Dean of UK College of Public Health says state officials' efforts against the pandemic kept Kentucky from being a hotspot

By Hal Morris
University of Kentucky

Donna Arnett makes no bones about her goals for the UK College of Public Health.

“We’re a very ambitious college with a very ambitious agenda,” says Arnett, the college’s dean since 2016.

The Covid-19 pandemic has done nothing to derail that agenda, just maybe sidetracked it a bit. But as millions get vaccinated and life begins to return to normal, Arnett can again refocus on the college’s strategic plan to be "a catalyst of positive change for population health."

Donna Arnett (UK photo by Pete Comparoni)

“We’re able now to restart some of our work that’s always done in person with community partners or participants in our research programs. That’s been helpful,” Arnett says. “Public health is a very collaborative field. We tend to be partners with other people on campus in putting together research programs. The ability to meet again in person and generate those research ideas, I think, is very important to our future.”

The college was thrown headfirst into the battle against the coronavirus.

Faculty member Kathleen Winter went into the field immediately with the Fayette County Health Department, led its contact-tracing efforts for a year, and is now the state epidemiologist.

The state Cabinet for Health and Family Services recruited Keith Knapp, a professor of health management and policy, to lead the effort to thwart the pandemic long-term care and other congregate facilities, the populations most vulnerable to Covid-19.

Arnett said she believes the mitigation measures taken by Gov. Andy Beshear and his administration helped Kentucky avoid becoming a pandemic hotspot.

“Our governor’s progressive stand on utilization of mask mandates, reducing the number of people allowed at restaurants, reducing the size of gatherings, the overall communication messaging about how we are in this together, I think, sent a real message that this is important for our community,” she says. “I think those measures really did make an impact.”

Arnett is a member of UK's Screening, Testing and Tracing, to Accelerate Restart and Transition (START) Committee, which helped create recommendations for tracing contacts of infected people. She recommended UK examine wastewater on campus, which can reveal the virus’ presence in a facility.

The university has used the technique, which Arnett says “is an effective way to identify where an infection is growing in terms of numbers infected.”

The committee recommended that in-person classes end before Thanksgiving and students not return until late January. “I’m proud of us for making that recommendation because I personally was concerned about the surge that would happen after the Thanksgiving, Christmas and New Year holidays. In fact, it did happen. We had enormous numbers of infections in that period in the U.S. and the commonwealth.”

Arnett says the college also circulated two pandemic op-eds, on why masks are important, and one regarding vaccines, which at this point are approved for emergency use.

“When we heard the vaccines were coming, we put out a message early on explaining that the vaccines are not experimental. The methodology has been in the works for many years. We were ahead of the curve on trying to get the messaging out and the right messaging out about the safety of the vaccines,” Arnett says. “We were also concerned about how to message minority and other underserved communities because they are the most vulnerable and have experienced the most loss in our state. We’ve been working with the governor’s office to work on that messaging for vaccines.”

As the vaccines began rolling out earlier this year and Kroger Field was set up for distribution, “Everybody jumped in,” Arnett says. “Our faculty, staff and students jumped in and were boots on the ground, doing the work in contact tracing initially. I’m very proud that our college has had such a remarkable presence in the state in terms of this pandemic.”

And UK as whole has been instrumental in getting vaccines to where they are needed the most, Arnett says: “UK HealthCare has been very proactive in setting up these remote clinics and getting the vaccine to places where people are rather than asking everyone to access the stadium back when we had the stadium up and running.”

Back to the plan

As millions get vaccinated and life begins to return to normal, Arnett can again turn her attention to the college’s agenda while still minding the pandemic threats, which she says are here to stay in some form.

An Eastern Kentucky native, Arnett came to UK five years ago after serving for 11 years as chair of epidemiology at the University of Alabama-Birmingham. She says she felt like UK was the best place to help take on Kentucky’s health challenges.

“It was important for me to return to my birth state. It’s a state where there are so many public health issues,” she says. “UK being the land-grant institution of the state and the flagship, I thought it would be a great opportunity to use my talents in the area of cardiovascular health here at UK and extend that throughout the commonwealth.”

When Arnett arrived at UK, she wanted to focus on chronic disease and substance-use disorder, conditions she called a “nightmare” in the state.

“How we build health in rural communities was a major focus. How do we address the issues of obesity, diabetes and cardiovascular disease in our communities? The use of Extension agents in our counties has been an effective way to deliver education to communities,” she says. “Those were the driving things that I wanted to do when I arrived. I wanted to really build our research profile both at the college and in the broader university. I wanted to build our undergraduate training programs so it could have a larger impact in public health in the state.”

Arnett also points out that the College of Public Health has been active in improving cancer screening rates, particularly colon cancer. Over the past eight years, she says Kentucky has gone from 49th to second in screening rates.

Helping people understand exactly what "public health" encompasses is always a goal as well, Arnett says, because just about every facet of life deals with public health.

“We can span the science from really basic toxicology to things like how you communicate with populations to both educate and inspire them to have healthy behaviors. We also work in policy,” she says. “How do we provide economic analysis to the state to inform our Medicaid policy? We touch such a breadth of different disciplines that you could be a biostatistician major to a toxicology major to a health behavior specialist. It all fits under our college.”

“The great thing about public health is when things are working, you never hear about it because we’re keeping everything safe. When you think about food safety, that’s public health. When you think about sanitation and environment, that’s public health. We’re really foundational.”

Agriculture Commissioner Quarles calls on Beshear to set a date to reopen the state and ditch his goal of 2.5 million vaccinations

State Dept. for Public Health map, relabeled by Ky. Health News; for a larger version click on it.

By Melissa Patrick
Kentucky Health News

As Gov. Andy Beshear continues to call for a total 2.5 million Kentuckians to get their first shot of a Covid-19 vaccine, using it as the marker for when he will lift all capacity restrictions on most businesses, one state official says it's time to ditch that plan and simply set a date to reopen the state. 

"It is unrealistic to think that this governor is going to reopen the state and lift restrictions immediately," Agriculture Commissioner Ryan Quarles writes in an op-ed. "That’s why I am challenging the governor to set a full reopening date to give our people certainty and the ability to plan for a responsible reopening." 

Beshear has said that getting 2.5 million Kentuckians is not a random number when it comes to lifting capacity restrictions. He has also noted that as Kentucky moves toward this goal he is willing to incrementally lift some restrictions, as he has already done, he said after Quarles's statements.

“Because so many Kentuckians have rolled up their sleeves for these vaccines, these shots of hope, we’ve been able to increase capacity in most businesses to 60% and return child care classrooms to their traditional sizes,” Beshear said in a news release Wednesday. “We’ve been able to shorten and simplify Healthy at Work minimum requirements. We’ve been able to lift the mask mandate for smaller, outdoor events. That’s all because of you. And as more Kentuckians get vaccinated, it will be safer to lift even more restrictions.”

Beshear reported 1,837,229 Kentuckians have received at least one dose of a Covid-19 vaccine, or 41% of the population. Of those, 2,053 were given Tuesday, leaving 662,708 more Kentuckians needing a first shot to reach the governor's 2.5 million goal. 

Quarles, a Republican, is a leading prospect for the party's nominee to face Beshear in the 2023 election for governor. He says it's time for Beshear to follow the direction of GOP governors in Tennessee and Florida who have fully re-opened their states, saying Beshear "is holding Kentucky's economic engine hostage." 

