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Showing posts with label poverty. Show all posts
Showing posts with label poverty. Show all posts

Monday, 20 June 2016

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

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By Melissa Patrick
Kentucky Health News

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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)

Wednesday, 18 May 2016

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

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Photo from npr.org
By Danielle Ray
Kentucky Health News

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thursday, 16 April 2015

Princess Health andSchool nutritionists' lobbying group, freshly funded by grocery makers, wants more funding and flexibility with school-lunch rules.Princessiccia

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School nutrition officials want more flexibility with new school lunch rules to cut down on the waste of unwanted food, Spencer Chase reports for Agri-Pulse, a Washington newsletter. Julia Bauscher, president of the School Nutrition Association, told the House Education and Workforce Committee that the organization supports the rules, but needs more funding to enforce them  and more flexbility to serve foods students will eat. (USDA graphic)
"SNA is requesting 35 cents more in federal funding for each lunch and breakfast that is served in the school lunch program, up from the additional six cents the government provided when the new standards were put in place," Chase writes. Bauscher told the committee, �That will help school food authorities afford the foods that we must serve, but unfortunately that won't make students consume it.�

Bauscher, who said SNA wants Congress "to soften the bill's target levels for more whole grains and less sodium in school meals," said that "in many cases, the new requirements have forced school lunch programs outside of budgetary constraints, forcing them to ask school districts to make up the difference. According to SNA, school districts will absorb $1.2 billion in new food and labor costs in 2010," Agri-Pulse reports. SNA has drawn major funding from some food manufacturers.

Chase writes that 51 percent of students qualify for free or reduced lunches, the first time the number has topped 50 percent in at least 50 years.

Friday, 3 April 2015

Princess Health andStudy of poor but healthy Appalachian counties aims to find community-based approaches to improving the region's health .Princessiccia

Princess Health andStudy of poor but healthy Appalachian counties aims to find community-based approaches to improving the region's health .Princessiccia

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Though some people equate Appalachian areas with poverty, David Krol seeks to "shine a light" on a different picture�one that reflects "how health can flourish across Appalachia," despite data that confirms economic hardship, Krol writes for the Robert Wood Johnson Foundation.

While Krol was reviewing the Appalachian Regional Commission's county-based economic data, which compares economic indicators like poverty and unemployment rates with national averages and then ranks each county, it occurred to him to overlay this county index with the annual County Health Rankings.

For the most part, Krol said he found what he expected, "that the most economically distressed counties in Appalachia would also be in the lowest quartiles of health outcomes and factors for their state." But some counties that were economically distressed ranked in the top quarter of their state in health factors and outcomes.

"What was it about Wirt County, West Virginia; Pickett County, Tennessee; and Oktibbeha County, Mississippi, that helped them overcome significant economic challenges towards better health outcomes when similarly distressed counties in the same state did not?" he wrote.

The need to know why these "unexpected outliers" occurred has prompted Krol, with the help of the ARC and the Foundation for a Healthy Kentucky, to study how these counties have accomplished this and to look at whether this could be re-created in similar communities.

"This approach is rooted in the belief that communities have the best solutions to the problems they face�as opposed to solutions driven by outside experts," he wrote.

It�s an opportunity to �go beyond the data.. to community conversations about what�s important,� Susan Zepeda, CEO of the foundation, told Krol.

Krol wrote, "Quantitative data can get only get us so far�it�s up to us to ask those critical questions of �Why? How? What can be done? It�s up to us to turn data into action."

Monday, 12 May 2014

Princess Health and Princess Health andSchools keep adjusting to national nutrition guidelines.Princessiccia

Princess Health and Princess Health andSchools keep adjusting to national nutrition guidelines.Princessiccia

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Paducah-area school districts "continue to adjust school meals to ensure students are fed complete, healthy meals every day," Kathleen Fox reports for The Paducah Sun.

