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

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

dental care exercise federal spending health rankings hospitals immunizations local government nursing homes obesity oral health physical activity poverty seniors state government vaccinations

Gusty 12:57 Add Comment

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)

Princess Health and CDC boss Tom Frieden, at SOAR, gives examples of how communities can improve health, such as smoking bans. Princessiccia

Princess Health and CDC boss Tom Frieden, at SOAR, gives examples of how communities can improve health, such as smoking bans. Princessiccia

blood pressure cardiovascular disease heart disease hypertension obesity physical activity pregnancy smoking smoking ban smoking bans teenagers teens tobacco tobacco prevention walking

Gusty 13:08 Add Comment

By Al Cross
Kentucky Health News

PIKEVILLE, Ky. -- Speaking to a region with some of the nation's poorest health, the top federal public-health official gave examples of how individual communities and states have made themselves healthier.

"Health is not just about health, it's about society," Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, told more than 1,000 people at the Shaping Our Applalachian Region Innovation Summit in Pikeville. "Healthy societies are more productive, and productive societies are more healthy."

Referring to Kentucky's high rates of disease and factors that cause them, Frieden said bringing Eastern Kentucky's health statistics up to the national average would save more than 1,000 lives a year.

Frieden cited six communities that have tackled specific health issues, such as obesity, lack of physical activity, heart health, smoking and teen pregnancy.

Obesity is one of SOAR's three main health targets, but it's not an easy one, Frieden said. He said Somerville, Mass., reduced obesity in children under 6 by 21 percent by making it a community issue, with creation of farmers' markets for local produce, construction of walking paths and the mayor leading community walks.

"Physical activity is the closest thing to a wonder drug," Frieden said, because it helps prevent heart disease, strokes, diabetes and cancer, improved mood and lengthens life.

The leading preventable cause of death is smoking, Frieden said, calling for ordinances and laws making workplaces smoke-free. "Nobody should have to risk getting cancer to come to their job," he said.

Heart disease is the most preventable major cause of death, Frieden said, explaining how Minnesota and Grace Community Health Centers in Knox, Clay, Leslie and Bell counties have improved heart health by improving treatment of high blood pressure, or hypertension. "It's the single most important thing" to do for heart health, and it's simple, Frieden said, because the medicine is inexpensive and taken once a day with few if any side effects.

Frieden said the CDC thinks a lot about teen pregnancy because "Teen pregnancy perpetuates a cycle of poverty." He said Spartanburg, S.C., reduced teen pregnancy by 61 percent from 2001 to 2014 partly because South Carolina's Medicaid program paid for long-acting, reversible contraception immediately after delivery, and was the first state to give full reimbursement for post-partum insertion of intrauterine devices for birth control. Kentucky Medicaid doesn't cover such services.

Princess Health and Changes coming for Nutrition Facts labels on food products: emphasis on calories, added sugar and serving size. Princessiccia

Princess Health and Changes coming for Nutrition Facts labels on food products: emphasis on calories, added sugar and serving size. Princessiccia

calories childhood obesity diet federal regulation food food and drug administration food industry food marketing nutrition obesity

Gusty 14:14 Add Comment

Associated Press

By Danielle Ray
Kentucky Health News

Nutrition labels on food products will undergo a facelift over the next two years.

The U.S. Food and Drug Administration finalized plans Friday to change labeling to emphasize calorie count and added sugars in an effort to simply nutrition labels and clarify serving sizes.

First lady Michelle Obama, a longtime crusader against childhood obesity, said parents will benefit from the upcoming changes.

"You will no longer need a microscope, a calculator, or a degree in nutrition to figure out whether the food you're buying is actually good for our kids," she told The Associated Press.

The overhaul puts less emphasis on fats and more on caloric value and added sugars. Calories on upcoming labels will be listed in larger font than other nutrient facts. Added sugar will get its own line, separate from naturally occurring sugar.  Currently, both added and naturally occurring sugars were lumped under one category, "Sugars."

New labels will also include a new "percent daily value" for added sugar, which will tell consumers how much of their recommended daily intake they will get from a given item. The FDA recommends consuming less than 10 percent of total daily calories (200 calories in a typical diet) from added sugar.

"The new labels should also spur food manufacturers to add less sugar to their products," Michael Jacobson, president of the advocacy group Center for Science in the Public Interest, told AP. He said that under current labeling, it's nearly impossible for consumers to know how much sugar fits into a reasonable diet.

The footnote will better explain what "percent daily value" means. It will read: �The % Daily Value tells you how much a nutrient in a serving of food contributes to a daily diet. 2,000 calories a day is used for general nutrition advice.�

Serving sizes will also be clearer. The biggest difference will be that serving sizes will be based on what consumers typically eat instead of what they should eat. About one-fifth of foods will undergo revised calculations. For example, a serving size of ice cream will be 2/3 of a cup; previously it was a 1/2 cup.

If you've ever been duped into consuming more calories than you intended, or tried to calculate exactly what fraction of a slice of pizza constitutes a serving size, you're in luck. Package size affects what people eat, the FDA noted. So, products that were previously between one and two servings, such as a 20-ounce soda, will be labeled as a single serving, since consumers generally eat or drink the entire contents in one sitting.

Larger containers, like pints of ice cream, will have dual column labels: one column with information for a single serving and the other with information for the entire container.

Labels will also include two additional nutrients: potassium and Vitamin D.

Industry reaction was predictable. A representative for the Sugar Association told AP that emphasis on added sugar could confuse consumers, but other industry leaders welcomed the changes.

