Program for mothers and pregnant women with substance-use disorder gets grant to help more Black women get its services

Freedom House (Photo provided to Kentucky Lantern)

By Sarah Ladd

Kentucky Lantern

The Volunteers of America chapter that includes Kentucky will spend $123,000 over the next nine months to figure out how to get more Black women into treatment for substance-use disorder.

Volunteers of America Mid-States received the money from the Kentucky Association of Health Plans, the trade group for health insurers in the state, to fund a new initiative called Access Justice.

With the grant money, scholar, writer and activist Brandy Kelly Pryor will evaluate VOA’s Freedom House, which is a program for “pregnant and parenting women” who have substance-use disorders. Her report is due in April.

The 31-year-old program, with locations in Louisville and Manchester, also lets minor children (under the age of 18) stay with their mothers during treatment. Kelly Pryor will primarily study Louisville and may branch out elsewhere at later.

Jennifer Hancock, president and CEO of Volunteers of America Mid-States, said this move is in direct response to the high rates of maternal mortality among Black women and the disproportionately high overdose rates among Black Kentuckians.

Kentucky overdose deaths decreased in 2023 for the second year in a row, according to the state's Drug Overdose Fatality Report.

In 2022, 2,135 Kentuckians died from an overdose, marking the first decline since 2018. Ninety percent of those deaths were from opioids and/or fentanyl.

In 2023, the number of fatal overdoses was down to 1,984. Fentanyl, a powerful synthetic opioid, was involbved in 1,570 of those — about 79% of the 2023 deaths. The 35-44 age group was most at risk, the report shows. Methamphetamine was involved in 55% of 2023’s overdose deaths.

Despite the overall decrease in the state, the number of Black Kentuckians who died from a drug overdose increased from 259 in 2022 to 264 in 2023.

A 2023 state report on maternal mortality also showed substance-use disorder contributed to nearly 60% of all maternal deaths. Most maternal deaths in Kentucky, 88%, are preventable, says the report from the state Cabinet for Health and Family Services.

Black partcipants at Freedom House's Kentucky locations are less likely to complete its program than those of other races, Hancock said.

“I think some of it is about the stigma that they face coming into treatment,” Hancock said. “I think that there could be some cultural and familial pressures that they experience disproportionately.”

Kelly Pryor’s study is expected to provide answers as to why Black Kentuckians leave the Freedom House program without completing it, she said.

“Women, generally speaking, have to be convinced that they deserve treatments and that they are worthy of getting this help and support versus trying to do it on their own,” Hancock said.

In her analysis, Kelly Pryor will “identify gaps in care and opportunities for improvement, ensuring that substance-use-disorder recovery services are equitable and accessible for everyone who needs them,” VOA said. The nonprofit will then come up with plans to fill any gaps in care and access.

Hancock doesn’t know if the solution will be “an internal-to-VOA process that needs to be improved, or if it’s more of a public campaign that we need to wage to reassure Black women that they’re worthy of treatment, that treatment is a place where they can feel supported and feel seen and heard.”

The measure of success, Hancock said, will be when VOA and Freedom House start seeing “better engagement rates of Black women” and higher program completion rates.

Kelly Pryor said in a prepared statement, “Building on principles of healing justice, we will ensure a process that facilitates those most affected, leading us toward the best solutions for recovery and prevention. This effort will take time and involve critical self-reflection, yet the return will have an indelible impact on Kentucky and beyond.”

Community event at church addresses health needs in Frankfort

A variety of health-focused vendors set up tables in the parking lot of First Baptist Church Frankfort on June 14 to share information and host activities with attendees. (UK photos by Lindsay Travis)

By Lindsay Travis
University of Kentucky

Coretta Scott King said, “The greatness of a community is most accurately measured by the compassionate actions of its members.”

On a warm Saturday in June, First Baptist Church Frankfort opened its doors to more than 500 individuals in the community to put an emphasis on their well-being. It was part of the fourth annual Dr. Rosby L. Glover Unity in the Community event — a day of fun, food, music and raising awareness.

The fruits of this effort are an extension of collaborations with key community partners, including Capital City Activity Center, Meals on Wheels Greater Frankfort, Kentucky State University Cooperative Extension and the University of Kentucky.

“The day is an effort to bring the whole community together, to not only just have fellowship, but to bring awareness to physical health, diabetes and other health issues,” said Bishop Tiangello Hill, senior pastor of the church. “It means that we're doing our job. It means that we are reaching beyond the four walls and being a help to all mankind.”

The event is held in honor of the church’s late pastor, the Rev. Dr. Rosby L. Glover, who made it his mission to be an advocate for the Frankfort community for children and families. His widow, Lady Kimberly Glover, said “This was a vision of ours, and I’m elated to see Frankfort continue my husband’s mission to serve the community and its families.”

The compassion for Frankfort is evident in talking to those behind the June 14 event, like Glover.

“People care about this event because when people get together, we're all just people,” she said. “No matter what race, what nationality, it’s bringing love for one another, showing how much we care. And just to know that the church is here to help anyone in need.”

In an effort to share important health information with the community, inside the church, guests could complete free health screenings. The Lions Club partnered for diabetes screenings and the Franklin County Health Department donated screening materials and time for blood pressure screenings.

UK's Refocus Project, aimed at African Americans, answered
questions about opioid overdoses. (UK Photo by Lindsay Travis)

Tents and tables lined the church parking lot and nearby Clinton Street showcasing the services provided by a variety of health-focused agencies. Among those tables were UK’s Sanders-Brown Center on Aging and its Engaged Aging Lab, the College of Health Sciences’ Physical Therapy program, the Research Examining Factors Associated with the Opioid Crisis among Underserved African Americans (REFOCUS) research team, and the Cooperative Extension Service.

It’s an intentional approach from researchers and clinicians at UK to address the specific needs of the Frankfort community. The city, at one time, had the nation’s second-highest prevalence of Alzheimer’s disease in African American adults among other health challenges.

The partnership is an important one to Elizabeth Rhodus, assistant professor at Sanders-Brown and the Department of Behavioral Science in the UK College of Medicine.

“We connected with Dr. Glover a few years ago to think about how we can help provide health care, access and resources to individuals in the community,” said Rhodus. “We are excited to see that partnership grow.”

Saturday’s event is an extension of Sanders-Brown’s partnership with First Baptist Church Frankfort. Researchers meet monthly with church members to help address the commumity's needs. It’s part of Rhodus’ Engaged Aging Lab, which takes lessons learned from research and clinical spaces out into the communities to address health gaps.

Rhodus and her team provide support and resources for Alzheimer’s disease and dementia through research which focuses on everyday activities that support healthy brain aging, caring for individuals with dementia and community-engaged research for health equity. They use practical methods and everyday items in ways to help people live healthy and reduce their risks for diseases.