Noting some estimates that it could be August before the state meets Beshear's goal, he calls the governor's plan to wait until 2.5 million first doses are given "absolutely unacceptable," adding, "The longer Kentucky refuses to open up, the longer we will lose jobs and workers to other states."

Daily numbers: As the political debate heats up, so does the the state's positive-test rate, a leading indicator of cases to come. The share of Kentuckians who tested positive for the virus in the past seven days is 3.57%, up for the seventh consecutive day.

Beshear announced 710 new cases on Wednesday, lowering the seven-day rolling average by 5, to 619. The daily report says nearly 25% of the new cases, or 176, were in people 18 and younger.

The latest American Academy of Pediatrics' Children and Covid-19 State Data report said there was a 4% increase in the number of child Covid-19 cases in the U.S. April 15-29, for a total of 151,535 more new cases. In Kentucky, 15.1% of cases have been in people under the age of 19, says the report.  

The statewide rate of daily new cases over the last seven days is 11.45 cases per 100,000 residents.  The New York Times ranks Kentucky's rate 24th among the states. 

Counties with rates double the statewide rate were Powell, 68.2; Robertson, 47.4; Hickman, 39.1; Lewis, 38.7; Bath, 34.3; Simpson, 29.2; Menifee, 28.6; Montgomery, 26.4; and Mason, 23.4.

Kentucky hospitals reported 420 patients with Covid-19, down 14 from yesterday; 111 in intensive care (up 9); and 46 of those on a ventilator (down 2). 

The Lake Cumberland hospital readiness region is using right at 80% of its intensive-care beds, with 13.3% of beds used for Covid-19 patients. No other region is above 80%.

The state reported 10 more Covid-19 deaths, all of them from regular health-department reports. That brings the death toll to 6,542.  

The fatalities were a Henderson County woman, 98; a Jefferson County woman, 52; a Lawrence County woman, 74; a Livingston County woman, 49; a Lyon County man, 77; a Mason County woman, 84; a Nelson County woman, 84; a Nelson County man, 81; a Pike County man, 65; and a Pulaski County woman, 68. 

In other pandemic news Wednesday:

• Counties with 10 or more new cases were Jefferson, 116; Fayette, 53; Oldham, 31; Montgomery, 25; Daviess, 21; Clark, 20; Boone, 17; Warren, 16; Jessamine and Kenton, 15; Franklin and Henderson, 13; Floyd, Laurel, McCracken, Shelby and Whitley, 12; Grayson and Madison, 11; Boyd, Letcher, Powell and Scott, 10.
• University of Kentucky Cooperative Extension Service offices are partnering with local, state and federal agencies to serve as host sites for coronavirus vaccine clinics, Katie Pratt reports for the College of Agriculture, Food and Environment.  The federally operated sites opened the last week of April at the Henderson and Laurel county extension offices. The walk-in clinics will be open for the next six to eight weeks, and between the two of them can administer 7,000 vaccines each week. The sites also serve as a base for mobile vaccination units. Pratt reports extension offices in Breckinridge, Washington, Owen, Boyle and Knox counties have worked with local hospitals, health departments and community partners to serve as vaccination sites for their communities.
• People may now get Covid-19 vaccines at most CVS pharmacies without an appointment, including 76 in Kentucky, Deborah Yetter reports for the Louisville Courier Journal. WDRB reports that Walmart and Sam's Club are also offering walk-up vaccine clinics at their pharmacies. 
• The University of Louisville continues to study the long-term effects of Covid-19 and welcomes anyone over 18 who has had the virus to participate, WDRB reports. The research will focus on heart and lung function.

UK starting to offer diabetes prevention program through local extension agents trained to deliver it; first one was successful

Downloadable chart explains diabetes prevention program used by University of Kentucky.

By Katie Pratt
University of Kentucky

The University of Kentucky is helping prediabetic Kentuckians prevent or delay developing type 2 diabetes through a collaboration between the UK Cooperative Extension Service and UK HealthCare’s Barnstable Brown Diabetes Center.

UK extension agents deliver the Centers for Disease Control and Prevention’s National Diabetes Prevention Program to people who have prediabetes or are at a high risk for developing type 2 diabetes.

Prediabetes and diabetes are big problems in Kentucky. According to the 2019 Kentucky Diabetes Report, 10 percent of Kentucky adults have been told by a medical professional that they have prediabetes, 12% have diabetes, and Kentucky has the nation's fourth highest mortality rate from it.

The prevention program teaches evidence-based ways to make lifestyle changes to eat healthier, increase physical activity and improve coping mechanisms. The program includes weekly meetings for the first six months with the goal of losing 5% to 7% of body weight. The second six months has fewer meetings, as the focus turns to keeping the weight off.

People who successfully complete the year-long program lower their risk of developing type 2 diabetes by more than 50%, research has shown.

The collaboration between Barnstable Brown and Extension began in Washington County, where it has been successful. Scott County is to be next.

In Washington County, 12 adult participants lost an average of 5.6% of body weight, and 75% met the weight-loss goals they set at the start of the program. Also, 100% of participants stayed in the program, and said they appreciated the information and the sharing of personal stories.

Zoom meetings allowed them to continue the sessions during the pandemic. It hit about halfway through the program, which began in September 2019.

Extension agent Cabrina Buckman

“The participants were so good about being flexible, and stuck with me,” said Cabrina Buckman, Washington County extension agent for family and consumer sciences, who led the program. “I tried to keep them engaged along the way by providing them with packets and newsletters. They enjoyed Zoom once they got the hang of it.”

Buckman added, “As a result of the program, individuals overcame certain nutrition-related obstacles including making healthier snack choices and buying less junk food for snacks. Participants shared they made healthy changes to their activity by walking, ordering walking sticks and being more active overall each day. Most importantly, participants shared that throughout the program they learned they were a work in progress and tried to have more patience with themselves.”

The Barnstable Brown center was already offering the Diabetes Prevention Program to patients on UK’s campus in Lexington.

“Partnering with Extension allows Barnstable Brown to increase our breadth and depth for DPP services across Kentucky,” said Laura Hieronymus, the center's associate director of education and quality services. “This collaboration shows that extension agents can successfully deliver this program.”

In order to present the program, extension agents are trained as program lifestyle coaches. This training is coordinated through Barnstable Brown. The agents also receive support from UK specialists in family and consumer sciences.

“This program is incredibly effective at helping people reduce their diabetes risks, so we are excited that our extension agents have the opportunity to be trained through Barnstable Brown to offer it,” said Heather Norman-Burgdolf, assistant extension professor for food and nutrition in the UK College of Agriculture, Food and Environment.

With first vaccinations expected Monday, but only the beginning of long rollout that will run well into summer, Beshear urges caution

A container with insulated boxes of vaccine is rolled into the UPS
Worldport in Louisville. (Photo provided by governor's office)

By Al Cross
Kentucky Health News

As the first shipments of coronavirus vaccine arrived in Kentucky, and the pandemic's advance remained steady, Gov. Andy Beshear again asked Kentuckians to "remain vigilant," said a press release from his office.

The state reported 2,454 new cases of the virus, more than 100 fewer than last Sunday, and its seven-day rolling average of new cases dropped to 3,228. During that time, the state saw 1,235 fewer cases than the previous week, and the share of Kentuckians testing positive continued to fall.

