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Monday, 7 April 2014

Princess Health and Princess Health andKentucky ranks 49th in well-being survey, and Eastern Kentucky's congressional district ranks last in the nation.Princessiccia

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Kentucky ranked 49th in the nation in a survey that measures perception of well-being, ranking higher than West Virginia and lower than Mississippi, and its 5th Congressional District ranked dead last in the nation.

"The survey assessed people's emotional and physical health; behavior that affects health, such as smoking or exercising; job satisfaction and access to basic needs, including food and housing; and their outlook on life," Bill Estep reports for the Lexington Herald-Leader. The Gallup Organization and Healthways, a Tennessee-based company that provides services to improve well-being, administered the survey.

Kentucky has ranked 49th each year except for 2008, the year the index began, when it ranked 48th. Factors contributing to this result include high poverty, top smoking rates, many uninsured people, high depression rates, drug abuse, obesity and other health issues. "Our health status is dismal in Kentucky," state Health Commissioner Stephanie Mayfield told Estep.

Louise Howell, a consultant for Kentucky River Community Care, said Eastern Kentucky has "profound health disparities." Harlan County lost 13,054 years of individual lives due to premature death, according to the survey. In Breathitt County, only 25.1 percent of people have access to satisfactory exercise opportunities. In Martin County, 37.4 people smoked.

Shaping Our Appalachian Region, a program Gov. Steve Beshear and 5th District Rep. Hal Rogers began last year, is forming strategic plans to improve the region's economy through expansion and diversification. This summer the public meeting will take place to brainstorm ideas and promote involvement. "I think this is the toughest most difficult region we've worked in, ever," said Charles W. Fluharty, who heads the Rural Policy Research Institute and is interim executive director of SOAR. However, he said the region will benefit from people's awareness that the coal-depend region has to try to a new strategy, Estep writes.

Dee Davis, president of the Center for Rural Strategies in Whitesburg, told Estep: "People realize if we've got any chance at all we've got to seize the reins; we've got to diversify the economy." (Read more)

Saturday, 5 April 2014

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

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

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

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

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

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

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

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

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

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

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

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

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

Friday, 4 April 2014

Princess Health and Princess Health and'Stars are aligned' for making Ky. healthier, and let's start with schools, health commissioner tells County Health Rankings event.Princessiccia

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Kentucky is poised to make itself healthier, and one key push needs to be making schools smoke-free, the two top officials in charge of the effort told a gathering of state and local health leaders and activists in Frankfort on Wednesday.

Mayfield
"We know our health statistics are bad, but the stars are aligned for Kentucky, and the time to get healthy is now," Dr. Stephanie Mayfield, the state commissioner of public health, said at a gathering held to highlight "Signs of Progress" in conjunction with the national release of the fifth annual County Health Rankings.

"We're seeing changes that we haven't seen in a generation or multiple generations," Mayfield said, such as the expansion of Medicaid under federal health reform; the enrollment of almost 400,000 Kentuckians in the program or private coverage through the state insurance exchange, Kynect; and a coordinated effort by state agencies to make specific improvements in Kentucky's health statistics.

"I can't stop smiling about this," Mayfield said of the effort, called Kyhealthnow. "This is public health at its best," using accountable strategies to reach measurable goals. "These are strategies we need to implement across our state," she said, "but we need to do it in a  way that's not condemning to people and helps them make healthy choices."

Mayfield is co-chair of the effort, headed by Lt. Gov. Jerry Abramson under appointment from Gov. Steve Beshear. Both of them said it must include a stringer effort to ban smoking on school grounds.

Abramson (cn|2 image)
"Only 33 of our 173 school districts have tobacco-free policies," Abramson said with a touch of incredulity, repeating the line for impact. "We have areas where the government has stepped up [with a smoking ban] and the school districts haven't; we have areas where the school districts have stepped up and the governments haven't; and unfortunately, we have lots of areas throughout the commonwealth of Kentucky where neither has occurred"

Mayfield said, "It is disgraceful that all of our schools are not smoke-free. . . . We need to target our children," because the tobacco companies are.

