Princess Health and Kentuckians tell pollsters they are concerned about air quality, but don't seem to put their concern into action.Princessiccia

Princess Health and Kentuckians tell pollsters they are concerned about air quality, but don't seem to put their concern into action.Princessiccia

air pollution Foundation for a Healthy Kentucky poll public health

Gusty 14:08 Add Comment

A recent poll shows that more than half of Kentucky adults, especially women, are concerned about air quality in their community, but only 48 percent say they change their behavior when an air quality alert is issued.

Perhaps they have never heard of an air quality alert, which is issued by a local or state air-pollution authority to protect the public's health from air pollution. The U.S. Environmental Protection Agency monitors air quality and uses an Air Quality Index to warn the public when the amount of particle pollution or ozone in the air may harm their health.
????
When pollution gets to a level of concern, alerts or action days are issued in participating areas, which in Kentucky are Louisville, Lexington and the Mammoth Cave area (primarily Edmonson County). This could explain why almost 30 percent of poll respondents from Louisville said they were very concerned about air quality in their community, and only 13 percent of respondents from Appalachia indicated this level of concern.

Almost 60 percent of Appalachians said they are not concerned at all about the air quality in their community, compared to 26 percent of Louisville respondents that aren't at all concerned. Few Eastern Kentucky counties are part of an air-quality monitoring program. In addition to the areas monitoring for alerts or action days, 37 Kentucky counties (colored in the map) participate in the monitoring program. Click here to compare counties.?

Counties covered by an air-quality monitoring program are colored.

The poll indicated that just 20 percent of Kentucky adults said they change or limit their activities a lot when air quality alerts are issued, and about 30 percent said they change their behavior a little.  Respondents from the Louisville region were most likely to change or limit their activities, while those in the Lexington area were the most likely to not change or limit their behavior at all. 

When air quality is at an unhealthy level, people can protect themselves by limiting outdoor activities or avoiding heavy exertion.  These protective measures are even more important for those sensitive to air pollution, such as people with heart or lung disease, the elderly and children.

�The quality of our air impacts all of us, but is particularly important for sensitive groups, such as children with asthma. When an air quality alert is issued, we can protect ourselves and our families by avoiding heavy exertion and limiting outdoor activities,� said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll. �We can also do our part to limit emissions and protect our neighbors by turning off our car�s engine while we are waiting.� 

Almost 30 percent of Kentucky adults and 40 percent of Western Kentucky adults said they never turn their car�s engine off when waiting in their car and not moving, as in a traffic jam, train crossing or drive-through. Including those who never turn off their cars, more 60 percent said they wait at least four minutes before turning off their car�s engine when waiting in the car and not moving. Experts recommend turning off a waiting car�s engine after just ten seconds in order to save gas and limit emissions.

The poll was funded by the foundation and the Health Foundation of Greater Cincinnati and was conducted last year from Sept. 20 to Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones and the poll has a margin of error of plus or minus 2.5 percentage points.

Princess Health and Public Health Week theme: It's a good investment, saving lives and money.Princessiccia

Princess Health and Public Health Week theme: It's a good investment, saving lives and money.Princessiccia

health departments public health

Gusty 13:15 Add Comment

April 1-7 is National Public Health Week, and the Kentucky Department for Public Health is working to raise awareness and help people live longer, healthier lives by promoting the 2013 week's theme: the return on investment of public-health services.

Everyone likes sound, stable and high-return investments, and research shows that investing just $10 per person each year in proven, community-based public health efforts can save the nation more than $16 billion within five years. That�s a $5.60 return for every $1 invested.

�Our nation and community simply cannot sustain the current trajectory of health care spending and chronic disease Dr. Stephanie Mayfield, the state health commissioner, said in a Cabinet for Health and Family Services release. �Fortunately, we know that investing in prevention and public health can make an enormous difference and it�s the right direction for Kentucky to move in to address poor health outcomes.�

Supporting public health approaches to better health outcomes does reap life-saving returns, said Mayfield. For example, research shows that each 10 percent increase in local public health spending contributes to a nearly 7 percent decrease in infant deaths, a 3.2 percent decrease in cardiovascular deaths and a 1.4 percent decrease in diabetes-related deaths.

�In some way, public health touches everyone, every day in Kentucky. We are dedicated to making our infrastructure even stronger, including ongoing work to become nationally accredited in 2014, finding opportunities for improvement within our programs, and focusing on overall prevention for the health and well-being of Kentuckians,� said Mayfield.

Since 1995, communities nationwide have celebrated National Public Health Week each April to draw attention to the need to help protect and improve the nation�s health and to educate the public, policymakers and practitioners.

�We hope this week will serve as an opportunity for the public to learn more about the vital role of public health in Kentucky,� said Mayfield. (Click to learn more about the Kentucky Department for Public Health or National Public Health Week)

Princess Health and Food Reward Friday. Princessiccia

Princess Health and Food Reward Friday. Princessiccia

Food reward Fridays

Gusty 03:00 Add Comment

This week's "lucky" winner... milkshakes!

Read more �

Princess Health and Will Kentucky expand Medicaid, and if so, how?.Princessiccia

Princess Health and Will Kentucky expand Medicaid, and if so, how?.Princessiccia

Affordable Care Act governor health insurance insurance managed care Medicaid poverty

Gusty 11:30 Add Comment

By Molly Burchett
Kentucky Health News

Kentucky is one of the last states to decide whether to expand Medicaid under federal health reform, and now that the General Assembly has gone home, Democratic Gov. Steve Beshear can turn his attention to the many questions that linger. Some Republican legislators think he will expand the program, but they worry about the cost when the state would have to start helping cover the new expenses, beginning in 2017.

Republican Gov. Bill Haslam of Tennessee decided Wednesday that he will not pursue Medicaid expansion, saying that it could put hospitals in financial jeopardy by giving them more patients on which they lose money, reports Michelle Kaske of Bloomberg. If he is right and the same logic applies to Kentucky, Medicaid expansion in the state could harm the rural hospitals and providers -- some of whom are already squeezed by the issues with the new managed-care system.

Along with Kentucky, 10 other states are undecided about Medicaid expansion: Alaska, Indiana, Kansas, Nebraska, New York, Oregon, Utah, Virginia, West Virginia and Wyoming. The map by The Advisory Board Company shows the lay of the land; for an interactive picture that outlines the research behind the map, click here.?????

Red=Not participating; Pink=Leaning toward not participating;
Gray=Undecided; Blue=Participating; Light Blue=Leaning toward participating

Only three states with Democratic governors are undecided; 18 Republican governors have rejected expansion. Kentucky is shown as leaning for it because Beshear has repeatedly said that he will expand Medicaid if the state can afford it. He has also mentioned that the state can reserve the right to pull out of the deal in 2017, when it must paying 3 percent of the cost of covering the newly insured, reaching 10 percent in 2020. Still, the questions about cost and affordability remain, and Beshear could be considering another option.

Tennessee has joined Ohio and Arkansas in negotiating with the Obama administration over plans to use federal Medicaid money to purchase private insurance for those who can't afford it but don't qualify for Medicaid now. However, Haslam's plan has been held up because the administration placed too many conditions on the money, writes Kaske. Republicans in other states, including Florida, Louisiana, Pennsylvania and Texas, have expressed interest in this option since Gov. Mike Beebe of Arkansas, a Democrat, ignited the wildfire of creating a hybrid of the two alternatives, reports Robert Pear of The New York Times.

The idea of privatizing Medicaid expansion appeals to many doctors and hospitals because they typically receive higher payments from commercial insurance than from Medicaid. However, many Kentucky hospitals and providers are concerned about the managed-care program that is run by three private organizations, and are calling for immediate action. Beshear has not said whether he will sign or veto a bill that would subject the managed-care firms to the prompt-payments and dispute-resolution rules of the state Department of Insurance.

