Princess Health and Princess Health andBeshear signs bill allowing limited use of oil extracted from marijuana to treat children's seizures.Princessiccia

Princess Health and Princess Health andBeshear signs bill allowing limited use of oil extracted from marijuana to treat children's seizures.Princessiccia

drugs General Assembly legislation legislature prescription drugs research

Gusty 21:02 Add Comment

Gov. Steve Beshear has signed into law a bill allowing doctors at the University of Kentucky and the University of Louisville, or those conducting a clinical trial approved by the U.S. Food and Drug Administration, to prescribe a marijuana extract to treat seizures in young people.

Denton (Herald-Leader photo)

Senate Bill 124 was sponsored by retiring Sen. Julie Denton, R-Louisville, who said its passage was unimaginable a decade ago, according to the Lexington Herald-Leader. The General Assembly rejected legislation to authorize medical use of marijuana, but legislators and the Beshear administration agreed to SB 124 because tearful parents testified for the bill and cannabidiol contains none of marijuana's psychoactive ingredient.

"Both our law enforcement leaders and our drug policy director worked with the legislators on this bill, and they gave the bill their support," Beshear said in a press release. "Because the bill has been carefully constructed to require that any prescriptive recommendation for the oil can come only from physicians at the state�s research universities or through an FDA clinical trial, I am confident that this law will provide the relief that these families seek, without creating complications for our law enforcement community.�

Princess Health and Princess Health andRoy Butler, 'father of Medicaid' in Kentucky, passes.Princessiccia

Princess Health and Princess Health andRoy Butler, 'father of Medicaid' in Kentucky, passes.Princessiccia

Medicaid rural health

Gusty 14:40 Add Comment

Roy Butler, called "Father of Medicaid" in Kentucky, died Monday morning of complications from Parkinson's disease. He grew up during the Great Depression on a farm in Franklin County, where he learned to work hard, reports Kristie Hamon of The State Journal. He served in the Army with occupation forces in Japan, then Georgetown College and the University of Kentucky. In 1951 he began working with the commonwealth of Kentucky; he spent more than 41 years with the state, and he prioritized "health and social programs within the Cabinet for Human Resources," Hamon writes.

Roy Butler and his family (State Journal photo)

Butler had a very positive influence on Kentucky Medicaid. "The most satisfying aspect was being able to expand the program in terms of the number of health services being offered as well as increased benefits to the providers of care," Butler said recently. He acknowledged co-workers' contributions: "The second-most satisfying aspect of the job was the number of terrific, talented people that I met, especially the staff of people that I worked with such as Janie Miller and Mark Birdwhistell, and having a major impact on the direction of the program."

Miller, a former secretary of health and family services, now runs the Kentucky Health Cooperative, a non-profit insurer created under federal health reform. Birdwhistell, a UK HealthCare executive, told Hamon, "Roy Butler is an extremely phenomenal administrator, extremely knowledgeable and hardworking. . . . I owe him a great deal of gratitude for teaching me everything I learned."

Butler was named to UK's College of Public Health Hall of Fame last fall. He remained married to Elise Lois Watkins Butler for 53 years until she died in 2004, and they had three children. One, Lane Butler Jacobs, recalled an occasion when he father was very upset that someone required a medical procedure and no apparent way to get it covered by Medicaid. Jacobs said she asked her father if he knew the person, and he said, "No, but then what difference would that make? What if this was your mother or your aunt or your daughter? Wouldn't you want to do everything you could do to save their life?"

Jacobs told Hamon, "He also benefited the lives of many other people. Probably more than he can possibly imagine." The story requires a log-in and password to view.

Princess Health and Princess Health andPoll gauges Kentuckians' consumption, sources and opinions of drinking water; E. Ky. likes bottled water more than other areas.Princessiccia

Princess Health and Princess Health andPoll gauges Kentuckians' consumption, sources and opinions of drinking water; E. Ky. likes bottled water more than other areas.Princessiccia

diet food water

Gusty 14:34 Add Comment

Drinking water is necessary for the human body to work properly. Because one can consume water through drinking other beverages or eating foods like lettuce, tomatoes, oranges and melons, the federal Centers for Disease Control and Prevention does not recommend drinking a particular number of cups per day. However, it does recommend drinking water instead of other high-calorie beverages, especially if a person is trying to remain at a healthy weight, according to the Foundation for a Healthy Kentucky's latest release of information from its 2013 Kentucky Health Issues Poll.

The poll, in October and November, gauged Kentuckians' consumption, sources and opinions of their drinking water. While 24 percent reported drinking eight or more cups of water each day, 8 percent said they don't drink water daily. Thirty-two percent said they drink one to three cups per day, and the remaining 35 percent say they drink between four and seven cups.

About half of those surveyed (52 percent) reported drinking tap water most often, and 39 percent said they drink mostly bottled water. Only 4 percent said they primarily drink well water, showing how extensive water lines have become in rural areas. Louisville-area citizens are more inclined (61 percent) to report drinking tap water than people from other areas, and Eastern Kentucky residents were most likely to report drinking bottled water (50 percent) or well water (10 percent).

Why don't some Kentuckians drink tap water? More than four in ten (43 percent) cite the taste of the water as an explanation. Some also say it seems unsafe (13 percent), that they have access to bottled water (13 percent) or that they believe chemicals are in the water (11 percent).

The poll, co-sponsored by Interact for Health of Cincinnati, has an error margin of plus or minus 2.5 percentage points.

Princess Health and Calorie Intake and the US Obesity Epidemic. Princessiccia

Princess Health and Calorie Intake and the US Obesity Epidemic. Princessiccia

overweight

Gusty 05:00 Add Comment

Between 1960 and 2008, the prevalence of obesity in US adults increased from 13 to 34 percent, and the prevalence of extreme obesity increased from 0.9 to 6 percent (NHANES surveys). This major shift in population fatness is called the "obesity epidemic".

What caused the obesity epidemic? As I've noted in my writing and talks, the obesity epidemic was paralleled by an increase in daily calorie intake that was sufficiently large to fully account for it. There are two main sources of data for US calorie intake. The first is NHANES surveys conducted by the Centers for Disease Control. They periodically collect data on food intake using questionnaires, and these surveys confirm that calorie intake has increased. The problem with the NHANES food intake data is that they're self-reported and therefore subject to major reporting errors. However, NHANES surveys provide the best quality (objectively measured) data on obesity prevalence since 1960, which we'll be using in this post.

Read more �

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

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

Appalachia economy poll public health rural health rural-urban disparities state government survey wellness

Gusty 13:32 Add Comment

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)

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

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

Affordable Care Act Appalachia elections General Assembly governor health insurance health reform legislature Medicaid obamacare Patient Protection and Affordable Care Act politics poverty

Gusty 17:38 Add Comment

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.

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

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

county health county health departments farmers' markets health rankings health reform nutrition public health smoking state government tobacco tobacco prevention

Gusty 15:42 Add Comment

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."