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

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

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

Gusty 21:01 Add Comment

By Melissa Patrick
Kentucky Health News

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Princess Health and Official praises needle exchanges and medication-assisted treatment for addiction: 'Treatment works. Recovery is possible.' . Princessiccia

Princess Health and Official praises needle exchanges and medication-assisted treatment for addiction: 'Treatment works. Recovery is possible.' . Princessiccia

addiction drug abuse drug treatment health care access heroin needle exchanges pregnancy public health

Gusty 16:12 Add Comment

Scott Hesseltine

Scott Hesseltine, the new vice-president of addiction services at Louisville's Seven Counties Services, talked on Kentucky Educational Television about needle exchanges and a new model of addiction treatment that combines medication assisted treatment with an abstinence-based model of care.

"We are in the midst of a tragic public-health crisis and it's claiming the lives of our citizens at astronomical rates," he said, noting that more than 1,000 people die from drug overdoses in Kentucky each year and that the state has the highest rate of hepatitis C in the nation.

Seven Counties Services provides behavioral-health services, primarily for people on Medicaid, in Jefferson County and six neighboring counties: Henry, Oldham, Trimble, Spencer, Shelby and Bullitt.

The interview on "Connections with Renee Shaw" was part of KET's "Inside Opioid Addiction" initiative, which is funded in part by a grant from the Foundation for a Healthy Kentucky. It aired in June.

Hesseltine, who came to Seven Counties Services from the Hazelden Betty Ford Foundation, a nationally recognized drug and alcohol treatment center, commended Kentucky's "forward thinking" in passing an anti-heroin bill last year.

Among other things, the bill allows needle exchanges to decrease the spread of infectious diseases, like hepatitis C and HIV, that are commonly spread by drug users sharing needles. They require both local approval and funding and have met with some resistance because many think they condone or perpetuate drug use.

Asked about that, Hesseltine said research shows that needle exchanges do what they are meant to do -- reduce the incidence of infectious disease among intravenous drug users.

He noted that Justice Secretary John Tilley, who was instrumental in passing the heroin bill as a state representative, said at a recent community forum in Corbin that research found that addicts who are involved in needle exchange programs are five times more likely to enter treatment.

"And we know treatment works and recovery is possible, so any avenue to slow the spread of disease and to help more people find the solution in recovery is a positive thing," he said.

Another point of contention among some lawmakers is that some of the state's needle-exchange programs don't adhere to a needle-for-needle exchange, which they say was the intent of the law,but instead provide as many needles as the addict needs for a week.

Hesseltine said the needs-based model decreases needle sharing and thus disease, so "Needs-based is more appropriate; it is more evidence based."

Hesseltine told Shaw that while working at Hazelden, he was part of an initiative that completely "altered the way we provided care." The new program, called COR-12, combines medication-assisted treatment with the 12-step abstinence model, which had been the only accepted recovery treatment program at Hazelden.

Hesseltine brought the new model with him to Seven Counties Services and said he likes to call it "medicated assisted recovery." He said "It has to be done appropriately so we are helping to stabilize someone from their biological symptoms of addiction so they can then engage in the recovery process."

Hesseltine told Shaw that addiction isn't curable, but is treatable.

"I would say it is a chronic disease that can be put into remission with structure, support, accountability and behavioral interventions," he said. "Curable? No, but like diabetes -- not curable, but certainly manageable."

Shaw asked if any addict is beyond reach. "Only someone who is not alive," Hesseltine replied. "Treatment works. Recovery is possible." He said that is why access to naloxone, the overdose-reversal drug branded as Narcan, is so important.

Asked what policy changes he would like to see, Hesseltine listed increased funding for drug treatment, "high level" models of care that shift addiction services to local communities, and repeal of the Medicaid rule that doesn't allow any reimbursement for mental-health and substance-use-disorder residential treatment facilities with more than 16 beds.

With treatment, Hesseltine said, "People can go from a pitiful and incomprehensible demoralization, a state where they have no hope to one of having hope, to being a productive member of society and to really regaining a place where they feel good about themselves and they are leading a life full of joy and freedom."

