Sophie Henney of Paducah chose two days after her 14th birthday to tell her story of depression and thoughts of suicide. She wanted to share her story—and her name—to help others who may be in the same situation, Genevieve Postlethwait reports for The Paducah Sun.
In Kentucky, 15 percent of teens say they've thought about committing suicide, according to the 2013 National Youth Risk Behavior Survey. According to the Centers for Disease Control and Prevention's 2013 data, 11 out of every 100,000 young people die by suicide. Every year between 1999 and 2013, Kentucky ranked 16th in the nation for rate of deaths by suicide for individuals between ages 15 and 24.
On the way to church on New Year's Eve night, Sophie told her mom, Peggy, "I wouldn't hurt myself, but I don't want to go back there to that school. I'd rather be dead." Sophie attended a small private school and hadn't had a pleasant fall semester: the other girls in her class were excluding her, and she had thought some of them were her friends, Postlethwait writes. "We found out several months later she was actually formulating a plan to do it," Peggy said. "As much attention as I was paying to her, I still didn't know. I beat myself up for several months, thinking that there was more I could have done."
Both Sophie and her counselor have released Peggy of the blame, but she still feels responsible. "I could have lost my child," Peggy said. "And there are people here who have lost their child. . . . We can talk about texting and driving; we can talk about drinking and driving; but we can't talk about suicide. We've got to start changing something."
The stigma surrounding suicide and a lack of information about it are two main things that stand in the way of changing the way people talk about suicide, said Laurie Ballew, medical director of Lourdes Behavioral Health. She said people didn't used to talk about cancer because of the stigma. "Now we talk about it," Ballew said. "We're out about it, we're loud about it, and we're educating about it. That's what we need to do with suicide and mental health issues."
Gretchen Roof, site administration at Four Rivers Behavioral Health in Paducah, "said at least once a week a child comes to them at Four Rivers who they worry may be a suicide risk." When that happens, there are several options. Children may see a counselor once per week or every other week. They can go to Four Rivers every weekday after school. In more severe cases, "'partial-hospitalization'"is an option, where the child attends school at the center while also participating in therapy from 8 a.m. to 4 p.m. every weekday," Postlethwait writes. Most of the schools in the area allow Four Rivers counselors to spend approximately one day per week in each school, which removes the need for transportation and the stigma associated with entering a mental health facility.
Roof said that parents, teachers, preachers and kids should not be afraid to talk about depression or suicidal thoughts in themselves or observed in others, Postlethwait writes. "If you have or know a child who appears depressed, or is having some sort of significant change in their behavior, a change in appearance even . . . be especially tuned-in to that child," Roof said. "Don't be afraid of saying, 'I'm concerned about you. What's going on?' and don't be afraid of asking, 'Have you thought about hurting yourself?'" Something people are afraid to ask such questions because they think they will give the person ideas, Roof said, but research shows that is false. "They will tell you, and you are the intervention that has been waiting to happen for them."
Sophie said, "I was very relieved when we went to Christmas break, and by New Years Eve, I was like, I don't want to go back. I want this to be over. I don't want to see them again. The only thing I can really think of to say is, get help. That's what made me better. Tell somebody. Talk to somebody. don't just keep it quiet."
Tuesday, June 16, 2015
Monday, June 15, 2015
Foundation for a Healthy Kentucky accepting nominations for its board of directors and Community Advisory Committee
The Foundation for a Healthy Kentucky is accepting nominations for its board of directors and Community Advisory Committee.The 15-member board is responsible for preserving the foundation’s $45 million endowment and upholding its charitable mission of addressing the unmet health care needs of Kentuckians. It gets advice from by the 31-member advisory committee.
People who will bring diversity to the foundation, and who are not affiliated with the health field, are especially encouraged to apply, the foundation said in a news release.
Nominations are being accepted for four seats on the board of directors, one from each of the following districts, with counties listed, and one at-large member:
· District 3: Adair, Bell, Casey, Clay, Cumberland, Clinton, Estill, Jackson, Garrard, Green, Knox, Laurel, Lee, Leslie, Lincoln, Marion, McCreary, Metcalfe, Monroe, Nelson, Pulaski, Rockcastle, Russell, Taylor, Washington, Wayne or Whitley.
· District 5: Anderson, Boyle, Bourbon, Clark, Fayette, Franklin, Jessamine, Madison, Mercer, Scott or Woodford.
· District 7: Boyd, Breathitt, Carter, Elliott, Floyd, Greenup, Harlan, Johnson, Knott, Lawrence, Letcher, Martin, Magoffin, Menifee, Montgomery, Morgan, Owsley, Perry, Pike, Powell, Rowan, Wolfe
· At large: Residents of any county in Kentucky can be nominated.
The foundation is also accepting nominations for nine new Community Advisory Committee members, who provide advice and recommendations to the board, serve as community liaisons, serve on foundation committees, take part in the annual policy forum and appoint or nominate candidates for director.