"Action is needed to address the problems that patients and hospitals are experiencing with Medicaid managed care and to make the system work properly," wrote Harold "Bud" Warman, chair of the Kentucky Hospital Association, and Charles Lovell, chair-elect of the association, in a recent Herald-Leader article that laid out the various problems with the system. "And with the possibility that Medicaid will be expanded in Kentucky to include an additional 350,000 people, it is critical that these issues be addressed right away to avoid even greater problems in the future."

Either using federal dollars to buy private insurance in order to cover newly qualified individuals (the hybrid plan) under the health law's expansion  or expanding in the "traditional" way will not change the current managed care structure of Medicaid in Kentucky. Yet, it would mean that 350,000 more Kentuckians would be covered under managed care; Medicaid would cover those earning up to 138 percent of the federal poverty level, currently up to $15,856 a year for an individual.

The money that the federal government offers for expansion is very tempting. The question then may be, how will it be used?

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Senate sends bill for prompt payment by managed-care firms to Beshear, who won't say whether he will sign or veto it.Princessiccia

Princess Health and Senate sends bill for prompt payment by managed-care firms to Beshear, who won't say whether he will sign or veto it.Princessiccia

General Assembly governor health insurance legislature managed care Medicaid mental health state government

Gusty 14:15 Add Comment

A bill aimed at resolving payment disputes between medical providers and Medicaid managed-care companies passed unanimously Monday in the Senate, and has been sent to Gov. Steve Beshear for his consideration.

House Bill 5, sponsored by House Speaker Greg Stumbo, D-Prestonsburg, would apply existing prompt-payment laws to managed-care firms and would set up an appeal process in the Department of Insurance to handle disputes between them and medical providers. Those claims are now handled by the Cabinet for Health and Family Services, which administers Medicaid and has had some problems with the bill.

Hospitals, doctors and other health-care providers have complained that the cabinet is not resolving their payment disputes with managed-care firms, putting many rural hospitals, clinics and health departments in serious financial binds.  Mental health centers have also reported cutting back services.

Asked last night what he would do with the bill, Beshear said the cabinet "has worked with the managed-care organizations and health-care providers to reduce problems during the change, and many concerns have been addressed.  However, I recognize that some issues persist.  I will review this bill carefully.�

Beshear has 10 days, excluding Sundays, to decide whether to veto the bill, sign it into law or allow it to become law without his signature. Stumbo said that if bill is vetoed it would likely be House Bill 1 in the 2014 session, reports Jessie Halladay of The Courier-Journal. The bill is a top priority for many health-care providers.

Princess Health and State Auditor Edelen says state must fix managed-care issues that have put rural hospitals and providers on brink of survival.Princessiccia

Princess Health and State Auditor Edelen says state must fix managed-care issues that have put rural hospitals and providers on brink of survival.Princessiccia

health care access hospitals managed care Medicaid rural health state government

Gusty 19:52 Add Comment

State Auditor Adam Edelen said last week that shoring up the financial base for rural hospitals in Kentucky is the number one challenge to the state's Medicaid managed-care system.

The managed-care system has left rural hospitals at a tipping point that determines whether or not they will survive, which is deeply disconcerting when considering access to quality health care for Kentuckians in rural areas, Edelen said in a cn|2 "Pure Politics" interview. The state has a significant rural population, and "you can't overstate the importance of these rural hospitals," he said.

Hiring private companies to manage Medicaid has helped Kentucky slow cost increases in the $6 billion program, but the system has serious structural issues, and hospitals, doctors, dentists and other providers say the managed-care organizations (MCOs) are not paying them for treating Medicaid patients, Jacqueline Pitts of cn|2 reported.

There are many stories "about providers who have submitted claims and all of sudden, these MCOs change the rules, and so these claims are deemed unclear or improper and they are sent back," House Speaker Greg Stumbo said.

Edelen said the problem is that there is no consistent oversight in the claims process from the cabinet, and there is no opportunity for the provider to respond. "Right now we have our providers up against such a wall that the choice is to do one of two things," he said. "It's either to opt out of Medicaid, which is not something we want to do considering we have one of the largest percentage of population on Medicaid anywhere in the country, or go to the courts," which is inefficient and expensive.

�You have good people in the cabinet trying to manage it, you�ve got providers that are just trying to provide services to people, but we�ve got to have a better system of oversight and accountability because if that happen and we begin to lose hospitals in rural Kentucky then we have significantly reduced the level of quality of life for the people of Kentucky,� Edelen said.

Fixing the system for those hospitals and doctors is what is so important to the state as a whole, he said. He said the state and MCOs have had enough time to work out glitches with doctors and hospitals, and they must make some substantial changes before medical care for Kentucky�s neediest suffers any more.

Princess Health and Managed care, pension payments causing problems for community mental health centers; Edelen, C-J call for changes.Princessiccia

Princess Health and Managed care, pension payments causing problems for community mental health centers; Edelen, C-J call for changes.Princessiccia

community health centers health care managed care Medicaid mental health mental illness

Gusty 19:33 Add Comment

"Kentucky mental health centers are cutting back services and struggling to assist patients the first time they�re admitted because of ongoing struggles with Medicaid managed care," Don Weber reports for cn|2. "At the same time, they�re losing out on federal grants because of red flags caused by their administration costs being inflated by increasing contributions to the public pension system."

NorthKey Community Care Mental Health Center in Northern Kentucky, which serves eight counties, had to close its adult day-treatment programs for the seriously mentally ill. Dr. Owen Nichols, the president and CEO, told Weber, �I get calls periodically from elderly parents in the community wanting help with their adult child that suffers from schizophrenia because they�re now wandering the streets, having some difficulties with local authorities.�

A recent editorial in The Courier-Journal addresses Kentucky's need for better mental health treatment, saying that Kentucky has "an underfunded, fragmented and now �thanks mostly to Medicaid managed care �hopelessly complicated system of mental health care."

The editorial notes last week's C-J articles in which reporters Laura Ungar and Chris Kenning uncovered the problems families face when navigating a fragmented mental-health system while trying to provide appropriate treatment for a loved one suffering form a severe mental illness, in addition to the "F" grade Kentucky received for its poor mental-health funding.

The editorial also describes how structural issues with managed care, which began in November 2011, have complicated the state's mental-health system. It notes the community mental-health centers asked to be left out of managed care, "pointing out they already operate efficiently and amount to only about 3 percent of the state�s $6 billion a year Medicaid program."

In addition, the editorial notes, "State Auditor Adam Edelen recommended the Cabinet for Health and Family Services take mental health out of managed care and let the state resume running it." Against his advice and the requests of community mental-health centers, the state expanded managed care of mental health. Now some haven�t been paid for Medicaid services since January, when managed care took effect, the editorial says.

"The nightmare needs to end for the many Kentuckians who need basic mental health services," says the editorial. "It�s time for the state to fully explore this system and, if folks are serious about improving it, fix the problems and find the money to fund it." (Read more)

Princess Health and Newly formed Kentucky Health Cooperative gets OK to offer plans in state's health insurance exchange.Princessiccia

Princess Health and Newly formed Kentucky Health Cooperative gets OK to offer plans in state's health insurance exchange.Princessiccia

health insurance health reform insurance insurance exchange

Gusty 19:20 Add Comment

The new Kentucky Health Cooperative's health-insurance plans have received approval from the state Department of Insurance and will be available on Kentucky's insurance exchange market when it opens in October.

�This is a red-letter day for Kentuckians,� Janie Miller, CEO of the cooperative, said in a news release. �Although health-care cooperatives have offered quality care and lower overhead expenses to members since the 1930s, they�re the �newest kid� on Kentucky�s health insurance block. Efforts are underway to help the public become familiar with the cooperative concept.� The cooperative was formed with a mixture of private capital and federal loans.

