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

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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

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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

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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

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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.