Alex Smith

The KCUR news staff presents the State of Kansas City series as a look ahead to 2020 on topics of importance to the region. Find the State of Kansas City report on other topics in the series as they are published each weekday, Jan. 6–Jan. 20. Follow coverage on these topics at KCUR.org and on 89.3 FM throughout the year.

Health care — who gets it, who doesn’t, and how we pay for it — will command as much attention in Missouri and Kansas politics this year as on the national scene.

A nationwide campaign is looking for solutions to loneliness.

When children are diagnosed with attention deficit hyperactivity disorder, stimulant medications like Ritalin or Adderall are usually the first line of treatment.

Lori Pinkley, a 50-year-old from Kansas City, Mo., has struggled with puzzling chronic pain since she was 15.

She's had endless disappointing visits with doctors. Some said they couldn't help her. Others diagnosed her with everything from fibromyalgia to lipedema to the rare Ehlers-Danlos syndrome.

When Porter Hall of Raymore, Missouri, was a year old, he broke out in hives after eating a spoonful of peanut butter. It led to a scary night in the emergency room and a diagnosis of peanut allergy.

But today, Porter, who’s now five, is giving peanuts another shot with the help of Kansas City doctors, who have been giving him tiny doses of peanuts over the course of months.

This oral immunotherapy treatment isn’t a cure, but doctors say these tiny exposures may help to reduce or prevent severe reactions – although some critics are warning families to consider the risks. 

Hundreds of young German football fans in blue jerseys dance and sing in the streets before a soccer match in Manchester, England.  

This rainy northwestern city is the third largest in the United Kingdom. Known for its music scene and soccer, it’s a city brimming with young people .

But for many of those young people, like 17-year-old Lee Smelhurst-Hudson, life in Greater Manchester can be tough.

The Buck O’Neil Bridge just north of downtown is one of more hectic traffic spots in Kansas City, Missouri, and for Shari H, a car accident here in 2012 turned out to be life-changing.

She didn’t have any major injuries, but after days and weeks passed, she realized that her post-accident soreness wasn’t going away.

When Victoria Worden of Kansas City was pregnant with her fourth child, she was addicted to heroin and hated herself for it.

Medical researchers have made giant leaps in diagnosing Alzheimer’s disease, which could make it possible to detect the illness long before memory and cognitive problems show up.

There is no cure for the fatal, degenerative disease, and it remains one of the  diagnoses most feared by patients. But researchers and patient advocates say it’s still worth facing their fears and getting tested.

A few years ago, Kansas City restaurateur Anton Kotar surveyed the local and national restaurant scenes and concluded his town’s reputation as a steakhouse paradise had slipped.

The problem, he says, is the way conventional beef is raised – bulked up with grain on feedlots, making it cheap and plentiful and changing what Americans expect to taste.

A few years ago, Renea Molden’s doctors told her they wanted to take her off hydrocodone pills. 

“I was mad,” Molden says. “I’ll be honest. I was mad. I was frustrated.”

The 39-year-old woman from Kansas City struggles with pain caused by fibromyalgia, herniated spinal discs and degenerative disc disease. She says the three opioid pills a day that doctors wanted her to stop taking seemed to be the only way she could make it through work, go shopping or even fix dinner.

Maita thinks he was seven years old when he and his family were forced out of their home in Bhutan.

Starting in the late 1980s, the Himalayan country began driving out people who were ethnically Nepali. They fled across the mountains to Nepal, where they were settled in impoverished refugee camps.

“I didn’t even know Nepal. I didn’t know anything about it,” Maita explains using sign language. “We didn’t have any food. We didn’t have any shelter. We needed help cause we were starving.”

President Trump has pledged to not make cuts to Medicare, the federal insurance program for seniors, but Seema Verma, administrator of the Centers for Medicare and Medicaid, acknowledges that changes are needed.

One of the program’s main funds, the Hospital Insurance Trust Fund, is expected to be depleted in 11 years.

On Monday, Verma was in Olathe, Kansas to talk with seniors about Medicare and encourage them to take part in Medicare open enrollment, which runs from October 15 through December 7.

The health care plan unveiled last month by the Republican-controlled U.S. Senate met with fierce opposition from hospital, doctor and patient advocacy groups. Among them was the National Rural Health Association, which is based in Leawood, Kansas, and represents doctors, nurses and hospitals in rural areas nationwide. 

Twenty-four-year-old Kalee Woody says that when she was growing up in Bronaugh, Missouri, she saw the small town slowly fading. Businesses closed, growth stagnated and residents had to drive to other places to see a doctor.

It is a town that, like many towns in rural areas of Missouri and other Midwest and Great Plains states, is recognized by the federal government as having a shortage of healthcare providers.

By the time Stephenie Hashmi of Lenexa, Kansas, was in her mid-20s, she had achieved a lifelong dream: She was the charge nurse at one of Kansas City’s largest intensive care units. But even as she cared for patients, she realized something was off with her own health.

“I remember just feeling tired and feeling sick and hurting, and not knowing why my joints and body was hurting,” Hashmi says.

Hashmi was diagnosed with systemic lupus, a disease in which the body’s immune system attacks its own tissues and organs.

Pretty Prairie, Kansas, population 680, had a moment in the spotlight during the confirmation hearings for new Environmental Protection Agency head Scott Pruitt.

Kansas Sen. Jerry Moran mentioned Pretty Prairie as an example of a community that’s struggling because of EPA regulations that Pruitt could ease.

On a chilly winter morning, dozens of truck driver trainees file into a classroom at the headquarters of Prime Inc., a trucking company based in Springfield, Mo.

At the front is Siphiwe Baleka, an energetic former swimming champion in his mid-40s. He delivers grim news about trucker health to the new recruits.

"If you haven't started to think about this, you need to start right now," Baleka says. "You are about to enter the most unhealthy occupation in America."