Six Kentucky hospitals get national recognition for specialty care

By Melissa Patrick

Kentucky Health News

Six Kentucky hospitals have been awarded 2024 Healthgrades Specialty Excellence Awards, for placing in the top 5% or 10% of hospitals within a health-care specialty. 

"We celebrate the recognized hospitals for their steadfast dedication to high quality specialty care,” Dr. Brad Bowman, chief medical officer and head of Data Science at Healthgrades, said in a news release. "Healthgrades 2024 Specialty Excellence Awards and Ratings showcase hospitals nationwide that deliver consistently exceptional patient outcomes in a given medical specialty."

Healthgrades is an online source for information about physicians, hospitals and healthcare providers.

Mercy Health Lourdes Hospital in Paducah was recognized as one of the top 100 hospitals in the nation for five specialties, including critical care, gastrointestinal care, gastrointestinal surgery, pulmonary care and stroke care. 

Saint Joseph Hospital in Lexington was recognized as a top 100 hospital for critical care and pulmonary care. 

Frankfort Regional Medical Center was recognized as a top 100 hospital for prostate surgery. 

Owensboro Health Regional Hospital was recognized as one of the nation's top 50 hospitals for vascular surgery. 

St. Elizabeth Edgewood Hospital was the recipient of a "Cardiac Surgery Excellence Award," "Stroke Care Excellence Award" and "Surgical Care Excellence Award." 

Baptist Health Paducah was the recipient of  a "Vascular Surgery Excellence Award." 

Healthgrades says data for the rankings come from Medicare Provider Analysis and Review (Medpar) files for 2020-22. The analysis looked at patient outcomes for 31 common procedures and conditions from virtually every hospital in the country. Medpar files have records for all Medicare beneficiaries who use hospital inpatient services.

Website offers evidence-based data about nutrition, supplements

By Melissa Patrick

Kentucky Health News

If you are looking for detailed information about research on nutrition and food supplements, a website called Examine.com is a resource to provide that information. 

Examine is a "leading source for evidence-based information about nutrition and supplement research that is independent from advertisers," a news release said.

"We never start with an objective, like low-carb or high-carb, pro-supplement or anti-supplement," the Examine website says. "Rather, we simply report on all the evidence that’s been published."

Examine was founded in 2011. Its website says that neither it, nor any member of its research team, is affiliated with any supplement or food company and that it is funded through its 13,000 individual subscriptions -- with no ads, sponsorships or industry ties. Its email list numbers 200,000.

"This has allowed the team of researchers to operate independently and focus their energy on analyzing the latest research and studies about nutrition and supplements," the release says.

Examine.com is structured around 25 broad health categories and includes the latest research for nonmedical interventions for  hundreds of conditions.

For example, a search for "Ketogenic Diet" leads to a page that defines the term and includes information about what the research says about such a diet, whether it is safe or not, and links to studies that are related to specific health outcomes on this diet -- such as its impact on blood pressure or blood glucose. The page links to even more research analysis regarding related topics. 

Do you appreciate Kentucky Health News? Here's a chance to help make it even better, and get your gift matched!

By Al Cross, Publisher, Kentucky Health News

Director emeritus, Institute for Rural Journalism, University of Kentucky

For more than a dozen years, Kentucky Health News has provided news you can use, to help keep you and your family healthy, or get healthier. We have also kept Kentuckians up to date on their health-care system and things that affect it, including government actions.

Melissa Patrick and Al Cross of Kentucky Health News

We hope you appreciate our work, which is done mainly by a part-time reporter, Melissa Patrick, and funded by the Foundation for a Healthy Kentucky. Now we have a way for you to show your appreciation and expand our efforts, with a contribution that will be matched — for a limited time.

Kentucky Health News has joined NewsMatch, the largest collaborative fundraising campaign to support independent, nonprofit journalism in the United States. Its annual matching-gift campaign runs through Dec. 31.

Through the end of the year, NewsMatch will double your donation to Kentucky Health News, up to $1,000 and a total match of up to $13,000. That amount would increase our budget by almost 30 percent and enable us to do more of our important work, such as covering health issues in the legislature.

No one covers health issues in Kentucky like we do, and the news coverage is badly needed, because Kentucky is a state with poor health status. One key to raising that status is reliable information, especially at a time when some health topics have become polluted with misinformation, even disinformation. You can count on us to bring you the facts, plus the opinions of qualified experts. We keep our opinions out of our news stories, which are republished by news outlets all over the state.

