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Transcript of JoCo on the Go podcast 2/10/20

Theresa Freed (00:00):

On this week's episode, Johnson County Department of Health and Environment experts will share details of the recently-released Community Health Assessment. They'll talk about life expectancy in our County and how that varies depending on where you live in the County and why that might be. They'll also talk about the cost of raising a family in Johnson County. Finally, they'll discuss why connectedness is key to surviving.

Announcer (00:22):

Whether you live in or just love Johnson County, Kansas, JoCo On the Go has everything Johnson County. Here's what's happening and what's coming up in the community you call home.

Theresa Freed (00:37):

Thanks for joining us for JoCo on the Go, I'm your host Theresa Freed, a Johnson County resident and employee of Johnson County government. According to the Robert Wood Johnson Foundation's county health rankings from 2019, Johnson County is Kansas' healthiest county and part of that is based on life expectancy. Here to talk about that and the most recent Community Health Assessment we have with us, Megan Foreman, a program manager with the Johnson County Department of Health and Environment and Elizabeth Holzschuh, an epidemiologist also with DHE. Thank you both for being here today. All right. First off, can you talk a little bit about what the Community Health Assessment is?

Megan Foreman (01:14):

Certainly, it's actually something that we conduct every three years at the Johnson County Department of Health and Environment. Really all governmental public health agencies do this as part of their foundational services that they provide to a community. So we've been doing ours really since, I think it's 1996, right?

Elizabeth Holzschuh (01:30):

So really we do the Community Health Assessment part of our accreditation process. Johnson County was the first County to be accredited in the state of Kansas. But really it's more than that. We want to figure out what is really going on in our community, what's making people healthy, what's making them unhealthy, what they're struggling with. Because we know that health has so many different pieces that go into it. From things like income and transportation and housing to whether or not you have access to a doctor. So we want to figure out what is going on in our community. So really we as the health department with our partners can identify strategies to help improve the lives of our community members.

Theresa Freed (02:05):

Okay. And so part of that is life expectancy. So how does that play a role?

Elizabeth Holzschuh (02:10):

Right so life expectancy is a measure that we use and really it says that if a baby was born in a specific neighborhood or in a specific county, how long would they be expected to live? When we see lower life expectancies, what that is pointing to are people dying earlier in life. So we've heard a lot in the news lately about the fact that the life expectancy in the U S has been declining over years. And really it's because people are dying earlier in their lifespan. So if things like suicide and drug overdose that are taking people prematurely, and so if you have a neighborhood where you're seeing people die earlier than you would really expect them to, you're going to see a lower life expectancy than some other neighborhood where people living into their eighties and nineties and you know, dying from things like cancer or just old age. So it's a really great indicator for us to figure out how healthy a community is.

Theresa Freed (02:57):

Okay. And so, you know, we already talked about fact that Johnson County is ranked as the healthiest in Kansas, so you would not necessarily anticipate there would be a gap in life expectancy across our County, but there is, can you tell us about that?

Elizabeth Holzschuh (03:09):

Yeah, so this was something that we have sort of been looking at for a lot of years. One of the federal agencies, CDC, had put out some estimates looking really looking at these really small neighborhoods about 1500 people who live in these neighborhoods. When we saw, when we started looking at it was there's actually a 12 year life expectancy difference. So if you are born at Shawnee Mission and Quivira, you're really only expected to live to 74 years, but if you are born five miles down the street at 75th and Nall actually expected to live till 86 years. So really vast disparity, only a short distance apart.

Theresa Freed (03:43):

And so what could be influencing that?

Elizabeth Holzschuh (03:44):

So when you actually look at who lives in these neighborhoods, it becomes really pretty clear. So poverty, which you know is based on how much you make and the size of your family. So if some family of three makes about $22,000 or less than they're considered in poverty. So we know in our shorter life expectancy neighborhood, the one at Shawnee mission and Quivira there is about one in five kids live in poverty in that neighborhood as opposed to basically zero kids living in poverty over at 75th and Nall. We also know that the median household income, so basically how much household is bringing in for their income annually is about half of that. And our lower life expectancy neighborhood compared to the higher life expectancy neighborhood.

