Wendell and Mary Berry welcome Prince Charles and wife to Louisville, where prince will focus on local food and sustainability

In honor of a royal visit on Friday to Louisville by Prince Charles and his wife Camilla, Duchess of Cornwall, who will be highlighting issues of sustainability and local food, renowned farmer-author-poet-philosopher Wendell Berry and his daughter Mary Berry, executive director of The Berry Center in New Castle, have written a welcome letter, published in The Courier-Journal. It begins:

Sir,

Your presence among us honors us. We have taken courage from your courage in opposing those who destroy for short-term profit the substance, health, and beauty of this world, which we did not make and cannot conserve except in obedience to its natural laws and to the divine imperative of human stewardship.

You will not be surprised to learn that in Kentucky, as in much of the world, the ways of conserving the land, the water, and the air are repeatedly blocked by the combination of corporate wealth, political connivance, academic complacency, and a deficit of hope where hope is most needed.

Here as elsewhere, the damages done by surface mining are severe, permanent, and largely unrestrained; the loss of land to "development" is, arithmetically, unsustainable; our use of our forests is for the most part ecologically unsound; our farmlands are eroding under an increasing burden of annual grain crops; those lands are priced beyond the reach of aspiring small farmers; and our streams are everywhere degraded by chemical and other pollutants.

But I believe you will be unsurprised also to learn that in Kentucky, as in places similarly exploited and threatened all over the world, there is a growing number of people and groups of people competently aware of, and determinedly opposed to, the diminishment of the natural health and beauty of our state and our world. We are proud to welcome you into the company of friends and allies who, like you, are unrestingly committed to the work of ecological sense and sanity. (Read more)

McCreary County smoking ban fails; story on hearing offers a picture of the strong feelings, pro and con, that the idea evokes

The McCreary County Fiscal Court was unable to move forward with a vote on a smoking-ban ordinance because it lacked a motion for a second reading, Janie Slaven reports for the McCreary County Record.

The ordinance was first presented to the court by Champions/UNITE for a Drug-Free McCreary County in November, but did not get its first reading until February, on a 4-1 vote. But after a public meeting on March 12 and in the presence of a "packed courtroom," County Judge-Executive Doug Stephens asked for a motion for a second reading, but didn't get one.

Approximately 20 people attended the one-hour public hearing, held two hours prior to the regularly scheduled meeting, Slaven reports.

One citizen against the ordinance vowed to "campaign against everyone who votes for this." Other opponents said that "smokers can't be blamed for every cancer occurrence." While others were concerned that there would be no end to the government's involvement, alluding to the day when caffeine might be banned because of health risk, Slaven writes.

A store owner, Rick Wilson, said that "while he respects Champions' mission, he believes the issue of smoking in businesses should be left to the business owners themselves," expressing great concern that the ordinance also included private spaces within a business, like offices and company vehicles. Other business owners agreed with him, even while recognizing the health hazards of second-hand smoke, Slaven reports.

Advocates of the ordinance also voiced their opinions. One Champions member presented the cost burden of smoking and second-hand smoke, saying the "health effects of second-hand smoke cost $10 billion per year."

The Lake Cumberland District Health Department’s Tracy Aaron noted that nearly 40 percent of people in the county smoke and asked the fiscal court to consider the ordinance a public-health issue affecting not only non-smoking customers but also employees. “People have to work, and it’s hard to find jobs,” she said. Upon this suggestion, citizen Albert Coffey urged her to return to her home county, Slaven reports.

Several citizens offered different solutions to an ordinance including increased community education and also a suggestion to put it on the ballot. State law does not allow that.

"For now, on both the county and state level, the issue is dead," Slaven writes, referring to a statewide smoking ban that passed the Democrat-controlled state House but was placed in an unfavorable committee in the Senate.

Slaven also reports that the McCreary County Board of Education is expected to consider adopting a tobacco-free policy at its March 24 meeting and notes that the school district already has an indoor smoke-free policy.

UK gets $2.5 million for rural child poverty nutrition center

L-R: Nancy Cox, dean of UK's College of Agriculture, Food
and Environment; Secy. Tom Vilsack; Gov. Steve Beshear.

Kentucky Health News

Agriculture Secretary Tom Vilsack announced at the University of Kentucky Thursday that the Department of Agriculture will give UK $2.5 million to establish the USDA Rural Child Poverty Nutrition Center.

"This program will target child hunger and poverty in persistently poor rural communities by partnering with agencies who have the resources and expertise to make a difference," Gov. Steve Beshear said in a UK news release. "This program will do more than offer aid. It will attack the root causes of child hunger and poverty."