Miller, a former secretary of the state Cabinet for Health and Family Services, said the cooperative is like member-owned and member-operated credit unions, rural electric cooperatives and food co-ops. �Think agriculture cooperative extension offices, and consider the impact such organizations have made,� she said. �Doing so makes it easy to imagine the potential, similar value to the citizens of our Commonwealth offered by a health cooperative.�

Joe Smith, chair of the cooperative's board of directors, said �A gateway has been opened to individuals and small businesses seeking more affordable, consumer-friendly, quality-driven health insurance options.�

Details about the cooperative plans offered to individuals and businesses with 50 or fewer employees on the nw state insurance exchange will be announced in the coming months. (Read more at the KYHC website)

Princess Health and State Health Department gets diabetes prevention funding; will focus on prediabetes detection and lifestyle changes.Princessiccia

Princess Health and State Health Department gets diabetes prevention funding; will focus on prediabetes detection and lifestyle changes.Princessiccia

diabetes federal grants grants health departments obesity prevention public health

Gusty 19:08 Add Comment

The state Department for Public Health has been awarded a $134,380 federal grant to help reduce high rates of prediabetes and Type 2 diabetes in Kentucky.

�Diabetes is a tremendous public health concern that is both horrific for the individual, if unmanaged, and costly in terms of medications, various complications and long-term hospitalizations that are so often associated with the disease,� Audrey Haynes, secretary of the Cabinet for Health and Family Services, said in a press release.

In 2009, Kentucky's rate for diagnosed diabetes was the fourth highest in the nation at 11.4 percent of the population, compared to a national median of 8.3 percent. The rate means an estimated 366,000 adults in Kentucky have diabetes. An additional 266,000 Kentuckians are estimated to have prediabetes, according to the CFHS website.

Prediabetes often leads to Type 2 diabetes, the most common type, within a few years, but lifestyle changes promoted by the federal Diabetes Prevention Program can decrease the risk of developing diabetes by almost 60 percent, according to a recent study published in the Journal of Preventive Medicine.

�We must act now to begin reversing the devastating impact of diabetes on our state,� Haynes said. �We are excited to continue our work with the Diabetes Prevention Program to help more Kentuckians start making healthier lifestyle choices so they can avoid developing diabetes and lead longer, healthier lives.�

The DPP specifically targets individuals with prediabetes and works with them to reduce their risk of developing Type 2 diabetes. The risk factors for both are: being older than 45, being overweight or obese, physical inactivity, having a family history of diabetes, ever having gestational diabetes, high blood pressure, abnormal cholesterol, having a history of cardiovascular disease and being African-American, Hispanic/Latino, Native American, Asian American or Pacific Islander. Click here to take the diabetes risk test.

The federal Centers for Disease Control estimates that national efforts to prevent Type 2 diabetes could save $5.7 billion in health care costs by preventing 885,000 cases in the next 25 years. Kentucky will focus on three diabetes prevention strategies that involve raising awareness among health care providers to improve detection and treatment of prediabetes and encouraging both state/local government and business to add lifestyle change programs to the list of covered services under health plans, says the news release. (Read more about diabetes and prevention in Kentucky).

Princess Health and Neuronal Control of Appetite, Metabolism and Weight. Princessiccia

Princess Health and Neuronal Control of Appetite, Metabolism and Weight. Princessiccia

cardiovascular disease diabetes hyperphagia overweight

Gusty 19:00 Add Comment

Last week, I attended a Keystone conference, "Neuronal Control of Appetite, Metabolism and Weight", in Banff. Keystone conferences are small, focused meetings that tend to attract high quality science. This particular conference centered around my own professional research interests, and it was incredibly informative. This post is a summary of some of the most salient points.

Rapid Pace of Scientific Progress

Read more �

Princess Health and Food Reward Friday. Princessiccia

Princess Health and Food Reward Friday. Princessiccia

Food reward Fridays superstimuli

Gusty 03:00 Add Comment

This week's luck winner(s)... pastries!!

Read more �

Princess Health and 7 Tips To Fight Bad Weather And Bad Mood. Princessiccia

Princess Health and 7 Tips To Fight Bad Weather And Bad Mood. Princessiccia

Gusty 16:11 Add Comment

Dark after 4 pm, cold, damp... This is November, and we have to get used to the unfriendly weather for another 3-4 months at least! So instead of complaining about it every day, let's see what we can actually do to cheer ourselves up!

1. Flowers

Flowers remind us of spring and summer. Make sure you have flowers at home and at your workplace. You can buy one in a very small pot, so it will fit on your work desk. Choose the ones of your favorite color, or the ones which bring some nice memories back. They will definitely make you smile whenever you look at them.

2. Summer Hits

 Buy or download summer hits and listen to them while driving or on the bus. You can make a track list with summer hits of different years, or you can choose the year you have the best summer memories from, and download all its summer hits. People might look at you strange while you are smiling in the rain, but you got what you wanted, feel the summer, and that's the most important.

3. Smile and laugh!

When the sun is shining, we smile involuntarily. Now when there is no sun, we still want to smile and laugh, because it is good for our health.

Smile is contagious. So make sure you avoid grumpy people and try to be around happy, smiling people. Being around them will give you lots of positive energy and will make you smile too.

Go to Youtube and search for your favorite comedy. Whether it is Friends, or Mr. Bean, or Tom&Jerry, give yourself 10 minutes, and just watch and laugh. You will see how different you will feel after only 10 minutes!

Laughter really does have healing power, whatever our problem is.

4. Choose the right food!

Many people are emotional eaters, which means they eat more either when they are happy, or unhappy, or even when stressed. And guess what? Most of the people tend to eat more when they are down.

Now, if you go to a chipper, then very soon you will be in an even worse mood. Filling your bag with chocolate bars and then eating them will only have a short term positive effect, and then you'll be down again. Not even to mention the other negative effects to your health.

Chocolate - yes, raw cocoa powder really is a mood booster food, beside its plenty other health benefits.

Here are two very easy tips for a home-made chocolate treat, ready in 5 minutes:

a/. What you'll need: 1 pack (100 gsm) raw flaked almonds, 1-2 tablespoons raw cocoa powder, healthy liquid sweetener (honey, agave nectar, maple syrup), little bit of water.

Put the almond flakes in a bowl, add the cocoa powder (start with 1 tablespoon, and then add more if you wish, depending how 'chocolatey' you prefer it), add 1-2 table spoons of your chosen sweetener and then start to stir it with a spoon. You can add 1-2 table spoons of water to make it easier to stir and to loosen the texture.
The amount of sweetener and cocoa powder is absolutely up to you and your taste buds.
Extra tip: Top it with some fresh strawberries and bananas, or any other fruit. Enjoy! :)

b/. What you'll need: blender, 2-3 bananas, 1-2 tablespoon raw cocoa powder, sweetener if needed (in case the banana is not ripe enough), healthy ones of course: xylitol or one of the above mentioned ones.

Blend bananas and cocoa powder together, and add sweetener if needed. If it is too thick for you, add water or rice milk. So easy, healthy and yummi! :)
You can also use dried dates to sweeten anything when you use the blender.

5. Sunbed

Now this one is not the healthiest tip I admit. However, if not overused, it could be good for you.  It is not the best for your skin if getting too much of it. You might have a nice tan but your skin will age earlier than you would like it to.

So when day after day no sunshine at all and you feel really down, give it a go. 5-10 minutes only, and you will feel like coming back from a sun-holiday.
As I said before, make sure you don't visit the tanning shop too often.

