Food-as-medicine effort at UK gets a boost from new endowment

Alison Gustafson (UK photo by Sabrina Hounshell)

By Christopher Carney

University of Kentucky

One of the first two Gatton Foundation endowed professors at the University of Kentucky is Alison Gustafson, who directs the Food as Health Alliance. The endowment, from a $100 million gift by the late Bill Gatton, will provide funds to developing and expanding food-as-medicine programs across the state.

The money will help build capacity for health-care providers to get key services for diet-sensitive patients who are at risk of food insecurity. Gustafson is also developing and expanding community partnerships, offering approved food-as-medicine programs to those who qualify, and building a referral and network hub that will give patients a connection to services regardless of location. 

“Our team will be conducting expansion efforts for screening and referral, capacity building among community groups, outreach, UK Cooperative Extension training and research projects to better serve Kentuckians experiencing food insecurity,” Gustafson said. 

Gustafson is a professor in the Department of Dietetics and Human Nutrition in the Martin-Gatton College of Agriculture, Food and Environment and the College of Nursing. Under terms of the gift from the Bill Gatton Foundation, distinguished faculty get resources to continue meaningful research, extension and instructional programs related to advancing UK’s land-grant mission. 

The Food as Health Alliance was launched at UK in 2023 to boost health and well-being in the state through the combined application of agricultural, medical, and nutritional resources. Gustafson works to bring together clinical and community research to address the dual challenges of food insecurity and diet-related chronic diseases that many Kentuckians face.

Gustafson earned a doctoral degree in nutrition epidemiology from the University of North Carolina and a master's degree in public health from Boston University. As a master's student, she spent a year in Zimbabwe working with AIDS orphans. She has worked in local and state health departments, focusing on community health for disadvantaged populations. 

The other Gatton endowed chair, Tiffany Messer, will get support for student training and success, water-quality needs assessments, and low-cost water-quality treatment options. She is an associate professor of biosystems and agricultural engineering in the college.

Health-care industry is most at risk from cyberattack, study says

Health care is increasingly more at risk of cyberattacks than other industries, according to a recent study by Soax, a data-collection platform, reports Cara Smith of Inside Health Policy.

As cyberattacks against Change Healthcare and Ascension, a 19-state hospital system, "disrupted the health-care industry, lawmakers, doctors, payers and other stakeholders are scrambling to prevent future cyberbreaches to protect the health-care system," Smith reports.

"The health-care industry is the most vulnerable sector, topping the ranking with 809 data-violation cases in 2023. This is a staggering surge in incidents from the prior year, with cases totaling 343 in 2022 -- a 136% increase, the study found. Further data revealed that these cases affected 56 million victims."

For the study, Soax used data from the Identity Theft Resource Center, and it says "the health-care industry should be on high alert," Smith reports.

May is Bladder Cancer Awareness Month, and Kentucky ranks high; UK doctor explains it, and how to detect and manage it

Illustration by irkus Creative, iStock/Getty Images Plus

By Dr. Zin W. Myint

University of Kentucky

Kentucky has one of the highest rates of new cancers in the U.S., with bladder cancer in the top 10 list of new diagnoses. Understanding the signs, risk factors and preventive measures is important for early detection and management.

What are the symptoms and signs? The most common symptom of bladder cancer is the presence of painless blood in urine. If you notice blood in your urine, don't ignore it and go to your doctor right away. Other signs to look out for are more frequent urination and an increased urge to urinate, especially accompanied by pain or discomfort. Persistent pain in the lower back or pelvic region that only gets worse over time is also a symptom.

What can increase the risk of developing bladder cancer?

• Smoking is the biggest risk factor. Tobacco smoke contains many harmful chemicals that can damage the bladder lining, increasing the risk of developing cancer.
• Exposure to certain industrial chemicals such as paint, dye, metal processing and petroleum products.
• Family history and genetics. If your family has a history of bladder cancer, you should be tested if you notice any of the symptoms above.
• Some chemotherapy drugs and medications are linked to bladder cancer increased because they can irritate the bladder.
• Environmental factors, including drinking water contaminated with arsenic.
• Chronic urinary tract infections may contribute to bladder cancer development as chronic inflammation causes damage to the protective layer of cells lining the bladder.
• A personal history of bladder cancer is also a risk factor, due to its high recurrence rate.
• Other risk factors include chronic indwelling urinary catheter or history of radiation to the pelvic area.

