Princess Health and Princess Health andSome school districts reject federal offer of free lunch for all students, saying schools would lose money on the deal.Princessiccia

Princess Health and Princess Health andSome school districts reject federal offer of free lunch for all students, saying schools would lose money on the deal.Princessiccia

child obesity nutrition school lunch schools

Gusty 13:47 Add Comment

Some school districts are rejecting a federal program that would provide free meals to all students in districts with a certain percentage of students in poverty, Jared Nelson reports for The Times Leader in Princeton, after the Caldwell County Schools decided against joining the Community Eligibility Program.

�Right now, we are not at the economically feasible point to do that. We would lose money,� District Food Service Director Will Brown told Nelson.

Nelson writes, "The district�s food service program is largely self-sufficient, earning income based on students and teachers who pay full-price for meals, and federal reimbursement for those meals and those provided to students qualifying for free or reduced-rate lunches."

If everyone gets a free lunch, �You are losing all of your students on full paid status,� Brown said. �You�re losing that revenue.� He said the number of qualifying students is �not high enough to do that.�

In other words, Nelson writes, "Having a percentage sufficient to qualify ... is different from having a percentage that would make the program viable locally. . . . Brown said other districts have signed on to the CEP program in prior years and been adversely affected. . . . The revenue earned each year allows the food services department to be able to use its own funds to cover the costs of most repairs, new equipment, and other expenses required during the school year and in the summer.

The program "is expanding nationwide this year, after being tested in 11 states, including Kentucky," Nelson notes. Qualifications are based on students in households in the Supplemental Nutrition Assistance Program (food stamps), the Kentucky Transitional Assistance Program, certain Medicaid recipients and foster children. (Read more; subscription required)

Princess Health and Princess Health andHow to keep kids safe from traumatic brain injuries this summer.Princessiccia

Princess Health and Princess Health andHow to keep kids safe from traumatic brain injuries this summer.Princessiccia

children physical activity traumatic brain injuries

Gusty 18:20 Add Comment

About 1.7 million people in the U.S. suffer a traumatic brain injury each year, and nearly half a million children under 15 visit an emergency room for TBI. A brain injury is traumatic if it disrupts the normal function of the brain.

Dr. Michael Egnor, vice-chairman of neurology at New York's Stony Brook University Hospital and director of pediatric neurosurgery at Stony Brook Children's Hospital, provides ideas for how parents can help protect their children from brain injuries this summer.

Families are going on more bike rides, but not everyone knows that bicycle accidents are most likely to happen within five blocks of home. "Make sure your child wears a helmet every time he or she rides a bicycle, scooter or skateboard," Egnor said. "We're seeing the most head injuries right now in skateboarding, especially in young teens, who might think it's just not cool to wear a helmet."

Each year more than 200,000 children suffer from injuries on playgrounds in the U.S., according to the U.S. Consumer Product Safety Commission. The main cause is falls. Egnor suggested looking for shredded mulch, pea gravel, crushed stone and other loose surfaces and being extra careful on asphalt and concrete.

Parents with older children and teens should be aware of possible diving accidents. "In about 50 percent of cases of catastrophic injuries, alcohol or drugs is involved," Egnor said. "Ensure that responsible adults supervise pool parties and other events where swimming and diving are involved."

Egnor also warned of concussions during summer sports. He said, "The few serious injuries we treat from organized sports are usually accidents that probably could not have been prevented," he said, while many of the concussions he treats are mild because many sports require helmets.

Dealing with serious injuries quickly is key, Egnor said. "The full extent of the injuries may not appear immediately." (Read more)

Princess Health and Princess Health andPanel of physicians at national conference discuss future of rural primary care, how to solve doctor shortages.Princessiccia

Princess Health and Princess Health andPanel of physicians at national conference discuss future of rural primary care, how to solve doctor shortages.Princessiccia

doctor shortage physicians primary care rural health rural-urban disparities

Gusty 17:56 Add Comment

More needs to be done to address the shortage of primary-care physicians, a big problem in rural areas and much of Kentucky, according to a panel of physicians at "Rural Health Journalism 2014," Kris Hickman writes for the Association of Health Care Journalists, which sponsored the conference.

Almost half of rural U.S. counties, 44 percent, struggle with primary care physician shortages, said Andrew Bazemore, M.D., M.P.H., director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care of the American Academy of Family Physicians. According to a presentation at the 2013 Kentucky Rural Medical Educators Conference, Kentucky had a 1,287:1 primary care physician to citizen ratio, which is 557 short of the national average.

The national shortage is expected to worsen soon because almost 27 percent of those providers are older than 60, said Mark A. Richardson, M.D., dean of Oregon Health and Science's School of Medicine.

Bazemore said the medical community needs to draw more attention to the need for more primary care physicians in rural areas. He also said that for every dollar spent on health care, only six or seven cents are spent on primary care. "States facing a shortage should remember that primary care is the logical basis of any health care system," Bazemore said.

Richardson recommended that medical schools try to recruit students who have rural backgrounds because they're more likely to return to practice in rural areas. He and Bazemore agree that students who practice in rural areas should be given loan forgiveness or scholarships. "Debt prevents many people from choosing primary care," Bazemore said.

