County Health Rankings and Roadmaps report considers social rules, power
Johnathan Sublet, who spoke recently at a Topeka Work event, uses the annual County Health Rankings and Roadmap to help the organization he heads, SENT Topeka, be aware of community health needs. (Jill Rice)
TOPEKA — Societal rules — written and unwritten — and how power is distributed and wielded within communities are new measures tracked by an annual report that offers insights into health at a county level.
The 2025 County Health Rankings and Roadmap report, put out by the University of Wisconsin Public Health Institute and the Robert Wood Johnson Foundation, is used by local, regional and state leaders to determine how to understand and impact the health of residents within their communities. Factors that impact health were updated this year for the first time since 2014, said Bethany Rogerson, UWPHI co-director.
'We are focused on lifting up policies and practices that can create the conditions so that everyone has the ability to thrive,' she said. 'Where you live, where you work all play a really important role in shaping health, and that health is more than health care.'
The addition of societal rules and power categories encourages communities to assess those concepts and determine how to make policy and practical changes to improve the health of citizens, Rogerson said.
'We know that community conditions don't just happen by chance,' she said. 'So we realized an opportunity to invite people to explore how community conditions come to be. How did our housing, how did our jobs, our schools, all the aspects that we know shape health, how did they come to be and who shaped them and how?'
SENT Topeka, an organization that works to support Topeka residents through building resilience and relationships, uses the County Health Rankings for data and health insights. Founder and executive director Johnathan Sublet said the new measures fit into the work the organization is doing. He pointed to the food pantry at SENT, which is structured to work like a grocery store where people have choice.
'The first thing a person often loses when they become under-resourced is choice,' Sublet said. 'When we define poverty, it is not just the access to money. We define it as lack of choice in a person's life. Every single person has infinite dignity, value and worth. We want to do everything we can to affirm that dignity, value and worth they have.'
'Part of that means giving them choice back, and it also means giving them power in decisions that are being made within their sphere of influence,' he added.
Wyatt Beckman, senior analyst with Kansas Health Institute, said the broad categories of societal rules and power added this year support discussion at the county level that can be impactful in looking at how the factors influence community conditions.
Expanding the conversation can elicit change, he said.
'You can build community power when you organize and act together, and do things like set agendas, shape who's involved in discussion and decision-making, cultivate relationships, and that power can shape societal rules,' Beckman said. 'Power is not meant to be listed as an inherently good or bad thing, but it's an acknowledgement and does help us have conversations about not only the factors that are shaping health, but how those factors are being influenced and maybe can be adjusted.'
An example Beckman offered is the education people receive, which he said is important to quality of life and shaping experiences.
'Some of the big decisions around that education can be shaped by people who sit on boards of education. Those boards of education have a role in shaping the budgets and policies and regulations that inform and guide that education,' he said.
Communities can ask questions about who is invited into policy-making discussions, including whether they're encouraging and receiving diverse opinions. Partnership and building trust are key elements in working together as a community, Sublet said. At SENT Topeka, focusing on dignity and support are key to building that trust.
'Dignity for us means not doing for someone what they can and should do for themselves. We don't give away everything for free that we do,' he said. 'It means that we don't feel like we transform people's lives or change people's lives, but we journey with them in their lives as much as they allow us to.'
Important in their interactions is not feeling as if SENT Topeka is 'the voice for the people,' Sublet said.
'We want to help them understand the voice they already have and affirm that,' he said. 'While we'll help prepare them for conversations, we don't feel it's our job to go in and speak for them in situations.'
Additional new measures included in the County Health Rankings and Roadmap report this year are:
Access to libraries
Disability: Functional limitations
Feelings of loneliness
Lack of social and emotional support
Access to parks
Adverse climate events
Beckman said the County Health Rankings report is especially helpful at a community level because even when the state may seem to overall be doing well with specific measures, individual counties may be having a different experience.
He noted that most Kansas counties are doing better than the average county in the United States, but that doesn't mean there aren't individual counties showing challenges.