"This update is timely as diets, eating patterns and consumer preferences have changed dramatically since the Nutrition Facts panel was first introduced," Leon Bruner, of the Grocery Manufacturers Association, told AP.

Most food manufacturers have until July 2018 to comply. Smaller manufacturers will have an additional year.

The FDA proposed the changes two years ago. They are the first major update to nutrition labels since labeling was introduced in 1994. So far, more than 800,000 foods have nutrition labels.

For more information on the changes, click here.

Princess Health and 1/2 of cancer deaths and maybe 1/2 of new cases could be prevented by exercise, watching food and drink, and not smoking. Princessiccia

Princess Health and 1/2 of cancer deaths and maybe 1/2 of new cases could be prevented by exercise, watching food and drink, and not smoking. Princessiccia

cancer obesity prevention research smoking tobacco tobacco prevention

Gusty 08:31 Add Comment

Half of all cancer deaths could be prevented "by applying insights that we've had for decades � no smoking, drinking in moderation, maintaining a healthy body weight and exercising," Carolyn Y. Johnson reports for The Washington Post, about a study published in JAMA Oncology.

Those measures could also cut new cancer cases by 40 to 60 percent. Those are big numbers, and especially important for Kentucky, which has some of the nation's leading rates of cancer and death from it � and, not coincidentally, is among the national leaders in smoking and obesity.

"Some of the declines we have already seen in cancer mortality � the large decline in lung cancer � that was because of efforts to stop people from smoking," Siobhan Sutcliffe, an associate professor in the division of public health sciences at Washington University in St. Louis, told Johnson. "Even while we�re making new discoveries, that shouldn�t stop us from acting on the knowledge we already do have."

Sutcliffe was not involved in the study, which used "large ongoing studies that have closely followed the health and lifestyle habits of tens of thousands of female nurses and male health professionals," Johnson reports. "They divided people into two groups: a low-risk group that did not smoke, drank no more than one drink a day for women or two for men, maintained a certain healthy body mass index, and did two-and-a-half hours of moderate aerobic exercise a week or half as much vigorous exercise.

"The team compared cancer cases and cancer deaths between the low- and high-risk groups and found that for individual cancers, the healthy behaviors could have a large effect on some cancers: The vast majority of cases of lung cancer were attributable to lifestyle, as well as more than a fifth of cases of colon cancer, pancreatic cancer and kidney cancer.

"Then, they extrapolated those differences to the U.S. population at large, finding an even larger proportion of potentially preventable cancer cases and deaths. For women, they estimated 41 percent of cancer cases were preventable and 59 percent of cancer deaths. For men, 63 percent of cancer cases were potentially preventable and 67 percent of deaths."

The researchers at Massachusetts General Hospital and the Harvard T.H. Chan School of Public Health noted some caveats: "The high-risk group in the study is healthier than the general U.S. population, so there are reasons the numbers may be slightly overestimated," Johnson writes. "But Mingyang Song, the researcher who led the work, argues the numbers are a good approximation because they may be underestimating the effects of lifestyle, too, because they selected a narrow range of lifestyle factors."

Princess Health and Childhood obesity rates continue to rise nationally while Ky.'s rate has leveled off, but 1/3 of kids are still overweight or obese. Princessiccia

Princess Health and Childhood obesity rates continue to rise nationally while Ky.'s rate has leveled off, but 1/3 of kids are still overweight or obese. Princessiccia

childhood obesity farm to school nutrition obesity pediatrics physical activity research school lunch schools

Gusty 09:46 Add Comment

By Melissa Patrick
Kentucky Health News

Nationally, childhood obesity rates are not declining and severe obesity rates are still rising, especially among minority children. However, in Kentucky, child obesity rates have remained stable and the rates of obesity for minority children are not rising.

�Understanding the ongoing trends in obesity is important for public health and policymakers,� lead researcher Asheley Skinner, who is with the Duke Clinical Research Institute, said in a news release. �Our study suggests that more than 4.5 million children and adolescents in the U.S. have severe obesity."

The study, published in the journal Obesity, examined data from the National Health and Nutrition Examination Survey between 1999 and 2014 and found that 33.4 percent of children in the U.S. were overweight, meaning their body mass index (BMI) was above the 85th percentile for children their age. BMI levels estimate body fat based on height and weight.

In 2013-14, the study found that nearly 24 percent were obese, or above the 95th percentile, and that 2.4 percent were severely obese, or more than 140 percent of the 95th percentile.

The authors noted that the only statistical increase in child obesity since 2011 was found in those who were severely obese, which went up 2.1 percent, and this increase was most prevalent among African American and Latino children. The report also said that while there has been an increase in obesity in all age groups over the past 30 years, it "may be leveling off."

It could be that this "leveling off" effect is happening in Kentucky, where more than one-third of children are either overweight or obese.

The State of Obesity report found that 18 percent of Kentucky's high school students are obese, almost 20 percent of its 10- to 17- year olds are obese and 15.5 percent of its 2- to 4- year-olds from low-income families are obese. The report also shows that these rates have remained consistent for high school obesity since 2003, 10- to 17- year-olds since 2004 and the 2- to 4- year-olds since 2003.

The Kentucky Youth Risk Behavioral Survey also shows no overall statistical changes in obesity rates among  Kentucky's high-school students, including the state's African American high school students, whose rates range from from 15.5 percent obese in 2005 to 19.1 percent in 2013, or its Hispanic high school students, whose obesity rates were 15.5 percent in 2007 and 18.8 percent in 2013, the only two years with available data.

