Kentucky spends less than a penny of its tobacco-settlement money on prevention programs; few states do very much

By Molly Burchett
Kentucky Health News

A new report says that 15 years after the 1998 state tobacco settlement, Kentucky ranks 38th in the nation in funding tobacco prevention and cessation programs, only 3.7 percent of the amount recommended by the federal Centers for Disease Control and Prevention.

The CDC recommends that the state spend $57.2 million a year on programs to help people quit smoking, but Kentucky is only planning to spend $2.1 million in 2014 on them, says the new annual report from the Campaign for Tobacco-Free Kids. Last year's report ranked Kentucky 37th as it planned to spend the same amount.

The goal of these programs is to help kids and adults quit smoking. Of the $320.3 million in revenue the state will get from the settlement in the current fiscal year, Kentucky will spend just 0.7 percent of it on tobacco-prevention programs, or less than a penny of every dollar it collects in revenue, the campaign says in a news release and a chart.

Kentucky has the highest smoking rates in the country, a an estimated 28.3 percent of adults and 24.1 percent of high-school students smoke. Each year, tobacco claims 7,800 lives and costs the state $1.5 billion in health care bills, about $487 million of which are covered by the federal-state Medicaid program, and each Kentucky household pays an estimated $582 per year in taxes to cover smoking-caused government expenditures, the release says.

To reduce smoking and its negative consequences, health advocates are calling on Kentucky leaders to pass a comprehensive, statewide ban on smoking in workplaces and enclosed public spaces. Some advocates also call for an increase in the state's tobacco tax. The report says Kentucky has the 40th lowest cigarette tax in the country at 60 cents per pack, 93 cents below the state average. It was doubled a few years ago.

"Tobacco takes a terrible health and economic toll on Kentucky, but state leaders can do something about it by increasing funding for tobacco prevention and passing a comprehensive, statewide smoke-free law," said Matthew L. Myers, president of the campaign. "The evidence is clear that reducing tobacco use not only saves lives, it also saves money by reducing tobacco-related health care costs. It's one of the smartest investments Kentucky can make."

Nationally, the report finds that most states are failing to adequately fund tobacco prevention and cessation programs. States will collect $25 billion from the tobacco settlement and tobacco taxes in 2014, but will spend just 1.9 percent of it on prevention programs.

States are spending only 13 percent of the CDC's recommended $3.7 billion in funding for these prevention programs, and only two states – Alaska and North Dakota – spend the recommended amount.

Green = State spends 50 percent or more than recommended amount; Orange= 25-45 percent of recommended amount; Yellow = 10-24 percent of recommended amount; Gray = less than 10 percent of recommended amount 

"Tobacco use is the number one cause of preventable death in the U.S., killing more than 400,000 people and costing $96 billion in health care bills each year. Nationally, about 18 percent of adults and 18.1 percent of high school students smoke." says the report.

Since the states settled their lawsuits against the tobacco companies in November 1998, the Campaign for Tobacco-Free Kids has issued annual reports to hold states accountable for settlement spending, an amount estimated to be $246 billion over the first 25 years.

The annual report on states' funding of tobacco prevention programs, titled "A Broken Promise to Our Children: The 1998 State Tobacco Settlement 15 Years Later," was released by the campaign, the American Heart Association, the American Cancer Society Cancer Action Network, the American Lung Association, the Robert Wood Johnson Foundation and Americans for Nonsmokers' Rights.

Kids Count shows Ky. tops in smoking by pregnant mothers, has a wide range of local data about children's well-being

By Molly Burchett
Kentucky Health News

The annual Kids Count report on children's well-being, released Tuesday by the Annie E. Casey Foundation and Kentucky Youth Advocates, says the state leads the nation in smoking by pregnant mothers and more than one in four children in Kentucky lived in poverty in 2012. It argues for improvements in preventive care and newborn health throughout the state.