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 Ky. has plan to keep Zika virus out of state, but needs your help; travelers to Zika-affected areas need to take precautions. Princessiccia

Princess Health and Ky. has plan to keep Zika virus out of state, but needs your help; travelers to Zika-affected areas need to take precautions. Princessiccia

birth defects mosquitoes pregnancy prevention public health

Gusty 10:53 Add Comment

By Melissa Patrick
Kentucky Health News

State officials launched a mosquito prevention campaign May 9 at the Kentucky State University Research Farm near Frankfort as part of the state's efforts to combat the Zika virus, with an emphasis on the need for Kentuckians to do their part at home and when they travel.

"Zika prevention is mosquito prevention," Health Secretary Vickie Yates Brown Glisson said at the news conference where she introduced the campaign, "Fight the Bite Day and Night."

To date, six cases of Zika have been confirmed in Kentucky, all in people who were infected abroad and then returned to the U.S. But Glisson said it is "very possible" that Kentucky could have a local outbreak because the state has the species of mosquito that transmits the virus.

Of the 59 mosquito species in Kentucky, only one, Aedes aegypti, a small, black mosquito that bites mostly during the day, has been confirmed as a Zika carrier, and it is "very rare," accounting for "roughly one out of every 5,000 or so mosquitoes that we catch here in Kentucky," said Grayson Brown, director of the Public Health Entomology Laboratory at the University of Kentucky. However, Brown said six or seven other species in the state could be Zika transmitters, including the state's most common monquito, Aedes albopictus, better known as the Asian tiger mosquito.

The major concern is that a Zika-infected person will return to the U.S., get bitten by a mosquito that can transmit it to the next person it bites, with the cycle continuing.

Symptoms of the virus include fever, rash, joint pain and red eyes, although about 80 percent of people who are infected with the Zika virus never show symptoms.

Those in greatest danger from the infection are women in early pregnancy. Infants born to Zika infected mothers are at high risk for microcephaly, a condition where the infants head is smaller than normal, as well as other possible severe fetal brain defects. It has also been associated with Guillain-Barre syndrome, a rare disorder in which the body's immune system attacks its nerves, in adults. The World Health Organization has declared Zika an international health threat.

Dr. Ardis Hoven, infectious disease specialist with the Kentucky Department of Public Health, urged travelers to protect themselves from mosquitoes by using EPA-approved repellents and wearing protective clothing while in affected areas, and doing so for three weeks after returning home to prevent transmission to local mosquitoes.

"If everyone does this, it greatly reduces the risk of Zika ever getting into Kentucky's mosquito population," said Hoven, who is also chair of the World Medical Association. "We are counting on you, so please take this advice seriously."

The state has created an extensive action plan to monitor Zika infected mothers and their infants that includes a monitoring schedule, and access to many social and healthcare services as needed. The state health department has reported that one of the confirmed Zika cases in the state is a pregnant woman.

Hoven advised pregnant women to not travel at all to affected areas and specifically said, "Pregnant women should not attend the Olympics," which will be held in Rio de Janeiro in August.

Concerns about Zika in Rio prompted Amir Attaran, a professor in the School of Public Health and the School of Law at the University of Ottawa, to write a commentary for the Harvard Public Health Review, calling for the Olympic Games to either be postponed or moved to another country.

"Does it really make sense to send a half-million [Olympic tourists] into Rio, which is, to be very clear, not the fringes of the outbreak? It's the heart of the outbreak," Attaran told NPR. "But is it at the end of the day sensible to run the risk of a global epidemic of, let's face it, brain-damaged babies, when that could be avoided by simply postponing the games or moving them elsewhere?"

Attaran, whose wife is from Brazil, told NPR that while the risk is quite low for individual athletes or individual tourists, "when you multiply (that) by 500,000, the odds are extremely high that somebody will take the disease elsewhere and seed a new outbreak."

Zika can also be transmitted sexually, which has occurred about 10 times now in the United States, Hoven said.

Shelley Wood, nurse consultant for Zika at the state health department, said male travelers without symptoms should use condoms for eight weeks after departure from a Zika-affected area. Men with Zika symptoms should get tested and use condoms for six months, and male travelers with pregnant partners should wear condoms throughout the pregnancy .