These reports did not break down the different levels of obesity.

Studies have shown that children with severe obesity are at an increased risk for heart disease, Type 2 Diabetes and even cancer when compared to children who are only considered overweight or mildly obese, says the release.

Skinner said it is time to expand local interventions and to find new treatment approaches.

"Addressing obesity in children is going to require a true population health approach, combining efforts at individual, healthcare, community and policy levels," she said in the release.

What is Kentucky doing about childhood obesity?

Kentucky's schools, as community partners in the battle against childhood obesity, are working to combat it through both nutrition and movement initiatives.

For example, most public Kentucky schools participate in the 2010 Healthy, Hunger-Free Kids Act that requires schools to provide healthier foods for their students; many schools participate in the Fresh Fruit and Vegetable Program, which provides a daily fruit or vegetable snacks to every student in participating schools; and more than 80 Kentucky school districts participate in the National Farm-to-School program.

Jamie Sparks, the school health and physical education director for the Kentucky Department of Education, said in an e-mail to Kentucky Health News that Kentucky schools are working to get students more active through several initiatives.

Sparks pointed out several successes, including school partnerships with the Alliance for a Healthier Generation initiative; a partnership with Humana Vitality called Students with Active Role Models, which encourages teachers and school staff to earn Vitality points by leading physical activity with their students; and partnerships with an online program called GoNoodle, which increases physical activity time in the classroom.

In addition, Sparks said, "Kentucky ranks second in the percentage of public schools enrolled with Let�s Move Active Schools. We have hosted 10 Physical Activity Leader trainings in the past three years."

But is that enough to make a difference?

Dr. Willian Dietz, author of an accompanying journal editorial, said there is a shortage of care-givers to treat obesity, noting that every primary care provider who takes care of children is likely to have about 50 pediatric patients with severe obesity in their practice. He also said that most of these providers aren't trained to treat childhood obesity, nor are they compensated appropriately, if at all, to treat it.

"We need more effective, cost-efficient and standardized approaches and services to manage children with the most severe obesity. This research emphasizes the urgency with which we must develop and validate a reimbursable standard of care for severe obesity in children and adolescents,"Elsie Taveras, spokesperson for The Obesity Society, said in the release.

It should be noted that Dietz, who is the director of the Global Center for Prevention and Wellness at George Washington University, said in his editorial that other data shows obesity rates have declined in two- to five- year olds. He said that this doesn't mean this study is incorrect because different time frames were used. "It all depends on how you look at it," he said. He did, however, acknowledge that severe obesity is increasing among adolescents.

He said, �The authors� observation that severe obesity has increased is of great concern, especially because children with severe obesity become adults with severe obesity.�

Princess Health and Struggling Tenn. hospital takes care of Kentuckians, who get better care than Tennesseans thanks to expanded Medicaid. Princessiccia

Princess Health and Struggling Tenn. hospital takes care of Kentuckians, who get better care than Tennesseans thanks to expanded Medicaid. Princessiccia

accountability drug abuse economy health care access Medicaid obesity Patient Protection and Affordable Care Act rural health rural hospitals

Gusty 18:04 Add Comment

Jellico Community Hospital, just across the Kentucky border in Tennessee along Interstate 75, was taken over by Community Hospital Corp. last May, but that's not a guarantee it will survive, especially since Tennessee refuses to expand Medicaid to its poorest citizens, as Kentucky has, Harris Meyer reports for Modern Healthcare.

Meyer notes that one of the contributing factors to the hospital's struggle is the Tennessee Legislature's refusal to expand Medicaid under health reform to those who make up to 138 percent of the federal poverty level. That would decrease the hospital's level of uncompensated care.

About half the hospital's patients come from Kentucky, and its administrators, doctors and nurses all told Meyer that it is easier to get testing and specialty care for Kentucky Medicaid patients than for uninsured Tennessee patients who would qualify for expanded Medicaid.

�We're able to do more for Kentucky patients,� Christy Elliott, the hospital's case management supervisor, told Meyer. �For Tennessee patients, it's a struggle. If you don't have insurance, you don't get services.�

One such patient was Rebecca Jarboe, a mother of three from Kentucky. She told Meyer that she went into a "difficult" labor during a snowstorm on Valentine's Day. Because of the weather and her condition, she said she and her husband decided to travel 14 miles from their home to Jellico to have the baby, instead of making the 70-mile-journey down I-75 to the University of Tennessee Medical Center in Knoxville, 20 miles of which would have been over snow-covered Pine Mountain (known locally as Jellico Mountain).

�The care here is excellent,� a tired-looking Jarboe told Meyer while lying in her hospital bed cradling 2-day-old Silas and surrounded by her family. �Whatever you need, they are right at the door, and everyone is really friendly.�

The 31 states that have expanded Medicaid have been able to "shore up finances" in many of their rural hospitals, Meyer writes, but others have not fared so well. Nationwide, more than 50 rural hospitals have closed in the past six years, and nearly 300 more are in deep financial trouble, according to the National Rural Health Association.

A state report by then-Auditor Adam Edelen last year found that one in three of Kentucky's rural hospitals were in poor financial condition. Since the release of the report, several Kentucky rural hospitals have merged with larger hospital groups to make ends meet and rural hospitals in Nicholas and Fulton counties have closed.

