Surgeon general wants health warnings on social-media platforms, which he blames for mental illnesses among youth

Surgeon General Vivek Murthy (AP photo by Susan Walsh)

By Michlle Chapman
Associated Press

The U.S. surgeon general has called on Congress to require warning labels on social media platforms and their effects on young people’s lives, similar to those now mandatory on cigarette boxes.

In a Monday opinion piece in the The New York Times, Dr. Vivek Murthy said that social media is a contributing factor in the mental-health crisis among young people.

“It is time to require a surgeon general’s warning label on social-media platforms, stating that social media is associated with significant mental health harms for adolescents. A surgeon general’s warning label, which requires congressional action, would regularly remind parents and adolescents that social media has not been proved safe,” Murthy said. “Evidence from tobacco studies show that warning labels can increase awareness and change behavior.”

Murthy said that the use of just a warning label wouldn’t make social media safe for young people, but would be a part of the steps needed.

Social media use is prevalent among young people, with up to 95% of youth ages 13 to 17 saying that they use a social media platform, and more than a third saying that they use social media “almost constantly,” according to 2022 data from the Pew Research Center.

“Social media today is like tobacco decades ago: It’s a product whose business model depends on addicting kids. And as with cigarettes, a surgeon general’s warning label is a critical step toward mitigating the threat to children,” Josh Golin, executive director at Fairplay, an organization that is dedicated to ending marketing to children, said in a statement.

Actually getting the labels on social media platforms would take congressional action — and it’s not clear how quickly that might happen, even with apparent bipartisan unity around child safety online. Lawmakers have held multiple congressional hearings on child online safety and there’s legislation in the works. Still, the last federal law aimed at protecting children online was enacted in 1998, six years before Facebook’s founding.

“I am hoping that would be combined with a lot of other work that Congress has been trying to do to improve the safety and design and privacy of social media products,” said Dr. Jenny Radesky, a developmental behavioral pediatrician at the University of Michigan and leader at the American Academy of Pediatrics. “Those two things would have to go hand in hand, because there’s so much that Congress can do to follow the steps of the United Kingdom and the European Union in passing laws that take into account what kids need when they’re interacting with digital products.”

Even with Congressional approval, warning labels would likely be challenged in the courts by tech companies.

“Putting a warning label on online speech isn’t just scientifically unsound, it’s at odds with the constitutional right to free speech,” said Adam Kovacevich, CEO of the tech industry policy group Chamber of Progress. “It’s surprising to see the U.S. surgeon general attacking social media when teens themselves say it provides an important outlet for social connection.”

Last year, Murthy warned that there wasn’t enough evidence to show that social media is safe for children and teens. He said at the time that policymakers needed to address the harms of social media the same way they regulate things like car seats, baby formula, medication and other products children use.

To comply with federal regulation, social media companies already ban kids under 13 from signing up for their platforms — but children have been shown to easily get around the bans, both with and without their parents’ consent.

Other measures social platforms have taken to address concerns about children’s mental health can also be easily circumvented. For instance, TikTok introduced a default 60-minute time limit for users under 18. But once the limit is reached, minors can simply enter a passcode to keep watching.

Murthy believes the impact of social media on young people should be a more pressing concern.

“Why is it that we have failed to respond to the harms of social media when they are no less urgent or widespread than those posed by unsafe cars, planes or food? These harms are not a failure of willpower and parenting; they are the consequence of unleashing powerful technology without adequate safety measures, transparency or accountability,” he wrote.

In January the CEOs of Meta, TikTok, X and other social media companies went before the Senate Judiciary Committee to testify as parents worry that they’re not doing enough to protect young people. The executives touted existing safety tools on their platforms and the work they’ve done with nonprofits and law enforcement to protect minors.

Murthy said Monday that Congress needs to implement legislation that will protect young people from online harassment, abuse and exploitation and from exposure to extreme violence and sexual content.

“The measures should prevent platforms from collecting sensitive data from children and should restrict the use of features like push notifications, autoplay and infinite scroll, which prey on developing brains and contribute to excessive use,” Murthy wrote.

Sens. Marsha Blackburn (R-Tenn.) and Richard Blumenthal (D-Conn.) supported Murthy’s message Monday.

“We are pleased that the surgeon general — America’s top doctor — continues to bring attention to the harmful impact that social media has on our children,” the senators said in a prepared statement.

The surgeon general is also recommending that companies be required to share all their data on health effects with independent scientists and the public, which they currently don’t do, and allow independent safety audits.

Murthy said schools and parents also need to participate in providing phone-free times and that doctors, nurses and other clinicians should help guide families toward safer practices.

While Murthy pushes for more to be done about social media in the United States, the European Union enacted groundbreaking new digital rules last year. The Digital Services Act is part of a suite of tech-focused regulations crafted by the 27-nation bloc — long a global leader in cracking down on tech giants.

The DSA is designed to keep users safe online and make it much harder to spread content that’s either illegal, like hate speech or child sexual abuse, or violates a platform’s terms of service. It also looks to protect citizens’ fundamental rights such as privacy and free speech.

Officials have warned tech companies that violations could bring fines worth up to 6% of their global revenue — which could amount to billions — or even a ban from the EU.

Murthy’s focus is on teens and social media, but Radesky noted that adults could use a warning label too.

“What we’ve heard from teens is that they want their parents to be on social media less and on their devices less,” she said. “That’s another behavior change we hope that parents will reflect on and think about — ‘where could I cut down or create some boundaries to create more family time or sleep time?’ — and not only hyper-focusing on what teens are doing, but really what all of us as a society are doing in terms of healthy relationships with technology.”

AP Technology Writer Barbara Ortutay contributed to this story.

Learning CPR for children and infants could help save a little life

(Photo from Prostock-Studio, via iStock/Getty Images Plus)

By Dr. Callie L. Rzasa

University of Kentucky

More than 23,000 children in the United States suffer an out-of-hospital cardiac arrest annually. Although the reported number of infant out-of-hospital cardiac arrests varies widely, only 6.5% for children less than 1 year old who experience an out-of-hospital cardiac arrest survive to hospital discharge.

According to the National Center for Injury Prevention and Control, unintentional choking and suffocation are a leading cause of all injury deaths for infants less than a year old. Nearly 3,500 infants die each year in the U.S. from sleep-related infant deaths such as suffocation, entrapment, strangulation and sudden infant death syndrome.

Make safety a habit at home by implementing safe sleep practices, such as making sure babies sleep in their own crib or bassinet on a firm, flat surface without potential suffocation hazards such as blankets, stuffed animals or crib bumpers.

New parents, grandparents, babysitters and caregivers should take the time to learn infant- and child-specific CPR (cardiopulmonary resuscitation). It’s important to remember if the child is unresponsive, not breathing or only gasping, call 911 and start CPR immediately.

For a child 1 or older:

• Push on the middle of the chest 30 times at a depth of 2 inches with one or two hands at a rate of 100 to 120 compressions per minute.
• Provide 30 compressions and then give two rescue breaths.
• Repeat cycles.

For an infant younger than 1:

• Push on the middle of the chest 30 times at a depth of 1½ inches with two fingers at a rate of 100 to 120 compressions per minute.
• Provide 30 compressions and then give two rescue breaths.
• Repeat cycles.

If you have access to an automated external defibrillator, use it as soon as possible. Most AEDs are equipped with child- and infant-sized pads. They can help guide CPR and provide treatment for certain heart arrhythmias. Continue compressions until emergency services arrives.

For more information about CPR for adults, children and infants, find a class or training center near you.

Callie L. Rzasa, M.D., is medical director of Kentucky Children's Hospital Congenital Heart Clinic and American Heart Association board president in Central and Eastern Kentucky.

