Approximately 411,000 children live in a four county Kansas City metro area, accounting for 25.6 % of the population. A community health assessment by Children’s Mercy with assistance from Professional Research Consultants, examined current health status of children in the metro area, identified unmet needs and current health priorities, explored community strengths and gaps in resources, and provided insights to health advocates and providers.
The report identified numerous issues including poverty, employment, violence, parent support, access to care, mental/behavioral health, housing, obesity, food insecurity, early education and infant mortality.
Listen in as Margo Quiriconi, Director of Community Health Initiatives at Children’s Mercy, explains the key findings of the study and plans to address them.
The State of Children’s Health in Kansas City
Featured Speaker:
Margo Quiriconi
Margo Quiriconi currently serves as the Director of Community Health Initiatives at Children’s Mercy Hospital. In 2013, Margo founded the consulting group Q Works, LLC focused on improving the education and health for underserved populations. Before this, Margo worked in a number of health-related organizations. During her 20-year tenure at the Ewing Marion Kauffman Foundation, Margo led initiatives in the areas of education, health and entrepreneurship. In 2012, Margo served as the Chair of the Women’s Foundation Research and Evaluation Committee that created the Her Reality and Her Voice reports. Margo is active in a number of community organizations and serves on the Board of Directors of The Skillbuilders Fund, KC Healthy Kids, The Child Protection Center and The Lead Lab. Margo holds Bachelor’s degrees in the fields of Nutrition (Michigan State University) and Nursing (St. Louis University) and a Masters of Public Health in Maternal and Child Health (University of North Carolina-Chapel Hill). She is a Doctoral Candidate at the Tulane School of Public Health and Tropical Medicine. Transcription:
The State of Children’s Health in Kansas City
Dr. Michael Smith (Host): Today's topic is “The State of Children's Health in Kansas City.” My guest is Margo Quiriconi. She currently serves as Director of Community Help Initiatives at Children's Mercy Hospital. Margo, welcome to the show.
Margo Quiriconi (Guest): Thank you. I'm glad to be here, Dr. Mike.
Dr. Smith: I want to talk a little bit about you first--how you got started in what you're doing in community health. I noticed also that you founded something called the consulting group, Q Works. What don't you tell us a little bit about that?
Margo: I got started and the importance of children's health is that when I was a middle school child, my family moved from Michigan down to Mississippi. When I moved down to Mississippi, I always remember, even as a young middle school student and living on, that I just saw the incredible inequities about how children were living and were treated in schools and in their communities, and I never liked that. I committed myself and my career to working on improving community-based programs and outcomes for children. I have a strong belief that no matter where you're from, what your zip code is, that all children should have the same opportunity and have the same potential. So, that's led me to a lot of really exciting opportunities, working on infant mortality in the Mississippi Delta, to developing adolescent pregnancy and parenting programs, to working with a philanthropy organization in Kansas City where we were transforming education systems and education programs for children across the community. I then started a consulting group where I worked on a number of exciting projects looking at high utilizers of the emergency rooms at some of our local public hospitals, to working on the development of an infant mortality project in the eastern part of Missouri, in St Louis, and in the boot heel where there's the highest infant mortality, to an another project working on with our local Black Healthcare Coalition. I really enjoyed the diversity of the projects and was happy to come here to Children's Mercy to a new position that they had established to try to bring a more strategic approach to the community work that Children's Mercy was engaged in.
Dr. Smith: Let's bring it back to Kansas City. The topic is the state of children's health in Kansas City. So, just in a nutshell where in your opinion, Margo, do you think Kansas City has been, where is it today, and where is it going when it comes to the state of children's health?
Margo: I think one of the concerns all along for Kansas City is that we don't have enough emphasis on what's really happening in the day to day lives of our infants, children, and adolescents. We need more of a stronger emphasis on what can we do to make the conditions better. There's a number of efforts in the community that are happening to improve the schools and improve different systems, but we're still seeing that children and families are under a lot of stress in the region. A lot of that is from financial stress. A lot of it is just from the stress of managing dual working families, managing all of the different demands and expectations we have that society is putting on children and their families. In our report, we did this study of what's happening with children's health in four counties, in Johnson and Wyandotte Counties in Kansas, and Clay and Jackson Counties in Missouri. One of the themes that we saw throughout when we surveyed families and when we did focus groups and talked to key informants, was that they recognized and addressed that families are really under a lot of financial stress and stress in getting their day to day work done, and that has implications for children.