As an example, he pointed to Russell, Edwards and Kingman counties, which have seen 'years for potential life lost' increasing at a level higher than what is seen in the state and U.S. overall.
That factor is a unique angle on what most of us think as life expectancy, Beckman said.
'What years of potential life lost does is it adds up and turns into a rate all of the years between a person dies and the age 75,' he said. 'So it sets age 75 as that average life expectancy, and any deaths before that are added up. What that means in practice is if there are, for whatever reason, things that are causing earlier deaths in a community, that's really going to increase years of potential life lost.'
Beckman called the increase in years of potential life lost 'pretty stark,' and said the increase can't be explained by the COVID-19 pandemic. While the County Health Rankings report doesn't answer why that's happening, it provides the information so that county and state officials can dig deeper.
Broadening of data collected in the County Health Rankings and Roadmap report comes even as its publisher, the University of Wisconsin Public Health Institute, expects to lose funding in 2026. The Robert Wood Johnson Foundation is pulling funding it has supplied for the past 15 years.
'RWJF remains committed to public health data and to meeting the needs of the communities we strive to serve,' a foundation spokesperson said. 'We remain steadfast in our support of the UWPHI team in this final chapter to ensure a thoughtful and collaborative wind-down of the program through the end of 2026.'
Rogerson at UWPHI said the organization's work is rooted in their long-term tracking of health data and information.
'We know that that work to realize that vision is not done,' she said. 'We are still navigating and determining our next steps, but we hope to continue the work as much as possible for as long as possible. We know that communities, policy makers, students, lawmakers, rely on data- informed strategies and narrative change strategies, to advance work related to health and equity.'
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
25-05-2025
- Yahoo
Molokai wins Culture of Health Prize
The island of Molokai is perhaps the most rural of all of the main Hawaiian isles, with a population of just about 7, 400 on about 260 square miles of land. With its rugged landscape and steep sea cliffs, Molokai stands apart from other isles shaped by tourism and outside interests, according to the Robert Wood Johnson Foundation. Its close-knit community, meanwhile, has long prioritized the aina (land ) and residents' health and self-sufficiency. These are the very reasons the foundation chose Molokai for its 2024, which comes with $250, 000. Out of hundreds of applicants from across the U.S. last summer, the foundation chose nine. It's a first for Molokai—and a first for Hawaii. 'Honestly, this is really the first time our community has been recognized for our years and years of innovative efforts to try and solve our crises, ' said Kawaipuna Kalipi, a Ph.D. student in political sciences at the University of Hawaii at Manoa. 'Because on Molokai, especially, we know people won't come to save us.' Kalipi, also general manager of the Molokai Heritage Trust, co-wrote the prize application with Momi Afelin, a Molokai native and Ph.D. student at the Harvard T.H. Chan School of Public Health, highlighting the community's efforts to be resilient. Applying for the award also was intended to honor Molokai's beloved physician Dr. Noa Emmett Aluli, who at the age of 78. Aluli was a family practice doctor at the Molokai Family Health Center for decades, as well as a Native Hawaiian health advocate and activist renowned for protesting U.S. military bombing on Kahoolawe. 