In a national County Health Rankings video, Grant County School Supt. Sally Skinner said, "We have for some time realized the connection between healthy students and strong academic results." Grant County was recognized nationally for focusing on its health ranking as a motive for improvement, and for raising it from 89th to 60th out of 120 counties.

The program also featured videos of three other counties (Floyd, Franklin and Todd) that have used the rankings and associated data to motivate their efforts. The counties are representative of many others "that are doing something" to improve community health, said Dr. Connie White, clinical director for the state Department of Public Health.

Floyd County was recognized for its work against diabetes; Franklin County was noted for its creation of smoke-free environments; and Todd County was recognized for starting a farmers' market to make more fresh produce available.

"There are so many exciting efforts under way in Kentucky," said Katie Wehr of the Robert Wood Johnson Foundation, which funds the County Health Rankings and Roadmaps. She praised the three health departments that have won national accreditation: Franklin County, Three Rivers and Northern Kentucky. "You are demonstrating to the rest of the nation what's possible."

The foundation held similar events in Rockingham County, North Carolina, and Amherst, N.Y., a Buffalo suburb, to mark the fifth anniversary of the rankings and the importance of the roadmaps, which give communities guidance on campaigns to improve community health.

"The rankings are the starting point for the conversation," said Kitty Jerome, director of the Roadmaps to Health Action Center at the University of Wisconsin. "The number is not as important as the people in this room."

Abramson said it's unfortunate that so many Kentucky counties are chronically at or near the bottom of the rankings. "Many areas simply aren't getting the message," he said, "and anything we can do to spread that message and beat that drum is very important. . . . "We've got to do something in a coordinated, collaborative way to bring about an enhanced environment of health for our citizens."

"We are all on the same page," said Jane Chiles, chair of the Friedell Committee for Health System Transformation, which co-sponsored the event and is working with other groups on a statewide, county-by-county campaign to improve the state's health. "It is a winning collaboration going forward that will result in a healthier Kentucky."

Former University of Kentucky president Lee Todd, who emceed the event, said the state needs to declare war on what he calls "Kentucky's uglies" to get citizens and communities motivated to improve their health. He acknowledged that the term "war" is "a little tough-sounding, but I think it's time we get mad enough about some of the statistics. . . . If we had one one-hundredth the interest in moving our health rankings as we do our basketball rankings, we would be a top-ten state."
Princess Health and Princess Health andKentuckians who ran into problems signing up for insurance on state website get a second chance through April 11.Princessiccia

Princess Health and Princess Health andKentuckians who ran into problems signing up for insurance on state website get a second chance through April 11.Princessiccia

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Kentuckians who had trouble starting or completing their application during the open enrollment period can still apply for subsidies and purchase health coverage at Kynect.ky.gov through midnight April 11.

This applies only to those who completed their applications by March 31. All individuals must select a plan by midnight April 15, with coverage beginning May 1, according to a state press release.

�This will be the last chance for most people to sign up for private health plans and possibly receive discounts until the fall open enrollment period,� Carrie Banahan, executive director of Kynect, said in the release. �We strongly encourage those who still need to select a plan to do so as soon as possible. Those who have started applications should work to complete them quickly too, to reduce possible wait times toward the end of the grace period.�

To sign up during the special enrollment period, you will be asked to attest that you attempted to complete an application by March 31, and had problems doing so. When you connect to the Kynect website, there will be a button to select when the special enrollment screen comes up.

Kentuckians who need assistance can also contact the Kynect call center at 1-855-4kynect weekdays from 7 a.m. to midnight Eastern time or from 8 a.m. to 4:30 p.m. Eastern time Saturday and Sunday. They can also search at Kynect.ky.gov to find a Kynector or insurance agent who can assist them with enrollment, or visit a local Department for Community Based Services office.

Individuals who qualify for Medicaid can apply at any time. But only those who experience a qualifying event, such as the loss of employer-sponsored health insurance coverage, will be able to purchase private health plans.

The next open enrollment period begins Nov. 15, 2014.

More than 370,000 Kentuckians have enrolled in new health coverage through Hynect between Oct. 1 and March 31. This is more than 1 out of every 12 Kentuckians, or 8.6 percent of the state�s population, according to the release.