UK will partner with the Altarum Institute and the Southern Rural Development Center to develop the center. They hope to administer grants to as many as 30 impoverished rural areas in up to 15 states. The communities would use the funds to better coordinate existing child-nutrition programs as well as find new ways to target child food insecurity, the release says.

Rural children who live in poverty are some of the most vulnerable, and 85 percent of all persistently poor counties in the U.S are rural. Twenty-six percent of Kentucky's children live in poverty.

Community health groups, with focus on prevention, fight to be part of new setup for lowering health costs, improving outcomes

The Patient Protection and Affordable Care Act is forcing doctors and hospitals to collaborate on lowering health-care costs while improving health outcomes. Community health groups that focus on preventive care are battling to be included as part of the solution, Laura Ungar reports for The Courier-Journal and USA Today.

One way physicians and hospitals are coming together to "reduce the duplication of services and keep large groups of patients well" is by forming accountable care organizations. Community health groups are having to fight for a "seat at the table" in these "doctor-dominated boards of ACOs," Ungar writes.

Such groups often offer less expensive, non-medical solutions for preventive health, according to a 2014 report by a North Carolina physicians' coalition. Some ACOs are beginning to include them as partners, but Bo Bobbitt, a Raleigh health-care lawyer who was lead author of the report, told Ungar, "The bad news is that the gap between the medical system treating illness and disease and the community health system was larger than we had feared."

Jose Pagan, a health economist who directs the New York Academy of Medicine's Center for Health Innovation, told Ungar that another key challenge is that doctors and hospitals are going to keep working to keep the money flowing their way. "If you go to a surgeon for a solution, they're not going to give you massage therapy," he says. "There's going to be progress, but it's going to be very slow."

Traditionally U.S. health care has focused its attention on "costly medical intervention," Ungar reports, instead of lifestyle changes, with only 3 percent of the $2.6 trillion health-care budget being spent public health and prevention, despite preventable chronic conditions accounting for 75 percent of medical care, according to a 2012 Institute of Medicine report.

"Compared to even the best medical therapy, we can decrease heart attacks, strokes and deaths by between 35 percent and 45 percent by changing lifestyle," Paul Rogers, a Louisville cardiologist at one of KentuckyOne Health System's healthy lifestyle centers, told Ungar.

For example, losing about 10 percent of weight reduces cardiac risks significantly, and losing 15 to 20 percent begins to reverse diabetes, lowers blood pressure, improves sleep and improves cholesterol level, Rogers said.

Another challenge for community-based programs is that little money goes into research on wellness programs, "and without studies, few will invest in their programs," Ungar notes.

Some members of Congress don't see nutrition, physical fitness or stop-smoking campaigns as health funding and gripe about the "nanny factor," Georges Benjamin, a physician who is executive director of the American Public Health Association, told Ungar.

As a result, "annual funding authorized by the ACA for the Prevention and Public Health Fund was supposed to hit $2 billion starting in 2015 but won't reach that level until at least 2022," Ungar reports.

Lifestyle changes are known to help chronic conditions, and Ungar gives many examples in the article. Here is one: Kevin French, 57, a construction contractor in Louisville, told Ungar that he began having chest pain and had to have two stents implanted in his heart in 1993.  And through cardiac rehab, he learned that his previous eating habits, which included lots of fast food, lack of exercise and smoking, played a big part in his heart problems. But with the help of the healthy lifestyle center, he said he  has "basically changed everything" about  his lifestyle and that's "improved not only his health but his family's as well."

Study: Loneliness increases risk of dying more than obesity

Kentucky Health News

Loneliness increases your chance of dying, according to a study by Brigham Young University and published in the journal Perspectives on Psychological Science. It found that the subjective feeling of loneliness increases risk of death by 26 percent, social isolation increases mortality risk 29 percent and living alone, 32 percent.

"The heightened risk for mortality from a lack of social relationships is greater than that from obesity," the study report says.

“This is something that we need to take seriously for our health,” Julianne Holt-Lunstad, an author of the study, told Justin Worland of Time magazine. “This should become a public-health issue." 

The researchers noted the difference between feelings of loneliness and the state of being socially isolated or alone and found that "both are potentially damaging."  Even those who said they were happy being alone had an increased risk of death, as did those who had many social connections, but said they were lonely. And though more conclusive data is needed,  those who felt lonely and were alone "may be at the greatest risk of death," Holt-Lunstad told Worland,

“If we just tell people to interact with more people, that might solve the social-isolation issue, but it might not solve the loneliness issue,” she told Worland. “I think we need to acknowledge that both of these components are important.”

Research shows that relationships improves health by "helping us manage stress, improving the functioning of the immune system and giving meaning to people's lives," Worland writes.