Men's Health Month a reminder to schedule preventive screenings

By Melissa Patrick
Kentucky Health News

Men's Health Month in June is a reminder for men to think about their health and consider making some screening appointments that could lengthen, or even save, their lives. 

Why is it so important for men to take care of themselves? For one thing, on average in the United States, men die nearly six years earlier than women. 

That is a wider gap than before the pandemic, which took a disproportionate toll on men. Researchers also note that men are more prone to unintentional injuries, such as drug overdoses and  accidents. Homicides, heart disease and suicides also contribute to the worsening life expectancy for men. 

Men's Health Month is a time for men to take charge of their health and to schedule their preventive  health screenings, especially for the conditions that if caught and treated early could save their life. 

Some recommended screenings include: 

 

Heart disease is the leading cause of death in men, according to the Centers for Disease Control and Prevention.  The American Heart Association says the key screenings for heart health involve an annual physical that include test for blood pressure, cholesterol, body weight and diabetes. Smoking is also a major cause of heart disease, and a health-care provider can help with a cessation plan. 

Skin cancer: Increased sun exposure and fewer trips to the doctor put men at a higher risk of developing skin cancer, so it's important to not only protect your skin when outdoors, but to see a dermatologist if you notice any change in a mole's color or appearance, or if they bleed, ooze, itch, appear scaly or become tender or painful. A dermatologist can also do a full-body skin cancer screening. 

Lung cancer: Kentucky still has one of the highest smoking rates in the nation and leads the nation in lung-cancer cases and deaths. Lung-cancer screening via low-dose computed tomography (a low-dose CT scan) is recommended for anyone 50 to 80 who smokes or has quit in the past 15 years and has at least a 20 pack-year smoking history (a pack per day for 20 years or two packs per day for 10 years). 

Prostate cancer: On average, one in eight men will be diagnosed with prostate cancer and it is the second leading cause of death among men, according to the American Cancer Society. It is recommended that prostate cancer screenings for men who are at average risk begin at age 50. 

Colon cancer: Routine screening for colorectal cancer is recommended to start at age 45. Men with a family history of the cancer may be advised to get screened earlier.

Diabetes: In Kentucky, about 100,000 people have diabetes and don't know it. That's why it's important to get screened with a blood test even when you don't think you have any symptoms.

Mental health: A primary-care provider is a good place to start if you are seeking help with a mental-health concern. Mental Health America of Kentucky also offers a free, online mental-health screening. The new, national 988 suicide/crisis hotline is available 24/7.

"While men are diagnosed with depression half as often as women and are less likely to attempt suicide, men die by suicide three to four times more frequently," says a peer-reviewed article in the American Medical Association Journal of Ethics by Nathan Swetlitz. "Although there is no one-to-one correspondence between depression and suicide, depression is one of suicide’s most significant risk factors."

Independent pharmacists start ads asking Congress for relief from pharmacy benefit managers, ask Supreme Court to hear a case

Photo by Getty Images via The Commonwealth Fund

Kentucky Health News

Independent community pharmacists have begun an advertising campaign to get Congress to rein in pharmacy benefit managers, the middlemen between drug and health-insurance companies. They are also challenging a court ruling that could negate the PBM reforms made by Kentucky and other states.

The ad campaign was launched Thursday, June 13, by the National Community Pharmacists Association. Its CEO, B. Douglas Hoey, said "Eighty percent of all prescriptions in the U.S. are controlled by just three pharmacy benefit managers, and they are all owned by or affiliated with the largest insurance companies in the country. These are Fortune 15 corporations that behave like monopolies, and they are hurting patients with higher prescription costs and killing off small businesses at the average rate of one every day. There is broad bipartisan support in Congress for reform, and we are determined to get it passed before the end of the year."

On Friday, June 14, NCPA joined other pharmacy groups in asking the U.S. Supreme Court to reverse a recent decision from the Tenth Circuit Court of Appeals against a 2019 Oklahoma law than bans PBMs from requiring patients to pick up their prescriptions from PBM-affiliated pharmacies. The groups say the ruling "imperils laws enacted in almost every other state following the 2020 Supreme Court ruling" that approved state regulation of PBMs, reports Gabrielle Wanneh of Inside Health Policy.

In 2023, the Kentucky General Assembly passed Senate Bill 188, aimed at keeping the state's independent pharmacies from closing. It sets dispensing fees, bans PBMs from forcing patients to get their drugs through mail order, and keeps them from steering patients to pharmacies that they own. The PBMs argued that the law will cause insurance premiums to increase and its mandates in the bill won't allow businesses to gain from savings that PBMs offer.

Independent pharmacies say they are losing money because of low fees paid by PBMs. The bill sets a minimum dispensing fee of $10.64 per prescription for the state's independent pharmacies until a study of dispensing costs is completed by the state Department of Insurance. This "gap-fill payment floor" will not be available to chain pharmacies. The results of the study will eventually dictate what the dispensing fee should be going forward. The study is to be repeated every two years, with fee adjustments made accordingly.

The law, sponsored by Sen. Max Wise, R-Campbellsville, also prohibits a PBM from reimbursing a pharmacy that it owns at a higher rate than a community pharmacy, or from keeping a community pharmacy from filling a 90-day prescription for a maintenance drug. And a PBM will not be able to penalize a community pharmacy from sharing information with a patient on the cheapest option to pay for their medications.

In third round of grants from opioid settlements, director passes on one, saying Coleman opposes syringe-exchange programs

Russell Coleman announced Chris Evans's
appointment on Dec. 19. (WKYT image)

By Melissa Patrick
Kentucky Health News
 

The leader of the agency that makes grants from the state's opioid settlements declined to vote for a grant with more money for a syringe-exchange program, saying Attorney General Russell Coleman does not support such programs -- which are considered a key tool for reducing harm to people who inject drugs.

Kentucky Opioid Abatement Advisory Commission Director Chris Evans, who works for Coleman, passed on a June 4 vote that approved a grant to the Boyle County Agency for Substance Abuse Prevention, one of 119 such county agencies.

"This application does increase outreach, which includes educational training, Narcan distribution and referrals to treatment," Evans said. "However, the request does increase the funding of the syringe-service position, which the Office of the Attorney General does not support syringe exchange programs. So I will be passing on the vote of this application."

Asked later why Coleman opposes syringe-exchange programs, Coleman spokesman Kevin Grout said in an email, "Attorney General Coleman is committed to supporting effective prevention, treatment and enforcement efforts. He strongly supports the distribution of Naloxone and other overdose reversal drugs. However, he cannot support syringe-exchange programs, which he believes enable drug use without effectively promoting recovery."

Syringe exchanges are supported by research. The Centers for Disease Control and Prevention says injection drug users who have access to syringe exchanges are five times more likely to get treatment than those who don’t. Another study says the exchanges do not encourage drug use or increase the frequency of drug use among current users.

The exchanges were authorized by the state's 2015 anti-heroin law, in an effort to thwart the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users. As of March 14, the state had 80 operational syringe exchange programs in 65 counties.

Later voting against the grant request because of their opposition to syringe exchange programs were commission members State Treasurer Mark Metcalf and retired Master State Trooper Darren "Foot" Allen, whom Coleman appointed to fill a slot representing law enforcement.

Allen said, "There's some people that I trust that tell me this is okay. However, I'm just not in favor of needle exchange. I suspect that this time next year, I won't change my position but I am open to looking at that option," he said. 

Despite the opposition, Boyle County's ASAP grant request for $282,610 passed with a 6-2 majority vote. The commission is comprised of nine voting and two non-voting members from the legislature.

Third round of grants approved

The Boyle County grant was the only one put up for a vote that had any opposition at the commission's June 4 meeting. In all, the commission members approved 51 organizations to receive just over $12 million in grant money. 