Is there a screening for bladder cancer? We do not screen for bladder cancer in the general population because current studies do not show sufficient benefit.

How can you reduce risks? Reducing the risk of bladder cancer stars with adopting healthy lifestyle choices and minimizing exposure to known risk factors:

• Quitting smoking is one of the most effective ways to reduce the risk of bladder cancer, creating a healthy bladder lining. We highly advocate for smoking cessation, and individuals who smoke should be actively encouraged to pursue cessation treatments, which may include medication and counseling. It is advisable to engage in discussions with your healthcare provider to explore effective methods for quitting smoking and receive personalized support tailored to your needs.
• Minimize or avoid chemical exposure and take safety precautions when working with chemicals that are known to be harmful. For instance, remember to wear gloves while using potent cleaning agents at home as numerous chemicals can permeate the skin. If you’re employed in a refinery setting, prioritize the use of protective gear. Similarly, if you’re a painter, ensure to work within well-ventilated areas to minimize exposure to potentially harmful substances.
• Stay hydrated. Drinking plenty of water throughout the day is vital for maintaining bladder health, reducing the risk of urinary tract infections, and facilitating the swift elimination of toxins from your system.

Zin W. Myint, M.D., is a medical oncologist at UK Markey Cancer Center.

Falling immunization rates pose threats to Kentucky and the rest of nation; immunization climate remains 'turbulent,' observer says

Foundation for a Healthy Kentucky photo

By Melissa Patrick

Kentucky Health News

The immunization crisis in Kentucky is not just a Kentucky issue, but is happening nationwide.

"It's not going to take long before we see the effects of falling rates of immunizations. We're seeing some decrease across the board, again, from coast to coast, border to border," said Dr. Christopher Bolling, who represented the Kentucky Chapter of the American Academy of Pediatrics on a May 8 webinar hosted by the Foundation for a Healthy Kentucky titled “Tackling the Immunization Crisis.”

Bolling said many people have a "false view" that nothing will happen because of these falling immunization rates because it's been so long since we've seen the illnesses that they protect against.

As a recent example, on May 7, the Lexington-Fayette County Health Department reported another cases of pertussis, or whooping cough. It was the city's third case since late April. Since April 1, cases have also been confirmed in Boyd, Jessamine, Logan, Pulaski and Warren counties.

Brice Mitchell, spokesperson for the state Cabinet for Health and Family Services, told Kentucky Health News that there were 84 confirmed cases of pertussis in Kentucky in 2023, and 32 confirmed so far in 2024 -- about the same rate, but dependent on confirmations that may be delayed.

Looking forward during the webinar, Bolling said it's important to not let the controversies surrounding the Covid-19 vaccine influence people's decisions to get vaccinated against other diseases.

"We really do not want to see it start affecting other vaccines as well," he said. 

Looking at Kentucky's vaccination rates, he said that with the exception of young children's diphtheria, tetanus and pertussis vaccines, Kentucky's vaccination rates are lower than the national averages. 

In particular, Bolling pointed to Kentucky's low measles-mumps-rubella vaccination rate. He said Kentucky's rate is 90.1%, the national rate is 93.1% and the level to achieve herd immunity is 95%. 

"So we are susceptible," he said. Herd immunity is the level needed to protect people who can't or won't be vaccinated for various reasons.

Bolling offered suggestions for health-care providers and others for how to talk to people about immunizations and fight misinformation. He said it's important to always remember that behavior changes must be self-motivated.

"The choices they make are going to be based on their own values, their own standards, and their own understanding," he said. "So you really want to evoke within them things that are going to help them make good decisions." 

Kelly Taulbee, director of communications and development at Kentucky Voices for Health, called the current climate around immunizations a "turbulent space." 

"Something to keep in context is you have entire families that don't talk to each other anymore, friends that have lost connection simply because of the positions they took during the pandemic on immunizations," she said. 

Taulbee stressed that the importance of keeping an eye on policies that would hurt the state's immunization rates, pointing to eight bills that were filed in the 2024 legislative session that did not pass. 