6. Production 

Sounds weird? Keep reading. Rain, cold, bad mood, you feel like not doing anything. Now this is the point where you should find the thing you have to do but have been postponing for a while. Is it doing your administration? Is it cleaning the shelves in the kitchen? Whatever that is, if you do it and finish the job, the satisfaction will be such a great feeling  that you will forget about all the bad things straight away.

Production, and seeing your product, is something which brings real happiness. Try it and you'll see!

7. Last but not least: Exercise!

The lower you feel, the higher the benefit will be. Awful weather? Think about the sunny feeling after your class or after your exercise. Not to mention the countless of other benefits of exercising beside the mood-booster one.

I'm always proud of my Zumba students when coming to the class in horrible weather, and the feedback I receive is that it is always worth it :)

So try the things above whenever you need some healthy mood-booster and weather-fighting ideas.

And book your place to one of my ZUMBA classes in Dublin 2, Dublin 6 and Dublin 8. CLICK HERE!

Princess Health and New health ranking of counties places Oldham at top for second straight year; some counties had big jumps and drops.Princessiccia

Princess Health and New health ranking of counties places Oldham at top for second straight year; some counties had big jumps and drops.Princessiccia

county health health outcomes health rankings

Gusty 12:35 Add Comment

By Molly Burchett
Kentucky Health News

A new report of the national county health rankings shows several Kentucky counties have improved in the last two years while others have gotten significantly worse.

For the second year in a row, Oldham County ranked best in health outcomes, and Floyd County ranked worst this year, but the statistical differences among closely ranked counties are so small that they are subject to error margins. The rankings recognize that by placing the counties into quartiles, or fourths, of the state's 120 counties.

Ranks in quartiles: white, 1st-30th; gray, 31st to 60th; light green, 61st to 90th; dark green, 91st to 120th.

The results were released Wednesday in the fourth annual County Health Rankings by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, and are available at www.countryhealthrankings.org. Detailed, county-by-county health data are available at KentuckyHealthFacts.org.

Morgan County jumped two quartiles over the past year, improving its rank by 40 notches, from 69th to 29th. Another strongly positive change from last year was Mercer's County's improvement from 61st to 40th.

On the other hand, other county rankings worsened: McLean went down two quartiles and 36 steps, from 57th to 93rd. Bourbon went from 42nd to 68th, Gallatin went from 71st to 94th and Hickman County 31st to 61st.

These Eastern Kentucky counties have been listed in the bottom quartile (91st to 120th) for the past three years: Lawrence, Johnson, Martin Powell, Wolfe, Magoffin, Floyd, Pike, Breathitt, Knott, Jackson, Owsley, Perry, Letcher, Clay, Leslie, Knox, Bell and Whitley.

The rankings are based on a model of population health that emphasizes the many factors that, if improved, can help make Kentucky communities healthier places to live: health behaviors, such as diet, exercise and alcohol use; clinical care, including access to care and quality of care; social and economic factors, such as education, employment and income; and the environmental quality of the physical environment.

Other factors considered in the rankings include the rate of people dying before age 75, high-school graduation rates, unemployment, access to healthy foods, air and water quality, income, and rates of smoking, obesity and teenage pregnancy.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Study suggesting that coal is a cause of health problems in E. Ky. is disputed by industry and politicians, defended by researcher.Princessiccia

Princess Health and Study suggesting that coal is a cause of health problems in E. Ky. is disputed by industry and politicians, defended by researcher.Princessiccia

air pollution Appalachia environmental health health outcomes research rural health

Gusty 11:24 Add Comment

By Molly Burchett
Kentucky Health News

A heated debate centers on new research showing that residents in Floyd County, where coal is stripped from the tops of mountains and ridges, report more health problems than those in two nearby communities without such mines, Elliott and Rowan.

The study, published in the online Journal of Rural Health, is the latest by Dr. Michael Hendryx of West Virginia University to suggest that residents of mining areas have poorer health conditions and experience more serious illness. It is available to readers of Kentucky Health News by clicking here.

Unlike some of his West Virginia research, Hendryx does not say there is a correlation between mining and poorer health outcomes in Eastern Kentucky. He does suggest the possibility of a connection by showing residents' self-reported health problems like asthma, chronic obstructive pulmonary disorder and hypertension are more common in mining areas. And in an interview, he said he believes there is a connection.

Stonecrest Golf Course at Prestonsburg in Floyd County,
built on a reclaimed mountaintop-removal coal mine.

The study and its critics highlight the challenges and pitfalls of discussing and reporting such research. The study's underlying motives and methodology are contested. The president of the Kentucky Coal Association, Bill Bissett, said Hendryx has reached a conclusion and is seeking evidence to support it.

"Bissett's accusation is completely false," Hendryx replied. "On the contrary, he is obviously the one with the biased perspective and has a strong financial motivation to try to discredit this work."

Bissett questions the study's use of self-reported health measures that did not consider medical history. Self-reporting is susceptible to bias, which can be reduced by using other sources of data/. This study only included data collected from interviews conducted by volunteers, which may have introduced more bias, Bissett said.

Hendryx replied, "We used undergraduate students from Christian colleges who were trained to be fair and objective in the survey procedures, and to use the same procedures in both the mining and non-mining communities." He said Peter Illyn, who runs the Christian organization Restoring Eden, approached him to do the survey because Illyn "wanted to give the students this experience, and he wanted to replicate the survey that we had done the previous year in West Virginia, this time in Kentucky."

The volunteers interviewed 544 participants lived in Floyd County and 351 in Rowan and Elliot counties, where coal is not mined. It used standard statistical devices to control for factors that might influence health status: age, sex, education, marital status, work as a coal miner, weight and tobacco habits. However, there was no consideration of health behaviors such as drug and alcohol use, wellness measures, exercise or other healthy lifestyle habits that could have positive influences.

"The survey had to be brief with the time and resources we had," said Hendryx. "We did measure overweight and obesity, which is a reflection of diet and exercise. We measured tobacco use. We did not measure alcohol use in this survey but in other studies we have found that heavy alcohol use is not common and is not an explanation for the findings."

Kentucky House Speaker Greg Stumbo, who is from Floyd County, said he disagreed with the use of Rowan County, home of Morehead State University, as a control group due to the higher rates of education attainment and per capita income, reported Ronnie Ellis of Community Newspaper Holdings Inc.

Stumbo told Ellis, �Everybody in the world knows that you can take a population that is less well educated and that has a lower per capita income and you�ll see their health habits are (worse) and hence their rates of diseases are attributable to those two things.� Rowan has a much better health status than surrounding counties, according to the latest national County Health Rankings.

Hendryx defended his research controls and the process of relying on self-reported medical histories. He said the health problems may be caused by tiny particles of dust from coal mining, which have been linked to health problems, can penetrate the lungs to cause health impacts, reported James Bruggers of The Courier-Journal. Hendryx said there are also concerns about polluted water and soil.

The study's data only hint at a connection between surface coal mining and poor health. Hendryx said he can�t prove that mountaintop removal is causing people to get sick, but he believes it is. What is needed, he told Bruggers, is a more thorough and expensive �gold standard� study of air and water quality near residences, and samples of blood, hair and toenails that can reveal exposure to pollutants.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Most Kentucky adults don't know that drug overdose is the leading cause of death in the state, but those in the east do.Princessiccia

Princess Health and Most Kentucky adults don't know that drug overdose is the leading cause of death in the state, but those in the east do.Princessiccia

drug abuse drugs Foundation for a Healthy Kentucky poll prescription drug abuse prescription drugs rural health

Gusty 07:10 Add Comment

Drug overdoses, driven largely by prescription drug abuse, overtook motor vehicle accidents as the leading cause of unintentional deaths in Kentucky back in 2010 and remain the state's leading cause of death. From 2000 to 2010, the number of drug-overdose deaths in Kentucky rose a staggering 296 percent, highlighting the state's drug abuse epidemic that now kills more than 1,000 Kentuckians a year. But a recent poll suggests many Kentuckians are not fully aware of the state's drug problem.