The legislature created the commission to distribute the state's portion of the approximately $900 million in settlements with opioid manufacturers and distributors, half of which goes to the state and the other half goes to cities and counties. The commission is housed in the attorney general's office and is headed by Evans, a former chief operating officer for the U.S. Drug Enforcement Administration.

Of the $12 million in this round of grant money, 28 of the awards were given for treatment and recovery, and 23 were given for prevention. This is the third round of state grants, with $32 million awarded to 59 groups in the first round and $13.9 million awarded to 34 groups in the second round.

Asked for brief details of each grant, Grout said they would be announced next Thursday at a press conference at DV8 Kitchen-East End in Lexington, one of the grant recipients.

The 28 new treatment and recovery grants are:

Appalachian Regional Healthcare, $94,572.
Backroads of Appalachia, $167,025.
Boyle County ASAP Board, $282,610.
Celebrate Recovery Fairdale, $30,004.
Center for Employment Opportunities, $255,109.
Chrysalis House, $227,273.
Comprehend Inc., $426,087.
Eastern Kentucky Concentrated Employment Program, $450,000.
Family Nurturing Center of Kentucky, $221,937.
Family Scholar House, $245,110.
Grin Grant, Lexington, $361,251.
Hope Center, Lexington, $680,280.
Hope Springs Church, $50,462.
Horsesensing Inc., $115,219.
Isaiah House, $250,000.
Ky. Hospital Research and Ed. Foundation (Ky. Hospital Assn.), $250,000.
Lake Cumberland Area Development District, $277,552.
Life Learning Center, $498,500.
Mercy Health - Marcum and Wallace Hospital, Irvine, $179,834.
Natalie's Sisters, $88,356.
Northeast Kentucky Regional Health Information Organization, $331,997.
Ramey-Estep Homes, $222,801.
Recovery Café Lexington, $276,278.
Transitions Inc., $156,000.
Voices of Hope - Lexington, Inc., $538,021.
Volunteers of America Mid-States, $664,587.
Four Rivers Behavioral Health, $232,251.
Young People in Recovery, $301,440.

The 23 new prevention grants are:

Anderson County ASAP, $171,100.
Appalachian Research & Defense Fund (Legal Aid), $125,000.
Big Brothers Big Sisters of the Bluegrass, Inc., $185,301.
Boys and Girls Clubs of Kentuckiana, $200,000.
Carter County Public Library, $101,500.
Covington Partners, $225,450.
Cumberland Trace Legal Services (Legal Aid), $125,000.
DV8 Kitchen Vocational Training Foundation and DV8 Kitchens, $151,730.
Girl Scouts of Kentucky Wilderness Road Council, $59,052.
Jewish Family and Career Services, $77,207.
Legal Aid Society, $125,000.
Legal Aid of the Bluegrass, $125,000.
Mercy Health - Lourdes Hospital, $76,552.
Operation Parent, $87,011.
The Safety Blitz Foundation, $126,335.
Scott County Sheriff's Office, $91,847.
Taylor County Schools, $208,824.
Three Rivers District Health Department, Owenton, $320,803.
University of Kentucky Research Foundation, $380,572.
Operation UNITE, $751,850.
Wanda Joyce Robinson Foundation, $90,472.
WestCare Kentucky, $100,404.
Young Men’s Christian Association of Greater Louisville, $248,487.

The grant application portal is closed until the commission opens it for the next round of awards.

Whooping cough cases keep rising in Lexington and statewide; anyone with cold-like symptoms lasting 2 weeks should get tested

By Melissa Patrick
Kentucky Health News

Fayette County continues to experience a whooping cough outbreak, part of a statewide year-to-year increase in cases of the disease that is most serious in infants, young children and those with chronic diseases.

"Lexington has more pertussis, or whooping cough, cases in the last six weeks than the previous five years combined," Kevin Hall, communications officer for the Lexington-Fayette County Health Department, said in an email. "Fayette County is now up to 27 confirmed cases reported since April 26 . . .  compared to 16 total the previous five years."

Statewide, 25 of 120 counties have reported cases, and the total (76) has almost reached last year's total (84) with more than half of the year remaining.

2024 pertussis cases by county
(Data from state Dept. for Public Health)

Whooping cough, known medically as pertussis, is a highly contagious respiratory illness spread by coughing and sneezing.  Infected people can spread the disease from the start of symptoms and at least two weeks after coughing begins. 

Early symptoms of whooping cough look like a common cold, including runny nose, sneezing, mild cough and low-grade fever. After one to two weeks, long coughing spells develop, which often occur in explosive bursts, sometimes ending with a high-pitched whoop and vomiting. This can go on for up to 10 weeks or more, according to the Centers for Disease Control and Prevention.

The best way to prevent whooping cough is through vaccination. The childhood vaccine is called DTaP. Infants should receive a series of DTaP immunizations at 2, 4, and 6 months, with boosters at 15-18 months and 4-6 years. Children should then get a single dose of the booster, called Tdap, at 11 or 12. Boosters are required every 10 years to maintain efficacy.

"Anyone with cold-like symptoms lasting a week or two should ask their provider to be tested for pertussis," said Hall. "A cough isn’t always present, and the violent cough takes a few weeks before it appears, if it happens at all."

So far in 2024, 76 confirmed cases of pertussis have been reported in Kentucky. That's up from 46 confirmed cases that were reported by the state to Kentucky Health News in mid-May. The state had 35 cases in 2022 and 84 in 2023.

Last May, State Epidemiologist Kathleen Winter said at an immunization summit that the U.S. has a spike in pertussis about every five years. She said there was a "major epidemic" in 2012 and "We are well positioned to have another one." 

Asked about this, Brice Mitchell, a spokesman for the state Department for Public Health, said in an email dated May 24 that while cases of pertussis tend to peak every three to five years, this pattern was disrupted during the Covid-19 pandemic. 

"In recent years, pertussis incidence has remained low in Kentucky. (35 cases in 2022 and 84 cases in 2023) The last major peak occurred in 2016-2017 when 463 and 449 cases were reported, respectively," he said. "There is no clear indication that Kentucky is currently headed into an elevated incidence year for pertussis, however the Kentucky Department for Public Health continues to work with local health departments to identify cases and closely monitor trends." 

Kentucky ranks 38th in child well-being, two slots higher than in 2023; latest report shows big jump in child and teen deaths in '22

Table from Kids Count 2024 Data Book

By Melissa Patrick
Kentucky Health News

Kentucky, where nearly one in four people are children, ranked 38th among states for the overall well-being of its children, rising two slots from the last report, according to the 2024 Kids Count Data Book. 

The 35th annual Data Book, released June 10 by Kentucky Youth Advocates and the Annie E. Casey Foundation, rates children's overall well-being through 16 indicators in four major domains: health, economic security, education and family and community.

Overall, Kentucky improved in six of the 16 indicators, but went backward in six others, including all four indicators used to measure education. The most recent data are from 2022. Here's a look at each domain:

Health: Kentucky's health ranking improved to 36th in this year's Data Book, up from 40th last year, even though two of the indicators used to measure health worsened. 

The latest report shows a big increase in the rate of deaths of children aged 2 through 18. It rose to 37 deaths per 100,000 residents in 2022, up from 29 per 100,000 in 2019.

The percentage of low birth-weight babies (less than 5.5 pounds at birth) also inched up to 8.9% in 2022, from 8.7% in 2019. The national average was 8.6% in 2022. 

New data were not available for the percentage of Kentucky's children and teens who are overweight or obese. That rate was 38% in 2021-22, much higher than the national average of 33%. 