Jessy Sanders, health communicator program manager for the Kentucky Rural Health Association's Immunize Kentucky Coalition, announced their upcoming events. Symposiums will be held in Hazard May 17, Somerset Aug. 8 and Paducah Aug. 23, and the 2024 Immunization Summit will be held Oct. 9. 

AMA president-elect, from Louisville, lays out his ideas for getting more physicians in rural areas, reforming prior authorization

By Melissa Patrick
Kentucky Health News

With about 46 million people in the U.S. living in rural areas and new research showing they are more likely to die early from the five leading causes of death than their urban counterparts, the American Medical Association is sounding the alarm. 

AMA President-elect Bruce Scott (AMA photo)

"Rural health is America's health," Dr. Bruce Scott of Louisville, AMA president-elect, told reporters in a May 9 press conference in conjunction with the National Rural Health Association annual conference in New Orleans. "We need policymakers to understand that the American Medical Association is deeply concerned about the ever-widening health disparities between urban and rural communities. disparities that are at the root of why rural Americans suffered disproportionately high rates of heart disease, cancer, stroke, respiratory illness, diabetes, and unintentional injuries." 

Scott, who is board-certified in both otolaryngology and facial plastic surgery, served as the Kentucky Medical Association's president in 2018-19. He will become AMA president in June. 

Scott pointed to several environmental, economic and social factors factors that put people who live in rural communities at a higher risk of death from these often preventable conditions. But the AMA's focus, he said, is on the health-care worker and the physician shortage and how this affects rural people's health. 

He added that these shortages are hitting rural areas the largest and are "creating health-care trends that are simply unacceptable. We need to reverse these trends for all individuals to live a long, healthy and active life."

Scott said rural areas have about 30 physician specialists for every 100,000 residents, compared to 236 per 100,000 in urban communities, and he noted that more than 130 rural hospitals closed from 2010 to 2021, with many more on the verge of closing today. 

Also, he said that in 2023, 65% of rural communities had insufficient access to primary-care physicians, including pediatricians. And, he said there are not enough residency spots to train doctors in rural areas. 

"History has shown us that residents, 80% of the time, tend to wind up practicing within 80 miles of where they've done the residency," Scott said. "So residency location becomes very important. In addition, medical schools are receiving fewer and fewer applicants from individuals from rural areas."

Call for Medicare reform

Scott said the AMA is working to build a stronger physician workforce, which he said starts with supporting physicians who are already in practice, to keep them practicing.

"AMA is focused on fixing the systemic issues of our health-care system that are known to be driving physician burnout, and contributing to early retirement and physicians leaving practice altogether," he said. "Highest among these problems are the broken Medicare physician payment system and the administrative burdens." 

The problem, said Scott, is that Medicare payments to doctors are not keeping up with inflation. He said that when adjusted for inflation, the payment rate to physicians has dropped 29% since 2001, and private payers and other insurers have linked their payments to the Medicare structure. 

"We need a system that is sustainable, predictable, and provides at least an annual inflation update that encourages patients choice rather than consolidation," he said. "We need Congress to act." 

Administrative burdens

Scott said physicians spend two hours on administrative work for every one hour with patients, contributing to burnout and hindering patient care. 

A key contributor to this is "prior authorization," which requires a physician to get approval from a third-party payer for care that the physician and patient have agreed on before it can be implemented.  

"On average, physicians complete 45 prior authorizations per week and it's even worse in primary care," Scott said. "The prior authorization process is overused, overly burdensome and wastes physicians' time. But I'm even more concerned about the fact that prior authorization hurts patients." 

He added, "We need Congress and payers and the administration to respond, because the result is that physicians are getting burned out and they're leaving practice, not because they don't want to practice medical care anymore, but because the system is making it more and more difficult for them to care for their patients." 

During the 2024 legislative session, Rep. Kim Moser, R-Taylor Mill, again filed a bill to address the prior authorization issue in Kentucky, but health insurers blocked it. It would have exempted from the process health-care providers who have had 90% or more of their claims approved. 

