Princess Health and Donna Arnett, new UK public-health dean, says research is important to reducing Kentucky's huge health disparities. Princessiccia

Princess Health and Donna Arnett, new UK public-health dean, says research is important to reducing Kentucky's huge health disparities. Princessiccia

epidemiology public health research University of Kentucky

Gusty 13:00 Add Comment

Donna Arnett, dean of the College of Public Health at the University of Kentucky, says research is essential to reducing Kentucky's huge health disparities, as illustrated by the recent release of data showing a wide range in life expectancy among counties.

In a UK news release and video, Arnett, a genetic epidemiologist and native of London, noted the "devastating impact" that obesity, diabetes, cancer, drug-abuse and overdose deaths have in her native state.

�Public health is at the heart of answering the challenges of those critical diseases in Kentucky, " Arnett said. "We in public health are really at the forefront of first detecting these epidemics, and then finding strategies and interventions to help eliminate those disparities.�

Arnett's passion for research began during her early career as a nurse when she was working next to a dialysis clinic at a Department for Veterans Affairs hospital and noticed that more African-American men were sent to the clinic than men of other races.

�I�ll never forget, in my hallway in this VA hospital, every day men would be coming down the hallway, and they�re almost all African American,� Arnett said. �I said, �You know, there has to be something about being African American and having kidney failure.��

This prompted her to create an informal hypothesis that this was linked to a genetic code in African American men that put them at a higher risk of kidney failure. She was right. While her original hypothesis evolved, it was validated after numerous studies.

Arnett obtained a doctorate in epidemiology from the University of North Carolina and built a career in public health. She has received research funding from the National Institutes of Health for more than 20 years, and brought three active NIH projects to UK when she became dean of the public-health college in 2015. Among other leadership roles, she has served as the president of the American Heart Association.

Serving as AHA president showed Arnett that "solving the most urgent health problems in the nation requires the collaboration among different professionals and organizations devoted to health and uniting the research efforts and knowledge of diverse investigators," and she is working to establish partnerships across the state, the UK release and video say.

"Science now is really multi-disciplinary," Arnett said, "so we have to function in a team."

Princess Health and Forrest W. Calico, national leader in rural health care, dies at 75. Princessiccia

Princess Health and Forrest W. Calico, national leader in rural health care, dies at 75. Princessiccia

Appalachia books obituaries public health rural health rural hospitals

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Forrest W. Calico

Dr. Forrest W. Calico, a nationally recognized expert on rural health-care quality, died Monday at his home near Crab Orchard "after striving against multiple myeloma for several years," said his obituary in the Lexington Herald-Leader. He was 75.

A native of Garrard County, Calico received his medical degree from the University of Kentucky in 1966. He also held a master's degree in public health from Harvard University. In the U.S. Air Force, he was a flight surgeon at Area 51 in Nevada, a family physician, residency director and hospital administrator, earning the Bronze Star. He was president and CEO of Appalachian Regional Healthcare from 1993 to 1999, a health-systems adviser to the federal Office of Rural Health Policy and a senior quality adviser to the National Rural Health Association. In 2007 he was named a Rural Hero by the National Rural Assembly and in 2010 entered the UK College of Public Health Hall of Fame.

In retirement, Calico remained active at the state and local levels, serving on the boards of the Foundation for a Healthy Kentucky, the Friedell Committee for Health System Transformation and the Lincoln County Board of Health. In 2012 he published a memoir, Out of the Blue, with the subtitle "How open doors and unexpected paths set the course of my life."

Calico is survived by his wife Patricia Calico, their son Jefferson and wife Cari, daughter Tricia and husband Wes Cohron, his sister Helen Eden, a nephew and six grandchildren. A celebration of his life will be held Saturday, June 18, from 2 to 5 p.m., with a memorial service at 3 p.m., at The Church at Cedar Creek at 5787 US 150, east of Stanford. Memorial donations may go to The Friedell Committee, PO Box 910953, Lexington KY 40591, or the Dr. Patricia A. Calico Endowed Nursing Scholarship at UK, 315 College of Nursing Building, Lexington KY 40536.

