How Good Is Health Care in Missouri?

Many of my friends are involved in discussions about health care. A common thing I hear is that people are happy with the parts of the health care system that affect them personally. Often, there is a story, such as: Doctor (you supply the name) found a cancer in my (you supply the relative); he/she started therapy just in time and that person’s life was saved.

That is wonderful. But is that all there is? The health care debate seems centered on financial issues. Where is the dialogue about health? With all the talk in the news and elsewhere, is something missing? Could your health be better?

Missouri is blessed with many health care educational programs. There is the Saint Louis University Medical School, the first school west of the Mississippi, founded in 1836. Then there is the School of Medicine at Washington University, the Kirksville College of Osteopathic Medicine, the University of Missouri–Columbia Medical School, the University of Missouri–Kansas City Medical School, and the College of Osteopathy in Kansas City. In addition, there are plans to build a program in Joplin. If so many physicians are being produced, then health care in this state should be pretty good. Is it?

To find out about that, one must look at how the health care system product is measured. Although asking your aunt about her cardiologist and how well he responds to her needs can be helpful, aggregate data is needed to get valid information. The common tools used by states to measure health care system outcomes are: 1) life expectancy; and, 2) infant mortality.

According to the World Bank, “life expectancy at birth is the average number of years a newborn infant would be expected to live if health and living conditions at the time of its birth remained the same throughout its life.” That definition includes both the current health of a population and the quality of care people receive when sick.

In 2000, the U.S. Census Bureau said that life expectancy in Missouri was 76.2 years, and it has improved since then to 76.4. That can be contrasted with 78.5 in Iowa, 77.5 in Kansas, 76.7 in Illinois, 75.3 in Kentucky, 75.3 in Oklahoma, 75.1 in Arkansas, and 75.0 in Tennessee. Missouri is in the mid-range among our adjoining states, but not at the top, and many states have life expectancy rates higher than ours.

In 2009, the average life expectancy for the entire United States was 78.11, and more than half the people in this country were doing better than Missourians. What is most disturbing is that there are several countries in 2009 with life expectancy rates better than ours. With this measure, many people are found to have better health than we have in the United States, and in America many states are reported to have better health care results than we have in Missouri.

The second most frequently used gauge of health care system outcomes is the infant mortality rate. It is used to evaluate prenatal care, postnatal care, and all the other aspects of society that affect young children. The following are the rates for infants under one year of age per 1,000 live births in 2005. In Missouri it is 7.5, Kansas 7.4, Iowa 5.3, Illinois 7.4, Kentucky 6.6, Tennessee 8.9, Arkansas 7.9, and Oklahoma 8.1. Our state, again, is in the middle range. That year, the infant mortality rate for the entire US was 6.89 per 1,000 live births. Once again, it seems that Missouri’s health care results are not as good as the average for our country.

How does this compare with the rest of the world? Many international organizations study this. The easiest numbers to access come from groups interested in economics, such as the Organization for Economic Cooperation and Development. Among OECD nations, the average is 6.1 per 1,000 live births. The United States is not too far from that average — but Missouri is. In 2005, there were five countries with infant mortality rates of less than 3.5. What is the difference? Do they care more about their children than we do?

What is the matter with health care in Missouri? These are only a couple of the areas that need improvement. Please be sure that your quality of health is included in the health care discussion.