Showing posts with label health rankings. Show all posts
Showing posts with label health rankings. Show all posts

Sunday, 12 June 2016

Princess Health and Health ranking of Kentucky seniors moves up, but they are still last in health outcomes, says America's Health Rankings. Princessiccia

By Melissa Patrick and Al Cross
Kentucky Health News

Kentucky moved up three spots, from 48th to 45th, in the fourth annual Senior America's Health Rankings Report. But the state ranked last in health outcomes and 44th in determiners of those outcomes, so it remains one of the least healthy places in the nation for seniors to live.


Among negative measures, Kentucky seniors ranked first in preventable hospitalizations, second in tooth extractions and premature death; and third in physical inactivity and hospital re-admissions within 30 days of discharge.

Among positive measures, the state also ranked poorly: for example, 46th in the percentage (34%) of seniors who reported that their health status was good or excellent and 48th in the percentage (56.9%) who reported having no disability.

The state's best ranking was No. 3 in influenza vaccinations, reflecting an increase to 70 percent from 62 percent of seniors vaccinated in the past two years. It was No. 8 in the percentage of seniors with arthritis who self-report arthritis or joint pain does not limit their usual activities. It tied for 10th in the percentage of seniors with a "creditable prescription-drug plan" and was 17th in the percentage of senior who reported having a mammogram or a colonoscopy or similar screening.

Kentucky ranked low in volunteer activity by seniors (45th) and nursing home quality (43rd) but has fewer people in nursing homes who perhaps shouldn't be there. Only 7 percent of its nursing-home residents, the No. 7 ranking, were considered "low care" and thus candidates for living in less restrictive environments. However, it was 46th in the number of personal-care and home-health aides per 1,000 adults aged 75 or older.

The state tied for 44th in the percentage (32.1) of seniors who reported falling in the previous 12 months. It was 44th in the percentage (42.8) of seniors who were enrolled in hospice during the last six months of life after being diagnosed with a condition that carried high probability of death.

It was also 44th in a related measure, the percentage (16.6) of seniors who spent seven or more days in an intensive- or critical-care unit during their last six months. Generally, use of an ICU correlates with the number of ICU beds, which "could indicate a supply-induced remand," the report says. "Overusing the critical care system often goes against the wishes of dying patients and is costly. Research indicates many patients receive care they would not choose in their final days."

The rankings are based on 35 measures of health, as well as supplemental measures such as education and mental health. Combined, they paint a picture of how individual behavior, our communities and their environments, health policy and access to care influence health.

One area that Kentucky consistently ranks low in is government support for seniors in poverty. It was 45th again this year, spending $382 per senior when federal, state and local funds were all counted. Massachusetts, which ranked first in overall senior health this year, spends $4,053 per senior in this category, more than any other state but Alaska, which has many rural elderly. The national average, which has been declining, is $811.

Kentucky leads the nation in smoking, so it's no surprise that its seniors also rank in the bottom five states for this negative category (47th). Kentucky seniors' smoking rate is 12.4 percent; the national average is 8.8 percent. Both have declined about 40 percent in the last 15 years.

Smoking is the leading cause of preventable death in the United States," says the report. "Cessation, even in older smokers, can have profound benefits on current health status as well as improve long-term outcomes."

Kentucky was fifth from the bottom in dental visits by seniors, but the good news is that the share of seniors having such visits rose to 57 percent from 53 percent last year.

"Poor oral health is associated with such chronic diseases as diabetes and cardiovascular disease, and can have a large impact on quality of life resulting in pain and affecting the ability to chew or speak," says the report.

Kentucky improved its senior obesity ranking, another negative measurement, to 24th from 41st. About two out of every seven Kentucky seniors are obese, or 27.5 percent, the same as the national average. Last year the rate was 29.6 percent.

"Obese seniors experience more hospitalizations, emergency department visits, and use of outpatient health services than non-obese seniors, leading to higher health care costs," says the report. "Physical activity, healthy diet, supportive communities and social networks, and an environment that encourages exercise all play a role in reducing obesity in older adults."

The report says that between 1999 and 2014, Kentucky's middle-aged population (50-64) saw a 34 percent increase in in obesity and a 68 percent increase in diabetes. These findings were similar across the nation.

The report says Kentucky's senior population is expected to increase 44 percent by 2030. "Over the next 15 years, the health of this population will be challenged by large numbers of new people becoming seniors and the additional health challenges, such as diabetes, that this groups brings with them," it says."These higher rates of diabetes and obesity are expected to put significant strains on the Medicare program and the overall health-care system."

The report, sponsored by the United Health Foundation, is a call to action for states, offering specific benchmarks that can be changed to improve health.

Louisiana again ranked last for overall senior health, followed by Oklahoma. Kentucky, West Virginia, Arkansas and Mississippi had similar scores. The top six states for overall senior health are Massachusetts, Vermont, New Hampshire, Minnesota, Hawaii and Utah. Click here for the full report. (Click on chart for another version that may be clearer)

Friday, 3 June 2016

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

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.�

Sunday, 17 April 2016

Princess Health and If legislature won't help protect Kentuckians from the health threat of tobacco, local governments should, Herald-Leader says. Princessiccia

Since the Kentucky General Assembly "adjourned without tackling the addiction that kills the most Kentuckians, tobacco," local communities need to take up the challenge, the Lexington Herald-Leader said in an editorial Sunday.

To drive home the primary role that tobacco plays in Kentucky's poor health, the newspaper ran a map of the most recent County Health Rankings, showing that "the places where smoking rates are highest have the worst health outcomes."