Meyer also notes that Jellico hospital's problems go deeper than just not expanding Medicaid. In its service area good-paying jobs with health benefits have dwindled, only 10 percent of the population has private health insurance, residents have higher-than-average rates of disease, and there is rampant obesity and drug abuse. A similar story could be told about many rural Kentucky communities.

In addition to providing health care, the 54-bed hospital with its staff of 232 is the community's largest employer, as is often the case. The mayor of nearby Williamsburg, where the hospital has a clinic, noted that new businesses will often not consider moving to a community without a hospital.

�A lot depends on economic development in these communities,� Alison Davis, a professor of agricultural economics who studies rural healthcare at the University of Kentucky, told Meyer. �What are they going to do to create jobs? It's the No. 1 issue besides substance abuse they are facing. It's a struggle, and not every community will make it through.�

Adventist Health System, out of Florida, announced in May 2014 that it wanted to get rid of the hospital because it was losing "millions a year." A year later, CHC, a Texas-based not-for-profit with a mission to preserve access to healthcare in rural communities, took over the hospital and its clinic. CHC owns, manages and provides support to 21 community hospitals nationwide, according to a news release.

CHC told Meyer that it is optimistic the hospital will survive because of the medical staff's commitment to keeping quality healthcare in their community. It has also implemented cost-saving measures, like decreasing staff and installing a less costly electronic health record system, and is exploring ways to further save money, while increasing its client base.

But several local business leaders told Meyer they weren't so sure the hospital will survive.

�There have been so many layoffs that they don't have enough people to do lab work or X-rays, and you have to wait and wait,� Elsie Crawford, business manager of the Wilkens Medical Group in Jellico and a member of the City Council, told Meyer. �You can't draw more patients if you don't have enough people to take care of them.�

Dr. Charles Wilkens, who helped establish and maintain the hospital, told Meyer, �People would die for lack of health care if we didn't have a hospital in this community.�

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 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.

Princess Health and Obesity and depression may contribute to daytime sleepiness.Princessiccia

Princess Health and Obesity and depression may contribute to daytime sleepiness.Princessiccia

depression obesity research sleep sleep apnea

Gusty 14:10 Add Comment

Obesity and depression, not just lack of sleep, contribute to daytime drowsiness, according to Penn State College of Medicine researchers. Daytime drowsiness or sleepiness affects up to 30 percent of the U.S. population. It can reduce work productivity and cause car accidents. According to the States of Obesity report, 33.2 percent of Kentucky adults are obese.

The Penn State study used physiologic sleep data to show a connection between obesity and depression or sleepiness. Study participants filled out a comprehensive sleep history and physical examination and were evaluated in a sleep laboratory. "Obesity and weight gain predicted who was going to have daytime sleepiness," said Julio Fernandez-Mendoza, assistant professor of psychiatry at the Sleep Research and Treatment Center. "Weight loss predicted who was going to stop experiencing daytime sleepiness, reinforcing the causal relationship."

Body mass index and sleepiness association was independent of sleep duration, so obese people might be sleepy during the day regardless of how much sleep they get. Obesity is also associated with sleep apnea. The chief reason heavy people are more tired is that fat cells create immune compounds called cytokines that make one sleepy.

According to the study, depressed people have daytime drowsiness because they have trouble falling asleep and often wake up during the night. "The mechanism that we believe is playing a role here is hyperarousal, which is simply going to bed and being to alert; in other words, people with depression feel fatigued but do not necessarily fall asleep during the day, Fernandez-Mendoza said.

The study showed that a one-size-fits-all method for treating daytime drowsiness will not be effective. Daytime sleepiness doesn't always mean a person doesn't get enough sleep, Fernandez-Mendoza said. "The main causes of a sleepy society are an obese society, a depressed society and, to some extent, people who have a physiological disorder. By looking at our patients more closely, we can start personalizing sleep medicine."

Princess Health and One of every three U.S. adults have a combination of risk factors that increase their risk for heart disease and diabetes.Princessiccia

Princess Health and One of every three U.S. adults have a combination of risk factors that increase their risk for heart disease and diabetes.Princessiccia

blood pressure cholesterol diabetes heart disease obesity research

Gusty 13:23 Add Comment

More than one-third of adults in the U.S. have a combination of health conditions that put them at higher risk of heart disease and diabetes, and this condition affects nearly half of adults aged 60 and older, according to a new study recently published in the Journal of the American Medical Association.

Image: healthyanswers.com

This combination of health conditions, when found in one person, is called metabolic syndrome. It includes abdominal obesity, high blood pressure, increased fasting glucose levels and abnormal cholesterol levels.

The study collected data gathered by the federal Centers for Disease Control and Prevention from adults 20 and older from 2003 to 2012. It found that about a third had a metabolic symdrome in 2011-12, and nearly half of those 60 and older did. Among those 20 to 39, the rate was 18 percent.

The study report says these were "concerning observations" because of the country's aging population. Hispanics, at 39 percent, were found to have the highest prevalence of metabolic syndrome among ethnic groups. Women had a higher prevalence than men in all age groups.

The American Heart Association says the best way to control the risk factors contributing to metabolic syndrome are to lose weight and increase physical activity. It also encourages patients to routinely monitor their weight, blood glucose, cholesterol and blood pressure and treat these risk factors according to established guidelines.

Princess Health andMost Kentuckians don't think insurance rates should be higher for the obese, but are divided on increasing smokers' rates.Princessiccia

Princess Health andMost Kentuckians don't think insurance rates should be higher for the obese, but are divided on increasing smokers' rates.Princessiccia

Foundation for a Healthy Kentucky health insurance obesity poll smoking tobacco

Gusty 10:51 Add Comment

By Melissa Patrick
Kentucky Health News

By a very small margin, Kentuckians think insurance rates should be higher for smokers if the insurance company provides a free smoking cessation program, but most don't think rates should be higher for those who are overweight, says the latest Kentucky Health Issues Poll.