The current seven-day positivity rate is 8.52%, 1.23 percentage points below where it was last Sunday, 9.75%. That's a decrease of 12.6%. The rate, which Health Commissioner Steven Stack has called a "leading indicator" suggestive of future trends in cases, has declined for 10 consecutive days.

“We are seeing good trends and getting great news in our battle against Covid-19,” Beshear said in the release. “Now we are less than 24 hours from the true beginning of the end of this virus,” with the arrival of vaccine.

The first plane from the Pfizer Inc. plant in Michigan arrived at the United Parcel Service hub in Louisville at 12:06 p.m., reports Lucas Aulbach of the Courier Journal. The shipments are being sorted "and shipped out the same day to destinations across the eastern U.S.," he writes.

Beshear said in another news release that he expects the first Kentucky vaccinations Monday -- at 11 strategically selected hospitals that can maintain ultra-cold storage of the vaccine -- and nursing homes, where pharmacy chains CVS and Walgreens have federal contracts to vaccinate residents and staff.

One of the first boxes that arrived at the UPS Worldport was headed to a nearby hospital and another was going to an undisclosed Kentucky site, NBC reported.

Health Commissioner Steven Stack said in the release, “Early doses will be limited in supply and immunization will begin with nursing-home residents and frontline health-care workers. From there, as vaccine shipments continue, Kentucky will immunize all health-care (including oral-health) workers and first responders, followed by the K-12 education community, to get our children and educators safely back to school.”

Beshear said, “Our community doctors and nurses, as well as long-term care residents and staff, are preparing to do their part first. We will all get a turn. When it is your turn, I strongly encourage you to get vaccinated so you can do your part to protect yourself, your family and our entire state.”

Stack said the state is awaiting more guidance from federal officials on who will come next. He added, “Having vaccines this quickly is a modern medical miracle. Having patience in the months ahead is essential, though, as vaccine supplies increase and hopefully all interested persons have access to vaccination by the end of summer 2021.”

The 11 hospitals expected to get 12,675 doses of the vaccine are in Louisville, Paducah, Bowling Green, Madisonville, Pikeville, Corbin, Lexington and Edgewood. Another 25,350 are going to CVS and Walgreens for nursing homes.

The vaccine developed by Moderna, which does not require ultra-cold storage, is expected to get federal approval next week. Between the two, Kentucky could get 150,000 doses this month, Beshear said. Both require second doses, which will come in later shipments. 

"The immediate goal is reducing Covid-19 deaths," the release said. "With 66% of the deaths coming from long-term care facilities, vaccines could help significantly decrease Kentucky’s Covid-19 death toll beginning in January. Also, because long-term care residents tend to require the most care, vaccinations in these facilities will help reduce Covid-19’s burden on Kentucky’s health-care system."

Sunday's 15 Covid-19 fatalities, which raised the state's toll to 2,207, were a 75-year-old Bell County woman; two women, 65 and 58, from Boone County; an Caldwell County man, 85; two Daviess County women, 65 and 74; a woman, 82, and a man, 79, from Hopkins County; a Jefferson County man, 83; a Kenton County man, 85; a Lawrence County woman, 58; an Oldham County man, 56; two Pulaski County women, 89 and 50; and a Taylor County man, 76. 

In other coronavirus news Sunday:

• Counties with 10 or more new cases were: Jefferson, 446; Fayette, 165; Boone, 115; Pulaski, 111; Kenton, 106; Mercer, 79; Hardin, 75; McCracken, 61; Harlan, 52; Campbell, 48; Boyle, 44; Bullitt, 39; Warren, 39; Russell, 36; Carter, 34; Laurel, 33; Daviess, 32; Taylor, 30; Whitley, 30; Boyd, 29; Scott, 29; Jessamine,  27; McCreary, 26; Franklin, 24; Madison, 23; Letcher, 22; Bell, 21; Christian, Greenup, Lincoln and Wayne, 19; Grant and Perry, 18; Adair, Henderson, Nelson and Oldham, 17; Breckinridge and Pike, 16; Calloway, Floyd, Shelby and Spencer, 15; Meade and Trimble, 14; Casey, Graves and Harrison, 13; Bracken, Grayson and Green, 11; and Allen, Estill, Logan and Monroe, 10.
• Hospitalizations for Covid-19 remained steady, at 1,712, with 434 of them in intensive care and 224 of those on ventilators. The share of intensive-care patients on ventilators is 52%, which is the average for the past month. 
• The Centers for Disease Control and Prevention approved the Pfizer vaccine for use in 16- and 17-year-olds. The Food and Drug Administration approval Friday was for adults.
• Extension volunteers in northeastern Kentucky made 250 surgical gowns for employees at Primary Plus, which has 10 clinics in the region and was having difficulty getting protective gear to do coronavirus testing, Katie Pratt reports for the University of Kentucky.
• "A bipartisan group of senators is expected to introduce a $908 billion coronavirus relief bill as soon as Monday, with a twist: The deal is expected to be split into two pieces," Politico reports, citing "two people familiar with the negotiations. One would be a $748 billion piece of coronavirus relief with less controversial items like schools and health care; the other would marry $160 billion in money for local governments with a temporary liability shield. Those two components have been the toughest part of the negotiation so far, and Senate Majority Leader Mitch McConnell has suggested dropping them and concentrating on the less divisive areas. McConnell had long called a liability shield from coronavirus legislation his 'red line,' while congressional Democrats say the money for states and cities is their top priority. Some Republicans from states with hard-hit budgets like Sen. Bill Cassidy (R-La.) also are pushing for local aid, but many conservatives don’t want to send money to states. Splitting the bill could make it more likely that a relief package can be finalized before Congress leaves for the holidays — something deemed essential with 12 million Americans set to lose unemployment benefits in the coming weeks."

45 share recovery stories in Addiction Recovery Week in Wolfe County, nation's most vulnerable to disease outbreaks from drugs

Tinley Creech, Darian Creech, Connie Campbell and Ashton Burks pose after doing the virtual 5K as part of Wolfe County Addiction Recovery Week. All are in the same household. (Photo provided)

By Katie Pratt
University of Kentucky

Recovering from drug addiction can take many years with many bumps in the road along the way, as Wolfe County resident Dena Brooks can attest. Brooks has been in recovery for nearly six years. Today, she stays busy raising her daughter and working as the director of the Wolfe County senior citizens center.

“My life is finally where it should be now,” she said. “I have a new home, a new job and am very involved with the community.”

But getting to this point in her life was not easy. For years, Brooks used pills and then progressed to meth. She went to federal prison for nine months on a drug conviction. After her release, she sought help at a drug treatment center so she could regain custody of her daughter. After leaving the center, she stayed sober for three years before she relapsed. She was arrested on another federal drug charge but has since had her conviction overturned. Since then, she has been determined to stay sober.

“Drugs do not discriminate,” she said. “If my story can help one person, it is worth telling.”

Brooks was one of 45 Wolfe County residents who shared their drug recovery stories as part of Wolfe County’s Addiction Recovery Week, organized by the Wolfe County office of the University of Kentucky Cooperative Extension Service, Wolfe County Schools Family Resource and Youth Services Center and the Agency for Substance Abuse Policy.

During the week, the organizations hosted in-person and virtual events to celebrate those in their community who are recovering from drug addiction and to provide them with resources to support their continued sobriety.

“It was such a positive thing to see somebody finally caring about recovery and praising people who are in recovery,” Brooks said. “No one has done anything like this for Wolfe County before.”