You can nominate yourself or someone you know by completing a nomination form, and attaching a resume or bio by July 24. You can submit the form online, by mail or via email to: Mary Jo Shircliffe, COO, Foundation for a Health Kentucky, 1640 Lyndon Farm Court, Suite 100, Louisville KY 40223. Her e-mail is mschircliffe@healthy-ky.org. For more information call 502-326-2583 or (toll-free) 877-326-2583.
Saturday, June 13, 2015
Seniors get a lot of anti-anxiety drugs, sometimes in dangerous combination with narcotics; Ky. ranks third in the nation in that
When Medicare's drug program, called Part D, was put into place more than a decade ago, Congress decided to not pay for anti-anxiety medications. In 2013, when Medicare started paying for them, the program went from spending nothing for these medications to paying more than $377 million, Charles Ornstein and Ryann Grochowski Jones report for ProPublica, a nonprofit, investigative news organization.
Using anti-anxiety drugs in combination with narcotics increases the risk of overdoses, but Kentucky has many doctors who prescribe a lot of both. More than 100 Kentucky doctors each wrote at least 1,000 prescriptions for both types of drugs in 2013, according to data compiled by ProPublica.
That ranked Kentucky third in the nation, trailing only Florida and Alabama. Other southeastern states dominated the top 10. California, the nation's most populous state, ranked eighth; Tennessee was fourth and Ohio was ninth.
ProPublica has an application that lets you look up, by doctors' names, cities or ZIP codes, the number of Medicare claims they filed in 2013, the amount of money, the number of patients and the number of prescriptions for brand-name drugs.
The anti-anxiety drugs, some known as benzodiazepines, include popular tranquilizers such as Valium, Xanax and Ativan.
Using anti-anxiety drugs in combination with narcotics increases the risk of overdoses, but Kentucky has many doctors who prescribe a lot of both. More than 100 Kentucky doctors each wrote at least 1,000 prescriptions for both types of drugs in 2013, according to data compiled by ProPublica.That ranked Kentucky third in the nation, trailing only Florida and Alabama. Other southeastern states dominated the top 10. California, the nation's most populous state, ranked eighth; Tennessee was fourth and Ohio was ninth.
ProPublica has an application that lets you look up, by doctors' names, cities or ZIP codes, the number of Medicare claims they filed in 2013, the amount of money, the number of patients and the number of prescriptions for brand-name drugs.
The anti-anxiety drugs, some known as benzodiazepines, include popular tranquilizers such as Valium, Xanax and Ativan.
Lawmakers initially chose to keep them out of Medicare Part D because they had been linked to abuse and an increased risk of falls among the elderly. Doctors kept prescribing them to Medicare enrollees, who found other ways to pay for them.
In 2013, the year Medicare started covering benzodiazepines, it paid for nearly 40 million prescriptions, ProPublica found. Generic versions of Xanax (alprazolam), Ativan (lorazepam) and Klonopin (clonazepam) were among the top 32 most-prescribed medications in Medicare Part D that year.
The American Geriatrics Society "discourages the use of benzodiazepines in seniors for agitation, insomnia or delirium because they can be habit-forming and disorienting and their effects last longer in older patients." The society does say the drugs "are appropriate to treat seizure disorders, severe anxiety, withdrawal and in end-of-life care," ProPublica notes.
One geriatric psychiatrist told ProPublica that the drugs are a "very real safety concern" for the elderly, and that he and others in his field don't use them as a "first-, second-, or third- line of treatment." Some geriatric psychiatrists have voiced concerns that these drugs are now being used instead of antipsychotics, since Medicare has pushed to reduce the use of antipsychotics, particularly in nursing homes, because of their risks.
Several doctors who rank among Medicare's top prescribers of the drugs told ProPublica that any risks of anti-anxiety drugs are outweighed by their benefits. One said that the drugs worked well for his patients, many of whom were trying to kick addictions to narcotics, but struggled with anxiety and depression.
However, ProPublica also found that some doctors appear to be prescribing benzodiazepines and narcotic painkillers to the same patients, which increased the risk of misuse and overdose. That's where Kentucky ranked third.
Dr. Leonard J. Paulozzi, a medical epidemiologist at the federal Centers for Disease Control and Prevention, co-authored an analysis showing that benzodiazepines were involved in about 30 percent of the fatal narcotic overdoses that occurred nationwide in 2010, ProPublica reports.
Friday, June 12, 2015
Louisville opens first needle exchange in state; officials predict rural counties will be slow to follow
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Photo by Scott Utterback, The Courier-Journal
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Louisville Metro Public Health & Wellness opened its mobile needle-exchange program Wednesday, June 10, making Louisville the first place in Kentucky to implement such a program.
Lexington and Northern Kentucky are expected to follow soon, but officials say that establishing needle exchanges in much of Kentucky will be "more politically complex," Mike Wynn reports for The Courier-Journal.
