Princess Health and Kids Count report finds Ky. remains in the bottom 1/3 of states for children's well-being; is this a predictor of the state's future?. Princessiccia

Princess Health and Kids Count report finds Ky. remains in the bottom 1/3 of states for children's well-being; is this a predictor of the state's future?. Princessiccia

children children's health economy education poverty pregnancy research teens wellness youth

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By Melissa Patrick
Kentucky Health News

If Kentucky's future lies in the well-being of its children, there's reason to worry, because a recent report shows that Kentucky consistently remains in the bottom one-third of states for this measure.

The 2016 Kids Count report ranks Kentucky 35th in the overall well-being of its children, down from 34th last year. The state showed a significant improvement in its health ranking and a further drop in its teen birth rate, but otherwise didn't show much change from last year's report by the Annie E. Casey Foundation and Kentucky Youth Advocates.

"The real issue is not a drop or increase of one position, but rather that Kentucky continues to be in the bottom one-third of all states," KYA Executive Director Terry Brooks said in a news release. "Are we really content with the idea that two-thirds of America's children are better off than Kentucky kids?"

The annual report offers a state-by-state assessment that measures 16 indicators to determine the overall well-being of children. The latest data are for 2014, and is compared with data from the last six or so years earlier. The report focuses on four major domains: economic security, education, health and family and community security.

Kentucky continues to rank highest in health, climbing to 16th from 24th in 2015, 28th in 2014 and 31st in 2013. Contributors included a continued drop in the number of children without health insurance (4 percent); a 15 percent decrease in child and teen mortality, fewer teens abusing alcohol or drugs (4 percent) and improvements in the percentage of low-birthweight babies (8.8 percent).

The state's greatest drop among the rankings was in economic security, going down to 37th from 32nd last year. Education (27th) saw a slight improvement from the past two years and the family and community (38th) rankings remained similar to the past three years.

The release notes that the state now ranks 10th for the percentage of children with health insurance.

"We are seeing better outcomes for kids in Kentucky, and expanded health coverage and access to quality care play a vital role in making that happen," Susan Zepeda, CEO of the Foundation for a Healthy Kentucky, said in the release. "Research shows that when parents have health coverage, their children are more likely to also be signed up for health insurance."

Another bright spot in the report is that the state's teen birth rate continues to drop. It declined 34 percent from 2008 to 2014. While Kentucky still has one of the nation's highest teen birth rates, it dropped to 35 births per 1,000 girls aged 15-19 in 2014, down from 39 per 1,000 in 2013 and 53 per 1,000 in 2008. The national average is 24 per 1,000, an all-time low.

Kentucky consistently ranks lowest in the "family and community" domain, with 35 percent of its children living in single-parent families; 12 percent living in families where the household head lacks a high school degree; and 16 percent living in high-poverty areas, which are neighborhoods where more than 30 percent of residents live in poverty.

"Kentucky will thrive when policies that support the whole family, caregiver and child, are implemented," Adrienne Bush, executive director of Hazard Perry County Community Ministries, said in the release.

And though the state's education ranking improved to 27th from 30th, not much has changed in these indicators since the foundation started doing this report. The bottom line is that more than half of fourth graders (60 percent) still can't read at a national proficiency level and that the majority of eighth graders (72 percent) still aren't proficient in math. (In 2007, these indicators were 67 percent and 73 percent respectively.)

"Student performance should alarm parents and business leaders and jolt Kentucky leaders into making fundamental education reform a policy priority to ensure college and career readiness," Brooks said.

In addition, more than half the state's three-and four-year-olds (58 percent) don't attend pre-school and 17 percent of its high school students don't graduate on time.

Perhaps the direst message from the report is about the state's economic well-being. One in four Kentucky children live in poverty (26 percent), a rate that has remained higher than it was pre-recession when it was 23 percent, says the release. Nationally, the child poverty rate is 22 percent.

"Growing up in poverty is one of the greatest threats to healthy child development," says the report. "Poverty can impede cognitive development and a child's ability to learn."

The report also says 35 percent of Kentucky's children live in homes with parents who don't have secure employment, which places the state in the bottom 10 states for this indicator. It also found that 28 percent live in households with a high housing-cost burden.

The release suggested "bipartisan solutions" to improve the well-being of Kentucky's children, including expanding oral health coverage; supporting school-based health centers; education reform that includes public charter schools, expanded child care assistance and family-focused tax reforms.

Princess Health and Wellness coalition in Perry County, where life expectancy is state's lowest, gets funding from Foundation for a Healthy Ky.. Princessiccia

Princess Health and Wellness coalition in Perry County, where life expectancy is state's lowest, gets funding from Foundation for a Healthy Ky.. Princessiccia

Appalachia children children's health education farm to school farmers' markets food Foundation for a Healthy Kentucky foundations grants hospitals life expectancy nutrition philanthropy schools

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The Foundation for a Healthy Kentucky has funded the Perry County Wellness Coalition's three-year plan to encourage fitness and better nutrition in school-age children, "Kids on the Move!"

The wellness coalition will receive $144,450 from the foundation this year, matched by $124,944 from the community, to increase access to physical activity and provide healthier food options and nutrition education. Perry County has the lowest life expectancy in Kentucky.

"Our children are the most valuable resource we have," said Gerry Roll, executive director of the Foundation for Appalachian Kentucky, which is serving as fiscal agent for the coalition. "It's the best investment we can make as a community partner."

The health coalition will work with local schools to implement physical activity and nutrition-policy changes, collaborate with local farmers' markets for a strong farm-to-school component, and coordinate with other community agencies to create a lasting and collective impact.

The project also will implement best-practices nutrition and exercise programs in schools, support community gardens, summer feeding programs, and a "Farmacy" program to increase the purchase of healthier produce at farmers' markets and local grocery stores, among other changes to be coordinated by the agencies in the coalition.

The Appalachian Regional Healthcare hospital in Hazard will be the administrative hub for the coalition, providing leadership and sharing its expertise in promoting community health. "We have already begun these efforts by providing fitness fairs and health screenings to over 20 schools in our service area and reaching a little more than 2,500 middle school and high school age kids this year alone," said Hazard ARH Community CEO Dan Stone said.