“We focus on telling people about five main areas to try to reduce your risk for dementia: sleep, nutrition, exercise, novelty — or doing something new — and socializing, are the great things for your brain,” said Celeste Roberts, research program manager at the Engaged Aging Lab.

Oil timers can relax the mind and body through visual cues.

Roberts kept a bottle of lavender-scented lotion and an oil timer on the table. The items may be simple, but as Roberts explains, they can relax the mind and body through aromatherapy and visual cues.

She and Sanders-Brown’s April Stauffer answered questions from people stopping at their tables for hours. They handed out helpful flyers on a range of topics related to brain health.

“Having a conversation with people about what they can do every day on their own and giving them the tools they need to ask the right questions about their health is key,” said Roberts. “Unity in the Community gives us an opportunity to start that conversation.”

On Clinton Street in downtown Frankfort, physical therapy students looked like they were playing games with attendees who stopped by their table. In actuality, they were conducting fall risk and balance assessments they’d use in clinic — a four-square step test and a timed up-and-go test out of a chair.

“Depending on how they score we can tell them if they’re at an increased risk for falls or not and provide them with helpful information,” said Sheila Clemens, an assistant professor in the Department of Physical Therapy. “This community is potentially at risk for being underserved and they may not get this information elsewhere. We’re happy to offer this easy access.”

In the next booth, the focus was on engaging members of the Black community in research. It’s part of the REFOCUS project, led by Danelle Stevens-Watkins, acting dean and professor in the Department of Educational, School and Counseling Psychology in the College of Education.

“We came to this event to help educate the community about opioid overdoses,” said Mona Goggins, a research assistant with REFOCUS. While the number of overdose deaths in Kentucky declined 9.8% frpom 2022 to 2023, there was an 8% rise in overdose deaths among Black Kentuckians. “Our hope is people want to participate in our study so we can increase awareness and gather information that will improve treatment in the Black community.”

The project is primarily focused on Lexington and Louisville, but the REFOCUS representatives shared that guests were “getting what they needed from the table” from education to sharing stories to seeing themselves represented in research efforts.

“I think that when you try to look at treatment from just one lens, you miss out on so many different groups in the population. I think it's important to recognize what different cultural backgrounds and factors that influence people's lives in the way that they experience opioid use,” said De’Asia Beard, a REFOCUS mresearch assistant.

UK’s Cooperative Extension Service has been a long-time partner in this community initiative. Sanders-Brown works closely with Carla Carter, an extension agent for family and consumer sciences at the Franklin County Extension Office.

Carter, a long-time member of First Baptist Church Frankfort, helps coordinate monthly workshops at the church and was the emcee for the Dr. Rosby L. Glover Unity in the Community. She thanked Debora Bobbitt and Reverend Anna Jones for organizing the day.

The event took a holistic approach to community health, with pieces focused on the spectrum of age ranges represented. In addition to health screenings for older age groups, the church donated 65 bicycles to kids in the community — doubling their previous giveaway goal — to foster health and exercise.

It took a team of people to put on the event and a strong spirit of collaboration from the team at the church to make such an impact in the capital city.

Rhodus and her team know there’s a health need in this area that can benefit from targeted resources and outreach paired with different research approaches. The team shares a similar goal with First Baptist Church Frankfort:

“Let’s literally build unity within all of these communities to support every individual, wherever they’re at in their aging journey — childhood all the way throughout their older age,” said Rhodus. “Let’s tailor the health pieces that they need to support a healthy, active lifestyle.”

Where to find more information:

• Sanders-Brown offers a variety of resources for people with questions about brain health. You can get started online here.
• The Engaged Aging Lab is ready to help caregivers and community members. You can find those resources online here.
• Anyone with questions about the study REFOCUS and opioid use in the Black community can email REFOCUS@uky.edu.
• UK’s physical therapy program also offers clinics for the public. More information is available online here.
• The Cooperative Extension Service provides practical education to help people, businesses and communities solve problems, develop skills and build a better future. Find more about their services online here.
• The Kentucky State University Cooperative Extension Program strengthens underserved communities, families, farmers, individuals and youth to improve their quality of life with state-of-the-art, research-based educational programs. You can learn more about their services online here.

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

Biden administration indefinitely postpones ban on menthol cigarettes amid election-year pushback from Black voters, others

Menthol cigarettes and other tobacco products are displayed at a store in San Francisco on May 17, 2018. For the second time in recent months, President Joe Biden’s administration has delayed a plan to ban menthol cigarettes, a decision that is certain to infuriate anti-smoking advocates but could avoid angering Black voters ahead of November elections. (Associated Press file photo by Jeff Chiu)

By Matthew Perrone and Zeke Miller

Associated Press

President Joe Biden’s administration is indefinitely delaying a long-awaited menthol cigarette ban, a decision that infuriated anti-smoking advocates but could avoid a political backlash from Black voters in November.

In a statement Friday, Biden’s top health official gave no timeline for issuing the rule, saying only that the administration would take more time to consider feedback, including from civil rights groups.

“It’s clear that there are still more conversations to have, and that will take significantly more time,” Health and Human Services Secretary Xavier Becerra said in a statement.

The White House has held dozens of meetings in recent months with groups opposing the ban, including civil-rights organizers, law-enforcement officials and small business owners. Most of the groups have financial ties to cigarette companies.

The announcement is another setback for Food and Drug Administration officials, who drafted the ban and predicted it would prevent hundreds of thousands of smoking-related deaths over 40 years. The agency has worked toward banning menthol across multiple administrations without finalizing a rule.

“This decision prioritizes politics over lives, especially Black lives,” said Yolonda Richardson of the Campaign for Tobacco-Free Kids, in an emailed statement. “It is especially disturbing to see the administration parrot the false claims of the tobacco industry about support from the civil rights community.”

Richardson noted that the ban is supported by groups including the NAACP and the Congressional Black Caucus.

Previous FDA efforts on menthol have been derailed by tobacco industry pushback or competing political priorities. With both Biden and former President Donald Trump vying for the support of Black voters, the ban’s potential impact has been scrutinized by Republicans and Democrats heading into the fall election.

Anti-smoking advocates have been pushing the FDA to eliminate the flavor since the agency gained authority to regulate certain tobacco ingredients in 2009. Menthol is the only cigarette flavor that wasn’t banned under that law, a carveout negotiated by industry allies in Congress. But the law instructed the FDA to continue studying the issue.

More than 11% of U.S. adults smoke, with rates roughly even between white and Black people, but about 80% of Black smokers smoke menthol, which the FDA says masks the harshness of smoke, making it easier to start and harder to quit. Also, most teenagers who smoke cigarettes prefer menthols.