Scott said the AMA is "fighting for legislation fixes" to increase incentives for physicians to work in rural areas, to expand the number of residency spots, particularly in primary care and in rural areas, to make the pandemic's telehealth flexibilities permanent, and to allow qualified international medical graduates to keep practicing in America. 

Asked about the role of advanced-practice registered nurses and physician assistants to help increase access to care in rural areas, Scott said that "there is absolutely" a role for these "physician extenders" in a physician-led team model. 

"The AMA believes strongly in the concept of a physician-led medical team, where every component of the team is working to the highest level of their knowledge base and their experience," he said. "Now, we're not in favor of independent practice for nurse practitioners or PAs. We think that patients, no matter what ZIP code they happen to live in, deserve care by a physician." 

Most Kentucky hospitals in national patient-safety ratings got 'C' grades again; state is 35th in share of hospitals with 'A' ratings

By Melissa Patrick

Kentucky Health News

Most of the Kentucky hospitals graded on a nonprofit group's twice-a-year report card for patient safety again got a C in the latest report. 

The Leapfrog Group, based in Washington, D.C., rates nearly 3,000 general acute-care hospitals based on how well they protect patients. Most of Kentucky's 126 hospitals are relatively small, so they are not rated by Leapfrog; it rated 62 Kentucky hospitals.

The group does not grade small hospitals with "critical access" status because they don't have to report quality measures to the federal government; nor does it grade specialty hospitals, government hospitals, or hospitals that don't have enough publicly reported data.

Leapfrog gave 'A' ratings to 10 Kentucky hospitals; Kentucky's percentage of A grades, 16.4%, ranked it 35th among states. That was up two slots from the last report, when it ranked 37th. Leapfrog gave Bs to 19 Kentucky hospitals, Cs to 27 and Ds to 5.  

The grades are based on more than 30 measures that indicate how well hospitals protect patients from preventable errors, injuries, accidents and infections. 

The spring 2024 report showed 92% of U.S. hospitals have seen improvements in at least one of three infections associated with hospitals. Methicillin-resistant Staphylococcus aureus (MRSA) decreased by 30%, central line-associated bloodstream infections decreased by 34% and catheter-associated urinary tract infections decreased by 30%. This good news comes after a six-year high for those infections was reported in the fall 2022 report. 

"While today’s results are promising, patient safety remains a crisis-level hazard in health care. Some hospitals are much better than others at protecting patients from harm, and that’s why we make the Hospital Safety Grade available to the public and why we encourage all hospitals to focus more attention on safety,” Leah Binder, president and CEO of The Leapfrog Group, said in a news release. 

She added, "According to a summary of peer-reviewed research published in British Medical Journal, an estimated 250,000 people a year die of preventable errors and infections in hospitals, which makes patient safety problems the third leading cause of death in the United States." 

The spring 2024 report also showed some improvements on patient experience measures compared to fall 2023. The release notes that these measures worsened during the pandemic and have still not returned to pre-pandemic levels. These measures look at things that have a direct impact on patient safety outcomes, including nurse communication, doctor communication, hospital staff responsiveness, communication about medicine and discharge information. 

"Patient experience is very difficult to influence without delivering better care," Binder said, "so these findings are encouraging."

The Leapfrog site offers details on the measures for each hospital under the heading Infections. It also provides detailed information under headings titled Problems with Surgery, Practices to Prevent Errors, Safety Problems, and Doctors, Nurses and Hospital Staff. The information is provided in an easy-to-read, color-coded scale that indicates how the hospital is performing.

The report uses data from the Centers for Medicare and Medicaid Services, Leapfrog's own survey and other supplemental data sources. Leapfrog says hospitals are only graded if they have submitted adequate data for evaluation.

Top Scores

Hospitals getting As were Baptist Health La Grange, Baptist Health Lexington, Deaconess Henderson Hospital, Georgetown Community Hospital, Meadowview Regional Medical Center in Maysville, the Medical Center at Bowling Green, Saint Joseph-London, St. Elizabeth Healthcare-Edgewood, T.J. Samson Community Hospital in Glasgow, and TriStar Greenview Regional Hospital in Bowling Green.  

Screenshot of page for Georgetown Community Hospital

Georgetown Community Hospital received an A after getting six consecutive Cs.