Wood also said couples should take steps to prevent conception for at least eight weeks after returning from a Zika-affected area, and women should not travel to such areas eight weeks before they are trying to conceive.

State officials urged Kentuckians to be vigilant about mosquito control and reminded them to remember the "3 D" approach to decrease the risk of infection by mosquitoes:

• Drain all standing water where mosquitoes breed such as bird baths, tires, buckets and gutters
• Defend against mosquitoes with approved insect repellents at all times for outdoor activities.
• Dress in light colored long sleeved shirts and pants.

State Agriculture Commissioner Ryan Quarles announced a partnership between his Agriculture Department and the health ahency as part of its Zika prevention plan. This partnership allows health officials to mobilize "strike teams" and use Agriculture Department equipment if the state begins to have local transmissions of Zika. Typically, the Agriculture Department sprays for mosquitoes at the request of local officials or local health departments.

Hoven said, "As with all public health issues, the best form of protection is prevention, not clean-up."

The University of Kentucky College of Agriculture website has the latest updates on Zika and its spread.

Princess Health and Stanford hospital is first in Kentucky to go back to laughing gas, or nitrous oxide, to relieve the pain of childbirth. Princessiccia

Princess Health and Stanford hospital is first in Kentucky to go back to laughing gas, or nitrous oxide, to relieve the pain of childbirth. Princessiccia

babies pain pain management pregnancy rural hospitals

Gusty 09:43 Add Comment

Photo: Abigail Whitehouse, Interior Journal

Ephraim McDowell Fort Logan Hospital's Birthing Spa in Lincoln County is the first in Kentucky to offer nitrous oxide, often called laughing gas, as an alternative pain relief measure for women during childbirth, Abigail Whitehouse reports for The Interior Journal in Stanford.

Dr. James Miller, the unit's medical director, told Whitehouse that the Birthing Spa aims to provide support and comfort to mothers during labor and that nitrous oxide, which was commonly used for this purpose in the 1950s until epidural anesthesia became popular, provides another option to help decrease anxiety and pain during childbirth.

"We in our unit found, when we started hearing again about the nitrous oxide, that it just fit really well with our philosophy of trying to offer choices to moms," Miller told Whitehouse.

Miller said that while epidurals continue to be used most often during labor for pain management, the procedure comes with some risk and are expensive.

"Epidurals cost a lot and haven't shown the benefits. And they changed labor from a low-risk setting to a high-risk setting," Miller told Whitehouse. "With an epidural, we know that it drops the mom's blood pressure, so they have to have an IV ahead of time and load up on fluids to try to prevent the drop in blood pressure, and then it can still happen. Then you have to monitor the baby's heart tones."

In addition to nitrous oxide, the Birthing Spa also offers alternate options for pain management during childbirth, including: water births, which he said have been proven to lower cost and shorten the length of labor, showers big enough for two with multiple shower heads, a nursing staff trained to "almost function as a doula," a beautiful garden to walk in, and massage chairs. The unit also offers epidurals or an alternative intravenous medication for pain.

Miller noted that nitrous oxide, which is delivered through a mask, allows laboring mothers control over their pain management because they can put it on and remove it as needed; it can also be used earlier in the process than an epidural.

Miller told Whitehouse, "It's very fast acting so when the pain is starting to contract, they start breathing the medicine and within seconds it takes effect and then as the pain resolves, they take the mask away and the medicine wears off that quickly too."

Princess Health and Zika update: Local anti-mosquito action needed; McConnell, Rogers at center of debate over Obama's request for more funds. Princessiccia

Princess Health and Zika update: Local anti-mosquito action needed; McConnell, Rogers at center of debate over Obama's request for more funds. Princessiccia

birth defects Congress federal spending mosquitoes pregnancy prevention public health virus

Gusty 17:14 Add Comment

Mosquitoes can carry Zika. (NPR photo)

By Melissa Patrick
Kentucky Health News

While all 388 Zika virus cases confirmed in the continental U.S., including six in Kentucky, have been in people who were infected abroad and then returned to the states, a health official said on "Fox News Sunday" that it is likely the U.S. will have its own outbreak.