For decades, cigarette companies focused menthol advertising and promotions in Black communities, sponsoring music festivals and neighborhood events. Industry documents released in litigation show companies viewed menthol cigarettes as a good “starter product” because they were more palatable to teens.

The FDA released its draft of the proposed ban in 2022. Officials under Biden initially targeted last August to finalize the rule. Late last year, White House officials said they would take until March to review the measure. When that deadline passed last month, several anti-smoking groups filed a lawsuit to force its release.

“We are disappointed with the action of the Biden administration, which has caved in to the scare tactics of the tobacco industry,” said Dr. Mark Mitchell of the National Medical Association, an African American physician group that is suing the administration.

Separately, Rev. Al Sharpton and other civil rights leaders have warned that a menthol ban would create an illegal market for the cigarettes in Black communities and invite more confrontations with police.

The FDA and health advocates have long rejected such concerns, noting FDA’s enforcement of the rule would only apply to companies that make or sell cigarettes, not to individuals.

An FDA spokesperson said Friday the agency is still committed to banning menthol cigarettes. “As we’ve made clear, these product standards remain at the top of our priorities,” Jim McKinney said in a statement.

Smoking can cause cancer, strokes and heart attacks and is blamed for 480,000 deaths each year in the U.S., including 45,000 among Black Americans.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

2023 was a tough year in many ways, but saw significant positive developments in science and medicine, Washington Post reports

2023 saw new understanding and the start of a treatment

for dementia, as clinical trials cotinue at the University

of Kentucky and other sites. (iStock photo via Washington Post)

Kentucky Health News

Despite wars, the most mass killings since 2006 and the hottest average temperatures in human history, "2023 also was a year with significant positive developments, including in scientific research and medicine," The Washington Post reports, with a motive: "Research has indicated that uplifting news can provide an emotional buffer against distressing news and feelings of hopelessness — and even encourage optimism or action." Here are some things the Post listed:

The World Health Organization approved a new malaria vaccine that has been shown to be much more effective than the only previous vaccine against the potentially deadly disease. "The WHO said it expects the vaccine, which costs $2 to $4 per dose and has been shown to reduce symptomatic cases by 75 percent after three doses within a year, to be available by the middle of 2024," the Post reports. The U.S. has about 2,000 cases of malaria each year, most of them contracted in other nations.

The Food and Drug Administration approved the first pill to treat postpartum depression, which affects up to one in five womenand can cause "experience intense hopelessness and, in rare cases, psychosis — and it can last for years," the Post notes. "The new drug is taken once a day for two weeks and, unlike the existing treatment of an IV injection that may take as long as 60 hours to administer in a health-care setting, it can be taken at home."

The FDA also approved two gene-therapy treatments for sickle-cell disease, "a rare and debilitating condition that affects around 100,000 Americans, most of them Black. The disease causes extreme, constant pain and can drastically cut the life span of those affected," the Post notes. "Both are intensive, expensive procedures — and require chemotherapy, which has significant side effects. But patients who have received the treatments have spoken of its profoundly beneficial impact on their lives."

Scientists made progress in understanding dementia, the Post reports. One study "suggested that lifestyle habits, including regular mental and physical activity, eating a healthful diet, and regular social contact were linked with a slower rate of memory decline," the Post reports. "Another found that living in areas with more natural green spaces was associated with lower rates of hospital admissions for diseases including dementia, while separate research indicated that the use of hearing aids could cut the risk of cognitive decline by nearly half."

Meanwhile, the FDA approved, for the first time, to a drug that modestly slows Alzheimer’s disease. While difficult questions about safety, effectiveness and cost remain, many neurologists say that having a drug that slows Alzheimer’s is nonetheless a milestone after years of failed trials. The University of Kentucky is one of the sites of the clinical trials, and at last report was still seeking participants.

Biden administration again delays menthol-cigarette ban as Black support for Biden drops; anti-smoking advocates push back

Photo from ash.org

Kentucky Health News

The Biden administration has again delayed issuing a decision to eliminate menthol cigarettes, with plans to finalize the final rule next March, according to an updated regulatory agenda posted online by the White House Office of Management and Budget. 

Administration officials told The Washington Post that the delay comes after "fierce lobbying from critics who warn that a prohibition could anger some Black smokers who favor the product and could hurt President Biden's reelection prospects." Biden's support among Black voters has dropped about 20 percentage points in the past year, NBC News reports.

Four other officials told the Post, on the condition of anonymity, that the process could be delayed even further. 

The delay follows intense pressure from tobacco lobbyists, HealthDay reports.

Yolonda C. Richardson, president and CEO of the Campaign for Tobacco-Free Kids, said in a statement that it was "disturbing that this delay comes just two weeks after the tobacco industry and its army of lobbyists met with top officials at the White House." Further, she says the delay "allows the tobacco industry to continue profiting at the expense of Black lives." 

Richardson added, "The scientific evidence shows that menthol cigarettes are more addictive, easier for kids to start smoking and harder for smokers to quit. For decades, the tobacco industry has marketed these products to Black communities, causing devastating and disproportionate harm to the health of Black Americans. . . . Research shows that prohibiting menthol cigarettes will save up to 654,000 lives within 40 years, including the lives of 255,000 Black Americans."

When added to cigarettes and cigars, menthol’s minty taste and cooling effect limit throat irritation, making the products more appealing — especially new and young smokers — and it interacts with nicotine to enhance its addictive effects and makes quitting smoking harder, according to the Centers for Disease Control and Prevention.

According to research published earlier this year in the journal Nicotine and Tobacco Research, 43% of adults who smoked cigarettes in the past month in 2020 used menthol, with use most common among Black adults, at 80%. 

Prior to the announcement of the delay, the rule was widely expected to be published in late 2023 or early January, although it was likely be further delayed by legal challenges.  

The delay set in motion a string of statements from anti-smoking advocates calling on the Biden administration to issue the final rule by the end of this year. 

"Ending menthol cigarettes is pivotal to eliminating the dramatic health inequities in who uses tobacco products in the United States and who is most affected by tobacco-caused disease and death, said Harold Wimmer, president and CEO of the American Lung Association.

"Tobacco use is the number one cause of preventable death in the U.S. and claims 45,000 lives every year among Black Americans alone. A recent study quantified the disproportionate harms from menthol cigarettes to Black Americans, finding that menthol cigarettes were responsible for 1.5 million new smokers, 157,000 smoking-related premature deaths and 1.5 million life-years lost among Black Americans from 1980 to 2018. Halting the sale of menthol cigarettes lays the groundwork for reversing decades of disparities in tobacco use, disease and death in Black and Brown communities." 

