Baby death rate fell 6% in Kentucky in 2022 while it increased nationally and in most states that border Kentucky, CDC reports

By Al Cross

Kentucky Health News

For the first time in 20 years, the rate of infant mortality in the U.S. showed a statistically significant increase in 2022, according to preliminary data from the Centers for Disease Control and Prevention. The national baby-death rate rose 3 percent from 2021, but in Kentucky it dropped 6 percent.

The rate measures the percentage of babies who died before their first birthday. The national rate rose from 5.44 deaths per 1,000 births in 2021 to 5.6 per 1,000 in 2022. Kentucky's rate fell from 6.15 in 2021 to 5.77 in 2022 and now ranks 28th among the states. In 2021, the state ranked 17th.

Cabinet for Health and Family Services graph; click to enlarge

Kentucky's infant-mortality rate has usually been higher than the nation's, reflecting its status as a poor state with lower-than-average health, but in 2019 its rate was 4.9 deaths per 1,000 births and the national rate was 5.6 per 1,000.

The state has fared worse in maternal mortality, the rate of women who die while pregnant or within six weeks of givign birth. It led the nation in 2021. Last year, when it ranked sixth nationally, state officials extended postpartum Medicaid coverage to one year after birth; it had lasted for only 60 days.

Infant mortality declined in Kentucky and 17 other states in 2022, led by Nevada at 22 percent, followed by Alabama, New Hampshire, Arkansas, Alaska, Colorado, Connecticut, Rhode Island, Minnesota, South Carolina and Kentucky.

Following Kentucky on the list of states with decreases were Mississippi, which still had the nation's highest rate, 9.11 per 1,000; North Carolina, 6.49; Oklahoma, 6.89 (all down about 3%); and Illinois, 5.59 (down 1%).

Most bordering states showed an increase in rates: Ohio, 7.11 (up 1%); Virginia, 6.21 (up 4%), Indiana, 7.16 (up 6%); Tennessee, 6.61 (up 7%); West Virginia, 7.32 (up 8%); and Missouri, 6.77 (up 16%). Arkansas continued to have one of the higher rates, 7.67 per 1,000, but had one of the bigger decreases, 11%.

Experts were uncertain of the reasons for the national increase. They noted increases in maternal complications and cases of bacterial meningitis, influenza and respiratory syncitial virus (RSV), both of which "rebounded last fall after two years of pandemic precautions, filling pediatric emergency rooms across the country," Mike Stobbe of The Associated Press reports.

"The U.S. infant mortality rate has been worse than other high-income countries, which experts have attributed to poverty, inadequate prenatal care and other possibilities," Stobbe notes. "But even so, the U.S. rate generally gradually improved because of medical advances and public-health efforts."

Too many pregnant Kentuckians and babies in 'maternity deserts' and Ky. has no birthing centers; midwives say they could help

Laura Browning, an Eastern Kentucky doula and midwife student, with her four children in a selfie.

By Sarah Ladd
Kentucky Lantern

During three of her four pregnancies, Laura Browning drove three hours round-trip past hospitals to get prenatal care from midwives in Lexington, the only place that offered what she needed.

She even made the trip while in labor with her first baby, feeling that “the care that I was receiving” from midwives “was worth that risk” of birthing in her car.

As deaths from pregnancy rise in the United States, Browning and other advocates say Kentucky could fill gaps in prenatal care by educating and certifying more midwives, attracting more to the doula profession and encouraging the creation of freestanding birth centers in the state.

The shortage of care for pregnant people is documented in a recent March of Dimes report, “Nowhere To Go: Maternity Care Deserts Across the U.S.”

More than 2 million Americans, most of them rural, live in “maternity care deserts,” defined in the report as having “no hospitals providing obstetric care, no birth centers, no obstetrician/gynecologist and no certified nurse midwives.”

In 2021, 14.2 percent of mothers received inadequate prenatal care, says the March of Dimes, which gave Kentucky an F on its annual report card this year, making it one of just nine states (plus Puerto Rico) to get a failing rating.

Almost half of Kentucky’s 120 counties — 48% — are maternity-care deserts, according to the March of Dimes study.

Prenatal care provided by midwives has been shown to prevent costly complications in mothers and babies, including cesarean deliveries and low birth weights. The March of Dimes reports that “midwifery care has been associated with an increased chance of having a low-intervention birth and lower cost of care due to significantly lower odds of medical intervention.”

Yet only about 8% of births in the U.S. are attended by midwives. In Kentucky, 700 to 800 babies are born every year outside hospitals, and are usually delivered with midwives present. There were 51,688 live births in Kentucky in 2020.

Certified nurse-midwives and certified midwives are accredited by the Accreditation Commission for Midwifery Education and pass national exams after graduate-level studies, according to the American College of Nurse Midwives.

The midwives and midwifery students who spoke with the Kentucky Lantern expressed passion for serving their communities and reported low rates of transfer to hospitals, easing the burden of hospital staff shortages.

Mary Harman

Also, midwives can provide important inclusive services to people who are “beyond the binary,” said Mary Harman, the only midwife within a two-hour drive from Pike County who travels that far for clients.

“Not every person needs an OB-GYN,” Harman said, but they cannot accept insurance or Medicaid, which is another barrier to their practice, Canary Nest Midwifery.

Research also suggests that freestanding birth centers, which are staffed by midwives and offer holistic birthing options for people who qualify, reduce the cost of care while producing higher patient satisfaction.

Kentucky is in the minority of states that have no freestanding birth centers. The American Association of Birthing Centers reports that more than 384 freestanding birthing centers are operating in 37 states and the District of Columbia, a 97 % increase since 2010.

Advocates attribute the lack of birthing centers to the difficulty of obtaining the state-required certificate of need in the face of opposition from hospitals that can mount costly legal battles, such as the one waged by three hospitals against a retired Army officer who tried to open a birthing center in Elizabethtown.

She prevailed in Franklin Circuit Court, which overturned a hearing officer’s denial of a certificate of need, but was forced to give up in 2017 when the hospitals won on appeal.

Rep. Jason Nemes, R-Louisville, has sponsored legislation in the past to remove the certificate-of-need requirement for birthing centers and will continue to support them. He has called the law mandating the certificate “very cumbersome.”

In 2019, the legislature did take action aimed at licensing more certified professional midwives, after the Kentucky Hospital Association and Kentucky Medical Association dropped their years of opposition.

The results have been underwhelming. In the almost four years since the law was enacted, the number of certified nurse-midwives and certified midwives in Kentucky has increased by only 12 — to 131 providers, reports the American Midwifery Certification Board.

