Health & Fitness

Kansas City’s killers: guns, pills and cigarettes

Opioid deaths in Kansas City are triple the national average, one of a handful of ways that public health in the city lagged the national average.
Opioid deaths in Kansas City are triple the national average, one of a handful of ways that public health in the city lagged the national average. TNS

Kansas City has a thing for drugs, guns and smokes.

And that’s killing us.

Data released Tuesday comparing cities on various measures of public health showed Kansas City residents more likely than those elsewhere to drop dead from drugs in the heroin family, to get injured or killed by firearms or to die from lung cancer.

The numbers released by the Big Cities Health Coalition compared 28 cities on measures ranging from cancer deaths to binge drinking. (Fewer Kansas Citians tend to get drunk than those in other cities.) The database covers the largest cities in the country defined by the population within their city limits. That leaves out some large metro areas, such as St. Louis. And not all cities reported data in every category.

Largely drawn from city health departments, the numbers showed deaths from opiates in Kansas City at 15.7 for every 100,000 people — or more than three times the national average.

Clinicians say they see a growing trend of opiate addiction, here and across the country, with numbers climbing the fastest among young adults. The addictions come in two ways, said Marsha Page-White, the clinical director overseeing substance abuse disorders at ReDiscover in Kansas City.

First, adults typically begin taking prescribed painkillers after an injury or illness, become addicted and begin to abuse the drugs. Missouri is the only state that doesn’t monitor prescriptions through an electronic database, systems that can serve as early warnings to alert physicians about what medications have already been issued to a patient. That, Page-White said, makes it easier for people to go “doctor-shopping” to feed their addictions.

So someone recovering from a car accident, for instance, moves from pain treatment to addiction and goes to multiple physicians to get Oxycontin or other opioids.

Next, that person’s children, looking for recreational drugs, gain access to prescription opioids and develop their own addictions.

“Because of the cost of the pills, the use escalates to heroin,” she said. “Heroin’s really cheap.”

Especially troubling is the growing practice of mixing opiates with other drugs, particularly benzodiazepine in the form of Valium or Xanax. When combined, they pose a risk to breathing.

“They’re ground up together and the user might not know what’s in the mix or how strong it is,” Page-White said. “They shoot it, snort it, smoke it.”

Kansas City also appears to be a trigger-happy place. Only people in Detroit were more likely to die from gunshots.

The national firearm death rate is 10.4 people per 100,000, including both rural and large metropolitan areas. In Kansas City, the rate is 21.4 people per 100,000. Kansas Citians also show up at hospital emergency rooms with bullet wounds at nearly twice the national rate. Only Detroit, with almost twice our gun death rate, and Cleveland had more than Kansas City.

Officials in Kansas City have typically complained that Missouri laws have made guns too easily available, with the General Assembly catering to rural appreciation of firearms in a way that doesn’t recognize a gun violence problem in urban areas.

Mayor Sly James’ office said in an email Tuesday that “the data in the report illustrates … a challenge we cannot ignore or hope someone else will solve.” The statement said the city’s power to “limit access to guns is limited,” but that education and jobs can offer a start.

“We have worked consistently to try to reduce the rate at which people view guns as a solution to their problems,” James said in the email.

In September, James was publicly critical of legislation that lifted the need for training or background checks to carry a concealed weapon.

“Rather than looking for solutions to our gun violence problem,” the mayor said on Twitter, “our legislature is poised to double down on stupid.”

Kansas City Police Chief Darryl Forté has said in the past that better schools and the targeting of career criminals can help to reduce deadly shootings, but that “we can’t alleviate the issue of gun violence until we address the issue of people who have guns that shouldn’t, and that is something that must be done in the Missouri legislature.”

So far in 2016, the city has seen 112 homicides, compared with 94 this time last year. Of those this year, 100 involved firearms.

Cancer was the biggest killer of dozens of factors the Big Cities database compared. Measuring all types of cancer deaths, Kansas City ranked about 10 percent above the national average.

The most profound difference came from lung cancer, where Kansas City showed a death rate of 55.5 per 100,000 people in 2013, the most recent year for which local numbers were available. The national rate that year listed at 43.4 for every 100,000 Americans.

Roughly nine in 10 lung cancer deaths are directly attributable to smoking. The adult smoking rate in Missouri is 24 percent, compared with less than 18 percent nationally. Missouri is home to the lowest tobacco taxes in the country. Voters rejected efforts to increase those taxes in 2002, 2006, 2012 and 2016.

Adjusted for age, the Big Cities survey showed Kansas City second only to Detroit in the lung cancer death rate.

“That’s ascribable to one simple fact: the adult smoking rate,” said Roy Jensen, the director of the University of Kansas Cancer Center. “In large part, that’s due to a low tobacco tax.”

If the death rate reflected a problem in available health care, he said, Kansas City would see elevated mortality rates tied to other forms of cancer. But the city’s death rate among women with breast cancer, for instance, stands roughly in line with national averages.

HIV and AIDS also pose above-normal risks in Kansas City. And the way cases pile up poses a particular problem — Kansas City acts as a regional draw for people diagnosed with the virus elsewhere, meaning federal funding for their care stays in their hometowns even as they congregate here.

Diagnoses of HIV measure at close to the national average. But as the disease progresses to AIDS, Kansas City’s cases accumulate at almost twice the rate of the country as a whole. And HIV-related deaths, at 4.8 per 100,000 people, are more than twice the national rate.

More than four out of five cases in Kansas City appear in men who have sex with men. Frank Thompson, the manager of HIV services for the Kansas City Health Department, said the city acts as a magnet for gay men in the region because it’s more welcoming to them and offers health services they can’t get in more rural areas across Missouri, Kansas, Iowa and Nebraska.

Often, he said, they’ve been diagnosed with the disease before coming here. Consider a man who’s identified as HIV-positive while living in, say, Warrensburg, Mo. He might move to Kansas City to be part of the LGBT community or to tap into the metropolitan area’s health system. But the federal funding generated by his case would still go to his hometown.

“This becomes kind an epicenter where people gravitate,” Thompson said.

While Kansas City’s HIV death rate is above the national average, he noted that it was comparable to Denver — the city included in the coalition that both most resembles Kansas City and reported numbers on such cases.

Among other things, the Big Cities data showed that compared with national averages, Kansas City has a lower rate of traffic deaths; a slightly higher suicide rate; a life expectancy 2.2 years below average; and fewer salmonella infections than the norm.

Scott Canon: 816-234-4754, @ScottCanon