Please help us expand our work. Donate today by clicking here. All donations to the Institute for Rural Journalism's enrichment fund through Dec. 31 will go to support Kentucky Health News. If you or your organization would like to discuss how you might provide continuing support, email al.cross@uky.edu.

'Toddler formulas' for infants and young children offer little nutritional benefit, writes a UK specialist in pediatric digestion

Photo by tun723, iStock/Getty Images Plus via UK

By George J. Fuchs III, M.D.

University of Kentucky

A recent report from the American Academy of Pediatrics as part of my work on the AAP Committee of Nutrition addresses the claims made by the manufacturers of so-called “toddler formulas," purporting to bolster the immune system and improve brain development. Simply put, a nutritionally complete super formula that gives your child a brain boost and protects them from diseases is too good to be true.

Nutrition is integral to a child’s cognitive and physical development, especially in the first years of their life. Additionally, these years represent a narrow window of time during which nutritional status and the right nutrients at the right time are primary determinants of health and risk of obesity, diabetes and other diseases in childhood and through adulthood.

While the benefits of breastfeeding in the first six months of life are well-documented, there are numerous reasons why some infants must subsist on iron-fortified formulas. The composition of infant formulas is standardized and regulated by the Food and Drug Administration per the Infant Formula Act of 1980 and the manufacturing facilities are regularly inspected.

Recently, liquid nutritional products referred to as “formulas” have been developed for the older infant and toddler and increasingly promoted by manufacturers. Older infant-young child formulas (OIYCF) are marketed under identities such as “transition formulas,” “toddler formulas” or “growing-up milks." These formulas are not to be confused with medical or therapeutic formulas for conditions such as chronic gastrointestinal diseases, metabolic disorders or food allergy, the use of which are prescribed and monitored by pediatric specialists.

Unlike infant formulas, there are no standard criteria for the composition of OIYCFs. Some of these formulas have been criticized as having elements considered to be unnecessary or potentially detrimental, including high or low protein, and higher sodium content relative to cow milk and added sweeteners. OIYCFs are considered by some to be “sugar-sweetened drinks” and have been associated with greater intakes of sweetened beverages as well as sweetened dairy products, such as fruit yogurts and cream cheese desserts.

Advertisement practices for OIYCFs often convey them as a necessary “next stage” or “next step” for optimal nutritional intake. Manufacturers of OIYCF make claims that are not required to be based on scientific evidence or be reviewed or approved by the FDA. Claims of improved brain development or immune function have incorrectly shown to influence parents’ belief that OIYCFs are healthier than breast milk or cow milk. OIYCFs are not nutritionally complete and are marketed to parents of healthy children as a replacement or substitute for cow’s milk.

The diets of young children are generally adequate for most micronutrients, although possible gaps exist, especially for vitamins D and E and fiber. Nearly all store-purchased cow milk in the United States is fortified with vitamin D, thus eliminating the need for a supplemental formula. Additionally, OIYCFs are considerably more expensive than cow milk and can represent a significant cost burden to families, especially when consumed daily. Parents and caregivers are advised to provide nutritionally balanced diets that include fortified foods; children consuming a diet of solid foods that provide sufficient iron and vitamin content have no need for supplemental formulas.

If you are concerned about your child’s nutritional intake, ask their pediatrician for recommendations for a balanced, nutrient-rich diet to help ensure proper cognitive and physical development during formative early years.

Dr. George Fuchs is a pediatric gastroenterologist at Kentucky Children’s Hospital and a professor in the UK Colleges of Medicine and Public Health.

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."

State's weekly respiratory-virus update shows hospitalizations of Kentucky children for RSV are increasing

By Melissa Patrick
Kentucky Health News

The state Department for Public Health's weekly respiratory virus update, released Thursday, Nov. 2, showed that Covid-19 and respiratory syncytial virus (RSV) activity was moderate, and influenza was low, but increasing, and hospitalizations for Covid-19 and the flu remain low, but are increasing for children with RSV. 

The state's respiratory-virus website, found at CoverYourCough.ky.gov, shows emergency-department visits and hospital visits for all three respiratory viruses increased in the week ended Oct. 22, with ED visits increasing to 1,754 from 1,692 the week before, and hospitalizations increasing to 258, up from 249 the prior week. 