But with more Americans living alone than ever before and technology like texting and social media minimizing "flesh and blood" social connections, opportunities for loneliness and social isolation have increased.

Holt-Lunstad  told Worland that policy interventions for this issue might be difficult, but suggested that health-care providers need to begin identifying at-risk patients and communities need to re-think how neighborhoods are designed to help combat this problem.

Poll: Ky. parents think children's school lunches are very or somewhat nutritious, but they want more scratch-made options

Kentucky Health News

Most Kentucky parents think school lunches are nutritious, but should offer more made from-scratch options, according to the latest Kentucky Health Issues Poll.

The poll, taken Oct.8 through Nov. 6, found that 67 percent of Kentucky parents said their oldest child's school lunch was very or somewhat nutritious, while 23 percent said it was "not that nutritious"or not nutritious at all.

Opinions about the nutrition of school lunches varied across the state with 80 percent of parents in Northern Kentucky, 73 percent in greater Lexington, and 70 percent in Western Kentucky saying their child's lunch was very or somewhat nutritious, and 63 percent of parents from greater Louisville and 57 percent of parents from Eastern Kentucky saying so.

Asked if their school needed more made-from-scratch options, 69 percent of parents said it did, while 20 percent said their child's school offered enough of this option. Most parents in each region said they wanted to see more made from-scratch options, topping out at 82 percent in Eastern Kentucky.

Kentucky is first in the nation for high-school obesity, eighth in obesity of children 10 to 17, and sixth among 1-to-4-year-olds from low-income families, according to the "States of Obesity" report.

“School nutrition is one element of overall strategies to reduce childhood obesity and improve health,” said Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which sponsors the poll with Interact for Health, formerly the Health Foundation of Greater Cincinnati.

The Institute for Policy Research at the University of Cincinnati surveyed a random sample of 1,597 adults via land line and cell phone. The margin of error for the "parents" subgroup, adults with school-aged children living in the household, is plus or minus 4.7 percentage points.

Study: American children's diets will cause early heart disease; Kentucky kids seem to be on the same track

Kentucky Health News

A study shows that American kids are eating themselves toward early heart disease.

The study, published in the journal Circulation: Cardiovascular Quality and Outcomes, looked at a nationally representative group of children and found that "American kids eat too much sugar and salt, they don't eat enough fruits and vegetables, and far too many are overweight," , Maggie Fox reports for NBC News. And of the 8,900 children aged 2 to 11 surveyed, "most were not meeting the goal on three out of four measures of healthy living."

"Our findings indicate that, in general, children start with pretty good blood pressure," Dr. Donald Lloyd-Jones of the Northwestern University Feinberg School of Medicine, who oversaw the study, told Fox. "But if they have a horrible diet, it will drive a worsening body mass index and cholesterol levels."

The research found that fewer than 1 percent of the children in the study had four or five of the main components of a healthy diet; only 3 percent of boys and 2 percent of girls ate enough whole grains daily; more than half of the children drank too much sugar-sweetened beverages; and fewer than 10 percent ate the recommended amount of fruits and vegetables. The study also found that 30 percent of the children surveyed were overweight or obese, Fox reports.

This poor diet could "put many on the road to heart disease," Fox writes.

And Kentucky's children, who rank eighth in the nation for child obesity, are likely walking down this road to poor health.

The Centers for Disease Control and Prevention 2013 State Indicator Report on Fruits and Vegetables found that only 50 percent of Kentucky adolescents reported eating fruit and 43 percent reported eating vegetables with a median intake of one time per day for both.

As for sugar-sweetened beverages, the 2013 Kentucky High School Youth Risk Behavior Survey found that in the seven days prior to the the survey: 33 percent of high school students drank a sugared soda one or more times a day; 25 percent drank a sugared soda two or more times per day; and 15 percent drank a sugared soda three or more times per day.

"It seems that children in the United States are losing their ideal cardiovascular health status," the researchers wrote, Fox reports. The study found about "40 percent of the kids already had poor to worrying cholesterol levels."

The main components of a healthy diet, according to the study, are: eating four and a half cups or more of fruits and vegetables each day; three servings of whole grains a day; two servings of fish a week; minimal amounts of sugar; and below 1,500 milligrams of sodium a day.

NBC has previously reported that many studies have found that children who have risk factors for heart disease show signs of clogged arteries that are typically found in middle-aged adults.

But another study found that that eating a diet high in fruits and vegetables, low in saturated fats and low on fatty meat "dramatically cuts the risk of heart disease and stroke," Fox writes.