The coalition is among seven Kentucky communities funded by the foundation's "Investing in Kentucky's Future" initiative, which is spending $3 million over five years to fund communities working to improve the health of their school-aged children. The other groups are in Breathitt, Clinton, Grant, Jefferson and McLean counties, and in Boyd and Greenup counties. Perry County was in the original announcement and recently completed its detailed plan. It shares with Breathitt and Wolfe counties the state's lowest life expectancy, 70 years.

Princess Health and Salmonella outbreak in 35 states linked to live poultry; 21 cases reported in Kentucky; here are some tips to avoid infection . Princessiccia

Princess Health and Salmonella outbreak in 35 states linked to live poultry; 21 cases reported in Kentucky; here are some tips to avoid infection . Princessiccia

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U.S. Centers for Disease Control and Prevention photo

Poultry specialists from the University of Kentucky are urging Kentuckians who raise chickens or ducks to take extra precautions against salmonella infection, since 21 cases have been reported in the state.

�Any contact with live poultry puts you at risk for salmonella infection,� Jacqueline Jacob, UK poultry extension project manager for the College of Agriculture, Food and Environment, said in a news release. �Salmonella germs can be in the birds� droppings and on their bodies and also on their cages, coops, hay, plants and the soil where they live and roam.�

Salmonella is a bacteria that makes people sick. Symptoms usually develop 12 to 72 hours after exposure and include diarrhea, fever and abdominal cramps. The illness usually lasts four to seven days. Children under 5, adults older than 65 and those with weakened immune systems are at the greatest risk of being severely affected.

These infections are part of a seven-state salmonella outbreak that have all been linked to contact with life poultry from multiple hatcheries. Jacob cautioned that any chicken can carry salmonella, even if it looks clean and healthy.

So far, more than 300 people have been infected, with more than one-fourth of those children aged 5 or younger, according to the federal Centers for Disease Control and Prevention.

�Many of the cases in the current outbreak are linked to backyard flocks, so we want to remind folks of simple things they can do to protect themselves," Jacob said.

Tips to avoid infection:

• Wash hands thoroughly with soap and water immediately after touching live poultry or anything in the area where they live.
• Do not let live poultry inside the house, or around areas where food or drink is located.
• Do not let children younger than 5 handle or touch live poultry without supervision.
• Adults should supervise the handwashing of young children.
• Keep poultry away from your nose, mouth and eyes.
• Wash your hands with sanitizer that has a 99 percent or higher bacteria kill rate after handling poultry at shows and fairs.

�It�s also a good practice to be careful when you wash equipment or eggs in the kitchen sink,� Jacob said. �You don�t want to cross contaminate food. Always use a good disinfectant to clean up in the kitchen when you�re finished.�

Click here for more advice from the CDC for backyard flock owners.

Princess Health and Youth injuries from e-cigarettes spike; FDA is starting to regulate them, but study authors say not enough to protect children. Princessiccia

Princess Health and Youth injuries from e-cigarettes spike; FDA is starting to regulate them, but study authors say not enough to protect children. Princessiccia

children's health e-cigarettes federal legislation research vaping

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By Melissa Patrick
Kentucky Health News

The number of young children swallowing or being exposed to the liquid nicotine used in electronic cigarettes has "skyrocketed," jumping 1,500 percent from 2012 to 2015, one co-author of a recent study says.

"E-cigarettes and liquid nicotine can cause serious poisoning, and even death, among young children," Dr. Gary Smith, co-author of the study, told Randy Dotinga for HealthDay. "Like other dangerous poisons, they should be kept out of sight and reach of children, preferably in a locked location."

The research, published online May 9 in the journal Pediatrics, follows an announcement that the U.S. Food and Drug Administration will now regulate e-cigarettes. The rule bans the sale of e-cigarettes to minors, requires health warnings on all packaging and advertisements and requires manufacturers to get federal approval on all products introduced to the market after Feb. 15, 2007. It does not address marketing or advertising. The measure goes into effect Aug. 8, and gives affected industries two years to comply.

E-cigarettes, which are battery-powered devices that heat up fluid that includes nicotine and other ingredients such as flavors and chemicals, have become increasingly popular. They are now the most common form of nicotine use among teenagers. Researchers found that it is the liquid nicotine that poses the greatest danger to children.

The study looked at calls to the National Poison Data System about nicotine and tobacco products from January 2012 to April 2015, and focused on calls about children under the age of 6. The NPDS received 29,141 calls for nicotine and tobacco product exposure during this time, averaging 729 child exposures per month.

It found about 14 percent, or 4,128 of the calls were about exposure to e-cigarettes and involved children aged 2 or younger. Most of the exposures were due to ingestion.

"Children exposed to e-cigarettes had five times higher odds of a health care facility admission and almost 3 times higher odds of having a severe outcome than children exposed to cigarettes," says the report. "One death occurred in association with a nicotine liquid exposure."

"These are not trivial exposures. There were comas, seizures, and even one death in the 40-month period we studied, and these exposures were predictable and preventable," Smith told MedPage Today. "E-cigarettes and vaping liquids are products that should never have entered the market without adequate consideration of the harms they could cause to young children."

Smith, also the director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Ohio, told HealthDay that more needs to be done.

"Other prevention steps include prohibiting the use of flavors, as was done for cigarettes since 2009, restricting the use of packaging and labeling attractive to children, ensuring that liquid nicotine compartments on e-cigarettes are child-resistant, and limiting the concentration and/or quantity of nicotine in refill products," he said.

Gregory Conley, president of the American Vaping Association, a nonprofit group dedicated to education about e-cigarettes and vapor products, told HealthDay that the concern about e-cigarettes is "overblown."

He told HealthDay that the child who died "consumed a homemade nicotine liquid concoction that's much stronger than retail versions." He also pointed out that the number of cases have declined since this study was conducted, saying that this is likely due to increased publicity about the risk.

Co-author Henry Spiller, director of the Central Ohio Poison Center at Nationwide Children's Hospital, encouraged parents of young children who vape to treat liquid nicotine like a poison, suggesting that they keep refill containers "up, away and out of sight, preferably in a locked location" and to not leave vaping devices laying around.

Study authors encourage parents to call the Poison Help Line immediately, at 1-800-222-1222, if their child has been exposed to e-cigarettes.

Princess Health and KET programs focus on oral health, 'just as critical to the well-being of Kentuckians' as problems that have a higher profile. Princessiccia

Princess Health and KET programs focus on oral health, 'just as critical to the well-being of Kentuckians' as problems that have a higher profile. Princessiccia

children children's health dental care dental health dentistry oral health seniors

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Kentucky Educational Television has turned its attention to oral health, which it says is "just as critical to the well-being of Kentuckians" as the state's "alarmingly high rates of cancer, heart disease, diabetes, and obesity."

