Yes, if it hasn't greened up - and hasn't shown this lingering redness before - the implication is there is something haywire with the rooting environment.

On the subject of pink kousas, I have always thought they looked unappealing, to put it mildly. However when I visited Issima Plant Works and Sakonnet Garden in June of 2022, I couldn't believe how gorgeous the pink kousas along the coast of Rhode Island looked. I don't know what cultivars were involved but clearly they were 1) more commonly planted up there and 2)looked better in climates that stay 'chilly', by eastern US standards, in early summer...than they do anywhere around the mid-Atlantic. Of course this doesn't jibe with GG's account of not liking them in the PNW, but, first of all to each his or her own, second of all, there could be other temp, rainfall, or even soil differences at play. Maybe the PNW is too chilly, we're too warm, and coastal RI is just right? Around here all kousas seem to have their sepals quickly 'melt' from the June heat, it perhaps makes the pink ones uglier as they develop brownish off colors.

"I've observed the same with other woodies such as viburnum plicatum tomentosum some rhodies and a stewartia." With the exception of fruit trees, the vast majority of woody plants do NOT observe alternate bearing or biennial flower production. Once established, they will flower consistently year after year provided weather conditions are acceptable for the flowering. I would be interested in seeing any scientific evidence that would support the alternate year theory. With a degree in horticulture and many decades growing and gardening professionally, I have never seen any reference to this outside of fruit bearing trees.

"what steps are best after a few years and the growth pattern is clear to promote upward growth vs sideways." As everyone keeps telling you fighting against natural growth patterns is a losing game. If you needed a narrow tree here a Kousa might not have been the best choice. That said- let it grow to develop some trunk girth. Over the years do some reading and educate yourself as to aesthetic pruning techniques- you can absolutely influence the future growth of most plants by carefully chosen pruning cuts. But you can't just dive in with a lopper- you need to understand how to encourage the limb grow to the left vs. the right, to grow upward instead of outward etc. - how to redirect growth. It can be done but you need to study up. One book I might suggest is The Pruning Book by Lee Reich.