"We're going to see some parts of our state where this is available and others where it is not," Scott Lockard, president of the Kentucky Health Departments Association, told Wynn. "Rural areas are opting for a slow and deliberate approach, heavy on education and dialogue," he said, and some communities won't even consider a exchange because of "seemingly endless hoops to jump through."
Bullitt County, south of Louisville, is a prime example. There, officials told Wynn that they plan to do a needs assessment and host a community forum with input from law enforcement and mental health experts.
"It's a work in progress," Public Health Director Andrea Renfrow told Wynn. "We are not able to go as quickly as Louisville Metro."
One critic, Magistrate Joe Laswell, told Wynn that he had talked to many voters who are against the exchanges and want to know why police wouldn't arrest addicts when they show up to swap out dirty needles. "I believe in charging and incarcerating," he said, apparently unaware that the addicts would need to have drugs in their possession to be charged.
Lockard, who heads the Clark County Health Department, told Wynn that he won't ask his board to take a vote until August and that he can't predict the political outcome when it goes to city and county officials.
In three other Bluegrass counties, Scott, Harrison and Nicholas, the board of the Wedco District Health Department wants to start a needle exchange, reports The Cynthiana Democrat, but can't proceed in any of the counties without approval of the fiscal court.
Democratic state Rep. John Tilley of Hopkinsville, the legislature's biggest proponent for needle exchanges, told Wynn that giving city councils and fiscal courts final authority over the programs was necessary to sooth critics and pass a comprehensive heroin bill this year.
Opponents of the law say the exchanges promote drug use, while proponents cite evidence that doesn't support those claims, but instead "help prevent the spread of deadly and expensive diseases and pull addicts into treatment programs while keeping dirty needles out of parks and off the streets," Wynn writes.
A Lexington Herald-Leader editorial wrote about needle exchanges: "Congressional critics rely on a gut feeling that providing needles endorses drug use, but 20 years of research argues otherwise." Listing that where there are syringe exchange programs:
- Participants are five times more likely to get treatment.
- HIV and hepatitis C declines among drug users.
- Participants can get referrals to substance abuse treatment, disease prevention education, vaccinations, condoms, counseling and testing for communicable diseases.
- Costs are more than recaptured. A 2011 European study found that $1 spent on needle-exchange programs yielded $27 in health-care cost savings, prompting an international report to call needle exchanges "one of the most cost-effective public health interventions ever funded."
Thursday, June 11, 2015
Common heartburn medications are linked to heart attacks
Research made possible by data mining reveals evidence that a common group of heartburn medications is associated with a greater risk of heart attack, according to Stanford University researchers, Lenny Bernstein reports for The Washington Post.
The heartburn drugs in question are known as proton-pump inhibitors, such as Nexium, Prilosec and Prevacid. Bernstein writes that "they are some of the most widely used drugs in the world and that an estimated 113 million prescriptions for the drugs are written for them around the world each year."
Bernstein notes that the Stanford study, published in the online journal PLOS One, recognizes that it was not designed to show cause and effect, and agrees that a large, prospective clinical study could establish whether the drugs are actually causing more heart attacks.
But one of the authors of the study, Nicholas J. Leeper, an assistant professor of cardiovascular medicine and vascular surgery at Stanford, told Bernstein that the U.S. Food and Drug Administration "should be aware of these findings" and "we do think patients should think about their risks and benefits and should discuss their risk with their doctor."
Nigam Shah, lead author of the research, cautioned that because some of these drugs are now available over the counter, it is important to tell your physician if you are taking them.
The research combed through 16 million electronic records of 2.9 million patients in two separate databases (one database was from hospital patients and the other from private office or clinic patients) and found that people who take the medication to suppress the release of stomach acid are 16 to 21 percent more likely to have a heart attack, Bernstein reports.
The research theorizes that proton pump inhibitors may reduce production of nitric oxide from cells that line the inside of the circulatory system, including the heart. Lower levels of nitric oxide have long been associated with cardiovascular problems, Leeper told Bernstein. This theory is being tested in the lab.
The Stanford study found no association between medications that combat heartburn by blocking histamine production, like Zantac and Pepcid, and increased risk of heart attack.
The heartburn drugs in question are known as proton-pump inhibitors, such as Nexium, Prilosec and Prevacid. Bernstein writes that "they are some of the most widely used drugs in the world and that an estimated 113 million prescriptions for the drugs are written for them around the world each year."
Bernstein notes that the Stanford study, published in the online journal PLOS One, recognizes that it was not designed to show cause and effect, and agrees that a large, prospective clinical study could establish whether the drugs are actually causing more heart attacks.
But one of the authors of the study, Nicholas J. Leeper, an assistant professor of cardiovascular medicine and vascular surgery at Stanford, told Bernstein that the U.S. Food and Drug Administration "should be aware of these findings" and "we do think patients should think about their risks and benefits and should discuss their risk with their doctor."