KET's John Gregory, in a story about three recent programs, notes that two in five Kentucky children have never been to a dentist and "Poor oral health can contribute to other physical problems like diabetes, cardiovascular disease, and possibly even Alzheimer�s. It can impact how students learn."

�There�s thousands of children on a daily basis attending school with pain that is totally preventable,� Louisville health-care consutant Lacey McNary said on KET's "Connections" with Renee Shaw. �It is really hurting them with their success rates in school and otherwise overall well-being.�

McNary and Dr. Laura Hancock Jones, a dentist with the University of Kentucky's Western Kentucky Dental Outreach Program, blamed the lack of dentists in rural Kentucky and the refusal of many dentists to accept Medicaid, which covers 1.3 million Kentuckians.

But there are more longstanding factors, such as smoking, which makes periodontal disease six times more likely, and eating habits. "Jones says foods rich in carbohydrates and beverages that are high in sugar create the perfect breeding ground for bacteria that feed tooth-eating acids," Gregory reports.

And Jones says we have other bad habits, too: "She says studies show that almost a third of the population never flosses, and brushing and flossing twice a day is recommended. She adds that fear also contributes to bad oral health outcomes."

Other recent reports from KET have reported on a study of the state's oral health, the importance of good oral-health practices to seniors, and how the use of dental sealants in schools with high-risk populations has helped improve oral health.

The latter program featured Dr. M. Raynor Mullins, professor emeritus at UK's College of Dentistry, who "was instrumental in getting dental sealants added to Kentucky�s Medicaid program as a preventive service in the 1990s and has been involved with numerous oral health outreach initiatives across the state during the past 40 years," Gregory reports.

�A tooth has multiple surfaces � smooth surfaces and pit-and-fissure surfaces,� Mullins explains. �Smooth surfaces are the sides of the teeth, and fluorides are very effective about strengthening them. On the other hand, you have these pits, crannies, and fissures on the tops of the teeth and in certain locations on the sides of the teeth, where they are very susceptible to the infection of tooth decay. Sealants are very effective in preventing pit-and-fissure decay.�

Princess Health and Clinton County coalition works to change the health lifestyle of its children, in an effort to change the local health culture. Princessiccia

Princess Health and Clinton County coalition works to change the health lifestyle of its children, in an effort to change the local health culture. Princessiccia

child obesity children children's health exercise health rankings nutrition school lunch school nurses schools youth

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By Melissa Patrick

Kentucky Health News

Public officials and local leaders in a small, rural county in Southern Kentucky that ranks near the bottom of in the County Health Rankings for the state have formed a coalition to improve the health of its community, with a focus on its children.

Clinton County (Wikipedia map)

Clinton County ranked 102nd out of 120 Kentucky counties in the 2016 County Health Rankings. �We recognize that. We saw that in our kids,� Lora Brewington, chief compliance officer of Cumberland Family Medical Center Inc., told Kentucky Educational Television in a report to be aired soon about the coalition.�And if we don�t change something now, we�re going to be going to the funeral home for kids a lot younger.�

So, with the help of the Foundation for a Healthy Kentucky, they formed the Clinton County Healthy Hometown Coalition to implement a multi-faceted public health program for the community's citizens, that focuses on its children.

�The coalition came together [according to] Aristotle�s thinking, that the whole is greater than the sum of its parts,� Brewington told KET. �We have a lot of great groups, that do a lot of great things, but if everyone is going for the same goal, and the resources are not combined, you�re not going to accomplish anything. And once we get everybody together and on the same page, by combining resources, we�ve been able to do some great things.�

Paula Little, assistant superintendent and supervisor of instruction for Clinton County schools, told KET that the coalition recognized most of the county's health issues stemmed from obesity, and decided to focus their efforts on the children in the community to change their culture.

"So we feel like if we can start young and start with our children and teach them healthy habits and healthy lifestyles that when they grow up they won't be faced with obesity and all of those chronic diseases that go with it," Little said.

Many of the coalition�s activities are school-based. Teachers have incorporated physical activity into the school day as well as during their morning routines and after-school day-care programs.

The coalition has worked with the schools to improve nutrition. Fruits and vegetables are now served every day with every meal. The schools also began offering supper to students during the school year and has since served over 6,400 meals. The program began last October.

Recognizing that an estimated 38 percent of Clinton County's children live in low-income families, the coalition launched a summer food program that delivers breakfast and lunch in a retrofitted school bus called the Bus Stop Caf� to areas in the county with high student populations.

The Healthy Hometown Coalition has also implemented school-based health clinics, which provides for the healthcare needs of students through a public-private partnership while they are at school. The clinics are run by the Cumberland Family Medical Center. In addition to providing clinical care, the clinics provide body mass index assessments and provide nutrition and obesity counseling.

�It�s about accessibility,� Brewington said. �It�s about the kid who has a cough and needs to see a doctor, but the parent can�t take off from work. ...It's about having healthcare right there where the child is the majority of the time."

Not mentioned in the KET report is that Clinton County schools implemented a comprehensive smoke-free policy last year that will go into effect in July. The policy will ban smoking on school property both during school hours and during school sponsored events, and also includes electronic cigarettes and all vapor products.

The coalition is working to change the culture of its community so that a healthy lifestyle becomes the norm, and not the exception.

�When you�re attempting to change a culture, and change the way people live, that�s a very long process,� Little said. �And it has to be something that�s consistent, that�s ongoing, and it has to be a message that children hear everywhere they go in the community.�

A full-time coordinator, April Speck, manages the various coalition programs and writes a weekly health column in the Clinton County News that often celebrates individual success stories. The coalition also sponsors community events, and has built a new playground.

�What makes me feel good about it is that I know there�s a real need here,� Speck told KET. �There�s a lot of kids who have childhood obesity... And just seeing them start to make changes in what they are doing, how much they are eating, their water intake, I know that we�re making an improvement.�

Princess Health and Clark County schools to provide mental health services via contract with agency that can bill Medicaid or private insurance. Princessiccia

Princess Health and Clark County schools to provide mental health services via contract with agency that can bill Medicaid or private insurance. Princessiccia

behavioral health children's health education Medicaid mental health schools teenagers teens youth

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Facing a surge in behavioral health cases among students, the Clark County Board of Education has contracted with a mental-health agency services for all preschool through high school students in the district.