Of those, ED visits for Covid-19 increased by 1, to 796; visits for flu totaled 776, up from 717 the previous week; and 182 were seen for RSV, an increase of 2.  

In that same week, Covid-19 hospitalizations dropped to 166, down from 181 the prior week; flu hospitalizations increased to 50, up from 41 the prior week; and RSV hospitalizations increased to 42, up from 27 the prior week. 

According to the Centers for Disease Control and Prevention, reporting information through Oct. 28, 18 Kentucky counties had a medium rate of hospital admissions for respirator illnesses, a designation for counties with between 10 and 19.9 admissions per 100,000 residents. 

Those counties were Rowan (13.5 admissions per 100,000); Pike (10.6); Morgan (13.5); Monroe (10.7); Metcalfe (10.7); Menifee (13.5); Martin (12.4); Magoffin (10); Letcher (13.9); Lawrence (12.4); Johnson (10); Hart (10.7); Greenup (12.4); Floyd (10); Elliott (13.5); Carter (12.4); Boyd (12.4); and Barren (10.7). 

In the week ended Oct. 22, Kentucky reported 1,549 laboratory-confirmed tests for Covid-19, up from 1,397 the prior week; and 131 positive laboratory tests for the flu, up slightly from 128 the prior week. 

Children: Kentucky children under the age of 18 saw an increase of seven ED visits for all three respiratory viruses in the week ending Oct. 22, to 709. There was a jump in hospitalizations for all three viruses in this age group, increasing to 53 from 31 the week before. 

Among children, 410 of them were seen in the ED, up from 377 the prior week; 134 were seen for the flu, down from 162 the prior week; and 165 were seen for RSV,  up from 162. 

In the week ended Oct. 22, 39 children were hospitalized with RSV, up from 21 the prior week. Nine had been hospitalized for the flu and five for Covid-19.

The best ways to protect yourself and others from these viruses are to stay up to date with your vaccines, stay home if you are sick, keep your hands washed, cover your mouth and nose with a tissue when you cough or sneeze and then throw the tissue in the trash, and if you don't have a tissue, cough or sneeze into your elbow, not your hands. In addition, they ask people who are at high risk for serious illness to consider wearing a mask.

Deaths: In the week ended Oc. 8, Kentucky reported one Covid-19 death and one flu death, all of them adults. 

At upcoming holiday celebrations, focus on social connections, not on the food; eat mindfully to avoid celebration guilt

Photo by iStock from "How to eat healthy during a holiday celebration," by Hola 

By Patty Craig
Beech Tree News, Morgantown

We will soon enter the holiday celebration season. Our culture promotes celebrating with food – despite staggering obesity statistics. Anticipating those celebrations, how might health-minded people celebrate?

First, carrying extra weight is a real problem. The Centers for Disease Control and Prevention website reports: “The obesity prevalence was 39.8% among adults aged 20 to 39 years, 44.3% among adults aged 40 to 59 years, and 41.5% among adults aged 60 and older.”

Obese children may have to deal with psychological problems such as anxiety and depression, low self-esteem and lower self-reported quality of life, social problems such as bullying and stigma, and obesity as adults.

Obese adults face high blood pressure and high cholesterol, Type 2 diabetes, breathing problems, joint problems, gallstones and gallbladder disease. Additionally, “adults with obesity have higher risks for stroke, many types of cancer, premature death, and mental illness such as clinical depression and anxiety.”

Patty Craig

Why, then, is food a part of life’s celebrations? The Cultural Awareness International website says: “Conceivably it (food) is the most significant commonality that humanity shares. Whatever shape, form, flavor, or seasoning food may take around the world, people eat. More than that, across the world, people enjoy eating.”

Food is a way to show hospitality, and it provides an opportunity to make connections. Food is generally provided with celebrations throughout the life cycle – from birth to death, including many holidays.

How can we find a healthy balance? In a Film Daily article by Samantha Williams ("Healthy Celebrations: Striking a Balance between Indulgence and Wellness"), the author discussed how to be mindful and still savor a celebration. Two of her points resonated with me:

“Set Realistic Expectations: Understand that celebrations are exceptions, not the norm. Don’t expect to maintain your usual dietary and fitness routines during every celebration. Instead, aim for balance over time.

“Focus on Social Connection: Celebrations are about connecting with others and making memories. Shift your focus from food to the people and experiences around you.”

By eating mindfully, a balance between indulgence and wellness can be achieved, ridding us of celebration guilt.