Princess Health and Princess Health andStudy says children who have less screen time show benefits in all areas of their lives, though not immediately.Princessiccia

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It's hard enough for parents to set expectations for children when everyone can see an immediate result, like a clean room or a grade; it is even harder to set expectations for children when it takes months to see the outcome, like the benefits that come from limiting screen time.

A study by Iowa State University, published in JAMA Pediatrics, says reducing the amount of time children spend on the computer or in front of the TV, as well as monitoring content, will help them sleep more, do better in school, behave better and lower the risk of obesity. But these results don't happen immediately, making it hard for parents and kids to buy into decreasing screen time, reports Newswise, a research-reporting service.

The study suggests parents find a healthy balance with screen time. The American Association of Pediatrics recommends that children under 2 not watch any television, and that older children have no more than one or two hours of screen time a day.

Fifty-six percent of children in Kentucky spend more than two hours a day playing video games, watching television, videos or DVDs, or on the computer, according to a 2012 survey of parents by the Foundation for a Healthy Kentucky. The children in the Iowa study averaged more than 40 hours of screen time a week, not counting time spent on a computer at school.

The study analyzed the media habits of more than 1,300 school-aged children who were recruited to participate in an obesity prevention program. Students and parents were surveyed about screen time, exposure to violent media, bedtime and behavior. Teachers reported grades and commented on student behavior. School nurses measured student's height and weight. Data were collected at the start of the program and seven months later at the end of the program and collective patterns were identified.

KidsHealth.org makes these suggestions to create good TV habits in your home:
1. Limit TV-watching hours
2. Put other things to do in the TV room:  books, kids' magazines, toys, puzzles, games
3. Keep TVs and internet connections out of the bedrooms
4. Turn the TV off during meals
5. Don't allow kids to watch TV while doing homework
6. Treat TV as a privilege to be earned
7. Establish and enforce family TV viewing rules
8. Record and watch only the shows you want your kids to watch

Wednesday, 2 April 2014

Princess Health and Princess Health andState will reopen health-insurance enrollment for eight days, starting Friday, citing heavy demand.Princessiccia

Princess Health and Princess Health andState will reopen health-insurance enrollment for eight days, starting Friday, citing heavy demand.Princessiccia

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Kentucky will extend its deadline to sign up for insurance under federal health reform, citing a surge of last minute applications. Gov. Steve Beshear announced Tuesday that Kentuckians will be able to enroll from Friday, April 4 through Friday, April 11.

The official deadline had been midnight Monday, March 31 for those using the state insurance exchange, Kynect. People eligible for Medicaid can apply on the exchange at any time. The details on how this special enrollment period will work, including call center hours, will be announced Thursday, according to a news release from the governor's office.

The days between March 31 and April 4 will allow time to adjust computers for the extension, Cabinet for Health and Family Services spokeswoman Gwenda Bond told Mary Meehan of the Lexington Herald-Leader. She also said it will allow "Kynectors" to set up appointments with people in their communities to help process their applications.

Over the weekend, 21,000 people signed up, including 12,000 Monday, state officials said.

As of April 1, 370,829 Kentuckians had enrolled through the exchange; 293,802 of those signed up for Medicaid, and 77,027 signed up for private insurance. When open enrollment began Oct. 1, state officials estimated there were 640,000 uninsured in Kentucky. Some people getting coverage through the exchange were insured but their policies were canceled because they didn't comply with the reform law.

The federal government's website, HealthCare.gov, was reported to be overwhelmed with users on Monday. Bond said Kynect did not experience any "glitches" in the rush to sign up for health insurance on Monday, Meehan reports.

Princess Health and Uncovering the True Health Costs of Excess Weight. Princessiccia

Princess Health and Uncovering the True Health Costs of Excess Weight. Princessiccia

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Is excess weight hazardous to health, or can it actually be protective? This question has provoked intense debate in the academic community, in some cases even leading researchers to angrily denounce the work of others (1). There is good evidence to suggest that excess body fat increases the risk of specific diseases, including many of our major killers: diabetes, heart attack, stroke, heart failure, cancer, and kidney failure (2). Yet strangely, the studies relating excess weight to the total risk of dying-- an overall measure of health that's hard to argue with-- are inconsistent. Why?
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