Some hospitals have doula and midwife programs, such as the University of Kentucky’s midwife clinic and Norton Healthcare’s doula program.

Among the barriers to increasing midwifery care in Kentucky is the $1,000 cost of renewing a Certified Professional Midwife license. Compare that with $110 in Tennessee, $200 in California or $322 in New York.

Earlier this year, Kentucky took advantage of an opportunity in the American Rescue Act Plan to put in place one of the March of Dimes recommendations by increasing postpartum care under Medicaid from 60 days to 12 months. The change will allow an estimated 10,000 Kentucky mothers to maintain their health coverage for one year after giving birth.

Stark racial disparities in maternal mortality

The March of Dimes reports that deaths from pregnancy are increasing in the United States, which already has one of the highest maternal death rates among high-income countries.

About 900 women in the U.S. died from pregnancy-related issues in 2020, up 14% from 2019 and up a whopping 30% from 2018. Sixty-three percent of pregnancy-related fatalities are preventable, says the report. In Kentucky, preterm births increased in 2021 to 12%, up from 11% in 2020.

Pregnancy is especially dangerous for Black Americans, who are three times more likely to die from pregnancy than their white counterparts. Conversely, white women are more likely to have access to good prenatal care than Native, Black, Pacific Islander, Asian and Hispanic women. 

Those stark disparities are not lost on the expectant mothers who turn to doulas to guide them through their pregnancies and births. Doulas provide moral, physical or other support to pregnant people throughout pregnancy, delivery and postpartum.

Meka Kpoh, a doula in Louisville, founded the nonprofit Black Birth Justice to help mothers and babies get off to a healthy start all the way through the critical postpartum period. She has been in birth work long enough that the March of Dimes report wasn’t news to her.

She said these gaps in care should be taken seriously.

“The maternity care deserts aren’t going to just erase themselves,” said Kpoh, who is also in training to be a midwife. “It’s not going to be like next year there’s going to be a new hospital and every community has a hospital at least 30 to 40 minutes away. That’s not going to happen, at least not anytime soon. So it’s really important for there to be options for families like licensed certified home birth midwives.”

Kpoh said many of the clients she sees are driving hours from rural areas. “It’s really insane to me,” she said, “that we are their only option.”

In addition to more doulas and midwives, she said Kentucky needs freestanding birthing centers.

“Pregnant people are driving three hours just to get prenatal care, just to give birth, just to have postpartum appointments,” she said. “It’s ridiculous.”

To get the kind of care they want, Kpoh said many pregnant people end up facing a difficult choice: “Either they drive three hours to a hospital or they catch their baby by (themselves),” she said, adding: “I don’t recommend that for anyone.” 

Renee Basham, a doula, founded the nonprofit community doula program Hope’s Embrace to help pregnant people who are often cut off from help. Basham and her 30 doulas serve those who are unhoused and those with drug addictions.

“You’re not necessarily treated well if you are by yourself,” said Basham. “And so having people … vouch for you, or speak up for you or remind you to speak up for yourself … all of that … contributes to better outcomes.”

 
The stigma of going against the norm

Anihhya Trumbo, a doula who serves the Lexington area, said there remains a stigma about birth outside a hospital.

“Kentucky is a state where it’s always been preached that doctors know best,” she said. “It’s a bit of a taboo if you go outside of what is … considered the norm here.” 

Doula and midwife-assisted birth isn’t a new thing, either, she said.

“This is something that’s been going around since the beginning of time,” said Trumbo, who is also a military veteran. “We just got Western medicine and that’s what changed the norm but home birth and having the natural birth — that’s how we got here.”

Browning was so committed to midwifery care for herself that from six weeks gestation to birth, she drove three hours for her prenatal appointments. She’s now living in Laurel County but lived in Estill at the time of that first pregnancy.

Already a doula, Browning told the Kentucky Lantern that she is in midwifery school herself now “because women should not have to drive that far for care.”

“It’s definitely a need that we have here.”

UK hospital, celebrating 60th anniversary of its opening, recalls the governor for whom it was named: A.B. 'Happy' Chandler

A.B. Chandler breaks ground for the hospital. (UK photo)

As the University of Kentucky celebrates the 60th anniversary of the opening of its medical center, it asked the grandson of the governor who campaigned for it, and for whom it is named, to reflect on what it means to the state.

Ben Chandler, who had his own political career and now runs the Foundation for a Healthy Kentucky, said in a video interview with UK that A.B. "Happy" Chandler "felt like an institution was needed, which not only educated health care providers who would then fan out across the eastern part of the state, but also a place where people from Eastern Kentucky could come to get health care. . . . Eastern Kentucky had a high rate of infant mortality, they had several counties that had no physician at all, and almost no health care whatsoever."

The Albert B. Chandler Hospital has done "incalculable" good, Chandler said. "There's just no way you can describe it. Not only do you have the medical benefits that accrue as a result of the establishment of this institution, but the economic advantages that are connected with it. UK HealthCare is one of the largest employers in Lexington and Central Kentucky. And if you can think about the importance of this from an economic standpoint for the city of Lexington, it really just boggles the mind. There are very few things that have happened economically in Lexington that have been as important as the establishment of this medical facility."

Albert Benjamin Chandler III said his grandfather "would be really astonished at the growth and at the stewardship that has taken place throughout these years. He would be very, very proud of the people who were instrumental in building this institution. And he would just be incredibly proud of their stewardship of it over the years, and probably pretty surprised at just how dramatic its effect has been."

Opinion: Legislature is moving bill that would restrict abortion rights while ignoring several filed to help babies and mothers

This opinion was originally published in the Lexington Herald-Leader.

By Linda Blackford

Herald-Leader Opinion Editor

Why bother writing about abortion access in Kentucky? The die is cast, as it were, with superdupermajorities in the state House and Senate who can legislate however they want. It’s very possible that in the near future, the Supreme Court will strike down the constitutional right to an abortion, and Kentucky will become once again home to back alleys and wire hangers. We already have a trigger law in place outlawing the practice in Kentucky as soon as the Supreme Court rules.

On Tuesday, March 1, the House Veterans, Military Affairs and Public Protection Committee, which for some strange reason now hears abortion bills instead of the Health and Family Services Committee (because Health members might be too touchy-feely?), approved House Bill 3, the new omnibus bill that does all kinds of things to make it even harder to get an abortion here. The bill takes special aim at MAB, medication that can cause an abortion very early on in a pregnancy, and is so safe and effective that it accounts for half of all abortions in Kentucky and was recently approved by the Food and Drug Administration to be sent through the mail directly to people’s homes.

