Friday, 11 April 2014

Princess Health and More Graphs of Calorie Intake vs. BMI. Princessiccia

In the last post, a reader commented that the correlation would be more convincing if I graphed calories vs. average BMI rather than the prevalence of obesity.  It was a valid point, so I went searching for average BMI values from NHANES surveys.  I dug up a CDC document that contains data from surveys between 1960 and 2002 (1).  Because these data only cover five survey periods, we only get five data points to analyze, as opposed to the eight used in the last post.  The document contains BMI values for men and women separately, so I averaged the two to approximate average BMI in the general adult population.  It's also worth noting that I use the approximate midpoint of the survey period as the year.

First, a graph of average BMI over time.  It went up:



Now, let's see how well average BMI correlates with calorie intake:


The correlation between calorie intake and obesity prevalence was remarkable, but this correlation is simply incredible.  An R-squared value of 0.98 indicates that daily calorie intake and average BMI are almost perfectly correlated.

We can further deduce that each 100-calorie increase in daily food intake is associated with an 0.62-point increase in average BMI among US adults.  

Princess Health and Princess Health andMcConnell continues attack on Obamacare as Washington Post gives him 'four Pinocchios' for misleading article in C-J.Princessiccia

U.S. Sen. Mitch McConnell took the resignation of Health and Human Services Secretary Kathleen Sebelius as an opportunity to repeat his criticism of the Patient Protection and Affordable Care Act.

"Regardless of the administration�s public explanation for the secretary�s exit, Obamacare has been a rolling disaster and her resignation is cold comfort to the millions of Americans who were deceived about what it would mean for them and their families," McConnell said in a press release. "Countless Americans have unexpectedly been forced out of the plans they had and liked, are now shouldering dramatically higher premiums, and can no longer use the doctors and hospitals they choose. Beyond that, virtually everyone who has come into contact with this law has had new reason to worry about what it means for the government to control their health care."

McConnell has been perhaps the leading critic of the law, which led New Yorker magazine cartoonist Barry Blitt to make him the focal point of his artwork on this week's cover, which shows President Obama administering medicine to McConnell as House Speaker John Boehner moves on and Rep. Michelle Bachman and Sen. Ted Cruz await their spoonful. For Blitt's brief explanation of his work, click here.

The point of the cartoon is that despite criticism and a troubled national rollout, the administration exceeded its goal of 7 million people signing up for Obamacare by the original March 31 deadline. In Kentucky, enrollment on the Kynect exchange is now more than 402,000, with several thousand more having been determined eligible for a subsidy to buy private insurance. In an April 10 press release, the state said 79,580 people have bought private policies and 322,827 have qualified for coverage under the federal-state Medicaid program.

McConnell bases part of his criticism on the state's initial report that 285,000 people "might be affected if they had substandard plans," The Courier-Journal said in an editorial. "A month later�in December 2013�Kentucky revised the figure to 168,000 and the [Washington] Post said the number could be as low as 100,000." The Post's Glenn Kessler, in his Fact Checker column, recently gave McConnell the maximum "four Pinocchios" for a misleading op-ed piece in the Louisville newspaper attacking the reform law.

The senator wrote, �Only approximately 64,000 Kentuckians enrolling in Obamacare have enrolled in a private plan in Kentucky�s own Obamacare exchange, far fewer than the 280,000 who received cancellation notices of plans they had and liked.� Kessler says that number is nowhere near correct.

Kessler writes that the 64,000 number (now up to almost 80,000; see above) "can be related only to the 130,000 individual plan policies. Adding in small-group policies inflates the total. . . . When the state made the announcement, it did not know how many plans might actually comply with the law; it just described the size of the individual and small-group markets." Also, he notes, not all the cancellation notices are going out at once: "We have no idea what the flow would be, but just taking a simple average over 12 months yields 11,000 individual policies a month. That adds up to only 55,000 individual policies since November, yet McConnell assumed that all of the notices had been mailed and received."

Finally, Kessler writes, "The 280,000 figure is out of date. In December, the state said it had determined that more than 48,000 plans were grandfathered in under ACA and that nearly 64,000 qualified for transitional relief under an administrative fix announced by the Obama administration. (The state did not distinguish between individual and small-group plans in its announcement, but overall that�s a 40 percent reduction.) That brought the total down to 168,000, a figure that was reported." McConnell spokesman Don Stewart said the fundamental point of the letter, that Democrats were touting Obamacare's successes and ignoring its pitfalls, was still correct.
Princess Health and Princess Health andLouisville jails sign up inmates for health coverage to save the state money; other jails around state may follow suit.Princessiccia

Princess Health and Princess Health andLouisville jails sign up inmates for health coverage to save the state money; other jails around state may follow suit.Princessiccia

Louisville jails are holding daily health insurance sign-ups for released inmates, Chris Kenning reports for The Courier-Journal.