The report is part of the 23rd annual release of the County Data Book, which contains a wide range of county-by-county data that are indicators of children's well-being. Unlike previous annual reports, this one ranks Kentucky counties on overall child well-being and on four domains: economic security, education, health, and family and community strength.

The county-by-county assessment found seven counties that scored substantially higher on overall child well-being rankings: Boone, Calloway, Meade, Oldham, Spencer, Washington, and Woodford. The six counties clearly at the bottom, in descending order, were Owsley, Knox, Elliot, Martin, Fulton, and Clay.

Health affects almost every aspect of child well-being. On the four scores in the Health domain (smoking during pregnancy, low-birthweight babies, asthma hospitalizations and teen births) Oldham and Boone counties scored much higher than other counties, and Bell and Fulton counties, in the southeastern and southwestern corners of the state, scored the lowest.

The chart to the right indicates how much worse Bell and Fulton ranked than similar counties. 

The data from this year’s Kids Count book, as well as new and historical data for the many other indicators Kentucky Youth Advocates tracks, can be found at the Kids Count Data Center by clicking here. The data cover counties, school districts, cities and Metro Louisville council districts.

Based on the latest available data from 34 comparable states, in 2011 Kentucky had the highest rate of women who smoked during pregnancy. Nationally, 9 percent smoked during pregnancy while 23 percent did in Kentucky.


Babies born to mothers who smoked during pregnancy are more likely to suffer low birth weight, premature birth and infant death, and almost one in every 10 babies in Kentucky were born at low birth weight, says the report. While the national average for low-birthweight babies is 8.1 percent of all live births, low-birth-weight babies made up more than 14 percent of births to mothers in Lawrence, Lewis, Martin, and Wolfe counties.

“We know smoke-free policies will reduce smoking during pregnancy and reduce the number of babies born at a low birth weight,” said Terry Brooks, executive director of Kentucky Youth Advocates. “It’s time to do what works and enact a comprehensive, statewide smoke-free law. We need to protect all children, not just those lucky enough to be born in a smoke-free community.”


In addition to babies born to mothers who smoke during pregnancy, those born to teenage mothers are at increased risk of low birth weight and other health problems, says the report.

While the state's rate of births to teenage mothers has declined each year since 2007, it remains higher than the national average, which has shown a similar decline. There were 43 teen births for every 1,000 females aged 15-19 in 2011, compared to the national rate of 31. The report says Oldham County had the lowest rate of teen births (1.3 percent) while McCreary County had the highest (8.6 percent). It also says the most effective way to keep reducing teen births rate is to educate young people about sex and risky sexual behaviors, and to provide access to contraceptive methods.

While Kentucky has made progress in providing health-care coverage for children and newborns, the state is among the leaders in childhood obesity, diabetes and asthma, and has a greater-than-average number of children with disabilities or other chronic health problems like cystic fibrosis or heart disease, the report says. "Yet families face many hurdles when they seek treatment for their children. They may lack health insurance or lack transportation," it says. "Some areas do not have enough health-care providers."

Report calls for investments in Kentucky children

Higher teen-birth rates are found among communities of color, which are also disproportionately affected by poverty, says the report. One in four of Kentucky's children live in poverty.

This rate and the number of unemployed parents, which went up by 24,000 between 2007 and 2012, have increased since the 2008-09 recession. Poverty rates in 2012 were highest among African American children (52 percent) and Hispanic or Latino children (41 percent). Living in a high-poverty area puts a child at greater risk for poor health and educational outcomes.

A widespread lack of economic security is perhaps the greatest concern for many kids in the state, says the report. The Kentucky Cabinet for Health and Family Services recently cut spending for the Child Care Assistance Program and the Kinship Care Program. As a result, 8,700 families lost assistance for child care, and financial support was also eliminated for main relatives who raise children unable to live with their parents. The report calls for restoration of these programs and more investments in Kentucky’s children.