I’ve read that health is an investment, not an expense. The Roman poet Virgil said, “The greatest wealth is health.” And I agree.

So what about those holiday celebrations on the horizon? I say yes, let’s provide the food, but not push anyone to eat or drink what’s being served. After all, we may not understand their situation, and we don’t want to be stumbling blocks to their health goals.

Patty Craig of Morgantown is a mother, grandmother and retired educator.

Nursing homes say they can't afford more staff, but critics say they manipulate their financial arrangements to make that case

Photo via iStock and KFF Health News

By Jordan Rau

KFF Health News

Nursing homes say they can’t afford higher staffing, as the Biden administration proposes to require. But their finances are often opaque.

Perhaps the biggest mystery, as the Monday deadline for comments on the proposal nears, is how much extra money do the nation’s 15,000 homes actually have to hire and retain more nurses and aides.

The proposal has provoked a fierce lobbying battle between nursing homes and patient advocates, with more than 22,000 comments filed already to the Centers for Medicare and Medicaid Services.

Official nursing home financial records — those submitted to the government — report that more than 4 in 10 homes lost money in 2021. The industry says that it can’t afford higher payrolls. But instead of pumping more dollars into Medicare and Medicaid to ostensibly help homes hire more staff, CMS has proposed a relief valve: exempting homes from higher staffing requirements if they’re more than 20 miles from any other long-term care facility and in an area with a documented shortage of health-care workers. That would include many Kentucky nursing homes.

To the further consternation of patient advocates and many rank-and-file nurses and aides, the agency announced in its draft rule, released in September, that it may also exempt homes that are financially struggling.

Beyond understaffing concerns, excusing broke homes could encourage more financial chicanery in an industry where many operators have mastered the art of appearing poor while their owners siphon money into their own pockets.

The most common trick, honed over decades, involves owners setting up a bunch of separate companies to offload big chunks of the nursing home business — sometimes management, the staff, the equipment or the building itself.

Those companies charge the nursing home whatever their common owner decides, while only the licensed home is required to reveal its finances to the government. The industry insists there is no evidence these related companies charge any more than independent contractors would.

The CMS proposal would require that states do more to track how much money each home spends on direct care billed to Medicaid, the biggest source of revenue for most homes. In theory, that could help discover which homes are shortchanging employees — and patients. The requirement, however, may be no match for the ingenuity of industry accountants, and notably lacks transparency about where money from Medicare, private insurance and out-of-pocket revenue ends up.

Existing federal rules only require homes to have at least one registered nurse working for eight consecutive hours each day, and at least one licensed nurse to be on duty around-the-clock. (Those workers are usually licensed practical nurses, or LPNs, who don’t go through as much professional education as registered nurses do.) CMS has mandated that homes have “sufficient” staffing but has never defined the term.

The new proposal would require each of the nation’s 15,000 nursing homes to have at least ne registered nurse on duty for every 44 residents, and a nurse aide for every 10 residents.

The agency has indicated it might add yet another requirement when it finalizes its rule: An umbrella staff ratio of one nurse or nurse aide of any kind for about every seven residents.

(If you’re reading the rule or planning to comment, be aware that CMS talks about staffing in a less accessible way than we do here, using a measurement of hours per resident day — HPRDs, in nursing-home lingo — instead of a staff-to-resident ratio.)

Patient advocates say the industry has plenty of money to raise staffing levels. They are demanding much more staffing than required in the CMS proposal, enough to provide the highest quality care — not just a minimum level of acceptable coverage.

Advocates want at least one nursing home worker for about every six residents, which a 2001 CMS study concluded would result in the best care. But in a move that enraged proponents of greater staffing, CMS didn’t even bother modeling that scenario when it drafted its proposal.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at Kaiser Family Foundation — an independent source of health policy research, polling and journalism.

 

Poll shows Beshear, Cameron in dead heat; most voters say they oppose current abortion law that lacks rape and incest exceptions

Emerson College graph adapted by Kentucky Health News; click to enlarge

By Al Cross
Kentucky
Health News 

From the start, the X factor in the Kentucky governor’s race has been former president Donald Trump: Would his endorsement propel Republican Attorney General Daniel Cameron past Democratic Gov. Andy Beshear, who has had high approval ratings and led in every public poll? Now a poll taken in the last four days indicates strongly that it could.

