Study of preventive health status finds Kentucky is in the middle of the pack generally, but has several good and bad aspects

A study that looked at preventive health services among states in three categories found that Kentucky fell near the middle of the pack for most of the measures, but was in the top 10 for adult flu vaccinations and top five for prevention of high blood pressure, but in the bottom 10 for human papilloma virus vaccinations for males.

The America's Health Rankings' Spotlight: Prevention study, released in partnership with the American College of Preventive Medicine, took an in-depth look at three categories of preventive services: access to health care, immunizations and chronic disease prevention, to "drive awareness and understanding" of the importance of preventive services and interventions.

The report notes that prevention is a "meaningful part of the solution" as the American healthcare system "sharpens its focus on quality, affordability and overall value." (Chart: Each state is a green dot, national average is a gray diamond and Kentucky is a blue diamond; click on image for larger version)

Access to health care was examined by looking at health care coverage, dedicated health care providers and annual dental visits.

"Access to health care is a key part of disease prevention," says the report. "Individuals without health insurance often have more difficulty accessing the health care system, are less likely to participate in preventive care programs, and have more unmet health needs than those with health insurance."

The report found that 90 percent of Kentuckians reported they have some kind of health insurance, above the national average of 87.6 percent.

Since the implementation of the Patient Protection and Affordable Care Act and the expansion of Medicaid to those whose incomes are up to 138 percent of the federal poverty level, the uninsured rate for Kentuckians aged 18 to 64 has dropped from 25 percent in 2013 to 13 percent in 2015, according to a recent Kentucky Health Issues Poll. Another Foundation for a Healthy Kentucky study reports that thousands of newly insured Kentuckians have used their preventive health services, including dental services, which are free under health reform.

Overall, 79.4 percent of Kentuckians said they had a regular health care provider. The national average is 76.7 percent. Hispanics (47.5 percent) fell below this rate as did Kentuckians between the ages of 18 and 44 years of age (66.5 percent).

Only 61 percent of Kentuckians said they had had a dental visit in the past year, which is lower than the national average of 65.3 percent. Income and education were the greatest barriers to getting dental care in the state, with only 41.2 percent of those who made $25,000 or less seeing a dentist and only 35.7 percent of Kentuckians with less than a high school education seeing a dentist.

A recent study on oral health found that 100,000 more Medicaid-eligible Kentuckians got an oral health service in 2014 than in 2013, prompting the project director for the study to say in an interview, "Kentucky's support for an adult dental benefit is huge."

Immunizations were examined through four different immunization measures that included children, teens and adults.

Overall, 72.3 percent of Kentucky's children had the recommended series of childhood immunizations, 85.5 percent of adolescents had the recommended Tdap (tetanus, diphtheria and pertussis) immunization, and 78.2 percent of adolescents got the recommended meningitis vaccine. All of these were close to the national averages of 71.6 percent, 87.6 percent and 79.3 percent respectively.

However, while 37.4 percent of Kentucky's adolescent females got the recommended HPV vaccine only 13.3 percent of the state's adolescent boys did, placing the state in the bottom 10 states for this measure. National averages were 39.7 percent and 21.6 percent respectively.

Kentucky, with 43.9 percent of its adults vaccinated for the flu, was in the top 10 states for this measure; and 67.7 percent of Kentuckians older than 65 reported being vaccinated for pneumonia. National rates were 40.4 percent and 68.5 percent respectively.

"Vaccines are among the most cost-effective clinical preventive services and one of the best tools for preventing infectious diseases," says the report. "Vaccinations have led to a 95 percent decrease in vaccine-preventable diseases over the last 50 years, and yet VPDs remain a major cause of U.S. morbidity and mortality with thousands of cases of illness and deaths each year."

The chronic disease prevention category was examined through three measures: adult awareness of high blood pressure, cholesterol check and colorectal cancer screening.

"Heart disease and cancer are the top two causes of deaths in the United States, accounting for 46 percent of all deaths in 2013, "says the report. "Routine screening can lead to early detection and treatment of chronic disease risk factors, including high cholesterol and high blood pressure, reducing heart disease and cancer mortality."

The report found that 39.1 percent of Kentuckians have been told they have high blood pressure, which places Kentucky in the bottom five states for this condition. Nationally, 31.4 percent of adults have high blood pressure, although many have it, but aren't aware of their condition, says the report.

Overall, the report found that 77 percent of Kentuckians have been tested for cholesterol in the past five years and 67 percent of Kentuckians aged 50 to 74 have had a colorectal cancer screening. Nationally 76.4 have had a cholesterol check and 66.4 percent have had a colorectal cancer screening.

"According to the Centers for Disease Control and Prevention, Americans use clinical preventive services at half the recommended rate, leading to tens of millions of individuals missing out on basic preventive care. Past research from the Institute of Medicine has also estimated that in one year, the United States spent $55 billion due to missed preventive opportunities," says the report.