The Democrat-controlled state House passed a statewide ban on smoking in workplaces last year, but the bill got nowhere in the Republican-controlled Senate, and with new Republican Gov. Matt Bevin opposed to it and all House seats on the ballot this year, the bill didn't get a vote in the House.

Bevin has said smoking bans should be a local decision. The editorial says, "One of the cheapest, most effective ways to do that (since the legislature won�t) would be to join the places across Kentucky that have enacted local smoke-free laws." About one-third of Kentucky's population lives in jurisdictions with comprehensive smoking bans.

Read more here: http://www.kentucky.com/opinion/editorials/article72143017.html#storylink=cpyThe
Read more here: http://www.kentucky.com/opinion/editorials/article72143017.html#storylink=cpy

Sunday, 10 April 2016

Princess Health and  Rural drug-overdose rates, high in Kentucky, blamed partly on limits on treatment medication and mental-health services. Princessiccia

Princess Health and Rural drug-overdose rates, high in Kentucky, blamed partly on limits on treatment medication and mental-health services. Princessiccia

"People in rural areas of Appalachia are more likely to die early deaths than in other parts of the country," and a big reason is that they "die from drug overdoses at greater rates than the rest of the country," writes Kery Murakami, the Washington, D.C., reporter for Community Newspaper Holdings Inc.'s CNHI News Service.

Murakami notes that in Leslie County, Kentucky, 7.9 of every 10,000 residents overdosed each year in 2012-14. "That�s six times the national rate," and third in the nation, he writes, citing the annual County Health Rankings done for the Robert Wood Johnson Foundation by the University of Wisconsin Population Health Institute. Several other Appalachian counties in Kentucky and West Virginia rank high.

The rates are high partly because "addicts in some parts of the country get turned away by doctors and are not given a drug called buprenorphine that is used to kick opioid addictions," Murakami reports, citing addiction experts. "Buprenorphine causes less euphoria and physical dependence and can ease withdrawal and cravings."

However, "Federal law caps the number of patients to whom a doctor is allowed to prescribe the drug, out of concern of creating places where large numbers of addicts receive opioid-based medication. Such treatment hubs, much like methadone clinics, bring unwanted community opposition, said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence. That limits treatment choices in rural areas, where one doctor might be the only one licensed to prescribe buprenorphine for hundreds of miles."

The Department of Health and Human Services is moving to ease the limits, and Sens. Ed Markey, D-Mass., and Rand Paul, R-Ky., want to go even further. "But some addiction experts are concerned that raising the caps on buprenorphine will nudge the country toward treating addiction with medication rather than counseling, Murakami reports. The department�s proposed rules would require mental-health care, which is often hard to get in rural areas. The senators� bill would not.

�Turning people away from the most evidence-based treatment we have for a chronic, life-threatening disease is heart wrenching for a doctor,� Dr. Kelly Clark, president-elect of the American Society of Addiction Medicine, told CNHI. �Rural areas have been hit hardest by this round in overdoses, which is the worst round of overdose deaths in our country.� She said medication is especially important in rural areas because opioid use spreads among families. �In rural areas, you�re treating the person, their parents and grandparents,� she said. �Entire families are addicted. It�s not like saying, �Stay away from certain friends,� if they�re shooting up with their sister and their mother.�

Thursday, 17 March 2016

Princess Health and Annual County Health Rankings for Kentucky show many shifts in the middle echelons, not much at the top and bottom. Princessiccia

By Melissa Patrick
Kentucky Health News

The sixth annual County Health Rankings report shows little change in Kentucky's top and bottom rankings, but there were a few surprises, with several counties showing up in the top 10 for the first time.

Marshall County was one, ranking 10th in both health outcomes and health factors, the rankings' two main measures. This is an improvement from last year's 26th in outcomes and 19th in factors. Bullitt County also moved into the top 10 for the first time this year, ranking sixth for outcomes, up from 27th.

Health outcomes include length and quality of life. Health factors contribute to outcomes and include four categories: health-related behaviors, clinical care, social and economic factors, and the county's physical environment. The rankings for each county are relative to other counties in the same state.

"Communities use the rankings to help identify issues and opportunities for local health improvement, as well as to garner support for initiatives among government agencies, healthcare providers, community organizations, business leaders, policy makers, and the public," says the report.

The County Health Rankings are a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

2016 Health Outcomes - Kentucky
The report is a general categorization of a county's health status. The rankings are arranged in quartiles, or four numerical classes, to de-emphasize the small statistical differences among closely ranked counties. Kentucky has 120 counties, in quartiles of 30.

The bottom quartile comprises almost entirely Appalachian counties, the only exception being Fulton, in the Mississippi Delta at the state's western tip.

Oldham and Boone counties continued to be the top two for health outcomes in the state, as they have been since the rankings began. Spencer County, ranked third, spent the last two years ranked 11th. Shelby and Scott counties are ranked fourth and fifth in outcomes. All are suburban, formerly rural, counties in the state's three major metropolitan areas.

The bottom 10 counties in health outcomes are all rural. They saw little change from last year, with Harlan (117) and Wolfe (119) being the only new additions. The bottom five counties in outcomes are Floyd, Harlan, Perry, Wolfe and Owsley (which has been ranked last for health outcomes every year, except 2013, when it ranked 102nd).

Counties that saw the greatest improvements in health outcomes were Livingston (LG on map), moving up from 70th to 35th; Trimble (TI), moving up from 56th to 27th; and Crittenden (CD), moving up from 64th to 38th. All these counties moved into a higher quartile with these ranking changes.