Most inmates qualify for expanded Medicaid under the Patient Protection and Affordable Care Act, and Medicaid applications can be made at any time, not just during the annual sign-up period. Officials told Kenning that after the first four days, they had processed 18 applications, mostly for Medicaid.

The benefit to prisons and jails is twofold: Inmate hospitalizations lasting more than 24 hours can be billed to Medicaid, and getting coverage for released inmates provides insurance to a population that has a high rate of chronic disease, substance abuse and mental illness -- conditions that often bring them back to prison, Kenning writes.

This treatment is often only a temporary fix, because repeat offenders fail to continue their treatment when released because of a lack of health insurance, officials acknowledged.

"I know some people will think, 'I can't afford health insurance myself. Now a person in jail gets access to health care?'" Mark Bolton, director of Metro Corrections, told Kenning. "But taxpayers are paying for these people anyway."

Kenning reports that in Louisville, "Metro Corrections' health care costs make up $9 million of its $52 million budget � a result of treating medical conditions including diabetes, heart disease, infections and drug problems." The jails house an average of about 2,000 people.

U.S. Sen. Mitch McConnell does not support the signups, telling The Courier-Journal that it adds burdens to an already strained Medicaid program that is hard-pressed to find enough doctors willing to accept Medicaid patients. "This is yet another disturbing aspect of a profoundly troubling piece of legislation," he told Kenning.

Plans to expand to other jails and other parts of the state are in the works, said Barbara Gordon of the Kentuckiana Regional Planning and Development Agency, a Louisville-area government clearinghouse that provides "Kynectors" to help people sign up on Kynect, the state health-insurance exchange. They now spend two hours a day at the jail and hope to eventually have someone there full time, Bolton told Kenning.

About a third of people going in or out of prisons and jails would qualify for expanded Medicaid, and 24 percent would qualify for subsidized private insurance, estimates Dr. Fred Osher, director of health systems and services policy for the nonpartisan Council of State Governments Justice Center.

The state Department of Corrections projects that by shifting the costs of those 24-hour hospital stays to Medicaid, the state prison system would save more than $5 million a year, Kenning reports. The system has seen health costs rise to more than $54 million this year, from $34 million in 2004.
Princess Health and Princess Health andNew law bans sales of electronic cigarettes to minors.Princessiccia

Princess Health and Princess Health andNew law bans sales of electronic cigarettes to minors.Princessiccia

Sales of electronic cigarettes to people under 18 are now illegal in Kentucky, following Gov. Steve Beshear's signing into law Thursday of a bill that had support from cigarette manufacturers, many of whom are also getting into the e-cigarette business.

Senate Bill 109, sponsored by Republican Paul Hornback of Shelbyville and Dennis Parrett of Vine Grove, took effect immediately because it contained an emergency clause. A House committee had approved a similar bill, but it did not contain an emergency clause and never came to a vote in the full House.

The law bans the sale to minors of "alternative nicotine products," defined as "a noncombustible product containing nicotine that is intended for human consumption, whether chewed, absorbed, dissolved, or ingested by any other means," but "does not include any tobacco product, vapor product, or any other product regulated as a drug or device by the United States Food and Drug Administration." It also adds to state law more detailed definitions of "tobacco product" and "vapor product," and also bans the sale of the latter to minors.

Thursday, 10 April 2014

Princess Health and Princess Health andKET's 'Safe and Sound: Raising Emotionally Healthy Children in a Stressful World' premieres April 17, first airs April 21.Princessiccia

Princess Health and Princess Health andKET's 'Safe and Sound: Raising Emotionally Healthy Children in a Stressful World' premieres April 17, first airs April 21.Princessiccia

Though new parents often have access to many resources of information on how to care for their children physically, they are usually not as well-informed about raising them to be strong and healthy emotionally, and esearch shows that children who grow up stressed can face brain development  and long-term health issues, KET "Be Well Kentucky" reports.

The state network will present a special report, "Safe and Sound: Raising Emotionally Health Children in a Stressful World," designed to teach parents to be the best they can be, in various locations across the state.

The program will be aired Monday, April 21 at 9/8 p.m. It was produced partly with funding from the Foundation for a Healthy Kentucky.

A public screening and panel discussion of the program will be held Thursday, April 17 at 5:30 p.m. at the Kentucky Science Center in Louisville.

Guests are invited to a 4:30 p.m. reception at the Leadership Louisville Center at 732 W. Main St. The event is free, but registration is required, and seats are limited. Click here to register.

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

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

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.