The poll, taken Oct. 8 to Nov. 6, found that 50 percent of Kentucky adults said it would be justified to set higher insurance rates for people who smoke, while 45 percent said it wouldn't be justified. Five percent were undecided. This finding was basically the same whether the person had insurance or not.

The poll's margin of error was plus or minus 2.5 percentage points, which applies to each number, so the results were right on the error margin. That means in 19 of 20 cases, the results would be the same if the entire adult population of Kentucky were asked the question.

The poll found that most Kentuckians who have never smoked (63 percent) said insurance companies should not set higher insurance rates for people who smoke. Former smokers, at 51 percent, were less likely to agree with that opinion.

With about 27 percent of Kentuckians smoking, Kentucky leads the nation in smoking percentage, lung cancer and lung cancer deaths, which collectively come with a price tag.

Smoking cost the state $1.92 billion a year for health-care expenditures directly as a result of tobacco use, which amounts to $988 million a year in total taxpayer cost from smoking-related expenses, or $591 per household, Wayne Meriweather, chief executive officer of Twin Lakes Regional Medical Center in Leitchfield, representing the Kentucky Hospital Association, told legislators in December.

The poll also found that the majority of Kentucky adults, 67 percent, think it is unjustified to set higher insurance rates for people who are significantly overweight. Opposition was higher, 77 percent, among those who reported being in fair or poor health; among those who said they were in excellent or very good health, only 58 percent were opposed.

Kentucky ranks fifth in the nation for adult obesity, with one in three Kentuckians considered obese, according the "States of Obesity" report. This also comes with a price tag.

A study in the American Journal of Health Promotion found that a morbidly obese employee costs his or her employer approximately $4,000 more in health care and related costs every year than an employee of normal weight.

The poll was sponsored by the Foundation for a Healthy Kentucky and Interact for Health, formerly the Health Foundation of Greater Cincinnati, and was conducted by the Institute for Policy Research at the University of Cincinnati. It surveyed a random sample of 1,597 adults via land lines and cell phones.

Princess Health andFederal dietary guidelines recommend cutting back on red and processed meat, sugar and refined grains.Princessiccia

Princess Health andFederal dietary guidelines recommend cutting back on red and processed meat, sugar and refined grains.Princessiccia

food nutrition obesity sugar

Gusty 20:09 Add Comment

The Department of Agriculture and the Department of Health and Human Services have released proposed 2015 Dietary Guidelines for Americans. The guidelines, released every five years, "provide authoritative advice about consuming fewer calories, making informed food choices, and being physically active to attain and maintain a healthy weight, reduce risk of chronic disease, and promote overall health," says USDA.

It shouldn't come as a surprise that the 2015 guidelines recommend eating healthier foods, while cutting back on less healthy alternatives. "The committee basically recommended Americans take up a diet that is higher in vegetables, fruits, whole grains, low- or non-fat dairy products, seafood, legumes and nuts," Chris Clayton reports for DTN The Progressive Farmer. "We should cut back on red and processed meats and sugar-sweetened foods, drinks and refined grains. And we should be moderate in our alcohol."

Recommended cutbacks of certain foods have not gone over well with those food producers, who met this week to give feedback on the Dietary Guidelines Advisory Committee's recommendations, Clayton writes. The North American Meat Institute argued that "lean meat, poultry, red and processed meats should all be part of a healthy dietary pattern because they are nutrient-dense protein."

Shalene McNeill, a nutritionist for the National Cattlemen's Beef Association, "told the committee that its recommendation to exclude lean meat ignores decades of nutrition science," Clayton writes. McNeill said Americans should be encouraged to eat more lean meat, along with fruits, vegetables and whole grains. Grain, sugar and milk producers also expressed displeasure with the proposed rules.

Most nutritionists have embraced the proposed rules, but say the key is getting people to adopt them, Andrea McDaniels reports for The Baltimore Sun. Among those rules is limiting sugar intake to 200 or less calories, or 10 percent of total calories, per day. Currently, Americans get about 13 percent of their calories, or 268 calories, from added sugar.

"On the flip side, some foods once shunned are now accepted," McDaniels writes. "Research has found that cholesterol-high foods are no longer believed to contribute to high blood cholesterol, so people can now indulge in shrimp, eggs and other foods that were once off limits, the panel said. Rather than focus on cholesterol, people should curb saturated fat to about 8 percent of the diet."

The panel also said "up to five cups of coffee a day are fine, so long they are not flavored with lots of milk and sugar," McDaniels writes. "The panel also singled out the Mediterranean diet�rich in fish and chicken, fruits and vegetables, nuts, whole grains, olive oil and legumes�for its nutritional value."

Princess Health and Princess Health andPeople with a genetic risk of obesity should avoid saturated fat, national study of 2,800 people suggests.Princessiccia

Princess Health and Princess Health andPeople with a genetic risk of obesity should avoid saturated fat, national study of 2,800 people suggests.Princessiccia

diet genetics nutrition obesity research

Gusty 21:20 Add Comment

A new study shows that avoiding saturated fat may be advantageous for those whose genetic makeup predisposes them to obesity. Researchers from the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University used 63 gene variants associated with obesity to determine a genetic risk score for obesity for more than 2,800 white, American adults participating in two studies about heart disease prevention.

