Princess Health and Princess Health andUK hospital tells 1,079 former patients that a laptop computer with their medical records was stolen in early February.Princessiccia

Princess Health and Princess Health andUK hospital tells 1,079 former patients that a laptop computer with their medical records was stolen in early February.Princessiccia

electronic health records hospitals medical records privacy University of Kentucky

Gusty 09:55 Add Comment

The University of Kentucky reported Wednesday that personal health information of 1,079 people who had been patients at its hospital was on a laptop computer that was stolen in early February.

UK HealthCare said the computer, which was password-protected, belonged to one of its pharmacy billing management vendors. The computer contained dates of birth, medical records and perhaps some patients' insurance carriers and ID numbers, but not Social Security numbers or bank information, UK said.

"We have no reason to believe at this time that any data has been compromised, but under federal privacy regulations we are required to notify people whose information was on the computer in question," UK spokesman Jay Blanton said. "We are also notifying those individuals directly about what has occurred. In that communication, we provide information about where people can contact UK HealthCare for further information." For coverage from WKYT-TV, click here.

Princess Health and Princess Health andNew County Health Rankings report shows same counties at top and bottom, but many have shown moves in the rankings this year.Princessiccia

Princess Health and Princess Health andNew County Health Rankings report shows same counties at top and bottom, but many have shown moves in the rankings this year.Princessiccia

Gusty 07:30 Add Comment

By Melissa Patrick
Kentucky Health News

The fifth annual County Health Rankings report shows that some Kentucky counties have made great improvements in their rankings over the last five years, while others have significantly dropped or remained stuck at the bottom.

The report estimates each county's overall health outcomes (length and quality of life) and its overall health factors (determinants of health). These categories are broken down into eight different areas that are measured and calculated to rank each county relative to the other counties in the same state.

Local communities can use the data "to see how they compare to other Kentucky counties on several health dimensions," said Susan Zepeda, president/CEO of the Foundation for a Healthy Kentucky. "We hope local leaders will use this information to identify both health challenges and policy opportunities." The foundation operates a complementary data website, kentuckyhealthfacts.org, with detailed information on each county's health status.

The last five years have shown some great improvements in the health outcomes and health factors in some of Kentucky's counties. The factors used in the rankings have changed somewhat over the years, some statistical modeling is involved, and statistical differences among closely ranked counties are so small that they may not be significant.

Thus, the rankings should be viewed more as a general categorization of a county's health status than be used to make specific comparisons with counties that are relatively close in the rankings. To emphasize that, the University of Wisconsin's Population Health Institute, which compiles the data, groups counties in quartiles, or fourths of the whole. Kentucky has 120 counties, in quartiles of 30.

McLean County (ML on the map, southwest of Owensboro) is the only one that showed major improvement in both measures, moving up to 45th now from 85th in health outcomes, and up to 51st now from 79th in health factors.

Other counties that showed the most improvement in health outcomes are Hickman, moving up to 56th from 95th; Grant, moving up to 58th from 89th; Elliott, moving up to 66th from 93rd; and Simpson, moving up to 27th from 54th.

A video on Grant County is part of this year's national presentation, also funded by the Robert Wood Johnson Foundation. To watch it, click here.

Grant County was spotlighted because community members used its low ranking as a motivation for improvement. One goal of the project is to provide specific health information to counties that can be evaluated and used to improve their health status.

The counties that showed the most improvement in health factors are Bracken, moving up to 40th from 74th; Meade, moving up to 49th from 83rd; Hart, moving up to 62nd from 91st; and Graves, moving up to 42nd from 73rd. Four other counties, besides McLean, moved up 28 spots in this category: Union (to 43rd from 71st), Marion (to 36th from 64th), Christian (to 66th from 94th) and Carlisle (to 21st from 49th).

Because the rankings are relative, within the state, as many counties must move down as move up, and some counties have shown significant drops in the last five years.

Morgan and Carlisle counties both plummeted 48 spots in the rankings for health outcomes over the five-year period. Morgan fell from 14th to 62nd and Carlisle dropped from 25th to 73rd. These counties were followed by Bath, moving from 67th to 99th; Harrison, from 47th to 77th; and two that dropped 29 spots: Union, which fell from 45th to 74th, and and Robertson, which went from 57th to 86th.

Larger drops were seen in health factors. Fulton County showed a whopping 61-place decline in the last five years, from 48th to 109th. Robertson dropped to 91st from 37th; Lincoln dropped to 95th from 45th; Harrison dropped to 50th from 16th; and Clinton dropped to 89th from 60th.

The top and bottom counties in the rankings have showed very little variation over the last five years. This year the top five counties for health outcomes are: Oldham, Boone, Shelby, Calloway and Scott. The top five for health factors are Oldham, Woodford, Boone, Fayette and Scott.

All five are some of the state's wealthiest and most educated counties, and the five at the bottom are some of the poorest and least educated.

The bottom five counties for health outcomes this year are Lee, Breathitt, Wolfe, Floyd and Perry, at 120th. The bottom five for health factors are Leslie, Magoffin, Wolfe, Martin and Clay, at 120th. These overlapping groups of counties form a contiguous area in the middle of Eastern Kentucky.

Year-to-year changes are subject to more statistical doubt, but some counties showed big movements in their rankings form last year. Carlisle County showed the single greatest drop in health outcomes, dropping 29 spots, from 44th to 73rd. Adjoining Harrison County dropped 22 spots in health outcomes, moving from 55th to 77th. Trimble County dropped 26 spots in health factors, moving from 21st to 47th.

It will be interesting  to watch Bracken County, whose improvement of 30 spots to 40th from 70th this year might reflect in better health outcomes in the future.