The revised National School Lunch Program "places the emphasis on portion size and healthier food options such as fruits, vegetables and milk," Fox notes. "The requirements to make lunches and breakfasts healthier, which have been phased in over the last two school years, will continue to change for the 2014 school year. All pastas and other grain products in schools will have to be whole-grain rich, defined as 51 percent or more of whole grain, and the first ingredient has to be whole wheat or grain."

Half the grain products in Paducah Public Schools are whole grain, and some are white to head off complaints, Nutrition Director Penny Holt told Fox. Holt "doesn't foresee major issues in switching the remain half to whole grain," Fox writes. "She said many of the whole grain products are popular with students including brown rolls, flatbreads, short slice Domino's pizza crust and honey wheat whole grain wraps."

"The healthier options are growing in popularity, especially with our younger kids who have become more familiar with them," Holt said. All children in the school system receive free breakfast and lunch as part of a special federal program for schools with a large percentage of children in poverty.

"Holt said the greater challenge will be adhering to the stricter sodium guidelines with meals and higher nutritional value for snacks or a-la-carte items," Fox reports. "Items that can be served other than those on the daily menu include baked chips and whole grain cookies, but nothing with minimal nutritional value such as soda or candy."

In the McCracken County Schools, Food Services Director Sara Jane Hedges "said the district already has success with many of its whole grain alternatives, including its pastas and pizza crusts," Fox writes. "She said the change toward healthier a-la-carte options, which now have to provide additional nutritional value, will not be a problem because the district has already worked toward offering foods that meet those guidelines." (Read more; subscription required)

Sunday, 4 May 2014

Princess Health and Princess Health andKentucky leads nation in percentage of children who have been diagnosed with attention deficit hyperactive disorder.Princessiccia

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Kentucky leads the nation in the percentage of children who have been diagnosed with attention deficit hyperactive disorder, according to the latest available data, which "showed that ADHD levels have risen steeply in the past decade across the nation," Laura Ungar reports for The Courier-Journal.

Ungar writes that "19 percent of Kentucky children ages 4-17 have been diagnosed with ADHD at some point, compared with 11 percent nationally and 16 percent in Indiana." Almost 15 percent of Kentucky children had the diagnosis in 2011, based on polling by the U.S. Centers for Disease Control and Prevention.

"We're probably over-diagnosing it to a certain extent," Dr. Christopher Peters, a psychiatrist and assistant professor of pediatrics at the University of Louisville, told Ungar. "But these numbers indicate a problem. There are many kids in need."

The high numbers could "reflect the state's rampant poverty, since ADHD is identified more frequently in the poor," Ungar writes. "Others say more children here may be genetically prone to the disorder or face other risk factors. . . . Studies show that at least a third of parents who had ADHD as children have kids with the diagnosis."

Any over-diagnosis may stem from "overworked primary care doctors who aren't experts in the disorder" and may be over-diagnosing � and possibly over-prescribing � both locally and nationwide," Ungar writes. "Roughly 8 percent of of school-aged boys nationally and nearly 4 percent of girls took ADHD medications in 2012, according to data from the pharmacy benefit management firm Express Scripts."

There are "financial incentives" for an ADHD diagnosis, Ungar notes. "A diagnosis may translate into disability payments if a child has measurable and serious problems, and students with ADHD can get extra help in school. . . . Experts say the higher numbers may also indicate greater awareness of the disorder, meaning the truly needy are getting the medication, therapy and support they deserve."

However, Dr. Carmel Wallace, pediatrics chairman at the University of Kentucky, "said parents rarely push for a diagnosis to get a disability check," Ungar reports. "And the threshold for disability is high."

Still Kentucky has high rates of children and adults getting Social Security disability payments, and ranks high in some risk factors for ADHD.

"Scientists also have linked ADHD to alcohol and tobacco use during pregnancy � although doctors said it's unclear whether smoking is a cause or simply occurs more often in families with afflicted children," Ungar reports. "Kentuckians smoke at the nation's highest rate and also have high rates of substance abuse overall."