Richardson said the most important factor for where medical students end up practicing is where they completed their training. "Rural training is one of the highest predictors of a rural practice and should be required," he said. To do this, the government-imposed cap on graduate medical education spending would have to be abolished.

"Medical care is not a free market dynamic," Richardson said. "We pay for health care transactions, rather than health." (Read more)

Princess Health and Princess Health andStudy concludes that fasting can reduce cholesterol levels for people in danger of developing diabetes.Princessiccia

Princess Health and Princess Health andStudy concludes that fasting can reduce cholesterol levels for people in danger of developing diabetes.Princessiccia

blood pressure cholesterol diabetes research

Gusty 11:45 Add Comment

New research suggests that occasional fasting can help pre-diabetics from developing diabetes, which is more common in Kentucky than most states.

After 10 to 12 hours of fasting, the body looks for other energy sources to sustain itself, so it removes LDL (bad) cholesterol from fat cells and converts it into energyaccording to researchers at the Intermountain Heart Institute at Intermountain Medical Center in Murray, Utah.

"Fasting has the potential to become an important diabetes intervention," in addition to lifestyle changes and weight loss, said Benjamin Home, the lead researcher.

The study focused on prediabetics between the ages of 30 to 69 with at least three of the following metabolic risk factors: a large waistline, a high triglyceride (type of fat in the blood) level, a low HDL (good) cholesterol level, high blood pressure and high blood sugar after fasting.

"Over a six-week period cholesterol levels decreased by about 12 percent in addition to the weight loss," Home said. "Because we expect that the cholesterol was used for energy during the fasting episodes and likely came from fat cells, this leads us to believe fasting may be an effective diabetes intervention."

The removal of LDL cholesterol from the fat cells for energy use should help stop insulin resistance, which happens when the pancreas keeps producing more and more insulin until it can't make enough for the body, and the blood sugar rises. "The fat cells themselves are a major contributor to insulin resistance, which can lead to diabetes," he said. "Because fasting may help to eliminate and break down fat cells, insulin resistance may be frustrated by fasting."

Home noted that although fasting might be effective for protecting against diabetes, the results were not immediate. "How long and how often people should fast for health benefits are additional questions we're just beginning to examine." (Read more)

Princess Health and Princess Health andProposed waiver from school nutrition guidelines sparks debate.Princessiccia

Princess Health and Princess Health andProposed waiver from school nutrition guidelines sparks debate.Princessiccia

childhood obesity children children's health nutrition school lunch schools

Gusty 14:02 Add Comment

The controversial school lunch waiver debate that began in Washington has migrated to Kentucky. While supporters claim that the proposal assists rural schools, some opponents say it defeats the purpose of years of work to fight one of the U.S.'s highest childhood obesity rates, John Moritz writes for McClatchy Newspapers, parent of the Lexington Herald-Leader.

Next week the House of Representatives is expected to vote on a measure that would let schools ask for a one-year waiver to get out of the new federal school lunch nutritional standards�if the school can show that meeting those guidelines would require them to keep operating meal programs at a loss. The measure is part of a spending bill for the Department of Agriculture passed by the House Appropriations Committee, headed by 5th District Rep. Hal Rogers, R-Somerset.

Michael Saucedo, 9, eats lunch at Russell Cave Elementary
School in Lexington. (Herald-Leader photo by Pablo Alcala)

USDA guidelines, enacted in 2012, call for schools to serve a fruit and a vegetable with each meal. "The guidelines also mandated a switch to 100 percent whole grains by this summer, required milk servings be 1 percent or fat-free and imposed calorie and sodium limitations based on age group," Moritz writes. "Standards also were set for a limited amount of saturated fats per serving, while banning the use of trans fats."

Although the Fayette County Public Schools lunch program will not likely apply for a waiver because the system's meal program is operating in the black, Director of Child Nutrition Michelle Coker told Moritz the waivers would helps smaller Kentucky school districts.

Scott County Nutritional Services Director Mitzi Marshall told Moritz the district is losing money because fewer students are buying the healthier lunches, and even some students who could get free or on-sale lunches have been bringing food from home. She said the guidelines have "gone a little overboard." Coker said cafeteria workers told her that students do not eat the healthy food, forcing the district to increase trash collection. "She estimated that as much as 75 percent of the fruits and vegetables were thrown away," Moritz writes.

"You can put the best meal out there, the most healthy meal, but if they are not eating it, they are not healthier," Coker told Moritz. Before the new guidelines, schools provided fruits and vegetables as an option for children instead of as a requirement.

Supporters of the guidelines argue that tastes can change and schools need to come up with creative strategies for that. "Our schools need to be an environment that makes the healthier and easier choice for our children," said Susan Zepeda, president of the Foundation for a Healthy Kentucky.

According to a report by the Trust for America's Health and the Robert Wood Johnson Foundation, Kentucky ranks eighth in the nation for obesity among children ages 10 to 17 and third among high-school students.