Megan Foreman (04:24):

The way that we usually talk about the relationship between money and health money can't buy you health. That's true, but it can certainly get you access to all of the environments that would make you more healthy. So a neighborhood with sidewalks, access to really good schools access to health insurance and a doctor that you can see regularly. And even, you know, maybe some more nuanced things like less toxic stress over your life. Things that we know really impact kind of your ability to not only live a long time but also to live healthy while you are alive.

Elizabeth Holzschuh (05:01):

Yeah. And I think also the other piece with money is that we know that people who are living in poverty or even people who are low income, so we came about twice that amount of money. So family of three living on 42 or $43,000 or less. There's a lot of financial strain on those families because the cost of living is so high in Johnson County. And that kind of stress of trying to figure out how to put food on the table or if you're gonna be able to pay your rent or your mortgage this month can actually cause a lot of physical manifestations. It puts you at a higher risk of heart disease and diabetes, insomnia. It makes your brain synapsis actually fire more slowly. So all of these pieces lead into a poor quality of life and more unhealthy life.

Megan Foreman (05:39):

So one thing we know about poverty in Johnson County, there are 32,000 residents who live in poverty. That said another way is that if poverty were a city in Johnson County, it would be the sixth largest city. So while our statistics don't necessarily ring alarm bells when compared to other counties, it really does mean that there are humans who are living really stressful, difficult lives and kind of facing a lot of barriers to surviving.

Theresa Freed (06:06):

And one of those stressors that is mentioned in the health assessment is childcare. So can you talk about what that link is between childcare costs and in poverty or, or your health?

Elizabeth Holzschuh (06:17):

Absolutely. So this is actually very personal to me. I have a 3 year old and what we know is that sending your child to a childcare center in Johnson County for a year costs more than tuition at a public state university. So I pay more for my kid's tuition at a childcare center than parents were sending their kids to KU. And so when you think about already the financial stress on families, and then you add this piece in, which is really critical, we know that early childhood education is a key piece to health. It's a proven strategy that will cause improved health across the lifespan when kids have access to this quality childhood education. And so this is a key piece when people can't either send them there or then they have to turn to illegal care, potentially, friends and family. And it really just continues that chronic stress that these families are under.

Megan Foreman (07:08):

So in order to come up with the data that we use and the information that we use in this Community Health Assessment in 2018 we went door to door and surveyed residents. One of the questions that we asked was about the sort of items that were making them feel financially stressed. So we asked about credit card debt, medical bills, but childcare was one of those issues. And I think what we saw kind of anecdotally was that not every resident has young children and is really struggling with this cost right now. But for those who do have young children, almost to a person said that this was a huge financial stressor in their life.

Theresa Freed (07:41):

I imagine as a mother of two children, one of them 2 one of them 7, you know, we also face that same struggle. Which is why my husband is now a stay at home dad, so we can avoid that. But I can totally understand why that would be a stressor for a lot of a lot of families. It is a huge chunk of the family budget. Now when we talk about the health assessment and how people can interact with this information, you guys have a new website that includes all these details and it's called Health Happens Here. So, and we'll of course have the link to that in our show notes, but can you talk a little bit about why it's important to have that information available to the public so that they can access it easily?

Megan Foreman (08:19):

Yeah, certainly. So it's actually exciting for us to be able to put it out on this website. It's healthhappensherejoco.com. You know, like I said at the beginning, we've been doing these community health assessments for 25 years. Well, so it's really nothing new for us to pull this information together. What is new is the packaging. We've kind of put it in a new shiny wrapping, right? But the intention is really to, to lay a foundation for our partners, for our residents, for people to really be able to both see themselves in the story of health of Johnson County. And then to dive in and sort of think about ways that they as individuals might be able to contribute to better health and better equity in our community.