"Taken together, the data tell a clear story: Kentucky kids need the attention of Kentucky leaders," says the report. “It’s time to make children and families a priority in our state by investing in programs that keep parents working and promote economic security,” said Brooks.

Click here to get more information about the Annie E. Casey Foundation or view its policy reports.

Some schools let kids with live head lice stay; policy change has some Kentucky parents scratching their heads

By Molly Burchett
Kentucky Health News

School districts across the country are adopting policies that say students diagnosed with live head lice or nits (louse eggs) can remain in school and parents don't need to be alerted when their child comes in contact with lice. Others schools say they will keep strict lice policies and will continue to alert parents about lice infestations. What's the policy at your child's school?

The American Pediatric Association, the Harvard School of Public Health and the National Association of School Nurses recommend that schools discontinue "no-nits" policies, taking the position that students should not be excluded from school due to suspected head lice or due to nits only. The Kentucky Department of Education and the Kentucky School Board Association also support this recommendation.

The organizations say "no-nit" policies that require a child to be free of nits before they can return to schools should be discontinued because nits are very unlikely to hatch and become crawling lice, nits are cemented to hair shafts and are unlikely to be transferred to another person, and the burden of absenteeism to the students and communities isn't doesn't outweigh the risks of head lice.

This policy shift is designed to help keep children from missing class and to shield children with lice from embarrassment, but these more lenient policies are bugging some parents, reports Jennifer Kerr of The Associated Press.

One school in Paducah says its strict policy about alerting parents if their child gets lice won't change anytime soon, reports Mychaela Brunen of WPSD-TV.

Vicki Brantner has been a school nurse at McNabb Elementary School in Paducah for six years and says the school's strict lice policy is here to stay. "When we have somebody that has head lice, we have a step-by-step procedure that we give to them to take home, it's not only washing the hair, but you have to clean your environment," Brantner told Brunen.

"We have a no-nit policy which means not only can they be here if they have the actual bug, but all the eggs removed also," said Brantner. She said parents with elementary school-aged kids should check their child's hair for lice once a week.

Marcey Davis, a mother of five, said she appreciates getting notices about lice infestations from McNabb Elementary. "It keeps me informed as a parent, as to what's going on in their classrooms and the school," she told Buren. "Parents need to stay on top of in order to keep a lice-free school, at the risk of embarrassing my child, I would rather know about it."

The head louse is a parasitic insect that can be found on the head, eyebrows, and eyelashes of people, and the CDC estimates that 6 million to 12 million infestations occur each year between schoolchildren between the ages of 3 and 11. It is much more common for schoolchildren to get lice because schools bring large numbers of children together where they are in close contact with each other, reports Mike Potter of the University of Kentucky College of Agriculture.

Here are some tips from the CDC that can be used to prevent and control the spread of lice:

• Avoid head-to-head (hair-to-hair) contact during play and other activities at home, school, and elsewhere (sports activities, playground, slumber parties, camp). 
• Do not share clothing such as hats, scarves, coats, sports uniforms, hair ribbons, or barrettes.
• Do not share combs, brushes, or towels. Disinfest combs and brushes used by an infested person by soaking them in hot water (at least 130°F) for 5–10 minutes. 
• Do not lie on beds, couches, pillows, carpets, or stuffed animals that have recently been in contact with an infested person.

Herald-Leader blasts UK for secrecy surrounding children's heart program and its efforts to rebuild it despite nearby competition

The Lexington Herald-Leader blasted the University of Kentucky in an editorial Sunday for "stonewalling questions about the decision to halt pediatric cardiothoracic surgeries and the mysterious sidelining of Dr. Mark Plunkett, the high-profile surgeon UK hired in 2007 to rebuild that program."

Mark Plunkett

The editorial says UK officials implied that "all would be clear" after their examination of the children's heart program, but "nothing is clear" after they issued a 100-page report that "offers no explanation about what went wrong. In fact, Plunkett's name never appears in the report."