As in some prior years, the only good news in the health category was that the percentage of children without health insurance stayed the same in 2022, at 4%. The national rate is 5%, reflecting the fact that 10 states have still not expanded Medicaid as Kentucky has.

For larger, clearer versions of these tables, click on them.

Economic well-being: Kentucky ranked 36th in the Economic Well-Being domain, up from 41st last year. Kentucky's children remained the same in two of the indicators used to measure economic well-being, including children living in households with a high housing-cost burden (23%) and teens not in school and not working (8%). The state saw  improvements in the percentage of children living in poverty (21%) and the share of children whose parents lack secure employment (28%). 

Family and Community:  Kentucky ranked 43rd in this domain, down one slot from last year. The state showed improvement in all indicators, including children living in single-parent homes (34%), children in families where the household head lacks a high school diploma (10%), children living in high-poverty areas (11%) and teen births per 1,000. In 2022, there were 22 teen births per 1,000 females aged 15-19. In 2018, that number was 25 per 1,000. In 2022, the national rate was 14 per 1,000. 

Education: Kentucky ranked 33rd in the Education domain, down from 29th in the last report. All four of the indicators used to measure education worsened. 

The biggest change was seen in the percentage of eighth graders not proficient in math, increasing to 79% in 2022, up from 71% in 2019. The percentage of fourth-graders not proficient in reading also increased, to 69%, up from 65%. The report also shows that the percentage of children ages 3 and 4 not in school also increased slightly, to 61% in 2018-22, up from 59% in 2013-17. 

“To meet educational milestones, kids of all ages must have what they need to learn – from enough food and sleep, to a safe way to get to school, to supports such as tutoring and mental-health services," Terry Brooks, executive director of KYA said in a news release. "And they must be in schools where there is a qualified and well-supported teacher in every classroom. ” 

The release says learning losses from the Covid-19 pandemic have cost the state decades of progress in education. 

Brooks points to a time in Kentucky when public education was a place where Kentuckians found common ground and that Kentucky schools were the "envy of the nation" in the early 90s. 

"We need to re-claim that legacy. We need to move from where we are – when seemingly public education is the most politized and divisive policy issue in Frankfort – and reclaim the ethos of Kentuckians joining together when it comes to K-12 classrooms,” he said in the release. “That kind of common ground agenda is essential for our children and just as critical in building a strong workforce and economy for the future. That means resources for sure, but it also means engagement by us all and a fundamental restructuring of how we do ‘school’ in Kentucky.”

Further, it points to chronic absences that have increased, particularly among children living in poverty. The Data Book shows that 25% of  the state's children were chronically absent in 2021-22. 

Adverse childhood experiences also effect a child's ability to learn. In Kentucky, the report says 47% of the state's children in 2021-22 had experienced one or more ACEs.

And while the percentage of the state's high-school students graduating on time dropped one percentage point, to 90% in 2020-21, from 91% in 2018-19, that's still better than the national rate of 86%. 

This year's report focuses on how to help children get back on track when it comes to education. 

KYA and the Casey Foundation offer recommendations for how to make sure children can thrive in the classroom, including the need for "access to low- or no-cost meals, a reliable internet connection, a place to study, and time with friends, teachers, and counselors." 

Other recommendations are to deepen investments in school wraparound services to address chronic absences, to expand access to intensive tutoring and to utilize all of the allocated pandemic relief funding to prioritize the social, emotional, academic and physical well-being of students.

Deaths from colorectal cancer in Appalachian Kentucky have declined, but far less than in the rest of the nation, UK study says

County rates per 100,000 are seen in five ranges or quintiles.(Map adapted by Kentucky Health News)

Kentucky Health News

Deaths from colorectal cancer in Appalachian Kentucky declined from 1999 to 2020, but far less than the rate of decline in the rest of the nation.

That's the upshot of a University of Kentucky study analyzing death data.

It found that in the 54 Kentucky counties served by the Appalachian Regional Commission, the mortality rate fell from 31.24 deaths per 100,000 residents in 1999 to 24.46 per 100,000 in 2020. But the national rate dropped by almost half, from 27 deaths per 100,000 Americans in 1999 to 14.81 in 2020. In non-Appalachian Kentucky, the rate dropped from 27.6 to 17.1.

During the entire 21 years covered by the study, the colorectal-cancer death rate in Appalachian Kentucky was 25.8 per 100,000 residents. In the 66 non-Appalachian counties, the rate was about 22 per 100,000. The national rate was 19.43 deaths per 100,000. Kentucky has the fourth highest death rate. 

The Kentucky county with the highest age-adjusted rate from 1999 through 2020 was Fleming, at 39.6 deaths per 100,000 residents. The next highest were Harlan, 34.4; Bath, 33.2; Pike, 32.1; Breckinridge, 31.6; Henry, 31.5; Todd, 31.1; Carter, 30.7; Lewis, 30.7; Cumberland, 30.6; Mason, 30.5; Lawrence, 30.4; Morgan, 30.4; Clay, 30.2; Letcher, 29.7; Washington, 29.4; Nicholas, 28.6; Breathitt, 28.5; Perry, 28.5; Floyd, 28.3; Monroe, 28.3; Powell, 28.2; and Nelson, 27.9 (all in dark blue on the map).

The counties with the 10 lowesr rates were Lyon, 14.9 per 100,000; Trimble, 16.97; McCracken, 17.7; Jessamine, 18.2; Shelby, 18.3; Madison, 18.4; Bullitt, 18.7; Trigg, 18.8; and Owen, 18.8.  Rates for Hickman and Robertson counties were not reported due to small case numbers.

The study, in the journal Gastroenterology, used data from the Centers for Disease Control and Prevention on the causes of death for Americans 15 or older. Its lead author is Dr. Syed Hassan, a research coordinator and clinical research scientist in UK's Department of Internal Medicine.

Hassan "said efforts to enhance screening rates should be improved and more education on colorectal cancer is needed," according to a UK news release.

He noted that In Appalachian Kentucky, nearly 41% of the colorectal cancer deaths occurred at home, suggesting that many victims might not have been seen by a doctor until the cancer had significantly advanced.

“That’s concerning, in my opinion,” Hassan said. “Access to health care, lifestyle related modifiable risk factors and education are important factors we should further work upon.”

Hassan also said anxiety about colonoscopies and other cancer screenings, and lack of education about the disease, may also play a role: “Many of these patients might’ve believed that they probably wouldn’t be able to afford as much care due to their socioeconomic status.”

Screening for colon cancer is recomended to start at age 45, because cancers of the colon and rectum tend to occur after age 40, but recent studies have shown increases in younger people, especially those with risk factors.

These cancers tend to run in families; studies show that if a close relative has had colorectal cancer, you can be predisposed to polyps — pre-cancerous lesions that can lead to the development of the cancer,

Other risk factors include age and lifestyle factors such as smoking, sedentary living, obesity, a diet rich in red meat, salt and saturated fats or a low-fiber diet.

Southern Baptist Convention opposes in vitro fertilization, passing resolution offered by head of denomination's Louisville seminary

Southern Baptist Theological Seminary President
Albert Mohler spoke in a YouTube video on May 23.

UPDATE, June 15: For a New York Times story on how the resolution was developed, and its political ramifications, click here.

Kentucky Health News

The Southern Baptist Convention voted Wednesday to oppose the use of in vitro fertilization, in which many human embryos are created outside the body but only one or a few are implanted in the uterus.

The resolution, adopted at the denomination's annual meeting in Indianapolis, was offered by R. Albert Mohler Jr., president of the Southern Baptist Theological Seminary, and Andrew T. Walker, an associate professor of Christian ethics and public theology at the Louisville school.