Nigam Shah, lead author of the research, cautioned that because some of these drugs are now available over the counter, it is important to tell your physician if you are taking them.
The research combed through 16 million electronic records of 2.9 million patients in two separate databases (one database was from hospital patients and the other from private office or clinic patients) and found that people who take the medication to suppress the release of stomach acid are 16 to 21 percent more likely to have a heart attack, Bernstein reports.
The research theorizes that proton pump inhibitors may reduce production of nitric oxide from cells that line the inside of the circulatory system, including the heart. Lower levels of nitric oxide have long been associated with cardiovascular problems, Leeper told Bernstein. This theory is being tested in the lab.
The Stanford study found no association between medications that combat heartburn by blocking histamine production, like Zantac and Pepcid, and increased risk of heart attack.
Bevin says he will end all Obamacare programs in Ky., including Medicaid expansion that has added more than 400,000 to rolls
Matt Bevin, the Republican nominee for governor, has made clear that if elected he would end the Medicaid expansion that has provided free health coverage for more than 400,000 poor Kentuckians.
During his primary campaign, Bevin never made that quite plain, saying he would close the state's health-insurance exchange, Kynect, because it would cost "hundreds of millions of dollars." Kynect is paid for by insurance companies, so Bevin was alluding to to the state's projected cost of expanding Medicaid, which enrolls through Kynect.
The Washington-based publication Politico reported on June 10, after interviewing Bevin, that he would not only close Kynect but roll back the Medicaid expansion: “You may or may not have access to Medicaid going forward,” he said. “People are not on it for extended periods of time. It’s not meant to be a lifestyle. It really isn’t. The point of it is to provide for those who truly have need.”
Gov. Steve Beshear "is furious" about Bevin's plan, Politico reported. “I am not going to allow someone to become governor of this state who wants to take us back to the 19th century,” the governor said in a telephone interview. “For a serious candidate for governor to be advocating a simple repeal of the whole program without offering any kind of alternative which will continue health care for these people is irresponsible.”
Beshear expanded the eligibility rules for Medicaid as part of implementing the Patient Protection and Affordable Care Act, raising the income limit to the law's required 138 percent of the federal poverty level, from the state's previous level of 69 percent.
The federal government is paying the entire cost of the newly eligible Medicaid recipients though next year. In 2017, the state would begin to pay 3 percent, rising to the reform law's cap of 10 percent by 2020. A study by Deloitte Consulting and the Urban Institute at the University of Louisville — "which Republican critics have rejected as spin," Politico says — has said the expansion more than pays for itself through 2020 by expanding health-care jobs and generating tax revenue.
Jobs are growing as projected by the study, according to the Cabinet for Health and Family Services, which handles Medicaid.
Cabinet spokeswomnan Jill Midkiff said the study estimated that 32,000 jobs would be created through 2015 as a result of the expansion. "U of L projected this growth would primarily be in the areas of retail trade, finance and insurance, administrative services, health and social services, accommodations and food services and other services," Midkiff said. "These sectors were estimated to account for more than 28,000 of the 32,000 jobs created." She said the latest Bureau of Labor Statistics figures show that "these sectors have grown by more than 29,000 jobs from 2013 until April 2015. Therefore, the most recent BLS numbers indicate that UofL’s estimates are on target to meet projections."
Politico says a Bevin victory could "blot an Obamacare bright spot," since Kynect has "worked virtually glitch-free." Through April, 106,000 Kentuckians had obtained tax-subsidized, private insurance coverage through Kynect, which is also the portal for enrolling in Medicaid.
Bevin says he would move those people to the federal exchange, which has been marred by technological issues and charges insurance companies much more to use it than Kynect does. But that plan would not work if the U.S. Supreme Court rules this month that the tax subsidies are not legally available through the federal exchange.
"That doesn’t worry Bevin," Politico reports, quoting him: “You’re worrying about a hypothesis. Let’s let the Supreme Court rule.”
And what about the new Medicaid recipients who would lose their benefits if Bevin wins? He "insists that Obamacare is coverage in name only — that Kentuckians still lack access to high-quality health care, partly because Medicaid pays doctors such low rates, partly because he says too many people rely on emergency rooms," Politico reports, quoting him: “Just having health insurance doesn’t mean you’re going to get health care.”
Attorney General Jack Conway, the Democratic nominee, declined Politico's request for an interview. Campaign spokesman Daniel Kemp said, “Jack wants to make sure that the hundreds of thousands of Kentuckians who now have health insurance through Kynect, especially kids, keep their health insurance — not play politics or push an ideology that’s out of touch with Kentucky’s values.”
Politico observes, "Conway is in the tricky spot of embracing Kynect while trying to keep his distance from Obama and Obamacare, a term that still generates ire among Kentucky residents. A September 2014 Marist [College] poll found that 61 percent of registered Kentucky voters had an unfavorable impression of Obamacare. Only 17 percent had negative feelings about Kynect."
