Princess Health and 28% of Ky. adults 18-64 say they lack health coverage; 41% lacked it sometime in last year; employer coverage down since '08.Princessiccia

Princess Health and 28% of Ky. adults 18-64 say they lack health coverage; 41% lacked it sometime in last year; employer coverage down since '08.Princessiccia

economy Foundation for a Healthy Kentucky health care access health insurance jobs poll recession

Gusty 13:38 Add Comment

Nearly three in 10 working-age adults in Kentucky are not covered by any form of health insurance, and the number who get health insurance from their employer, or their spouse�s employer, has plummeted since 2008, the first year of the Great Recession, according to the latest Kentucky Health Issues Poll. The decline accelerated in the last year, and was accompanied by a big jump in the percentage on public insurance.

The poll, taken Sept. 20 through Oct. 14, found that 28 percent of adults aged 18 to 64 said they had no health insurance at the time they were interviewed, and 41 percent said they had been uninsured at some point in the previous year.

The survey found that 37 percent get their insurance from an employer or spouse�s employer, well below the 55 percent figure in a similar poll in 2008. Conversely, 27 percent are now covered by some form of public insurance, way up from the 10 percent in 2008.

Medicaid in Kentucky covers households with incomes up to 70 percent of the federal poverty threshold; 43 percent of working-age adults living at or below that level reported being uninsured last fall. Among those with incomes more than double the poverty level for their size household, 15 percent said they were uninsured.

The poll was conducted for the Foundation for a Healthy Kentucky and the Health Foundation of Greater Cincinnati by the Institute for Policy Research at the University of Cincinnati. Pollsters contacted a random sample of 1,680 adults throughout Kentucky by telephone, including landlines and cell phones. The poll questioned only working-age adults about insurance because 98 percent of seniors have some form of health coverage. The poll has a margin of error of plus or minus 2.5 percentage points.

Princess Health and Kentucky ranks 10th in nation for injury-related deaths.Princessiccia

Princess Health and Kentucky ranks 10th in nation for injury-related deaths.Princessiccia

helmets injuries injury prevention motorcycles prescription drugs seat belts

Gusty 13:04 Add Comment

Injuries are the third leading cause of death nationally, the leading cause of death for Americans between the ages of 1 and 44. Kentucky is among the nation's most problematic states, and it could take several more steps to prevent injuries, says a new state-by-state report on injury-prevention policy.

Kentucky ranks 10th in the nation for injury-related deaths, with a rate of 76.5 such deaths per 100,000 people, and the state spends about $26.8 million for injury-related medical expenses. New Mexico has the highest rate of injury-related deaths, 97.8 per 100,000 people, and New Jersey has the lowest at 36.1. The national rate is 57.9, so Kentucky's rate is almost a third higher than the nation.

Kentucky scored with only three of a set of 10 key indicators for injury prevention: its primary seat belt law, which most states also have; its prescription drug monitoring program, driven by heavy abuse of painkillers; and a strong law on youth sports concussions. Among the injury-prevention indicators that Kentucky lacks, it does not:

• Require bicycle helmets for all children.
• Require that children ride in a car seat or booster seat to at least the age of eight.
• Require helmets for all motorcycle riders. (It once did, but when the law was repealed, deaths rose 50 percent, the report says.)
• Does not require mandatory ignition interlocks for convicted drunk drivers.
• Does not allow people in dating relationships to get protection orders.

The report by the Trust for America�s Health and the Robert Wood Johnson Foundation concludes that millions of injuries could be prevented and billions of dollars could be saved in medical costs each year if more states adopted, implemented and enforced additional research-based injury prevention policies and programs. (Read more).

Princess Health and Tips to help avoid a preventable return trip to the hospital.Princessiccia

Princess Health and Tips to help avoid a preventable return trip to the hospital.Princessiccia

hospitals patients prevention

Gusty 12:50 Add Comment

Patients too often leave the hospital without knowing how to care for themselves, leading to a preventable return. Here are tips to improve your chances of a successful recovery at home:

Be sure you understand your illness, and the care you received in the hospital.

Ask if you will require help at home. Can you bathe yourself? Climb stairs? Will you need bandages changed or shots? If so, do you have a caregiver to help, or will you need to arrange a visiting nurse?

Repeat back your care instructions to those who give them, to be sure you understand them.

Ask for a written discharge plan that lists your medical conditions, your treatments, and the plan for your ongoing care.

Get a list of all medications, how to use them, and what to do if you experience side effects. Be sure to ask whether to continue medications you were taking before this hospitalization.

Ask what symptoms suggest you�re getting worse and what to do if that happens, especially at night or during the weekend.

What follow-up appointments will you need and when? Ask if your hospital will make the appointments for you, and send your records.

Do you have transportation home, to follow-up appointments, and to the drugstore?

If you have a regular physician, make sure the hospital sends a report of your hospital stay.

If you are uninsured or will have difficulty affording prescriptions, a hospital discharge planner or social worker may be able to link you to community resources that can help.

