Beshear lays out plan for improving Kentucky's health, with specific goals and largely administrative strategies

By Al Cross
Kentucky Health News

Gov. Steve Beshear set seven specific, numerical goals Thursday for improving Kentucky's "dismal" health status, which he said is hurting the state's education, productivity, attractiveness to employers, state revenues "and our very quality of life."

Beshear, whose term ends in early December 2015, set the goals to be met by Jan. 1, 2019 and said he would hold his appointees "accountable for measurable, reasonable progress." The goals of the program, dubbed "kyhealthnow," are:

• Health insurance: Reduce the share rate of uninsured Kentuckians to less than 5 percent, through Kynect, the insurance exchange Beshear created under federal health reform.

• Smoking: Reduce Kentucky’s smoking rate, now the highest in the nation at 28.3 percent of adults, by 10 percent. The strategies include increasing the use of smoking-cessation therapy, now covered under Medicaid, by half; and two major legislative items, a statewide smoking ban and a higher cigarette tax, for which Beshear said he would keep pushing in next year's legislative session if not passed in the current one. "Smoking is the single biggest factor negatively affecting the overall health of Kentuckians," he said.

• Obesity: Reduce the rate by 10 percent through 13 separate strategies, including measures to encourage physical activity, using Kynect to double the number of enrollees in the state diabetes prevention program, and partnering with school districts to increase the number that collect and report students' body-mass indexes. Kentucky is the fifth worse state for physical activity among adults.

• Cancer: Reduce cancer deaths by 10 percent, largely through more screening. Kentucky has the nation's highest cancer death rate.

• Cardiovascular Disease: Reduce cardiovascular deaths by 10 percent, with measures such as more smoking cessation and aspirin therapy. Kentucky has the nation's third-highest death rate from diseases of the heart and circulatory system.

• Dental Decay: Reduce the percentage of children with untreated dental decay by 25 percent, and increase adult dental visits by 10 percent. The strategies include public-private partnerships to see that three-fourths of the state's grade schoolers get fluoride varnish treatments. "the poor dental health of Kentuckians has not only subjected Kentucky to ridicule, but has detrimental impacts on children, the workforce and families," Beshear said.

• Drug Addiction: Reduce deaths from drug overdose by 25 percent, and reduce the average number of poor mental health days of Kentuckians by 25 percent. The strategies include a "Good Samaritan Law" for people seeking drug treatment for themselves or others, and 50-percent increases in the availability of substance-abuse treatment. Kentucky ranks third in the nation in drug overdoses.

From left: Cabinet Secretary Mary Lassiter, Justice Secretary
J. Michael Brown, Beshear, Abramson, Haynes, Mayfield

Increasing drug treatment would cost money, but Beshear said the state, nonprofits and the private sector can make most efforts "with very little cost to anybody." For a complete list of the goals and strategies, click here.

Beshear named Lt. Gov. Jerry Abramson to head a working group that will push the goals, with Public Health Commissioner Dr. Stephanie Mayfield Gibson as vice chairman. The group will contain leaders from every state cabinet and will seek advice and partnerships from agencies and institutions outside state government.

Health and Family Services Secretary Audrey Haynes acknowledged that improving Kentucky's health status requires individuals to change their unhealthy behaviors, but said the greater availability of health insurance through Medicaid and subsidized insurance gives them more opportunity to do that. "Now we just have to lead them to the water and make them drink," she said, adding later, "We have to put peer pressure on each other," and health-care providers "have to become educators, more than ever."

Beshear discounted an Oregon study that found expanding Medicaid didn't improve the health of new beneficiaries, saying it only covered two years. "We all know this is a long-term process," he said. "We need to look 10, 15 years out. . . . This is for the next generation." For a story and six-minute video from Nick Storm of Time Warner Cable's cn|2, click here.

Kentucky Chamber of Commerce President Dave Adkisson attended the announcement and distributed a written endorsement saying, "The business community has grown increasingly troubled by the impact of our state's poor health status on workforce productivity, absenteeism, health insurance rates and tax bills."

The Foundation for a Healthy Kentucky said it sees in Beshear's plan "a mix of winnable battles – and a commitment to measuring impact – that together will help make Kentucky healthier and more competitive.  Decreasing smoking and the number of families living without health insurance, and increasing the numbers of Kentuckians with ready access to healthy foods and safe places for active living, in the near term is likely to have the payoff we all seek in reducing preventable disease and death from cancer and heart problems in years to come."