Ungar's example of an ADHD child was, in preschool, "a tiny tempest � at times defiant, other times bouncing distractedly from toy to toy at daycare, while other children were absorbed in play," but as a second-grader "is doing well . . . with a mild stimulant and counseling." Here's a C-J video of another ADHD child and her mother discussing how they deal with it:

Thursday, 1 May 2014

Princess Health and Princess Health andLess than 60% of Kentuckians say they visited a dentist in the past year, ranking the state 43rd in the nation.Princessiccia

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Kentucky ranked 43rd among the 50 states in percentage of people who told pollsters that they had visited a dentist in the past 12 months. The rankings in the annual Gallup-Healthways Well-Being Index appeared to be driven largely by income and insurance.

"Residents of the 10 states with the highest dental-visit rates are somewhat more likely to say they have enough money to pay for healthcare than residents in the 10 states with the lowest dental visit rates, 84.8 percent vs. 77.6 percent," Lindsey Sharpe of Gallup reported. "Further, the bottom 10 states for dental visits have a significantly higher average uninsured rate, at 20.5 percent, than the top 10 states for dental visits (12.6 percent). Previous Gallup research shows that the likelihood of visiting the dentist annually increases with income."

Kentucky's 58.6 percent rate of reported visits in the past year ranked just below Missouri, at 59 percent, and ahead of Tennessee and West Virginia, with 56.9 and 56.6 percent, respectively. Figures for other adjoining states were Illinois, 66%; Indiana, 61.8%; Ohio, 63.6%; and Virginia, 67.5%.

Ranking below West Virginia were Texas, 56.3%; Arkansas, 56,1%; Louisiana, 55.3%; Oklahoma, 55.2%; and Mississippi, 53 percent. The top state was Connecticut at 74.9 percent, followed by Massachusetts at 74.5 percent and Rhode Island at 73.8 percent.

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

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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.''

Saturday, 5 April 2014

Princess Health and Princess Health andRepublicans wait for elections and chance to roll back Medicaid expansion; few Kentucky Democrats defend Obamacare.Princessiccia

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Though thousands of their constituents have benefited from it, Republican state legislators say they are planning to roll back Democratic Gov. Steve Beshear's expansion of Medicaid under the Patient Protection and Affordable Care Act if they take control of the state House this fall or win the governorship next year.

In other words, the "wildly successful" rollout of the health-reform law in Kentucky has not changed the politics of it in the state, reports Louisville native Perry Bacon Jr., political writer for Yahoo! News.

Stivers and Beshear
Bacon starts his story by focusing on the home county of state Senate President Robert Stivers, a Republican from Manchester: "In one of the poorest areas of Appalachia, about 2,500 people have signed up to get health insurance over the last six months � a number that represents more than a tenth of Clay County�s residents. One hundred and twenty miles way, the county�s state senator, Robert Stivers, is laying out his plans to gradually gut the Affordable Care Act in Kentucky, which provided his constituents with insurance."

Stivers acknowledged that the Medicaid expansion has benefited his neighbors, but told Bacon that it is �unsustainable� in the long run. For the first three years, the federal government is paying the entire cost of the expansion, but starting in 2017, the state will have to pay 5 percent, rising in steps to a cap of 10 percent in 2020.

Beshear cites a study showing that the expansion will pay for itself, largely by creating jobs in health care, and Health Secretary Audrey Haynes told Kentucky Health News that the expansion brought $45 million to health-care providers in the state in January, the first month it was in effect.

Republican Rep. Robert Benvenuti of Lexington, a former state health official, doesn't buy the Democratic sales pitches. �I think it�s immoral to give you something you know we can�t pay for,� he told Bacon. �Why are you creating dependency you know you can�t afford?�

Stivers suggested that Republicans could gradually reduce the income limit for Medicaid eligibility, now 138 percent of the federal poverty level, to reduce costs, but "The Obama administration has long said it would not support such a partial expansion of Medicaid," Bacon reports.