In an effort to gauge awareness of the problem, the Kentucky Health Issues Poll asked Kentucky adults whether traffic accidents, falls, firearms or unintentional drug overdoses resulted in the highest dumber of deaths in the state each year. Only 44 percent of Kentucky adults correctly indicated that drug overdose is the leading cause of unintentional Kentucky deaths; 43 percent incorrectly identified traffic accidents as the leading cause.

Respondents from Eastern Kentucky, where the problem is most prevalent  were more likely to correctly identify it as the leading cause of death, at 69 percent. However, only 29 percent of Louisville-area respondents did.

�Experts have reported significant prescription pain reliever abuse in eastern Kentucky,� said Susan Zepeda, presient of the Foundation for a Healthy Kentucky, which co-sponsored the poll.  �It is no surprise that the Kentuckians most aware of this issue are those who are living in this region.  Awareness is the first step towards curbing this trend � it is up to all of us to get involved and take action to reduce the toll of this health crisis.�

The poll was conducted for the foundation and The Health Foundation of Greater Cincinnati from Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by land line and cell telephones, and the poll's margin of error is plus or minus 2.5 percentage points.

Princess Health and Legislature eases physician assistant rules; nurse practitioners' prescription power, Medicaid prompt-payment bills, others linger.Princessiccia

Princess Health and Legislature eases physician assistant rules; nurse practitioners' prescription power, Medicaid prompt-payment bills, others linger.Princessiccia

children's health doctor shortages doctors General Assembly health care access insurance legislation managed care Medicaid nurse practitioners physician assistants prescription drugs state government

Gusty 05:38 Add Comment

By Molly Burchett and Al Cross
Kentucky Health News

The Kentucky General Assembly has joined other states in easing the restrictions on physician assistants� medical practice, but has held up a similar move for advanced registered nurse practitioners. Both issues relate to the shortage of medical practitioners in many Kentucky counties, and the quality of medical care.

The Senate added the physician assistant language of Senate Bill 43 to House Bill 104, an art-therapy bill, in order to preserve an agreement between the Kentucky Medical Association and the Kentucky Academy of Physician Assistants. It will repeal the law that bans PAs from practicing for their first 18 months unless a physician is on site; one will still have to be available by telephone. The amended bill has been sent to Gov. Steve Beshear for his signature or veto.

The amendment was used because the House had tacked onto SB 43 an amendment from advance practice registered nurses that would have repealed the need for them to have a collaborative agreement with a physicians to prescribe non-narcotic drugs. The KMA opposes that idea.

"It's looking like the doctors win," said Sen. Julie Denton, R-Louisville, who favors the repeal. "I'm not hopeful" it can pass, she said, but added that some physicians also favor it: "With Obamacare coming in, we're going to need all the front-line physicians we can get." Leading opponents of the measure, Republicans Katie Stine of Fort Thomas and Carroll Gibson of Leitchfield, didn't return a call seeking comment.

Nurse practitioners say that SB 43 is necessary to allow them to fill health-care gaps in rural Kentucky and address the state's shortage of primary-care providers. The Kentucky Coalition of Nurse Practitioners and Nurse Midwives says in an article prepared for Kentucky newspapers that NPs have never been required to practice under physician supervision and 17 states allow full prescribing authority for non-scheduled medications.

The Medicaid prompt-payment bill, HB 5, went to a conference committee after the House refused to go along with Senate changes, and may be considered when the legislature returns later this month, ostensibly to consider any bills Beshear vetoes. The bill would apply prompt-payment laws to managed-care organizations and would move Medicaid late-payment complaints to the insurance department; those are now handled by the Cabinet for Health and Family Services, which administers Medicaid.

In the final crunch to pass legislation before the veto recess, lawmakers attached seven health care-related bills to HB 366, which had focused on identifying congenital heart disease in newborns. It had 10 additional measures "hung on it like a Christmas tree before the free conference committee of House and Senate members," reports Ryan Alessi of cn|2's "Pure Politics."

The bills still hanging on the measure, dubbed the "healthy Christmas tree," are:

• HB 187, addressing a free prescription-drug program for under-insured Kentuckians.
• HB 79, which would exempt licensed health care providers from being disciplined for prescribing naloxone in the event of an overdose.
• HB 387, which aims to provide nutritional supplements for low-birth-weight newborns.
• SB 201, which addresses licensed diabetes educators.
• SB 38, to require Medicaid to accept provider credentialing by a Medicaid managed-care organization.
• SB 108, relating to managed-care contracts with the IMPACT Plus program, a behavioral health program for children.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Kentucky families struggle to care for violent, mentally ill children, and say their plight has been made worse by managed-care firms.Princessiccia

Princess Health and Kentucky families struggle to care for violent, mentally ill children, and say their plight has been made worse by managed-care firms.Princessiccia

health insurance insurance Medicaid mental mental health mental illness

Gusty 20:40 Add Comment

Kentucky families struggle to care for violent, mentally ill children, and say their plight has been made worse by managed-care companies that fragment mental-health care and make it harder to find appropriate, stable treatment, which ultimately places the larger public at risk, Laura Ungar reports for The Courier-Journal.

Ungar writes that the lives of these Kentucky families resemble in part the one that lead to a devastating outcome in Newtown, Conn., where 20-year-old Adam Lanza, who had poor mental health and was under his mother�s care, went on a shooting rampage in an elementary school and killed 20 students and six staff members.

To represent the Kentucky families fighting, this battle, Ungar tells the story of the Davies family, who battle to keep themselves safe from the violent rage of their 14-year-old daughter, Lucy, while struggling to find the help she needs. Lucy has threatened to kill her 16-year-old sister, Katie, and herself, she�s tried to throw Katie and her father Dan down the basement stairs, and she�s been abusive to her mother.

Lucy suffers from a long list of disorders: neurological problems from fetal alcohol spectrum disorder, a mood disorder, post-traumatic stress disorder, and cognitive difficulties, Ungar reports. "Since Lucy was adopted at age 9, she�s received fragmented treatment in more than six facilities and doctors� offices, none of which have been able to stop her violent outbursts," Ungar writes. Now, her Medicaid managed-care insurer, Coventry Cares, won�t cover her treatment in an Illinois facility called NeuroRestorative, which Ungar says offers her the best chance at improvement.

"The care tracking is just so fragmented, and we have managed-care companies that determine from afar what care people can get. They go from provider to provider. It�s a tragedy," said Louise Howell, president of Buckhorn Children and Family Services, where Lucy was treated briefly before becoming too violent for the staff. �This child is a perfect example of someone in need of a strong therapeutic community," Howell said. "And there�s so many of them."

Before going to Buckhorn, Lucy was at Rivendell Behavioral Health Services in Bowling Green, where she received brief treatment after threatening to kill her sister. From Buckhorn she got an emergency transfer to Our Lady of Peace in Louisville, which could handle her high level of violence. She was released when she moved from the Medicaid plan Kentucky Spirit, which plans to break its contract with the state, to Coventry Cares, with which Our Lady of Peace had severed ties.

Lucy's mother told Ungar that every switch of caregiver and facility increases the trauma to her daughter, who desperately needs stable care. Lucy�s parents say she would have such stability at NeuroRestorative, where her fetal alcohol syndrome could be addressed on a long-term basis. But two doctors working for Coventry, who have never examined Lucy, told her parents that Conventry "won�t cover the placement because there�s no evidence that inpatient care for brain trauma is medically necessary," Ungar reports.