Morgan County, which for years had health outcomes far better than its health factors, saw the greatest decline in the outcome rankings, moving from 48th to 76th. It was followed by Russell, which fell from 61st to 88th; and Bracken, which dropped from 46th to 72nd. Russell County remained in the same quartile as last year, but the other two counties shifted to a lower one.

2016 Health Factors - Kentucky
The top five counties for health factors have all been in the top 10 before. They include Oldham, Boone, Spencer, Woodford and Campbell counties; Campbell had dropped last year to 12th.

The bottom five counties for health factors are Magoffin, Wolfe, McCreary, Breathitt and Bell, all in the Eastern Kentucky Coalfield.

Counties that saw the greatest improvement in health factors were Clark, moving from 53rd to 29th; Gallatin, going from 89th to 67th; and Crittenden, rising from 86th to 64th. Only Clark, just east of Lexington, moved into a higher quartile.

Counties that saw the greatest declines in health factors were Taylor , dropping from 30th to 58th; Butler, falling from 66th to 94th; and Union, dropping from 46th to 73rd. Each of these counties dropped into a lower quartile. Butler, Fulton and Carroll were the only non-Appalachian counties in the bottom quartile.

The report identifies "meaningful gaps" that exist between the best and worst Kentucky counties and suggests that policymakers look at these gaps as they search for ways to improve the counties' health, including: adult smoking, adult obesity, uninsured rates, preventable hospital stays, education levels, unemployment, children in poverty and income inequality.

The report says, "Every year, over 2,800 deaths in Kentucky could be avoided if all residents in the state had a fair chance to be healthy."

Tuesday, 15 March 2016

Princess Health and 85 percent of Kentucky adults want schools to be tobacco-free, but only 28 percent of the state's school districts are. Princessiccia

An overwhelming majority of Kentucky adults, 85 percent, want schools to be tobacco-free, according to the latest Kentucky Health Issues Poll.

But only 28 percent of the state's school districts have "protected students, staff members, teachers and guests from secondhand smoke by enacting 100 percent tobacco-free school policies," says a press release from Interact for Health, which co-sponsored the poll with the Foundation for a Healthy Kentucky. A list of the districts is at www.tobaccofreeschoolsky.org.

"Kentucky ranks 50th, the worst state in the nation, in the percentage of secondary school campuses that prohibit tobacco use in all locations at all times," the release says. "Nationally, 65 percent of schools have such a policy." In Kentucky, such policies are set by local boards of education.

The state's tobacco heritage remains strong. In 2015, 23 percent of Kentucky middle-school students reported trying cigarettes, and 28 percent of high school students said they used cigarettes, cigars, or smokeless tobacco.

The poll found large majorities of smokers, former smokers and non-smokers in favor of tobacco-free campus policies, and support was strong across party lines. The greatest opposition was found among the poor, African Americans, people who haven't gone to college and those who said their general health was fair or poor.

Susan Zepeda, president and CEO of the foundation, said in its news release, "A 100 percent tobacco-free campus policy reduces a young person's exposure to second-hand smoke and allows adults to model tobacco-free lifestyles. Notably, Kentucky smokers understand this important issue. Eighty percent of current smokers favor tobacco-free school policies in their communities."

The Kentucky Health Issues Poll was conducted Sept. 17 through Oct. 7 by the Institute for Policy Research at the University of Cincinnati. The sample of 1,608 adults has an error margin of plus or minus 2.4 percentage points.

Friday, 29 May 2015

Princess Health and Kentucky's seniors rank 48th in insurance firm's health rankings.Princessiccia

Click here to go to interactive map.
Kentucky seniors ranked in the bottom 10 states for 23 of the 35 measures ranked by the 2015 America's Health Ranking Seniors Report, placing Kentucky in 48th place for the second year in a row.

�The report is a call to action. We believe you can�t improve what you don�t measure,� Dr. Julie Daftari, market medical director for United Health Care of Kentucky told Alyssa Harvey of the Bowling Green Daily News. �It may start with seniors taking individual action. If we live long enough, we�ll be part of these statistics in the future."

Kentucky seniors ranked last in two areas, total health outcomes and preventable hospitalizations; next to last in premature deaths and education and in the bottom three states for smoking, seniors who are considered underweight, and poor mental health days.

The report notes that smoking is the leading cause of preventable death in the U.S. and "older smokers are at an increased risk of smoking-related illness as they tend to be heavy smokers with an average smoking duration of 40 years" and "are less likely than younger smokers to believe that smoking harms their health." Kentucky, with 11.8 percent of its seniors regularly smoking, ranked third highest in senior smoking, behind Nevada and Mississippi.

The report is intended to point out the health challenges facing today's seniors and offer a starting point to help states determine what needs to change. That being said, Kentucky ranks very low in an area that could help improve these outcomes: community support, where it ranks 45th.

The report did say that Kentucky seniors do have some strengths. They have a low prevalence of chronic drinking, low percentage of adults needing pain management, high flu vaccination coverage and a low percentage of low-care nursing home residents.

More Kentucky seniors also reported very good or excellent health since last year's report, up to 33.7 percent from 31.2 percent.

The report noted that a decrease in physical inactivity is a nationwide problem for seniors, with 33.1 percent of seniors nationwide reporting they did not get enough physical activity. This percentage was even higher in Kentucky at 40.2 percent, which is higher than the previous two years (34.5 percent in 2014 and 17 percent in 2013).

The report notes that today, one in seven Americans are aged 65 and older, and in the next two decades the rest of the 77 million baby boomers will move into this demographic. The report also projected the increase in Kentucky's senior population between 2015 to 2030 will be 41.8 percent.