Also, "Some Republicans privately concede it will be difficult to roll back expansion of health insurance to so many," Bacon reports, quoting a "top GOP operative" as saying, "Three hundred thousand people are on this now. It's going to be hard to take this away from people." And since that anonymous person spoke, the number is close to 400,000.

House Republicans tried to force a floor vote on Obamacare in the current legislative session, but Democrats foiled that through a parliamentary maneuver.

"Steve Robertson, chairman of the Kentucky Republican Party, said the GOP statehouse candidates would run this fall on the mantle of repealing the health care law, looking to gain five seats and the House majority," Bacon reports. "And a Republican could replace Beshear," who can't seek re-election in 2015. Robertson said, �It�s a question of when, not if, when Kentucky will become just truly a red state.�

Bacon writes, "Democrats acknowledge the political challenge in defending the law. They say the policy success has done little to shift the politics because anything associated with Obama is unpopular in Kentucky. . . . The stories of the newly insured are drowned out, politicians in both parties here say, by the enduring unpopularity of Obamacare and the man it is named after, concerns (often unfounded) that the law has caused premiums to increase for people who previously had insurance and general confusion about the law, particularly the individual mandate" to buy insurance.

"Other than Beshear, many of the state's leading Democrats, aware of the lingering tensions around the ACA, avoid speaking about it publicly, wary of being seen as too supportive of 'Obamacare'," Bacon reports.

Monday, 31 March 2014

Princess Health and Princess Health andObamacare raised woman's premium 74% but she's thankful it has extended health care to those who didn't have it.Princessiccia

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"Beneath the loud debate" about the Patient Protection and Affordable Care Act, it is "quietly starting to change the health care landscape," writes Abby Goodnough of The New York Times, in the latest installment of her series looking at the law through the lives and businesses of Kentuckians.

"In Kentucky alone, more than 350,000 people � about 8 percent of the state�s population � have signed up for coverage," Goonnough notes. "Insurers and medical providers are reporting steady demand from the newly covered for health care, ranging from basic checkups to complex surgical procedures." About 80 percent of the signups in Kentucky are for Medicaid, and that number is likely to increase, because while open enrollment in private plans for 2014 closes tonight at midnight, Medicaid accepts enrollees year-round.

Goodnough's story looks at a new Medicaid enrollee, a man who is having difficulty affording his subsidized policy, and a woman whose income is so high that she couldn't even get subsidies for a new policy through the state health-insurance exchange � but who, like the other two, came to one of the Family Health Centers in Louisville because her doctor wasn't in the network for her new policy. The centers "primary and preventive care in low-income neighborhoods where private doctors are scant," and just over half their patients last year had no coverage, Goodnough reports.

New York Times video; to play it, click on image
Donna Morse, 61, is a widow who "lost her insurance last year because it did not meet the new law�s standards. Now she has a new plan with much higher premiums, and which few doctors and hospitals will accept," Goodnough writes. "She is paying $448 a month for a new Humana plan, up from the $258 monthly premium she paid before," an increase of 74 percent. And when she took her prescription to her neighborhood Walgreens, she "discovered that the chain did not accept her new Humana policy, a so-called narrow network plan with a limited number of providers."

Nevertheless, Morse, a dental hygenist, told Goodnough that she was �very pleasantly surprised� by her experience at the clinic and �I�m really thankful that a lot of people are getting health care that couldn�t have it in the past.�

That describes David Elson, 60, "a self-employed businessman with a multitude of health problems and medical bills," and forgot to pay the first month's premium for his subsidized policy; and Tamekia Toure, 40, a diabetic and single mother who moved to Louisville from Alabama and got on Medicaid but found a job at Amazon soon after her clinic appointment. "She was elated to find work so quickly . . . but also a little scared," Goodnough writes. "Would her new income make her ineligible for Medicaid, so soon after she had signed up? With the expanded program, this so-called churning in and out of Medicaid, based on changes in income, is expected to be common, and for many, problematic." (Read more)

Tuesday, 25 March 2014

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

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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)

Monday, 24 March 2014

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

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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)

Wednesday, 5 June 2013

Princess Health and Fewer families report having trouble paying medical bills; near-poor struggle more than poor families.Princessiccia

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Fewer American families are having problems paying medical bills, but 20 percent of them, particularly those without insurance and those that are "near poor" but not :poor," still struggle with health costs, says a study released Tuesday by the National Center for Health Statistics.