Her eyes full of tears, Cynthia Davies told Ungar, �You cannot look into my daughter�s eyes and tell me she doesn�t deserve care. She�s a human being.� (Read more)

Princess Health and Kentucky receives an F grade for its low funding of mental-health services; supply falls short of demand.Princessiccia

Princess Health and Kentucky receives an F grade for its low funding of mental-health services; supply falls short of demand.Princessiccia

health care access health insurance Medicaid mental health state budgets state government substance abuse

Gusty 20:36 Add Comment

Kentucky's supply of mental-health services is much lower than demand for those services, in terms of state funding, and the state spends only 45 percent of the national average in mental-health funding per person.

In 2010, Kentucky dedicated about $232 million to mental-health services, according to the Kaiser Family Foundation, which is $54 per person, compared with a U.S. average of $121 that year. That ranks Kentucky among the bottom 10 states without including individual mental health reimbursements for Medicaid, reports Chris Kenning of The Courier-Journal.

The state's Medicaid rates for mental-health services haven't been raised substantially in years, and only a fraction of mental-health facilities offer residential treatments, reports Kenning. He also reports the most recent �Grading the States� report of the National Alliance on Mental Illness gave Kentucky an F in 2009. The group considered measures such as the number of programs using evidence-based practices and the number of psychiatric beds.

Kentucky officials cite new efforts to improve care, such as partnering with the University of Kentucky at a new Eastern State Hospital that will open soon, and pursuing a change to allow Medicaid funding of community outpatient teams, reports Kenning. Kentucky also funds 14 regional community mental-health centers, which served 160,000 people last year, and there are 179 mental-health facilities, which include 40 offering residential care, reports Kenning.

Yet, these efforts fall short of providing mental health services for those Kentuckians in need.  In 2011, a surprisingly high 42 percent of Kentucky adult females and 31 percent of Kentucky males reported having poor mental health. Experts estimate that one in four people will suffer from some form of mental illness in a given year, which is nearly 1.1 million people in Kentucky, Kenning reports. 

It is critical for Kentucky officials to examine this issue in light of the Department of Health and Human Services rule that included mental-health benefits and treatment of substance-abuse disorders as part of the 10 "essential health benefits" insurance plans must provide when federal health reform takes full effect next year. HHS estimates it will expand mental-health and substance-abuse treatment benefits to 62 million Americans, and there is already a shortage of such services in Kentucky.

Princess Health and Kentucky hospitals gave $1.96 billion to communities in 2011, including $576.7 million cover of Medicare, Medicaid shortfalls.Princessiccia

Princess Health and Kentucky hospitals gave $1.96 billion to communities in 2011, including $576.7 million cover of Medicare, Medicaid shortfalls.Princessiccia

community health centers hospitals Kentucky Hospital Association Medicaid Medicare University of Louisville

Gusty 15:31 Add Comment

In 2011, despite economic and financial obstacles, Kentucky hospitals' estimated value of benefits to their communities up 17 percent from the year before, to $1.96 billion. So says the Kentucky Hospital Associated 2011 Community Benefits Report, compiled by the Kentucky Hospital Association with data submitted by hospitals. (Chart gives a breakdown of hospitals' total community benefits and services expenditures in 2011.)

Kentucky hospitals say they absorbed $576.7 million in 2011 shortfalls from Medicaid and Medicare, which cover 19 and 55 percent of Kentucky hospital patients; those losses were 26 percent larger than 2010, and may nearly double under federal health reform, to an estimated $852 million by 2019.

Bridging gaps created by Medicaid and Medicare underpayment is only one example of how the 131 Kentucky hospitals demonstrate their commitment to local communities by investing in community needs, the report says. In addition to covering government shortfalls, community benefits include providing charity care, forgiving bad debt and supporting medical research.

In 2011, the reports says, Kentucky hospitals financed $451 million in charity care, which means they cared for the sick and injured even if those patients could not afford care.

In Glasgow, T.J. Sampson Community Hospital and Dr. Bharat Mody (left), a general surgeon, have teamed up to fulfill the unmet health care needs of low-income, working, uninsured or under-insured adults of Barren County through a charity program called Community Medical Care. The program provides assistance with basic coverage for those who qualify, in addition to helping cover the cost of medications, glasses or hearing aids.

In 2011, Kentucky hospitals absorbed $426.5 million in bad debts, losses due to patient non-payment that often occur in hospital emergency rooms. Dennis Manners, who had a $500,000 medical bill and sometimes visited the ER 25 times a month, is one patient out of the total 22 percent of University of Louisville patients who cannot afford care and often cannot even afford their $15 co-pay. Highlighting its efforts to give back to the community, the reports says U of L developed a new treatment plan for Manners, which included sending him to a treatment center outside of Cincinnati.

Many health-improvement services in Kentucky communities, such as health fairs, screening programs, immunization clinics, health needs assessments and community planning, are financed by Kentucky hospitals. According to the report, $43.7 million was spent by these hospitals on such outreach programs that serve all ages and a number of special needs populations. For example, Northern Kentucky's St. Elizabeth Healthcare is fighting against cardiovascular disease, diabetes and stroke with its Cardiovascular Mobile Health Unit that brings vascular services to the community for easy access, screenings, risk appraisals and education.

Hospitals also spend a lot of money, an estimated $127.5 million in 2011, to ensure health professionals are properly educated -- a great need in Kentucky, where 59 of the 120 counties are designated as health professional shortage areas. One effort, the Rural Physician Leadership Program on the campus of St. Claire Regional Medical Center in Morehead, addresses this shortage by training physicians to serve in rural areas of Kentucky and the nation.

Other community benefits include subsidized health services, estimated at $32.3 million, to support programs like Highlands Regional Medical Center's Highlands Center for Autism in Prestonsburg (left). The center is the first of its type in the state and was created in 2009 to address autism in Kentucky, which is estimated by the Center for Disease Control to be diagnosed in one out of every 88 children, says the report. Each child at the Highlands center has a customized treatments plan involving psychologists, educators, behavior analysts, speech pathologists, pediatricians and neurologists, who collaborate to help children with autism reach their full potential.

The annual KHA report reminds people what hospitals do for the state and provides education about ongoing efforts. A more recognizable contribution is that Kentucky hospitals had a combined spending of $6.4 billion in 2011 on staff salaries, purchases or supplies and services that create a�ripple effect� in the overall economy to generate state businesses, jobs, and tax revenue. The reports says St. Joseph Mount Sterling, for example, provided 213 jobs and generated about $12 million in annual local payroll in 2011. Kentucky hospitals' compensation comprises 5.8 percent of all wages and salaries in the state.

The reports says hospitals are more important than ever to the overall economic health of Kentucky communities. This is the fourth year for the report, generated by the voluntary KHA survey and other data sources, including the annual survey by the American Hospital Association; Kentucky Hospital Statistics, 2013; and Kentucky Hospitals� Economic Importance to Their Communities, 2011. The KHA report covers community benefit expenditures made in 2011, which is the most recent year for which statewide data is available.

Princess Health and Food Reward Friday. Princessiccia

Princess Health and Food Reward Friday. Princessiccia

Food reward Fridays

Gusty 03:00 Add Comment

This week's lucky "winner"... fried Coke!

Read more �

Princess Health and Atherosclerosis in Ancient Mummies Revisited. Princessiccia

Princess Health and Atherosclerosis in Ancient Mummies Revisited. Princessiccia

cardiovascular disease disease diseases of civilization

Gusty 19:00 Add Comment

Many of you are already aware of the recent study that examined atherosclerosis in 137 ancient mummies from four different cultures (1). Investigators used computed tomography (CT; a form of X-ray) to examine artery calcification in mummies from ancient Egypt, Peru, Puebloans, and arctic Unangan hunter-gatherers. Artery calcification is the accumulation of calcium in the vessel wall, and it is a marker of severe atherosclerosis. Where there is calcification, the artery wall is thickened and extensively damaged. Not surprisingly, this is a risk factor for heart attack. Pockets of calcification are typical as people age.

