Priority County: Clay County, Missouri
The purpose of the 2015 Susan G. Komen Community Profile Report (CP) is to conduct an updated needs assessment of Komen Kansas City’s 17-county, bi-state service area. This comprehensive study utilizes quantitative (statistical) and qualitative (focus group and provider interview) data collection and analysis. The assessment is used to establish priorities for the Affiliate’s decisions regarding grant funding, education, marketing and outreach and public policy activities. It is our road map for future funding and will guide the Affiliate’s Strategic Plan for the next several years.
CLAY COUNTY, MISSOURI
Clay County has been chosen as a target community due to breast cancer death rates and trends, as well as the breast cancer incidence and late-stage diagnosis of breast cancer rates. It is also a high priority county based on the intervention times needed to meet Healthy People 2020 goals.
The county’s breast cancer incidence, death, and late stage diagnosis rates are all higher than the United States, as well as the service area’s averages. Additionally, trends in data show these incidence rates and late-stage diagnosis rates are getting higher. Simultaneously, the breast cancer death rates are lowering.
On the plus side, Clay County women (ages 50-74) self-reported obtaining a screening mammogram within the last two years at a rate higher than the service area and the United States averages. The increase in incident rates may be correlated to the above average mammography screening rates in Clay County.
Analysis by Target Community
Clay County has a substantial amount of breast health services available to residents. Multiple hospitals provide a full “continuum of care” for breast cancer. However, Clay County also has a relatively high number of breast cancer deaths and late stage diagnosis rate. Considering that screening rates in this county are not significantly different from the service area’s average, a strong emphasis must be placed on navigation, diagnosis, and treatment of breast cancer. In addition, the analysis reveals that the majority of breast health services, particularly treatment, are in the Southwest region of the county, centered in North Kansas City and Liberty. Those in other regions of the county have very few readily accessible breast health services.
Public Policy Implications
Because Missouri and Kansas chose not to expand Medicaid, a coverage gap is left of people making too little to qualify for federal help. The authors of ACA intended these individuals to be covered by Medicaid expansion, but both states in our service area opted to not expand. Therefore, most of Kansas and Missouri’s poorest, working-age residents — those under age 65 and below the poverty line of $11,490 for an individual and $15,510 for a couple — aren’t eligible for government help. In Kansas there are currently 369,000 uninsured individuals – 78,000 in Kansas (21% of uninsured) who would have been eligible for Medicaid if the state expanded will fall into the coverage gap. In Missouri, 93,000 of the 834,000 uninsured adults (23% of the uninsured) will fall into this gap.
Through advocacy efforts and partnerships, Komen Kansas City continues to be a voice for breast health in both Missouri and Kansas. Komen Kansas City advocates for funding of breast health screening, research, and treatment programs.
Our Mission Action Plan
Women in Clay County have incidence rates, death rates and late-stage diagnosis rates that are higher than the US and service area averages. Incidence and late-stage diagnosis rates are expected to increase. The health system analysis found that there are multiple hospitals providing the full breast cancer continuum of care but the majority of those services are available in the Southwest region of the county (North Kansas City and Liberty).
In order to address the issues identified in Clay County, the affiliate plans to focus efforts around patient navigation support, provision of affiliate-based education to individuals, and raising awareness amongst the health system of the needs in the county. Komen Kansas city has set the following objectives for our work in the community:
- In FY16, hold at least two collaborative meetings with healthcare providers in Clay County to develop a plan on how to improve breast health needs
- Beginning with FY17, a key funding priority will be developing or improving patient navigation programs targeting Clay County women
- By the end of FY19, a minimum of 15 outings will be conducted in Clay County using the affiliates Connecting for a Cure curriculum
We look forward to providing you reports on our efforts over the next few years.