Mountain Comprehensive Care will place a mental health therapist in every school to address issues immediately, at no cost to the district, Whitney Leggett reports for The Winchester Sun: "In the past three years, the district has seen the number of students in the home-hospital program because of mental-health issues surpass those with physical ailments."

Greg Hollon, director of pupil personnel and support services, told Leggett, �Previously, about 80 percent of home-hospital students were for physical ailments and 20 percent for mental. Fast forward a couple of years later, and that has switched to 65 percent mental, 35 percent physical.�

Hollon said the therapists at each school will help the district stay on top of problems. �This puts someone in the buildings full time to be there to address issues as they occur,� rather than requiring staff to call Mountain or some other agency.

Mountain, based in Prestonsburg, is able to provide the service without charge because it can bill Medicaid or private insurance.

Princess Health and Pediatricians' national group calls for at least one nurse in every school; Ky.'s schools have a long way to go to meet that goal. Princessiccia

Princess Health and Pediatricians' national group calls for at least one nurse in every school; Ky.'s schools have a long way to go to meet that goal. Princessiccia

children's health pediatrics school nurses state budget youth

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By Melissa Patrick
Kentucky Health News

Kentucky's high schools fall far short of new recommendations by the American Academy of Pediatrics that call for every school in the United States to have at least one nurse on site.

Only 42.2 percent of Kentucky's high schools have a full-time nurse, 37.4 percent have a part-time nurse and 20.4 percent do not have one at all, according to research led by Teena Darnell, assistant professor of nursing at Bellarmine University.

"School nurses improve school attendance and decrease the dropout rate which leads to better academic outcomes. . . . Most importantly, they help keep the nearly 680,000 children attending public school in Kentucky safe, healthy and ready to learn," Eva Stone and Mary Burch said in an e-mail to Kentucky Health News.

Stone, an advanced-practice registered nurse, is the director of student support services for Lincoln County Schools. Burch is the health coordinator for Erlanger-Elsmere Schools.

The pediatrics academy's policy statement, published in its journal Pediatrics, replaces a previous recommendation that districts have one nurse for every 750 healthy students, and one for every 225 students who need daily professional nursing assistance.

"The use of a ratio for workload determination in school nursing is inadequate to fill the increasingly complex health needs of students," says the policy statement.

School nurses today monitor more children with special needs, help with medical management in areas such as attention-deficit/hyperactivity disorder, diabetes, life-threatening allergies, asthma and seizures and also provide immunizations, work on obesity prevention efforts and provide substance abuse assessments, among other things, says the statement.

As school nurses have been eliminated from school budgets, school-based health centers, which provide health care to students through a public-private partnership, have become popular. This model allows schools to bill private insurance or Medicaid for services to offset some of the costs.

Most recently, the Carter County Board of Education unanimously approved a one-year contract with Kings Daughters Medical Center of Ashland to provide its school health services, Joe Lewis reports for the Grayson Journal Times. The hospital will provide a nurse practitioner who will rotate throughout the district's schools.

That doesn't comply with the new guidelines to have one nurse in every school, but the program plans to use telemedicine to keep the nurse practitioner connected to the schools throughout the day.

"Unfortunately, Kentucky has no requirement to have a registered nurse in every school," Stone and Burch write. "Every school needs a nurse. What we see in the schools is a reflection of the health of the community. Kentucky is missing an incredible opportunity to not only keep children safe at school but also to implement a system of improving long term health in the commonwealth."

Princess Health and Slicing your way to an apple a day: Americans' apple consumption is on the rise because we're eating them in small pieces. Princessiccia

Princess Health and Slicing your way to an apple a day: Americans' apple consumption is on the rise because we're eating them in small pieces. Princessiccia

children's health diet health nutrition school health school lunch

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Photo from livestrong.com

By Danielle Ray
Kentucky Health News

Presentation is everything. Apple consumption is on the rise, and researchers at Cornell University think pre-sliced apples are the cause.

The 2013 Cornell study explored why so many whole apples served in school lunches ended up uneaten in the trash. Researchers found that eating whole apples can be difficult for young children with small mouths and for kids with missing teeth or braces. The study also noted that older girls find whole fruits messy and unattractive to eat.

The study found that consumption jumped by more than 60 percent when apples were served sliced. These findings back up U.S. Department of Agriculture statistical data about overall apple consumption. Data show that Americans ate more than 510 million pre-sliced apples in 2014, up from fewer than 150 a decade before.

Likewise, overall apple consumption has grown by 13 percent percent since 2010, according to USDA data. Americans ate about 17.5 pounds per capita in 2013, the most in nearly a decade.

Why does simply slicing an apple matter? The difference between a whole apple and apple slices may seem silly or superficial, especially to an adult, but the inconvenience is a barrier nonetheless, David Just, a professor of behavioral economics at Cornell and one of the researchers behind the study, told Roberto Ferdman of The Washington Post.

"It sounds simplistic, but even the simplest forms of inconvenience affect consumption," Just said. "Sliced apples just make a lot more sense for kids."

The rise of mass-produced pre-sliced apples probably has a lot to do with the fast food industry. McDonald's added apple slices to its menu in 2004 in an effort to give parents healthier options. The company began automatically serving apple slices with Happy Meals in 2012, causing apple sales to skyrocket.

McDonald's has served more than 2 billion packages since first offering apple slices as a side, a representative for the company told the Post. In 2015 alone, the company served nearly 250 million packages of sliced apples, which amounts to more than 60 million apples, or about 10 percent of all fresh sliced apples sold in the United States, the Post noted.

The USDA, which oversees school lunch programs, can't be sure of how many schools offer pre-sliced apples versus whole apples, as local school districts make that decision. However, the agency does make recommendations and encourages schools make fruit appealing in presentation.

The problem with the pre-sliced apple trend? It may lessen food waste, but it increases plastic waste, which puts a strain on the environment. McDonald's apple slices, for example, are served in plastic wrappers. These wrappers are recyclable, yes, but two important differentials exist. First, "recyclable" does not mean it was made of recycled materials, only that it has the potential to be recycled. Second, just because consumers can recycle the wrappers does not mean they will.