I'm not going to re-hash the paper in detail because that has been done elsewhere. However, I do want to make a few key points about the study and its interpretation. First, all groups had atherosclerosis to a similar degree, and it increased with advancing age. This suggests that atherosclerosis may be part of the human condition, and not a modern disease. Although it's interesting to have this confirmed in ancient mummies, we already knew this from cardiac autopsy data in a variety of non-industrial cultures (2, 3, 4, 5).

Read more �

Princess Health and ZUMBA Fitness For Increasing Happiness. Princessiccia

Princess Health and ZUMBA Fitness For Increasing Happiness. Princessiccia

Gusty 15:58 Add Comment

How do you usually relieve your anxiety when you are stressed out? Eating? Spending hours in front of the television? Increasing your use of cigarettes, alcohol and drugs (both illegal and legal)? With all of these you attempt to take your mind off your worries, and sometimes it seems to work in the short term.

However, these strategies - like enjoying a chocolate cake or having an extra glass of wine - have negative consequences. In the long run, some of these behaviors which became your habit in order to increase happiness will actually decrease it. 

The Right Choice 

There is another strategy for improving mood that not only seems to make people happier, but can be the key to long-term happiness: exercise.

When we run, swim, walk, bike, Zumba, or engage in any other form of physical exercise, we generally seem to feel less anxious and happier. 

In addition to increased energy, physically active people may feel a sense of accomplishment in meeting personal fitness goals. Also, they may feel proud of the improved physical appearance that those hours in the gym have produced. And getting outdoors on a nice day - or even working out indoors around a bevy of strangers - stimulates the mind and shakes up what may be for some people an otherwise monotonous and cubicle-centric daily existence.

A Bit Of Science

Interestingly, happiness and exercise are similar in two notable ways: both are independently associated with a boost to the immune system, and also with the release of endorphins.

Both exercise and happiness lead to increased production of antibodies, which are a special type of protein produced by the immune system. People who are happy are more resistant to diseases ranging from the common cold to heart disease, while stress and anxiety tend to make people more susceptible to sickness, including diabetes and stroke. Happiness has been shown to increase antibodies by as much as 50 percent. Exercise has been shown to increase antibody production by as much as 300 percent. And since people who exercise tend to report higher levels of happiness, the exercise-induced happiness improves the immune system independent of the physiological effects of the exercise.

How To Start?

The key here is to find the exercise you really enjoy. The one where you know how good you feel afterwards. And that promise of feeling good gives you the power to get out of the house even when you feel terrible. Because you know how amazing you will feel one hour later. 

There are people who go jogging, or swimming or biking, and there are many who go to an energizing Zumba Fitness class. 

Never tried ZUMBA? Join one of our Zumba classes in Dublin 2, Dublin 6 or Dublin 8 and I'm sure you won't regret!

To see times, locations and maps, CLICK HERE

Source for this article:

http://science.howstuffworks.com/life/exercise-happiness.htm

Princess Health and Poll shows Kentucky health-care providers often fail to discuss HIV testing with patients.Princessiccia

Princess Health and Poll shows Kentucky health-care providers often fail to discuss HIV testing with patients.Princessiccia

AIDS doctors Foundation for a Healthy Kentucky HIV medical education nurse practitioners physician assistants physicians poll

Gusty 14:51 Add Comment

A new poll suggests that most Kentucky health-care providers follow guidelines for discussing HIV screening with their patients, despite the the importance of early treatment to prevent its progression to AIDS.

Although the Centers for Disease Control and Prevention recommends routine HIV screenings for most patients, just 32 percent of Kentucky adults aged 18 to 64 report discussing HIV testing with their medical provider, according to the Kentucky Health Issues Poll.

About 40 percent of Kentucky adults reported they had never been tested for HIV. It�s estimated that 4,500 Kentuckians are living with HIV infection and it is estimated nationally that one in five people who have HIV do not know they do.

�It made headlines earlier this month when a little girl - the second person in history - was cured of HIV. As exciting as this development was, for most people, HIV remains a life-long condition that must be managed through medication to keep it from progressing to AIDS. The CDC�s recommendations are meant to improve the overall population health by detecting HIV so treatment can begin,� said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll.

�It appears that Kentucky providers are either not adhering to the routine screening recommendations or not communicating this message clearly to patients,� she said.

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points

Princess Health and Conway, other AGs ask FDA to require generic prescription pain pills to be abuse-resistant, tamper-resistant.Princessiccia

Princess Health and Conway, other AGs ask FDA to require generic prescription pain pills to be abuse-resistant, tamper-resistant.Princessiccia

attorney general drug abuse drug companies food and drug administration generic drugs prescription drug abuse prescription drugs

Gusty 14:47 Add Comment

Generic versions of popular pain relievers must be made harder to abuse, in order to curb prescription drug abuse that is epidemic in many states, Attorney General Jack Conway and 47 other attorneys general said in a letter sent to federal officials Monday.

The National Association of Attorneys General letter encourages the Food and Drug Administration to adopt standards requiring manufacturers and marketers of generic prescription painkillers to develop tamper- and abuse-resistant versions of their products, because the attorneys general are concerned that non-medical users are shifting to non-tamper-resistant formulations of generic opioids.

�Prescription drug abuse is an epidemic that kills more than 1,000 Kentuckians each year,� Conway, who co-chairs NAAG�s Substance Committee, said in a news release. �The development of tamper-resistant and abuse-deterrent opioid drug products is a valuable aid to the law enforcement, legislative and public awareness initiatives many of us have implemented in our states to combat prescription drug abuse.�

Prescription drugs can be deadly when abused, and fatal drug overdoses are now the leading cause of death due to unintentional injury in the United States and Kentucky, exceeding even motor vehicle deaths, according to the Centers for Disease Control and Prevention. Federal data show that U.S. drug overdose deaths totaled 38,329 in 2010, rising for the 11th straight year, and accidental deaths involving addictive prescription drugs overshadow deaths from illicit narcotics.

In Kentucky, the number of drug-overdose deaths in Kentucky rose a staggering 296 percent from 2000 to 2010, according to the Kentucky Injury Prevention and Research Center. Kentucky is one of the most medicated states in the country, and has the sixth highest overdose rate. Last year, 220 million doses of the highly addictive painkiller hydrocodone were dispensed in the state -- that�s 51 doses for every man, woman and child in the state, says the AG release.

The news release from Conway's office said he led the effort to reach out to the FDA, along with Attorneys General Luther Strange of Alabama, Pam Bondi of Florida and Roy Cooper of North Carolina. Click here to read the letter; for a news release, click here.

Princess Health and Bill encouraging schools to stock EpiPens to stop deadly allergic reactions will become law.Princessiccia

Princess Health and Bill encouraging schools to stock EpiPens to stop deadly allergic reactions will become law.Princessiccia

allergies food allergies General Assembly legislation legislature state government

Gusty 14:39 Add Comment

A bill encouraging Kentucky schools to stock EpiPens, or epinephrine auto-injectors, to stop anaphylaxis, a life-threatening allergic reaction, has passed will soon be signed into law by Gov. Steve Beshear.

When someone has anaphylaxis, the sooner you use an EpiPen, the better the outcome can be, said Thomas Sternberg, an allergist at Graves-Gilbert Clinic in Bowling Green, told Alyssa Harvey of the Daily News.

Under House Bill 172, schools could keep at least two EpiPens in case of emergency, and school boards would develop and approve policies and procedures for managing a student�s life-threatening allergic reaction, reports Harvey.