The report says 54.2 million people, or 20.3 percent of families headed by someone under the age of 65, had difficulty covering medical expenses in the first half of 2012. During the first half of 2011, 21.7 percent of families, or 57.8 million people, found it difficult to pay medical bills.

Hispanics (25.2 percent) and blacks (27.9 percent) were more likely than whites (20.1 percent) or Asians (10.3 percent) to report trouble paying their medical bills, says the report. It says families with incomes from 100 to 199 percent of the poverty line were most likely to have difficulty paying medical bills, probably because those below the poverty line qualify for Medicaid. State income limits vary; in Kentucky, income-based Medicaid is available to those with incomes less than 70 percent of the poverty line.
'Poor' are below the poverty line. 'Near poor' had incomes of 100 to 199 percent of the poverty line. 
Among families with insurance, 14 percent of those with private insurance and 25.6 percent  with Medicaid or other public insurance had similar problems paying bills in the first half of 2012, which represents a 1.7 percent and 2.5 percent decrease from 2011, respectively. For a report on the study, click here.

Thursday, 9 May 2013

Princess Health and Medicaid expansion could change Kentucky's course, big time.Princessiccia

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NEWS ANALYSIS
By Al Cross
Kentucky Health News

"Today we change the course of Kentucky's history."

It is not often that a public official can say such a thing with a large measure of credibility, but Gov. Steve Beshear legitimately raised that hope Thursday, as he announced that he would expand Kentucky's Medicaid program under federal health reform.

Beshear with graph predicting positive impact on budget
If Beshear's vision is fulfilled, Kentucky will no longer have one of the unhealthiest populations of any state, a change that will make it more attractive to employers, and any Kentuckian who wants health insurance will be able to get it.

It is in large measure the realization, in the state where all President Harry Truman's grandparents were born, of his 68-year-old dream of national health insurance. The statue of Truman's vice president, Alben Barkley of Paducah, seemed to shine a little more brightly than usual in the Capitol rotunda as the press-conference crowd dispersed.

But this is a project with many moving parts -- billions of dollars, thousands of health-care providers, hundreds of thousands of Medicaid beneficiaries, and scores of political and bureaucratic decisions -- and much could go wrong.

Skeptics point to the problems with the managed-care Medicaid system that Beshear implemented too hurriedly, apparently to avoid complicating his November 2011 re-election, and argue that the program needs fixing before adding 300,000 new enrollees to the 825,000 already on the rolls. Beshear says he's tackling the problems, the program is "working pretty well" and the managed-care companies can handle the influx.

The skeptics also question whether the state can afford the match for the federal funds. "Broad and vague anxieties," Beshear called them, and he came armed with two studies concluding that expansion would actually gain the state money -- mainly because of the billions it will send to the state's health-care providers, creating more jobs, but also because many of the 300,000 or so newly eligible people are not expected to enroll, based on a Price Waterhouse Coopers study drawing on research by the Congressional Budget Office.

University of Louisville research
Preliminary estimates were that expansion would add 400,000 Kentuckians to the Medicaid rolls. However, the study estimated that only 308,000 will become eligible and that only 188,000 will enroll, thus costing the state much less than some expected when it has to match federal funds beginning in January 2017. The initial match will be 5 percent, rising to 10 percent in 2020. The estimated cost for the newly eligible in fiscal 2020-21 is $151 million, in a state budget that is likely to exceed $10 billion. (The state's current share of Medicaid costs, 29.5 percent, is about $1.5 billion a year.)