Wolfe County (Wikipedia map)

Wolfe County is consistently one of the state’s poorest counties and faces many drug-related issues with little resources. It leads the nation for the vulnerability of its population to an outbreak of HIV or Hepatitis C because of the opioid epidemic and a lack of a local syringe exchange. In 2018, it had one of the state's highest per-capita rates for drug arrests.

Alyssa Cox, family and consumer sciences extension agent, had been working with her extension colleagues Heather Graham and Jessica Morris and community partners to create the recovery week prior to the pandemic. While the pandemic changed how they delivered their programming, it did not change the week’s focus.

“The goal of this week was to bring awareness to the challenges of addiction recovery and to rally behind our local residents who fight this battle every day,” Cox said.

One of the week's highlights was the opportunity for people in recovery to share their stories and personal photos during a Facebook Live event. As their stories were told, Morris, the county’s 4-H youth development agent, lit a sparkler in their honor.

“Often, you hear about the drug busts or people saying, ‘That’s just another drughead.’ It is so nice for extension to show us that they care and brag on us,” said Tosha Turner, who also shared her recovery story during the event. “It really means a lot.”

Turner has been in recovery for four years. She was addicted to pills and meth. Her drug addiction led her to robbery. She sought treatment after going to jail for her first felony.

“I was as bad as they come, because I didn’t care about anyone or anything when I was on drugs,” Turner said. “If I can recover, anyone can do it.”

She said her daughters are the reason she stays in recovery. Since she has been in recovery, she has worked and saved money to purchase a car. She is now going back to school to become a nurse.

In addition to sharing local recovery stories, extension and its community partners offered socially distant yoga in the park. Individuals in recovery received vouchers for 10 free yoga sessions, thanks to the Agency for Substance Abuse Policy. Each participant also received a free yoga mat.

Graham, who is Wolfe County’s extension agent for agriculture and natural resources, spearheaded a countywide road cleanup in which participants received a cleaning kit and could clean any road in the county they chose.

The extension office also hosted a Recovery Run, which was a virtual 5K that individuals could participate in to honor someone in recovering from addiction. Race participants received a free T-shirt and resources related to substance use and addiction that they picked up through an extension drive-thru event. The Agency for Substance Abuse Policy also offered a free, drive-thru Narcan training for anyone interested.

Cox said due to the success of the week, extension plans to host the event again in 2021.

Study shows nutrition education for low-income people in eight Southeast states resulted in healthier diets and better budgeting

By Melissa Patrick

Kentucky Health News

A little education goes a long way when it comes to helping people with limited budgets eat healthier and not run out of food before the end of the month. 

For a larger version of the chart, click on it.

So says a study by the Public Health Institute's Center for Wellness and Nutrition, published in the Journal of Nutritional Science.

It found that residents with low incomes in eight Southeastern states, including Kentucky, "consumed significantly greater amounts of fruits and vegetables, and improved several other shopping and nutrition-related behaviors" after they participated in the U.S. Department of Agriculture's SNAP-Ed program. SNAP is the Supplemental Nutrition Assistance Program, formerly known as food stamps.

“Healthy foods can be expensive, and a SNAP budget is modest. But SNAP-Ed is helping low-income Americans in the Southeast make strategic choices that stretch their food dollars and empower them to choose more fruits and vegetables and other healthy foods,” Amy DeLisio, the center's director and co-author of the study, said in a news release.

“In the long run,” DeLisio said, “these changes can play an important role in reducing their likelihood of diabetes, hypertension and other nutrition-related diseases, and in reducing health-care costs across the region.” 

SNAP-Ed provides comprehensive nutrition education and obesity-prevention interventions for individuals and families whose incomes are below 185% of the federal poverty line. Participants are not required to get SNAP benefits. 

Using 2017 data from 25 participating agencies in the Southeast, including surveys from more than 43,000 low-income children and adults before and after SNAP-Ed interventions, the study found people were more likely to meet USDA nutrition recommendations and manage their food resources better after participating in the program.   

On average, the study found low-income participants increased their daily consumption of fruit by 1/3 cup; increased their daily consumption of vegetables by 1/4 cup; drank more water and less sugar-sweetened drinks, and were more likely to drink low-fat or nonfat milk.

They were also likelier to choose healthier foods on a budget; read nutrition labels or ingredient lists; compare prices before purchasing foods; identify foods on sale or use coupons; use a list while shopping; and not run out of food before the month's end.

The report notes that in a region that experiences some of the highest rates of obesity and unhealthy dietary behaviors in the nation, "our study shows that SNAP-Ed programs can be part of the solution."

The study also documented 701 policy, systems and environment supports that complement the SNAP-Ed programs in the region, including things like creating edible gardens and improving food displays in school cafeterias. 

What about Kentucky?

In Kentucky, the Nutrition Education Program encompasses two separate USDA programs, SNAP-Ed and the Expanded Food and Nutrition Education Program. The programs are offered in each of the state's 120 counties and are run by extension agents or one of the 96 NEP assistants. 

NEP director Marisa Aull said the program is designed to provide its clients with life skills to promote a healthier lifestyle and to make the healthiest choice the easiest choice. 

"A lot of times it is simply lack of knowledge," Aull said. "Our program really does focus on bringing education to the individual so that they, along with their family, can make those choices and be healthier."

Omolola Adedokun, senior Extension specialist for evaluation, explained, "With education on how to spend the money, by using coupons, by being able to follow what's on sale, what's not on sale, and by budgeting for food, that by looking at cheaper options, like frozen vegetables, or canned vegetables, people will be able to eat healthier and in alignment with USDA guidelines."

Aull said the program is especially important in Kentucky, a state known for its high obesity rates and poor health.

According to America's Health Rankings, Kentucky is one of the worst states for adult obesity, with 36.6% of its adults obese. Thirty-eight percent of the state's children are either obese or overweight, the second highest in the nation, according to the 2020 Kids Count report.

Kentucky also ranks among the 10 worst for heart disease and diabetes, and is No. 1 in cancer deaths -- all conditions that could improve with better nutrition and exercise practices.

The study did not provide any state-specific data, but the 2019 NEP report says 97% of Kentucky's adult participants showed improvement in one or more diet quality indicator, like eating more fruits or vegetables, drinking less sugared soda and cooking dinner at home; 84% increased their physical activity; 92% showed safer food storage and prep; and 91% showed better food resource management. 

Kentucky had more than 4,500 participants in the SNAP-Ed program, said Adedokun. 

As for youth, after participating in the "Super Star Chef" program, which was offered in 53 counties, 99.6% of the state's 789 youth participants reported they could identify healthy foods; 96% said they planned to drink more water every day; and 95% said they planned to try new foods. The report says the two programs had 368,584 children and youth contacts. 

Aull said young people are an important part of the program because they often share their excitement for what they've learned with their families, inspiring them to eat healthier. 

"We often hear anecdotally, that they convince their family to try a new food or they convince their family to go to the farmers market where the family previously was maybe hesitant to go. . . .  The key to the family is often through youth," she said. 

Aull stressed that each of these small changes are important because they could have a lifelong impact, and not just for the individual but society at large.

"If we look at it from a kind of return-on-investment side, it has an effect on generational poverty, it has an effect on their health and well-being, and it also has an effect on those local health care systems," Aull said. "Those small changes lead to big impacts for not just our state as a whole but . . . their community, their city, their family. And we feel like those changes will also break a lot of cycles that need to be broken, that really are just due to lack of resources and lack of opportunity."