Elizabeth Holzschuh (09:07):

And I think part of that is, you know, because we are the healthiest County, there is this illusion that everybody is doing really well in Johnson County. And what we've found is we talked to people in our community and we looked at all the data is it's definitely not equitable across the board. And so we want to make sure that everybody's aware of their neighbors struggles of, you know, the person down the road because it's only once we start developing connectedness within our communities, we can really start seeing health improve.

Theresa Freed (09:34):

Okay. And that is a kind of a final note on, on that webpage is talking about connectedness and why is that important? What role does that play in health?

Megan Foreman (09:42):

So, you know, we know that loneliness or social isolation is as damaging to health as smoking. So, you know, going back to some of what Elizabeth said about the toxic stress and how over time those things can really add up to impact your health. Social isolation is the same thing. So nationally we know that one in four people say they don't have someone, a close confidant, somebody that they can just talk to if they're feeling down. We don't have numbers on Johnson County specifically for that, but we do know that our connectedness, some of the measures that we use have been going down over time.

Elizabeth Holzschuh (10:14):

And I think, you know, this certainly isn't something that's unique to Johnson County. We are hearing about it nationally and internationally. But if we think about our lifestyle, at least mine, I pull out of my garage every morning and I drive myself to work and I work a full day and then I come home and I drive back in my garage and I shut my garage door and then I'm at home with my family. So that ability for us to connect with our neighbors and have those authentic connections are really decreasing. And that causes that isolation that Megan was talking about.

Megan Foreman (10:40):

I think what's really what's interesting about some of the research around social connectedness is that it doesn't have to be a spouse or a best friend that you spend hours and hours and hours with every week. It's really about just being seen and heard. And that can happen in a lot of different parts of life for people. It could be the workplace, it could be maybe school drop off for your kids or a church gathering. There's lots of places where just in five or 10 minutes, you know, you can feel valued and seen as a person. This is one of these invitations that we have to residents to sort of get involved in what we're doing here. As government public health, we, we can't regulate that people know their neighbors. We can't you know, come up with a ticket if you haven't had a meaningful interaction with another human today. And that's not really our role either. But you know, part of what we're hoping to do by kind of teeing this issue up in our community and shining a spotlight on it, is that people can, can look around their own social networks and think, how can I make a difference to somebody today? How can I interact and make sure that I'm really reaching out to the people who I interact with everyday.

Theresa Freed (11:45):

Okay you know, we've heard the term or the phrase, it takes a village, you know, to raise a child or something that, so that really seems to speak to that we don't have the, those same support systems that maybe we use to with family and friends close by. You can, you know, you can drop a child off and run to the grocery store or if you are feeling stressed out. So that's really the message that people need to start engaging with each other and not just necessarily on social media or whatnot, but in person and having those interactions.

Megan Foreman (12:10):

I did read an article from a local professor, I believe that said that social media interaction is like the junk food of social interaction. It may satisfy you for just a minute, but it doesn't really have the, the deep nutrients that we need to really be connected in a society.

Theresa Freed (12:26):

All right, that makes sense. In support of the, the website is also a dashboard and so that's going to be easy accessible information that you can capture quickly. Is, does that mean it will be updated on a continual basis or what are you going to be doing with that?

Elizabeth Holzschuh (12:41):

Yeah, absolutely. So one of the really great things about the platform that we went with, they automatically update most of the data that's in there, whenever it becomes available. And then the additional data, some of the stuff that comes out of our shop we will also update it so that we imagine this to be a living document that we will add to as we identify new data that either supports or refutes our story and to continue to engage our community around what is really going on. And I'd also like to point out that when a lot of people hear dashboard, they sort of envision lots of graphs and really difficult things. And that is not what this is. We really tried hard to make it visually interesting with graphics that you don't need an advanced stats degree to understand along with a really beautiful narrative to help you understand how all of these different pieces connect and how housing and financial stress and the cost of childcare and social connectedness can all impact your health.

Theresa Freed (13:33):

Okay. And so obviously the goal of every person is to, or most people at least is to live as long as possible. And so the message here is you need that connectedness and what are the other keys?