Dr. Smith: I have it here. You're speaking about the community health assessment that Children's Mercy did with assistance, I think, from some professional research consultants in that four county region and from that report here, I have listed that the report identified numerous issues including poverty, employment, violence, parent support, access to care, behavioral health, housing, obesity, food insecurity, early education, and infant mortality is the main focus that Children's Mercy wants to move forward with. Where are you at with that? I mean, that's a big list, right?
Margo: Right.
Dr. Smith: It's a lot to try to make improvements. So, what's the plan? You have identified the issues, I guess. What's the plan, then, moving forward for the kids, at least in those four counties?
Margo: Yes. I want to clarify that those important issues that you listed, we took the data from the needs assessment out to a group in the community of close to two hundred individuals, and they actually identified that list as being what they saw were critical issues facing children and families in our communities. We took that list back in to Children's Mercy and went to probably close to over six hundred of our staff members across the Children's Mercy system, presented data to them, presented those eleven issues and then, we had a process where we ranked those issues on what could children through Mercy really make a short-term impact on. The top three issues that rose where we could really play a significant role were in infant mortality, in mental health and as well as an access to care. Now, the other issues on that list, we have a number of really important programs happening in those areas but we felt we wanted to trim that list down and say, "Okay, these are three we want to go deeper on in the next three years."
Dr. Smith: Let's talk about one of those specifically that Children's Mercy is going to focus on and that's the access to care because I know that's a big issue depending on where you live. Right? If you're close to Children's Mercy, you're getting the best of the best--all the specialists you need, but as you go further and further out from the city, obviously, access to care becomes an issue. What's the plan, then, to correct that? Is it simply opening up more satellite clinics? Is that part of it? What are you guys thinking?
Margo: We are in the planning process right now, and we're looking deeply at the data that we received from the community health needs assessment, as well as we are bringing in different community partners to better understand what they're seeing might be some of the barriers to access to care, and what they think could improve access to care. For example, one of the pieces that we discovered in our needs assessment is that a bit over 44% of the families in Clay County who participated in our telephone survey of this assessment shared with us that they had struggles with or delays in getting access to health care in the past year. We paired that data, we at Children's Mercy has an urgent care facility on Barry Road in the Northland, and so we looked at with some of the physicians at that facility and looked at the urgent care utilization, and we discovered that one of the zip code zones in that area north of the river, has some of the highest urgent care utilization of any zip code zone in the four counties. Now we're working with the Northland Health Alliance and some other partners to better understand what the struggles of some of those families are, what's making it difficult for them to get into primary pediatric care, and to identify with a medical home because urgent care is not the place where you go for your routine health care and that's what we were seeing from some of the data that some of the families are going to urgent care, perhaps, twelve times a year.
Dr. Smith: They are using that as their primary physician, basically?
Margo: That's what we're hearing and that's what we're seeing from the data, yes.
Dr. Smith: Where do you think in this process, does telemedicine play a role in some of this?
Margo: We are working and looking at identifying how telemedicine might play a role in working on providing primary care and what the best access points are for telemedicine but, certainly, all of that is on the table. We're examining what might be the best way that we can use our resources and work with community partners. Some of these challenges take more than just one organization and, then, really finding out what the families need and better understanding. So, what's making it more comfortable for them to go to the urgent care versus going into a primary care provider, and how we can get them into the best care for their children.
Dr. Smith: As the director of Community Health Initiatives at Children's Mercy hospital, Margo, what are some of your goals for the near future for your program?
Margo: One of our goals is that we are developing what we call the “implementation strategies” around each of those three priority areas. That's one of my close goals, to develop meaningful implementation or action plans about how we're going to work on these issues over the next three years. Another important goal that we've had is we've started a few new programs here in the past year at Children's Mercy, so working with my colleagues in the institution who are working on those programs to help them to get those programs off the ground, to help them make additional community connections that they need, and to develop the evaluation strategies. One of those programs is called “Coaching Boys Into Men,” and this is an adolescent program targeted at high school athletes, and works towards reducing violence in interpersonal relationships between young men and young women, and young men and other young men. It's been an evidence-based program on which the Centers for Disease Control has conducted very positive research studies. We have been training high school coaches in the Kansas City, Missouri, school district, and their athletic coaches, to be delivering this program with their athletes. The word so far from the coaches is that they are just loving this program. We're going to continue to work on expanding that and addressing additional needs they have.