"People with a higher genetic risk score, who also consumed more of their calories as saturated fat, were more likely to have a higher body mass index, the ratio of body weight to height," Newswise reports.

"We already know there are certain genes that interact with dietary fat and affect BMI," said senior author Jose M. Ordovas, Ph.D., director of the Nutrition and Genomics Laboratory at the USDA center and a professor at the Friedman School of Nutrition Science and Policy at Tufts. We "saw that while total fat intake was related to higher BMI, people who were genetically predisposed to obesity and ate the most saturated fat had the highest BMIs."

The study is published in the Journal of the Academy of Nutrition and Dietetics. The findings also take into consideration factors like age, sex and physical activity levels. Ordovas and the other researchers believe that those who have genetic makeups predisposing them to obesity might be more easily affected by saturated fat, which is often found in fatty cuts of meats, butter, cheese and other high-fat dairy products.

Ordovas said that although they cannot yet explain with confidence the "role of saturated fat intake in obesity . . . Some clinical models suggest that saturated fat might interfere with activity in the part of the brain that lets us know we're full, in addition to a few studies in people that suggest a diet high in saturated fat interferes with satiety." Ordovas also said that if additional research could explain the connection between obesity-related genes and saturated fat, people would have even more convincing reasons to eat less saturated fat. (Read more)

Princess Health and Princess Health andWhat you eat, such as refined and easily digestible carbohydrates, may be more important that how much you eat.Princessiccia

Princess Health and Princess Health andWhat you eat, such as refined and easily digestible carbohydrates, may be more important that how much you eat.Princessiccia

diet nutrition obesity research

Gusty 12:14 Add Comment

By Melissa Patrick
Kentucky Health News

Our weight is determined by the number of calories we take in compared to the number of calories we expend. So, if you over-eat and don't exercise, all those extra calories will be stored as fat, and the solution to losing the fat is to eat less and exercise more, right? What if this isn't true?

For most people, over the long term, eating less doesn't work, nutritionists David S. Ludwig and Mark I. Friedman write in an opinion piece for The New York Times. They suggest it is time to look at another idea, one that says overeating is not causing us to get fat, but that the process of getting fat is causing us to overeat.

This hypothesis suggests that when fat cells take in too many calories, those calories increase the amount of fat tissue instead of providing the energy our bodies need to function. When this happens our bodies still think we need food, so they continue to tell us we are hungry. Thus, we eat more and subsequently gain weight, Ludwig and Friedman write in The Journal of the American Medical Association.

Studies have shown our bodies have a "set point" for weight largely determined by our genes, Ludwig and Friedman note. If this is true, they then pose the question: Why has obesity almost tripled since 1960, and what can we do about it?

Ludwig and Friedman write that among the many biological factors that affect the storage of calories in fat cells, one has an indisputably dominant role: the hormone insulin. We know that excess insulin causes weight gain, and insulin deficiency causes weight loss. We also know that highly refined and rapidly digestible carbohydrates, like sugar or potatoes, produce the most insulin.

The authors suggest that the increasing amount of refined carbohydrates in Americans' diets has "increased insulin levels, put fat cells into storage overdrive and elicited obesity-promoting biological responses in a large number of people."

The authors suggest that one reason we consume so many refined carbohydrates is because they have been added to processed foods in place of fats, especially since low-fat diets are the most recommended diet. However, several studies cited in the article show that low-fat diets are the least effective way to lose weight.

The authors recognize that existing research cannot provide a definitive test of their hypothesis and the existing trials have exhibited major limitations, but it is time to "invest much more in this research." The cost savings for treating diabetes alone�predicted to approach half a trillion dollars by 2020�would make it a good investment.

If this hypothesis turns out to be correct, the authors say obesity treatment would more appropriately focus on diet quality rather than calorie quantity.

"With reduced consumption of refined grains, concentrated sugar and potato products and a few other sensible lifestyle choices, our internal body weight control system should be able to do the rest," they write. "Eventually, we could bring the body weight set point back to pre-epidemic levels. Addressing the underlying biological drive to overeat may make for a far more practical and effective solution to obesity than counting calories."

David S. Ludwig directs the New Balance Foundation Obesity Prevention Center at Boston Children�s Hospital and is a professor of pediatrics at Harvard Medical School. Mark I. Friedman is vice president of research at the Nutrition Science Initiative. (Read more)

Princess Health and Princess Health andStudy: Banning sugary drinks from SNAP would reduce obesity and Type 2 diabetes; subsidy would boost fruit consumption.Princessiccia

Princess Health and Princess Health andStudy: Banning sugary drinks from SNAP would reduce obesity and Type 2 diabetes; subsidy would boost fruit consumption.Princessiccia

diabetes food stamps fruit nutrition obesity research sugar vegetables

Gusty 08:43 Add Comment

A measure preventing people from purchasing sugar-sweetened beverages through the Supplemental Nutrition Assistance Program, or food stamps, would significantly reduce obesity and Type 2 diabetes in adults under 65, and adding a subsidy for fruits and vegetables would more than double the number of SNAP participants who meet federal vegetable and fruit consumption guidelines, says a new study published in Health Affairs.

Research has shown that people on food stamps suffer diabetes, heart disease and obesity at higher rates than people who are in the same tax bracket but not on food stamps, Diane Jeanty reports for PBS Newshour. In 2013, these findings prompted 18 mayors from major U.S. cities to write to Congress with a push to ban the use of food stamps to purchase sugar sweetened beverages.