Those are just estimates. "I believe reality will dwarf those numbers on the spending side," Tea Party activist David Adams, who says he plans to challenge the plan in court, told reporters. But for the time being at least, Beshear has the numbers on his side, and he said they are "very conservative."

The governor said opponents of the plan "fall back on national politics" and say expansion means that Kentucky, a state that President Obama lost big both times, will be "supporting Obamacare. To them I say, 'Get over it.' . . . I'm going to do what's best for Kentucky's people, period." Asked why so many governors have rejected expansion, he said it was mostly "partisan politics."

Conservative columnist John David Dyche cites an Oregon study saying Medicaid is ineffective, but a Harvard School of Public Health study in three other states showed that expansion of Medicaid improves health and saves lives.

Beshear said the expansion, along with health insurance and subsidies available through a state-run exchange that is also part of health reform, would give the state a healthier workforce because studies show that people with health insurance are less likely to skip exams and let health conditions worsen and become costlier and more difficult to treat. "The lack of early care is one reason that Kentucky's health picture is so horrendous," he said.

Kentucky's workforce is one of the nation's least healthy, and the state has a disproportionate number of working-age people who are not in the workforce because of health problems. The state ranks first in smoking, cancer deaths and preventable hospitalizations; second in heart disease and poor physical-health days; third in heart attacks and poor mental-health days; and in the top 10 in diabetes,  cholesterol and sedentary lifestyles. That hurts the state's image as well as its economy, Beshear said. "There will be a huge economic effect for a healthier Kentucky."

He said most of the newly eligible people are not "freeloaders asking for a handout," but people who are working at jobs without health insurance. He said another 332,000 Kentuckians will get insurance through the state exchange, 276,000 of them with subsidies available to people with incomes up to 400 percent of the poverty level. Without Medicaid expansion, he said, 206,000 would not be eligible for Medicaid or a subsidy, and "We cannot leave those people stranded."

The health-reform law tried to force states into expanding Medicaid, but the U.S. Supreme Court ruled that the states should make the choice without fear of financial penalties. The law calls for expansion to cover people under 65 in households up to 138 percent of the federal poverty level -- currently $15,856 for an individual or $32,499 for a family of four.

Republicans can do little to stop the expansion. They control the state Senate, but Medicaid eligibility and benefit decisions belong to the executive branch, and even if a bipartisan legislative committee were to block the implementing regulations, Beshear could override it.

Or perhaps we should say he would override it. Emotional at times, Beshear called the move "the single most important decision of our lifetime for improving the health of Kentuckians" but said it was easy to make. As a governor who has failed to win his main campaign promise, expanded gambling, and has had relatively little money to spend because of the Great Recession, this is likely to be his largest legacy.

For details and background from the governor's office, click here. For Beshear's YouTube commentary on the issue, click here.

Wednesday, 8 May 2013

Princess Health and Beshear looks likely to announce that he will expand Medicaid .Princessiccia

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Gov. Steve Beshear appears likely to announce tomorrow that he will expand Kentucky's Medicaid program to people in households with incomes up to 138 percent of the federal poverty level, under federal health-care reform.

The notice of the governor's news conference about "Decision regarding Medicaid expansion" says it will be held in the ornate State Reception Room on the second floor of the state Capitol, an unlikely venue for an announcement that would disappoint so many of his natural allies in the Democratic Party. And Rep. Tom Burch, D-Louisville, chairman of the House Health and Welfare Committee, reiterated his February prediction that Beshear would expand Medicaid, cn|2 reports.

Under health reform, the federal government would pay all the cost of the estimated 400,000 newly eligible Kentuckians in Medicaid in 2014, 2015 and 2016. The state would pay 3 percent of the added cost in 2017, rising to 10 percent in 2020. Beshear has said the state should expand Medicaid if it can afford it.

Some Republicans have said the state can't afford it, but national research has estimated that the state's cost for Medicaid would increase only 5 to 6 percent over the amount it would pay if the program were not expanded. The federal government now pays more than 70 percent of the program's cost in Kentucky.