Dr. Smith: What you're taking on, obviously, Margo, is a huge job and it's so important. If you look at the issues that we identified in the phone survey, I mean, these are societal issues that I think does take an organization, an institution like Children's Mercy, to kind of champion and network and bring other organizations in. I think you're doing a great job and I want to thank you for the work that you're doing. I look forward to maybe having you come back on maybe in a year or so, and hear where you're at with everything. I think that would be good. Margo, thanks for coming on the show today. You're listening to Transformational Pediatrics for Children's Mercy Kansas City. For more information you can go to childrensmercy.org. That's childrensmercy.org. I'm Dr. Mike Smith. Thanks for listening.
The State of Children’s Health in Kansas City
Dr. Michael Smith (Host): Today's topic is “The State of Children's Health in Kansas City.” My guest is Margo Quiriconi. She currently serves as Director of Community Help Initiatives at Children's Mercy Hospital. Margo, welcome to the show.
Margo Quiriconi (Guest): Thank you. I'm glad to be here, Dr. Mike.
Dr. Smith: I want to talk a little bit about you first--how you got started in what you're doing in community health. I noticed also that you founded something called the consulting group, Q Works. What don't you tell us a little bit about that?
Margo: I got started and the importance of children's health is that when I was a middle school child, my family moved from Michigan down to Mississippi. When I moved down to Mississippi, I always remember, even as a young middle school student and living on, that I just saw the incredible inequities about how children were living and were treated in schools and in their communities, and I never liked that. I committed myself and my career to working on improving community-based programs and outcomes for children. I have a strong belief that no matter where you're from, what your zip code is, that all children should have the same opportunity and have the same potential. So, that's led me to a lot of really exciting opportunities, working on infant mortality in the Mississippi Delta, to developing adolescent pregnancy and parenting programs, to working with a philanthropy organization in Kansas City where we were transforming education systems and education programs for children across the community. I then started a consulting group where I worked on a number of exciting projects looking at high utilizers of the emergency rooms at some of our local public hospitals, to working on the development of an infant mortality project in the eastern part of Missouri, in St Louis, and in the boot heel where there's the highest infant mortality, to an another project working on with our local Black Healthcare Coalition. I really enjoyed the diversity of the projects and was happy to come here to Children's Mercy to a new position that they had established to try to bring a more strategic approach to the community work that Children's Mercy was engaged in.
Dr. Smith: Let's bring it back to Kansas City. The topic is the state of children's health in Kansas City. So, just in a nutshell where in your opinion, Margo, do you think Kansas City has been, where is it today, and where is it going when it comes to the state of children's health?
Margo: I think one of the concerns all along for Kansas City is that we don't have enough emphasis on what's really happening in the day to day lives of our infants, children, and adolescents. We need more of a stronger emphasis on what can we do to make the conditions better. There's a number of efforts in the community that are happening to improve the schools and improve different systems, but we're still seeing that children and families are under a lot of stress in the region. A lot of that is from financial stress. A lot of it is just from the stress of managing dual working families, managing all of the different demands and expectations we have that society is putting on children and their families. In our report, we did this study of what's happening with children's health in four counties, in Johnson and Wyandotte Counties in Kansas, and Clay and Jackson Counties in Missouri. One of the themes that we saw throughout when we surveyed families and when we did focus groups and talked to key informants, was that they recognized and addressed that families are really under a lot of financial stress and stress in getting their day to day work done, and that has implications for children.
Dr. Smith: I have it here. You're speaking about the community health assessment that Children's Mercy did with assistance, I think, from some professional research consultants in that four county region and from that report here, I have listed that the report identified numerous issues including poverty, employment, violence, parent support, access to care, behavioral health, housing, obesity, food insecurity, early education, and infant mortality is the main focus that Children's Mercy wants to move forward with. Where are you at with that? I mean, that's a big list, right?
Margo: Right.
Dr. Smith: It's a lot to try to make improvements. So, what's the plan? You have identified the issues, I guess. What's the plan, then, moving forward for the kids, at least in those four counties?