Baptist Health Lexington has received an A grade for 13 consecutive grading periods. Deaconess Henderson moved up from a B grade in the fall 2023 report. The rest in this top group also received As in the fall. 

Shifts up and down

Four Kentucky hospitals moved down to a B after getting an A on the last report, including Norton Audubon Hospital, Norton Brownsboro Hospital, Norton Hospital and Norton Women's & Children, all in Louisville. 

Five Kentucky hospitals moved up to a B after getting a C on the last report, including Baptist Health Deaconess Madisonville, Baptist Health Richmond, Harrison Memorial Hospital in Cynthiana, Middlesboro ARH Hospital and the University of Kentucky Albert B. Chandler Hospital. 

Other hospitals with B grades are Baptist Health Louisville, Baptist Health Paducah, Clark Regional Medical Center in Winchester, Owensboro Health Muhlenberg Community Hospital in Greenville, Saint Joseph East in Lexington, St. Elizabeth Healthcare-Fort Thomas, St. Elizabeth Healthcare-Florence, U of L Health Shelbyville Hospital, UK HealthCare Good Samaritan Hospital and Blanchfield Army Community Hospital in Fort Campbell. 

Five Kentucky hospitals moved up from a D to a C: Hazard ARH Regional Medical Center, Jackson Purchase Medical Center in Mayfield, Jewish Hospital in Lexington, Kentucky River Medical Center in Jackson and UofL-Sts. Mary and Elizabeth Hospital. 

Three hospitals moved down from a B to a C: Kings Daughters Medical Center in Ashland, Monroe County Medical Center in Tompkinsville and Whitesburg ARH Hospital. 

The remaining 19 hospitals with a C all got Cs on the last report card too. 

Taylor Regional Hospital in Campbellsville moved down from a C to a D and Jennie Stuart Health in Hopkinsville moved up to a D after being the only hospital in the fall 2023 report to get an F. 

Other hospitals with D grades are Highlands ARH Regional Medical Center in Prestonsburg, Murray-Calloway County Hospital and Pikeville Medical Center. 

No Kentucky hospitals got an F on this report. 

Click here for a list of frequently asked questions about the survey. Click here to see if your hospital was graded. 

Online vision retailer Warby Parker will pay Ky. civil penalty for letting 69 Kentuckians to take its online vision test, illegal in Ky.

Image on Warby Parker's "Get a Prescription" page

Kentucky Health News

Warby Parker, an online retailer of prescription glasses, contact lenses and sunglasses, has agreed to pay at least $55,200 to the Commonwealth of Kentucky for allowing 69 Kentuckians to take its online vision test, contrary to state law, Attorney General Russell Coleman's office said in a news release Friday.

Coleman's office alleged that from July to October 2021, 69 Kentuckians were improperly given Warby Parker’s online test. "When the attorney general’s Office of Consumer Protection alerted Warby Parker of the problem, the company cooperated with the investigation and took the test offline," the release said. "Following a voluntary settlement process, Warby Parker will be penalized $138,000. If there are no further violations for five years, the amount will be reduced to $55,200."

The "Get a Prescription" page on Warby Parker's website says the online vision test is available to people who "reside in an eligible state, due to state-level regulations," and disqualifies residents of Alaska, Connecticut, the District of Columbia, Georgia, Idaho, Kentucky, New Mexico, South Carolina, South Dakota, Washington and West Virginia, using their two-letter postal abbreviations.

Kentucky consumers may complain about a business operating in the state to Coleman’s office at https://www.ag.ky.gov/Resources/Consumer-Resources/Consumers/Pages/Consumer-Complaints.aspx.

17 Ky. schools have free online mental health wellness course

Kentucky Health News map; for a larger version, click on it

More than 1,500 students in 17 Kentucky schools recently gained access to a free digital course on mental wellness, provided by the Medicaid program of Anthem Inc., one of the health insurers that manages the federal-state health program in Kentucky.

"The announcement comes during Mental Health Awareness month and as more adolescents, especially girls, report depressive symptoms," notes Sarah Ladd of the Kentucky Lantern.