Anita Courtney, who helped the Better Bites program that aims to offer healthier food items for children at swimming pools, public parks and after-school programs, said, "Great work has been done to shift the food that our tax dollars pay for our kids. It just boggles my mind that [Congress] would consider pulling the plug on that."

Coker said a waiver wouldn't mean a school district reverts to its old ways of offering greasy, fatty and sugary foods, but would give an extra year to meet all the requirements. (Read more)

Princess Health and Princess Health andAltria, parent of Philip Morris, reports spending most on lobbying the 2014 legislature but says it didn't fight smoking ban.Princessiccia

Princess Health and Princess Health andAltria, parent of Philip Morris, reports spending most on lobbying the 2014 legislature but says it didn't fight smoking ban.Princessiccia

cigarettes e-cigarettes General Assembly legislation legislature lobbying smoking smoking ban smoking bans tobacco tobacco prevention

Gusty 13:53 Add Comment

The parent firm of the nation's largest cigarette company again reported spending more than anyone else on lobbying the Kentucky General Assembly, but says it did not fight the bill that would have imposed a statewide smoking ban in most public places.

"Altria Group, the parent company of Philip Morris USA and U.S. Smokeless Tobacco, reported spending $156,200, "far more than any other company or group, Tom Loftus reports for The Courier-Journal. "And it got the things it wanted from Kentucky lawmakers: tobacco taxes were not increased, no new tax was put on electronic cigarettes and the tobacco-industry supported bill to ban the sale of electronic cigarettes to minors passed."

Spokesman David Sutton "said not a penny of Altria's lobbying campaign went to defeat the so-called 'smoke-free' bill, though he said the company opposes such complete smoking bans within private businesses," Loftus reports. "He said he suspected Altria's lobby spending topped the list because 'We fully disclose everything'," including research time of its legal staff and its "grassroots activation" work to rally its supporters in Kentucky.

The Campaign for Tobacco Free Kids, "which reported spending $6,284 during the session, earlier this month blamed Altria for leading the successful defeat of the bill to ban smoking in indoor public places like bars and restaurants," The Courier-Journal reports.

"They've spent a lot of money on lobbying for years," the campaign's Betsy Janes told Loftus. "They've sent their message out for so long and have relationships with legislators. It's hard for us to compete with that." (Read more)

The campaign's Amy Barkley told Kentucky Health News that Altria's assertion "is very hard to believe. That said, I don�t have any hard evidence to dispute their claim. We all know the tobacco industry�s influence is very deep in Frankfort, so perhaps they didn�t need to overtly lobby against the smoke-free bill."

The Kentucky Farm Bureau Federation, which gets funding from Altria for some of its programs, lobbied against the smoking ban. It ranked eighth in lobbying expenses, with $68,821. For The Courier-Journal's lst fo top lobbying interests, click here.

Princess Health and Princess Health andAt least one additional health-insurance company is expected to sell policies on Kynect exchange next year.Princessiccia

Princess Health and Princess Health andAt least one additional health-insurance company is expected to sell policies on Kynect exchange next year.Princessiccia

Affordable Care Act health insurance health reform insurance coverage insurance exchange obamacare Patient Protection and Affordable Care Act state government

Gusty 10:15 Add Comment

The five insurance companies that sold policies this year on Kynect, Kentucky's health-benefit exchange, want to return in 2015, and Dayton, Ohio-based CareSource wants to join as well. Officials said they believe other insurers will sign up to sell policies next year, too, which will benefit consumers, Jack Brammer writes for the Lexington Herald-Leader.

""Consumers benefit from the choices that come with more competition," Insurance Commissioner Sharon P. Clark said. Cabinet for Health and Family Services Secretary Audrey Tayse Haynes said she hopes than even more Kentucky residents will set aside time to examine the plans on Kynect when the second round of open enrollment begins Nov. 15.

Anthem, Humana, Bluegrass Family Health, United Healthcare of Kentucky and Kentucky Health Cooperative offered plans on the exchange this year, and Humana was the only one that didn't offer small group market insurance, for two to 50 people. Humana, Anthem and the cooperative offered individual coverage.

Jonathan Copley, CareSource's executive director for Kentucky, said the company's participation in Kynect is "an extension of our commitment to provide affordable coverage to Kentuckians who need it most. We are expanding our reach to one of Ohio's bordering states to offer affordable health care coverage. Kynect represents a successful model on the marketplace, and we are excited to offer CareSource."

Though the tentative deadline for insurers to request to be on the exchange was April 1, the official deadline has been extended as a result of inquiries, Brammer reports.

In Kynect's first open-enrollment period, from Oct. 1 through March 31 about 421,000 Kentuckians enrolled for coverage, and the increasing number of insurers seems to be a sign even more people will sign up next year. Last month The New York Times reported that "8 million people signed up for coverage in 2014 under the federal health care law and that estimates put next year's national enrollment near 13 million," Brammer writes.

This year monthly rates for those enrolled in Kynect ranged from $47 for older couples without dependents to $403 for families of four with a total income of $70,000 per year. Health and Family Services spokeswoman Jill Midkiff told Brammer that an average premium wasn't calculated because of the many variables such as age and family membership. (Read more)