Dr. Karen E. Knudsen, CEO of the American Cancer Society Cancer Action Network, noted that the Food and Drug Administration has had authority to ban menthol cigarettes and flavored cigars for 14 years and that any delay in doing so "only benefits the tobacco industry at the expense of public health. Tobacco is a primary driver of all cancer disparities, and the number one cause of cancer deaths nationwide, and flavors like menthol have been proven to make it easier to start and harder to quit using deadly products. There is no scientific rationale for permitting any flavored tobacco product to remain on the market. FDA stated that a comprehensive end to the sale of menthol cigarettes is projected to result in 324,000 to 654,000 fewer smoking related deaths." 

The FDA is also pursuing a ban on flavored cigars and new limits on nicotine in cigarettes, although the process of finalizing those rules is to be delayed until at least March as well, the Post reports. 

Nancy Brown, CEO of the American Heart Association, also issued a statement of concern, urging the administration to issue "strong final rules without delay." She said, "Each day we wait for the final rules to be released is another day Big Tobacco will hook new users and target communities with menthol cigarettes and flavored cigars."

Tobacco companies continue to oppose the ban, "insisting science shows menthols pose no greater risk than other cigarettes," the Post reports. "R.J. Reynolds, which makes Newport, the nation’s top-selling menthol brand, said in a statement Tuesday that a ban would hurt small businesses, dent tax revenue and contribute to a dangerous illegal market."

Food and Drug Administration sends White House office proposed regulations banning menthol cigarettes and flavored cigars

Ash.org

On Friday, the Food and Drug Administration sent the White House Office of Management & Budget its long-in-the-making regulations that would ban the sale of menthol cigarettes and flavored cigars.

 

OMB "serves as a clearinghouse of sorts for executive actions like this," notes Halfwheel, a cigar site. "While the Biden administration is in favor of both bans, OMB is also likely to add scrutiny to FDA’s plans, including asking the agency questions about the economic impacts of the bans—both for the government and businesses—as well as questioning certain legal aspects of the proposal. Historically, OMB has also been a place where the tobacco industry has lobbied to try to soften the impact of rules."

Ten years ago, citizens petitioned the FDA for impose the bans, and went to federal court to force the agency to act. Ordered to respond by April 29, 2021, the FDA said "it was planning on banning both flavored cigars and menthol cigarettes, plans that it said would be announced within a year," Halfwheel notes. "Nearly a year to the date—April 28, 2022—FDA announced that it was moving forward with both proposed regulations, starting the formal rulemaking process that the agency must follow when it crafts new regulations. This included creating proposed rules, as well as allowing for comments about the proposed rules. The commenting period ended in early August 2022."

Menthol cigarettes made up 36% of all cigarette sales in the U.S. in 2018. Anti-smoking groups have cited research that shows cigarette companies have deliberately targeted African American communities, especially youth, with marketing menthol cigarettes, cigars and other tobacco products. Menthol products also have a strong appeal for youth, since menthol numbs the throat and reduces irritation from smoking and makes it easier for them to start smoking.

Once the rules clear OMB, expected before the end of the year, they would not take effect for a year, FDA has said. "The tobacco industry is likely to sue FDA and will likely ask for an injunction until after those lawsuits are resolved, further delaying the enforcement," Halfwheel reports.

As overdoses among Blacks in Kentucky more than double, UK researchers explore their relations with drug-treatment providers

By Amanda Nelson
University of Kentucky

Black adults share about their experiences in drug treatment in a new University of Kentucky study published in the Journal of Substance Abuse Treatment.

Until now, few studies have included the voices of Black people and their experiences with treatment providers. Study authors hope it will inform changes to promote successful recovery and healing.

The study was conducted among 39 African Americans in Kentucky, where opioid-related deaths recently more than doubled among Blacks. All the interviewees had used opioids within the past six months.

Researchers found three primary themes influenced interviewees’ perceptions about treatment for substance-use disorder, centering on:

• Readiness for change, influenced by whether the treatment was mandated by an external entity such as the legal/justice system, or individuals were able to decide for themselves they were ready for help;
• Characteristics of their treatment provider (race, gender, the provider’s personal substance-use history, as well as their ability to build rapport, maintain confidentiality, and seem motivated to help);
• Relational support from people in the interviewees’ lives, such as partners and family members.

Danielle Stevens-Watkins (UK photo by Mark Cornelison)

Exploring factors likely to impact the experiences of Black adults in treatment is an important step to being able to culturally adapt treatment strategies and integrate approaches that will have more meaningful effects among this underserved population, said Danelle Stevens-Watkins, professor of counseling psychology in the UK College of Education Department of Educational, School and Counseling Psychology and UK’s associate vice president for research in diversity and inclusion.

The paper is the first to be published from a $3.2 million National Institute on Drug Abuse project led by Stevens-Watkins, now in its second year. The project will include interviews with 800 African Americans who misuse prescription and illicit opioids, filling a need for data on this under-served group.

Readiness for change

Research conducted among primarily white participants has found that time in substance-use treatment tended to increase readiness to change, regardless of whether it was mandated by the legal system. But that was not true among African Americans in the study.

“The men and women in our study reported less success in their experiences with treatment when it was mandated, versus something they sought out because they wanted it for themselves,” said Candice Hargons, associate professor of counseling psychology and interim chair of the Department of Educational, School and Counseling Psychology.

Possible reasons that participants felt this way about mandated treatment were tied to the culture and climate of mandated-treatment settings.

The study authors suggest that assessing Blacks for readiness and motivation is important, especially when treatment is mandated. They said helping them reduce feelings of loss of control in treatment could increase desire to engage in the process. This could be accomplished, for instance, through developing a collaborative experience, where clients have a role in defining their needs.

While the interviewees understood that personal investment in the treatment process was necessary for recovery, some may have overestimated that wanting it for yourself was the predominant driver in the recovery journey, the study authors wrote.

“Many of the people who talked to us for this study felt someone can simply ‘will’ themselves into recovery,” said postdoctoral fellow Brittany Miller-Roenigk. “Having a personal investment in the process is important, but you also must consider the biological aspects of recovery and the ways treatment helps to address those. It really takes both a readiness for change and a supportive therapeutic environment along the way.” 

Provider characteristics

The study’s look into the lived experiences of Black men and women who use opioids also highlighted how provider characteristics can largely influence the treatment process. Many expressed a difficulty in trusting others, complicated by a lack of racial similarity with providers.

“There is a great need to recruit more Black therapists,” said Natalie Malone, Ph.D. student in counseling psychology. “Many of the participants in this study had never or rarely encountered a provider of color. Several talked about needing to feel the therapist will understand them when talking about experiences of racism, discrimination and microaggressions.”

A few said that race did not matter, if the provider had the ability to build rapport, avoid a judgmental tone and maintain confidentiality.

While most participants felt they could best express themselves to a race-matched provider, opinions were mixed on participants’ preference for providers who had experienced addiction. Some felt providers who were in recovery could better understand them. A few said they preferred providers who had never experienced addiction because they did not trust their providers’ sobriety, meaning it would be difficult to confide in someone that may have questionable time clean from substances.