During his primary campaign, Bevin never made that quite plain, saying he would close the state's health-insurance exchange, Kynect, because it would cost "hundreds of millions of dollars." Kynect is paid for by insurance companies, so Bevin was alluding to to the state's projected cost of expanding Medicaid, which enrolls through Kynect.
The Washington-based publication Politico reported on June 10, after interviewing Bevin, that he would not only close Kynect but roll back the Medicaid expansion: “You may or may not have access to Medicaid going forward,” he said. “People are not on it for extended periods of time. It’s not meant to be a lifestyle. It really isn’t. The point of it is to provide for those who truly have need.”
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| Democratic nominee and Attorney General Jack Conway, with Gov. Steve Beshear; GOP nominee Matt Bevin (AP photos via Politico) |
Beshear expanded the eligibility rules for Medicaid as part of implementing the Patient Protection and Affordable Care Act, raising the income limit to the law's required 138 percent of the federal poverty level, from the state's previous level of 69 percent.
The federal government is paying the entire cost of the newly eligible Medicaid recipients though next year. In 2017, the state would begin to pay 3 percent, rising to the reform law's cap of 10 percent by 2020. A study by Deloitte Consulting and the Urban Institute at the University of Louisville — "which Republican critics have rejected as spin," Politico says — has said the expansion more than pays for itself through 2020 by expanding health-care jobs and generating tax revenue.
Jobs are growing as projected by the study, according to the Cabinet for Health and Family Services, which handles Medicaid.
Cabinet spokeswomnan Jill Midkiff said the study estimated that 32,000 jobs would be created through 2015 as a result of the expansion. "U of L projected this growth would primarily be in the areas of retail trade, finance and insurance, administrative services, health and social services, accommodations and food services and other services," Midkiff said. "These sectors were estimated to account for more than 28,000 of the 32,000 jobs created." She said the latest Bureau of Labor Statistics figures show that "these sectors have grown by more than 29,000 jobs from 2013 until April 2015. Therefore, the most recent BLS numbers indicate that UofL’s estimates are on target to meet projections."
Politico says a Bevin victory could "blot an Obamacare bright spot," since Kynect has "worked virtually glitch-free." Through April, 106,000 Kentuckians had obtained tax-subsidized, private insurance coverage through Kynect, which is also the portal for enrolling in Medicaid.
Bevin says he would move those people to the federal exchange, which has been marred by technological issues and charges insurance companies much more to use it than Kynect does. But that plan would not work if the U.S. Supreme Court rules this month that the tax subsidies are not legally available through the federal exchange.
"That doesn’t worry Bevin," Politico reports, quoting him: “You’re worrying about a hypothesis. Let’s let the Supreme Court rule.”
And what about the new Medicaid recipients who would lose their benefits if Bevin wins? He "insists that Obamacare is coverage in name only — that Kentuckians still lack access to high-quality health care, partly because Medicaid pays doctors such low rates, partly because he says too many people rely on emergency rooms," Politico reports, quoting him: “Just having health insurance doesn’t mean you’re going to get health care.”
Attorney General Jack Conway, the Democratic nominee, declined Politico's request for an interview. Campaign spokesman Daniel Kemp said, “Jack wants to make sure that the hundreds of thousands of Kentuckians who now have health insurance through Kynect, especially kids, keep their health insurance — not play politics or push an ideology that’s out of touch with Kentucky’s values.”
Politico observes, "Conway is in the tricky spot of embracing Kynect while trying to keep his distance from Obama and Obamacare, a term that still generates ire among Kentucky residents. A September 2014 Marist [College] poll found that 61 percent of registered Kentucky voters had an unfavorable impression of Obamacare. Only 17 percent had negative feelings about Kynect."
New license plate would promote outdoor recreation, support environmental education programs; 900 buyers needed to start
A new "Let's Go Outside" license plate is being offered to give Kentucky motorists the opportunity to promote the health and environmental benefits of outdoor recreation.First Lady Jane Beshear unveiled the license plate June 10. She said that encouraging children to play outside will help improve their health and noted that "Kentucky has one of the highest childhood obesity rates in the nation," reports to The Lane Report.
Proceeds from the specialty plate will support the work of the Kentucky Environmental Education Council, including coordinating the Kentucky Green and Healthy Schools program and certifying professional environmental educators.
“Kentuckians have said in surveys that children not spending enough time outside is a major concern,” KEEC Executive Director Elizabeth Schmitz said. “One of our goals is to encourage children to embrace the outdoors and to teach them the importance of a clean environment for our health and preservation."
The Kentucky Environmental Education Council needs 900 applications, each accompanied by a $25 donation, before any plates will be manufactured.
Submitting the application does not obligate you to purchase the plate, but your donation will be credited toward the purchase of a plate once they are in production. If not enough applications are received, your $25 will be considered a tax-deductible donation.