Aull encouraged qualifying Kentuckians to participate in the free nutrition-education programs, which are being held virtually during the coronavirus pandemic. 

Denise Rennekamp, assistant NEP director, spoke to the importance of community partnerships to promote the program. For example, she said Feeding Kentucky and other food banks help connect food-insecure Kentuckians with their program. 

The number of Kentuckians on SNAP varies from month to month, with participation increasing since the pandemic came to Kentucky in March. In August, 606,216 Kentuckians received SNAP benefits. 

Click on the Plan, Eat, Move website to learn more about the program. Below is a video that tells more about the program.

Tick that can clone itself is found on cattle in Southern Ky. and wildlife in Eastern Ky.; it's also a threat to pets, and hard to identify

Asian longhorned tick (Photo by Anna Pasternak, UK)

By Katie Pratt
University of Kentucky College of Agriculture, Food and Environment

The Asian longhorned tick, which preys on a variety of hosts including humans and wild and domestic animals, has been found in Kentucky. This new tick is known to attack animals in large numbers and will be a concern to livestock producers, wildlife enthusiasts and pet owners.

“This tick is an aggressive biter and frequently builds intense infestations on domestic hosts that can cause stress, reduced growth and severe blood loss,” said Jonathan Larson, UK extension entomologist. “One reason for their rapid buildup is that the female ticks can lay eggs without mating. It only takes a single fed female tick to create a population of ticks. Potentially, thousands can be found on an animal.”

The tick has been found in small numbers on elk in Martin County and black bear in Floyd County. It was found in large numbers on a bull in Metcalfe County in the south-central part of the state.

“The Metcalfe County ticks were submitted by a veterinarian who answered a call about a bull so infested that it was showing signs of severe fatigue,” said Anna Pasternak, UK entomology graduate student who manages the Kentucky Tick Surveillance Program. Pasternak and Monica Cipriani, a student in the UK College of Public Health, sampled the Metcalfe County field and found more Asian longhorned ticks.

Metcalfe County (Wikipedia map)

“The Metcalfe County finding is particularly troubling,” Pasternak said. “It means the tick may have already spread farther across the state.”

The tick was found in the U.S. in 2017. It has also been confirmed in Arkansas, Tennessee, the Carolinas, West Virginia, Pennsylvania, Maryland, Delaware, New Jersey, New York and Connecticut.

In addition to wildlife, the asian longhorned tick preys on cats, dogs, horses and chickens. Humans also are a host. It is a known or suspected vector of several important livestock viral, bacterial and protozoan agents. Scientists are conducting tests on ticks collected in the United States, and it is likely that some ticks will contain germs that can be harmful to animals. 

The tick is hard to identify because it has no distinctive markings and unfed adults are smaller than other common adult ticks in Kentucky.

If you find an unusually large number of ticks on a pet or livestock, contact a veterinarian. If you think a tick might be an Asian longhorned tick, work with your county extension agent for agriculture and natural resources to submit the sample to UK entomologists for positive identification.

Ticks are a bigger problem than they once were, Kentucky Health News reported recently. UK has information on tick-bite prevention and removal at https://entomology.ca.uky.edu/ef618 and at county offices of the Cooperative Extension Service.

Grant will help UK Cooperative Extension Service expand opioid prevention and recovery efforts

The University of Kentucky Cooperative Extension Service has received a two-year grant to further its statewide efforts in opioid prevention and recovery, Katie Pratt reports for UK.

The more than $1 million grant from the Substance Abuse and Mental Health Services Administration will allow the program to expand its efforts to Southern and Western Kentucky.

As part of the grant, the program will offer an Addiction 101 course to discuss the science behind addiction, including genetic and hereditary risk factors for developing addiction disorder. Pratt reports that the course will be geared toward health-care workers, extension agents and community leaders and will be led by Alex Elswick, UK extension specialist for substance use prevention and recovery.

“We want to remove the stigmas associated with addiction, so health care workers and community members feel more comfortable and equipped to help those struggling with opioid use addiction and recovery,” Elswick told Pratt.

Other grant programs will include administering an evidence-based substance abuse program for middle-school students, called Botvin LifeSkills Training and an art program to provide individuals with a therapeutic outlet to express their feelings related to substance use and addiction, she writes.

In addition, Pratt reports that the extension program will be expanding its financial-education curriculum that specifically addresses money issues faced by those in recovery. The program, called "Recovering your Finances," was developed by Elswick and Kelly May, a UK senior extension associate. It is  being piloted in Mercer County and will be offered in Boyd, Bourbon, Knox and Leslie counties through a separate grant from the U.S. Department of Agriculture.

Pratt notes that many of these programs grant will build on the extension service’s existing programs to reduce opioid use and help recovery efforts, including efforts to teach gardening, nutrition and life skills to those in recovery, and support programs for families with a loved one with a substance-use disorder. Extension will also continue to offer support to local community health coalitions that address substance-use prevention and recovery, Pratt reports.

“The Kentucky Cooperative Extension Service is currently recognized as a leader among the land-grant university system for outreach efforts targeting substance use prevention and recovery,” Jennifer Hunter, assistant director for family and consumer sciences extension and one of the co-leaders on the grant, told Pratt.  “We are excited to be able to continue to expand our educational efforts and enhance the level of resources available at the community level.”

UK Extension Service teaches life skills such as nutrition in drug-treatment facilities; 10 counties have grants for gardens

By Katie Pratt
University of Kentucky

CAMPBELLSVILLE, Ky. -- Program assistants and agents with the University of Kentucky's Cooperative Extension Service are teaching life skills to help individuals recovering from drug and alcohol addiction live healthier lives once they leave treatment facilities.

In January, the UK College of Agriculture, Food and Environment hired recovering heroin addict and doctoral student Alex Elswick as extension specialist for substance-use prevention and recovery. He has started a program with agents in three counties; two other programs with agents in four other counties are to start next month. Elswick is co-founder of the UK Collegiate Recovery Community.

In Taylor County, program assistant Angie Freeman offers nutrition-education programs to clients at The Healing Place, an addiction recovery center in Campbellsville. She has led programs at the all-male treatment facility since 2013, presenting topics such as meal planning, MyPlate, food budgeting and food safety.

The education programs are funded by the federal Supplemental Nutrition Assistance Program, which includes what were once known as food stamps. This part of the program is known as "SNAP-Ed."

“Our eight-week class series is geared toward trying to have a healthy family and a healthy lifestyle on an economical level,” Freeman said. “Hopefully, they will take the things we have talked about and go home and actually meal plan using the weekly grocery ads, so they can make a really good shopping list and eat on a more economical basis.”

Freeman discusses ways clients and families can eat healthier.
(Photo by Steve Patton, UK Agricultural Communications)

The Healing Place staff report that the eight-week class greatly helped participants, so they now require all of their clients to complete the class before leaving the treatment facility.

Steve Croghan of Columbia has been a client at the center for six months, recovering from an addiction to suboxone and methamphetamine. When interviewed, he was days away from graduating from the program's first phase. He said Freeman’s class gave him information that will help him as he moves forward with his life.

“Angie and Kara have been tremendously helpful for us,” he said. “Angie actually takes the time with us to make us understand what is going on and gives us a lot of good nutritional values. It helps us live out there healthier.”

In addition to nutrition education, Freeman’s class tends a small, raised-bed garden on the property. Taylor is one of 10 counties that have grants from SNAP-Ed to install and help manage gardens at addiction recovery centers. 