The 17 schools in the program are Clay County Middle School, Daviess County High School, Estill County High School, Grant County Middle School, Graves County High School, Grayson County Middle School, Hazard Middle School, Henderson County High School, Bazzell Middle School in Allen County, Jenkins Independent School in Letcher County, Lewis County Central Elementary School, Marion County High School, Murray Middle School in Calloway County, Ohio County Middle School, Owensboro Middle School, Russell High School in Greenup County and Webster County High School.

The program has been launched in these schools and will continue into the 2024-25 academic school year, according to Quin Welch, media contact for Anthem Medicaid.

“Understanding Mental Wellness” is a course for students in grades 8, 9 and 10. It has six 15-minute lessons, according to Blackbaud, the digital-services firm that designed the course. 

Anthem says the course exposes students “to the experiences of others in order to develop awareness and empathy, reduce stigma, and provide facts on the prevalence and symptoms of mental health conditions.”

Students then “explore their own mental health, identify challenges they may face, and develop concrete strategies for managing those challenges while increasing their awareness of resources and empowering them with the knowledge, skills, and language necessary to identify and support a peer in need or at risk.”

Ladd reports, "Online previews of the course show a tour of mental health through the program, starting with a lesson on what mental health is and ending with the chance to create a personal wellness plan.

"Since the onset of Covid-19, mental health has worsened. In 2021, the Centers for Disease Control and Prevention found that sadness and hopelessness had increased from pre-pandemic levels, especially for teen girls. In 2017, 41% of female high school students and 21% of male high school students felt sad or hopeless. By 2021, those statistics were at 57% and 29%, respectively."

“Young people need resources and education from trusted sources to protect their mental health,” said Leon Lamoreaux, market president for Anthem Medicaid. He said the program “will help us reach students from all over the Commonwealth and equip them with tools and strategies that will make a positive difference in their lives for years to come.”

Tom Davidson, the CEO of Everfi, said the goal of the program is to help “those who are impacted by mental-health challenges, those who want to build and maintain positive mental health and those who have the opportunity to positively impact the mental health of a friend or peer.”

Parkinson's disease: Its symptoms, causes and management

Photo illustration by Pornpak Khunatorn, iStock/Getty Images Plus

By Dr. Zain Guduru

University of Kentucky

Parkinson's disease is a progressive neurological disorder that affects movement. Named after Dr. James Parkinson, who first described it in 1817, this condition currently affects millions of people worldwide. While there is no cure for Parkinson's disease, understanding its symptoms, causes and management strategies can significantly improve the quality of life for those living with the condition.

What is Parkinson's disease? PD primarily affects the brain's nerve cells responsible for producing dopamine, a neurotransmitter involved in movement regulation. As these cells degenerate or become impaired, dopamine levels drop, leading to the characteristic symptoms of PD.

Symptoms of Parkinson's disease:

• Tremors: Involuntary shaking, usually starting in the hands or fingers.
• Bradykinesia: Slowed movement and difficulty initiating movement.
• Muscle rigidity: Stiffness in the limbs or trunk, causing difficulty with movement.
• Postural instability: Impaired balance and coordination, leading to falls.
• Non-motor symptoms: These can include depression, anxiety, cognitive changes and sleep disturbances.

Causes of Parkinson's disease: The exact cause of PD remains unknown, but it's believed to involve a combination of genetic and environmental factors. Some potential factors that may contribute to the development of PD include:

• Genetic mutations: Certain genetic mutations have been linked to an increased risk of Parkinson's disease.
• Environmental factors: Exposure to toxins like pesticides, herbicides and heavy metals may increase the risk.
• Age: The risk of Parkinson's disease increases with age, typically affecting individuals over the age of 60.
• Brain changes: Abnormal protein deposits in the brain, such as alpha-synuclein, are associated with Parkinson's disease.

Managing Parkinson's disease: While there is no cure for PD, several treatment options can help manage its symptoms and improve quality of life:

• Medications: Dopamine replacement medications, such as levodopa, can help alleviate motor symptoms.
• Physical therapy: Exercise programs designed to improve flexibility, balance, and mobility can be beneficial.
• Speech therapy: Speech therapists can help with communication difficulties often associated with Parkinson's disease.
• Deep brain stimulation: In advanced cases, DBS surgery may be an option to help control motor symptoms.
• Lifestyle modifications: Eating a balanced diet, staying physically active, and managing stress can all contribute to better symptom management.