The two "acknowledged that the issue is divisive even among strongly anti-abortion Christians, and that Republicans have leaped to preserve access to fertility treatments," reports Ruth Graham of The New York Times. She quoted from an interview in which Mohler said: “I want to do more than nudge Republicans who are against us on this. I want to call them out for their error and inconsistency.” He said IVF as commonly practiced is “as immoral as anything we can imagine if we state the proposition clearly, but a lot of evangelicals don’t want to state the proposition clearly.”

Mohler told Politico that he is “very frustrated” with Republicans who favor legislation protecting IVF: “A lot of them are responding out of political expediency, not out of moral principle. You can’t say on one hand life begins at fertilization and then on the other hand say but now we’re not so concerned about that in this other arena.”

 

After the Alabama Supreme Court outlawed IVF this year, Republican politicians there and in other GOP-controlled states scrambled to protect the process. A bill to protect IVF in Kentucky got no hearing, and state law on the topic is unclear. Action by Congress is unlikely because 60 votes woudl be needed to pass such legislation through the Senate.

The Southern Baptist Convention is Kentucky's largest religious denomination. As of 2021, 1.2 percent of births in Kentucky involved the use of assisted reproductive technologies, mainly IVF; the U.S. rate was 2.3%.

The resolution is not binding on any church or member. It asks Southern Baptists “to reaffirm the unconditional value and right to life of every human being, including those in an embryonic stage, and to only utilize reproductive technologies consistent with that affirmation, especially in the number of embryos generated in the IVF process.”

The resolution also urges Southern Baptists to “advocate for the government to restrain” actions inconsistent with the dignity of “every human being, which necessarily includes frozen embryonic human beings.” In other words, unusued embryos should be frozen, not destroyed.

"Although the process . . . often results in the destruction of unused embryos, many Southern Baptists see that as fundamentally different from abortion because the goal of fertility treatments is to create new life," Graham reports. Convention messengers, or delegates, "heard several emotional testimonies, some from Baptists who hoped to soften the language of the resolution."

Megan Messerly of Politico reports, "As evangelicals become more educated on the issue, they are largely falling into two camps: those who believe that IVF can be practiced ethically if no embryos are destroyed, and those who like Mohler and Walker believe IVF is inherently unethical because it separates conception from the act of sex between husband and wife. Walker, acknowledging the former view, noted the resolution was 'drafted to pass.' A last-minute amendment sought to make clear that IVF is permissible in some circumstances, but failed."

Vote counts were not announced, but a convention spokesman told The Wall Street Journal that the resolution passed overwhelmingly.

At a Monday luncheon "hosted by a new conservative Christian advocacy group with Southern Baptist ties, Mohler compared the nascent evangelical conversation around in vitro fertilization to the years after the Roe v. Wade decision, when Catholics led the anti-abortion movement and evangelicals were less attuned to the issue," Graham reports, quoting him: “We had to learn after 1973 as evangelicals. We had to learn how to get this issue right.”

The Southern Baptist Convention did not declare its opposition to abortion until several years after the 1973 Roe v. Wade decision of the U.S. Supreme Court, which overturned itself in 2022 in a case styled Dobbs v. Jackson Women's Health Organization.

Dr. Bruce Scott, Louisville otolaryngoloist, becomes president of American Medical Association, says he's 'ready to fight' for docs

AMA President Bruce Scott, M.D.

Kentucky Health News

Dr. Bruce A. Scott, an ear, nose and throat specialist from Louisville, was sworn in Tuesday, June 11, as the 179th president of the American Medical Association, the nation’s largest organization of physicians.

“I became a physician to care for patients, and we all know that’s getting tougher every day,” Scott said in his inaugural address. “Our health-care system should help physicians provide good care, not get in the way!” He said “The AMA does for physicians and our patients what we as individual physicians cannot do.”

Scott said “two decades of spiraling Medicare payment cuts and ever-increasing administrative burdens” have increased burnout among doctors to the point that “almost two-thirds of physicians show signs of burnout. One-third plan to reduce their hours. One in five physicians are hoping to stop practicing or retire in the next two years.

“We can’t afford to lose even one more doctor! As a physician in an independent practice, I live these issues every day. I see my colleagues struggling. I feel the urgency of the moment. I will bring that urgency to my presidency. You better believe I’m ready to fight.” 

Scott has been president of his state and county medical associations and remains on their boards. "As a leader of these associations, he has fought for access to care for vulnerable populations, improvement in public health and reduction of administrative burdens in health care," an AMA news release said. He joined the AMA Board of Trustees in 2015 and was speaker of the AMA House of Delegates starting in 2019.

Board-certified in both otolaryngology and facial plastic surgery, Scott is president of Kentuckiana Ear, Nose & Throat, a six-physician independent private practice group, medical director of Premier Ambulatory Surgery Center, and holds a clinical appointment at the University of Louisville medical school.

Scott is a director of Health2047, the AMA’s Silicon Valley-based subsidiary that finds and funds tech-enabled commercial health-care enterprises. "In this role he is helping shape the future of medicine to empower patients and healthcare providers with meaningful and measurable impact," the release said.

He has written many articles for medical journals, as well as chapters in otolaryngology textbooks, He earned his undergraduate degree at Vanderbilt University, completed his education and residency at the University of Texas.

In his inaugural address, Scott told how he suffered a penetrating hand injury when he was 12 and a surgeon told his parents "that I was unlikely to ever regain normal use of my hand, and I would probably lose at least two fingers," but Dr. Joseph Kutz, Louisville's world-renowned hand surgeon, "saved my hand and spared my fingers, forever changing the course of my life -- and, although I didn’t know it at the time, putting me on the path that led to tonight. To this stage, to this incredible moment. I am a surgeon, using this very hand, because of a doctor."

Scott and his wife Christy have three adult children. He is the second Kentuckian in recent years to be AMA president; Dr. Steven Stack, the state public-health commissioner sicne January 2020, was president in 2016-17.

U.S. agency proposes rule to eliminate medical debt from most credit reports, saying it's an unreliable predictor of payment

Third Way graphic

Kentucky Health News

The federal Consumer Finance Protection Bureau is proposing to eliminate medical debt from most credit reports, stop companies from sharing debt information and bar lenders from making decisions based on medical data.

About 12 percent of Kentucky adults, more than 400,000 people, are estimated to have medical debt.

The proposed rule brought "immediate cheers from consumer advocacy groups that have long pushed for change," Amy Lotven reports for Inside Health Policy. "CFPB believes the rule . . .would remove as much as $49 billion in debt from 15 million Americans and increase credit scores by an average 20 points."

The agency's research has found that medical debt "is not a good predictor of loan repayments," so it thinks the regulation would "improve underwriting, stop denials of loans to consumers who would repay, and lead to about 22,000 additional safe mortgages a year," Lotven writes.

CFPB Director Rohit Chopra said the credit-reporting system is often inaccurate, yet is used "to coerce patients into paying medical bills that they do not owe."

In 2003, Congress restricted lenders from using medical information about debts, but "agencies created a regulatory loophole that let creditors use such information in their decisions," Lotven reports. The proposed rule "would close the regulatory loophole from 2003 by establishing guardrails for credit-reporting companies and banning lenders from taking medical devices as collateral for a loan as well as from repossessing a device if the loan is not repaid."

Vice President Kamala Harris and Lisa Lacasse, president of the American Cancer Society Cancer Action Network, said states should take similar action. David Kendall, senior fellow for health policy at Third Way, a centrist group that has produced several reports on debt, said the proposed regulation is the latest in a series of federal and state actions “to fight the scourge of medical debt. They have been preventing medical debt by expanding coverage, funding medical debt abolishment, and ending junk insurance that can lead to medical debt.”