Photo illustration from Deamstime

So why shout into the wind (again)? Well, I think it’s worth pointing out that Republicans are not the only ones who care about mothers and babies. The Kentucky House Democratic Women’s Caucus (again) has crafted a slate of maternal health bills, not one of which has been even assigned to committee.

They range from a sales tax exemption for breast pumps to bereavement leave in the case of a child’s death to Medicaid coverage for doulas. House Bill 37 would try to stem Kentucky’s horrific maternal mortality rates, including the fact that Black women die at more than double the rate of white women. According to the 2020 Maternal Mortality Report for Kentucky, in 2017, roughly 76 percent of all maternal deaths were preventable.

One exception is House Bill 174, which would extend Medicaid to new mothers for up to a year, which passed the House, and of course there are some Republicans, like Sen. Julie Raque Adams of Louisville, who have worked hard on issues affecting families.

But 16 bills from House Democrats would also address getting new mothers on Medicaid, postpartum depression, parental leave, and new rights for pregnant inmates. In other words, they are all trying to help the lives of mothers and babies in this state — actual people who are already here — in humane and holistic ways.

And let me say this again: None of these bills has been assigned to committee, which tells us that the majority party is not really that interested in doing anything but score political points.

There are two more bills that sit ignored in the Committee on Committees: House Bills 299 and 300 would require health-care plans to cover birth control before and immediately after a pregnancy. If I were worried about unwanted pregnancies, I’d be very interested in getting birth control to more people, but that is both logical and consistent, two words that don’t abound in Frankfort.

Despite what Republicans tell you, no one thinks abortion is grand or wonderful, but as many doctors will tell you, it can be an important part of women’s healthcare that should be between those women and their doctors. The fundamental hypocrisy of the GOP caring only about the unborn is alive and well. Sadly, it will probably be even more on display in the years to come. 

Linda Blackford writes columns and commentary for the Lexington Herald-Leader. She has covered K-12, higher education and other topics for the newspaper for the last 20 years.

Ky. has a high premature birth rate, but 2 programs are reducing it; one stresses home visitations; the other uses data analysis

By Melissa Patrick
Kentucky Health News

One in nine Kentucky babies are born prematurely, one of the nation's highest rates – so high that the March of Dimes gave the state a "D" on its 2018 Premature Birth Report Card.

A baby is premature if born before 37 completed weeks of pregnancy, four weeks short of full-term. In 2017,  just over 11 percent of Kentucky babies were born preterm. The national average is just under 10 percent, a rate that has risen three years in a row.

Because important growth and development happens during the last weeks of pregnancy, preterm babies are at an increased risk of neurologic, respiratory and digestive problems. Complications from being born early is the main cause of newborn death, says the March of Dimes.

Preterm babies are also at risk for long-term challenges, including behavioral and social-emotional problems, learning difficulties, and increased risk of conditions like attention deficit-hyperactivity disorder and increased risk of Sudden Infant Death Syndrome. As adults, they are more likely to have chronic diseases such as heart disease, high blood pressure and diabetes, says UK Healthcare.

The March of Dimes says that while the cause of about half of premature births is unknown, there are common risk factors, including a multiple pregnancy (twins), smoking or drug use during pregnancy, being underweight, having diabetes or having preeclampsia, a condition that is characterized by high blood pressure and the presence of protein in the mother's urine.

What's Kentucky doing about it?

Several programs work to lower the number of preterm births in Kentucky.

One is a voluntary home-visitation program called Kentucky Health Access Nurturing Development Services. Kentucky's HANDS  serves first-time, high-risk mothers through local health departments. It received a $7.5 million federal grant in October.

The HANDS program provides assistance to overburdened parents from the prenatal period to the child's third birthday. It served about 4,000 people in more than 2,000 homes through nearly 56,000 home visits in 2017, according to a Cabinet for Health and Family Services news release.

Research published in the journal Maternal Child Health, shows that participants in the HANDS program had fewer preterm births and low-birthweight babies, and decreased incidences of child abuse and neglect, especially among those who received seven or more prenatal home visits.

The data shows the rate of preterm births among expectant mothers who received one to three prenatal visits was 12.1 percent, above the state's relatively high average, while the rate for those who received seven or more visits was 9.4 percent, below the national average. Similarly, the rate of low-birthweight babies dropped to 6.5 percent among mothers with seven or more visits, compared to 8 percent who had only one, two or three visits.

The study also found that women in the program had increased access to prenatal care and decreased maternal complications during pregnancy.

The home-visitation program provides the at-risk mother with a family support worker who tailors a plan to meet her needs, including linking participants to community services needed to support a healthy pregnancy and birth. And after the child is born, the program helps families nurture healthy growth and development in the child and teaches them how to create safe homes.

Courtney Embry, a nurse from the Grayson County Health Department, said a family support worker provides education about nutrition in pregnancy and can help expectant mothers sign up for the Women, Infant and Children nutrition program, help them find resources to quit smoking, or help them find transportation to get to their prenatal appointments.

"We see a lot of moms who don't have transportation, so therefore they are not actually getting to their OB appointments," she said. "So we will help them find transportation." She said they do that through community transportation programs, programs that offer gas vouchers or helping them to find employment.

"The HANDS acronym sums up what we do," said Shelly Lambert, director of early-childhood services for the Lincoln Trail District Health Department. "We are a helping hand for parents. We are there to support them, to help them, to nurture them and help with the development of their child."

Carter County HANDS coordinator Jana McGlone said one reason the program is so successful is because it explains the "why" of it all, Lisa Gillespie reported for Louisville's WFPL in October.

“Their doc might say, ‘You need to take your prenatal vitamin,’ but he may not tell them, ‘OK, this is why you should take this’,” McGlone told Gillespie. “When they get that understanding and knowledge, it makes them want to do it more."

CDC photo

Another effort to reduce preterm births in Kentucky is a Passport Health Plan program that uses a maternity-analytics platform to identify at-risk mothers. Passport manages the care of more than 310,000 Kentuckians on Medicaid. The analytics were developed by Lucina Health, a Kentucky-based obstetric data management firm.

In just six months, Passport was able to identify 85 percent of its high-risk pregnant mothers during their first two trimesters and provide them with a personalized care plan designed to reduce their risks, according to a Lucina news release. It says the program has reduced early deliveries by 13 percent, earning Passport millions of dollars.

"Identifying and communicating with at-risk mothers as soon as possible is critical to reducing preterm birth rates in the United States," the release says. "Reducing preterm birth, a national public health priority, can be accomplished by implementing strategies that target modifiable risk factors and provide access to care with potentially high social and financial impact."