Princess Health and House Republicans want to make it harder for schools to get free meals for all students; could affect more than 350 Ky. schools. Princessiccia

Princess Health and House Republicans want to make it harder for schools to get free meals for all students; could affect more than 350 Ky. schools. Princessiccia

children children's health food income nutrition poverty school health school lunch schools

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Photo from npr.org

By Danielle Ray
Kentucky Health News

Kentucky school officials are concerned about a proposal by Republicans in the U.S. House that would make it harder for schools to offer free meals to all students using federal money.

The House is considering changes to the 2010 Hunger-Free Kids Act, now in its second year, which allows schools who serve a high-poverty population to offer free meals to every student.

Instead of collecting individual applications for free or reduced-price meals, the Community Eligibility Provision uses data that illustrates how many students in a given school may be "food-vulnerable": how many students live in households that receive government assistance, live in foster care, are homeless, and other similar criteria.

Under current CEP rules, schools with greater than 40 percent of students who qualify as food-vulnerable are eligible to offer free meals to all students. A bill approved May 18 by the House Education and Workforce Committee would raise the threshold to 60 percent, forcing schools between 40 and 59 percent range off the program.

"Proponents of community eligibility say it spares schools from paperwork and administrative burdens, and that it allows low-income children to eat free meals without the stigma or red tape of particpation in the free meal program, which is often a barrier for participation," Evie Blad reports for Education Week. "But Republicans on the committee said the provision is wasteful, potentially allowing children from higher-income families access to free meals."

The change could affect more than 350 Kentucky schools. Kentucky has 804 schools eligible to offer free meals under current CEP rules, according to the Center on Budget and Policy Priorities. Under the proposed bill, only 441 would qualify, according to the center.

More than 10,000 students at 17 public schools in Lexington alone would be affected, according to the Lexington Herald-Leader reported. More than 190,000 students statewide could be affected, the Herald-Leader said.

Nick Brake, superintendent of Owensboro schools, told Keith Lawrence of The Messenger-Inquirer that he is hopeful that his district will be spared cuts.

"I have been working with Congressman (Brett) Guthrie�s office on this issue," Brake said. "We are still looking at the overall numbers, but our district average is 63 percent, so it looks favorable that we will be able to continue to provide the benefit of this vital program in the future."

Muhlenberg County Supt. Randy McCarty told Lawrence he thought his district would still qualify. "Once a district goes CEP, it stays in place for four years," he said.

Hopkins County, which recently expanded its use of free meals to all public schools, faces uncertainty if the changes are passed.

"I have no idea if school districts will be grandfathered in, or how Congress will write everything, but I am afraid that if we don't jump on this now, we may not get this opportunity again," Michael Dodridge, food services director of Hopkins County schools, told Laura Buchanan of The Messenger in Madisonville. "I would hate to pass this up."

UPDATE, May 26: The Harlan Independent School Board voted to join the program, Joe Asher reports for the Harlan Daily Enterprise.

The proposed CEP changes are part of House Resolution 5003, the child nutrition reauthorization bill introduced by Indiana Republican Rep. Todd Rokita. For more information on the proposed changes, click here.

Princess Health and McDonald's stops sending to schools man who says he lost much weight eating only at McDonald's, including Big Macs and fries. Princessiccia

Princess Health and McDonald's stops sending to schools man who says he lost much weight eating only at McDonald's, including Big Macs and fries. Princessiccia

child obesity children children's health diet education fast food nutrition restaurants schools youth

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Photo via flickriver.com

McDonald�s has stopped "giving nutrition advice to students in schools, pulling back on a program that critics said was a subtle form of fast-food marketing that could imperil kids� health and understanding of nutrition," Roberto Ferdman reports for The Washington Post.

The company had been sending to schools "a middle-aged teacher from Iowa who came to fame after claiming to have lost almost 60 pounds eating only McDonald�s," including Big Macs and french fries, Ferdman writes.

"McDonald�s said in a statement this week that Cisna stopped those visits last fall, after a Washington Post article highlighted how McDonald�s used its relationship with local schools and teachers� associations to get its message in front of students. . . . McDonald�s had long defended the practice, saying that Cisna�s presentation was about choice, not about eating McDonald�s. But critics argued it amounted to little more than a veiled attempt to woo customers at a young and impressionable age."

Princess Health and Shepherdsville bans smoking with children in vehicle. Princessiccia

Princess Health and Shepherdsville bans smoking with children in vehicle. Princessiccia

children children's health local government motor vehicles smoking bans

Gusty 14:04 Add Comment

In the first such ban in Kentucky, the Shepherdsville City Council has passed an ordinance prohibiting smoking in motor vehicles with children inside them.

Smoking in vehicles with children "is something we see a lot around here," and is "a big problem," Kalynn Walls, a legal assistant who helped write the ordinance, told Laura Ungar of The Courier-Journal. The ordinance "is kind of a common-sense thing" that is designed partly "to spark other cities to adopt policies like this," Walls said.

The ordinance says people can't "use tobacco products with a residue of smoke" in a vehicle occupied by anyone under 18. The ban applies to cigarettes, cigars, pipes and other products, but not to e-cigarettes. It is a secondary offense, meaning drivers can't be pulled over for it, but can be cited if stopped for another violation. Conviction carries a fine of up to $250.

The ordinance was inspired by a similar law in England and is the first in Kentucky, according to Ellen Hahn, a University of Kentucky nursing professor and director of the Kentucky Center for Smoke-Free Policy.

Hahn told The Courier-Journal that she wishes Bullitt County, of which Shepherdsville is the county seat, prohibited smoking in workplaces. The county health board passed a smoking ban three years ago, but the fiscal court sued to overturn it, and the Kentucky Supreme Court said smoking bans should be enacted only by elected officials.

In Bullitt County, 27 percent of adults smoke, about the same rate as statewide. "Kentucky consistently has one of the highest adult smoking rates in the nation," Ungar notes.

Princess Health and FDA launches its first advertising campaign aimed at rural youth about the dangers of smokeless tobacco. Princessiccia

Princess Health and FDA launches its first advertising campaign aimed at rural youth about the dangers of smokeless tobacco. Princessiccia

children children's health smokeless tobacco tobacco tobacco prevention youth

Gusty 15:46 Add Comment

The U.S. Food and Drug Administration today launched a campaign on the dangers of smokeless tobacco among rural teens. FDA is expanding its �The Real Cost� campaign "to educate rural, white male teenagers about the negative health consequences associated with smokeless tobacco use," it says. "For the first time, messages on the dangers of smokeless tobacco use�including nicotine addiction, gum disease, tooth loss, and multiple kinds of cancer�are being highlighted through the placement of advertisements in 35 U.S. markets specifically selected to reach the campaign�s target audience."