Study participants also discussed differences in quality between mandated programs, compared to treatment programs available through insurance or direct payment. Some thought treatment facilities more likely to have Black patients had therapists with less education and training than those serving predominantly white patients. Participants also suggested that providers in mandated programs may have been facing burnout and lacked investment in the treatment process, too.

Relational support

Partners and family members were primary sources of support networks among the individuals in the study. Partners undergoing treatment simultaneously were most likely to provide support. Nobody in the study said their partners were a barrier to treatment.

For those with family members aware of their drug use, several identified their family as a primary source of support. Some family members were unsupportive of treatment due to their own personal substance use.

The researchers found a third theme they refer to as “absent support,” which had a negative impact but not a negative intent. This happened among participants’ families that spend time together socially but have a culture of not becoming involved in the personal affairs of others. Absent support was most often related to maintaining privacy, which is consistent in the literature among African Americans, the authors said.

When possible, the study authors suggest integrating peers, family members or partners into treatment may be a useful resource for reducing opioid use among African Americans.

The study authors are sharing these initial findings to highlight aspects of treatment that could be addressed to most likely influence success.

“It is important to take a deeper look into the lived experience of Black men and women who use opioids so that researchers, clinicians and those who influence programs that support recovery and healing have a better understanding of the factors that can make a true difference in their success,” said Destin Mizelle, a Ph.D. student in counseling psychology.

This is a critical time for Black individuals who use opioids, said Jovonna Atkinson, a master's-degree student in the College of Social Work.

Stevens-Watkins noted, “Overdose-related deaths are on the rise and Black men and women are more likely to face similar and sometimes harsher consequences than their white counterparts, including higher likelihood for criminal convictions, longer incarcerations, higher unemployment rates and increased mental health risks. The more data we can gather to inform culturally-tailored interventions, the greater chance we have to reduce the adverse social, legal and fatal consequences associated with opioid use among Black populations.”

FDA proposes ban on menthol cigarettes and cigars, popular among Blacks, whose leaders are divided on the matter

Photo from ash.org

Last week the U.S. Food and Drug Administration announced its long-anticipated plan to ban menthol cigarettes and all flavors in cigars. 

“The proposed rules would help prevent children from becoming the next generation of smokers and help adult smokers quit,” Health and Human Services Secretary Xavier Becerra said in a news release. “Additionally, the proposed rules represent an important step to advance health equity by significantly reducing tobacco-related health disparities.”

When added to cigarettes and cigars, menthol's minty taste and cooling effect limits throat irritation, thereby making the products more appealing to smokers -- especially new and young smokers. The  release adds that menthol also interacts with nicotine in the brain to enhance nicotine's addictive effects and makes it more difficult to quit smoking. 

One study estimates that banning menthol in cigarettes and cigars in the U.S. would lead to a 15% reduction in smoking as early as 2026 and prevent upwards of 650,000 deaths by 2060.

The Washington Post reports on another study published in the peer-reviewed journal Tobacco Control that "found that if a menthol-cigarette ban in the United States were to have the same effect as a Canadian menthol ban, more than 1.3 million additional smokers would quit, including more than 381,000 African Americans." Nearly 85% of Black smokers smoke menthol cigarettes, compared to 30% of white smokers who smoke menthols, says the FDA. 

The proposed menthol ban has divided Black leaders. Ben Crump, a Black civil-rights attorney, told Politico, “There’s a difference between theory and reality. The reality is, we know once you make laws and such then you have local and state actors who use those as weapons to marginalize Black people.”

FDA says it "cannot and will not enforce against individual consumers for possession or use of menthol cigarettes or flavored cigars" and enforcement will only address the industry, but some Black leaders, including Rev. Al Sharpton and others, disagree that this will be the reality. 

The African American Tobacco Control Leadership Council supports the proposed rule. "This is a major step forward in saving Black lives." Dr. Phillip Gardiner, co-chair of the council, said in a statement.   

Gardiner went on to encourage tobacco control activist to continue to fight to ban the sale of menthol tobacco products at the local, state and federal level, noting that the rule-making process and court challenges by the tobacco industry could mean it will be years before this ban could becomes effective.

Stanton Glantz, who continues to conduct tobacco research even after retiring from the University of California San Francisco in 2020, writes on his blog that "FDA has built a strong foundation to justify prohibiting menthol as a characterizing flavor in cigarettes," but its justification for granting exceptions for heated tobacco products and low nicotine-cigarettes "is very weak" and "should be dropped."  

The New York Times published an essay written by Keith Wailoo, a professor of history and public affairs at Princeton University, that provides a detailed walk through the history of how the tobacco industry hooked black smokers on menthols. He is the author of "Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette." 

"After decades of outcries from communities and public health experts about the health inequities and dangers posed by menthol marketing (with the NAACP now urging a ban), the FDA’s proposed rule that would impose the ban, announced April 28, is a long-awaited step that will save hundreds of thousands of lives in the decades to come," Wailoo writes. "We should not be distracted by those who work on behalf of the tobacco industry while claiming to speak for Black health and well-being. They are part of the web that has maintained the stranglehold, enticing consumers with deceptive promises."

The FDA says that in 2019 there were more than 18.5 million menthol cigarette smokers aged 12 and older in the U.S. which included high rates of youth, young adults, African Americans and other racial and ethnic minorities. In 2020 menthol made up 37% of the cigarette market in in the U.S., up from 26% in 2000, according to The Truth Initiative menthol fact sheet. 

The FDA is accepting public comments on its proposed rules for menthol cigarettes and flavored cigars through July 5. 

As vaccines go begging, Beshear says doses need to go where people are, and local leaders need to urge folks to get a shot

State table shows how supply of vaccines has exceeded demand for vaccinations recently.

By Melissa Patrick
Kentucky Health News

Almost every coronavirus-related question at Gov. Andy Beshear's news briefing Thursday ended with a call from him to get vaccinated, and that came after repeated pleas in his relatively short presentation for Kentuckians to sign up for one of the thousands of open vaccination slots across the state.

"While we vaccinated 125,210 new Kentuckians this last week, we received about 214,000 doses. So what that means is there are open appointments . . . not because we're not vaccinating still at a steady pace, but because we're getting more vaccine," Beshear said, "so we need people to get out there and to sign up." 

Beshear again listed regional vaccine sites with thousands of slots available next week, including U of L Health at Cardinal Stadium, with more than 11,000 slots open; Kroger Health at Greenwood Mall in Bowling Green (2,000); and the Kentucky Horse Park in Lexington (1,800); Baptist Health Corbin; the Christian County Health Department (1,000); and Pikeville Medical Center (1,000). 