'We co-wrote the application in honor of Uncle Emmett and his dedication to Molokai—but really, his dedication to aina, to all of Hawaii, ' Kalipi said, 'and his reminder to us that the health of the land is the health of the people, and the health of the people is the health of the land.' The Robert Wood Johnson Foundation, a national philanthropy dedicated to health equity that is based in Princeton, N.J., has been awarding the Culture of Health Prize since 2013. The prize honors the work of communities 'at the forefront of addressing structural racism and other structural injustices to advance health, opportunity, and equity for all, ' according to the foundation website. Awardees are honored for taking unique approaches to health by reshaping food systems, emboldening youth leaders while honoring elders and changing the narrative about their communities. The foundation recognized Molokai as a place 'where land and people have existed in a regenerative and symbiotic relationship.' The community of Molokai has had to be resilient and resourceful while facing issues of access to health care, high poverty rates, ongoing threats to its land and resources, and other challenges. 'We have to be very creative in the ways we build out our health equity because it's challenging for doctors to come to Molokai, ' Kalipi said. 'It's challenging to get specialists, and on Molokai, by specialists I mean an eye doctor and dentist.' The island has long faced a shortage of doctors, forcing residents to travel off island to seek routine and specialized health care, oftentimes without reliable transportation. Among some of Molokai's accomplishments highlighted by the foundation are community efforts to buy back nearly a third of land from a developer to protect it for the benefit of the community. That is the mission of the Molokai Heritage Trust, a member-managed nonprofit. 'I think Molokai has also understood itself to be aina momona, land of abundance, ' Kalipi said, 'so the planning that we do and the approach that we're trying to take is a holistic one—a planetary health approach.' Without land, there is no sustenance, according to Kalipi, and Indigenous ownership and stewardship of land is necessary in order for people to cultivate their own food. 'Our communities rely heavily on our land for food, ' she said, 'and if we lose that land, imagine how many more people would have to rely on the food bank.' According to the Molokai Community Health Center, about 45 % of the island's residents have incomes below 200 % of the federal poverty line. Programs like the Mobile Market, which provides an outlet for some 65 local farmers and food producers to sell their locally grown produce to Molokai families, are a step toward self-sufficiency. The foundation also noted other accomplishments, including the creation of a 'clean energy hui ' to plan and develop a portfolio of clean-energy projects islandwide supported by the community, along with efforts to prepare for climate change. In the face of climate change, Molokai has already started planning how to adapt to erosion, flooding and sea-level rise. Climate change is one of the big issues Molokai is facing, according to Kalipi, with questions of how to prepare for it discussed at community meetings. The majority of families on Molokai live at sea level on the east side of the island, and there are two homestead subdivisions on the coast. Invasive species, including axis deer and macro algae, also pose threats to Molokai's ecosystem. The overpopulation of deer has dried out mountaintops, according to Kalipi, bringing topsoil down into the ocean and onto coral reefs. Molokai's south shore is home to one of the longest, continuous coral reefs in the islands. The foundation lauded community partnerships to reclaim the shoreline by removing invasive macro algae that threaten nearshore fisheries. To date, more than 35, 000 pounds of algae have been removed and repurposed to enrich the soil. All of it, Kalipi said, is a reflection of the community's efforts. The prize money, she said, will go back to the community and be shared among 10 or so nonprofits. Other communities that were awarded the prize include Trenton, N.J.; Jurupa Valley and Sacramento, Calif.; Green Bay and Milwaukee, Wis.; Juneau, Alaska ; Lower Eastern Shore, Md.; Sussex County, Del.; and tribes in the Great Lakes region. Juneau, Alaska's capital city, was recognized for addressing structural racism and unraveling generational trauma in order to heal, along with its leadership in reviving Indigenous culture. Sacramento, California's capital, was selected for establishing an innovative youth program called the Children's Fund using local cannabis tax revenue to help finance programs addressing mental health, substance abuse, violence and homelessness.