The American Beverage Association pushed back, saying "sugared beverages were being targeted and were not the only causes for obesity," Jeanty writes.

A research team led by Dr. Sanjay Basu, an assistant professor of medicine at the Stanford University School of Medicine, conducted the study to determine how banning sugared beverages could affect the SNAP population�s level of risk for these diseases, Jeanty reports. They used a survey by the federal Centers for Disease Control, which assesses the nutritional status of adults and children, and combined it with current information on SNAP.

The study had two models, one that banned sugary beverages�excluding 100 percent fruit juice�and another that offered an incentive for SNAP participants to receive a 30 cent credit for each dollar spent on fruit and vegetable purchases. The study factored in metabolism rates and demographics such as race, age, gender and income to test the effects of the proposed measures, Jeanty reports.

They found that with a simulated ban, a person would reduce his or her calorie intake by 24 per day. They also found that obesity rates decreased 2.4 percent and type 2 Diabetes rates dropped 1.7 percent�or 240,000 people�Jeanty reports. The simulated subsidy, did not, however, have a significant impact on overall diabetes and obesity.

The study also found that by adding a simulated subsidy on fruits and vegetables, SNAP participants increased their consumption from 1/4 cup to 3 cups per day. However, increasing the amount of fruits and vegetables consumed is not enough to influence the reduction of diabetes and obesity on a national scale, according to Basu. �There would also have to be further reforms to also reduce the consumption of sugary beverages,� Basu told Jeanty.

The Illinois Public Health Institute, addressing a proposed ban in Illinois, found that SNAP participants would still purchase sugared beverages with their own money, even if they were banned, Jeanty reports. But Basu says that his study accounted for this consideration. Basu said it is time to perform a controlled study instead of a simulation model, Jeanty writes.

Princess Health and Princess Health andHealth foundation chief objects to bill that would allow school districts to get waivers from recent nutrition standards.Princessiccia

Princess Health and Princess Health andHealth foundation chief objects to bill that would allow school districts to get waivers from recent nutrition standards.Princessiccia

children's health Congress diet fruit obesity school lunch schools vegetables

Gusty 17:15 Add Comment

The president of Kentucky's public-interest health foundation is objecting to legislation recently approved by the U.S. House Appropriations Committee to allow waivers from the school nutrition enacted by the Department of Agriculture in 2010.

Susan G. Zepeda, Ph.D.

Susan G. Zepeda of the Foundation for a Healthy Kentucky says in a statement sent to Kentucky news media that the foundation's polls show that Kentuckians "want healthier foods in the schools," but fewer than one in four Kentucky adults "described the meals at their children's school or daycare as 'very nutritious'."

Zepeda notes that the Data Resource Center for Child and Adolescent Health showed that 35.7 percent of Kentucky children were either overweight or obese in 2011-12, that children living in poverty are more likely to be obese, and that polls show Kentucky adults think childhood obesity is a serious issue, and 78 percent of them approved of the new USDA meal standards, Zepeda notes.

The legislation would allow school districts that have lost money on meals for six months to ask for a waiver from the standards. Zepeda said "the major voice" for the bill was the School Nutrition Association, "a trade group of school food officials backed by such food companies as Coca-Cola, Domino�s Pizza and PepsiCo," but "19 of the association�s former presidents have called on Congress to reject the waiver. We add our voice to this call."

Princess Health and Princess Health andStudy finds that obese workers cost employers thousands in extra medical costs every year; Kentucky ranks ninth in obesity.Princessiccia

Princess Health and Princess Health andStudy finds that obese workers cost employers thousands in extra medical costs every year; Kentucky ranks ninth in obesity.Princessiccia

employers obesity research workplace health

Gusty 13:14 Add Comment

A morbidly obese employee costs his or her employer approximately $4,000 more in health care and related costs every year than an employee of normal weight, according to a study in the American Journal of Health Promotion. Kentucky ranks ninth in obesity among the states.

As might be expected, the study also found that obese workers with high blood pressure, diabetes and high cholesterol brought more costs than obese workers without those conditions. "Someone who is overweight or obese and also has diabetes is more likely to file a short-term disability claim compared to someone who doesn't have diabetes but is overweight or obese," said Karen Van Nuys, Ph.D., lead co-author of the study and economist at Precision Health Economics in Los Angeles.

The study showed that an employee with a body mass index of 35 has almost twice the risk of filing a short-term disability claim or workers' compensation claim than an employee with a BMI of 25. A BMI of 30 or more indicates obesity. While employees who are of average weight incur approximately $3,830 each year in medical claims, sick days, short-term disability and workers compensation, and morbidly obese employees incur about $8,067 every year.

The researchers analyzed three years of data from almost 30,000 workers, including "self-reported employee health information, medical visits and prescription claim and employer-reported data on absenteeism, short term disability and workers compensation claims."

"Overweight/obesity are just one of several modifiable risk factors in the workplace�but ones that are most problematic right now because they're getting worse by the minute," said Ron Goetzel, Ph.D., of the Johns Hopkins Bloomberg School of Public Health and Truven Health Analytics. 