Extension agents and program assistants in Jefferson, Pendleton, Daviess, Martin, Lawrence, Pulaski, Boyd and Madison counties have received funding to partner with local addiction recovery centers to install gardens at the facilities.

Christopher Browning is a Healing Place client from New Haven, recovering from a heroin addiction. Even though he was raised in rural Kentucky, he said the gardening classes have been eye-opening. He enjoys tending the garden.

“It’s something different to do in a place like this,” he said. “It makes us not so sheltered in. We get to get out and do some things that we might enjoy doing on the outside.”

The Healing Place started out with one raised-bed garden in 2018, with their clients raising cool- and warm-season salad ingredients. They added another bed this year and plan to add another in 2020.

“I really hope they gain basic knowledge about how to grow their own fruits and vegetables,” Back said. “Some of them have never really done this before, and it’s just a way for them to see it firsthand. Maybe later on down the road in their life, they may be interested in growing some on their own.” 

Recently, 17 men graduated from Freeman’s series of classes. Two of them were Croghan and Browning, who were excited about their accomplishment.

“It’s nice to actually complete something,” Browning said. “I have not done so well with that the last few years of my life, but I have actually had the patience and the time to do something productive.”

UK nurse creates Farm Dinner Theater as a way to remind farmers of safe practices; has some unexpected benefits

Deborah Reed (UK photo by
Mark Cornelison)

A University of Kentucky nursing professor has come up with a novel way to remind farmers about farm safety: dinner theater.

At Farm Dinner Theater, farmers watch each other perform funny skits with a serious message. At a recent show at the Lincoln County Extension Office in Stanford, Thelma Blair asked her husband Jack if he remembered to wear ear plugs before working on his loud farm machinery. The audience laughed as Jack yelled, "WHAT?" in response. "While they delight in Jack's feigned deafness, it serves as a reminder to use ear protection when working with machines, Hilary Brown reports for UK Now. The Blairs are respected farmers in their community, and were excited to participate in the program when their extension agent asked.

The skits may fill a need because health and safety standards don't apply to small family farms. Lectures aren't effective, and pamphlets are easy to ignore, so Reed, who grew up on a nearby farm, wanted to find another way to help farmers recognize farming hazards and practice safety measures, Brown reports.

"Based on our research, we found that farmers learned best from watching each other and stories based on real situations," Reed told Brown. "They like humor. From observing farmers and how they choose their work behavior we know they learn from an apprentice model where role modeling is so important." And a free dinner doesn't hurt.

Reed says the program has helped in ways she didn't expect, such as "how the farmers would come together and work out issues among themselves," Brown reports. "At one event, a farmer mentioned how his father, who was grappling with Alzheimer's, kept trying to get the keys to the family tractor. Their solution was to move the tractor out sight. Once they did that, he stopped trying to drive it."

Another unexpected benefit: Attendees say the program has helped relieve their stress. Farmers are under a lot of stress these days because of bad weather, the trade war, low crop prices and more, and depression and suicide among farmers has increased greatly in recent years. Farm Dinner Theater "gives farmers the opportunity to come together, discuss their situations, and to support each other," Reed told Brown. "Non-farm people in the community come to these events and have a better understanding of the stressors that farmers face and can support them better."

Brown reports, "The results of these events have been remarkable. Fifty percent of the farmers who attended reported to have incorporated changes in their habits and on their farms within two weeks. Sixty percent made changes within two months. The program was so successful, Reed, who has won numerous awards for the program and was named by Oprah Magazine as "One of Five Nurses Who Might Just Save the World", was appointed UK's first agricultural nurse, the first at a land-grant university. Her position is funded by UK's College of Agriculture, Food and Environment, and marks the beginning of a unique partnership" with the College of Nursing.

The project is funded with a grant from the National Institute for Occupational Safety and Health.

Boyd County extension agents teach children healthy living

By Katie Pratt and Jeff Franklin
University of Kentucky College of Agriculture, Food and Environment

Young children in Boyd County are learning healthy habits thanks to programming efforts by the University of Kentucky Cooperative Extension Service that include planting their own vegetables.

Susan Grimmett, program assistant for Supplemental Nutrition Assistance Program education, has worked with 300 students at four schools within the county to teach them about the importance of nutrition and physical activity within the school year. To do so, she used Organ Annie and other characters from The OrganWise Guys, a program initiated by two doctors to spread awareness about the importance of a healthy lifestyle to battle childhood obesity. Grimmett has used the program with Boyd County preschool through second-grade students for the past three years as students and teachers continue to request it.

“The students have enjoyed it, and they have learned a lot,” said Kelly Smallwood, a preschool teacher at the Early Childhood Learning Center-North in Ashland. “Every time Susan comes, she has something for them, and they enjoy that also.”

For one of the program’s culminating events this school year, Grimmett collaborated with Lori Bowling, Boyd County horticulture extension agent, to help the children grow their own pots of leaf lettuce. They chose lettuce, because the students could very quickly see growth. After the lettuce sprouts in the classroom, the children will take their pots home with the goal of sharing the message of nutrition and healthy eating with their families, many of which have limited resources and low incomes. The ultimate goal is for the children to harvest the lettuce and work with their parents to incorporate it into a family meal.

“If we teach them at this age about what’s healthy and the kind of diet they should be eating, hopefully as they progress through school, they will make wiser food choices and have a healthier lifestyle,” Bowling said. “We also want them and their parents to understand that you can grow your own food, regardless of where you live, as long as you have a container, seeds, sunlight and water.”

Even though their pots of lettuce are still small, Grimmett has heard many of the children are excited about growing the produce as some teachers have already received positive emails from parents about the project.

“They are eating healthier, and their parents are getting involved more and buying healthier foods at their children’s request,” Grimmett said.

Seven counties in Southern Kentucky stand out as 'Bright Spots' in study, pointing the way to healthier communities

By Melissa Patrick
Kentucky Health News

Nine counties in Appalachian Kentucky have been recognized as "bright spots" when it comes to health, and seven of them adjoin in Southern Kentucky: Green, Adair, Russell, Wayne, McCreary, Pulaski and Lincoln. The other two counties were Lewis and Morgan.

"The Bright Spots project offers hope and a path forward to a healthier Appalachian Kentucky," Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, said in a news release. "Congratulations to the hardworking leaders in the nine Kentucky counties that have formed strong, cross-sector coalitions to address pressing health issues in their communities."

The study, which looked for Appalachian counties that had better than expected health outcomes given their resources, analyzed 19 health indicators in each of the 420 Appalachian counties and identified 42 as Bright Spots.

The goal of the research was to to identify successful activities, programs and policies that other struggling communities could replicate. A report is scheduled to be released later this year to identify them. The study was sponsored by the foundation, the Appalachian Regional Commission and the Robert Wood Johnson Foundation.

All the adjoining Bright Spots counties except Lincoln are served by the Lake Cumberland District Health Department. Its health education director, Tracy Aaron, told Kentucky Health News that improving the district's health has been a group effort, and each county has a health coalition made up of numerous organizations, agencies and individuals that meets monthly to choose what health issues they want to address and to then create plans to work on them.

"Our communities are rural and have limited resources, so we all work together to identify and leverage resources," she said in an e-mail. "Many times we may facilitate the discussion around health and improving the health of the community, but we are very fortunate to have dedicated organizations and individuals [working with us] as we continue to improve the health of people that live in Lake Cumberland."