"It is likely we will have what is called a local outbreak," said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, Diane Bartz reports for Reuters.

Fauci said he did not expect a large number of people to become ill: "We're talking about scores of cases, dozens of cases, at most."

Dr. Ardis Hoven, infectious disease specialist for the Kentucky Department for Public Health, agreed and said the potential exists for Kentucky to have a local outbreak.

"I think it would be unreasonable for us to assume that we would not be at risk," she said in a telephone interview. "So therefore, we have to plan accordingly."

Hoven said mosquito control in the state is a "top priority," but said the bulk of this will have to happen at a local level.

She encouraged Kentuckians to talk about mosquito prevention with their friends and family and ask themselves, "What can I do in my community, in my yard, on my street to prevent mosquitoes from hatching and infecting those around me?"

Zika virus prevention strategy: Dress, Defend and Drain

The state has adopted a "3 D" approach to decrease the risk of infection by mosquitoes: Dress in light-colored long sleeved shirts and pants; Defend against mosquitoes with approved insect repellents; and Drain all standing water.

"If we can control mosquitoes in our region, we will go a long way to minimize the potential risk from infected mosquitoes," Hoven said.

The World Health Organization declared Zika a global health emergency in February. Those who have traveled to affected areas, such as Central and South America, are at the highest risk of contracting the virus, which is spread primarily by infected Aedes aegypti mosquito. It can also be spread through sexual intercourse. Aedes aegypti can be found in about 30 U.S. states, including Kentucky.

Zika virus is especially dangerous to pregnant women because it has been linked to thousands of cases of microcephaly, a condition where the infants head is smaller than normal, as well as other severe fetal brain defects, according to the federal Centers for Disease Control and Prevention. The state health department has reported that one of the confirmed Zika cases in the state is a pregnant woman.

The CDC is investigating the link between Guillain-Barre syndrome, a rare disorder in which the body's immune system attacks its nerves. And Fauci said there could be other neurological conditions caused by Zika that affect adults, Bartz reports.

"There are only individual case reports of significant neurological damage to people, not just the fetuses, but an adult that would get infected. Things that they call meningoencephalitis, which is an inflammation of the brain and the covering around the brain, spinal cord damage due to what we call myelitis," Fauci said. "So far they look unusual, but at least we've seen them and that's concerning."

Common symptoms of the virus are fever, rash, joint pain and red eyes, with symptoms lasting for about a week, though many with the virus have no symptoms. Currently there is no vaccine for Zika.

Funding to fight Zika held up in Congress

In February, President Obama asked Congress for an additional $1.9 billion in emergency funds to fight the Zika virus, including funds to develop a vaccine. This is in addition to $589 million in previously appropriated funds that have already been transferred to the effort.

That money should last through Sept. 30, the end of the federal fiscal year, but "There's going to need to be additional money, I don't think there's any doubt about that," Rep. Tom Cole, R-Okla., who chairs the House health appropriations subcommittee, told Susan Cornwell of Reuters April 13.

Top senators from both parties said "they are getting close to a deal to provide at least some emergency funding to fight the Zika virus, making it likely that the Senate will move ahead on the issue without waiting for the House," David Nather writes for STAT, an online health journal.

Senate Majority Leader Mitch McConnell, R-Ky., said at a news conference April 19 that congressional Republicans were working with the administration on the funding details, Peter Sullivan reports for The Hill.

�We're working with them on it to figure out exactly the right amount of money,� McConnell said at a press conference. �You know, how is it going to be spent? And I don't think, in the end, there will be any opposition to addressing what we think is going to be a fairly significant public health crisis."

Nevertheless, House Republicans kept saying they don't have enough information to approve the request.