But the report does acknowledge two challenges in rebuilding the program: "There are several excellent congenital heart centers in close proximity" to Lexington, and "In some cases we must regain the trust of our referring providers." Dr. Michael Karpf, UK's vice president for health, has been publicly appealing for referrals of all types from hospitals and physicians in Western Kentucky, where UK competes with Vanderbilt University.

Michael Karpf

"After two unsuccessful, no doubt very expensive, efforts to build this program, UK wants to try again," the editorial says. "And it wants to regain trust of referring physicians and families with very sick, very young children despite the fact that it has consistently undermined trust by refusing to answer legitimate questions. UK has in fact agreed to pay a lot of money to avoid a public discussion of what went wrong," keeping Plunkett on the payroll, then paying him $1.5 million for "a vow of silence on both sides."

The editorial concludes, "It is aggravating that UK, a public land-grant institution in a very sick state, is intent on carving out a specialized, expensive health-care niche that's already filled when there are so many needs that are not being met. It is also deeply disturbing that UK's energy and treasure are aimed at maintaining a shroud of secrecy over this program. We still don't know much about what happened in Plunkett's operating rooms but it is clear that UK botched this opportunity to regain the public's trust." (Read more)

Asked to reply, UK spokesman Jay Blanton said, "First, our job is to make sure that Kentuckians have access to the most complex health care. Kentuckians should not have to go outside Kentucky to have access to such high-quality, complex care. . . . If we didn’t have such a program, Kentuckians – particularly those in Eastern Kentucky – will have to leave the state for critically important pediatric care. Moreover, part of the requirements of having a Level 1 trauma center and service for this region is to have an appropriate presence in this critical area of children’s care.

"Second, we’ve been totally forthright. Our standards and expectations – for both transparency and quality – are evidenced by, among other things, our ranking just this month of 12th out of 118 academic medical centers for quality, by University Health Consortium. UHC provides an objective, impartial analysis across a range of quality measures. You don’t rank 12th in the country if you are not putting forward, in a transparent fashion, your numbers and outcomes across an array of metrics and quality measurements."

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Safety tips for trick or treating, Halloween parties

The state Department for Public Health offers these food safety tips to help you have a safe Halloween:

• Avoid having children snack while they’re out trick-or-treating so you can inspect the contents of their treat bag. Give children a light meal or snack before they go out trick-or-treating to help prevent them from snacking.
• Inspect commercially wrapped treats for signs of tampering, such as unusual appearance, discoloration, tiny pinholes or tears in wrappers. Throw away anything that looks suspicious.
• Discard fruit and homemade treats unless you personally know their source and make sure that all fresh fruit is washed prior to eating. When in doubt, throw it out. Parents of very young children should also remove any choking hazards such as gum, peanuts, hard candies or small toys.

Follow these tips for Halloween parties at home:

• If juice or cider is served to children at parties, make sure the juice is pasteurized or otherwise treated to destroy harmful bacteria. Juice or cider that has not been treated will state this on the label.
• Don’t taste raw cookie dough or cake batter.
• Before going bobbing for apples, reduce the number of bacteria that might be present on apples and other raw fruits and vegetables by thoroughly rinsing them under cool running water. As an added precaution, use a produce brush to remove surface dirt.
• Keep all perishable foods chilled until serving time, including cut melons, finger sandwiches, cheese platters, tossed salads, cold pasta dishes with meat, poultry or seafood and cream pies or cakes with whipped cream and cream cheese frostings. Don’t leave these foods out at room temperature for more than two hours.
• Remind children to wash their hands before eating to prevent foodborne illness.
• Remember some children have food allergies, so make sure that treats with peanuts or other nuts are clearly identified. 

The Cabinet for Health and Family Services Food Safety Branch can answer questions about food safety; it's at (502) 564-7181.