Parkinson's disease is a complex condition that requires a multidisciplinary approach to management. While there is no cure, early diagnosis and appropriate treatment can significantly improve the quality of life for individuals living with PD. By raising awareness, supporting research, and implementing effective management strategies, we can work towards a better understanding and treatment of Parkinson's disease.

Zain Guduru, M.D., is a neurologist with the Kentucky Neuroscience Institute and assistant professor in the University of Kentucky College of Medicine.

Stomach cancer: How to recognize the signs and reduce your risk

Illustration by peterschreiber.media via iStock/Getty Images Plus

By Dr. Joseph Kim

University of Kentucky

While stomach cancer was in the headlines not long ago with the sudden death of musician Toby Keith, the diagnosis is relatively rare. Stomach cancer now accounts for 1.4% of new cancer cases in the U.S., down from nearly 10% from 30 years ago.

With an average age at diagnosis of 68, stomach cancer is more common among older individuals. But it can happen to anyone, so it’s important to understand its symptoms, risk factors and steps you can take to lower your risk.

What are the signs and symptoms of stomach cancer? Early stage stomach cancer often has no symptoms. As the cancer progresses, patients may experience abdominal pain or discomfort, feeling bloated or full after eating small amounts, nausea or vomiting, unexplained weight loss, blood in the stool and difficulty swallowing.

What causes stomach cancer? There are not always clear risk factors for developing stomach cancer, but some factors tend to be associated with the onset of the disease. These include:

• Heavy consumption of smoked, salted and processed meats
• A diet low in fruits, vegetables and fiber rich foods
• Smoking tobacco
• Being overweight or obese

Other risk factors include gastroesophageal reflux disease (GERD), a family history of stomach cancer, Epstein-Barr virus and H. pylori bacterial infection.

What can I do to reduce my risk? While there is no guaranteed way to prevent stomach cancer, you can lower your risk by:

• Eating a balanced diet with plenty of fruits, vegetables and whole grains. Limit processed meats and smoked or salty foods.
• Maintaining a healthy weight through diet and exercise
• Quitting smoking and limiting alcohol consumption

Can I get screened for stomach cancer? Routine screening isn't currently recommended for everyone. But if you have certain risk factors, like H. pylori infection or a family history of stomach cancer, talk to your doctor about screening options like upper endoscopy or blood tests.

While treatments have progressed in recent years, the five-year relative survival rate for stomach cancer is 35.7%. Early detection can make all the difference for better treatment outcomes, so don't hesitate to reach out to your health care provider if you experience any symptoms or have risk factors that warrant screening.

Joseph Kim, M.D., is a surgeon at the UK Markey Cancer Center.

Kentucky Center for Smoke-Free Policy honors communities, groups and individuals who help create smoke-free communities

The Kentucky Center for Smoke-Free Policy at the University of Kentucky and the Kentucky Department for Public Health’s Tobacco Prevention & Cessation Program honored communities, groups and individuals from across the state who are leading the way to enact smoke- and tobacco-free policies at the 2024 Kentucky Tobacco Control Conference held April 23-24 in Lexington. 

“While tobacco use has decreased across the general population, disparities persist by geographic location, socioeconomic status, race, ethnicity, sexual orientation, gender identity, disability status, and mental health status,” Amanda Bucher, director of tobacco policy research and outreach in the College of Nursing at UK, said in a news release. “This is in part due to the tobacco industry’s targeted marketing of these populations. Our vision for a tobacco-free Kentucky must promote health equity and eliminate these disparities.”

Sydney Shaffer, the 2024 Smoke-free Youth
Advocate of the Year, poses with Lexington
Mayor Linda Gorton. (Photo by Tim Webb)

Sydney Shaffer, a high-school student from Scott County, received the Smoke-free Youth Advocate Award for excellence in promoting smoke-free policy and education about secondhand smoke. Shaffer has advocated for lung-health policies and youth-vaping prevention since losing her grandfather to lung cancer. She has spoken to policymakers about the importance of tobacco control policies at the local, state and national levels.