Van Nuys and Goetzel said their report is not meant to encourage employers to discriminate against overweight people, but Goetzel said employers should "invest in robust, comprehensive health promotion programs for their employees that include physical activity, healthy eating, stress and depression management and control of blood pressure and diabetes." He added, "If you do those in combination and you do them right, not only is [this type of intervention] cost-effective, in some cases it is cost-beneficial, so that there is potentially even a return on investment here for employers." (Read more)

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

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

cancer cardiovascular disease dental care dental health diabetes drug abuse drugs health rankings mental health obesity oral health state government

Gusty 20:23 Add Comment

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.�

Princess Health and Princess Health andHumana Inc. bus travels the rural roads of Mississippi, looking to enroll people in Obamacare by March 31 deadline.Princessiccia

Princess Health and Princess Health andHumana Inc. bus travels the rural roads of Mississippi, looking to enroll people in Obamacare by March 31 deadline.Princessiccia

health care health care access health insurance health journalism health reform obamacare obesity Patient Protection and Affordable Care Act poverty rural health

Gusty 13:13 Add Comment

Insurance providers have been scared off by Mississippi, one of the poorest and unhealthiest states in the country. Only nine percent of eligible residents have signed up for insurance under federal health reform, ranking Mississippi near the bottom of all states in Obamacare, with only 25,554 residents having signed up as of early March.

Politico photo by Madeline Marshall: Humana bus

Louisville-based insurance company Humana Inc. is attempting a unique way to try to get Mississippi residents signed up. The company has a bus that travels the state, having made more than 200 stops "pulling into hospital parking lots and Wal-Mart shopping centers, parking at churches large and small and hitting other obvious targets to find and convince the uninsured that President Barack Obama�s signature health achievement will benefit them," Jennifer Haberkorn reports for Politico. "Sometimes the company�s agents see dozens of people per stop. Other times, just a few individuals climb aboard."

Mississippi is the only state where Humana has a bus, Haberkorn writes. "It�s also the only state where the company is covering the co-pay for customers� first doctor�s visit before June, immediate cash savings that it hopes will get people to start a relationship with a primary-care physician. Officials declined to say exactly how much is being spent on the dual strategies."

Based on the dismal number of residents signing up, the bus hasn't exactly been a hit. Part of the problem is that rates in Mississippi are the third highest in the country, and that Humana is only one of two insurers in the state. "Despite all the political rhetoric about a government-run health program, Obamacare relies on private insurers to sell policies on the state and federal exchanges. If there�s no insurance company, then there�s really no Obamacare," Haberkorn writes. "And Mississippi is one of the last places the typical risk-averse health insurance company would choose to sell policies under the law. Statistically, it�s one of the unhealthiest states, topping the charts in all kinds of negatives such as obesity, diabetes, hypertension and cardiovascular disease � conditions that can be stabilized with treatment or kill without."

"But Humana has every incentive to sell as many policies as possible," Haberkorn writes. "The math involved is simple: Insurance works when there are more people enrolled, which spreads the risk of high costs across hundreds or thousands of customers. To succeed in a state like Mississippi, it had to go all out to get customers."

Humana originally offered policies in only four counties, but the state insurance commissioner persuaded it to go to 40. The company's Mississippi market director, told Haberkorn, �Back in August, when we added on an additional 36 counties, we had to act really quickly on how we would get to all of the people in those counties at such a last minute. Operating this mobile tour has allowed us to get to people, instead of waiting for them to come to us.� (Read more)

Princess Health and Princess Health andStudents in 2 Appalachian Ohio high schools help reduce classmates' consumption of sugary drinks, a bane in the region.Princessiccia

Princess Health and Princess Health andStudents in 2 Appalachian Ohio high schools help reduce classmates' consumption of sugary drinks, a bane in the region.Princessiccia

Appalachia child obesity nutrition obesity research schools sugar youth

Gusty 10:38 Add Comment

In a region where sweet-tea and soda is more popular than water, student-led groups in Appalachian Ohio were successful in reducing the amount of sugary drinks students consumed, reports The Ohio State University's Center for Clinical and Translational Science.

As part of the study, student-led teen advisory councils in the two Southern Ohio high schools implemented a 30-day intervention called "Sodabriety" to reduce the amount of sugary drinks students consumed. Results of the study were published in the March issue of the Journal of School Health.

The councils informed students about the risks of sugary drinks, put green ribbons on students' cars to remind them of the dangers, offered daily "sugar facts" during the morning announcements, performed soda-themed rap songs at student events and gave away water bottles with a "What's in your cup?" slogan.

The efforts paid off. Not only did some teens completely give up sugared drinks, but water consumption nearly doubled. Some students even reported weight loss, less acne and increased energy, Smith said.

A typical 20-ounce soda contains 15 to 18 teaspoons of sugar and upwards of 240 calories. A 64-ounce fountain cola drink could have up to 700 calories, says a fact sheet from the Harvard School of Public Health.

Kentucky high-school students rank third in the U.S. in obesity, with 33.4 percent overweight or obese, according to the federal Centers for Disease Control and Prevention. Consumption of sugary beverages is a problem in Appalachia, where obesity contributes heavily to the region's health issues.

�Teens who grow up in this region are ultimately more likely to die from cancer, diabetes and heart disease than any other place in the nation, and obesity is the common risk factor for all of those illnesses,� said nurse Laureen Smith, one of the researchers. �A child�s odds of becoming obese increases almost two times with each additional daily serving of a sugar sweetened drink, and Appalachian kids drink more of these types of beverages than kids in other parts of the country.�

Smith added, �Sugar sweetened beverages are the largest source of sugar in the American diet. For some teens, they account for almost one-third of daily caloric intake, and that amount is even higher among Appalachian adolescents. If we can help teens reduce sugared-beverage intake now, we might be able to help them avoid obesity and other diseases later in life.