On April 20, House Appropriations Committee Chairman Hal Rogers, R-Ky., said the Obama administration �continues to delay response efforts by refusing to provide basic budgetary information to Congress on their Zika funding request. This includes not answering our most basic question: �What is needed, right now, over the next 5 months in fiscal year 2016, to fight this disease?� In the absence of this information, the House Appropriations Committee will work with our colleagues in the House and the Senate to make our own determinations on what is needed and when, and to provide the funding that we believe is necessary and responsible.�

Five days earlier, White House Press Secretary Josh Earnest said Republicans have all the information they need to move forward, ABC reports. He said, �They've had ample opportunity to collect information, to ask questions of senior administration officials, to read letters, to read the legislative proposal that was put forward by the administration.� 

Princess Health and Teens who talk to their parents about sex make the best choices; Clark County will offer parenting classes on sex communication. Princessiccia

Princess Health and Teens who talk to their parents about sex make the best choices; Clark County will offer parenting classes on sex communication. Princessiccia

education pregnancy sex education sexually transmitted diseases teens

Gusty 08:19 Add Comment

In an average Kentucky high school class of 30 students, almost 13 of the teenagers say they have had sexual intercourse at least once, but many of them have never discussed sex with their parents.

And while Kentucky parents may think their children are learning about sex in the classroom because Kentucky mandates sex education, they may not realize that the state has no set curriculum for fact-based, comprehensive sex education, and the only thing required to be taught is abstinence -- an approach that has been proven ineffective, Aaron Yarmuth reports for Leo Weekly in an in-depth article about sex education in the state.

This lack of parent-teen communication about sex has prompted a study in Clark County that will include classes to help parents become more comfortable talking about sex with their children, Whitney Leggett reports for The Winchester Sun.

The classes will be led by Shannon Phelps of Winchester as part of her research to earn a doctorate in interdisciplinary education sciences from the University of Kentucky, Leggett reports. It is funded by a $15,700 grant from the Clark County Community Foundation.

�Because the subject matter is not one that many people are comfortable with, part of the objective is to help increase parents� comfort in discussing sexual health topics so they will be more likely to address those topics with their children,� Phelps told Leggett.

"The overall goals of the program are to increase frequency and quality of parent-child sexual health communication, improve parents� comfort and confidence in their communication with their children about sexual health topics and increase openness of sexual communication between parents and their children," Leggett writes. "Topics will range from abstinence to safe sex, contraception, resisting peer pressure and communicating with potential partners, among others."

Phelps said the six week courses will promote parent-child sexual health communication, which is associated with better sexual health outcomes for young people.

�Research tells us that children, especially adolescents, who have parents who communicate with them about sexual health topics have better sexual health outcomes,� Phelps told Leggett. �That follows logic... Sometimes parents are hesitant to talk to their children for fear that they�ll go and have risky sexual behaviors, but research tells us the opposite.�

Phelps told Leggett that studies show that when parents talk to their children about sex, "it can delay the onset of sexual behaviors and reduce unintended outcomes like sexually transmitted infections and unintended pregnancies," Leggett writes.

For more information email Phelps at shannon.phelps@uky.edu, or call 859-621-1065.

A study published in the Pediatric Journal of the American Medical Association found that nearly one-fourth of youth report that they have not discussed sexual topics with their parents, and even fewer report that they have had meaningful, open conversations with them about this subject. The study attributes this poor communication to parental embarrassment, parents' lack of accurate knowledge of the subject, and poor self-efficacy.

It's a topic that needs discussion in Kentucky because almost 10 percent of the state's middle-school students have had sexual intercourse and almost one-third of its high school students are sexually active, according to the 2015 Kentucky Middle and High School Youth Risk Behavior Survey.  The survey found that overall, 41.7 percent of Kentucky's high school students have had sexual intercourse at least once.

And there is an obvious disconnect related to birth control. Kentucky ranks seventh in teen births, at 39.5 births per 1,000 females aged 15 to 19, according to America's Health Rankings. The 2015 YRBS found that 14.5 percent of high school students did not use any birth- control during the last time they had sexual intercourse.

Princess Health and First case of Zika confirmed in Ky., from traveler to Central America; no threat to Kentuckians unless they visit affected areas. Princessiccia

Princess Health and First case of Zika confirmed in Ky., from traveler to Central America; no threat to Kentuckians unless they visit affected areas. Princessiccia

birth defects Cabinet for Health and Family Services mosquitoes pregnancy public health virus

Gusty 05:57 Add Comment

By Melissa Patrick
Kentucky Health News

After the first case of Zika was confirmed in Kentucky March 9, health officials held a news conference at the Capitol to raise awareness of the virus, noting that the state was coming up on the spring travel season.