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 Woman stuck by needle faces up to one year of testing for HIV and hepatitis; dirty needles becoming common in public places. Princessiccia

Princess Health and Woman stuck by needle faces up to one year of testing for HIV and hepatitis; dirty needles becoming common in public places. Princessiccia

hepatitis HIV needle exchanges public health public safety

Gusty 20:56 Add Comment

By Melissa Patrick
Kentucky Health News

A Monroe County woman was stuck by an insulin needle found in a pair of sweatpants she purchased at the Walmart in Tompkinsville and now faces up to a year of testing to make sure she hasn't been infected with HIV or hepatitis, Jacqueline Nie reports for WBKO-TV in Bowling Green.

Insulin syringes are commonly used by IV drug abusers

"I had to be tested for HIV and hepatitis and a drug screening," said Mary Crawford, who was stuck by the needle. "I have to go back from that in 30 days and be tested again, and again in 6 months from that 30 days."

"Crawford says through at least these next 7 months, she cannot share anything with her husband or children," Nie repports. Crawford warned others to be careful: "It could happen to anybody, anywhere."

The latest Kentucky Health Issues Poll found that 13 percent of Kentuckians said they knew someone with heroin problems. And insulin syringes and needles are commonly used to inject it.

Clark County Public Health Director Scott Lockard said that while this was the first time he had heard of a needle being placed in an article of clothing in a department store, he said it is not unusual for dirty needles to be found in public.

"Unfortunately it is becoming more common for used needles to be found by the public," Lockard said in an e-mail. "I have had reports of needles being found locally on streets, in parks, public parking lots, unoccupied buildings, and in restrooms in public venues."

The problem is so bad in Northern Kentucky, where 35 percent in the poll said they knew someone with a heroin problem, that they released public service announcements before Easter to remind children to look for needles before eggs. The Northern Kentucky Heroin Impact Response Taskforce organized police and egg-hunt organizers to search parks for needles prior to the hunts, and said it will continue to search public places for needles throughout the summer, Ben Katko reported for WXIX-TV (Fox 19).

One way to keep dirty needles off the street is through needle exchanges, which allow intravenous drug users to exchange dirty needles for clean ones. These programs were authorized in Kentucky by the 2015 anti-heroin bill, but require both local support and funding.

So far, only 14 counties in Kentucky have either approved or are operating needle exchanges: Jefferson, Fayette, Jessamine, Franklin, Clark, Kenton, Grant, Harrison, Pendleton, Carter, Boyd, Elliott, Pike and Knox. Some jurisdictions have rejected exchanges, saying they encourage drug use, despite pleas from experts who say that's not true and the programs lead users to treatment.

"Needle exchanges work," former state health commissioner William Hacker said. "It decreases the spread of infectious diseases. It takes dirty needles off the street. It is safer for the law enforcement and EMS. It also provides an opportunity to interact with people and divert them to effective treatment."

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 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 Top deputy in state health department named commissioner of Lexington health department. Princessiccia

Princess Health and Top deputy in state health department named commissioner of Lexington health department. Princessiccia

health departments public health state government

Gusty 11:29 Add Comment

Kraig Humbaugh

Dr. Kraig Humbaugh, senior deputy commissioner of the Kentucky Department for Public Health, has been named the Lexington-Fayette County commissioner of health, starting in June. He will replace Dr. Rice C. Leach, who died April 1 following a battle with cancer.

�I am honored to serve and look forward to working with the Board of Health, the hard-working team at the health department and the community to make Lexington a healthier place to live, work and visit,� Humbaugh said in a news release. �It�s important that we build on Dr. Leach�s legacy and the already strong foundation that the health department has in the community.�

A pediatrician by training, Humbaugh has extensive experience in public health, including epidemiology of communicable diseases and emergency preparedness and response.

�We are very excited to have Dr. Humbaugh join us as the next commissioner of health,� Paula Anderson, chair of the Lexington-Fayette County Board of Health, said in the release. �In addition to his exceptional background in public health, he has widespread leadership experience on the state level. He also knows Kentucky and has worked closely with the Lexington-Fayette County Health Department on many previous projects. All of those attributes made him the right choice to lead our health department.�

Humbaugh earned his undergraduate degree from Vanderbilt University and his medical degree from Yale University. He was a Fulbright Scholar at the University of Otago in New Zealand and received a Master of Public Health degree from Johns Hopkins University.