Kansas City Health Department data shows that in each of the last two years there were four ZIP codes in the city in which life expectancy was going down.
Department officials aren’t yet sure why, but they think it may be related to socioeconomic changes within those ZIP codes because those factors tend to influence health outcomes even more than medical care.
“If you don’t have a full service grocery store, if you have way too many liquor stores, if the structure in that ZIP code is not healthy, then those people who may have better incomes may be tempted (to say) ‘Well do I stay and try to restore my community and do that struggle to heal this, or do I go some place else where my kids may have a better shot,’” Health Department Director Rex Archer said.
In Kansas City, as in most cities, there’s long been substantial differences in life expectancy between those living in wealthy vs. low-income ZIP codes. That hasn’t changed: People near the Country Club Plaza or in parts of the Northland live 80 to 86 years, on average, while those in a strip of five ZIP codes that run north and south through the city’s core between US-71 and I-435 average 10 to 15 fewer years.
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But those five lowest ZIP codes aren’t the ones declining. Life expectancy in those ZIP codes has either stabilized or is rising.
It’s ZIP codes directly north and east of them, in the Raytown area and around the Missouri River, that are declining.
From 2011 to 2015, residents of 64117, 64123, 64133 and 64138 didn’t live as long as they did a decade earlier. The same was true from 2012 to 2016 for residents of 64138, 64123, 64129 and 64134.
In Kansas, life expectancy in Johnson County is 80 to 83 years and trending upward. In Wyandotte County, it’s 73 to 78 years and basically stable.
Archer said he wanted more time and more data before speculating about declines in some Kansas City, Mo., ZIP codes. They might be statistical aberrations. But in general, he said life expectancy has far more to do with socioeconomic factors like graduation rates, income and access to grocery stores than medical care.
“It’s not access to the ER or the hospital that’s the factor here,” Archer said. “It’s these situations in those communities.”
The declines may be part of larger trends. The average American lifespan declined nationally in 2015 for the first time in more than 20 years, dropping from 78.9 to 78.8. Kansas and Missouri have also been slipping down state health rankings in recent years.
Tracie McClendon-Cole, the health department’s community justice program manager, said she thinks the changes within Kansas City, Mo., may reflect migration patterns as people with more money move farther from the city’s core and take their tax base and economic infrastructure with them.
She said she could speak to that as someone who lives in 64133, an area of Raytown adjacent to the city’s major sports stadiums.
“As we grow and grow, the white flight begins to go farther and farther out, leaving an infill, but sometimes not the structural base that was previously enjoyed by that community,” McClendon-Cole said.
Census data showed major changes in racial demographics in the two ZIP codes that showed declines in both 2015 and 2016. For example, 64138 was 68 percent white and 27 percent black in 2000. By 2015, it was about 45 percent white and 45 percent black.
In 64123, the population was 66 percent white, 8 percent black and 15 percent “other,” including Hispanic or Latino of any race, in 2000. By 2015 it was 58 percent white, 7 percent black and 27 percent “other,” including Hispanic or Latino.
Pastor Cassandra Wainwright, the president of the Concerned Clergy Coalition of Kansas City, said she was surprised to hear that life expectancy was on the decline in 64138, a mostly residential area dotted with churches.
“Most of the people that are dying that I’ve seen in our Raytown area have been older individuals,” Wainwright said.
She said those who die young are usually victims of heart disease or cancer, but she has seen an increase in homicides as well.
Sarah Martin-Anderson — manager of community engagement, policy and accountability for the city health department — said homicides play some role in dragging down life expectancy, but infant mortality affects it more.
Scott Sundin, the senior pastor of the Blue Ridge Bible Church in 64138, said within his church community “we mostly bury people in their 90s.”
But outside of the church he sees signs of trouble, including what look like drug deals recorded by the church’s security cameras at night.
“I see an awful lot of people around me that almost look like the stereotypical PTSD (post-traumatic stress disorder) patient,” Sundin said.
Abdul Bakar, the director of refugee resettlement for Della Lamb, said toxic stress is also a factor in the life expectancy of international migrants who are changing the demographics of the 64123 ZIP. Life expectancy in that ZIP code was 72.5 as recently as 2010. It’s now about 67.
“They’re working two jobs to make ends meet,” Bakar said of the area’s new arrivals.
Lack of insurance is also a barrier to their health care, Bakar said. Most refugees are only eligible for Medicaid during their first three months in the United States. They don’t qualify for coverage help under the Affordable Care Act until they become citizens.
“As a result of that, they only go to the hospital, and only if they’re in pain,” Bakar said.
Sofia Khan, the founder of KC for Refugees, is a doctor who volunteers at the Peace Clinic, a free clinic that until recently was located in 64123. The clinic has moved just outside of the ZIP code to a new location at 500 Woodland Ave., but will serve many of the same people.
Khan said refugees and other migrants often need primary care doctors to educate them about preventative care that can extend their life spans.
She said she teaches them everything from where to get fresh diapers for their children, to when to get screenings like mammograms and pap smears.
But she said no amount of advice can overcome the economic struggles she sees in some families. She said she visited one home recently where multiple family members had serious health problems and they were living in a house with roaches.
“They are barely able to just pay the rent,” Khan said.
Archer said the health department is working with national non-profits to reduce the life expectancy inequalities in the city by addressing the toxic stress and trauma that keep kids from reaching their full potential in school, which perpetuates cycles of poverty that are correlated to poor health outcomes.
Debbie Bigelow, a volunteer executive director of the Clay County Clothes Closet, said poverty-related stress was also widespread among those served by her charity in 64117, a Northland ZIP code that is still about 80 percent white and showed a life expectancy decline from 2011 to 2015.
“Since 2014, we’ve seen a 24 percent increase in the number of people we’re serving,” Bigelow said. “We’re seeing a lot of grandparents that are raising their grandchildren, and that’s a lot of stress.”