McCreary and Wayne counties were part of a 10-county case study that took a deeper dive into what they were doing to improve the heath of their citizens, despite their many challenges. Both of these counties were named "Healthy Kentucky Policy Champions" by the foundation, citing the stuidies.

"What's happening in Wayne and McCreary counties is changing our understanding of what is possible for health in these and other Appalachian counties," Chandler said in the release announcing the awards. "They show us that there's always somewhere to start when working to improve health, and that dedicated individuals volunteering and working together with a few focused community leaders can change health outcomes for the better."

The report says Wayne County was one of three in the 10 case studies that stood out "for both the range of outcomes that were better than expected and the extent to which the outcomes exceeded expectations." The county performed better than expected on 16 of the 19 measured health outcomes, falling short in the areas of obesity, physically bad days and opioid prescriptions.

Cover page of report section on Wayne County

The Wayne County Health Department, part of the district health department, and the local office of the Cooperative Extension Service play "critical roles in improving community health," the report said.

It noted the department's program to increase access to healthy, local foods; its diabetes education work; and its strong HANDS (Health Access Nurturing Development Services) program, a voluntary home-visitation program for new and expectant parents, which the researchers say could be partly responsible for lower-than-expected rates of infant mortality and low birth weight.

"Wayne County’s strong community partnerships and social connections, integration of health services, and focus on healthy foods, are likely contributing to the better-than-expected health outcomes," the report says.

The county performed 36 percent better than expected for poisoning deaths, including drug overdoses; 34 percent better than expected for stroke deaths, 30 percent better than expected for heart disease hospitalization; 26 percent better than expected for the percentage of Medicare patients with depression; and 25 percent better than expected for years of potential life lost.

For example, the study found that 35.2 people per 100,000 in Wayne County actually died from a stroke, but when using a statistical model that factored in barriers to good health, the predicted stroke-death rate was 53.7 per 100,000. (The county's population is about 21,000.)

Cover page of report section on McCreary County

McCreary County, which has about 18,000 people, performed better than expected on 14 of the 19 measured health outcomes. It fell short in mentally bad days, suicide, diabetes, physically bad days and opioid prescriptions.

The report says the county has strong local volunteer organizations and emergency medical services, and a library that connects residents to health and social services.

Researchers found that the county performed 40 percent better than expected for injury deaths, 37 percent better than expected for stroke deaths; 34 percent better than expected for poisoning deaths; 19 percent better than expected for percentage of Medicare enrollees with depression; and 15 percent better than expected for years of potential life lost.

The report adds that local practices contributing to the overall health in McCreary County include intra-county cooperation and resource sharing, sustainable, community-focused nonprofit organizations, a strong integration of health services and systems, a shared value for health in the community and community engagement and dedicated local leaders.

Among other things, the report notes a strong health education program run by the district health department, which gives school-age children information on reproductive health, tobacco-use cessation and risky-behavior prevention. It also provides a health consultant for children and supports preventive initiatives like farmers' markets and smoke-free restaurants.

Among the other four Lake Cumberland counties named Bright Spots:

• Adair was 41 percent better than expected for poisoning and overdose deaths; 36 percent better than expected for unintentional injury deaths; and 26 percent better than expected for deaths from chronic obstructive pulmonary disease.
• Green scored 34 percent better than expected for poisoning and overdose deaths, and 31 percent better than expected for both years of potential life lost and opioid prescriptions as a percentage of Part D Medicare claims.
• Russell was 36 percent better than expected for heart-disease hospitalizations; 33 percent better than expected for opioid prescriptions as a percentage of Part D Medicare claims; and 18 percent better than expected for diabetes.
• Pulaski scored 39 percent better than expected for poisoning and overdose deaths; 26 percent better than expected for unintentional injury deaths; and 20 percent better than expected for stroke deaths.

The researchers report that while the counties in the case studies offered individual approaches to address their local health challenges, there were common themes, including: community leaders engagement, cross-sector collaborations, resource sharing, a commitment from local health care providers, active faith communities and grassroots initiatives to combat substance abuse.

In addition to a community of people with a shared value for health, the report says the Bright Spot communities also benefited from "anchor institutions," like schools, businesses, churches and hospitals that worked together to improve the health of their communities.

"The Bright Spots research is a roadmap for struggling Appalachian communities, showing how building strong coalitions and focusing resources in particular on reducing teen births and smoking, increasing physical activity and treating and preventing substance abuse can have an outsized impact on improving local health," Chandler said. "It also is a call to action for policy makers, funders and advocates to support laws and programs that are proven effective in addressing these issues."

The 10 case studies are at https://www.healthy-ky.org/res/images/resources/BrightSpotsCaseStudiesJuly2018.pdf. Data for all 420 Appalachian counties are at https://www.arc.gov/research/researchreportdetails.asp?REPORT_ID=144. The data can be mapped at https://healthinappalachia.org/.

This is the second report in the "Creating a Culture of Health in Appalachia: Disparities and Bright Spots" research initiative. The first report focused on health disparities in the region.

UK's Doug Scutchfield, international leader in public health, accepts Libraries Medallion for Intellectual Achievement

F. Douglas Scutchfield, M.D.

In what he called "a coda to my academic career," Dr. F. Douglas Scutchfield accepted the University of Kentucky Libraries Medallion for Intellectual Achievement Tuesday night.

Scutchfield, who retired as a UK professor in January but remains active in teaching, research and mentoring, has been an international leader in public health. He was founding director of UK's School of Public Health, now a college, and the UK Center for Health Services Research and Management. He has been chair of the Health Services Department and Preventive Medicine Department, and is a past associate dean of the College of Medicine. He was the first Peter P. Bosomworth Professor of Health Services Research and Policy.

UK President Eli Capilouto said in presenting the award that he greatly appreciated Scutchfield's willingness to teach undergraduate courses, something most professors with his portfolio don't do.

Scutchfield told the audience at the Libraries Spring Gala, "Many of my new ideas have formed as I work to prepare a presentation for students or listen to their consideration of a research topic for a thesis or dissertation." He also had some advice for his friend Capilouto and other university administrators about the need to help different academic disciplines work together to solve problems.

"The contemporary U.S. management model of the university as a business, with organizational hierarchies and operating divisions, colleges and departments, may not be the most effective organizational mechanism for addressing the creation of new and more effective ways of dealing with the problems that we should be attempting to address," he said. "If we are to best address our mission of the scholarship of integration, then we must find ways to encourage and support critical examination of new mental models and paradigms at the intersection of the academic disciplines we represent. We cannot work in silos; they must be bridged!"

As an example, Scutchfield cited the "socio-ecologic determinants of health," such as "education, jobs, socio-economic status, racial equity, housing and the built environment." He said the disciplines around those topics have "little interaction that focuses on the larger set of mental models and new paradigms to be derived from interaction about social determinants" of health.

Scutchfield said UK has "two potential illustrations of this potential," a new building where research will focus on health disparities, especially in Appalachia, and a possible planning grant from a foundation that, "if funded, leads to something bold to enhance the role of Extension in advancing health."

Born in Wheelwright, Scutchfield earned his bachelor’s degree from Eastern Kentucky University and his medical degree from UK. Following practice in Morehead, and in conjunction with that work, he began his career at UK as a field professor of community medicine. He was the first chair of the Department of Family and Community Medicine at the University of Alabama, then an associate dean of the College of Community Health Sciences. Later he became founding director of the Graduate School of Public Health at San Diego State University and held faculty appointments at the University of California campuses in Irvine and San Diego, a UK news release said.