The survey, taken by Emerson College of Massachusetts, shows Beshear and Cameron in a dead heat, with 46.9 percent for each candidate and 3.9 percent undecided. Another 2.3 percent said they would vote for someone else, which would require write-in voting, because no other gubernatorial slate is on the ballot. Adding undecided voters who said they were leaning one way or another, Cameron leads, 49.3% to 48.4%. The poll has an error margin of plus or minus 3 percentage points.

The result differs strikingly from an Emerson poll taken at the start of October, which showed Beshear with 49% and Cameron with 33%. But that poll was of registered voters, while this one was of 1,000 Kentuckians who said they were very likely to vote or had already voted. Early voting began Thursday, the last day of the poll, and about 2% of votes in statewide races are typically cast by absentee ballots.

Even with this poll, the big question about the election remains which voters will actually turn out to vote. In response to a question from Kentucky Health News, Emerson said it called about 250,000 people, texted about 15,000, emailed about 15,000 and had an online panel of voters aged 18 to 29. 

The poll started Monday, Oct. 30, and ended Thursday, Nov. 2. At midday Tuesday, the Cameron campaign sent Trump supporters a video endorsement of Cameron by the former president. Before that, TV advertising by Cameron and groups supporting him increasingly featured the endorsement, which Cameron obtained months before the Republican primary election.

Spencer Kimball, director of the poll, said in a press release that Cameron appears to have gained ground by consolidating support from Republicans who supported Trump in 2020. In the October poll, 54% of Trump supporters supported Cameron; in the latest survey, it was 79%.

The poll also found a similar increase for Cameron among voters aged 50 to 69; 58% of them said they support Cameron; in the October poll, he was getting only 36% of their votes. Beshear’s share dropped to 40% from 49%.

The poll also asked voters if they “support or oppose Kentucky’s current laws that ban abortion in nearly all cases, with no exception for rape or incest.” Beshear has criticized Cameron for opposing such exceptions and said the overturned Roe v. Wade Supreme Court decision was generally correct.
The poll found that 55% of likely voters oppose Kentucky's law and only 28% support it, with 17% unsure.

“Majorities of both men and women voters oppose the abortion law,” Kimball said. “Fifty-two percent of men and 58% of women voters oppose the laws, while support is relatively similar: 30% of male voters and 28% of women voters support the abortion laws.”

Three-quarters of Democrats said they oppose the law, and 47% of independents said likewise. Among, Republicans, 42% said they support it, while 37% said they opposed, and 21% were unsure. Generally, the younger the voter, the more likely they were to oppose the law.

The poll was sponsored by WDKY-TV, Fox 56, in Lexington. It was conducted mainly by automated, recorded calls to landlines. About 10% of responses came via texts to and from cell phones. About 34% came from an online panel of voters provided by Centiment Data and 1.6% came from emails provided by Aristotle, the Emerson press release said.

Most Kentucky adults favor requiring licenses to sell tobacco and vape products, and revoking licenses of repeat sellers to minors

By Melissa Patrick
Kentucky Health News

Most Kentucky adults support the idea of licensing retail stores to sell tobacco and electronic-cigarette products, and revoking the licenses of repeat offenders who sell the products to minors, according to a Foundation for a Healthy Kentucky poll taken Jan. 18-23.

Foundation for a Healthy Kentucky graphics; to enlarge any image, click on it.

Asked if they support or oppose requiring retailers that sell tobacco to be licensed, more than two-thirds of (69%) said they support the idea, 25% said they opposed it, and 6% said they were undecided. 

The question posed to them was, "Currently, tobacco retailers do not need a license to sell tobacco and vape products in Kentucky, but requiring such a license would be a way to make sure they are following and enforcing all the laws, including underage sales. Knowing this, do you support or oppose requiring retailers that sell tobacco to be licensed?" 

Then they were asked,  "If a licensed retailer were found to have repeatedly violated state law by selling tobacco and vape products to kids, would you support or oppose the revocation of their license?"

To this question, 86% of the respondents said they would support such licenses being revoked; 11% said they would oppose it; and 3% were undecided. 

The poll report said,  "Data shows licensing requirements for tobacco products reduces youth tobacco-initiation rates, usage of tobacco and electronic products, and allow cities to monitor compliance with tobacco control laws."

2023 National Youth Tobacco Survey graphic, depicting national data

The 2023 National Youth Tobacco Survey, released Nov. 3, shows that the nationwide effort to decrease youth tobacco and vaping rates is making some progress.