�The fact that we were able to identify key strengths and challenges gives Kentucky an opportunity to address those specific issues,� Daftari told Harvey. �If these challenges aren�t addressed, there may be a significant strain on health care in the future.�

The rankings were based on 35 measures of senior health including behavior determinants like smoking and dental visits; micro and macro community and environmental determinants like poverty and social support; policy issues like percentage of seniors on SNAP; and measures of clinical care like the percentage of seniors who receive home health.; and outcomes like the percentage of seniors who have fallen. It also included measures like education and cognition.

Friday, 17 April 2015

Princess Health andProposals sought for research of Appalachian 'bright spots' where health is better than socioeconomic factors would indicate.Princessiccia

Princess Health andProposals sought for research of Appalachian 'bright spots' where health is better than socioeconomic factors would indicate.Princessiccia

A three-year research project to determine factors that can support a culture of health in Appalachia and whether that knowledge can be translated into actions that address the region's health disparities has released its Request for Proposal to invite proposals from qualified research teams and consultants who would like to work on this project.

The project,�Creating a Culture of Health in Appalachia: Disparities and Bright Spots,� is sponsored by the Appalachian Regional Commission, the Robert Wood Johnson Foundation and the Foundation for a Healthy Kentucky and will run through the end of 2017.

The research for this project will identify Appalachian �bright spots,� where health outcomes are better than would be expected based on unemployment and poverty rates and other community factors, and try to figure out why. Researchesr will also try to determine why health outcomes in some communities are not as good as would be expected.

The request for proposals offers detailed guidelines for submissions, which are due June 8. Applicants are encouraged to register for a webinar, detailed on the RFP, to be held May 7 at 10 a.m. EDT. Click here for more information.

Friday, 30 May 2014

Princess Health and Princess Health andLouisville ranks next to last in fitness among 50 largest metros.Princessiccia

Princess Health and Princess Health andLouisville ranks next to last in fitness among 50 largest metros.Princessiccia

The Louisville metropolitan area ranks 49th for fitness among the nation's 50 largest metro areas in the newly released 2014 American Fitness Index, reports Laura Ungar of The Courier-Journal. The ranking is published by the American College of Sports Medicine and is based on 31 indicators of chronic health problems, health behaviors, recreational facilities and physical or built environments.

The Memphis metropolitan area was the only one ranked lower than Louisville. The Louisville metro area includes Jefferson County and eight surrounding counties in Kentucky and four in Indiana.

"There surely is a lot of room for improvement," Dr. Jonathan Becker, a sports medicine specialist at University of Louisville Family Medicine and KentuckyOne Health, told Ungar. "We need to be moving more, eating less and smoking less."

The Washington, D.C., area claimed the top spot as the nation's fittest, rising above Minneapolis-St. Paul, the winner for the last three years.

The negative scores on the index just kept adding up for Louisville, falling way below the targeted fitness index in areas such as smoking, federal aerobic-activity guidelines and the amount of fruits and vegetables consumed per day, Ungar reports. Louisville also had higher levels of disease than the targeted goals for asthma, diabetes and obesity.

"I'm not surprised, based on what I've seen," Patrice Fife, a certified fitness instructor for the Louisville Metro Department of Public Health & Wellness, told Ungar. She said diabetes in the region is "rampant." Overeating is a real problem, and people need to learn more about proper nutrition and portion control, she said: "They need to eat more fresh fruits and vegetables."

City officials and fitness advocates pointed to Louisville's efforts to improve the region's fitness, including programs that bring fresh fruits and vegetables into "food deserts," a ban on smoking ban in public places and expanded smoking-cessation classes. Louisville has also unveiled a plan to curb trans fats in local foods, expand outdoor smoke-free areas and prohibit idling vehicles when air quality is poor, among other things, Ungar notes.

Steve Tarver, chief executive officer of the YMCA of Greater Louisville, told Ungar, "It has taken decades for the Louisville region to become so unhealthy, and it will take a long-term commitment to get healthier. He said it will involve complex issues such as reducing racial and economic health inequities." (Read more)

Sunday, 27 April 2014

Princess Health and Princess Health andIn Floyd County, opinions about health care reform depend on whom you ask, and in some cases they are surprising.Princessiccia

At the Eula Hall Health Center in Grethel,
nurse Stephanie Clark takes vitals of Mary
Murphy, 54, whose leg blood clot wasn't
treated for 15 years because she couldn't
afford it. (C-J photo by Jessica Ebelhar)
"A team of journalists from USA Today and The Courier-Journal has found that in Floyd County, Obamacare is a neither a train wreck nor a cure-all. It's a work in progress; widely misrepresented and misunderstood, it's helped some people and hurt others, while a handful seem unaffected." So write Chris Kenning and Laura Ungar of The C-J, with Jayne O'Donnell and Rick Hampson of the national newspaper of C-J owner Gannett Co. Inc.

Newly insured people are being treated for ailments that they long ignored or tried to treat with inadequate resources, and people who couldn't get or afford insurance because of pre-existing conditions have been able to get it. "Yet, also because of Obamacare, insurance customers in this Appalachian community complain about higher deductibles and insuring those who don't work. Many say they can't afford even subsidized plans on the state's insurance exchange," the writers report. "Some small business owners say they may cut workers' hours. And hospital leaders say the law has exacerbated health-care trends, leading them to lay off workers and shut down an entire floor of Floyd County's largest hospital."

Advocates say the health-reform law will improve Kentucky's health by bringing care to those who haven't had it, but "Obamacare so far shows scant promise of being able to heal Floyd County, where generations of poor health habits and attitudes testify to poverty's victory" despite the "war" on it that President Lyndon Johnson declared in the region 50 years ago. "Real change, many say, will take decades, given the county's poor health: 35 percent of adults smoke, and the overall death rate is 42 percent above the national average. Many lack reliable transportation, have trouble taking time off from low-wage jobs for medical appointments or just don't believe in going to the doctor."

