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How can the government create an equal quality of healthcare for socioeconomic and racial groups?

What is Johnson and Jackson County?

Johnson County is the largest county of Kansas City, KS.

Jackson County is the largest county of Kansas City, MO. 

Take a moment to compare the demographics of the two counties, and consider the differing economic status of the two. 

 

  Johnson County Jackson County
People in poverty (%) 5.5 13.0
Bachelors Degree or higher (%) 55.3 30.9
Without health insurance (%) 7.2 12.5
Median household income in 2018 ($) 84,915 52,805
Population 602,401 703,011

We know that throughout the US, race and socioeconomic status are unfortunately linked. And while socioeconomic status informs the money and education put towards the quality of health care, health systems are also affected by these standards. 

Thus at the root of the issue of race and health care inequalities is a systemic inability to provide equal health care to those of differing socioeconomic groups. 

Source: US Census

How does quality of healthcare differ between Johnson and Jackson County?

What is the highest quality of hospital in either county? 

*Saint Luke’s was ranked highest in MO, but I chose to omit them from this consideration as they have locations in both KS and MO, and the statistics used for their ranking included the KS locations. 

University of Kansas Hospital 

A general medical and surgical facility and teaching hospital nationally ranked in eight different adult specialties, high performing in three adult specialties, and six procedures and conditions by the US World Report

Research Medical Center

Also a general medical and surgical facility and teaching hospital, Research Medical Center is high performing in two adult procedures and conditions, according to the US World Report

 

While the difference in quality between the two most prominent hospitals in either county is already evident, when looking at the quality of hospitals throughout the county, the shortcomings of Jackson County’s healthcare system is even more obvious. 

Jackson County does provide marginally more medical centers for their proportionately larger and more spread out population; however, as I interviewed a doctor who had completed his residency and fellowship at KU Medical Center (KS), before beginning to work at Research Medical Center (MO), he candidly stated: “While Research Medical Center certainly does provide healthcare, it simply does not have the funding to match the same level of growth and improvement as KU.” 

How does the funding for hospitals and medical workers wages differ between the two counties?

KU Medical Center receives funding from both the Ewing Marion Kauffman Foundation, a Kansas City nonprofit with an endowment of over $2 billion, and from the KU Endowment, which has $1.82 billion.

Research Medical Center, on the other hand, receives funding in a vastly different manner. In 2003 the hospital was bought by HCA Healthcare, which manages 185 hospitals and 119 surgery centers, with a revenue of $46.7 billion. When Research Medical Center was purchased, the hospital was only given $100 million. 

As far as wages go, Research Medical Center was in the news in June 2018, as nurses went on strike to protest the nurse retention rates of the hospital, as well as under-staffing. They cited non-competitive wages for the 169 nurses that quit in 2017.

More recently, nurses at Research Medical Center, as well as the other HCA hospitals in the region said that the hospital had not provided adequate protection during this COVID-19 pandemic.

As a survey completed by National Nurses United reports:

  • 35% of HCA nurses reported having access to N95 respirators, compared to 52% at other hospitals.
  • 16% reported having access to PAPRs, or powered air purifying respirators, compared to 23% at other facilities.
  • 7% reported having enough personal protective equipment to protect staff and patients in the event of a surge in patients, versus 19% at other hospitals.

Learn about the quality of healthcare in your state!

International? Look at the report and ranking of your country!


enjoy a beautiful picture of Kansas City before considering the difficult problem

Now the big question… How can we, as a society, fix these disparities?

Take steps to improve your community and learn about stories of social justice in the medical field.


Step 1: DO NOT Ignore the Problems

In Zimbabwe in the 1980s, Mary Bassett witnessed the AIDS epidemic firsthand, and she helped set up a clinic to treat and educate local people about the deadly virus. But looking back, she regrets not sounding the alarm for the real problem: the structural inequities embedded in the world’s political and economic organizations, inequities that make marginalized people more vulnerable. These same structural problems exist in the United States today, and as New York City’s Health Commissioner, Bassett is using every chance she has to rally support for health equity and speak out against racism. “We don’t have to have all the answers to call for change,” she says. “We just need courage.”

If the video is not working, you can use the link here.

It’s easy to see commonalities between Bassett’s description of the AID’s inequalities in Zimbabwe, and the similar disparity in medical research funding and COVID-19 protection between the hospitals in Johnson County and Jackson County. And instead of standing aside to accept the systemic inequalities that Bassett has seen throughout her career we can pursue the first step towards achieving health care equality. 

TED has an entire playlist on health care and racism! If you found this video interesting, you can find more like it here. 


Step 2: Speak Out!

In 1990s China, millions of destitute farmers had sought to make money by selling their blood plasma to government collection agencies located throughout China’s most impoverished regions. 

Shuping Wang, Who Helped Expose China's Rural AIDS Crisis, Dies at ...

Dr. Shuping Wang, a Hepatitis specialist (pictured to the left) suspected that improper sanitation measures had led to the rampant, secretive spread of HIV throughout the regions. She discovered that collection stations had been mixing donor blood and then re-injecting donors with the contaminated blood.

Almost all of the donors had become infected, and their blood was to be used throughout the country. After confirming her suspicions using her own equipment, Dr. Wang bypassed the Chinese government to warn foreign governments of the ongoing scandal, allowing the international community to implement proper procedures to protect both their own and the Chinese citizens. Learn more about her story from The Washington Post

Inform others around you, from your coworkers and family members, to those in your neighborhood or school community, about inequalities in the health care system so that these issues are acknowledged!


Step 3: Invest Your Efforts in the Proper Organizations

It’s true that as individuals, it’s really difficult to enact actual change on a larger scale; however, by contacting your local government or non-governmental organizations working in your city, you can focus your efforts on groups that already have the funding and resources to really lessen these inequalities. 

Are you located in the US or one of its territories? 

Contact the Director of your Department of Health here

Find an NGO that pursues the implementation of healthcare policies… Here are a couple operating in the US.

The American Heart Association  is currently pushing for several pieces of legislation that advocate for health care equity. You can contact your congressman or congresswoman about these issues and align yourself with their nationwide cause!

United Way has mobilized its members to advocate for increased affordability for healthcare. Check out their website to see their success stories, donate to their cause, or have your own advocacy letter sent in with their official plea!

And, if you are located abroad, here are a few US NGOs that operate internationally to improve global health.

MAP International  provides health care resources to those in marginalized communities, and disaster-relief to those facing extreme situations. 

Doctors Without Borders responds to international emergencies to provide a high standard of health care to those in countries that do not have adequate access. 


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