More background on Mediaid in Kentucky is available from a PowerPoint presentation that Deputy Medicaid Commissioner Lisa Lee gave yesterday at a meeting sponsored by the Foundation for a Healthy Kentucky and the Kentucky Rural Health Association. It can be downloaded here.

Monday, 15 April 2013

Princess Health and Beshear says he will decide in four to five weeks, or July 1 at the latest, whether or not to expand Medicaid.Princessiccia

Princess Health and Beshear says he will decide in four to five weeks, or July 1 at the latest, whether or not to expand Medicaid.Princessiccia

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By Al Cross
Kentucky Health News
This story has been updated.

Gov. Steve Beshear said Monday that he will decide within the next four to five weeks, or maybe by July 1, whether to expand the Medicaid program under federal health-care reform.

Beshear, who has said he would expand Medicaid if the state can afford it, told reporters that he is considering other factors, which he did not name. He said his administration has not calculated the cost of expansion, which the state would not pay immediately.

The federal government pays about 71 percent of Medicaid's cost in Kentucky, and would pay the full cost of covering those newly eligible in 2014-16. The state would have to pay 3 percent in 2017, rising to 10 percent by 2020.

About 830,000 Kentuckians are covered by Medicaid, and at least 400,000 more could be added if Beshear expanded it to include households earning up to 138 percent of the federal poverty level, as required by the reform law.

Another possibility is that Beshear would seek approval from the federal government to use federal money to subsidize purchase of private health insurance by the poor, which has been approved in Arkansas but not in Tennessee.

The governor's office, asked if the administration was considering that option and what other factors Beshear is considering, has not responded had this response: "The governor is considering multiple issues as he determines whether Kentucky will expand Medicaid eligibility.  Along with affordability for the state, he is also looking at potential economic impact through jobs and investment created by possible expansion, as well anticipated changes in health outcomes for newly-eligible Kentuckians."

That is also the case with There has still been no response from Humana Inc., which does much of its business through government-financed health plans. The Louisville-based insurance company was asked if it has had discussions with the Beshear administration about the idea of a Medicaid expansion that would use federal money to buy, or subsidize the purchase of, private health insurance.

"Beshear said Monday that he is getting a lot of pressure from the medical field � particularly hospitals � to green-light the expansion," Beth Musgrave of the Lexington Herald-Leader writes. "Hospitals will lose additional money they receive through Medicaid on Jan. 1 as part of the Affordable Care Act. Hospitals in Ohio and other states have also put pressure on state governments to expand Medicaid rolls."

Beshear said, �I think they look at the expansion as a means to at least replace some of that (money) that they are going to lose.�

Many Republicans have opposed expansion, "saying that the state could not afford it," Musgrave writes. "The Republican-led state Senate passed a bill during the legislative session that would have required that the two-term Democratic governor get legislative approval before expanding the health care program. But the measure died in the Democratic-controlled House. Beshear could expand the program via executive order."

Beshear said today, �We have a very large uninsured population and we have a very unhealthy population. Anything that we can do � that we can afford � to make our population more healthy, I�m certainly in favor of doing.� He added, �We are looking long-term as well as short-term from a financial standpoint to see if it makes sense for us.�

While he said he would act within four to five weeks, Beshear gave himself some wiggle room, saying also that he would make the decision by July 1, the beginning of the state's fiscal year. (Read more)

Thursday, 28 March 2013

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

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By Molly Burchett
Kentucky Health News

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

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

Along with Kentucky, 10 other states are undecided about Medicaid expansion: Alaska, Indiana, Kansas, Nebraska, New York, Oregon, Utah, Virginia, West Virginia and Wyoming. The map by The Advisory Board Company shows the lay of the land; for an interactive picture that outlines the research behind the map, click here.?????
Red=Not participating; Pink=Leaning toward not participating;
Gray=Undecided; Blue=Participating; Light Blue=Leaning toward participating
Only three states with Democratic governors are undecided; 18 Republican governors have rejected expansion. Kentucky is shown as leaning for it because Beshear has repeatedly said that he will expand Medicaid if the state can afford it. He has also mentioned that the state can reserve the right to pull out of the deal in 2017, when it must paying 3 percent of the cost of covering the newly insured, reaching 10 percent in 2020. Still, the questions about cost and affordability remain, and Beshear could be considering another option.