Get a name and number to call if questions about your hospitalization or discharge arise.

Sources: The Associated Press; Dr. Eric Coleman, University of Colorado; Robert Wood Johnson Foundation; Journal of the American Medical Association.

Princess Health and Beshear will expand Medicaid, Democrat and Republican say; D says governor believes the state can opt out if it's not affordable.Princessiccia

Princess Health and Beshear will expand Medicaid, Democrat and Republican say; D says governor believes the state can opt out if it's not affordable.Princessiccia

Affordable Care Act General Assembly health care access health care reform health insurance legislature Medicaid Patient Protection and Affordable Care Act politics state government

Gusty 08:46 Add Comment

State legislators in both parties say they expect Gov. Steve Beshear to expand Medicaid to cover several hundred thousand more Kentuckians who earn up to 138 percent of the federal poverty rate.

Rep. Tom Burch, chairman of the House Health and Welfare Committee, told Ryan Alessi of cn|2�s "Pure Politics" that the governor told him exactly that last week. And Sen. Tom Buford, R-Nicholasville, told Kentucky Health News that he expects Beshear to do the deed.

Burch told Alessi that Beshear has decided to move forward with the expansion because he believes the state would be able to opt out if state officials discover that Kentucky can�t afford it after 2017.

Beshear didn�t mention expansion in his State of the Commonwealth Address last week, and the governor�s office said the official decision hadn�t been made yet but didn�t dispute Burch�s statement, Alessi reports. Here is the salient part of his interview with Burch:



Buford said Beshear will be under much political pressure to expand Medicaid because it is President Obama's signature program and expansion will create jobs. However, Republican legislators generally  have opposed the expansion of Medicaid because the state can�t afford it. The federal government will cover the cost of covering the extra people from 2014 through 2016. Kentucky would have to kick in 5 percent of the costs starting in 2017 and 10 percent by 2020.  

The federal government covers roughly 70 percent of Kentucky�s $6 billion Medicaid program. It covers more than 800,000 Kentuckians and with the expansion, that number could grow to more than 1 million � or roughly a quarter of all Kentuckians, reports Alessi.

�I think it�s critical that we take a look at those to see how we achieve that. I�m not sure that this would be the way that would be best-suited to Kentucky and be fiscally responsible for the state of Kentucky,� Sen. Julie Denton, R-Louisville and chairman of the Senate Health and Welfare Committee, told Alessi in December (at 4:10 of the interview below). �Frankly, I don�t think we can afford to do it,� she said.

Princess Health and Nursing homes push for lawsuit protection with fast-moving bill and broadcast ads; newspaper editorials excoriate sponsor, industry.Princessiccia

Princess Health and Nursing homes push for lawsuit protection with fast-moving bill and broadcast ads; newspaper editorials excoriate sponsor, industry.Princessiccia

courts elder abuse elderly General Assembly legislation legislature nursing homes state government

Gusty 05:37 Add Comment

A state Senate committee has approved a bill that would require lawsuits against nursing homes to clear a review panel before going to court, a move that has drawn very sharp criticism from the editorial pages of the state's two largest newspapers. Meanwhile, the nursing-home industry is running television and radio ads urging calls to legislators in favor of the measure, which the Senate Health and Welfare Committee approved 7-4 last Wednesday without hearing from its opponents.

"Slimy action on questionable bill" read the headline over Tuesday's Lexington Herald-Leader's editorial, which began, "Good ideas can withstand criticism. So, when lawmakers move a piece of legislation without hearing from any of its opponents, you have to wonder whether they're sneaking through a stinker."

The chairman of the committee and the bill's sponsor, Sen. Julie Denton, R-Louisville, said some members had to leave for other meetings. "But somehow they had time to listen to industry spokesmen before voting," the Herald-Leader noted. "The nursing home industry claims that it is under siege from frivolous lawsuits drummed up by attorneys advertising for clients and that this legal threat pushes up nursing homes' insurance and legal costs, taking money that otherwise could go into patient care." (Read more)

The Courier-Journal editorial, which first reported the committee's action, accused Denton of "a brazen abuse of her power as committee chairman" and said sarcastically that she was "humane" to spare members of he committee "the ugly details of nursing home neglect and abuse. . . . Why should members, before lunch, have to consider graphic testimony about bedsores, near-starvation, dehydration and bowel obstructions suffered by elderly, helpless people? But for members of the General Assembly who are interested in the facts, here are some:

� Kentucky currently has about 23,000, mostly frail, elderly people who are residents in about 280 nursing homes. About half the homes have been cited by federal inspectors for a serious deficiency since 2009.
� 40 percent of the homes are rated at below average by the U.S. Center for Medicare and Medicaid Services when it comes to basic health and safety.
� In 2012, Kentucky ranked first in overall federal fines for violations and one Kentucky nursing home racked up the nation�s highest fines for the year.
� Kentucky ranks first in serious nursing home deficiencies that threaten the safety of residents. (Read more)

Sen. Ray Jones, D-Pikeville, who called Denton's move "blatantly wrong." has filed several floor amendments to the bill, which remained in the Senate Rules Committee Monday.

