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Reference analysis · August 2026

Kansas City Burden of Disease

Every major problem quantified in annual disability-adjusted life years (DALYs) and dollars, with 80% confidence intervals, for the five instrumented counties of the KC metro: Jackson, Clay, and Platte in Missouri, Wyandotte and Johnson in Kansas. 1.88 million people, about 85% of the MSA.

Method: WHO Global Health Estimates 2021 US cause rates × local population × adjustment factors built from county death certificates, CDC PLACES prevalence, and city data. This is the impact piece of a two-part EA-style cause prioritization; the interactive tractability and neglectedness analysis builds on it.

Total annual health burden

~620K

DALYs per year, 5-county core (envelope 570–700K)

Excess years of life lost before 75

62,160

every year, vs the Johnson County benchmark 20 minutes away

County life-expectancy gap

6.9 yrs

Johnson Co. 80.64 vs Wyandotte Co. 73.70 (CHR 2020–22)

Tangible economic damage

~$15B

per year across identified categories, excluding VSL valuations

The league table

Annual DALYs by problem, split into years of life lost to death (YLL) and years lived with disability (YLD). Whiskers are 80% confidence intervals. The KC/US column is the local rate divided by the national rate: the "is Kansas City distinctively bad here?" number. Hover or focus any row for details.

YLL (death) YLD (disability) 80% CI
Data table

The distribution finding

Excess premature mortality (years of potential life lost before age 75, YPLL-75) against two benchmarks. Against the US average, the metro nets out to almost exactly zero. Against its own healthiest county, it loses 62,000 years of life annually.

Kansas City's aggregate health is average; the problem is distribution. Johnson County (YPLL 4,977 per 100K, life expectancy 80.64) is one of the healthiest large counties in America. Jackson (11,090) and Wyandotte (11,751) run at more than double its premature-death rate, twenty minutes away, and the net-vs-US figure for the whole core is −2,058: Johnson's surplus almost exactly cancels the deficit everywhere else.[26] The ZIP-code life-expectancy gap is now pinned to its primary source, the city's own Community Health Improvement Plan 2022–2027: Brookside's 64113 at 86.3 years vs 64128 on the east side at 68.1, an 18-year gap that the CHIP notes widened from 12 years between 2016 and 2019. (A 19.3-year figure that circulated in local TV coverage appears in no primary source and is dropped.)[27]

Economic damages

Tangible annual costs (medical, productivity, property, criminal justice) in 2025 dollars. Value-of-statistical-life and quality-of-life valuations are deliberately excluded: they are the dollar shadow of the DALY column, and including both counts the same suffering twice. Hatched bars overlap the disease rows above them (tobacco's cost lives inside CVD, cancer, and COPD) and are never summed.

Tangible cost Overlaps disease rows 80% CI

Child poverty's $5–7B/yr is a long-run future cost (NAS Roadmap apportioned to ~60K local poor children), not current cash flow, and is listed separately from the annual-damage rows.[21] Comprehensive VSL-inclusive figures, for comparison against advocacy numbers: violence ~$3.5B, overdose ~$6B, traffic ~$8.9B.

What is distinctively Kansas City

Deviation from national baseline matters more than absolute size for local action. Eight places KC measurably departs from the country:

Method details

Unit and geography. Annual DALYs (YLL + YLD) and annual tangible dollars, for the 5-county core (Jackson 718.6K, Johnson 622.2K, Clay 259.8K, Wyandotte 165.3K, Platte ~110K people). Scaling to the full 2.2M MSA adds roughly 15–17% to most rows and changes no ranks.

Model. Local DALYs per cause = US cause-specific DALY rate per 100K (WHO Global Health Estimates 2021, which publishes YLL and YLD separately[1]) × local population × a local adjustment factor. Adjustments come from real local instruments: exact 2023 death counts by cause from Missouri Vital Statistics (Jackson County: 7,001 deaths; heart 1,414; cancer 1,291; homicide 180; suicide 134; accidental poisoning 282)[2], Kansas vital statistics[3], CDC PLACES prevalence with published CIs[4], KCPD's live homicide analysis[5], and verified county overdose and traffic counts.[6][7] Where no local instrument exists, the adjustment is 1.00 with a wide interval and a lower confidence grade.

