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Health director: Missouri has tools to improve health outcomes

by Joe Gamm | September 22, 2021 at 5:05 a.m. | Updated September 22, 2021 at 10:26 a.m.
<p>Julie Smith/News Tribune</p><p>The recently-named director of the Missouri Dept. of Health and Senior Services Dan Kauerauf poses for a photograph in his west side Jefferson City office.</p>

"Cubs," said Don Kauerauf, director of the Missouri Department of Health and Senior Services. "To the core."

Here in Mid-Missouri, when we meet somebody from Illinois, we want to get a feel for what makes them tick. Cubs or Cards? Are they secure enough in their support of the boys in blue to admit it? The answer is irrelevant. We're testing the mettle.

So, the new DHSS director is a Cubby. Don't blame him, he is from Illinois.

But being from Illinois, Kauerauf is also familiar with the rural/urban divide - like that we have here in Missouri.

Kauerauf comes from a state with double the population of Missouri, but some of the demographics of the states are similar - Illinois has a giant urban area, and many rural farming regions. Missouri has two major urban areas, with widespread rural communities.

Each has some of the largest (populated) counties in the United States, with perhaps some of the sparsest populated counties.

"A lot of the times, you look for the state to have one size fits all, and that's just not practical," he said. "There are various factors out there. There are some communities where people have to go a couple of counties for services."

Kauerauf wants to focus on technology to bring better health to communities.

Missouri may use distance learning and statewide investments in broadband to improve health outcomes.

He points out that Show-Me ECHO (Extension for Community Healthcare Outcomes) has been in widespread use.

Show-Me ECHO uses videoconferencing to connect experts with primary care providers, according to

"They collaborate in interactive case-based learning to develop advanced skills and best practices, which improves patient care access, quality and efficiency," the website says.

The sessions provide free continuing education.

There are vast health care deserts in Missouri that will require the state to use all existing technologies to overcome, Kauerauf pointed out.

He took the DHSS reins at the beginning of the month.

Before that, he was the assistant director of the Illinois Department of Public Health. He retired from that position, but couldn't stay out of public service and became chairman of the Illinois Terrorism Task Force (and was tied to Illinois Emergency management Agency).

Kauerauf, during a news conference last week, said he'd like to see Missouri health outcomes improve.

Much like overcoming the COVID-19 pandemic, there's no single answer to lift the state's health outcomes, he said.

"It's healthy eating. It's active lifestyles," he added. "We know that Missouri has some of the most extensive trail systems in the country."

That's what the state has to focus on.

Missouri has to build a strong foundation of keys for people to become healthy, he said.

"You have to have access to medical care," Kauerauf said. "If we don't have access to care - for screenings, for routine visits - we've got a problem."

We have to address the health care deserts, he said.

"The spotlight's on public health now. Like it or not, the spotlight's on it," he said. "It is interesting that when I started my career in public health, a good day in public health was - no one called. We were out of the paper. The media didn't question us."

The more Kauerauf thinks about those conditions, the more he realizes they don't represent good days.

"We've missed an opportunity to educate people. Right now, the spotlight's on public health, maybe not for a good reason, but the spotlight's on us," he said.

Public health officials have to take advantage of people looking at them now during the pandemic, and use that to begin talking about other challenges to public health, like the flu.

Here we go once again, into the flu season.

Last year, flu vaccinations and social distancing, had an effect on the flu season.

It really never developed.

This year will be different.

Children are back in schools.

Groups of people are gathering again.

"This is a year that we are going to have to watch carefully," Kauerauf said. "One of the problems is that when you first encounter symptoms of COVID-19, flu, allergies, and just kids with runny noses, symptoms are the same."

Getting vaccinated for the flu and COVID-19 is critically important to getting Missouri through the pandemic, he said.

"We're going to have to dispel some of the rumors that are already out there," Kauerauf said. "We've already heard rumors that people cannot receive the COVID-19 and the influenza vaccine at the same time. I've seen stories that are crazier than that - about reactions and whatever."

Rumors and misinformation is already circulating, he continued.

COVID-19 hospitalizations are decreasing across the state. Missouri would like that to continue, he said.

"We can't afford to have an influx of individuals with influenza in the hospitals," Kauerauf said. "This year, there's going to be probably a little more emphasis on the communications ahead of time."

Get the vaccines at the same time, he encouraged.

Public health programs will need revenue, he said.

Missouri needs to look at all avenues to increase funding.

The state needs sustained funding, not one-time sources, Kauerauf said.

"Yes we're underfunded, but when we develop funding, it has to be things for the long haul," he continued.

Public health has to be at the table when money from a settlement reached with three pharmaceutical companies is distributed.

Pharmaceutical distributors McKesson, Cardinal Health and AmerisourceBergen are to make payments totaling $21 billion over 18 years, and Johnson & Johnson is to pay $5 billion over nine years, according to the settlement reached in July.

Missouri already receives about $130 million a year from tobacco companies to compensate for health problems caused by smoking. Health advocates have criticized the state uses most of the money to help pay its annual Medicaid costs, rather than focusing on tobacco cessation programs.

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