Health officials in Wichita are looking to Tulsa, another conservative community, as a blueprint for Sedgwick County’s Health Department.
A group of Wichita officials, including County Commission Chairman Jim Howell and City Council member Janet Miller, made a trip to Tulsa on Monday that was paid for by the Kansas Health Foundation.
Last year, the Sedgwick County Health Department incurred $514,069 in cuts to programs that provided health education, community health assessments, immunizations, cancer screenings, and services meant to combat infant mortality.
$514,069 funding cuts to the Sedgwick County Health Department last year
Sedgwick County’s recommended budget comes out on July 13, and the final budget will be approved on Aug. 10.
Commissioner Richard Ranzau, who was the commission chairman last year, said at the time that he believes health is more of an individual responsibility than a governmental responsibility.
At the Tulsa visit, Howell said: “I’ll disagree with Commissioner Ranzau on this. I do think there’s a moral right of government for people who are desperately needy. The question is, to what level?”
I’ll disagree with Commissioner Ranzau on this. I do think there’s a moral right of government for people who are desperately needy. The question is, to what level?
Jim Howell, Sedgwick County commissioner
Problems facing Tulsa
Sixty-six percent of Tulsa County residents are overweight or obese, and the state of Oklahoma ranks second-to-worst in the nation for overall health performance, according to a 2015 Commonwealth Fund health scorecard report. Only Mississippi ranked worse. Kansas ranked 28 in the country.
And Oklahoma, much like Kansas, faces a budget hole at the state level. Like Kansas, it has incurred hits to its oil and gas industry.
Although county health funding is structured differently in the two states, both face budget constraints. For fiscal year 2017, the Tulsa Health Department will spend $44.14 per person on public health.
With Sedgwick County’s budget cuts last year, the health department now spends $22.45 per resident.
The Tulsa Health Department, which covers all of Tulsa County, has a six-person marketing team to educate the public about health, improve public health perception and connect residents with resources and information through media campaigns, advertisements, grant writing and community outreach.
Sedgwick County doesn’t have any marketing employees designated for the health department. The health department relies on the county’s five-person team that covers the entire county, except for elected officials.
The Tulsa Health Department director, Bruce Dart, said the health marketing team has been “crucial.”
Kaitlin Snider, marketing director for the Tulsa Health Department, said the overall goal is to “maintain a constant public image, so the public knows what we do and what we stand for.”
But for specific problems, she said, she and her team target their campaigns at populations in need of the information. For example, she said, they placed safe-sleep TV ads aimed at new parents in at-risk areas of town.
David Kendrick, chair of the Department of Community Medical Informatics at the University of Oklahoma, led a technology-sharing effort statewide in Oklahoma.
The future of data, he said, is predictive analytics to predict not just heart attack rates but who will have them.
Without the data, he said, “you’re just throwing darts.”
You’re just throwing darts.
David Kendrick, chair of the Department of Community Medical Informatics
But it can be difficult to get politicians on board.
“Health care isn’t a billion-dollar transaction,” Kendrick said. “… It’s millions of transactions, and you have to build the infrastructure to track those millions of transactions.”
Chronic disease researcher
For the past couple of years, the Sedgwick County Health Department hoped to create a position for someone to study patterns and causes of chronic diseases in the community, such as diabetes.
The job is called a chronic disease epidemiologist. The Tulsa Health Department has that position.
But even if Sedgwick County had someone in that role, that person wouldn’t have the resources to act on the patterns identified.
“There’s no reason to collect data if you can’t do anything with it,” said Adrienne Byrne-Lutz, director of the Sedgwick County Health Department.
A chronic disease epidemiologist was the number one recommendation for Sedgwick County in a 2013 evaluation by the National Association of Chronic Disease Directors. Byrne-Lutz and the rest of the Health Department knew the importance of the position, but knew funding cuts for health promotion programs were on the way in mid-2015.
“If you’re going to collect data, you have to create interventions,” she said.
The Sedgwick County Health Department has epidemiologists for communicable diseases, but not chronic diseases.
Board of Public Health
Tulsa and many other cities have a board of public health that acts as an advisory and policy board.
Nancy Keithline, now an emeritus member, said it takes a long time for people to become acquainted with all the health department’s programs and historical knowledge about public health in Tulsa.
Sedgwick County commissioners serve as the board of health in the absence of a separate board of public health.
Housing developers and city planners don’t always have public health in mind when choosing and approving neighborhood designs.
Because of that, developers have designed neighborhoods next to walking trails, schools and playgrounds without public entrances for the neighborhood. That forces neighbors to take circuitous routes to get to an area that could be a short walk away.
Housing developers often design neighborhoods next to schools, walking trails or playgrounds without public access.
Now, a Tulsa Health Department employee sits in on planning review committee meetings to recommend design changes that could improve physical activity and wellness.
The urban atmosphere of walkable cities is a concept that both Wichita and Tulsa have tried to foster.
But Jason Wagner, transportation planner for a metropolitan planning organization for Tulsa, says it’s not always straightforward.
“It’s not just the infrastructure,” he said. “I think it’s tempting to just say, ‘Well, we’ll put bike lanes everywhere and make sidewalks wide enough.’ ”
But, he said, the areas need to have destinations and interesting things to walk by.
“It’s easy to build a sidewalk and not easy to build a walkable area,” he said.
▪ Last summer, the Sedgwick County Commission eliminated funding for a report that assesses the county’s public health and identifies priorities, such as reducing obesity and diabetes.
It’s called the Community Health Assessment and a Community Health Improvement Plan. It’s required in order for health department accreditation and is used by nonprofits and other entities to apply for grants.
In Tulsa, the health department leads the effort for the assessment and plan but partners with local companies and organizations in the process.
Tulsa’s Dart said that evaluation is a key part of what his health department does.
“I think it’s irresponsible to lay out these programs without knowing how we’re doing,” he said.
Right now, an initiative from the Wichita Metro Chamber of Commerce called the Health Alliance is working to put together the health improvement plan.
“We’re trying to do it as a collaborative initiative, and it’s difficult,” said Becky Tuttle, project manager of HealthICT, which organized the Tulsa visit.
▪ The Sedgwick County Commissioners will set a budget this summer.
▪ Late this summer, Wichita will host a reciprocal visit for Tulsa Health Department representatives to learn about health programs in Wichita.