November is Prematurity Awareness Month.

65 kids a day are abused or neglected in Ky., third in nation; officials urge safe sleep practices, care about who provides care

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. – When it comes to keeping babies safe, three of the most important things are safe sleep practices, recognizing that bruising in non-mobile infants is not normal, and choosing an appropriate caregiver.

So said members of the state's Child Fatality and Near Fatality External Review Panel, who told legislators at the Sept. 19 joint health committee meeting that three-fourths of cases they reviewed in 2017 were "potentially preventable."

They lawmakers also heard the executive director of Prevent Child Abuse Kentucky say the state ranked No. 3 for "child maltreatment" in 2016. Jill Seyfred added that 23,827 Kentucky children were confirmed victims of child abuse or neglect in 2017, about 65 a day.

The ABCs – and D – of safe sleep

Dr. Jaime Pittenger, a review-panel member and the president of Prevent Child Abuse Kentucky, told the committee that 39 percent of the deaths the panel reviewed in 2017 involved sudden unexpected deaths in infancy, or SUDI, a broad term that covers both sudden infant death syndrome and other fatal sleeping accidents. That number is "on the rise this year," she warned.

Pittenger, who heads the pediatric residency program at the University of Kentucky, stressed the importance of following the ABC's of safe sleep to prevent injury or infant deaths – Alone, on their Back, and in a Clean, Clear Crib.

Safe Sleep Kentucky website graphic; for a larger version, click on it

And because so many of the fatalities or near-fatalities are connected to substance abuse, Kentucky has added a D to that list to point out the Danger of sharing a bed with a child, especially when under the influence of alcohol or other drugs.

Almost two-thirds of last year's SUDI cases in Kentucky involved an impaired caregiver who slept with their baby and the baby died from suffocation or asphyxiation, the review panel found.

Pittenger pointed out that many Kentucky infants don't have a safe place to sleep: "We can make it sound like everybody has a bassinet, a crib, but they don't."

Rep. Joni Jenkins, D-Louisville, suggested that the state look into providing children who don't have a crib with a "baby box" with instructions on safe sleep, as some other states and countries do.

"Some years ago we decided that every child that left the hospital ought to have the appropriate car seat," Jenkins said. "It seems to me that a logical [solution] is that every child that leaves the hospital after birth should have an appropriate place to sleep as well."

CDC photo

"Those who don't cruise, don't bruise": Pittenger offered this rhyme as a way to remember that bruising in infants not old enough to be mobile "is not normal." She was quick to point out that bruising doesn't always mean abuse, but "should raise a red flag to make you ask questions."

Paula Sherlock, a retired Family Court judge, stressed the importance of reporting bruising in non-mobile infants: "We don't want to think that our kids are abusing our grandkids, so we believe things that we shouldn't believe."

"Don't leave your child with someone you wouldn't leave a puppy with": This was Sherlock's advice for choosing a caregiver. She added, "People who have violent tempers, who have histories of domestic violence, should not be left in a care-giving role with children who can't defend themselves or tell anybody what happened," she said. "The vast majority of the kids we see are under the age of 4 and a huge portion of them are under the age of 2."

Happiest Baby blog photo

Sherlock said 41 percent of Kentucky children determined to have abusive head trauma in 2017 were left with a caregiver to whom they were not related. "Typical of that is the boyfriend who is watching the baby while mom goes to work," she said. "Mom has no affordable daycare, she has no good support system and so a completely inappropriate person is left with the child, who is not his child. We see a really startling number of these cases."

Abusive head trauma is also called "shaken baby syndrome." It can be caused by a direct blow to the head, dropping or throwing a child, or shaking a child resulting in an injury to the child's brain.

Seyfred said the top risk for these children are substance abuse and family violence. "Substance abuse was documented as a risk factor in 65 percent of the reports, with family violence as a risk factor in 42 percent," she said.

There are other dangers. Pittenger said people who have a history of crime or mental illness have also been connected to the majority of these abused and neglected children. The panel report found that 85 percent of the 2017 cases reviewed had a prior history with child protective services.

What's Kentucky doing to protect its children?

Sherlock and others stressed the importance of the review panel, which she said works to identify gaps in the system and to find ways to fix them.

She also stressed the need to get quick, efficient, affordable and non-punitive help for Kentucky parents who are suffering from addiction.

"These parents need help," she said. "These kids are very vulnerable and if they are being born to drug-addicted parents and then going home to be cared for by these parents, that is a recipe for disaster." Sherlock said, "My experience in court: drug addicted parents did not by and large beat their children to death . . . but the neglect is so gross and so widespread that these children are not fed, they are not supervised."

Rep. Kim Moser, R-Taylor Mill, and Sen. Reginald Thomas, D-Lexington, praised the HANDS program as a tool to help at-risk families learn how to better care for children. HANDS, for Health Access Nurturing Development Services, is a home-visitation program for new and expectant parents that works toward healthy pregnancies and births, healthy child growth and development, safe homes and self-sufficient families.

Thomas said he thought every parent would benefit from this program, but especially those at high risk. "The reality is that children don't come with a how-to manual," he said.

Moser also praised the START program, which integrates addiction services and other wrap-around services to families with at least one child under 6 years of age who is in the child-welfare system and has a parent with a substance-use disorder that puts that child at risk. START stands for Sobriety Treatment and Recovery Team. Moser said she would love to see both of these programs expanded.

Seyfred told the panel that Prevent Child Abuse Kentucky had recently partnered with WellCare and the Kentucky Hospital Association to create a video focusing on safe sleep, abusive head trauma, and choosing an appropriate caregiver to show new parents before they leave the hospital.

Pittenger spoke to the importance of this education: "One of the saddest stories I ever heard was a dad who just didn't understand that shaking would hurt his child. He never knew, he never thought that what he was doing when he lost his temper would hurt the child. Some people just don't know."

Kentucky has also passed laws to require caregivers and professionals who serve children to receive training on pediatric abusive head trauma.

Sen. David Givens, R-Greensburg, charged everyone at the meeting to tell at least one person with a newborn or who is pregnant about what they had learned about the importance of safe-sleep practices and quality caregivers.

"We could save one child's life just through that conversation," he said. "So let's do that. Let's all leave here today charged in the course of the next two weeks to have that conversation with at least one person. We may make a difference."

To report suspected child abuse in Kentucky, call 877-KYSAFE1 (597-2331) or online at https://prd.chfs.ky.gov/ReportAbuse/OutofHours.aspx. The national abuse hotline can be reached at 1-800-422-4453.