The Kentucky Association of Health Care Facilities is pushing the bill with TV and radio commercials urging calls to legislators. It placed $9,464 worth of ads on Lexington TV stations through Feb. 14.

Princess Health and First major study of diet and strokes links fried, sugary Southern diet, low on fruits and vegetables, to increased risk.Princessiccia

Princess Health and First major study of diet and strokes links fried, sugary Southern diet, low on fruits and vegetables, to increased risk.Princessiccia

diabetes diet heart disease soda stroke vegetables

Gusty 17:13 Add Comment

Genuine Kentucky fried platter:
Cornbread, fried catfish, fried green
tomatoes, fried apples and fried okra
(Photo from Ramsey's, Lexington)

By Molly Burchett
Kentucky Health News

People with a Southern diet, or one heavy on fried food and sugary drinks like sweet tea and soft drinks, are more likely to suffer a stroke, a new study finds.

It's the first big look at diet and strokes, and researchers say it might help explain people in the nation's "stroke belt" or southern states suffer more of them, reports Marilynn Marchione of The Associated Press.

These findings have important implications for Kentuckians because stroke accounts for 5.5 percent of Kentucky deaths each year and more than 81 percent of Kentucky adults eat fruit and vegetables fewer than 5 times a day, which is a indicator of risk for stroke:

Heart Disease and Stroke Risk Factors from federal Behavioral Risk Factor Surveillance System national survey	Ky.	U.S.
Eat fruits and vegetables less than 5 times/day	81.6	75.6
Overweight or obese	69.1	62.9
No moderate or vigorous physical activity	55.8	50.5
High total blood cholesterol	38.5	37.6
High blood pressure	30.0	27.8
Cigarette smoking	28.2	19.8
Diabetes	9.9	8.0

"We're talking about fried foods, french fries, hamburgers, processed meats, hot dogs," bacon, ham, liver, gizzards and sugary drinks, said the study's leader, Suzanne Judd of the University of Alabama in Birmingham.  For the study, a southern diet also included jerky, red meat, eggs, and whole milk.

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???????????Fried foods tend to be eaten with lots of salt, which raises blood pressure and sweet drinks increases risk for diabetes- both are known stroke risk factors, Judd said.

People who ate about six meals a week featuring these sorts of "Southern" foods had a 41 percent higher stroke risk than people who ate that way about once a month, researchers found.

In contrast, people whose diets were high in fruits, vegetables, whole grains and fish had a 29 percent lower stroke risk, reports Marchione.

"It's a very big difference," Judd said. "The message for people in the middle is there's a graded risk" � the likelihood of suffering a stroke rises in proportion to each Southern meal in a week. 

These findings were reported last week at the American Stroke Association conference. The study was launched in 2002 to explore regional variations in stroke risks and reasons for them.

Stroke death rates in Kentucky vary widely among counties. Here's a county map of the rates, from KentuckyHealthFacts.org, which has a county-by county list:

The map shows stroke rates in ranges per 100,000 population from 2003 through 2007. Purple counties had rates above 69; blue counties ranged from 52 to 69; turquoise were 44 to 52; light blue were 31 to 44 (the number that is about the national average), and tan were 18 to 31.

Princess Health and Some Christian Co. health board members balk at director's idea of using $100,000 of $2.4 million reserve for recreational trail.Princessiccia

Princess Health and Some Christian Co. health board members balk at director's idea of using $100,000 of $2.4 million reserve for recreational trail.Princessiccia

county health boards county health departments exercise health departments recreation

Gusty 09:20 Add Comment

The director of the Christian County Health Department urged its board to give $100,000 from reserves to fund a rail-to-trail project to provide residents with new opportunities for exercise.

Coverting old railroad beds to recreation trails could help improve Christian County's infrastructure to promote healthy living, which is needed because a study last year ranked Christian County 116th out of Kentucky's 120 counties in this area, said Health Department Director Mark Pyle.

The department has $2.4 million in reserve, but several board members opposed the idea, citing a budget shortfall this fiscal year, financial troubles with the school-nurse program and delays in Medicaid reimbursements, reports Nick Tabor of the Kentucky New Era.

The City of Hopkinsville hopes to raise $400,000 for the first phase of the trail project. A recreational trail would initiate a culture change and residents should have public resources equal to those of other regions, Mayor Dan Kemp told Taylor.

Pyle told Tabor the trail would help the health department accomplish its goal of advancing public health, and the reserve money isn't there for sitting on. He said he believes the board will agree to using the money for the project at its next meeting, April 22, after considering funding priorities.

The New Era endorsed the health department's contribution as a good investment in local health, which by law is the health board's responsibility. For a PDF of the editorial and the news story, click here.