He pleaded with Kentuckians to take whatever vaccine is available, and not wait for the single-dose Johnson & Johnson vaccine, saying Kentucky only got 7,800 doses of that vaccine this week, a drop from 65,000 last week, and state officials don't know how many it will get in the upcoming weeks. 

State table of variants by county; for a larger version, click on it.

He said if people "wait on the Johnson & Johnson vaccine, we might not win the race against the variants" of the virus that are more contagious and "It's going to take us longer to be able to fully ease the restrictions that we all want to get rid of. So come on, get out there, get your vaccine."

Beshear said so far, the state has detected 113 cases with "variants of concern" in Kentucky. All but two were the highly contagious B.1.1.7, which was first found in the United Kingdom. The Centers for Disease Control and Prevention website says 1,085 cases in Kentucky have undergone genomic testing to detect variants.

More than 1.5 million Kentuckians have received at least one dose of a vaccine, about 33% of the population. 

Reluctance to get the vaccine has been reported to be more common among rural whites, especially evangelicals, and urban Blacks.

Sarah Ladd and Chris Kenning of the Louisville Courier Journal report that the real reason vaccinations have lagged among Kentucky Blacks are lack of access, including things like "little or no transportation, no internet access, few if any nearby pharmacies and struggles trying to sign up online." 

Kentucky Health News asked Beshear if these are some of the reasons rural whites have been slow to get vaccinated, or if it had to do more with politics. Beshear said that while there are some similarities between rural and urban areas, there are also other nuances that must be recognized. 

He said some parts of the state have shown some higher hesitancy, naming Western Kentucky as one. 

He suggested it is time to try some new strategies, like programs that offer incentives for vaccination and getting more doses into places people regularly go to, such as pharmacies and grocery stores. 

The politics can be local, he said: "Some of the areas where we see the least amount of people taking vaccines are ones where we saw local leaders push back against what we were doing to protect people" earlier in the pandemic. "If you see enough of that, and someone is beating that drum beat long enough, again, it's going to make it harder to then convince people to get vaccinated. And so we're going to need help, both from those that have disagreed with us as we've gone along and those that have agreed with us to get it done."

Beshear suggested that on Monday, he would give Kentuckians a broad incentive to get a shot: set a vaccination level at which he would remove capacity restrictions, even for events of up to 1,000 people. 

"We still may be needing to wear masks, whether it's our restaurants, our bars, our offices and the rest, [but] we can get back to that 100 percent capacity," he said, "and it's all dependent on how quickly and how many people we can vaccinate."

Beshear said he thought if done safely and masking is strictly enforced, it will be safe to attend the Kentucky Derby on May 1, and he plans on being there. He also encouraged people to go ahead and get vaccinated now if they plan on being there, or anywhere that involves large crowds. 

"That ought to be on anybody's checklist who is planning on going," he said. 

Beshear said the state is tailoring some of its efforts toward young people, who he said weren't necessarily vaccine-hesitant, but more likely indifferent because the virus has not affected their age group as harshly. He noted that young people in other states have been hospitalized with variants.

Asked about a study, published in The Lancet Psychiatry journal, that shows one in three people who have had Covid-19 have suffered a neurological or psychiatric disorder within six months of infection with the virus, Beshear said he was still looking at the study, and that he expects there will be many more like it. He  also noted that Health Commissioner Steven Stack has warned all along that we don't know the long-term effects of having Covid-19. 

"Again, it has real health impacts. So get vaccinated, continue to wear your mask until we get to the end. And don't be cavalier, because while you may think that it's not going to hurt you the person you could spread it to could be could be suffering from this," he said.

Daily numbers: Beshear reported 645 new cases of the virus, bringing the state's seven-day average to 529, the lowest it's been since Aug. 11, when it was 528.

The share of Kentuckians testing positive for the virus in the past seven days was 2.81%, almost equal to the recent low of 2.8% on March 26 and 27. 

In long-term care, Beshear reported no new Covid-19 deaths, and only six new cases, five of them among employees. "That is the power of vaccinations," he said, referring to the fact that significantly more residents than employees have been vaccinated.

The state added 16 deaths to its list of Covid-19 fatalities. The state's death toll from the disease is 6,214. The 14-day average of regularly reported deaths is 11.6 a day, half what it was two and a half weeks ago.

The state said all 16 deaths were from regular health-department reports and none from the death-certificate audit. However, 10 of them were from 2020, with two dated in July. UPDATE, April 11: The Cabinet for Health and Family Services said nine of the 16 deaths were actually from the audit, which recently went farther back into 2020. "The first of these cases were incorrectly classified Thursday as regular rather than audit deaths because of the pathway through which they were submitted," cabinet spokeswoman Susan Dunlap said in an email.

The July fatalities were both from Jefferson County: a 64-year-old man and a 59-year-old woman. Later in 2020 were three Jefferson County women, 73, 80 and 87; two Jefferson County men, 61 and 72; a Laurel County woman, 77; an Oldham County man, 45; and a Carroll County man, 41.

All the 2021 fatalities on the daily death report were listed as occurring after March 19. They were a Christian County man, 68; a Daviess County man, 54; two Hopkins County women, 73 and 88; a Hopkins County man, 62; an an Ohio County man, 76.  

Unemployment: The state Labor Cabinet said it would shut the state's unemployment system for four days, starting at midnight Thursday to fight a "massive amount of fraud" that is affecting unemployment systems across the nation.

"We hate that we have to do this, to make things more difficult, but these criminals are relentless; they will not stop," said Amy Cubbage, Beshear's general counsel. 

During the shutdown, no new claims can be filed and claimants will be unable to request benefits. Staff will continue to work on existing claims. 

Cubbage said there have been attempts to change 300,000 personal identification numbers on claimants' accounts, not all of them current accounts.  

Claimants will need to set up new accounts next week with a new eight-digit PIN  that they will receive in by U.S. mail, as well as a new 12-digit password. Cubbage said active claimants will not need to file new claims.

In other pandemic news Thursday:

• The state's daily new-case rate over the past seven days was 9.67 per 100,000 residents, 0.1 less than Wednesday. Its rate ranked 34th among the states, according to The New York Times.
• Counties with rates more than double the statewide rate were Simpson, 43.8; Harlan, 29.1; McCreary, 28.2; Bracken, 27.5; Whitley, 27.2; Powell, 26.6; Floyd, 22.5; Knox, 22; Menifee, 22; Robertson, 20.3; Allen, 20.1; Mason, 20.1; Lawrence, 19.6; and Casey, 19.4.
• Counties with 10 more more new cases on the state's daily report were: Jefferson, 125; Fayette, 43; Clark, 23; Warren, 19; Boone, 18; McCracken, 16; Kenton, 14; Letcher, 14; Hardin, 13; Christian, 12; Harlan, 12; Floyd, Logan, Madison and Simpson, 11; and Allen, Daviess and Powell, 10.
• Kentucky hospitals reported 377 Covid-19 patients, six fewer than Wednesday, with 102 of them in intensive care (down 10) and 53 of those on ventilators (down 13).