Yahoo
19-05-2025
- Yahoo
GCHD calls on federal officials to protect Medicaid
May 19—MOSES LAKE — Earlier this month, the Grant County Health District announced the passing of a resolution to call on federal leaders to protect and maintain funding for Medicaid. The proposed federal budget calls for possible extensive cuts to the program, which provides health care coverage for millions nationwide and thousands within Grant County. "It came about from our health officer (Alexander Brzezny) who has been monitoring some of the conversations at the federal level and what he was hearing from some of the medical associations of some concerns that Medicaid funding could be reduced substantially," said GCHD Administrator Theresa Adkinson. "Looking at our data, we know this would have a huge impact on our health care system and our residents in Grant County," Adkinson said these concerns inspired her to meet with the GCHD Board of Health to explain why this would be important to Grant County. The resolution was adopted by the board April 9. "Once we get the resolution passed, then that authorizes the staff and I to be able to talk with elected officials about the subject and talk about those impacts," she said. After passing the resolution, the GCHD shared it with all their supporting associations as well as the federal and state elected officials with positive feedback. "It opens that door for a conversation so that while it's not on the docket right now, you know that these conversations are happening now," said Adkinson. "They have those talking points from back home on what the impacts would be, not in DC, but here in Grant County." Medicaid is a public health insurance program that provides free or low-cost health coverage to people with low income, disabilities, pregnancies and those living in long-term care facilities. In an article from KFF, formerly Kaiser Health News, on May 14 the House Energy and Commerce Committee plans to use the changes to the Medicaid program to help meet spending targets aimed at funding President Donald Trump's domestic priorities. The Congressional Budget Office estimates that the bill would decrease the federal deficit by more than $880 billion over 10 years. According to a press release by GCHD, cuts to Medicaid could severely impact access to care for 40% of Grant County residents and more than 1.8 million people across the state. This loss of coverage would threaten health coverage, especially in rural areas where resources are limited. The resolution states that, according to national County Health Rankings and Roadmaps, Grant County is faring worse than the average county in Washington for community conditions which determine health and worse for health outcomes which measure the health of local communities. Congressional Districts 4 and 5 have the highest proportions of adults and total population on Medicaid among Washington regions. "People will stop seeking care because they're concerned about out-of-pocket costs, so in a rural community such as ours, access to health care is critical," said Adkinson. "You don't want folks to have to drive far to seek healthcare and then we already have some healthcare deserts where our community health centers have opened their doors, like down in Mattawa." The resolution further says Medicaid is critical to the survival of rural Washington hospitals by being responsible for more than 25 percent of most Grant County hospitals' revenue. According to data provided by area legislators and hospitals, 30% of Samaritan Healthcare's revenue comes from Medicaid, and 27% of that for Columbia Basin Hospital. Nearby, Othello Community Hospital gets 58% of its revenue from Medicaid. Congressman Dan Newhouse, R-Wash., has said that the country needs to curb spending due to being more than $37 trillion in debt. Legislators from both sides of the aisle have said that spending needs to be cut, but that cuts to Medicaid should be minimal to ensure people have access to care. There is also concern that cuts to Medicaid could have impacts outside of negative impacts to access to medicine, including economic issues. An article from George Washington University said cuts to Medicaid and the Supplemental Nutrition Assistance Program could also trigger severe economic consequences. The combined cuts could result in the loss of around one million jobs, $113 billion decline in states' gross domestic products and $8.8 billion in lost state and local tax revenue in 2026 alone. "Medicaid and SNAP programs are not just designed to strengthen individual health and nutrition — they support the economic well-being of communities and businesses nationwide," said Leighton Ku, lead author and director of the Center for Health Policy Research and professor of health policy and management at GW's Milken Institute School of Public Health. Adkinson said any citizens within the community who have concerns about the issue can help by talking with federal officials through hotlines, emails or drop-down boxes and leave messages about how this would impact the community. "Personal stories always have an impact, it's one thing to look at a budget, it's another thing to start looking at the lives that are covered by this funding source and the jobs that could potentially be lost in our community as well," she said.