Morgan County is also one to watch. Its dismal health factors scores over the last five years, ranging from 96th to 111th, may have contributed to a drop in health outcomes, from 14th in 2010, to 23rd 2011, to 29th in 2012, to 69th in 2013 and to 62nd in 2014.

The downward trend in Nelson County's health-factor ranking, from 25th in 2013 to 46th in 2014, is also worth watching to see if this will reduce its consistently high ranking in health outcomes, ranging from 17th to 25th over the last five years.

The report uses data from the federal Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System, which constantly surveys Americans about their health. Because of small sample sizes for small counties, their figures are calculated through statistical modeling and comparison with counties of similar demographics.

Princess Health and Princess Health andFeds, state will allow mid-April enrollment for people who start but don't complete Obamacare applications by March 31.Princessiccia

Princess Health and Princess Health andFeds, state will allow mid-April enrollment for people who start but don't complete Obamacare applications by March 31.Princessiccia

health insurance health reform insurance exchange obamacare state government

Gusty 19:18 Add Comment

"The Obama administration has decided to give extra time to Americans who say that they are unable to enroll in health-care plans through the federal insurance marketplace by the March 31 deadline," The Washington Post reports. "Federal officials confirmed Tuesday evening that all consumers who have begun to apply for coverage on www.HealthCare.gov, but who do not finish by Monday, will have until about mid-April to ask for an extension."

The announcement will not change the policies and procedures of the Kentucky Health Benefits Exchange (branded as Kynect), said its executive director, Carrie Banahan. She said the exchange was already planning to enroll by April 15 people who had filed an application but not selected a plan by March 31, and will also enroll people who can show they tried to apply by March 31 but were prevented from doing so by a technical difficulty.

Here is more background from the Post.

Princess Health and Princess Health andFDA reviews alternatives to colonoscopies to screen for colorectal cancer, including mail-in, stool-sampling kits.Princessiccia

Princess Health and Princess Health andFDA reviews alternatives to colonoscopies to screen for colorectal cancer, including mail-in, stool-sampling kits.Princessiccia

cancer cancer screening colorectal cancer health rankings

Gusty 18:34 Add Comment

The Food and Drug Administration is examining the possibility of two alternatives to colonoscopies for identifying tumors and growths in the large intestine. Kentucky ranks high in deaths from colon cancer, partly because people resist having colonoscopies.

According to briefing documents posted online Monday, scientists are evaluating the precision of mail-in, stool-sampling kits from Epigenomics and Exact Sciences, which if approved could be on the market this summer, Matthew Perrone writes for the Minneapolis Star Tribune.

Stool tests have long been employed to help detect precancerous tumors, and colon cancer is often treatable if found early enough. So far, the two tests are more accurate than traditional blood stool tests, but they also more often reported growths when there were none.

"Colorectal cancer is the second leading cause of cancer death in the U.S., with over 50,000 deaths expected this year, according to the American Cancer Society," Perrone reports. Last year Kentucky had the fourth highest death rate for colon cancer in the nation, Dr. Amy Tiu noted in a March 15 article for the Lexington Herald-Leader.

Though colonoscopy is the most accurate screening, many people shun it because they think it will be uncomfortable or invasive, and a liquid compounds must be used to clean out the colon before the procedure. The blood-in-stool tests, though thought to be less accurate, may work just as well if employed each year, according to a federally appointed panel.

The new screenings are expected to be more expensive than traditional tests, and it is so far unclear how often people would need to be tested, Perrone reports.

"Only through a better understanding of other key factors, such as the screening interval, adherence, cost and diagnostic evaluation of positive results, can we determine the appropriate place for stool DNA testing on the screening menu," Drs. Douglas Robertson Dr. Jason Dominitz said in the briefing documents.

One of the proposed tests, Cologuard, detected colorectal cancer in 92 percent of patients who had cancerous tumors, while the traditional blood stool test only has 74 percent accuracy. "In patients with precancerous polyps the test was accurate 42 percent of the time, compared with 24 percent for the blood test," Perrone reports.

Epigenomics' Epi proColon test, however, did not meet all of the study goals. This test discovered cancer in 68 percent of patients who had cancerous tumors, but it only recognized healthy patients in 79 percent of cases. FDA scientists warned that "lower specificity could lead to an increase in the number of avoidable colonoscopies" and "adverse events associated with such invasive procedures," Perrone writes.

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

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

cancer cigarettes county health education health rankings lung cancer poverty rural health rural-urban disparities smoking smoking cessation tobacco tobacco prevention

Gusty 10:55 Add Comment

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)

Princess Health and Book Review: Your Personal Paleo Code. Princessiccia

Princess Health and Book Review: Your Personal Paleo Code. Princessiccia

book review diet

Gusty 05:00 Add Comment

Chris Kresser has been a major figure in the ancestral health community for some time now. It's funny to recall that I was actually one of his first readers, back in the early days of his blog when it was called The Healthy Skeptic and the audience was small. Chris's readership rapidly eclipsed mine, and now he's in high demand for his ability to convey ideas clearly and offer practical solutions to important health concerns.

He recently published a book titled Your Personal Paleo Code, which also happens to be a New York Times bestseller. The primary goal of the book is to help you develop a diet and lifestyle that support health and well-being by starting from a generally healthy template and personalizing it to your needs. Let's have a look.

Introduction

Kresser opens with the poignant story of his own health problems, which began with an infectious illness in Indonesia and several courses of antibiotic therapy. After years of struggling with the resulting symptoms, trying a variety of diets, and finally accepting his condition, he was unexpectedly able to recover his health by adopting a personalized Paleo-like diet that included bone broth and fermented foods.

Why Paleo?

Read more �

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

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

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

Gusty 13:13 Add Comment

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

Politico photo by Madeline Marshall: Humana bus

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

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

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

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

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