FDA�s Population Assessment of Tobacco and Health study found that 31.84 percent of rural, white males ages 12 to 17�629,000 total youths�either experiment with smokeless tobacco or are at-risk, says FDA. "According to the Substance Abuse and Mental Health Services Administration, each day in the U.S. nearly 1,000 males under the age of 18 use smokeless tobacco for the first time�almost as many male teenagers who smoke their first cigarette�making early intervention critical and highlighting a need for targeted youth smokeless tobacco prevention."

The campaign will be conducted through advertisements on television, radio, print, public signs, billboards, the internet and social media, says FDA. The agency is also partnering with Minor League Baseball teams, with stadiums promoting tobacco-free lifestyles "by displaying campaign advertising and providing opportunities for fans to meet and interact with players who support the campaign�s public health messages." (Read more)

Here's a link to the campaign�s bites and B-roll package; the ads are also available on YouTube: https://www.youtube.com/playlist?list=PLgf1d4CujVYYl8IZmTz5hedERt3f19hED

Princess Health and Is pervasive pornography the newest public-health crisis?. Princessiccia

Princess Health and Is pervasive pornography the newest public-health crisis?. Princessiccia

children children's health sex education sexual assault

Gusty 09:05 Add Comment

Gail Dines, a professor of sociology at Wheelock College in Boston and author of Pornland: How Porn has Hijacked our Sexuality, argues in an essay for The Washington Post that "porn is a public health crisis rather than a private matter."

The internet has made pornography generally accessible, to the point that porn sites get more visitors than Netflix, Amazon and Twitter combined" (a Huffington Post headline from 2013), some researchers estimate the average age of first viewing porn at 11, and "free and widely available pornography is often violent, degrading and extreme."

Gail Dines

Dines notes studies that have found correlations between porn viewing and sexual harassment and toleration of sexual assault, and that college-age women whose partners use porn "suffered diminished self-esteem, relationship quality and sexual satisfaction."

"As the evidence piles up, a coalition of academics, health professionals, educators, feminist activists and caregivers has decided that they can no longer allow the porn industry to hijack the physical and emotional well-being of our culture," Dines writes. "Culture Reframed, an organization I founded and currently chair, is pioneering a strategy to address porn as the public health crisis of the digital age. We are developing educational programs for parents, youth and a range of professionals that aim to help shift the culture from one that normalizes a pornographic, oppression-based sexuality to one that values and promotes a sexuality rooted in healthy intimacy, mutual care and respect."

Dines concludes, "Parents and educators at every level need to know that if porn is not discussed in a research-based, age-appropriate sexual health curriculum, its effects will surely show up as sexual harassment, dating violence and inadvertent �child pornography� on students� phones. Pornography can cause lifelong problems if young people are not taught to distinguish between exploitative porn sex and healthy, safe sex. As the research shows, porn is not merely a moral nuisance and subject for culture-war debates. It�s a threat to our public health."

Princess Health and Dr. Nikki Stone and mobile dental team in Hazard have helped cut tooth decay in the region 20 percent in a decade of operation. Princessiccia

Princess Health and Dr. Nikki Stone and mobile dental team in Hazard have helped cut tooth decay in the region 20 percent in a decade of operation. Princessiccia

children children's health dental care dental health oral health tooth decay

Gusty 14:03 Add Comment

By Ann Blackford
University of Kentucky

When Dr. Daria "Nikki" Stone, associate professor at the University of Kentucky College of Dentistry, became the director of the Ronald McDonald Care Mobile program in Hazard, she realized she was finally in the right place at the right time, where her piece of the puzzle fit in the big picture.

Growing up in Blackey, in Letcher County about 30 minutes from Hazard, she didn't know she wanted to be a dentist. She was always a good student and loved science classes in school but her passion had always been art. At her father's coaxing, she entered college as a pre-med major, and discovered through the UK Health Careers Opportunities Program that dentistry was a profession that merged her love of art and science.

Dr. Daria "Nikki" Stone (University of Kentucky photos)

"Now, I have a passion and love for what I do, preventing tooth decay in children in elementary schools, preschools and Head Start centers in Eastern Kentucky and advocating for underserved children," Stone said.

Stone married her high school sweetheart, Mark, and they have two children; Ana and Ian, 16 and 13. Her early career included part-time teaching and covering clinics in Prestonsburg and Hazard as a stay-at-home mom and working in New Mexico for the National Health Service Corps to retire a school loan. She got a transfer to be closer to family, and her last year with NHSC was just across the Kentucky border in Virginia.

She had been practicing dentistry for 10 years when UK hired her to head the Mobile Care program, coming full circle to the place she holds most dear.

"I love that I've been able to come home to Appalachia, there is no more beautiful place or more wonderful culture," she said. "I love the way my people talk and hug and laugh, and I love that we are a deeply spiritual people who are deeply connected to one another. My children are 10th generation Appalachians and I wouldn't want to raise them anywhere else."

UK's North Fork Valley Community Health Center's mobile dental outreach program celebrated 10 years of serving children in 2015. Stone has directed the program since its inception. She and several dental hygienists and assistants provide preventive dental care twice a year to 2,400 Head Start children in Perry, Knott, Letcher and Leslie counties and once a year to all public elementary schools in Perry and Knott counties. Children receive dental exams, cleanings, fluoride treatments, sealants and both classroom-based and individualized educational sessions. Dental education is also available to parents and teachers at various community events.

"Teaching is actually one of my favorite parts of my job," Stone said. "I also love the practical, day-to-day side of being with children, and I also love the philosophical aspect of why we're doing what we're doing. . . . Children are truly a blessing to work with; they are so very honest and keep us laughing all day. I love that we are preventing tooth decay before it starts and lowering the tooth decay rates in Eastern Kentucky, which has some of the highest rates of tooth decay in the nation."

Stone and patient Wyatt "Bebo" Goins at
Roy G. Eversole Preschool in Hazard

Tooth-decay rates in the center's service area have decreased nearly 20 percentage points, urgent dental needs have been cut in half, and treatment-completion rates for Head Start children with urgent dental needs have increased dramatically, from 8 percent to more than 60 percent.