The bill also helps schools receive or buy the auto-injectors through local health departments and directs the state Department for Public Health to develop clinical protocols for using the auto-injectors in schools. Harvey reports that EpiPens can be donated to schools, and the EpiPens for Schools Program will provide up to four free auto-injectors per school year; if more are needed, they can be purchased at a discounted rate.

"You don�t know when someone could have an anaphylactic reaction,� Rep. Addia Wuchner, R-Florence, who sponsored the bill, told the Daily News. She alluded to an incident in Virginia, where a 7-year-old student died last year after an anaphylactic reaction, and no medications were available at the school to treat her. "There could be a hero in the school who was able to reach for that epinephrine pen and save a child�s life and not a tragedy like in Virginia,� Wuchner said. She filed the bill late in the 2012 session, but the language has been revised for this year's session to encourage rather than mandate schools to stock EpiPens.

Amy Wallace, treasurer and former president of the Bowling Green area's Food Education Allergy Support Team, told Harvey she was disappointed schools will not be required to make necessary provisions, but said advocates of the bill are happy to see that the problem is being addressed. (Read more)

Princess Health and Feds letting Arkansas privatize Medicaid expansion; idea could spread like wildfire, as in Florida, but cost questions remain.Princessiccia

Princess Health and Feds letting Arkansas privatize Medicaid expansion; idea could spread like wildfire, as in Florida, but cost questions remain.Princessiccia

Affordable Care Act health care costs health care reform health insurance health policy insurance Medicaid Patient Protection and Affordable Care Act politics state governments

Gusty 18:58 Add Comment

Arkansas has turned heads nationally with its preliminary plan to expand Medicaid using the private insurance market, showing that the Obama administration is willing to give states more flexibility than expected in expanding the program.

Health and Human Services Secretary Kathleen Sebelius has agreed to a proposal by Arkansas Gov. Mike Beebe to reject the Medicaid expansion but use federal money to buy private health insurance for the 200,000 people who would have been covered under ordinary expansion, reports Sandhya Somashekhar of The Washington Post.

States that have come down on either sides of the Medicaid-expansion issue may reconsider their decision in light of the Arkansas proposal, said Sara Rosenbaum, a health law professor at George Washington University. "If Arkansas is allowed to do this, I expect it to spread like wildfire," Rosenbaum told the Post.

The first place could be Florida, where a state Senate committee rejected Republican Gov. Rick Scott's expansion plan and proposed a privatization plan like that in Arkansas. Last week, a House committee voted to reject any expansion of the program. Scott "made it clear he was not going to lobby the Legislature on Medicaid," preferring to emphasize other issues, The New York Times' Lizette Alvarez reports. For coverage from the Tampa Bay Times and The Miami Herald, click here.

Could the wildfire spread all the way up to Kentucky?

Gov. Steve Beshear has said he wants to expand Medicaid in Kentucky if the state can afford it, but many Republican lawmakers oppose the idea, saying it would not be fiscally responsible. On the national level, 26 states and the District of Columbia have expressed a desire to expand Medicaid, 17 have said they reject it and seven are undecided, according to the nonpartisan Kaiser Family Foundation.

A more flexibile arrangement could be a game changer because it makes expansion more appealing, especially for states where expanding Medicaid has been politically unpopular and polarizing. in Arkansas, which has a Democratic governor and a Republicna legislature, officials say that from an ideological standpoint, using private insurance appeals to lawmakers from both parties, reports Somashekhar. She reports that even Democratic-led states might prefer this arrangement because it gets rid of some bureaucratic hurdles.

However, there are questions about cost. The Congressional Budget Office estimates that private insurance plans cost $3,000 more per person than Medicaid, reports Somashekhar. On the other hand, Arkansas officials say the move could ultimately save money in administrative charges along with other cost-control measures.

Although the Arkansas proposal is not concrete, it provides proof that the Department for Health and Human Services encourages innovative, state-based approaches to promote expansion. Many states may develop a new route best suited to their specific needs, without having to leave federal money on the table. (Read more)

Princess Health and Deadly, recalled pills still circulating in Pennyrile Region.Princessiccia

Princess Health and Deadly, recalled pills still circulating in Pennyrile Region.Princessiccia

drug companies drugs food and drug administration pain pain management

Gusty 18:52 Add Comment

A pain reliever that has been recalled and declared dangerous by the Federal Drug Administration is still circulating around southern Kentucky.

The drug marketed under the name Reumofan Plus is being distributed in Elkton and the broader Pennyrile Region, despite being recalled, and a local doctor's office says patients on the drug have had dangerous side effects, reports Nick Tabor of the Kentucky New Era.

Dr. Keith Toms of Generations Primary Care told Tabor three of his patients have taken the drug and had bad side effects. One patient had dangerous elevations of liver enzymes, and two diabetic patients had dangerous spikes in blood sugar.

The Food and Drug Administration has received reports of deaths, strokes, severe internal bleeding, dizziness, insomnia, high blood sugar and other problems associated with the drug since June. The manufacturer, operating under the names Reumofan Plus USA, LLC and Reumofan USA, LLC, announced a voluntary product recall last month, reports Tabor.

According to the FDA, undeclared ingredients in the drug, which is used as a treatment for muscle pain, arthritis, osteoporosis, bone cancer and other conditions, could result in serious illness. Tabor reports a FDA laboratory analysis of Reumofan Plus found that it contains diclofenac sodium, a non-steroidal anti-inflammatory drug, and methocarbamol, a muscle relaxant.

Tabor reports the FDA has issued an alert telling consumers to stop taking the drug immediately and consult a health-care professional. The agency also said it may follow up on the Reumofan recall with warning letters, seizure, injunction requests or criminal charges. (Read more)

Princess Health and Survey finds employees pay greater share of health costs, and most large employers penalize them for using tobacco.Princessiccia

Princess Health and Survey finds employees pay greater share of health costs, and most large employers penalize them for using tobacco.Princessiccia

employers health care costs health insurance health reform smoking tobacco tobacco prevention

Gusty 18:46 Add Comment

As large employers respond to changes influenced by health care reform and rising costs of care, employees are paying a greater portion of their health-care costs. That trend that is likely to continue over the next few years, says a new report on employer-based health plans.

Although employers cover most costs of work-based plans, employees contribute 42 percent more for health coverage than they did five years ago, while employers paid 32 percent more, according to the study from the benefits consultant Towers Watson and the National Business Group on Health. Overall, costs went up 34.4 percent.

When employers were asked if they thought health plans would change by 2018, which is the year the excise tax on high-cost plans takes effect, 92 percent said plans would be different, and nearly half said they expect a significant or transformative change. Such change will increase both accountability and engagement for employees.

% of large employers saying they were "very confident" they would offer health benefits in 2022

Nearly two-thirds of employers surveyed offer employees financial rewards to encourage participation in health programs, according to the report, which said tying employee contributions to successful completion of specific tasks, such as health assessments and screenings, remains the most popular contribution strategy. Growth in the use of penalties to engage employees in health-program participation has slowed over the last two years, but the use of surcharges for tobacco use continues to grow. By 2014, 62 percent of surveyed companies are expected to apply tobacco-use surcharges.

"While U.S. employers remain committed to health care benefits for active employees over the next five years," the report says, "they are redifining their financial commitment in the short run and are more reluctant to commit to coverage for employees over a longer period."

The 18th annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care tracks employers' strategies and practices. It was completed by 583 employers,between November 2012 and January 2013. The report says it identifies the actions of the best performing companies as well as current trends in health-care benefit programs of U.S. employers with at least 1,000 employees. Survey respondents collectively employ 11.3 million full-time employees and have 8.5 million employees enrolled in their health care programs. Download a report PDF by clicking here.