"Among U.S. high-school students, current overall tobacco-product use declined during 2022-23 (16.5% to 12.6%)," the report said. "This decline was primarily driven by e-cigarettes (14.1% to 10.0%), which translates to 580,000 fewer high school students who currently used e-cigarettes in 2023. Among high school students, declines were also observed during 2022-2023 for cigars and overall combustible tobacco smoking, representing all-time lows."

Further, the survey found, "In 2023, 10.0% of high-school students and 4.6% of middle-school students used e-cigarettes during the past 30 days. From 2022 to 2023, a significant decline in current e-cigarette use occurred among high-school students . . . while no statistically significant change occurred among middle-school students," whose usage was much lower than that of high-school students, according to a Centers for Disease Control and Prevention report.  

The NYTS report said, "Sustained public health monitoring with implementation of evidence-based tobacco control strategies, including effective youth interventions, media campaigns, Food and Drug Administration regulations, and other proven tobacco-prevention policies might further reduce youth tobacco-product use."

The latest tobacco-use data for Kentucky is from the 2021 Youth Risk Behavior Survey.  It found that 4.9% of the state's high-school students said they currently smoked cigarettes and 21.9% said they currently used electronic vapor products. Among middle schoolers, the report found 1.6% of them said they currently smoked cigarettes and 13.8% of them currently used an electronic vapor product.  

In such surveys, "current use" is considered having used a tobacco product on at least one day during the 30 days prior to the survey. 

The foundation's survey was conducted by Mason-Dixon Polling & Strategy as part of a Kentucky poll. It surveyed a random sample of 625 registered Kentucky voters via landline and cell phone, giving it a margin of error of plus or minus 4 percentage points.

11/6/23 Correction: The story incorrectly attributed the 2023 National Youth Tobacco Survey with a quote that correctly should have been attributed to the Foundation for a Healthy Kentucky poll report: "Data shows licensing requirements for tobacco products reduces youth tobacco-initiation rates, usage of tobacco and electronic products, and allow cities to monitor compliance with tobacco control laws."

Ky. Rural Health Association to meet Nov. 16-17 in Bowling Green

The 25th annual Kentucky Rural Health Association conference will be held in Bowling Green Nov. 16-17 at the Sloan Convention Center, 1021 Wilkinson Trace. 

The keynote address will be given by Larry Weaver, an internationally touring motivational speaker and comedian.  This year's event will also include a reception to celebrate the association's 25th anniversary, and awards ceremony and a silent auction. 

For the agenda and other information, click here. For a limited time, the conference is accepting late registrations, along with non-KRHA member and student KRHA-member registrations. To register, click here.

Candidates for governor fuss over credit for opioid settlements

Gov. Andy Beshear and Attorney General Daniel Cameron in
December 2019, after Beshear appointed Cameron to fill his
unexpired term as AG (Associated Press photo by Bruce Schreiner)

By Aneri Pattani
KFF Health News

Opioid settlement cash is not inherently political. It’s not the result of a law passed by Congress nor an edit to the state budget. It’s not taxpayer money. Rather, it’s coming from health-care companies that were sued for fueling the opioid crisis with prescription painkillers.

But like most dollars meant to address public health crises, settlement cash has nonetheless turned into a political issue.

Gubernatorial candidates in Kentucky and other states are clashing over bragging rights for the funds — which total more than $50 billion and are being distributed to state and local governments over nearly two decades. Kentucky's share of the pie is $842 million.

Among the candidates are curremt or former attorneys general who pursued the lawsuits that produced the payouts. And they’re eager to remind the public who brought home the bacon.

“Scoring money for your constituency almost always plays well,” said Stephen Voss, an associate professor of political science at the University of Kentucky. It “is a lot more compelling and unifying a political argument than taking a position on something like abortion,” for which you risk alienating someone no matter what you say.”

Attorney General Daniel Cameron, the Republican candidate for governor, wants sole credit for the hundreds of millions of dollars his state is receiving to fight the opioid epidemic. In a post on X, formerly known as Twitter, he wrote that his opponent, former attorney general and Democratic Gov. Andy Beshear, “filed a lot of lawsuits during his time [in] office, but in this race, there is only one person who has actually delivered dollars to fight the opioid epidemic, and it’s not him.”