The Northern Kentucky towns of Corinth and Highland Heights received the Everette Varney Smoke-free Indoor Air Excellence Award for their "exceptional leadership" and collaborative efforts in promoting the health of their citizens by enacting comprehensive smoke-free workplace ordinances.

Dr. Timothy W. Mullett, medical director of UK's Markey Cancer Center Network, received the Lee T. Todd Jr., Smoke-free Hero Award for his courage, leadership, perseverance, and continuous commitment to smoke- and tobacco-free environments in the face of adversity.

Centre College received the Tobacco Free Campus Award for its exceptional leadership and collaborative efforts in promoting healthy campus environments by implementing a tobacco-free campus last year.

Jelaine Harlow, health-education coordinator for the Lake Cumberland District Health Department, received the Ellen J. Hahn Lifetime Achievement in Tobacco Control Award for an exceptional life devoted to leadership in advocacy and public service contributions in tobacco control.

Jessica L. Burris, UK Department of Psychology and Markey Cancer Center received the Timothy W. Mullett M.D. Lung Cancer Prevention Award for her leadership, devotion, and passion toward preventing lung cancer through policy change in tobacco control.

Dr. Michael Gieske, diredctor of lung-cancer screening at St. Elizabeth Healthcare in Northern Kentucky, received the David B. Stevens M.D. Smoke-free Advocate of the Year Award for excellence in promoting secondhand smoke education and smoke-free policy.

The event was also sponsored by UK Healthcare, the Kentucky Health Collaborative, the Kentucky Asthma Management Program, Aetna Better Health of Kentucky, the Kentucky Office of Community Health Workers, Appalachian Regional Healthcare, the Kentucky COPD Program, CHI Saint Joseph Health and Kentucky Voices for Health, a coalition of health-advocacy organizations.

2% fewer Ky. children were on Medicaid a year after pandemic re-enrollment began; total enrollment, including adults, dropped 9.5%

Top half of Georgetown University table, adapted by Ketucky Health News; to enlarge, click on it.

By Melissa Patrick
Kentucky Health News

Medicaid enrollment of Kentucky's children fell 1.6 percent since the continuous-coverage protections of the pandemic were lifted last year. That was one of the smallest declines in the nation.

Coverage of U.S. children fell 10% in the "unwinding" process, says the report from the Georgetown University Center for Children and Families, based on data from the Centers for Medicare and Medicaid Services.

Kentucky hasn't started the re-enrollment process for children yet because, unlike most states, it worked with the federal government to delay the restart of renewals for children until this September. So did North Carolina.

"The story of Georgetown's report is an incredible good news story that speaks to how well Kentucky did things for kids," said Priscilla Easterling, outreach coordinator for Kentucky Voices for Health, a coalition of health-care advocacy groups.

Nationwide, 4.16 million children were dropped from from Medicaid and the Children's Health Insurance Program, and most would likely still be eligible, says the report. The numbers do not reflect individual children, but the change in total enrollment, which fluctuates from month to month for various reasons.

In Kentucky, 10,477 fewer children were covered than the 648,865 who were enrolled in either Medicaid or KCHIP before the unwinding -- the gradual resumption of annual Medicaid coverage renewals. Renewals in Kentucky began in April 2023.

Overall, Kentucky's Medicaid rolls have declined 9.5 percent in the last year. The number enrolled in April was 1,561,400. County-by-county figures are available from the Cabinet for Health and Family Services.

Cabinet spokesperson Brice Mitchell told Kentucky Health News in an email that Kentucky was the first state to request and get approval to automatically grant children 12 months of continuous coverage, without needing to go through a renewal during the unwinding. 

"The state sought this flexibility to ensure our children kept access to the coverage they need and deserve," Mitchell said. 

The only way a child may be disenrolled during the 12-month continuous coverage period is if the child turns 19, a parent or guardian requests disenrollment, or if the child moves out of state, Mitchell said. 

Easterling said it is expected that the children's renewal period that begins in September will go smoothly since the state will have already processed the adult renewals. 

She also noted that it would be great if the state took advantage of an existing program that would allow continuous coverage for children up to age 3 as some other states have done.  

"We know that kids losing coverage and being uninsured negatively impacts their health and their family's finances, with the risk of big medical bills . . . that a family can't afford to pay," Easterling said.