Wednesday, June 10, 2015
Newspapers' data analysis finds that Kentucky's seniors on Medicare are among the sickest in U.S.; local data available
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| Red counties are over 21%. For map with data, click here. |
"That's not surprising," Fran Feltner, director of the University of Kentucky Center of Excellence in Rural Health, told The C-J's Laura Ungar. "And when you're having breathing problems, high blood pressure problems and other problems, to me it seems like you're waging a daily battle against the chronic diseases. It's hard to fight the battle ... and as you get older, it's harder."
The top 10 Kentucky counties ranked by percentage of the 65-and-older Medicare population with six or more chronic conditions are Clay, 27.1 percent; Breathitt, 26.3 percent; Johnson, 26.2 percent; Knott, 25.1 percent; Perry, 24.6 percent; Letcher, 24.2 percent; Bell, 24 percent; Floyd, 23.8 percent; Wolfe, 23.7 percent; and Taylor, 23.6 percent. Taylor County (Campbellsville) is not in Appalachia but borders three non-coal Appalachian counties.
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| Beve Cotton (C-J photo by Mark Mahan) |
Beve Cotton, 81 and with a long list of chronic diseases, is one of those seniors. He lives in Manchester, the seat of Clay County, which ranks 12th among more than 3,100 counties nationally for the percentage of seniors on Medicare with six or more chronic conditions, Ungar reports.
Ungar reports that Clay County, population 21,147, has many of the factors that combine to cause poor health.: "Nearly 38 percent of residents live below the poverty level, compared with a state average of 19 percent, according to the Census Bureau. Median household income is about $22,000 a year, about half the state average.Access to health care, especially specialists, is limited, and there are few well-stocked grocery stores or safe places to exercise. Smoking and obesity rates are sky-high."
Cotton, who grew up in Manchester, told Ungar that he depends on others for rides, frequently to doctors' appointments, including many at the Veterans Affairs Medical Center in Lexington, about 100 miles away. Webb noted that public transportation in the area costs $1.50 per mile.
Feltner added that many seniors in the area don't know how to prevent chronic disease, some have fatalistic attitudes and because many of them are on multiple medications, they face the dangers of drug interactions and side effects, Ungar reports.
Experts say that such high levels of illness hurts communities, "hastening a downward economic spiral locally and requiring huge portions of Medicare budgets," Ungar writes. It also overtaxes the medical communities in rural counties even thinner.
"These patients need to be seen frequently by doctors, and they need much longer visits. ... These folks need intense care," Dr. Michael Karpf, executive vice president for health affairs at UK, told Ungar. "Given the shortage of primary care in Appalachia, this kind of patient just exacerbates that shortage."
"The real issue is prevention — weight control, exercise, food habits," Karpf said. "But it's hard. Fast food is cheaper than wholesome, healthy food, and (the way people eat) is partly cultural. Those things are hard to change. It's a generational process."
Dr. Steven J. Stack of Lexington is sworn in as 170th president of the American Medical Association
Dr. Steven J. Stack, an emergency physician practicing in Lexington, was sworn in as the 170th president of the American Medical Association, the nation’s largest physician organization.
He is the organization’s youngest president in the past 160 years and is the first board-certified emergency-room physician elected to the post.
Stack says he will focus his tenure on advancing the AMA’s three strategic areas: improving health outcomes for those with pre-diabetes and hypertension; accelerating change in medical education to ensure physicians are prepared to meet the needs of a 21st century health care system; and enhancing physician satisfaction and practice sustainability.
"I am honored and privileged to be named president of an organization that is dedicated to the art and science of medicine and the betterment of public health and a profession that is working to improve the health of our nation," Stack said in a press release. "I look forward to serving on behalf of America’s physicians to not only create a brighter future for the medical profession but a healthier America one patient at time, one family at a time and one community at a time."
Stack gained national recognition for his expertise in health information technology while serving as chair of the AMA's Health Information Technology Advisory Group from 2007 to 2013. He has also served on multiple federal advisory groups for the Office of the National Coordinator for Health Information Technology and as Secretary for eHealth Initiative, a non-profit multi-stakeholder organization committed to advancing health care through health information technology.
In Kentucky, Stack has served as medical director of the emergency departments at Saint Joseph East in Lexington and Saint Joseph Mount Sterling, both part of KentuckyOne Health. He was also previous medical director of the emergency department at Baptist Memorial Hospital in Memphis, Tenn.
Stack was elected to the AMA Board of Trustees in 2006. In the last eight years, he has served in many leadership positions, including chair and secretary. Prior to his service on the AMA board, he was an elected leader in numerous state, national and specialty medical associations.
He is the second Lexington physician to lead the AMA in three years. Dr. Ardis Dee Hoven, an infectious-disease specialist at the University of Kentucky, led the group in 2013-14.