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

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

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

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

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

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

Tuesday, 5 March 2013

Princess Health and Study finds only counties in Appalachia, mostly in Kentucky, had increasing rates of death among both sexes as century turned.Princessiccia

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By Molly Burchett
Kentucky Health News

More than 40 percent of counties saw increases in female death rates as the 21st Century began, while the death rate for men rose in just 3 percent of counties, a study shows. Only Appalachian counties, mostly in Kentucky, had worsening rates for both sexes. (Click on a map for a larger version.)

Change In Male Mortality Rates From 1992�96 To 2002�06

Change In Female Mortality Rates From 1992�96 To 2002�06

On the Health Affairs maps above, blue counties showed substantial improvement, while those in aqua showed minimal improvement and worsening counties are in red.

The study identifies some shared characteristics among the 1,334 counties where more women are dying prematurely, but the main factors weren't medical or behavioral, according to David Kindig and Erika Cheng, authors of the study report.

Although counties with high rates of smoking and obesity had increased mortality rates, the report found socioeconomic factors in the Appalachian states of Kentucky and West Virginia, such as the percentage of a county�s population with a college education and the rate of children living in poverty, had more to do with increased mortality rates.

In Kentucky, Owsley County has been ranked last on health-related measures by the Population Health Institute. Areas like this in Appalachia suffered rising death rates in both sexes because college education is a rarity, child poverty is normal, recreational facilities are scarce, restaurants are mostly fast-food outlets, and adults lack social support, reports Geoffrey Cowley of msnbc.

The chart below shows how Kentucky compares to the national average in premature death and that Owsley County suffers from tremendously high rates.
County Health Rankings by University of Wisconsin's Population Health
Institute and the Robert Wood Johnson Foundation (countyhealthrankings.org)
These findings provide supporting evidence for the ever-increasing need for significant health improvement efforts in Appalachia. According to the report, efforts must extend beyond a focus on health care delivery and include stronger policies affecting health behaviors and the social and environmental determinants of health,with corresponding investments in those areas. (Read more)

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

Tuesday, 26 February 2013

Princess Health and Survey suggests Great Recession has harmed the health of Kentuckians.Princessiccia

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A recent poll shows continuation of a trend threatening Kentucky's overall health: as the number of Kentuckians living in poverty goes up, the percentage of adults who report their health as excellent or very good goes down.

Just over four in 10 Kentucky adults in the latest Kentucky Health Issues Poll described their health as excellent or good. In 2008, almost half used those descriptions.

People with higher incomes have consistently reported better health since the poll began tracking the health status of Kentucky adults 2008. Since research has shown a strong link between higher income and better health, the Great Recession and the resulting increases in unemployment, underemployment and poverty appear to be harming the overall health of Kentucky�s population.

In the accompanying graph, showing responses by income categories, FPL stands for federal poverty level, which in 2011 was a yearly household income of $22,350. Among the categories, 58 percent in the highest category said their health is excellent or good, but only 25 percent of those living in poverty used those descriptions.


Although the health status for each income category has remained fairly constant, the poll reflects federal data that show more people living in poverty. More than 33 percent in the latest poll were earning less than the federal poverty level; in 2008, that was only 19 percent. The polls, which used self-reporting of income and survey methods that differ from federal methods, showed much higher poverty rates than federal data.

�We know there is a direct relationship between income and good health, and these data reflect that,� said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, a sponsor of the poll. �While changes in our health-care delivery system may provide more health-care opportunities for low-income Kentuckians, these results show how vital a strong economy, and jobs that pay well, are to our population�s health.�

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