Mosquitoes carry Zika. (CNN image)

Gov. Matt Bevin, Health Secretary Vickie Yates Brown Glisson and Dr. Kraig Humbaugh, senior deputy commissioner of the Department for Public Health, emphasized that only those who have traveled to affected areas, like Central and South America, need to worry about contracting the virus, which is commonly transmitted through mosquitoes.

"Many areas, including most of our surrounding states, are reporting Zika cases," Humbaugh said in the news release. "For now, these positive results have only occurred in individuals who have traveled outside the country to places where the virus is currently spreading."

The infected male patient in Kentucky had recently returned to Louisville from Central America. Humbaugh said he presented with signs of fever and rash, which a "very astute" health-care provider suspected as symptoms of Zika.

Common symptoms of the virus are fever, rash, joint pain and red eyes,with symptoms lasting for about a week, according to the U.S. Centers for Disease Control and Prevention. Although many with the virus will not show symptoms, Humbaugh said.

Health officials stressed that Kentucky is not at risk, but said the state has a plan in case the Zika virus spreads. Glisson encouraged health-care providers to be alert to the symptoms of the virus.

She also noted that the Cabinet for Health and Family Services was partnering with Kentucky Emergency Management and the Kentucky Department of Agriculture to increase the monitoring and control of the state's mosquito population this year.

The CDC recommends that pregnant women or those trying to become pregnant postpone travel to affected areas. However, if they must travel to one of these areas, the CDC asks them to talk to their healthcare provider before they leave and strictly follow steps to avoid mosquito bites during the trip.

Humbaugh noted that increasing evidence has found a link between infection in pregnant women and infants born with microcephaly, a condition where the infants head is smaller than normal, which can lead to a variety of other health challenges.

The Washington Post reports that the Zika virus has "growing links to a broad array of birth defects and neurological disorders ... worse than they originally suspected, increasing the risk for devastating harm during pregnancy."

Until Zika, "there has never been a mosquito-borne virus that could cause serious birth deffects on such a large scale," CDC Director Thomas Frieden told reporters.

There is no vaccine or treatment for Zika.  The virus can also be spread through sexual intercourse, and it is still unknown how long the virus stays in semen, Humbaugh said.

Kentucky has at least one mosquito known to transmit Zika.

�We do have Aedes aegypti, but  they are a very small populations, from what I understand from our mosquito experts,� Humbaugh said. �Our entomologists at the University of Kentucky have been advising us on this particular area. However, we have other types of mosquitoes that may be what they call competent vectors. In other words they may be able to spread the disease, but at this point that hasn�t been shown that these other mosquito types are competent vectors.�

Humbaugh encouraged Kentuckians to take normal precautions to limit exposure to mosquitoes like using approved insect repellents, wearing long sleeves and pants when outdoors, to stay inside during dawn and dusk when mosquitoes are most active, minimize standing water and screening windows.

More information about Zika can be obtained from the department's Health Alerts website at http://healthalerts.ky.gov/Pages/Zika.aspx. For a full list of affected countries and regions visit http://www.cdc.gov/zika/geo/index.html.

Princess Health andAnthem gives $140,000 for 3-county program to cut smoking by pregnant women, still at 21.9% in Ky., among highest in U.S..Princessiccia

Princess Health andAnthem gives $140,000 for 3-county program to cut smoking by pregnant women, still at 21.9% in Ky., among highest in U.S..Princessiccia

pregnancy smoking tobacco tobacco prevention

Gusty 13:57 Add Comment

Health departments in Christian, Hopkins and Madison counties will start a program called Giving Infants and Families Tobacco Free Starts, with a $140,000 grant to the state health department from the Anthem Foundation.

The GIFTS program was created to help decrease the number of women who smoke during pregnancy and reduce exposure to secondhand smoke for the pregnant woman and her infant, a state news release said. Smoking before and during pregnancy is the single most preventable cause of illness and death among mothers and infants, according to the federal Centers for Disease Control and Prevention.