UPDATE, June 12: "Tuesday's announcement builds on a 2022 effort by the big credit bureaus TransUnion, Equifax and Experian to keep debt off consumers' reports until it's at least a year old," Axios reports. "The two major credit scoring companies, FICO and VantageScore, have also reduced how much medical debts can factor into consumers' scores at that time."

National Institutes of Health boss, at UK, says U.S. is better set for next pandemic but needs more 'really snappy real-time data'

National Institutes of Health Director Dr. Monica Bertagnolli spoke at UK. (WUKY photo by Josh James)

Kentucky Health News

The new director of the National Institutes of Health said at the University of Kentucky on June 10 that the U.S. hasn’t fully recovered from the Covid-19 pandemic, and long Covid remains a problem, but the nation is readier for the next pandemic than it was for the last one.

"We're better prepared, but we're not at all complacent about how awful pandemics are and the great suffering that comes from this, and the need to be constantly ready to spring into action," Dr. Monica Bertagnolli told Josh James of WUKY.

"We really hadn't before had a good, real-time feedback link with really snappy real-time data," she said, noting that she is starting a new reporting network for doctors to share such information.

"That data – both its reliability and collection – was one of the themes of Bertagnolli’s talk at UK," James reports. "She said the pandemic showed medical officials the necessity of creating a more responsive data ecosystem running all of the time, not just during major health emergencies."

Asked about efforts to combat distrust toward medical authorities, Bertagnolli said part of the solution is delivering tangible results for patients. She pointed to recent polling from the Pew Research Center about who people trust the most when it comes to medical information.

"The very highest trust was with their primary-care providers," she said, "which is why we're launching this new primary-care research network, because we want to put the research into the hands of people who are trusted, so that everybody can have the benefit."

Have a sun-safe summer by protecting your skin; here's how

Photo by RawPixel / iStock / Getty Images Plus

By Dr. John D'Orazio

University of Kentucky

Spending time outside in the summer is a great way to stay active, reduce stress and get vitamin D. It’s also important to make sure your skin is protected during your time outdoors.

Too much sun can cause skin cancer — the most common cancer in the U.S.  Most skin cancers are caused by too much exposure to ultraviolet light, which can damage skin cells.

Protecting your skin from UV rays is important all year long and not just during the summer. You can also be exposed to UV rays on cloudy or cool days.

Here are steps you can take to protect your skin from the sun:

Sunscreen: Use a broad-spectrum sunscreen that filters out two types of UV rays: UVA and UVB. It should also have a sun protection factor (SPF) of 15 or higher. Put a thick layer of sunscreen everywhere that will be exposed to the sun at least 20 minutes before going outside.

It’s also important to reapply your sunscreen because it does wear off. If you’re out in the sun for more than two hours or swimming, sweating or toweling off, you need to reapply.

Make sure your sunscreen isn’t expired. It’s shelf life is no more than three years and shorter if it’s been exposed to high temperatures.

Sunglasses: In addition to protecting your eyes from UV rays, sunglasses also protect the more delicate skin around your eyes from sun exposure. Most sunglasses sold in the U.S. block both UVA and UVB rays.

Hats and clothing: Hats with a brim all the way around that shades your face, ears and the back of your neck offer the most protection. Canvas works best and you should avoid straw hats that let too much sunlight through. If you wear a baseball hat, you should also protect your ears and the back of your neck with clothing, sunscreen or staying in the shade.

Long-sleeved shirts and long pants and skirts can also provide you some protection from UV rays. Clothing made from tightly woven fabric offers the best protection as well as darker colors.

Shade: You still need to wear sunscreen or protective clothing even when hanging out in the shade. Staying under an umbrella, tree or other covering can help you reduce your risk of sun damage and skin cancer. Taking breaks in shaded areas is also key on long days outside.

Other ways to stay sun safe include planning activities in the morning or late afternoon to avoid the most exposure to the sun.

Sunburn: A sunburn usually shows up four hours after being exposed to the sun, gets worse for about 24 hours and then fades in three to five days.

Treatment: You can take an over-the-counter pain reliever to help with the pain of a sunburn. A cool, wet cloth can also offer relief as well as applying aloe or moisturizer. It’s important to drink plenty of water to stay hydrated.

If you have blisters, don’t break them. Lightly bandage the area to prevent infection. If more than 15% of your body is sunburned, you’re in pain for more than 48 hours or have a fever of above 101 degrees, seek medical attention.

If you’re sunburned, avoid more time in the sun until your skin has healed.

John D’Orazio, M.D., Ph.D., is division chief for pediatric oncology, hematology and oncology at UK HealthCare and researches skin cancer at the UK Markey Cancer Center.

Drug-overdose deaths of Kentuckians fell 9.8% last year, but rate among state's Blacks increased 5%; overall U.S. decline was 3%

Graph by Kentucky Health News from state data

By Al Cross
Kentucky Health News

In 2023, 9.8 percent fewer Kentuckians died from drug overdoses than the year before, according to an annual state report released Thursday.

A preliminary report from the Centers for Disease Comtrol and Prevention last month showed a 7.9% decrease, but the CDC now includes deaths of non-residents. The state Office of Drug Control Policy says in the state report that it uses only resident deaths "to better target harm reduction and prevention activities for Kentuckians." 

The state report was funded by the CDC and prepared for the office by the Kentucky Injury Prevention and Research Center at the University of Kentucky, as an agent for the state Department of Public Health.

It said 79% of the overdose deaths involved fentanyl, a powerful synthetic opioid, and 55% involved methamphetamine, a stimulant with psychedelic properties. The numbers are based on blood tests of victims, who usually have more than one illegal drug in their bloodstream.

“Fentanyl is what’s driving this crisis. If we could ever get a handle on that I think out potential for success is unbelievable,” Van Ingram, director of the drug-control office since 2004, said at an event in the state Capitol rotunda attended by people from the treatment, recovery and law-enforcement communities.

Gov. Andy Beshear told the crowd, “Some of the best news in this report is how much better than we were than the rest of the country,” in which overdose deaths declined 3%, according to the CDC. “Today’s news follows a long list of positive actions we have taken with so many people in this room,” he said.

Earlier, Beshear said, "The sad fact is we still lost 1,984 Kentuckians." That is about the same as in 2020, and much more than 2019. And he noted that overdose deaths among African American residents of the state rose 5% in 2023, from 259 to 264, after rising 22% from 2021 to 2022. While the recent increase was much less, "That is unacceptable," he said.

The rate of drug overdose deaths among Black Kentuckians in 2023 was 68.3 per 100,000, which was 52% greater than the white rate of 45 per 100,000.

The age group with the most overdose deaths was 35-to-44-year-olds, with 571, but the number was 13.4% less than in 2022.

In that year, 2,135 Kentuckians died of drug overdoses. The decline of 9.8% “represents 151 families whose loved ones still have a chance to recover,” said Dr. Jody Jaggers, the Kentucky Pharmacy Education and Research Foundation's director of public health education.

Jaggers demonstrated how easy it is to use naloxone, which stops the effect of an overdose. "It's something that you can even teach a child to do," he said.

Known by the brand Narcan, the nasal spray is now easily available in generic form without a prescription. Jaggers said the key is getting it into the hands of people who are most likely to witness an overdose. 

The report says the state distributed 160,000 doses of Narcan in 2023, and Ingram indicated that the increased availability of naloxone was a factor in the 9.8% drop in overdose deaths. The state recently put up a website, FindNaloxoneNowKY.org, to help Kentuckians find it easily.