Cigarette-tax advocates say it would reduce smoking by pregnant women, a bad behavior in which Kentucky leads the nation

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. -- The best way to help pregnant women in Kentucky stop smoking is to increase the cigarette tax by $1, to $1.60. That was the main message at the Coalition for a Smoke-Free Tomorrow's Jan. 23 rally at the state Capitol.

Ben Chandler, chair of the coalition and the president and CEO of the Foundation for a Healthy Kentucky, told the small crowd that such an increase would result in nearly 6,000 fewer smoking-affected pregnancies and births over the next five years in the Commonwealth.

"Think of that: more than 1,000 Kentucky babies every year who are healthier because they were not exposed to the toxins in cigarettes while they grew and developed in the womb," Chandler said.

He added that Kentucky has the highest rate of smoking during pregnancy in the nation, with more than one in five pregnant women in the state smoking cigarettes at some time during their pregnancy. The national rate is 8 percent. That rate is even higher in 35 counties, 30 percent. And in four counties -- Clay, Jackson, Lee and Owsley -- it exceeds 41 percent.

Misti Williams tells how she quit smoking during her pregnancy
at a Coalition for a Smokefree Tomorrow rally. (Coalition photo)

Misti Williams, pregnant with her fifth child, said she smoked during her previous pregnancies, but decided she would quit when she learned of her current pregnancy. Her baby is due in a few weeks and she said she hasn't smoked since July.

"I want something radically different for this child," she said after the rally.

The 31-year-old Lexington woman attributed her success to her participation in a smoking-cessation program, which offered both counseling and an alternative list of activities to do when she had the urge to smoke. She said she uses that list as her screen-saver on her cell phone.

Williams talked about how hard it was to quit, but said every day she didn't smoke was a victory and she wants to encourage other pregnant women to keep trying, even if they relapse.

"I want to help other women who don't think it's possible," she said after the rally.

Smoking during pregnancy can cause miscarriage, premature birth, low birth weight, a variety of birth defects and even infant death, according to the federal Centers for Disease Control and Prevention.

Chandler also pointed out that pregnant smokers are also a budget issue because of the added expense incurred by the state to care for many of these infants, noting that women who smoke during pregnancy are two and a half times more likely to be on Medicaid.

women.smokefree.gov

Amanda Fallin-Bennett, a tobacco-control researcher in the University of Kentucky College of Nursing, said that while access to tobacco-cessation treatment is important for women who want to quit smoking during pregnancy, raising the cigarette tax by at least $1 would be more effective.

"Research shows that the most effective way to reduce smoking is raising the tobacco tax," Fallin-Bennett said. "In fact pregnant women along with kids are particularly likely to quit or reduce their smoking when the price goes up."

The CDC says: "A $1 increase in cigarette taxes increased quit rates among pregnant women by 5 percentage points. Higher cigarette prices also reduced the number of women who start smoking again after delivery."

Angela Brumley-Shelton, a tobacco coordinator with the Lexington-Fayette County Health Department, said that while researchers know that exposure to maternal smoking and second-hand smoke after birth puts an infant at a higher risk of death, they are still working to determine exactly why that is. "But in Kentucky, we know that it is one of the most consistent risk," she said.

Pregnant women who want to quit smoking should talk to their health care provider about quitting. The state tobacco quit line (1-800-QUIT-NOW or 1-800-784-8669) also offers special services and counseling for pregnant women and for those who have recently delivered. Click here to learn more about the state's quit line. The Smokefree Women website also offers tips and tools to help pregnant women quit smoking.

Appalachians die sooner than 20 years ago, and region has a higher infant-death rate than U.S.; both attributed to smoking

By Melissa Patrick
Kentucky Health News

People who live in Appalachia are dying sooner than two decades ago, and the region has a higher infant death rate compared to the rest of the nation. A new study blames both largely on the region's high smoking rate, as well as its other bad health habits.

“What this report shows is the extreme damage that tobacco is causing our people, and how we are getting hammered by it worse than any other place in this country," said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky.

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The study, published in the academic journal Health Affairs, compared infant mortality and life expectancy disparities in Appalachia to the rest of the United States between 1990 and 2013, using national vital statistics data.

It found that Appalachia and the rest of the nation had similar rates for infant morality and life expectancy in the 1990s, but by 2013 infant mortality was 16 percent higher in Appalachia, and adults in the region were living 2.4 fewer years than people who lived in the rest of the country: 76.9 and 79.3 years, respectively.

The study attributes these widening gaps to "persistent or increasing disparities in general living standards and health-risk behaviors such as adult smoking, smoking during pregnancy, obesity, physical inactivity, and heavy consumption of alcohol."

Heart disease, lung cancer and other respiratory diseases were among the leading causes of death in the Appalachian region during the study period, all conditions that can be caused by smoking.

"We are the cancer-mortality capital of the nation right now, and we just cannot let that stand," Chandler said. "If we truly want to change Kentucky’s health statistics, the single most effective thing we can do is to reduce our smoking rates."

Kentucky has the highest smoking rate in the nation, 26 percent of adults. But smoking affects children, even those who don't smoke. Smoking during pregnancy is a risk factor for both birth defects and SIDS, according to the federal Centers for Disease Control and Prevention.

While the number of Kentucky mothers who smoked during pregnancy dropped from 26 percent in 2006 to almost 20 percent in 2015, this is still significantly higher than the national rate of 8 percent. Overall smoking rates and pregnancy smoking rates are highest in the state's Appalachian counties.

The report says the higher rates of birth defects and Sudden Infant Death Syndrome deaths in Appalachia accounted for 60 percent of the difference in infant mortality between the region and the rest of the country in 2009-13. Other contributors included diabetes, kidney diseases, suicide, unintentional injuries (such as traffic accidents) and drug overdoses.

There could be other causes for the increasing disparity. The researchers said it is possible that more affluent, healthier Appalachian residents may have migrated to more urban and affluent areas of the U.S., thus increasing the health and economic inequalities between the region and the rest of the nation.

They called for policies that address the region's high smoking rates, high unemployment rates, low education levels, poor access to health care, high obesity rates, transportation and housing issues, and try to increase access to healthy foods, to decrease the current gaps in health outcomes.

“Given the national gains in life expectancy, seeing the increasing disparity between Appalachia and the rest of the United States should serve as a wake-up call,” Rebecca Slifkin, co-author of the study said in a news release. “Many of the reasons for the disparities we observe are due to differences in social determinants of health. We really need new investments to ensure that health is not determined by where one lives. As a society, we invest huge sums in medical care to extend an individual’s life; imagine the gains we could make if similar resources were devoted to public health.”