Positive-test rate rises; state has more new cases than last Sun.

State Department for Public Health map, relabeled by Kentucky Health News; click it to enlarge

By Al Cross

Kentucky Health News

The waning of the pandemic slowed in Kentucky Sunday, illustrating public-health experts' worries of another surge before the novel coronavirus is beaten.

The percentage of Kentuckians testing positive for the virus is the last seven days rose, the number of new cases was higher than the previous Sunday, and Kentucky's new-case ranking among the states rose two notches.

The positive-test rate is 4.12%. It was 4% Saturday, after dropping for all but one of the previous 16 days and generally falling for almost two months.

The state reported 526 new cases of the virus; the number last Sunday was 509. The seven-day rolling average of new cases fell by 21, to 874, but the state's new-case rate is 14th in the nation after falling to 16th on Saturday, according to the daily compilation by The New York Times.

Hospitalizations in Kentucky for Covid-19 fell by 33, to 558, and the number in intensive-care units fell by 15, to 156. But the number of ICU patients on ventilators rose to 82, or 53%; Saturday they numbered 72, or 42%.

Pressure on ICU beds in the Lake Cumberland hospital readiness region eased; 82% were in use, after weeks in which the figure was near or above 90%. The easternmost region, from Lee to Pike counties, was the only other one above 80%; 87% of its ICU beds are in use, but only 12% for Covid-19 patients.

The state listed 13 more deaths from Covid-19, all confirmed after review, raising Kentucky's pandemic toll to 4,819. In the last 14 days, the state has averaged 26.6 deaths per day, a figure that has varied little the last two weeks.

The state's daily report shows that Black Kentuckians' proportions of cases and deaths have declined to 8% and 8.2% of the totals, respectively, less than their 8.5% share of the state's population. For months, the rates were near or above double African Americans' population share.

Lyon County, site of many cases in state prisons, leads the nation in the rate of new cases over the last seven days, according to The Washington Post. The state's report says Lyon's rate is 358 cases per 100,000 residents and the statewide rate is 15.2. Other counties with rates more than twice the statewide rate were Rowan, 39.1; Owsley, 38.8; Clay, 35.2; Knox, 34.9; Simpson, 33.1; McCreary, 32.3; and Clinton, 32.2.

Counties with more than five new cases Sunday were: Jefferson, 106; Fayette, 59; Lyon, 30; Kenton, 16; Warren, 16; Daviess, 15; Scott, 14; Franklin, 11; Jessamine, 11; Boone, Bullitt, Hardin and Laurel, 10; Oldham, 9; Campbell, 8; Bell, Clay, McCracken and Nelson, 7; and Logan, 6.

Beshear says new sites will put vaccine close to all Kentuckians; opens assisted-living facilities to limited visitation; urges testing

White House Coronavirus Task Force graphic, adapted by Kentucky Health News

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear offered some good news at his last news conference of the week, announcing that 28 more coronavirus vaccination sites will open next week, and some long-term-care facilities will be able to allow visitation starting Saturday. He also said virus testing in Kentucky needs to increase.

"We are doing what we can on the state side to provide more visitation to those that have been fully vaccinated," Beshear said. "Again, as we emerge from this pandemic, we hope to be able to relax that further, but some really good news today." 

With the federal immunization program for long-term-care facilities wrapping up, Beshear announced that starting Saturday, Feb. 20, some will be able to allow "group activities, communal dining and visitation amongst vaccinated residents."

Beshear said the new rules will apply to residents in non-Medicare-certified facilities that have gone through the full vaccination process. He said such facilities include assisted-living homes, personal-care homes, intermediate care facilities for individuals with intellectual disabilities, and independent-living facilities.

The new guidance allows each fully vaccinated resident up to two visitors from the same household at one time.  Visitors will need to show proof of a negative coronavirus test within 72 hours of the visit, or proof of vaccination. Detailed guidance will be posted on the Cabinet for Health and Family Services' Office of Inspector General's website Friday. 

Beshear stressed that Medicare-certified nursing homes are still not included, saying the state is waiting for a change in guidance from the Centers for Medicare and Medicaid Services before it can make this change in the highest level of long-term-care facilities, skilled nursing.

Vaccines: Beshear announced that starting next week, the state will open an additional 28 vaccination sites, bringing the total number to 291. He said there will now be a vaccination provider close to every Kentuckian, although some will have to drive a bit farther than others.  

That number "isn't meant for the amount of supply we have now," he cautioned. "It's meant for the day that we get so much in that we can get everybody through. And my hope, a record rapid time to get everybody vaccinated. We're building for the future and our infrastructure is is way ahead of supply." 

Beshear said the state will add six new regional sites next week in Albany, Cadiz, Campbellsville, Hartford, Marion and Maysville. That brings the total number of regional sites to 51. Go to vaccine.ky.gov to find out how to sign up for an appointment at one of these sites. 

There will be 10 new Kroger sites, in Bardstown, LaGrange, Lebanon, Louisville, Madisonville, Morehead, Mt. Sterling, Owensboro, Somerset and Walton. That brings the total Kroger sites to 20. Appointments can be made at Kroger.com/CovidVaccine. 

There will be 10 new Walmart sites, in Alexandria, Ashland, Bardstown, Fulton, Hanson, Harrodsburg, Leitchfield, Princeton, Russellville and Somerset. That brings the total Walmart sites to 25. Appointments can be made at Walmart.com/CovidVaccine. 

Two more community health centers will offer vaccines, one in McKee and the other in Mt. Vernon. That brings these sites to nine. 

Also, there are 61 local health department sites and 125 federal-pharmacy-program sites: 78 Walgreens and 47 independent pharmacies that use the Good Neighbor Pharmacy brand. 

The daily vaccine report shows 555,373 Kentuckians have received at least one dose of  a coronavirus vaccine. That's about 12.4% of the state's population. 

Beshear encouraged people who needed to reschedule at the regional sites because of bad weather to follow the directions on their confirmation e-mail.

After saying Western Kentucky has only 15 Krogers, only 17 towns with a Walgreens and none of the community health centers that have vaccines, Scott Brown of WKDZ (Cadiz-Hopkinsville) asked Beshear to address the feelings of some in the region that it is short of vaccine sites.

Beshear said, "Number of sites are different from amount of vaccine that gets to a certain area. You know, there was a Western Kentucky legislator who was concerned about the amount several weeks ago and when we looked at the area, it was about 5 percent of the state's population and got about 13 percent of the vaccine in the early part of the rollout."