�Tobacco use is a serious problem in Kentucky, but it is an even more serious issue for women who smoke during pregnancy,� said Dr. Ruth Shepherd, director of the state health department's Division of Maternal and Child Health. �Smoking during pregnancy and infant exposure to secondhand smoke create numerous risks for babies, including pre-maturity and low birth weight, and risks for developing certain conditions like asthma.�

Smoking rates among pregnant Kentucky women dropped from 26.3 percent in 2004 to 21.9 percent in 2013, but that is still among the highest rates in the U.S. In 2013, 13.3 percent of Kentucky births to smoking mothers were premature, compared to 10.2 percent of births to mothers who did not smoke. Even more striking were these numbers: 13.6 percent of babies born to smokers had low birth weight, compared to only 7.5 percent of those born to non-smokers.

The GIFTS program includes a screening tool for assessing tobacco dependence; screening for depression, social support and domestic violence; individualized counseling and support; referral to a service that helps smokers quit; and educational materials, including relapse prevention and the risks of secondhand smoke exposure in the home.

�Reducing the amount of tobacco use and secondhand smoke exposure is not only crucial for improving the health of our state,� state Health Commissioner Stephanie Mayfield said in the news release. �We are thrilled to receive this grant from the Anthem Foundation and look forward to building on the success of GIFTS and working toward reaching our state�s health goals.�

Princess Health and Poor, rural mothers-to-be have high levels of stress, and few resources to help them handle it, small-scale study concludes.Princessiccia

Princess Health and Poor, rural mothers-to-be have high levels of stress, and few resources to help them handle it, small-scale study concludes.Princessiccia

children mothers neonatal care pregnancy research rural health

Gusty 12:15 Add Comment

Low-income pregnant women in rural areas experience high levels of stress, but lack the appropriate means to manage their emotional well-being, according to a small-scale study at the University of Missouri. The authors suggest that rural doctors should link these women with resources to help manage stress, Medical Xpress reports.

"Many people think of rural life as being idyllic and peaceful, but in truth, there are a lot of health disparities for residents of rural communities," Mizzou nursing professor Tina Bloom told Medical Xpress. "Chronic, long-term stress is hard on pregnant women's health and on their babies' health. Stress is associated with increased risks for adverse health outcomes, such as low birth weights or pre-terms deliveries, and those outcomes can kill babies."

Researchers studied about 25 rural pregnant women. Through interviews, researchers discovered that financial problems were one of the biggest stressers for them. Financial stress was exacerbated by the women's lack of employment, reliable transportation and affordable housing. The women also said that small-town gossip, isolation and interdependence of their lives with extended family members also increased stress. Almost two out of three women showed symptoms of depression, and one in four displayed symptoms of post-traumatic stress disorder. (Read more)

Princess Health and As U.S. teen birthrate reaches 70-year low, Ky. still 7th highest.Princessiccia

Princess Health and As U.S. teen birthrate reaches 70-year low, Ky. still 7th highest.Princessiccia

birth control pregnancy teenagers

Gusty 20:00 Add Comment

The teenage birth rate nationwide is the lowest in nearly 70 years, but Kentucky's rate is much higher than the national average � 46.2 births per 1,000 compared to 34.3 across the U.S.

That ranks it seventh highest in the nation, but the figure is down from 53.1 per 1,000 in 2007. Nationwide, the number is down from 61.8 per 1,000 in 1991. "Young people are being more careful," Sarah Brown, CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy, told Sharon Jayson of USA Today.

In 2010, a total of 367,752 infants were born to mothers ages 15 to 19. Mississippi had the highest rate, with 55 teen births per 1,000 and New Hampshire had the lowest with 15.7, according to the National Center for Health Statistics.

Girls who are having sex for the first time are much more likely to use contraception than their predecessors, notes Laura Lindberg, a senior research associate with the non-profit Guttmacher Institute in New York. She credited the lower teen-birth rate to "the elimination of pelvic exams before receiving prescriptions for hormonal methods, as well as use of long-acting methods such as IUDs." (Read more)