He was certified by the American Board of Preventive Medicine in 1974 and the American Board of Family Practice from 1971 to 1985. He was a charter diplomat of the latter organization and is a fellow of both. He is a fellow of the American College of Preventive Medicine, served as a regent and president, and won the college’s Distinguished Service Award and Special Recognition Award. He has served as a member of the board and as president of the Association of Teachers of Preventive Medicine, which gave him its highest recognition, the Duncan Clark Award.

Scutchfield is a member of the Public Health Accreditation Board and serves as chair of its Accreditation Committee. The board accredits local and state health departments, and Kentucky has been a leader in getting its departments accredited.He  served as a secretary-treasurer of the Association of Schools of Public Health, a member of the Secretary of Health and Human Services Health Promotion and Disease Prevention Council, and a board member of the Public Health Foundation, which presented him with the Theodore R. Ervin Award. He In 2004, he received the Balderson Lifetime Achievement Award of the National Public Health Leadership Network.

Scutchfield was a member of the American Medical Association House of Delegates and served as chair of the AMA Section Council of Preventive Medicine on several occasions. He was elected to membership in the AMA’s Council on Medical Education, and served as its vice chair and member of its executive committee. He represented the AMA as a member of the Accreditation Council on Graduate Medical Education, the Liaison Committee on Specialty Boards, the American Board of Medical Specialties and the Committee on Allied Health Education and Accreditation. He received AMA’s Dr. William Beaumont Award as its outstanding young physician in 1985 and its Distinguished Service Award, the highest recognition of a physician, in 2003.

A skilled editor, Scutchfield has served as editor of the American Journal of Preventive Medicine and is a member of the editorial board of the American Journal of Public Health. He also served as the editor of California Medicine and the San Diego Physician, both of which won awards during his tenure as editor. He served as editor of Appalachia Medicine and a member of the editorial board of the Journal of Community Health. He is the author of numerous textbooks, text chapters and published articles in referred journals. His avocational interest in Thomas Merton resulted in a book he co-authored with Paul Evans Holbrook Jr., The Letters of Thomas Merton and Victor and Carolyn Hammer: Ad Majorem Dei Gloriam, published by the University Press of Kentucky in 2015.

Scutchfield said his interest in Merton and the humanities reflect a part of his philosophy of being a physican. "I am a firm believer in the importance of humanity to those of us in the health professions," he said. "We do not treat a disease, we treat a person, thus we must know the humanness of the individual in front of us, as well as the diagnosis and treatment of their disease." He said student in the health professions "lack adequate exposure to the humanities in their science filled schedules."

Scutchfield has an international reputation and has been a consultant to government and non-governmental organizations in Panama, China, Saudi Arabia, Israel and Germany, as well as the U.S. But he never forgot Wheelwright, once one of Kentucky's biggest coal towns. “As a scholar, teacher, mentor, administrator and public health advocate, he has never forgotten his Floyd County roots even as he became internationally recognized and honored,” Dean of Libraries Terry Birdwhistell said.

The UK Libraries Medallion for Intellectual Achievement, created in 1990, recognizes Kentuckians who have made contributions of lasting value to the Commonwealth, and promotes education and creative thought. Past recipients include authors Wendell Berry, James Still, Bobbie Ann Mason, John Egerton and Guy Davenport; historians George C. Herring, Thomas D. Clark, George Wright and James C. Klotter; journalist Al Smith; and UK geographer Karl Raitz.

UPDATE: Al Smith praises Scutchfield in an op-ed for the Lexington Herald-Leader.

Lora Lee Howard, UK Cooperative Extension agent in Clay County, gets national award for her work in nutrition and health

Lora Lee Howard
photo: Matt Barton

Lora Lee Howard, a University of Kentucky Cooperative Extension agent in Clay County, has received the 2015 Family and Consumer Sciences Professional of the Year award, Aimee Nielson reports for UK.

Howard received her award Nov. 5 at the National Extension Association for Family and Consumer Sciences annual meeting in West Virginia. The award "recognizes individuals who have demonstrated successful interdisciplinary teamwork and partnerships across program areas for program excellence throughout a significant part of their extension career," Nielson writes.

“I was very humbled to receive this honor,” she told Nielson. “I share this award with the businesses, organizations and individuals that work cooperatively and volunteer their time to provide successful programs to improve the well-being of families in Clay County.”

Since 1981, Howard has spearheaded many programs and services, many of them supporting women's health and nutrition, and she has held many officer positions in professional development organizations. She’s also won numerous awards throughout her tenure in Cooperative Extension, Nielson reports.

“Every educational program that Lora Lee presents is focused on improving not only the life of the individual participant, but the family as a whole,” Louise Moore, UK Cooperative Extension District 2 director, told Nielson. “Whether it is teaching about nutrition, the importance of taking care of your health, increasing your physical activity or making handmade gifts, her programs provide tips on including the family in the activity, saving the family dollars or increasing family communication.”

Stanford doctor starts local 'Get Healthy Lincoln County' program, plans to take it statewide via Kentucky Medical Association

Part of the effort: A weekend workout group in Stanford

A Stanford physician who started a local movement for a healthier community plans to promote it statewide through the Kentucky Medical Association’s Commission on Public Health.

"Dr. Naren James said in the next year, under the Affordable Care Act, health insurance rates will be affected by the overall health of a community," Abigail Whitehouse reports for The Interior Journal. “Having a healthier community will actually have a tangible impact on people’s health insurance rate,” James told her.

James said he was motivated to start the program when he realized that that Kentucky ranks very high in childhood obesity, "which ultimately effects the future of a community," Whitehouse notes. Much of the program's focus is on increasing residents' physical activity.

“The reason why we did ‘Get Healthy Lincoln County’ was to make a model that could be used statewide,” James told her. She writes, "His goal is to promote the movement so that every community in Kentucky can find a coalition of people interested in health to create that 'get healthy' community."

“It has to be from the ground up, not from the top down,” James said. “When you deal with health, people have to make the choice. It has to be educational.”

In June, the program conducted several activities, "many of which were successful," Whitehouse reports. "Now that the 'Get Healthy Lincoln County' movement has been approved as an annual effort, James said a committee has already begun planning for next year by determining what did and didn’t work well this time around.

For example, a history walk around Stanford, Kentucky's second oldest town, "had a great turnout," James said. Also successful were "a Saturday morning of exercise" in a local park and "Dinner with a Doctor," Linda Carney of Texas, "who provided the crowd with a plant-based diet and spoke about the benefits of such diets," Whitehouse reports.

"What’s for Dinner Stanford?," a project of the local extension office, "invited the public to participate in a plant-based cooking class using local produce," Whitehouse writes. "James said that the cooking class has done well and will continue throughout the year, but it was realized that programs which require more commitment require more of a push."

For example, a program called "Eight Weeks to Wellness" needed "more events to sell it," James said. "Anything you’re going to do for several weeks, you have to sell it. . . . We need to sell it to people’s individual needs. They have to understand why health is impacting them personally."

"In a broader sense, James said people leading the 'get healthy' movement have to learn to speak the right language," Whitehouse reports. “The language about health is immediately negative,” he said. “It’s a cultural shift. Speaking about health positively is so important, which we tried to do with the Get Healthy program and I think overall it came across positively. Even the things that are negative can be turned into positive.”