West Virginia to involve Kentucky in examination of studies that link health problems to mountaintop-removal coal mining

Kentucky Health News

The administration of Democratic Gov. Earl Ray Tomblin of West Virginia "said Tuesday that it would initiate an evaluation of the growing body of studies that have found residents living near mountaintop removal coal-mining operations face increases risks of serious illnesses and premature death," Ken Ward Jr. reports for The Charleston Gazette. Studies have found correlations between mountaintop removal and cancer, birth defects and the endangerment of freshwater species.

Dr. Rahul Gupta, commissioner of the state Bureau for Public Health, "said that his agency would work with the state Department of Environmental Protection to examine the issue and to seek help from various federal scientific and regulatory agencies to review existing research on the subject," Ward writes. “The analysis is something that is needed going forward,” Gupta said. “The bottom line here is to let science speak for itself. It’s time that we attempt to do that.”

"Gupta said that his plan would 'engage surrounding states' such as Kentucky and Virginia to 'evaluate the scientific research being conducted by academia, non-profit groups, and others with an emphasis on peer-reviewed research to better understand the issues,'" Ward writes. "Also, Gupta said, his agency would work with the DEP to ask 'federal partners'—such as the U.S. Environmental Protection Agency, the Centers for Disease Control, and National Institutes of Health, and the federal Office of Surface Mining—to 'seek relevant subject matter expertise allowing for the exploration of a federal-state, multi-agency partnership to conduct analysis of the existing research in the field.'" (Read more)

Midwest pollen count indicates that seasonal allergies are expected to be worse than usual this year

Seasonal allergy sufferers beware. Allergy season is officially here and is predicted to be worse than usual, says a news release from Chicago's Loyola University Health System.

image from healthguru.com

After weeks of evaluation, the Gottlieb Allergy Count, which is the official daily allergy count for the Midwest, has detected moderate pollen in the air at a time that is typically low.

Dr. Joseph Leija,  retired allergist who continues to conduct the official daily allergy count, said in the release that the long cold winter with heavy snow is likely to cause "a bad allergy season."

“The prolonged, fierce winter may mean that tree, grass and mold spores appear simultaneously early in the season, causing a triple threat," he said in the release. "Heavy snow means lots of moisture to nourish budding trees and plant life. The continued dampness also fosters the growth of mold."

Here are some allergy relief tips from WebMD :

• Take your shoes off at the door.
• Wipe down your dog's coat before it comes in the house.
• Wash your hair before bed.
• Close the windows and doors, especially on high-pollen days.
• Use the "recirculate" option in the car.
• Service the filters in your furnace and air conditioner.
• Use a dehumidifier to maintain a humidity level of less than 60 percent in your home.
• Check the daily pollen count and plan accordingly.
• If possible, have someone else mow the lawn.
• Avoid sitting outside around freshly cut grass.
• Dry your clothes in a clothes dryer, not on an outdoor line. 

“People with allergies or breathing difficulties should be proactive now to preserve health," Leija said in the release. "Consult your allergist, have the ducts cleaned on your air conditioning system and start taking your allergy medicine so that when things really heat up, you are protected."

Click here to get the daily pollen count in your county from pollen.com.

Health foundation says consumers need price transparency; Medicaid health officer says some commercial interests want it

Kentucky Health News

The Foundation for a Healthy Kentucky says a major step needed to improve the health of Kentuckians is transparency of their health-care cost and quality.

"Consumers can (then) compare apples to apples," Susan Zepeda, the Foundation's president and CEO, told Greg Stotelmyer of Public News Service. "What is a particular procedure going to cost if I have it at this hospital versus that outpatient surgery center? What are my co-pays going to be or my deductibles under my insurance plan?"

The foundation recently recommended that Kentucky develop and establish an all-payer claims database, or APCD, for consumers and stakeholders as a tool for transparency. John Langefeld, chief medical officer of the state's Department of Medicaid Services, told Stotelmyer that "support for the idea is growing, including from many on the commercial side of health care."

But this type of transparency is not likely to happen without a law to require it, which Kentucky does not have, Stotelmyer reports.

Massachusetts is the only state that requires the type of health-care transparency the foundation is talking about. And while it is not a perfect system, with reported prices not reflecting all of the involved charges, frequent price changes and weak information about the quality of care, it is still "unlike anything else in the country," Martha Bebinger reports for Kaiser Health News.

Oregon could possibly become the second state to require health-care transparency. Two bills for it are pending in the current legislative session. One that would require hospitals to reveal their median prices for common inpatient and outpatient procedures, "is expected to get very little opposition as it makes its way through the legislative session," Chris Willis reports for KGW in Portland.

