Fewer and fewer Kentuckians over the past decade have told pollsters that their general health is very good or excellent

The number of Kentucky adults who say they're in very good or excellent health has gradually declined over the last decade, from almost half to only two-fifths.

That was among the findings of the Kentucky Health Issues Poll, co-sponsored by the Foundation for a Healthy Kentucky. "The decline is largely among those adults living on higher incomes, although lower-income Kentucky adults consistently report poorer levels of health," the foundation said in a press release.

"Nationally and in Kentucky, the opioid epidemic continues to take a major toll on health and life expectancy across income levels," said Ben Chandler, president and CEO of the foundation. "Cancer, heart disease and diabetes also shorten lives and reduce quality of life in Kentucky. In many cases, these diseases are completely preventable. But it's often the case that social and financial circumstances make healthier choices far more difficult for people living on low wages."

In the poll, 40 percent of adults said their general health was excellent or very good. That was virtually the same as last year's 39 percent; the poll's error margin is plus or minus 2.5 percentage points. But in 2008, the share reporting excellent or very good health was 49 percent. It declined steadily through 2013, improved a bit through 2016, then fell in 2017.

In that year, 1,468 Kentuckians died of drug overdoses, the foundation noted, adding that "Kentucky also has the highest rates of cancer incidence and deaths, and some of the highest rates of heart disease and diabetes in the country."

The recent decline in reported health status has been steeper among people whose incomes are least double the federal poverty level. In 2008, 66 percent of higher-income people reported very good or excellent health; after six years ranging from 55 to 60 percent, the share has fallen the last three years, hitting a low of 49 percent in 2018.

Among people with incomes below 200 percent of the poverty level, reported health status has fluctuated relatively little; it hit a low of percent in 2017 but rose to 30 percent in 2018. The difference is not statistically significant, because that smaller sample has a larger margin of error.

"We have a dual issues of declining higher-income population health and the inability to improve health among those living on low incomes," Chandler said. "These facts must sharpen the focus of policymakers and health advocates to support what works for these populations. Those include smoke-free and tobacco-free laws and higher tobacco taxes, improving nutrition and increasing physical activity in schools, and reducing the cost and improving access to preventive health screenings and substance use treatment."