"When the UK dental outreach team started seeing children in local schools and Head Start centers in 2006, over half the children in Perry County had untreated cavities and 20 percent had painful abscessed teeth," Stone recalled.

Stone said she has found her place in the world. "I once had a very spunky little girl come on the mobile unit and she was very excited to be there," she recalled. "She couldn�t stop talking and she spoke really fast, going from one topic to another without transition. She jumped up in the dental chair and asked me this question, 'Did you wish upon a star to be a dentist?' It really caught me off guard and I had to stop and think about it for a couple of seconds. I realized I probably had not ever wished upon a star to be a dentist, but for some reason God chose to bless me with the opportunity to be a dentist to this beautiful little girl anyway, and to provide preventive dental care services to over 10,000 children just like her who have come on the mobile unit in the past 10 years. And maybe some of them will wish upon a star to become dentists someday."

Princess Health and CDC says state spends less than 8% of what it should on preventing use of tobacco; companies spend 13 times as much.Princessiccia

Princess Health and CDC says state spends less than 8% of what it should on preventing use of tobacco; companies spend 13 times as much.Princessiccia

advertising children's health federal government smoking smoking cessation state budget state budgets state governments tobacco tobacco prevention youth

Gusty 16:43 Add Comment

Kentucky spends only 7.6 percent of what it should spend on preventing the use of tobacco, the federal Centers for Disease Control and Prevention says in its latest annual report on the subject.

The state spent $4.33 million on tobacco-control programs in 2011, the year covered by the report. The CDC said spending of $57.2 million was called for, since 29 percent of Kentuckians smoked that year. Tobacco-related illnesses are estimated to cost Kentuckians $3.3 billion a year.

South Carolina and Texas, which spent 6.5 percent and 7 percent of the recommended amounts, were also singled out for criticism by the CDC. Nationally, states spend less than 18 percent of what they should, $3.7 billion, in the agency's view. "Only Alaska and North Dakota funded programs at the CDC-recommended levels, $10.7 million and $9.3 million, respectively," Samantha Ehlinger of McClatchy Newspapers reports.

Read more here: http://www.kentucky.com/2015/06/25/3918046/cdc-says-kentucky-isnt-spending.html#storylink=cpy

"States that made larger investments in tobacco prevention and control have seen larger declines in cigarettes sales than the United States as a whole, and the prevalence of smoking has declined faster as spending for tobacco control programs has increased," the CDC report said. "Evidence suggests that funding tobacco prevention and control efforts at the levels recommended . . . could achieve larger and more rapid reductions in tobacco use and associated morbidity and mortality."

In contrast to the state spending of $658 million on tobacco control, tobacco companies spent more than 13 times as much on advertising and promotion in 2011: $8.8 billion, or $24 million per day, the report noted.

"During the same period, more than 3,200 youth younger than 18 years of age smoked their first cigarette and another 2,100 youth and young adults who are occasional smokers progressed to become daily smokers," the report said. "If current rates continue, 5.6 million Americans younger than 18 years of age who are alive today are projected to die prematurely from smoking-related disease. However, the tobacco-use epidemic can be markedly reduced by implementing interventions that are known to work."

For the CDC's latest comprehensive report on tobacco use in Kentucky, with data from 2012, click here. For county-by-county figures on adults smoking in Kentucky in 2011-13, click here.

Princess Health and 14-year-old from Paducah discusses her depression and thoughts of suicide to help others in a similar situation.Princessiccia

Princess Health and 14-year-old from Paducah discusses her depression and thoughts of suicide to help others in a similar situation.Princessiccia

children children's health parenting schools suicide

Gusty 07:57 Add Comment

Sophie Henney of Paducah chose two days after her 14th birthday to tell her story of depression and thoughts of suicide. She wanted to share her story�and her name�to help others who may be in the same situation, Genevieve Postlethwait reports for The Paducah Sun.

In Kentucky, 15 percent of teens say they've thought about committing suicide, according to the 2013 National Youth Risk Behavior Survey. According to the Centers for Disease Control and Prevention's 2013 data, 11 out of every 100,000 young people die by suicide. Every year between 1999 and 2013, Kentucky ranked 16th in the nation for rate of deaths by suicide for individuals between ages 15 and 24.

On the way to church on New Year's Eve night, Sophie told her mom, Peggy, "I wouldn't hurt myself, but I don't want to go back there to that school. I'd rather be dead." Sophie attended a small private school and hadn't had a pleasant fall semester: the other girls in her class were excluding her, and she had thought some of them were her friends, Postlethwait writes. "We found out several months later she was actually formulating a plan to do it," Peggy said. "As much attention as I was paying to her, I still didn't know. I beat myself up for several months, thinking that there was more I could have done."

Both Sophie and her counselor have released Peggy of the blame, but she still feels responsible. "I could have lost my child," Peggy said. "And there are people here who have lost their child. . . . We can talk about texting and driving; we can talk about drinking and driving; but we can't talk about suicide. We've got to start changing something."

The stigma surrounding suicide and a lack of information about it are two main things that stand in the way of changing the way people talk about suicide, said Laurie Ballew, medical director of Lourdes Behavioral Health. She said people didn't used to talk about cancer because of the stigma. "Now we talk about it," Ballew said. "We're out about it, we're loud about it, and we're educating about it. That's what we need to do with suicide and mental health issues."

Gretchen Roof, site administration at Four Rivers Behavioral Health in Paducah, "said at least once a week a child comes to them at Four Rivers who they worry may be a suicide risk." When that happens, there are several options. Children may see a counselor once per week or every other week. They can go to Four Rivers every weekday after school. In more severe cases, "'partial-hospitalization'"is an option, where the child attends school at the center while also participating in therapy from 8 a.m. to 4 p.m. every weekday," Postlethwait writes. Most of the schools in the area allow Four Rivers counselors to spend approximately one day per week in each school, which removes the need for transportation and the stigma associated with entering a mental health facility.

Roof said that parents, teachers, preachers and kids should not be afraid to talk about depression or suicidal thoughts in themselves or observed in others, Postlethwait writes. "If you have or know a child who appears depressed, or is having some sort of significant change in their behavior, a change in appearance even . . . be especially tuned-in to that child," Roof said. "Don't be afraid of saying, 'I'm concerned about you. What's going on?' and don't be afraid of asking, 'Have you thought about hurting yourself?'" Something people are afraid to ask such questions because they think they will give the person ideas, Roof said, but research shows that is false. "They will tell you, and you are the intervention that has been waiting to happen for them."