But physician and system theorist Deane Waldman argues in the Huffington Post that price transparency won't work. She says that transparency can't reflect the real cost of health-care, doesn't reflect health outcomes or quality of care, and when it does reflect outcomes, it only reflects the average outcome and not individual probabilities. She also says that because the current health-care in the U.S. is not a free market, consumers have no reason to economize.

The Foundation for a Healthy Kentucky disagrees. "Sunshine on pricing will make sure that we're all playing by the same rules," Zepeda told Stotelmyer. Kentucky has the ability to gather the data, but it still needs "the political will" to do so, she said.

Warren County school board bans tobacco use on campuses and by students and employees during extracurricular school activities

The Warren County Board of Education voted 4-1 on March 16 to ban the use of tobacco "by students, employees or those on school grounds or during extracurricular school activities" as of July 1, Charles Mason reports for the Bowling Green Daily News.

"Board Chairman Kerry Young dissented," Mason reports. "He said he wanted the district to establish designated smoking areas. Young said tobacco is legal for adults, and is a traditional cash crop for Kentuckians."

However, "Board Member Don Basham said it was in the best interest of the district to promote a tobacco-free environment," and the other three members agreed. 

About 40 of Kentucky's school districts have banned tobacco. "Warren will join Simpson County as the only two school districts in south-central Kentucky deemed 100 percent tobacco-free under state guidelines, Mason reports.

Beshear cites signs toward better health: kids are more active and getting more dental care; adults are getting more screenings

Kentucky Health News

Kentucky is moving toward achieving the broad, ambitious goals for better health that Gov. Steve Beshear laid out when he started the "Kyhealthnow" initiative in February 2014, his office says.

"More Kentuckians have health insurance, are covered by smoke-free policy, can access physical activity resources, seek care for heart disease and cancer prevention, and get dental services" since the initiative began, Beshear said in a press release.

The program builds on federal health reform, which has made Medicaid or private insurance available to hundreds of thousands of Kentuckians, many of whom were previously uninsured and unable to afford health coverage. According to a Gallup Poll released in February, 9.8 percent of Kentucky’s population is uninsured, down from 20.4 percent in 2013.

Kyhealthnow targets seven major health goals to be met by 2019, focusing on increasing health insurance coverage; reducing the smoking rate and tobacco use; lowering the prevalence of obesity; lowering cancer deaths; reducing cardiovascular disease; treating and reducing dental decay; and reducing drug overdoses and mental health issues in Kentucky.

The report said more adults have been screened and identified as having high blood pressure and are able to control their hypertension, and more adults have had their cholesterol checked.

Significantly more children on Medicaid are being seen by dentists, and the number of children enrolled in Medicaid receiving two fluoride dental varnishes per year has increased. The state has given money to five health departments for dental-hygiene programs, and will fund five more this year. "These programs broaden access to hygiene services, such as cleanings, screening and referrals, by providing staff and resources to supply mobile units to deliver care in schools," the release said.

School districts are showing an increase in the amount of time devoted to physical activity, the state reports. The Comprehensive School Physical Activity Program has been implemented at proficient or distinguished levels at all grade levels in 515 of the state's 746 elementary schools, 186 of the 329 middle schools and 109 of the 228 high schools. Also, more schools report they are using body-mass index data to inform school wellness policy.

The state health department is using federal funds to implement physical activity and obesity-prevention curricula in early-childhood care centers. "The goal is to develop healthy habits in children before the age of 5 and prevent obesity," the news release says.

To increase physical activity and deter obesity among older children and adults, the state is establishing “trail towns.” Morehead and Olive Hill were recently certified by the state Office of Adventure Tourism and eight more are expected to be certified this year. The Dawkins Trail, an ongoing rail-to-trail project in Eastern Kentucky, has reached a length of 18 miles.

Diabetes management has improved among adults, and a study of Medicaid patients showed an overall decrease in those with poor diabetes control, the release said. State employees now have easier access to the nationally recognized Diabetes Prevention Program, which helps people who are at risk of developing diabetes reverse the onset of the disease.

Dr. Stephanie Mayfield, the state health commissioner and vice chair of Kyhealthnow, has emphasized the importance of reducing tobacco use to make Kentuckians healthier. Beshear has expanded the ban on tobacco products and e-cigarettes on executive branch properties, making Kentucky one of only five states in the country with such a policy. Smoking bans exist in 24 communities, 37 school districts and 51 college or university campuses.

Kyhealthnow, chaired by Lt. Gov. Crit Luallen, includes people from many areas of state government who develop innovative strategies for addressing the state’s health woes and challenge local governments, businesses, schools, nonprofits and individuals to take meaningful steps toward improving health in their communities, the release said.