Some say the law didn't go far enough, and worry about its effect on hospitals. "It's insurance reform," said Bud Warman, president of Highlands Regional Medical Center in Prestonsburg, the Floyd County seat. "It's not health care reform.''

Sunday, 20 April 2014

Princess Health and Princess Health andCEO of Somerset hospital, rated by Consumer Reports as clearly the least safe in Kentucky, is resigning.Princessiccia

Mark Brenzel (Photo via Somerset Commonwealth Journal)
The CEO of the Kentucky hospital with by far the lowest safety rating from Consumer Reports magazine is resigning. Lake Cumberland Regional Hospital is one of 61 owned in 20 states by LifePoint Hospitals of Brentwood, Tenn.

In an April 14 message to the hospital staff, Mark Brenzel wrote, �A few weeks ago, I informed Scott Raplee, President of LifePoint�s Central Group, about my decision to step down  . . . I have struggled managing some health problems since last year that have required me to limit some activities including work hours. While these lifestyle changes have been helpful, they have made it difficult for me to keep up with the demands of this job.�

Brenzel concluded, �I have greatly enjoyed the last four years and am glad to be ending my hospital management career where it began in 1976 when I first visited LCRH [soon after it opened]. We have made great progress in improving patient care and implementing new strategies that will help LCRH be successful in the new healthcare reform environment. My wife and I are planning to stay in the community for the long term and look forward to supporting LCRH in any way that we can.�

Raplee told the Somerset Commonwealth Journal that LifePoint is doing national search to find a replacement for Brenzel, who will remain as CEO during the search. �We are discussing the possibility of Mark taking a new role with LCRH once the new CEO is hired,� Raplee said in a press release.

Friday, 4 April 2014

Princess Health and Princess Health and'Stars are aligned' for making Ky. healthier, and let's start with schools, health commissioner tells County Health Rankings event.Princessiccia

Kentucky is poised to make itself healthier, and one key push needs to be making schools smoke-free, the two top officials in charge of the effort told a gathering of state and local health leaders and activists in Frankfort on Wednesday.

Mayfield
"We know our health statistics are bad, but the stars are aligned for Kentucky, and the time to get healthy is now," Dr. Stephanie Mayfield, the state commissioner of public health, said at a gathering held to highlight "Signs of Progress" in conjunction with the national release of the fifth annual County Health Rankings.

"We're seeing changes that we haven't seen in a generation or multiple generations," Mayfield said, such as the expansion of Medicaid under federal health reform; the enrollment of almost 400,000 Kentuckians in the program or private coverage through the state insurance exchange, Kynect; and a coordinated effort by state agencies to make specific improvements in Kentucky's health statistics.

"I can't stop smiling about this," Mayfield said of the effort, called Kyhealthnow. "This is public health at its best," using accountable strategies to reach measurable goals. "These are strategies we need to implement across our state," she said, "but we need to do it in a  way that's not condemning to people and helps them make healthy choices."

Mayfield is co-chair of the effort, headed by Lt. Gov. Jerry Abramson under appointment from Gov. Steve Beshear. Both of them said it must include a stringer effort to ban smoking on school grounds.

Abramson (cn|2 image)
"Only 33 of our 173 school districts have tobacco-free policies," Abramson said with a touch of incredulity, repeating the line for impact. "We have areas where the government has stepped up [with a smoking ban] and the school districts haven't; we have areas where the school districts have stepped up and the governments haven't; and unfortunately, we have lots of areas throughout the commonwealth of Kentucky where neither has occurred"

Mayfield said, "It is disgraceful that all of our schools are not smoke-free. . . . We need to target our children," because the tobacco companies are.

In a national County Health Rankings video, Grant County School Supt. Sally Skinner said, "We have for some time realized the connection between healthy students and strong academic results." Grant County was recognized nationally for focusing on its health ranking as a motive for improvement, and for raising it from 89th to 60th out of 120 counties.

The program also featured videos of three other counties (Floyd, Franklin and Todd) that have used the rankings and associated data to motivate their efforts. The counties are representative of many others "that are doing something" to improve community health, said Dr. Connie White, clinical director for the state Department of Public Health.

Floyd County was recognized for its work against diabetes; Franklin County was noted for its creation of smoke-free environments; and Todd County was recognized for starting a farmers' market to make more fresh produce available.

"There are so many exciting efforts under way in Kentucky," said Katie Wehr of the Robert Wood Johnson Foundation, which funds the County Health Rankings and Roadmaps. She praised the three health departments that have won national accreditation: Franklin County, Three Rivers and Northern Kentucky. "You are demonstrating to the rest of the nation what's possible."

The foundation held similar events in Rockingham County, North Carolina, and Amherst, N.Y., a Buffalo suburb, to mark the fifth anniversary of the rankings and the importance of the roadmaps, which give communities guidance on campaigns to improve community health.

"The rankings are the starting point for the conversation," said Kitty Jerome, director of the Roadmaps to Health Action Center at the University of Wisconsin. "The number is not as important as the people in this room."

Abramson said it's unfortunate that so many Kentucky counties are chronically at or near the bottom of the rankings. "Many areas simply aren't getting the message," he said, "and anything we can do to spread that message and beat that drum is very important. . . . "We've got to do something in a coordinated, collaborative way to bring about an enhanced environment of health for our citizens."