Los Angeles Times
14-05-2025
- Los Angeles Times
California isn't backing down on healthcare for immigrants, despite Trump threats
SACRAMENTO — One of the many traits that set California apart from other states is the way undocumented immigrants are woven into our communities. Their economic impact is obvious, and the Golden State would be hard-pressed to keep our status as a world-competing financial power without their labor. But most Californians know, and are OK with the reality, that at least some of our neighbors, our kids' classmates, our co-workers, are without legal documents, or in blended-status families. Gov. Gavin Newsom took a stand Wednesday for those undocumented Californians that seems to have gone largely unnoticed, but which probably will be a big fight in Congress and courts. In his bad news-filled budget presentation, Newsom committed to keeping state-funded health insurance for undocumented residents (with cuts, deep ones, which I'll get to). Although some are disappointed by his rollbacks, many of which will hit citizens and noncitizens alike, standing by California's expansion to cover all low income people is a statement of values. 'We've provided more support than any state in American history, and we'll continue to provide more support than any state in American history,' he said. Sticking with that promise is going to be tough, and likely costly. This decision comes as Congress considers a Trump-led budget bill that would severely penalize states (there are 14 of them) that continue to provide health insurance to undocumented immigrants. California, of course, has the largest number of such folks on its Medi-Cal plan and would be the hardest hit if that penalty does indeed become the new law — to the tune of $27 billion over six years, according to the Center on Budget and Policy Priorities. To put that in perspective, the governor is now estimating a nearly $12-billion budget shortfall this year. That federal cut would add at least $3 billion a year to our costs once it hits. That federal cut, Newsom said, was 'not anticipated in this budget,' which means we are ignoring it for the time being. Federal programs aren't open to noncitizens, and no federal dollars are used to support California's expansion of healthcare to undocumented people. But Congress is threatening an approximately 10% cut in reimbursements to states that insure undocumented people via the Medicaid expansion that was part of the Affordable Care Act. That expansion allows millions of Americans to have access to healthcare. Those expansion funds are working in ways that many don't know about. For example, as Newsom pointed out, behavioral health teams doing outreach to homeless people are funded by Medicaid dollars. In all, about one-third of Californians rely on Medi-Cal, including millions of children, so this threat to cut federal funds is not an empty one, especially in a lean year. Katherine Hempstead, a senior policy advisor for the Robert Wood Johnson Foundation, which advocates for universal healthcare, said that the bill being debated by Congress is so full of cuts to healthcare that arguing against the provision penalizing coverage for undocumented people may not be a priority for most Democrats — making it more likely that the cut will get through. 'I don't know if this is going to be a do-or-die issue,' she said. And indeed, the pressure by Republicans to kill off coverage entirely for undocumented folks was quick. 'Gov. Newsom has only partially repealed his disastrous policy,' Rep. Kevin Kiley (R-Rocklin) said in a statement. ' It needs to be reversed entirely, or Californians will continue to spend billions on coverage for illegal immigrants and our state will lose an even larger amount in federal Medicaid funding.' Newsom has given economic reasons for sticking with the state's coverage for all low-income residents, regardless of status. When people don't have access to routine care, they end up in emergency rooms and that is extremely expensive. And also, Medicaid has to cover that emergency care, so taxpayers often end up spending more in the long run by skimping on upfront care. 'It's definitely important to the people that get the coverage because they don't really have an alternative,' Hempstead said. But that care has been vastly more expensive than California expected, also to the tune of billions of dollars in unexpected costs, in part because so many people have signed up. To the dismay of many, Newsom's budget reflects both recent economic woes — a $16-billion revenue hit caused by what he's dubbing the 'Trump slump' — as well as the state vastly understimating the cost of covering those undocumented folks. That shortfall may force cuts in the coverage that undocumented people qualify for if the Legislature goes along with Newsom's plan, or even parts of it. Most notably, it would cap enrollment for undocumented adults age 19 and over in 2026, effectively closing the program to new participants. That's a huge hurt. His plan also calls for adding a $100 per month premium, and other cuts such as ending coverage for the extremely popular and expensive GLP-1 weight loss drugs for all participants. 'I don't want to be in this position, but we are in this position,' Newsom said. Amanda McAllister-Wallner, executive director of Health Access California, called those cuts 'reckless and unconscionable' in a statement. 'This is a betrayal of the governor's commitment to California immigrants, and an abandonment of his legacy, which brought California so close to universal healthcare,' she said. I strongly believe in universal single-payer healthcare (basically opening up Medicare to everyone), so I don't disagree with McAllister-Wallner's point. In better days, I would hope to see enrollment reopen and benefits restored. But also, we're broke. This is going to be a year of painful choices for all involved. Which makes Newsom's, and California's, commitment to keep insurance for undocumented people notable. The state could back down under this real federal pressure, could try to find a way to claw back the benefits we have already given. But there's a moral component to providing healthcare to our undocumented residents, who are such a valuable and vital part of our state. Although the fiscal realities are ugly, it's worth remembering that in providing the coverage, California is sticking with some of its most vulnerable residents, at a time when it would be easier to cut and run.