The study used the 2008 Appalachian Regional Commission definition of Appalachia, which covers 428 counties in 13 states, 54 in Kentucky.

Opioid epidemic linked to rise in 'unsafe sleep' deaths of infants

Kentucky's opioid epidemic is increasingly leading not just to the deaths of drug users, but of infants put into "unsafe sleep" situations by users, reports Deborah Yetter of The Courier-Journal.

"A 4-month-old Bell County boy died after falling off the mattress where he had been sleeping with an adult using opioids," Yetter writes. "In Mason County, a 6-week-old girl was found blue and not breathing in bed with her uncomprehending mother. . . . The baby had suffered at birth from drug withdrawal; after her death, the mother tested positive for marijuana, opioids and methamphetamine."

Yetter notes that babies "should never sleep anywhere other than alone, on their backs and in a crib free of blankets or pillows."

The state's Child Fatality and Near Fatality External Review Panel has examined about 20 such cases in the past year, but is seeing only a fraction of the likely cases, a member of the panel, University of Louisville forensic pediatrician Melissa Currie, told Yetter, who notes, "Infant sleep deaths linked to abuse or neglect have doubled since 2014."

"As many as 100 Kentucky infants die each year from what's classified as Sudden Unexpected Infant Death, or SUID — often linked to suffocation when a sleeping infant's airway is obstructed," Yetter reports. "But most of such SUID deaths are not reported to or investigated by state social service officials as abuse or neglect and thus are never referred to the outside panel for review."


Dr. Lori Devlin, a neonatologist with Norton Children's Hospital and U of L, told Yetter, "We've got more and more women of childbearing age who are using opioids. It's making the whole thing a little bit scary."

I the past year, the state panel has also reviewed about a dozen cases "in which small children almost died after ingesting drugs found in their homes, including a toddler who had to be revived with the opioid overdose drug naloxone," Yetter reports.

Ky. inches up in national health ranking, due to more coverage, HPV vaccination; but at 44th, it still has much work to do

Graphics are from America's Health Ranking report

By Melissa Patrick
Kentucky Health News

Kentucky ranked in the bottom 10 states for 12 of the 34 measures ranked by the 2015 America's Health Ranking, placing it in 44th place, up three spots from 47th last year.

The 26th annual ranking, which calls itself "the country's annual health checkup," examines criteria such as behavior, community, environment, policy and clinical care. The report provides a benchmark for how a state's health changes from year to year, but is also meant to fuel dialogue that leads to action.

Kentucky leads the nation in cancer deaths (228.8 per 100,000 people) and preventable hospitalizations (85.1 per 1,000 Medicare beneficiaries). It ranks among the bottom five states for five other measures: smoking, drug deaths, children in poverty, poor mental-health days and poor physical-health days.

Additionally, the state ranked in the bottom 10 states for physical activity, air pollution, diabetes, cardiovascular deaths and premature deaths.

The report also noted Kentucky's strengths: the state has a low violent crime rate, a low prevalence of binge drinking, a high rate of high school graduation, a big decrease in the number of people without health insurance, and a 40 percent increase in female human papillomavirus vaccines, which target the HPVs that most commonly cause cervical cancer.

"A significant drop in the number of uninsured Kentuckians and an increase in preventive HPV vaccinations were two factors contributing to our rise in the annual rankings," Susan Zepeda, president of the Foundation for a Healthy Kentucky, said in news release. Here are some details from the report:

Kentucky has the nation's second highest smoking rate, 26.2 percent, barely trailing West Virginia's 26.7 percent. The national smoking rate is 18.1 percent, down from 19 percent last year. "Smoking is the U.S.'s leading cause of preventable death," says the report.

The state also has the second highest rate of children who live in poverty, at 30.3 percent, a decrease from last year's rate of 31.8 percent. The national rate is 21.1 percent, which is up from 19.9 percent last year. "Children in poverty are three times more likely to have unmet health needs than other children," says the report.

Kentucky's diabetes rate has hovered around 10.6 percent for the past three years, but this year it saw an 18 percent increase to 12.5 percent, causing it to rise to sixth in the nation for diabetes from 18th. The national diabetes rate is 10 percent. Diabetes is the seventh-leading cause of death in the U.S., says the report.

Kentucky's adult obesity rate dropped to 31.6 percent from 33.2 percent last year, causing it to drop to 12th in the nation for adult obesity from fifth. Nationally, 29.6 percent of adults are obese..

During a phone interview in November, state obesity-prevention coordinator Elaine Russell attributed thie drop in Kentucky's rate to the state's many obesity-related initiatives. "It is a comprehensive effort of many different programs, because we are all working toward the same goal to decrease chronic disease and obesity," she told Kentucky Health News.

Kentucky ranks third in drug overdose deaths at 24 deaths per 100,000 (the same rate as last year), compared to 13.5 nationally. Drug overdose is the leading cause of injury death in the U.S., says the report.

"This report is a call to action to make disease prevention a key component of our culture," Reed Tuckson, external senior medical adviser to United Health Foundation, said in the release. "We want to ensure everybody, no matter what state they call home, is empowered to make healthy decisions for themselves, their families and their communities."

Hawaii, for the fourth consecutive year, remains the healthiest state and Louisiana is ranked last.

The report, published by United Health in partnership with the American Public Health Association and Partnership for Prevention, uses data from well-recognized outside sources, such as the federal Centers for Disease Control and Prevention, American Medical Association, FBI, Dartmouth Atlas Project, U.S. Department of Education and Census Bureau.

To see the rankings in full, visit www.americashealthrankings.org.

Anthem gives hospital group grant to improve perinatal care, including discouraging early, medically unnecessary deliveries

The foundation of Anthem Blue Cross Blue Shield has awarded nearly $259,000 to an arm of the Kentucky Hospital Association to improve perinatal care and outcomes for mothers and their babies by discouraging early, medically unnecessary deliveries and encouraging breastfeeding.

Perinatal care, provided in the time around childbirth, is critical to ensure the good health of newborns, Anthem notes in a news release, pointing out that Kentucky's infant mortality rate is 6.6 deaths per 1,000 births, while the national rate is 6.1, and the state's rate of premature births, almost 14 percent, is well above the 9.6 percent goal set by the March of Dimes.

"The closer the baby is to full term, the better; but sometimes babies are born before they fully develop, weighing only a few pounds," the release notes. "When this occurs, long stays in the hospital neonatal intensive care unit (NICU) are necessary as these babies fight health complications while learning to breathe on their own without the use of a ventilator."

NICU stays are usually expensive. In 2012, Kentucky hospitals charged about $400 million for such treatment.