"We are all on the same page," said Jane Chiles, chair of the Friedell Committee for Health System Transformation, which co-sponsored the event and is working with other groups on a statewide, county-by-county campaign to improve the state's health. "It is a winning collaboration going forward that will result in a healthier Kentucky."

Former University of Kentucky president Lee Todd, who emceed the event, said the state needs to declare war on what he calls "Kentucky's uglies" to get citizens and communities motivated to improve their health. He acknowledged that the term "war" is "a little tough-sounding, but I think it's time we get mad enough about some of the statistics. . . . If we had one one-hundredth the interest in moving our health rankings as we do our basketball rankings, we would be a top-ten state."

Friday, 28 March 2014

Princess Health and Princess Health andCounty Health Rankings officials are coming to Kentucky Tuesday to spotlight local projects to improve community health.Princessiccia

Princess Health and Princess Health andCounty Health Rankings officials are coming to Kentucky Tuesday to spotlight local projects to improve community health.Princessiccia

State officials and health leaders will gather April 2 at the Kentucky History Center in Frankfort to celebrate Kentucky�s successes in implementing strategies for improving health at the community level, as reflected by the latest edition of County Health Rankings by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

Representatives of the foundation and the university will be at the Frankfort event, arranged by the state Department of Public Health, the Foundation for a Healthy Kentucky and the Friedell Committee for Health System Transformation, which is planning a statewide campaign to improve Kentucky's health status, community by community.

The event will highlight promising local health projects and initiatives to improve community health. It will feature four Kentucky counties � Grant, Todd, Floyd and Franklin counties � that have used the County Health Rankings to help their communities begin to show signs of progress.  Lt. Gov. Jerry Abramson will highlight Gov. Steve Beshear�s "Kyhealthnow" initiative to significantly improve Kentucky�s dismal health rankings and habits.

The County Health Rankings allow counties to see how well they are doing on 29 factors that influence health, including smoking, high school graduation rates, employment, physical inactivity and access to healthy foods. This year�s rankings include several new measures including housing, transportation and access to mental health providers.

�The County Health Rankings are a starting point for change, helping communities come together, identify priorities, and create solutions that will help all in our diverse society live healthier lives, now and for generations to come.�said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation.

Nationally, this year�s Rankings show that people living in the least healthy counties are twice as likely to have shorter lives as people living in the healthiest counties. For a story on the rankings in Kentucky, click here.

Thursday, 27 March 2014

Princess Health and Princess Health andGroup overseeing effort to make state healthier hears of 'dire need,' tools for improvement.Princessiccia

Kentucky's health is "in dire need of improvement," but the state has some tools to do that, including health-care reform and the insurance program for its own employees, the group of officials charged with improving the state's health heard at its first meeting Thursday.

Mayfield
Dr. Stephanie Mayfield, commissioner of the Department of Public Health, told the group overseeing "Kyhealthnow" that the state is near the bottom of national rankings on nearly every goal set for the effort, but "is poised to make strong progress through school-based programs and the fact that federal health reform has made preventive services free," a state press release said.

The goals are that by 2019, Kentucky will reduce its smoking, obesity and uninsured rates by 10 percent; cut its death rates from cancer and cardiovascular disease by 10 percent; reduce deaths from drug overdoses and the average number of poor mental health days by 25 percent; reduce the percentage of children with untreated dental decay by 25 percent, and increase adult dental visits by 10 percent.

The effort is overseen by state cabinet secretaries, other key state officials, Mayfield as co-chair and Lt. Gov. Jerry Abramson as chair, by appointment from Gov. Steve Beshear. They are to meet quarterly.

The oversight group also heard from Department of Employee Insurance Commissioner Joe Cowles, whose agency provides health insurance coverage for 266,000 members, including employees of state agencies, school boards and local government, as well as retirees under age 65 and their dependents.


Cowles talked about the two insurance plans that contain a wellness component designed to encourage plan members to lead healthier lifestyles. "These plans provide lower coinsurance, deductibles and out-of-pocket maximums," Cowles said. "But more importantly, those who choose a LivingWell plan are required to complete an online health assessment. This helps them become more aware of their current well-being and understand their health risks. And, they get a personalized plan of action so they can get or stay healthy."

The department also offers a diabetes prevention program at no cost, and it has shown encouraging results, as participants are improving their physical activity and overall health, Cowles said. And it has anti-fraud measures that track the distance members drive to fill prescriptions, what drugs they are buying, how often, and so on.


The officials also heard from Dave Adkisson, president and CEO of the Kentucky Chamber of Commerce, which has made the health and wellness of Kentuckians one of its top three priorities because health-insurance costs have increased and an increasing share of companies� tax dollars go to pay for health care. He said the state's health problems have reached 
�epidemic proportions.�

�We commend Governor Beshear for engaging his entire administration in a comprehensive effort to improve Kentucky�s health problems,� Adkisson told Kentucky Health News. �Health costs are a major issue among Kentucky businesses. But containing those costs can be like turning an aircraft carrier around in open water. We are glad state government as a huge employer has stepped up its efforts to encourage wellness among state employees and their family members who are covered by the state�s health insurance program. By being aggressive on wellness, prevention and disease management, tens of thousands of lives will be improved and health care costs paid by taxpayers will be contained.�

Tuesday, 25 March 2014

Princess Health and Princess Health andFDA reviews alternatives to colonoscopies to screen for colorectal cancer, including mail-in, stool-sampling kits.Princessiccia

Princess Health and Princess Health andFDA reviews alternatives to colonoscopies to screen for colorectal cancer, including mail-in, stool-sampling kits.Princessiccia

The Food and Drug Administration is examining the possibility of two alternatives to colonoscopies for identifying tumors and growths in the large intestine. Kentucky ranks high in deaths from colon cancer, partly because people resist having colonoscopies.