Beshear filed nine opioid lawsuits during his tenure as attorney general, several of which led to the current payouts. At a January news conference, Beshear defended his role: “That’s where these dollars are coming from — cases that I filed, and I personally argued many of them in court.”

Christine Minhee, founder of OpioidSettlementTracker.com, who is closely following how attorneys general handle opioid-settlement money, said voters likely don’t know that the settlements are national deals crafted by a coalition of attorneys general and private lawyers. So when one candidate claims credit for the money, his constituents may believe “he’s the sole hero in all of this.”

Candidates in other states are touting their settlement credentials, too. North Carolina Attorney General Josh Stein, a Democrat, lists securing opioid settlement funds at the top of the “accomplishments” section of his 2024 gubernatorial campaign website. West Virginia Attorney General Patrick Morrisey, a Republican gubernatorial candidate for 2024, has repeatedly boasted of securing the “highest per capita settlements in the nation” in news conferences and on social media and his campaign website.

Louisiana Attorney General Jeff Landry, a Republican who was recently elected governor, ran on a tough-on-crime platform, with endorsements from sheriffs and prosecutors. As attorney general, he led negotiations on dividing opioid settlement funds within the state, resulting in an agreement to send 80% to parish governments and 20% to sheriffs’ departments — the largest direct allocation to law enforcement in the nation.

In Kentucky, half the settlement money is being distributed among cities and counties, and the other half is controlled by the Opioid Abatement Advisory Commission, staffed by Cameron's office.

It’s a common joke that AG stands for “aspiring governor,” and officials in that role often use big legal cases to advance their political careers. Research shows that attorneys general who participate in multistate litigation — like that which led to the opioid settlements and the tobacco settlement before it — are more likely to run for governor or senator.

But for some advocates and people personally affected by the opioid epidemic, this injection of politics raises concerns about how settlement dollars are being spent, who is making the decisions, and whether the money will truly address the public health crisis. Last year, more than 100,000 Americans died of drug overdoses.

Average people “don’t really care about the bragging rights as much as they care about the ability to use that funding to improve and save lives,” said Shameka Parrish-Wright, director of Vocies of Community Activists and Leaders (VOCAL-KY), a Louisville-based advocacy group that champions investments in housing and health care.

“What I see in my state is a lot of press conferences and news pieces,” said Parrish-Wright, a Democrat who is active in local politics. “But what plays out doesn’t get to the people” — especially those deeply affected by addiction.

For example, when Beshear celebrated a decrease in the state’s overdose deaths, his announcement overlooked the increasing deaths among Black Kentuckians, Parrish-Wright said.

And when the Cameron aide who chairs the opioid commission proposed that 5% of settlement funds be used to research ibogaine — an illegal psychedelic drug that has shown potential to treat addiction — to help get it approved by the Food and Drug Administration, Parrish-Wright said her first thought was “most poor people can’t afford that.” A recent witness before the commission said the FDA is unlikely to approve it, and even iof it did, treatment should occur only in hospitals because of the risk of heart damage.

The ibogaine announcement caused additional controversy. It’s an experimental drug, and, if approved, the $42 million allocation would be the single-largest investment from the commission. The Daily Beast reported that a billionaire Republican donor backing Cameron’s gubernatorial campaign stands to reap massive profits from the drug’s development.

Neither Cameron’s office nor his campaign responded to requests for comment for this story.

Beshear’s office declined an interview request but referred KFF Health News to his previous public statements, in which he criticized the potential investment in ibogaine. He has suggested that Cameron, whose campaign has emphasized support for police, is not putting his money where his mouth is.

“If you only provide $1 million to law enforcement and 42 [million] to pharma, it doesn’t seem like you’re backing the blue. It seems like you’re backing Big Pharma,” Beshear said at a May news conference.

Minhee, founder of OpioidSettlementTracker.com, said she’s concerned that mixing politics with settlement funds could result in ineffective investments nationwide.

“If some of this money is going to be politicized to advance careers of attorneys general who support the war on drugs, then that is literally using monies won by death to feed into more death,” she said.

Parrish-Wright said she worries that candidates — and some voters — will forget about the significance of the money once ballots are cast. “We cannot let it fade after the election cycle,” she said.

Her solution depends in part on politics. She’s on the ballot herself Nov. 7, for a seat on Louisville’s Metro Council. If she wins, she said, she intends to keep the settlement in the public conversation.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of the Kaiser Family Foundation, an independent source of health policy research, polling and journalism.