The hospital association says it has been working to reduce early, elective deliveries, with the Anthem foundation's help, and the latest grant is designed to build on that work. It says the grant to its subsidiary, the Kentucky Institute for Patient Safety and Quality, will also promote breastfeeding, reducing blood infections in the hospital, and reducing complications related to inducing labor, including Cesarean sections.

"KIPSQ will work with all Kentucky hospitals that deliver babies to assure the best care during delivery and the best outcomes for mothers and babies," the KHA release says. "KIPSQ will collect data to measure progress and provide resources, tools and technical assistance in quality improvement techniques to reduce prematurity, unnecessary Cesareans and improve the long-term health of newborns.

KHA says 76 of Kentucky’s 131 hospitals are members of KIPSQ, which is expanding its membership to include long-term care facilities and physicians' practices. "The Anthem grant will improve the delivery of perinatal health care to all of the state’s birthing/neonatal hospitals, regardless of their participation in KIPSQ," the release says.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Kentucky, an independent licensee of the Blue Cross Blue Shield Association. The Anthem Foundation Inc. is a private, non-profit foundation.

Winter can be risky time for infants if 'safe sleep practices' are not followed, health department says; here are several safety tips

Practicing "safe sleep practices" and creating a safe environment for your baby could mean the difference between life and death during these cold winter months, the state Department for Public Health says in a press release.

"Kentucky’s infant mortality rate remains higher than the national average. This is due in part to sleep-related accidents that could be prevented with safety practices,” Ruth Ann Shepherd, M.D., director of the department's Division of Maternal and Child Health, said in the release.

Shepherd stressed the importance of never smoking around a baby, since secondhand smoke can contribute to sudden infant death.

So, what are safe sleep practices? The American Academy of Pediatrics gives these guidelines to prevent sleep-related deaths and to keep infants safe and comfortable:

Babies need to sleep alone in a crib, bassinet or play yard. An adult bed is never a safe place for an infant to sleep.

Ask your health-care provider when it is time to give the baby his or her own room.

Always place infants on their backs to sleep.  This reduces the risk of Sudden Infant Death Syndrome (SIDS).

Do not put soft objects in a baby's sleeping space. That means no stuffed animals, toys, loose bedding, bumper pads or pillows.

Put your baby back in his or her own crib after breast feeding.  While breast-feeding reduces the risks of SIDS, falling asleep with your baby after a feeding can be dangerous.

How you dress your infant for winter sleep is also important to keep your infant safe. The health department offers these guidelines:

• Dress infants in one-piece pajamas or wearable blankets, layered over an undershirt or "onesie."  The important thing is to not let your baby get too hot from overdressing or being wrapped in heavy blankets.
• Keep the baby's room at a temperature comfortable for an adult.
• If you must use a blanket for warmth, only cover the baby's feet and lower body.  Do not let the blanket come higher than the baby's chest.  The blanket should also be tucked in around the mattress at the sides and bottom of the crib so that it cannot slide up to cover the baby's face.

Portable heaters can also create a danger to infants. “Remember to keep all portable heaters away from the baby’s sleep area. The baby can overheat if too close to a heater, get burned or tangled up in the cords of small electric heaters,” said Sherry Rock, who runs the child-fatality prevention program. “These are just small steps for parents and caregivers, but they can make all the difference in keeping infants safe.”

FDA changes painkiller labels to warn expectant mothers, after 2,500% growth in number of Ky. babies born addicted to drugs

The U.S. Food and Drug Administration (FDA) announced Tuesday drug-safety labeling changes and new post-market study requirements for all extended-release and long-acting opioids, and Kentucky political leaders applauded these measures to curb prescription drug abuse.

Long-acting opioids are intended to treat pain but may also lead to drug abuse, dependence or other complications if taken during pregnancy or misused. Now, as part of new FDA safety measures, the boxed warning labels on these drugs will warn expectant mothers that “the use of the products during pregnancy can result in neonatal opioid withdrawal syndrome (NOWS),” says the FDA release.

NOWS is among a group of problems called Neonatal Abstinence Syndrome (NAS) that occur in a newborn exposed to addictive drugs while in the mother’s womb. The baby's addiction can lead to birth defects, low birth weight, sudden infant death syndrome and other health conditions.

Attorney General Jack Conway and his counterparts in other states asked the FDA to act after several states reported an increase in the number of babies born addicted to prescription drugs. In Kentucky, "Instances of NAS have risen 2,500 percent over the past decade – from 29 incidents in 2001 to 730 in 2011," says a Conway release.

“I applaud the FDA for making this change that will better alert physicians and patients about the dangerous consequences of using these powerful prescription painkillers during pregnancy,” Conway said. Also as part of these safety labeling changes, certain educational materials for patients and health care professionals will be modified to reflect the new labeling.

U.S. Senate Republican Leader Mitch McConnell also praised the FDA's decision, saying it is a positive step forward in the fight against the state's prescription drug abuse problem.

Because little is known about the risks of long-term use of long-acting opioids, the FDA is also requiring the drug companies that make these products to conduct further studies and clinical trials to assess the known serious risks of misuse, abuse, increased sensitivity to pain (hyperalgesia), addiction, overdose and death, says the FDA.

"Altogether, the actions we're now announcing are part of FDA's efforts to make opioids as safe as possible for those who need them," said Dr. Douglas Throckmorton, deputy director of regulatory programs in FDA's Center for Drug Evaluation and Research. "This is not the first or last initiative, and we will continue supporting broader efforts to solve the serious public health problems associated with the misuse and abuse of opioids."

Petition drive from parents asks UK Healthcare to release mortality rates for cardiothoracic surgeries on children

More than 250 people have signed a petition asking the University of Kentucky hospital "to make public the mortality rates for pediatric cardiothoracic surgery patients from 2010, 2011 and 2012," Linda Blackford reports for the Lexington Herald-Leader. "All pediatric cardiothoracic surgeries were suspended at UK last fall amid an internal review." UK spokesman Jay Blanton said Monday the investigation is not complete.

"In May, the state attorney general's office issued an opinion that said UK must release mortality rates and other data about the cardiothoracic surgery program to WUKY, the university-owned radio station," Blackford reports. "UK has acknowledged that it calculated mortality rates for the program as part of its investigation, but has refused to release them, citing patient confidentiality laws." The Herald-Leader also requested the information under the Kentucky Open Records Act.