Confidence intervals are 80% subjective intervals combining source CIs, the adjustment range, and a 7% envelope for base-rate and population uncertainty. Ranks should be read through the intervals: the top two are stable, the 3–5 cluster and the 10–14 cluster are internally unstable.

Framework note. WHO GHE uses a frontier life table, so YLL-per-death runs higher than IHME GBD conventions. Everything here shares one framework, so ranks and ratios are internally consistent; absolute DALYs run ~10–15% above what an IHME-based version would report. IHME's own US ranking (CVD > cancer > musculoskeletal > mental disorders) matches this table's top four.[9]

Double-counting rules. The league table holds mutually exclusive disease and injury endpoints. Risk factors and structural drivers (smoking, obesity, alcohol-as-risk, air quality, poverty, housing) overlap those endpoints; they are shown hatched in the dollar chart and never summed with it.

Known limitations. Kansas blocks county-level cancer-registry data by statute, so Wyandotte cancer leans on state rates. Kansas-side overdose and suicide counts are estimates. Musculoskeletal, digestive, neurological, and falls rows have no local instrument. 2021 base rates embed COVID-era and peak-violence conditions, which makes the violence and drug KC/US ratios conservative. Education proficiency figures never got primary verification (both state portals are bot-gated); the KCPS graduation figure is district-reported.

Sources

Every figure above traces to one of these. Flags note anything that resisted primary verification.