According to briefing documents posted online Monday, scientists are evaluating the precision of mail-in, stool-sampling kits from Epigenomics and Exact Sciences, which if approved could be on the market this summer, Matthew Perrone writes for the Minneapolis Star Tribune.

Stool tests have long been employed to help detect precancerous tumors, and colon cancer is often treatable if found early enough. So far, the two tests are more accurate than traditional blood stool tests, but they also more often reported growths when there were none.

"Colorectal cancer is the second leading cause of cancer death in the U.S., with over 50,000 deaths expected this year, according to the American Cancer Society," Perrone reports. Last year Kentucky had the fourth highest death rate for colon cancer in the nation, Dr. Amy Tiu noted in a March 15 article for the Lexington Herald-Leader.

Though colonoscopy is the most accurate screening, many people shun it because they think it will be uncomfortable or invasive, and a liquid compounds must be used to clean out the colon before the procedure. The blood-in-stool tests, though thought to be less accurate, may work just as well if employed each year, according to a federally appointed panel.

The new screenings are expected to be more expensive than traditional tests, and it is so far unclear how often people would need to be tested, Perrone reports.

"Only through a better understanding of other key factors, such as the screening interval, adherence, cost and diagnostic evaluation of positive results, can we determine the appropriate place for stool DNA testing on the screening menu," Drs. Douglas Robertson Dr. Jason Dominitz said in the briefing documents.

One of the proposed tests, Cologuard, detected colorectal cancer in 92 percent of patients who had cancerous tumors, while the traditional blood stool test only has 74 percent accuracy. "In patients with precancerous polyps the test was accurate 42 percent of the time, compared with 24 percent for the blood test," Perrone reports.

Epigenomics' Epi proColon test, however, did not meet all of the study goals. This test discovered cancer in 68 percent of patients who had cancerous tumors, but it only recognized healthy patients in 79 percent of cases. FDA scientists warned that "lower specificity could lead to an increase in the number of avoidable colonoscopies" and "adverse events associated with such invasive procedures," Perrone writes.

Princess Health and Princess Health andSmoking persists or even increases in poor, rural, working-class counties; New York Times cites Clay County as an example.Princessiccia

Clay County has a dubious distinction. It has the highest rate of smoking for any U.S. county with a population under 15,000. Researchers at the University of Washington pointed that out, and The New York Times focused on it in reporting the larger finding: Some poor, rural and working-class counties have increasingly high rates of smoking, while the smoking rates in wealthy counties continue to decline.

Ed Smith Jr.
(NYT photo by Tim Harris)
In Clay County, the smoking rate was 36.7 percent in 2012. �It�s just what we do here,� Ed Smith Jr., 51, told the Times, which reports, "Several of his friends have died of lung cancer, and he has tried to quit, but so far has not succeeded." (Institute for Health and Metrics map shows adult smoking rates by county; Clay and Knox counties are the red area in southeastern Kentucky. The interactive map shows how rates have changed since 1996, overall and among men and women. To view it, click here.)
The smoking rate among adults has decreased 27 percent since 1997, but only 15 percent among poor people, and haven't changed at all for adult smokers living in deep poverty in the South and Midwest, the study found. "The findings are particularly stark for women," Sabrina Tavernise and Robert Gebeloff write. "About half of all high-income counties showed significant declines in the smoking rate for women, but only 4 percent of poor counties did." Education also plays a role. "Americans with a high-school education or less make up 40 percent of the population, but they account for 55 percent of the nation�s 42 million smokers."

Clay County is one of the nation's poorest, and only 7 percent of its people have a college degree. The county seat, Manchester, passed an indoor smoking ban in 2012, and Manchester Memorial Hospital "runs a smoking-cessation program that offers free nicotine patches and gum in an effort to reach low-income smokers," the Times reports. �Smoking cessation is our biggest uphill battle,� Jeremy Hacker, the hospital�s community outreach coordinator, told the newspaper. Smoking is no longer a normal activity in urban places, he said, but in Clay, �It�s not viewed as a problem.� (Read more)

Sunday, 16 March 2014

Princess Health and Princess Health andNumber of Kentucky babies born addicted keeps rising quickly as heroin replaces harder-to-get prescription painkillers.Princessiccia

Despite the crackdown on prescription painkillers, more Kentucky babies are being born addicted, "fueled by a recent spike in heroin use," much of it by people who have found prescription painkillers harder to get, Laura Ungar reports for The Courier-Journal.

"The state has seen hospitalizations for drug-dependent newborns soar nearly 30 fold in a little more than a decade � from 28 in 2000 to 824 in 2012, according to a recent drug report from the Kentucky Injury Prevention and Research Center. Preliminary figures suggest that number will surpass 900 in 2013, according to state officials," Ungar reports, in a follow-up to a series she did on the state's prescription-drug abuse problems in 2012.

"The financial cost is also high � and climbing exponentially," Ungar writes. "Hospital charges for drug-dependent babies in Kentucky rose from $200,000 in 2000 to $40.2 million in 2012, with $34.9 million that year paid for by government Medicaid," nearly 30 percent of which comes from Kentucky taxpayers.

"Although there are no state-by-state statistics, Dr. Henrietta Bada, a neonatal-perinatal medicine doctor at the University of Kentucky, said she believes Kentucky has one of the nation�s worst problems with drug-dependent babies." the Journal of the American Medical Association reported that U.S. hospitalizations for drug-dependent babies rose 330 percent from 2000 to 2009; "Kentucky�s hospitalizations rose more than 1,400 percent during that same time," but the state has "only 55 treatment centers serving pregnant and postpartum women, the vast majority outpatient facilities," Ungar reports. That's �a fraction of what we need,� Attorney General Jack Conway told her.