Read more here: http://www.kentucky.com/2013/08/05/2751040/parents-push-petition-urging-uk.html#storylink=cpy

Read more here: http://www.kentucky.com/2013/08/05/2751040/parents-push-petition-urging-uk.html#storylink=cpy

The three-year span includes the tenure of ardiothoracic surgeon Dr. Mark Plunkett, who no longer works at UK. Jennifer Allen, whose one-year-old daughter died after having three surgeries performed by Dr. Plunkett, wrote on the petition, "We deserve to know this information, we CAN understand and comprehend this information. It is our right to know and the right of the public!" Allen's daughter suffered from hypoplastic left heart syndrome, where the left side of the heart is underdeveloped and can't pump blood properly. Allen told Blackford she finds it "very suspicious" that UK won't release the information. UK says there were so few surgeries at times that patients' identities could be deduced.

Tabitha Rainey, whose son survived cardiothoracic surgery at UK, before being moved to another hospital, started the petition after being interviewed by CNN, which reported on the issue over the weekend and updated its story today with news of the petition. She said she doesn't accept UK's response that publicly releasing mortality rates would somehow harm patient confidentiality, telling Blackford, "There are no names and no dates, just the data on how many have passed on." (Read more)

Read more here: http://www.kentucky.com/2013/08/05/2751040/parents-push-petition-urging-uk.html#storylink=cpy

Read more here: http://www.kentucky.com/2013/08/05/2751040/parents-push-petition-urging-uk.html#storylink=cpy

Read more here: http://www.kentucky.com/2013/08/05/2751040/parents-push-petition-urging-uk.html#storylink=cpy

Read more here: http://www.kentucky.com/2013/08/05/2751040/parents-push-petition-urging-uk.html#storylink=cpy

Read more here: http://www.kentucky.com/2013/08/05/2751040/parents-push-petition-urging-uk.html#storylink=cpReadmore here: http://www.kentucky.com/2013/08/05/2751040/parents-push-petition-urging-uk.html#storylink=cpy, wrto

Kentucky doctor honored for her work in bolstering health and preventing deaths of babies born a few weeks early

A Kentucky neonatalogist was honored this week for giving the state "a role in catalyzing a national movement around healthier babies." Ruth Ann Shepherd, M.D., division director for maternal and child health in the Kentucky Department for Public Health, was presented the Association of State and Territorial Health Officials Presidential Meritorious Service Award and recognized as "an early pioneer in recognizing the critical public health problem of preterm births in Kentucky, and that the troubling trend was common to most states in the country."

According to New Public Health, an online publication of the Robert Wood Johnson Foundation,  Shepherd’s research "revealed that babies born at 37 or 38 weeks had far worse health outcomes than babies born at 39 or 40 weeks. With support from the leadership at the Kentucky Department of Health, and many other organizations who have since taken up the cause of helping to create conditions for healthier babies, many states are beginning to make strides in preventing early births."

Charles Kendall, chief of staff at the Kentucky Health Department, told the online magazine that the  prematurity rate for infants in Kentucky was exceptionally high, averaging at about 36 weeks at the time of birth.  "There was a corresponding infant death rate that was far exceeding the national average When she looked at the data, it occurred to her that many of those deaths could have been prevented.," he said. "Much of the prematurity rate had nothing to do with medical issues. The data were telling her that women who smoke are much more likely to deliver early and to have smaller babies. The size of the baby was really the predictor for the infant death rate."

 But what Shepard also understood, said Kendall, was that a lot of these births were actually planned for convenience. "That was one of the more startling pieces of information from the data. In many cases it was not a medical issue but a lack of education or convenience. She also brought the science from her work that showed that the fetal brain is still in critical stages of development in those early weeks, and that it’s not at its full capacity until 39 or 40 weeks. That was very compelling. She also said this is not just a Kentucky issue. This is going on everywhere." ( Read more

Study estimates that secondhand smoke kills 42,000 Americans a year, and 900 of those are babies

More bad news for smokers and those who love them: A report out this week in the American Journal of Public Health says secondhand smoke is accountable for 42,000 deaths of non-smokers each year in the U.S., including nearly 900 infants. Kentucky likely has more than its share of those deaths because the percentage of Kentuckians who smoke is the nation's highest.

The study at the University of California, San Francisco notes that those annual deaths represent nearly 600,000 years of potential life lost and $6.6 billion in lost productivity, amounting to $158,000 per death.

The study by Wendy Max a professor of health economics at the UCSF School of Nursing, involved the first use of a biomarker to gauge the physical and economic impacts of cigarette smoke, and revealed that secondhand smoke exposure disproportionately affects African Americans, especially their infants. 

Infant mortality, pre-term birth, teenage pregnancy, children living in smokers' homes all drop even as as child poverty goes up

Nationwide, the rates of infants who die, babies who are born prematurely, teens who are having babies, and the percentage of young children who live in a home where someone smokes have all decreased in the last five years. But the percentage of kids who live in poverty has gone up.

These findings are some highlights of the report "America's Children in Brief: Key National Indicators of Well-Being, 2012," compiled by the Federal Interagency Forum on Child and Family Statistics. The report, which does not break down data by state, looks at children's demographic backgrounds, family and social environments, economic circumstances, health care, physical environment and safety, behavior, education and health.

"This year's report contains good news about newborns," said Dr. Alan E. Guttmacher, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. "Fewer infants were born pre-term and fewer died in the first year of life."

Among other findings: In the last five years there has been a five-fold increase in the percentage of teens who have received the vaccine that prevents the most dangerous form of meningitis. Other key findings show:
• A drop in the percentage of children who live in homes that are classified as food insecure.
• A drop in the percentage of teens ages 16 to 19 who don't work and are not enrolled in high school or college.
• A rise in the percentage of children from birth to age 17 who live in counties in which one or more air pollutants were above allowable levels.
• An increase of one statistical point in the average math scores for 4th and 8th graders from 2009 to 2011. For a quick glance at the findings, click here. (Read more)

Appalachian Regional Commission conference in Prestonsburg Sept. 7-9 to focus on improving access to health care

Featuring the insight of 42 federal, state and local health experts, officials and community leaders, the Appalachian Regional Commission's Healthy Families: Healthy Future conference will be held Sept. 7-9 in Prestonsburg.

The keynote address will look at different ways access to quality health care can be expanded. It will be given by Marcia Brand, deputy administrator of the Health Resources and Service Administration. HRSA is the primary federal agency for improving access to health-care services for people who don't have insurance, are geographically isolated, or are medically vulnerable.

Other conference topics include childhood obesity and diabetes; substance abuse in adolescents; improving access to dental care for children; health information technology; and Appalachian perspectives on infant mortality reduction.

The conference will be at Jenny Wiley State Resort Park in Prestonsburg. To register, click here. Online registration ends Wednesday, Aug. 31.