Among counties with 10 or more overdose deaths, for which overdose-death rates were calculated, the highest rates were in four counties that adjoin each other. Estill County had 27 overdose deaths for a top rate of 187 per 100,000 residents; second was Lee County, with 11 deaths for a rate of 155.9. Third was Breathitt County, which had 18 for a rate of 150.6. Fourth was Powell, which had 16 for a rate of 121.1. Fifth was Floyd, which nearly adjoins Breathitt; it had 35 deaths for a rate of 109.9 per 100,000.

Other counties with rates higher than 60 per 100,000 (in purple on the map below) were Bourbon, 85.9; Boyd, 94.2; Carter, 90.4; Clark, 72.9; Clay, 68.9; Franklin, 61.9; Garrard, 61.9; Jefferson, 66.3; Knott, 100; Lincoiln, 76.4; Madison, 72.1; Montgomery, 62.8; Perry, 93.3; Pike, 74.5; Rockcastle, 91.8; Rowan, 94.9; Wayne, 59.8; and Whitley, 59.3.

Counties with rates lower than those, but higher than the state average of 45.9 per 100,000, were Bell, 50.7; Boyle, 56.8; Bullitt, 51.6; Harlan, 57.3; Jessamine, 56.2; Johnson, 59.3; Laurel, 54; and Taylor, 50.1.

Map from state report, adapted by Kentucky Health News

Kentucky is seeing an 'unusually high uptick' in pertussis, known as whooping cough; Lexington outbreak grows to 24 cases

Kentucky doctors and the state Department for Public Health "are seeing an unusually high uptick in whooping cough," or pertussis, Louisville's WDRB reports. "Immunity for vaccination or natural infections wanes over time, so people who are fully vaccinated can still get whooping cough. Doctors said the vaccine lessens the severity and will likely keep someone out of the hospital."

Kentucky had 84 confirmed cases of pertussis in 2023, and 66 confirmed so far in 2024, said Brice Mitchell, spokesman for the department. That works out to just under two cases a week last year, and just under three cases a week so far this year. 

Seven more cases of pertussis were confirmed in Lexington last week, bringing the total to 21 since April 26. The Lexington-Fayette County Health Department declared a pertussis outbreak on May 20. UPDATE, June 9: The department confirmed three more cases, bringing the total to 24.

Most of Kentucky's cases have been in school-age children, but some been in infants and adults, WDRB reports.

"It's not unusual to actually see whooping cough; however, the numbers that are being seen, that is definitely unusual, " Dr. Mark Burns of the University of Louisville told WDRB. "It's usually not that prevalent as it is right now."

The state is part of a spotty national trend. Clusters of pertussing cases have also been reported in Oregon and wetsren Pennsylvania. Through May, about 5,000 cases had been reported in the U.S., more than double the number for the same five months in 2022.

"Rates of whooping cough, like those of some other infectious diseases, declined soon after the start of the pandemic, as people wore masks and practiced social distancing, precautions that many have ceased," The Washington Post reports, quoting experts. "But during the early months of the pandemic, when people feared being exposed to the coronavirus in a doctor’s office, some children may have missed vaccination appointments, leaving them vulnerable to future infections."

C. Buddy Creech, director of the Vanderbilt University Vaccine Research Program and a pediatric infectious-disease researcher for 20 years, told the Post, “This is still a terrible, terrible disease, one we’d do well to protect against.”

The Centers for Disease Control and Prevention says pertussis cases are returning to “pre-pandemic patterns,” more than 10,000 cases a year. The Post reports, "From January 2023 through May 25, 2024, whooping cough caused 15 deaths in the United States, though the CDC declined to say how many of those deaths occurred this year," indicating that the number is less than 5.

"England has also reported a substantial increase in whooping cough cases in the first three months of 2024, including the deaths of five infants," the Post reports. "Although the disease is best known for its toll on babies, the infection can cause serious illness in people older than 65, including rib fractures and significant pneumonia, Creech said."

Doctor at UK says you don't have to live with pelvic pain

Photo by Colorblind Images, DigitalVision / Getty Images Plus

By Dr. Johnnie Wright Jr.

University of Kentucky

Pelvic health is crucial to a woman’s overall well-being but is often misunderstood or overlooked. When symptoms such as urinary incontinence, pain or discomfort, or pain during intercourse occur, they are dismissed as a byproduct of pregnancy and childbirth or just something that comes with age like arthritis. But those symptoms can have a profound effect on a woman’s physical, emotional and social well-being and can lead to more serious complications if untreated.

One of the most common conditions is pelvic organ prolapse. This condition occurs when the muscles, ligaments and fascia of the pelvic floor weaken, causing one or more of the pelvic organs – uterus, vagina, bladder or bowel – bulges into or out of the vagina.

Symptoms of prolapse include:

• A heavy dragging feeling in the vagina or lower back
• Feeling of a lump in the vagina or outside the vagina
• Bowel symptoms, such as difficulty moving the bowel or a feeling of not emptying properly
• Pain or discomfort during sexual intercourse
• Urinary symptoms such as slow urinary stream, a feeling of incomplete bladder emptying, urinary frequency, urgency and urinary stress incontinence

Prolapse occurs in one of three women who have had one or more children. Prolapse can occur immediately after childbirth or take years to develop. Aging and menopause can lead to further weakening of the pelvic floor. While prolapse is common, only one in nine women need corrective surgery. Obesity, chronic cough, chronic constipation and heavy lifting or straining can put excessive pressure on the pelvic floor and exacerbate prolapse. Depression and anxiety are linked to urinary dysfunction; someone who feels they no longer can control their bladder may withdraw and become more socially isolated.

Physical therapy can help restore strength and function to the pelvic floor. Light-intensity exercises such as walking and yoga can stretch and strengthen the pelvic floor muscles, and there are a number of free apps with exercises for maintaining continence and preventing prolapse.

If you are experiencing pelvic pain or urinary issues such as urgency or a feeling of not completely emptying the bladder, talk to your primary care provider about a referral to a urogynecologist to discuss treatment options.

Johnnie Wright Jr., M.D., is division firector, Female Pelvic Medicine and Reconstructive Surgery, at UK HealthCare.

Remote Area Medical to offer free medical services, inlcuding dental and vision care, at clinic near Hazard Saturday and Sunday

Kentucky Health News

Remote Area Medical, a nonprofit group that provides free medical care, including dental and vision care, will hold a clinic Saturday and Sunday at East Perry Elementary School, 301 Perry Circle Road, Hazard, in collaboration with the University of Kentucky Center for Excellence in Rural Health.

The clinic will be open from 6 a.m. to 5 p.m. Saturday, 6 a.m. to 12:00 p.m. Sunday. The patient parking lot will open no later than 11:59 p.m. Friday night, June 7, and remain open. As patients arrive at the parking lot, they will be given information about the clinic.

Patients should be prepared with their own food, water, medicines, and clothing when arriving early. Bathrooms will be provided.

Health services are provided on a first-come, first-served basis. Due to time constraints, attendees should be prepared to choose between detal and vision services. Medical services are offered to every patient. All services are free and open to the public. No identification is required.

Given the possibility of inclement weather, volunteer cancellations, or other circumstances outside of RAM’s control, RAM encourages everyone who would like services, especially dental services, to arrive as early as possible. The clinic closing time may vary based on each service area’s daily capacity. Please check RAM’s clinic FAQ page for more information.

UK College of Dentistry faculty, residents, and dental students will provide serves including dental exams and cleanings, fillings, and extractions. The college has previously supported the dental care needs of Kentuckians at other RAM event locations, including Mayfield, Hazard, and Bowling Green.

Founded in 1985, RAM has treated more than 940,000 individuals with $200 million worth of free health-care services. More than 212,000 volunteers – licensed dental, vision, medical and veterinary professionals, as well as general support staff – have supported RAM’s mission.