Margo: Yes. I want to clarify that those important issues that you listed, we took the data from the needs assessment out to a group in the community of close to two hundred individuals, and they actually identified that list as being what they saw were critical issues facing children and families in our communities. We took that list back in to Children's Mercy and went to probably close to over six hundred of our staff members across the Children's Mercy system, presented data to them, presented those eleven issues and then, we had a process where we ranked those issues on what could children through Mercy really make a short-term impact on. The top three issues that rose where we could really play a significant role were in infant mortality, in mental health and as well as an access to care. Now, the other issues on that list, we have a number of really important programs happening in those areas but we felt we wanted to trim that list down and say, "Okay, these are three we want to go deeper on in the next three years."
Dr. Smith: Let's talk about one of those specifically that Children's Mercy is going to focus on and that's the access to care because I know that's a big issue depending on where you live. Right? If you're close to Children's Mercy, you're getting the best of the best--all the specialists you need, but as you go further and further out from the city, obviously, access to care becomes an issue. What's the plan, then, to correct that? Is it simply opening up more satellite clinics? Is that part of it? What are you guys thinking?
Margo: We are in the planning process right now, and we're looking deeply at the data that we received from the community health needs assessment, as well as we are bringing in different community partners to better understand what they're seeing might be some of the barriers to access to care, and what they think could improve access to care. For example, one of the pieces that we discovered in our needs assessment is that a bit over 44% of the families in Clay County who participated in our telephone survey of this assessment shared with us that they had struggles with or delays in getting access to health care in the past year. We paired that data, we at Children's Mercy has an urgent care facility on Barry Road in the Northland, and so we looked at with some of the physicians at that facility and looked at the urgent care utilization, and we discovered that one of the zip code zones in that area north of the river, has some of the highest urgent care utilization of any zip code zone in the four counties. Now we're working with the Northland Health Alliance and some other partners to better understand what the struggles of some of those families are, what's making it difficult for them to get into primary pediatric care, and to identify with a medical home because urgent care is not the place where you go for your routine health care and that's what we were seeing from some of the data that some of the families are going to urgent care, perhaps, twelve times a year.
Dr. Smith: They are using that as their primary physician, basically?
Margo: That's what we're hearing and that's what we're seeing from the data, yes.
Dr. Smith: Where do you think in this process, does telemedicine play a role in some of this?
Margo: We are working and looking at identifying how telemedicine might play a role in working on providing primary care and what the best access points are for telemedicine but, certainly, all of that is on the table. We're examining what might be the best way that we can use our resources and work with community partners. Some of these challenges take more than just one organization and, then, really finding out what the families need and better understanding. So, what's making it more comfortable for them to go to the urgent care versus going into a primary care provider, and how we can get them into the best care for their children.
Dr. Smith: As the director of Community Health Initiatives at Children's Mercy hospital, Margo, what are some of your goals for the near future for your program?
Margo: One of our goals is that we are developing what we call the “implementation strategies” around each of those three priority areas. That's one of my close goals, to develop meaningful implementation or action plans about how we're going to work on these issues over the next three years. Another important goal that we've had is we've started a few new programs here in the past year at Children's Mercy, so working with my colleagues in the institution who are working on those programs to help them to get those programs off the ground, to help them make additional community connections that they need, and to develop the evaluation strategies. One of those programs is called “Coaching Boys Into Men,” and this is an adolescent program targeted at high school athletes, and works towards reducing violence in interpersonal relationships between young men and young women, and young men and other young men. It's been an evidence-based program on which the Centers for Disease Control has conducted very positive research studies. We have been training high school coaches in the Kansas City, Missouri, school district, and their athletic coaches, to be delivering this program with their athletes. The word so far from the coaches is that they are just loving this program. We're going to continue to work on expanding that and addressing additional needs they have.
Dr. Smith: What you're taking on, obviously, Margo, is a huge job and it's so important. If you look at the issues that we identified in the phone survey, I mean, these are societal issues that I think does take an organization, an institution like Children's Mercy, to kind of champion and network and bring other organizations in. I think you're doing a great job and I want to thank you for the work that you're doing. I look forward to maybe having you come back on maybe in a year or so, and hear where you're at with everything. I think that would be good. Margo, thanks for coming on the show today. You're listening to Transformational Pediatrics for Children's Mercy Kansas City. For more information you can go to childrensmercy.org. That's childrensmercy.org. I'm Dr. Mike Smith. Thanks for listening.