Sophie said, "I was very relieved when we went to Christmas break, and by New Years Eve, I was like, I don't want to go back. I want this to be over. I don't want to see them again. The only thing I can really think of to say is, get help. That's what made me better. Tell somebody. Talk to somebody. don't just keep it quiet."

Princess Health and New license plate would promote outdoor recreation, support environmental education programs; 900 buyers needed to start.Princessiccia

Princess Health and New license plate would promote outdoor recreation, support environmental education programs; 900 buyers needed to start.Princessiccia

child obesity childhood obesity children's health environment environmental health exercise obesity state government

Gusty 06:49 Add Comment

A new "Let's Go Outside" license plate is being offered to give Kentucky motorists the opportunity to promote the health and environmental benefits of outdoor recreation.

First Lady Jane Beshear unveiled the license plate June 10. She said that encouraging children to play outside will help improve their health and noted that "Kentucky has one of the highest childhood obesity rates in the nation," reports to The Lane Report.

Proceeds from the specialty plate will support the work of the Kentucky Environmental Education Council, including coordinating the Kentucky Green and Healthy Schools program and certifying professional environmental educators.

�Kentuckians have said in surveys that children not spending enough time outside is a major concern,� KEEC Executive Director Elizabeth Schmitz said. �One of our goals is to encourage children to embrace the outdoors and to teach them the importance of a clean environment for our health and preservation."

The Kentucky Environmental Education Council needs 900 applications, each accompanied by a $25 donation, before any plates will be manufactured.

Submitting the application does not obligate you to purchase the plate, but your donation will be credited toward the purchase of a plate once they are in production. If not enough applications are received, your $25 will be considered a tax-deductible donation.

A link to download the application is available at www.keec.ky.gov/LetsGoOutside.

Princess Health and In-school health clinics not only meet the health-care needs of students and staff, but also their families.Princessiccia

Princess Health and In-school health clinics not only meet the health-care needs of students and staff, but also their families.Princessiccia

children children's health school nurses schools

Gusty 07:21 Add Comment

School-based health clinics in Kentucky could become a trend,  especially as the state searches for solutions to meet the health care needs of schools as budgets for school nurses continue to be slashed.

Southern Kentucky has Cumberland Family Medical, based in Burkesville, which has clinics at the five schools in Russell County and a deal to do likewise with the four in adjoining Adair County.

Western Kentucky has three such clinics, with two more likely to open next year, Genevieve Postlethwait reports for The Paducah Sun. 

The clinics are at McCracken County's Reidland Middle School, Lone Oak Elementary School, and Paducah's Morgan Elementary. Next school year a full-time clinic will open in McCracken County High School, hopefully followed by a clinic at McNabb Elementary.

These clinics exist as a partnership between Mercy Medical Associates and the local public school districts; the school districts supply the space, Mercy supplies and staff and the Lourdes Foundation helps with funding, Postlethwait reports.

An advanced practice registered nurse with Mercy Medical, Julie Higdon, said she has seen well over 30 patients at the Lone Oak clinic since it opened in mid-April. "That's not busy by ER standards," she said, "but that's busy for a little clinic that's just softly opened."

The clinics serve the entire "school family," from the students and their parents and siblings to the districts' teachers, staff and administrators, regardless of their ability to pay. "Their goal is to give the community the preventive, acute and critical health care it needs while reducing students' and teachers' time away from school, and parents' time away from work," Postlethwait writes.

"It's a big deal when you start talking about dollars and cents, too," Tennille Rushing, director of clinical operations for Mercy, told Postlethwait.  "Not only in the impact for the schools to have kids staying in the classroom and helping with attendance numbers, but for parents. If you only have a limited number of days that you can take off, and you have to take off half a day to go sit in a lobby somewhere with your child, you've missed a half day of pay."

These clinics will also help those without a primary-care provider, which are in short supply in the Paducah area. The Lone Oak clinic will remain open by appointment only this summer.

"I feel like these clinics really have the potential to meet a need for the community," Higdon told Postlethwait. "I feel like it has great potential to grow, I really do." (This story is behind a paywall.)

Princess Health and Clay County 4th and 5th graders participate in UK research of circadian rhythms and obesity, little studied in children.Princessiccia

Princess Health and Clay County 4th and 5th graders participate in UK research of circadian rhythms and obesity, little studied in children.Princessiccia

child obesity childhood obesity children's health chronic disease education obesity research University of Kentucky

Gusty 16:54 Add Comment

The University of Kentucky recently partnered with over 100 fourth and fifth grade students in two Clay County schools to study the relationship between circadian rhythms and weight in children.

Sydney Sester, a fifth grade student at Manchester Elementary School, said in a UK news release that in addition to learning more about science and helping others by contributing to research, participating in the study showed her the importance of maintaining a healthy weight and eating well.

"It made me want to be more responsible with food and be patient with what I eat and only eat when I'm hungry," she said.

The project, "Circadian Rhythm Parameters and Metabolic Syndrome Associated Factors in Young Children," also known as the Clay County Clock Study, is led by Dr. Jody Clasey, associate professor of kinesiology and health promotion, and Dr. Karyn Esser, professor of physiology.

The research team says it hopes to learn about the relationship between circadian rhythms, eating, and activity behaviors and the incidence of overweight and obesity in children.

And while the team is in the process of analyzing the data, Esser told a group at the 10th annual Center for Clinical and Translational Science conference in March that early data show 33 percent of the students in the study are considered obese, their initial blood pressure measurements are on the high end of normal, and the students are less active on weekends and nights than during the school week.

The data was gathered through electronic devices that the students wore for seven days to measure activity, heart rate and skin temperature. The students also kept a daily journal to record their sleep and eating activities each day.

Previous studies have shown that disrupting an adult's circadian rhythm is associated with increased risk for metabolic disease, which is a combination of chronic health conditions that puts a person at a higher risk of heart disease and diabetes. Similar research with children has been limited.

Esser noted that "Clay County and many of the counties in Appalachia have a much higher rate of these chronic diseases."

She also said that while it is known that light exposure affects the body clock, recent findings show that the time that we do activities, like exercising and eating, also contribute to circadian health, and that this is also likely true in children.

This research "could not only influence an individual, but school start times, activity intervention, just so many different areas from personal practice or behavioral choices to public policy, all for the metabolic or physiological good of the individual or collective body," Clasey said.