Vaccine misinformation abounds as measles spreads; 1 in 10 cases lead to infections that can cause learing loss

Photo from iStock/Getty Images Plus via KFF Health News

By Amy Maxmen and Céline Gounder
KFF Health News

Measles is on the rise in the United States. In the first quarter of this year, the number of cases was about 17 times what it was, on average, during the same period in each of the four years before, according to the Centers for Disease Control and Prevention. Half of the people infected — mainly children — have been hospitalized.

It’s going to get worse, largely because a growing number of parents are deciding not to get their children vaccinated against measles as well as diseases like polio and pertussis. Unvaccinated people, or those whose immunization status is unknown, account for 80% of the measles cases this year. Many parents have been influenced by a flood of misinformation spouted by politicians, podcast hosts, and influential figures on television and social media. These personalities repeat decades-old notions that erode confidence in the established science backing routine childhood vaccines. KFF Health News examined the rhetoric and explains why it’s misguided:

The "No-Big-Deal" trope: A common distortion is that vaccines aren’t necessary because the diseases they prevent are not very dangerous, or too rare to be of concern. Cynics accuse public-health officials and the news media of fear-mongering about measles even as 19 states report cases.

For example, an article posted on the website of the National Vaccine Information Center — a regular source of vaccine misinformation — argued that a resurgence in concern about the disease “is ‘sky is falling’ hype.” It went on to call measles, mumps, chicken pox, and influenza “politically incorrect to get.”

Measles kills roughly 2 of every 1,000 children infected, according to the CDC. If that seems like a bearable risk, it’s worth pointing out that a far larger portion of children with measles will require hospitalization for pneumonia and other serious complications. For every 10 measles cases, one child with the disease develops an ear infection that can lead to permanent hearing loss. Another strange effect is that the measles virus can destroy a person’s existing immunity, meaning they’ll have a harder time recovering from influenza and other common ailments.

Measles vaccines have averted the deaths of about 94 million people, mainly children, over the past 50 years, according to an April analysis led by the World Health Organization. Together with immunizations against polio and other diseases, vaccines have saved an estimated 154 million lives globally.

Some skeptics argue that vaccine-preventable diseases are no longer a threat because they’ve become relatively rare in the U.S. That is true, due to vaccination, but this reasoning led Florida’s surgeon general, Joseph Ladapo, to tell parents that they could send their unvaccinated children to school amid a measles outbreak in February. “You look at the headlines and you’d think the sky was falling,” Ladapo said on a News Nation newscast. “There’s a lot of immunity.”

As this lax attitude persuades parents to decline vaccination, the protective group immunity will drop, and outbreaks will grow larger and faster. A rapid measles outbreak hit an undervaccinated population in Samoa in 2019, killing 83 people within four months. A chronic lack of measles vaccination in the Democratic Republic of the Congo led to more than 5,600 people dying from the disease in massive outbreaks last year.

The ‘You Never Know’ trope: Since the earliest days of vaccines, a segment of the public has considered them bad because they’re unnatural, compared to nature’s bounty of infections and plagues. “Bad” has been redefined over the decades. They blame vaccines for ailments ranging from attention-deficit/hyperactivity disorder to autism to immune system disruption. Studies don’t back the assertions.

Skeptics also argue that their claims remain valid because vaccines haven’t been adequately tested. In fact, vaccines are among the most studied medical interventions. Over the past century, massive studies and clinical trials have tested vaccines during their development and after their widespread use. More than 12,000 people took part in clinical trials of the most recent vaccine approved to prevent measles, mumps, and rubella. Such large numbers allow researchers to detect rare risks, which are a major concern because vaccines are given to millions of healthy people.

To assess long-term risks, researchers sift through reams of data for signals of harm. For example, a Danish group analyzed a database of more than 657,000 children and found that those who had been vaccinated against measles as babies were no more likely to later be diagnosed with autism than those who were not vaccinated. In another study, researchers analyzed records from 805,000 children born from 1990 through 2001 and found no evidence to back a concern that multiple vaccinations might impair children’s immune systems.

Nonetheless, people who push vaccine misinformation, like independent presidential candidate Robert F. Kennedy Jr., dismiss massive, scientifically vetted studies. For example, Kennedy argues that clinical trials of new vaccines are unreliable because vaccinated kids aren’t compared with a placebo group that gets saline solution or another substance with no effect. Instead, many modern trials compare updated vaccines with older ones, because doctors consider it unethical to keep children in danger by giving them a sham vaccine when the protective effect of immunization is known. In a 1950s clinical trial of polio vaccines, 16 children in the placebo group died of polio and 34 were paralyzed, said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and author of a book on the first polio vaccine.

The ‘Too-Much-Too-Soon’ trope: Several best-selling vaccine books on Amazon promote the risky idea that parents should skip or delay their children’s vaccines. Paul Thomas wrotes in The Vaccine-Friendly Plan that “All vaccines on the CDC’s schedule may not be right for all children at all times,” and says children who have followed “my protocol are among the healthiest in the world.”

Since the book was published, Thomas’ medical license has been temporarily suspended in Oregon and Washington. The Oregon Medical Board documented how Thomas persuaded parents to skip CDC-recommended vaccines, and reported that he “reduced to tears” a mother who disagreed. Several children in his care came down with pertussis (whooping cough) and rotavirus, diseases easily prevented by vaccines, the board said. Thomas recommended fish-oil supplements and homeopathy to an unvaccinated child with a deep scalp laceration, rather than an emergency tetanus vaccine. The boy developed severe tetanus, landing in the hospital for nearly two months, where he required intubation, a tracheotomy, and a feeding tube to survive.

The CDC's vaccination schedule is tailored to protect children at their most vulnerable points in life and minimize side effects. The combination measles,-mumps-rubella vaccine isn’t given for the first year of a baby’s life because antibodies temporarily passed on from their mother can interfere with the immune response. And because some babies don’t generate a strong response to that first dose, the CDC recommends a second one around the time a child enters kindergarten because measles and other viruses spread rapidly in group settings. Delaying MMR doses much longer may be unwise because data suggests that children vaccinated at 10 or older have a higher chance of adverse reactions, such as a seizure or fatigue.

About a dozen other vaccines have discrete timelines, with overlapping windows for the best response. Studies have shown that MMR vaccines may be given safely and effectively in combination with other vaccines.

They Don’t Want You to Know’ trope: Kennedy suggests that scientific institutions oppress dissenting voices on vaccines for nefarious reasons. His running mate, lawyer Nicole Shanahan, has campaigned on the idea that conversations about vaccine harms are censored and the CDC and other federal agencies hide data due to corporate influence.

Such claims aren’t new, but the anti-vax movement has long had an outsize voice. The most listened-to podcast in the U.S., “The Joe Rogan Experience,” regularly features guests who cast doubt on scientific consensus. Last year on the show, Kennedy repeated the debunked claim that vaccines cause autism.

Far from ignoring that concern, epidemiologists have taken it seriously. They have conducted more than a dozen studies searching for a link between vaccines and autism, and repeatedly found none. “We have conclusively disproven the theory that vaccines are connected to autism,” said Gideon Meyerowitz-Katz, an epidemiologist at the University of Wollongong in Australia. “So, the public-health establishment tends to shut those conversations down quickly.”

Federal agencies are transparent about reactions that vaccines can cause. And the government has a program to compensate individuals whose injuries are scientifically determined to result from them. About 1 to 3.5 out of every million doses of the measles-mumps-rubella vaccine can cause a life-threatening allergic reaction; a person’s lifetime risk of death by lightning is estimated to be as much as four times as high.

“The most convincing thing I can say is that my daughter has all her vaccines and that every pediatrician and public health person I know has vaccinated their kids,” Meyerowitz-Katz said. “No one would do that if they thought there were serious risks.”