raising tobacco taxes or further regulating tobacco.
“It’s definitely going to be a long haul and a lot of work in both states,” Hembree said.
But the coalition of advocacy groups that helped bring indoor smoking bans to the metro area is still intact and willing to work on the initiative, she said. “I think we build from where we are.”
Behavioral health: The mental health system in the Kansas City area faces a crisis of increasing demand for services that it’s been unable to meet, the initiative’s behavioral health team said.
Waiting times for adults seeking psychiatric care average four to eight weeks; for children, it’s six months. Suicides in Missouri outnumber homicides by more than 2 to 1. About 2,500 youth are living on the streets, sleeping in cars or on someone’s couch on any given night in Kansas City.
“We know what contributes to the highest costs of behavioral health. That is mainly violence, homelessness and unmet psychiatric needs. We know how large that gap is,” said team vice chairman Dennis Meier of Synergy Services, a domestic violence shelter and services organization.
The local shortfall in behavioral health spending for children, youth and young families alone is estimated at $148 million per year, Meier’s team found.
Team members realize that kind of funding gap will be hard to close, but “we really saw this as an opportunity to tell the chamber the state of mental health in Kansas City in hope that something would resonate,” said team chairwoman Carla Gibson of the REACH Healthcare Foundation. “We wanted to give a full picture. It’s really, ‘What is there an appetite for taking on?’”
And there is “lower hanging fruit” for the chamber to tackle, Gibson said. That includes promoting widespread training in mental health first aid, analogous to CPR training, that offers instruction on how to identify people in crisis and direct them to appropriate help. Training teachers, police and other professionals in how to work with children who’ve been exposed to emotional or physical trauma also will yield large benefits, she said.
Heeter, the chamber president, said the chamber would be lobbying legislators for more mental health funds, as well has for higher tobacco taxes.
But those working on the Healthy KC initiative say they aren’t going to depend on Topeka or Jefferson City to get things done.
“It’s clear we can’t wait for the states,” said Bridget McCandless, president of the Health Care Foundation of Greater Kansas City. Just as with politics, she said, “all health is local.”