Megan Foreman (13:44):

So the site really takes kind of a dive into the social determinants of health. And if you sit in communication school for public health, you're not supposed to use that term because it's very jargon-y and nobody knows what it means. So it's really you know, the, the very beginning of our page says that health happens where we live, learn, work and play. So it's really these, this idea of how all of these different factors connect to build a healthy lifestyle or not. Obviously there's personal choice that's inherent in a lot of that, but I think for those of us who work in the public health system or in government or a nonprofit, I mean there's a lot of sort of helping sectors where I think we think about our responsibility to build environments where people can make the healthiest choice possible. I mean, I, you know, your question's hard because it's so multifaceted how long we live really just depends on a confluence of different factors. And so it makes it hard to kind of pick out. You should do these three things. You know, the chronic disease prevention background that I have. You should listen to your grandma and take a walk and be nice to your neighbors and eat some broccoli and that should help.

Elizabeth Holzschuh (14:54):

And from my infectious disease original background, get your flu shot, get your immunizations and wash your hands, which is going to be the best source of prevention.

Megan Foreman (15:02):

Yeah. I feel like eat some broccoli, wash your hands is pretty good advice. Would it kill you to eat a vegetable?

Elizabeth Holzschuh (15:10):

But I think really the fact that not everybody in our community is living as long as people just down the road. We know that when it comes to income inequality. So the sort of difference in how much people are making in different neighborhoods and segregation and all these other pieces it really decreases the health overall of everybody. So it's that idea of a rising tide lifts all boats. So if we all come together to work on these problems and these concerns and to reach out to your neighbor and know your friends, we really think that we can improve the health of all of our residents.

Theresa Freed (15:42):

You know, we kinda touched on this. If I'm a typical resident, which I am, I come to the website, how can I take the information from that website and use it to improve my own health?

Elizabeth Holzschuh (15:54):

Certainly. Well, the next, this isn't a standalone item. We not only collect information and figure out what is going on in the community, but then we identify key places where we can do the work where we see gaps and where we can try and improve the outcomes. And so that's called our Community Health Improvement plans. It's the second part and our four priority areas around our Community Health Improvement Plan, are Suicide Prevention, Substance Use, Housing and Social Connectedness. So if any of these are issues where you feel passionate about, please reach out to us. At the bottom of our dashboard is a contact us link. We're happy to get you information about those groups and how you can be involved. Also, again, reach out to your neighbor. Have you talked to your neighbor today? Go ask for a cup of sugar even if you don't need it, if you don't need it. It's a good, good segue. So because this is an ever evolving site and we'll be adding new information as we go along. In fact, I'm hopefully in the next, in the near future we will be releasing an adolescent health page cause we know adolescent health and particularly adolescent mental health is a big concern in our community. So if you want to stay up to date a, you can definitely follow JoCoHealth on Twitter and we'll update people there. We also have a mailing list for our Community Health Network, which is also open to the public and we do that meeting quarterly. So again that contact us link at the bottom of our dashboard is another way you can stay connected to what is going on.

Megan Foreman (17:16):

In addition to the Community Health Assessment, which is the healthhappensherejoco.com. We'll be working with our partners around Housing, Substance Abuse, Suicide Prevention and Social Connectedness to think about which strategies we want to pursue in cooperation to improve the lives of the residents of Johnson County. So those groups are open to the public. If people would like to get involved, they can use the contact us link at the bottom of the page.

Elizabeth Holzschuh (17:44):

And understanding that everybody has a role to play in this. We want feedback from the community, particularly when we start identifying strategies and what can really help people in their own lives. So we will also be having some listening sessions moving forward to talk with the community about each of these topic areas. So look out for those announcements. Again, social media is a really great way to stay connected to us, either at Facebook or Twitter. So those are going to be some other opportunities for people to get involved.

Theresa Freed (18:09):

All right. Lots of, lots of ways to engage with this information. Thank you both for being here today.

Announcer (18:13):

You just heard JoCo on the Go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov. For more on this podcast, visit jocogov.org/podcast. Thanks for listening.