Friday, 7 March 2014

Princess Health and Princess Health andTodd County weekly's editor-publisher wonders why so many uninsured locals haven't signed up for health insurance.Princessiccia

With open enrollment in the new health-insurance exchanges ending March 31, at least one country editor is wondering why most people in his community who lack coverage haven't take advantage of the historic opportunity. And since he's in Kentucky, he used the state's next-to-last ranking in the latest Gallup-Healthways Well-Being Index as the point of departure for an article that took up most of his editorial page.

"Kentucky is its own worst enemy . . . and if you think this is just an Eastern Kentucky problem, you aren't paying attention," Editor-Publisher Ryan Craig, right, wrote in last week's Todd County Standard, in Western Kentucky. "Our numbers suggest we are as miserable as anywhere in the state, i.e., the nation." Craig then listed statistics for poverty, income, education and health insurance and said bluntly, "We are near the bottom in all of these categories, which are the same categories that cause Kentucky to have such a dismal ranking in the Miserable Test year after year."

Craig says Todd County, "it, seems, is among the bottom of counties who signed up for the Affordable Care Act," and wonders why only 533 of the estimated 2,455 people in his county without health insurance have signed up for it: "Is it because of fear of the unknown? Politics? The prevailing answer people tell me is that they would rather pay the tax penalty and not have the insurance. What would happen if that person or someone in their family was in a car wreck? They readily admit that they are taking a big chance, but don't see how they can afford the insurance even when it is cheaper now, especially those who are very sick and couldn't get insurance before." One man told him he would have to declare bankruptcy.

"The deadline to apply for health insurance through the exchange is March 31," Craig writes. "If you don't have insurance, at least consider the process." The Standard has been judged Kentucky's best small weekly newspaper seven years in a row, but doesn't put news or editorials online. For a scan of the editorial as a PDF, click here.

Tuesday, 4 March 2014

Princess Health and Princess Health andWear blue on Friday, March 7 to mark Colorectal Cancer Awareness Month and encourage screening and colonoscopies.Princessiccia

Princess Health and Princess Health andWear blue on Friday, March 7 to mark Colorectal Cancer Awareness Month and encourage screening and colonoscopies.Princessiccia

Friday, March 7 will be "Dress in Blue Day" to mark National Colorectal Cancer Awareness Month and to help raise awareness about colon cancer in Kentucky, according to Madeline Abramson, wife of Lt. Gov. Jerry Abramson.

�Kentucky has one the highest mortality rates of colorectal cancer in the nation,� she said in a news release.  �The good news is that through preventative screenings, this deadly disease can be detected early and treated successfully. I ask Kentuckians to join me in wearing blue on March 7 to help spread the word about the risks of colon cancer and the importance of getting screened.�

The American Cancer Society estimates that about 2,200 Kentuckians will be newly diagnosed with colon cancer this year and nearly 900 of them will die from it.  Those over 50, or who have a family history of colon cancer, are at the greatest risk and should get regular colonoscopies, doctors say.

To help raise awareness in Frankfort, the State Capitol dome will be lit blue until March 7. Hospitals, businesses, churches, schools, banks, health departments and other organizations are planning and hosting special activities to commemorate the month and promote screening.  

For more information on Colorectal Cancer Month and Dress in Blue Day, visit Madeline Abramson�s website at http://1.usa.gov/NrsMriand the Colon Cancer Prevention Project site at http://bit.ly/1i3q98G. The Kentucky Cancer Program website at www.kycancerprogram.org has information about cancer prevention, awareness and treatment.

Sunday, 2 June 2013

Princess Health and New report ranks Kentucky 45th in overall senior health.Princessiccia

By Molly Burchett
Kentucky Health News

Everyone dreams about retirement being a happy, healthy time to finally settle down, take time for yourself, travel and count your blessings, but a recent reports suggests that if you want to retire right now in a healthy environment, don't stay in Kentucky.

Kentucky ranks 45th in overall health rankings for seniors and last in two measures: total health outcomes for seniors and preventable hospitalizations, says United Health Foundation's America�s Health Rankings Senior Report. Kentucky was next to last in cognition and education of seniors and  prevalence of dental visits, and likewise second worst in premature death rate for seniors.


The report shows Minnesota at the top of the list, with Vermont and New Hampshire following closely and Mississippi as the least healthy state for older adults.

This report aims to point out the health challenges affecting today�s seniors and encourage action that improves communities' overall health. In Kentucky, the reports shows community support is low, with total community expenditures at $358 per person aged 65 and older living in poverty, much lower than Minnesota's $542 per capita.

Not all of the report's findings about Kentucky were bad; the state is strong in three areas: underweight seniors, activity-limiting arthritis pain and low-care nursing home residents. And, on another positive note, Kentucky ranks 15th in the number of seniors receiving flu vaccines and 10th in pain management for seniors. Click here for details.

Determinants that were considered in the state's ranking include behaviors like smoking and dental visits; micro and macro community and environment measures like poverty and social support; policy measures like the state's geriatrician shortfall; and measures of clinical care like home health or hospital care and diabetes management.

The health of our state's seniors is critical, especially as baby boomers age. The number of Americans age 65 and older is expected to more than double by 2050, from 40.3 million to 88.5 million, according to the federal Centers for Disease Control and Prevention. About 13.5 percent of Kentuckians are 65 or older, which is higher than the national average.  Considering this, the report generates a provoking question. If our state's seniors are unhealthy, can Kentucky be healthy?