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| Dr. Steven J. Stack |
Stack says he will focus his tenure on advancing the AMA’s three strategic areas: improving health outcomes for those with pre-diabetes and hypertension; accelerating change in medical education to ensure physicians are prepared to meet the needs of a 21st century health care system; and enhancing physician satisfaction and practice sustainability.
"I am honored and privileged to be named president of an organization that is dedicated to the art and science of medicine and the betterment of public health and a profession that is working to improve the health of our nation," Stack said in a press release. "I look forward to serving on behalf of America’s physicians to not only create a brighter future for the medical profession but a healthier America one patient at time, one family at a time and one community at a time."
Stack gained national recognition for his expertise in health information technology while serving as chair of the AMA's Health Information Technology Advisory Group from 2007 to 2013. He has also served on multiple federal advisory groups for the Office of the National Coordinator for Health Information Technology and as Secretary for eHealth Initiative, a non-profit multi-stakeholder organization committed to advancing health care through health information technology.
In Kentucky, Stack has served as medical director of the emergency departments at Saint Joseph East in Lexington and Saint Joseph Mount Sterling, both part of KentuckyOne Health. He was also previous medical director of the emergency department at Baptist Memorial Hospital in Memphis, Tenn.
Stack was elected to the AMA Board of Trustees in 2006. In the last eight years, he has served in many leadership positions, including chair and secretary. Prior to his service on the AMA board, he was an elected leader in numerous state, national and specialty medical associations.
He is the second Lexington physician to lead the AMA in three years. Dr. Ardis Dee Hoven, an infectious-disease specialist at the University of Kentucky, led the group in 2013-14.
Advocates of school nutrition standards use high-school chefs' competition to show that food can still taste good
The higher school-food standards required by the Child Nutrition Act expire this year, and Republicans are continuing their efforts to roll back some of them. Democrats and advocates of the standards used a student cooking event on Capitol Hill to generate support for the standards, apparently to counter arguments of some school nutrition directors that some of the healthier options are more difficult to prepare and serve.
In the final competition, the top nine high-school teams served their winning dishes to lawmakers. The dishes had to follow their cafeterias' budgets and the national standards: To win, students had to include products rich in whole grains, low in sodium and a half-cup of fruits and vegetables, Whitney Forman-Cook reports for Agri-Pulse, a Washington newsletter. She doesn't list any of the dishes, but they're listed with the winners on the "Cooking Up Change" website of the Healthy Schools Campaign.
Sen. Debbie Stabenow, D-Mich., hosted the event. She said that she and Senate Agriculture Committee Chariman Pat Roberts, R-Kan., who has vowed to roll back some of the standards, have been discussing the issue, and she would like to pass a bipartisan bill by Sept. 30, when the current law's authority ends. One standard Stabenow doesn't want to compromise on is the requirement for a half-cup of fruit and vegetables; Michigan is a big fruit and vegetable state.
Stabenow said the Department of Agriculture "is very willing to work with schools where there are issues" in meeting nutrition requirements. (Read more)
Stabenow said the Department of Agriculture "is very willing to work with schools where there are issues" in meeting nutrition requirements. (Read more)
Partial knee replacement using a robotic arm used in Ky. for first time; offers hope of longer lasting knees that feel more natural
A partial knee replacement surgery that utilizes a robotic arm was performed for the first time in Kentucky in May, Mark Hansel reports for the Northern Kentucky Tribune.
Dr. Matthew Hummel of Commonwealth Orthopaedic Physicians, which serves the greater Cincinnati area, performed the Stryker MAKOplasty partial knee resurfacing procedure at St. Elizabeth Edgewood May 19.
Hummel said "benefits of the minimally invasive procedure are expected to include a more natural feeling post-surgery and improved recovery time," Hansel writes.
“Stryker MAKOplasty allows us to treat patients with knee osteoarthritis at earlier stages and with greater precision,” Hummel said. “Because it is less invasive and preserves more of the patient’s natural knee, the goal is for patients to have relief from their pain, gain back their knee motion, and return to their daily activities.”
Osteoarthritis is the most common form of arthritis and a leading cause of disability worldwide, according to the American Academy of Orthopaedic Surgeons.
Hummel said the procedure has been "around for several years," and that he has been tracking its progress, including recent results and upgrades in technology, before using it on his patients.
Hansel explains that the procedure is performed using RIO, a highly advanced, surgeon-controlled robotic arm system. The system correlates a pre-surgical plan that was created by using a CT scan of the patient's knee taken before the surgery with a three-dimensional, virtual view of the patient's bone surface during the procedure.
Hummel told Hansel that some patients are "apprehensive about having a robot perform the procedure," but assures them that "I am actually operating and doing all the work, but it is helping me apply the best laser lines and guiding techniques."
In addition to a more rapid recovery, the procedure is expected to result in reduced pain, a smaller scar, minimal hospitalization, less implant wear and loosening, and better motion that feels more natural, Hansel reports.