  1. WHO Global Health Estimates 2021, DALY/YLL/YLD by country (June 2024 revision), USA columns. who.int
  2. Missouri Vital Statistics 2023, Tables 16C/22A/23/26C. health.mo.gov (PDF)
  3. Kansas Annual Summary of Vital Statistics 2023; Kansas Infant Mortality and Stillbirth Report 2024. kdhe.ks.gov
  4. CDC PLACES, 2025 release (2023 BRFSS), county and place model-based estimates with 95% CIs, pulled via the Socrata API. data.cdc.gov
  5. KCPD Daily Homicide Analysis (pulled 2026-08-14): 2023=182, 2024=145, 2025=139. mediaweb.kcpd.org (PDF); KCPD 2025 year-end release (archived).
  6. KCUR Vision Zero reporting, Jan 2024 / Jan 2025 / Jan 2026: KCMO traffic deaths 102 → 97 → 68. kcur.org
  7. MIMH Addiction Science, KC-area drug-involved deaths (county medical examiner data): 4-county 2024 = 402, −10% vs 2023. mimhaddisci.org; Jackson County overdose fact sheet, MO DHSS (2022 vintage, archived).
  8. CDC VSRR provisional drug overdose deaths, Missouri 12-month-ending Dec 2023 (2,014) and Dec 2024 (1,482), pulled via API. data.cdc.gov
  9. GBD 2021 US Burden of Disease Collaborators, The Lancet (2024). PMC11694014
  10. Everytown Research, The Economic Cost of Gun Violence: Missouri $17.6B/yr, $2,875/resident; 87.8% of the national total is quality-of-life valuation (VSL $10.9M, 2019$). everytownresearch.org
  11. CDC, Economic Trends in Tobacco (verified from CDC’s archive mirror): cigarette smoking cost the US more than $600B in 2018 ($240B+ health care, ~$185B lost productivity from illness, ~$180B from premature death, ~$7B secondhand-smoke deaths). archive.cdc.gov
  12. AHA 2024 Heart Disease and Stroke Statistics (Circulation; verified verbatim from the PMC copy): average annual US CVD cost $422.3B in 2019–2020 ($254.3B direct + $168.0B indirect). PMC12146881
  13. American Diabetes Association, Economic Costs of Diabetes in the U.S. in 2022: $412.9B total ($306.6B direct). diabetes.org
  14. Greenberg et al., PharmacoEconomics 2021: US burden of adult MDD, $237B (2010) → $326B (2018). analysisgroup.com
  15. NHTSA, The Economic and Societal Impact of Motor Vehicle Crashes, 2019 (DOT HS 813 403): $340B economic, ~$1.4T comprehensive; $1.6M / $11.3M per fatality. crashstats.nhtsa.dot.gov (PDF)
  16. Sacks et al., Am J Prev Med 2015 (verified via CDC’s release): excessive drinking cost the US $249B in 2010, $2.05/drink; binge drinking 77% of costs. State-level Missouri figure not independently verifiable (article paywalled, state tool JS-only). archive.cdc.gov
  17. NCI Cancer Trends Progress Report (verified from the archived page): national cancer-care costs projected at $208.9B in 2020 (2020$, medical services + oral prescription drugs), built on Mariotto et al. 2020. progressreport.cancer.gov (archived)
  18. Ward et al. 2021, PLOS ONE: excess medical cost of obesity $1,861/adult/yr; $173B national (2019$). PMC7990296
  19. Florence et al., CDC MMWR 2021: state-level costs of OUD and fatal overdose, 2017: Missouri $18.515B; ~84% of the national total is intangible (QoL + VSL). PMC8344997
  20. McCollister, French & Fang 2010, Drug and Alcohol Dependence: cost per murder $8,982,907 (2008$); aggravated assault $107,020; robbery $42,310. doi:10.1016/j.drugalcdep.2009.12.002
  21. National Academies, A Roadmap to Reducing Child Poverty (2019): child poverty costs the US $800B–$1.1T/yr. nationalacademies.org
  22. CDC older-adult falls cost data: $50B national medical (2014$); Missouri $883M, Kansas $338M. stacks.cdc.gov
  23. Berkowitz et al., Health Services Research 2018 (verified from the PMC copy): food insecurity carries $1,863/person/yr excess health expenditures ($6,072 vs $4,208), $77.5B aggregate (NHIS 2011 + MEPS 2012–13). PMC5980147
  24. HUD CoC Performance Profile, MO-604, 2024: PIT 2,181 (2023: 1,986); chronic 377 (+35%). hudexchange.info (PDF)
  25. Eviction Lab, Kansas City tracker (Jackson County filings, monthly CSV). evictionlab.org
  26. County Health Rankings 2025, Missouri and Kansas data files: YPLL-75 and life expectancy with 95% CIs (2020–22 aggregate). Jackson 11,090.3 (10,807.9–11,372.7); Wyandotte 11,750.9; Johnson 4,976.6; life expectancy 74.76 / 73.70 / 80.64. countyhealthrankings.org
  27. ZIP-level life expectancy: KCMO Health Department, Community Health Improvement Plan 2022–2027: ZIP 64113 (Brookside) 86.3 years vs ZIP 64128 (east side) 68.1 years, an 18-year gap that grew from 12 years between 2016 and 2019 (CHIP figures confirmed via FlatlandKC’s coverage of the plan; the CHIP portal itself is a JS app). The once-circulating 19.3-year figure appears in no primary source and is dropped. flatlandkc.org
  28. Chetty et al., JAMA 2016: top-1% vs bottom-1% income life-expectancy gap, 14.6 years (men), 10.1 (women). jamanetwork.com
  29. KCUR, Dec 2024: 571 nonfatal shootings in 2024; KCPD 2025 release: nonfatal shootings −31%.
  30. EPA, annual PM2.5 design values 2020–2022 (Feb 2024 table): Jackson 7.9, Clay 6.0, Johnson 8.9, Wyandotte 10.8 µg/m³. epa.gov (PDF)
  31. Di et al., NEJM 2017;376:2513-22 (verified verbatim from the PMC copy): +7.3% all-cause mortality per 10 µg/m³ PM2.5 (95% CI 7.1–7.5); +13.6% (CI 13.1–14.1) below 12 µg/m³. PMC5766848
  32. FRED (St. Louis Fed) ACS series: poverty and median household income, Jackson / Wyandotte / Johnson counties, 2020–2024.
  33. Missouri Hunger Atlas 2023, Jackson County: food insecurity 11.5% overall, 16.1% of children (2021 data). mohungeratlas.org (PDF)
  34. Education: KCPS graduation rate rose from 72.2% (2022) to 88.6% (2025) per district board reporting (Beacon News; DESE-primary confirmation still blocked by the portal’s bot gate); KCPS proficiency and all USD 500 figures remain unverified and are not asserted. thebeaconnews.org partially unresolved
  35. Missouri DHSS childhood lead surveillance: latest opened data is 2019 statewide (1,426 elevated of 78,770 tested); the current annual report exists but its PDF links are dead and KC-specific current figures could not be retrieved. Treat as outdated. unresolved
  36. KCUR, Aug 2024: Missouri DHSS 34 heat deaths (2023) vs NWS 0; systematic undercount of heat mortality.