He added, "We actually argued with and won the argument with the federal government to add the local community pharmacies, to the Walgreens and the federal pharmacy program. And a lot of those are in Western Kentucky. Certain parts of Western Kentucky have a whole lot of options right now, Paducah being one."

The governor said every mayor and county judge-executive "wants to fight for a facility . . . and in many ways don't think it's their job about how much the next county has. The state, we've got to try to build a fair and equitable distribution that is on a statewide basis."

Prisoners: In response to a question, Beshear said the state hopes to vaccinate the 181 state prison inmates who are 70 and older in the next phase of vaccination. That phase, 1C, includes people in the general public who are 60 and older, those 16 and older with certain health conditions, and all essential workers.

Of the 9,547 state inmates, 214 are between 65 and 69, and 431 between 60 and 64. Last week, Health Commissioner Steven Stack stressed the importance of vaccinating those 60 and older because they account for 91% of the state's Covid-19 deaths.

Asked if he thought the prisons already had some herd immunity because so many inmates had been infected, Beshear said was a good question but they had not considered that possibility. Regardless, he said, the recommendation is for everyone to get vaccinated, even if they have had the virus. 

According to the Department of Corrections website, 6,907 inmates have ever tested positive for the coronavirus. That amounts to 70% of the population, close to the 75-80% needed for herd immunity. As of Feb. 18, there are 20 active staff cases and seven active inmate cases in the facilities.

Daily numbers: Beshear reported 963 new cases of the virus, bringing the state's seven-day rolling average to 1,125, the lowest it's been since Oct. 19. 

The share of Kentuckians testing positive for the virus in the last seven days crept up again, to 7.07%  on Thursday, up from 6.99% Wednesday and 6.58% Tuesday.  Beshear said this is likely related to the bad weather since testing is "really down this week" and those who are getting tested are likely sick. 

"We need people to get back to their normal habits and getting regularly tested," he said. "It both protects you and your family, and it gives us critical information we need in the state. It gives us the best data to make the best decisions." 

This week's White House Coronavirus Task Force report shows the negative trend for testing in the state, down by 2% in the week ended Feb. 12. The report showed that the recent decline in hospitalizations is a result of fewer patients over 70. Their case umbers are also down, and both trends seem related to vaccinations.

White House Coronavirus Task Force graphic, adapted by Kentucky Health News; click it to enlarge

On Thursday, Kentucky hospitals reported 935 Covid-19 patients, 260 of them in intensive care and 130 of those on ventilators. Beshear called these numbers "all pretty stable." Three of the hospital readiness regions have are using more than 80% of their intensive-care beds: Barren River, 81%; the easternmost region, from Lee to Pike counties, 86%; and Lake Cumberland, 91%. 

The statewide infection rate plummeted again, to 21.37 cases per 100,000 people in the last seven days, perhaps a result of decreased testing. Only two counties had an infection rate more than double the statewide rate: Metcalfe, 46.8; and Bell, 43.9. 

Nationwide, Kentucky's new-case rate is higher than most states. The daily compilation by The New York Times shows Kentucky has dropped out of the top 10, falling to 12th place on Thursday.

Beshear said 37 more Kentuckians have died from Covid-19, 31 of them confirmed and six probable. That brings the state's death toll to 4,373. The 14-day death average is down by 0.5, to 32.3. 

In other coronavirus news Thursday:

• Today's 37 fatalities were a Barren County woman, 83; a Breckinridge County woman, 90; a Bullitt County woman, 71; a Bullitt County man, 84; a Caldwell County woman, 71; a Caldwell County man, 71; a Casey County woman, 60; a Christian County woman, 40; a Fayette County woman, 68; two Fayette County men, 43 and 70; a Floyd County man, 73; a Graves County man, 72; a Hardin County man, 80; a Henry County man, 54; a Hopkins County man, 63; two Jefferson County women, 71,82; five Jefferson County men, 63, 78, 82, 87 and 93; a Kenton County woman, 101; a Lee County woman, 73; a Logan County woman, 64; a McCreary County woman, 60; a Marshall County woman, 77; two Marshall County men, 84,87; a Monroe County woman, 64; a Muhlenberg County woman, 69; a Shelby County woman, 79; two Spencer County women, 60 and 67; and a Todd County woman, 86.
• Counties with 10 or more new cases on Thursday were Jefferson, 145; Fayette, 66; Laurel, 41; Christian, 35; Kenton, 32; Boone, 28; Montgomery, 27; Bullitt, 24; Campbell, 23; Warren, 22; Jessamine and Madison, 21; Hardin and Shelby, 19; Boyd, 18; Pike, 17; Franklin and McCracken, 16; Bell, Greenup, Nelson and Scott, 14; Daviess, 13; Oldham, 12; Hopkins, Morgan and Spencer, 11; Clark, Knox and Mason, 10.
• In long-term care, 231 residents and 172 employees have an active case of the coronavirus, with eight residents and 10 staff added to that list Thursday. Beshear attributed seven more deaths of long-term-care residents to Covid-19, bringing the death toll to 2,236. He said the drop in case numbers is attributed to widespread immunization in these facilities. 
• Through a partnership with Lexington, the state and other community partners, the University of Kentucky will offer four mobile pop-up clinics to vaccinate medically underserved populations in Fayette County, it said.  The state will allocate 500 shots per weekend for each of the clinics, which will be open from 9 a.m. to 2 p.m. at each site. Community groups are working on who will be invited to the clinics; walk-up appointments will not be permitted. The coronavirus test and vaccines will be free. Here is the schedule: 
• Feb. 20: Keeneland, 4201 Versailles Road. Keeneland is providing vaccine to Hispanics who work in the track’s stable area and on Bluegrass horse farms.
• Feb. 27: First Baptist Church Bracktown, 3016 Bracktown Rd. (along Leestown Road).
• Mar. 6: Shiloh Baptist Church, 237 E. 5th St.
• Mar. 13: Charles Young Community Center, 540 E. 3rd.
• Follow-up clinics for booster shots and continued testing will be held at the same sites the following four weekends in the same order, says the  release. 
• University of Louisville Health will run similar pop-up clinics at predominately Black churches, WDRB reports. The first clinic is scheduled at Kingdom Fellowship Christian Life Center, 324 E. Broadway, Friday. Just under 800 people had signed up by Tuesday, Kate Springer reports.
• Maggie Menderski of the Courier Journal tells the story of St. Paul's Episcopal Church in Louisville, which collects food to help feed the hungry every week instead of holding services. So far, she reports they have collected more than 20,000 items since the pandemic began, lately averaging more than 600 items a week. 
• For winter weather updates and resources, visit snowky.ky.gov. For updates on roadway conditions, visit goky.ky.gov.
• Click here for an unemployment insurance update, found on the governor's news release.