“If my implants completely match my plan CT scan, I’m hopeful that with today’s technology, we can have knees that last 25 and 30 years,” Hummel said
Hummel has since performed the procedure on at least one other patients at St. Elizabeth Edgewood. It is anticipated that this procedure will be expanded to total hip and total knee replacements, but these procedures have not yet gained the U.S. Food and Drug Administration's approval.
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| RIO, Robotic Arm System (Photo from NKYTribune) |
Dr. Matthew Hummel of Commonwealth Orthopaedic Physicians, which serves the greater Cincinnati area, performed the Stryker MAKOplasty partial knee resurfacing procedure at St. Elizabeth Edgewood May 19.
Hummel said "benefits of the minimally invasive procedure are expected to include a more natural feeling post-surgery and improved recovery time," Hansel writes.
“Stryker MAKOplasty allows us to treat patients with knee osteoarthritis at earlier stages and with greater precision,” Hummel said. “Because it is less invasive and preserves more of the patient’s natural knee, the goal is for patients to have relief from their pain, gain back their knee motion, and return to their daily activities.”
Osteoarthritis is the most common form of arthritis and a leading cause of disability worldwide, according to the American Academy of Orthopaedic Surgeons.
Hummel said the procedure has been "around for several years," and that he has been tracking its progress, including recent results and upgrades in technology, before using it on his patients.
Hansel explains that the procedure is performed using RIO, a highly advanced, surgeon-controlled robotic arm system. The system correlates a pre-surgical plan that was created by using a CT scan of the patient's knee taken before the surgery with a three-dimensional, virtual view of the patient's bone surface during the procedure.
Hummel told Hansel that some patients are "apprehensive about having a robot perform the procedure," but assures them that "I am actually operating and doing all the work, but it is helping me apply the best laser lines and guiding techniques."
In addition to a more rapid recovery, the procedure is expected to result in reduced pain, a smaller scar, minimal hospitalization, less implant wear and loosening, and better motion that feels more natural, Hansel reports.
“If my implants completely match my plan CT scan, I’m hopeful that with today’s technology, we can have knees that last 25 and 30 years,” Hummel said
Hummel has since performed the procedure on at least one other patients at St. Elizabeth Edgewood. It is anticipated that this procedure will be expanded to total hip and total knee replacements, but these procedures have not yet gained the U.S. Food and Drug Administration's approval.
Tuesday, June 9, 2015
UK students in national program to educate kids about oral health
A University of Kentucky undergraduate dental group was recently spotlighted by the National Children's Oral Health Foundation for their passion to share oral-health education with elementary and middle schools in Kentucky, according to a UK news release.
UK Students United with America's ToothFairy was founded in 2014 and is made up of more than 100 UK undergraduates interested in dentistry, who are also part of the UK Pre-Dental Society.
The America’s ToothFairy® program is the branch of the National Children’s Oral Health Foundation that works to prevent childhood dental disease through community-based prevention, education and treatment services.
"At a young age, these children can lose and permanently damage their teeth," Nabeela Rahman, a first-year UK College of Dentistry student and former UKPDS president, said in the release. "Being able to help these children, even slightly, was a very rewarding experience for me."
Already this year, UK's SUAT chapter has held six community outreach events reaching more than 500 students, targeting schools in Lexington and some rural Kentucky areas. It is considered one of the largest and more active chapters in the nation, the release says.
At each event, SUAT members share oral health and nutrition information and demonstrate proper tooth brushing and flossing. They also share information about the effects of tobacco on oral health and send the students home with toothbrushes, toothpaste and floss.
Tooth decay is the most common chronic disease in children and adolescents ages 6 to 19, according to the federal Centers for Disease Control and Prevention. And a 2001 Kentucky oral health survey found that 29 percent of third- and sixth-grade students screened had untreated tooth decay and 75 percent had not seen a dentist in more than a year, according to the release.
UK Students United with America's ToothFairy was founded in 2014 and is made up of more than 100 UK undergraduates interested in dentistry, who are also part of the UK Pre-Dental Society.The America’s ToothFairy® program is the branch of the National Children’s Oral Health Foundation that works to prevent childhood dental disease through community-based prevention, education and treatment services.
"At a young age, these children can lose and permanently damage their teeth," Nabeela Rahman, a first-year UK College of Dentistry student and former UKPDS president, said in the release. "Being able to help these children, even slightly, was a very rewarding experience for me."
At each event, SUAT members share oral health and nutrition information and demonstrate proper tooth brushing and flossing. They also share information about the effects of tobacco on oral health and send the students home with toothbrushes, toothpaste and floss.
Tooth decay is the most common chronic disease in children and adolescents ages 6 to 19, according to the federal Centers for Disease Control and Prevention. And a 2001 Kentucky oral health survey found that 29 percent of third- and sixth-grade students screened had untreated tooth decay and 75 percent had not seen a dentist in more than a year, according to the release.
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