School nurses are an unfunded mandate for schools, which are picking up more of their cost as health department budgets shrink

Marion County nurse Renee Schooling helps
Levi Hardin, a Marion County first grader with
diabetes, check his blood sugar. (Lebanon
Enterprise Photo by Stevie Lowery)

Kentucky school nurses are stretched thin across the districts they serve and the budgets to pay for  them are stretched even thinner, because of budget cuts in the state Department of Public Health.

School districts are picking up the load, but often not all of it, because of their own financial challenges. "Basically it's one of the many unfunded mandates," Editor Stevie Lowery writes for The Lebanon Enterprise.

Lowery reports that the Marion County Schools currently share the cost of nurses with the Lincoln Trail District Health Department, with the schools paying 58 percent, or $161,000 a yera, and the department paying 42 percent, $116,000.

In some counties, schools are bearing the entire cost, which in some cases has reduced the availability of nurses, but Thursday night, the Christian County school board voted to hire another nurse, giving it one at every school, Editor Eli Pace reports for the Kentucky New Era in Hopkinsville.

Marion County Supt. Taylora Schlosser told Lowery that while her district values the services nurses provide, she and the school board will need to keep evaluating who pays for that service. The district plans to compare the cost of its contract with the health department and the cost of hiring its own nurses, with a commitment to not allow the level of service to change, Lowery reports.

“We will always have school nurses because we are going to take care of our kids,” Schlosser told Lowery. “How we pay for school nurses might change.”

In Kentucky, if a student requires medical care in order to attend school, state law requires school districts to provide the care.  Districts may hire nurses, contract with the health department, or use the medical supervision and delegation of medical tasks to district staff by local medical professionals, Lowery reports.

School nurses take care of students and staff who are injured or not feeling well, care for students with special medical or dietary needs, administer medications, conduct screenings, give flu shots, provide nutrition and wellness education, certify and give immunizations, and train staff in CPR, first aid and emergency administration of medication, Lowery reports.

“We’re not just boo-boos and Band-Aids,” Keown told Lowery. "Our main goal is to keep kids in school and keep them healthy so they can get a better education. Healthy kids make healthy students.” (Read more)

In Christian County, nurses have been called on almost 13,000 times this year, nurse coordinator Megan Kidd reported to the school board Thursday night. She said many students in the district don't have primary-care physicians and are told by their parents to see the school nurse, Pace reports.

"Kidd said 11 out of the district’s 15 schools have at least one diabetic student who depends on insulin," Pace writes. "In addition to insulin injections, other common reasons for trips to the nurse include allergic reactions requiring EpiPens and asthma attacks. Seizures also seem to be on the rise, Kidd said.

"But even though most of the visits were related to fairly common issues, Kidd told a story of a school nurse who once saw a student starting to show signs of leukemia. The nurse didn’t diagnose the child with cancer — that’s something a school nurse would be not allowed to do anyway, Kidd said — but the nurse pushed the child’s parents to go to the doctor, and the child did in fact turn out to have cancer." (Read more; subscription required)

KET program to feature citizens who work in three programs to improve the health of Kentucky children

The next episode of  KET's "Health Three60" series will be a program that features citizens who have made a difference in the health of Kentucky children. "Champions for Children's Health" premieres Monday, Oct. 21 at 9 p.m. Eastern Time. It is available online at www.ket.org.

Featured will be guest from HANDS (Health Access Nurturing Development Services), a  home-visitation program for new and expectant parents; Better Bites, of Lexington, whose goal is to transform the snacking culture to reduce childhood obesity; and Doctors and Lawyers for Kids, a Louisville group that helps families with legal issues, such as housing, custody and immigration, that may impact children’s health.

HANDS is a well-regarded, statewide program that works toward healthy pregnancies and births, healthy child growth and development, safe homes and self-sufficient families.  Referred participants begin the process with a home visit that determines the needs and concerns a family might have about pregnancy or a baby's first year.  Families then receive information and learn about resources available in the community to help them and based on the needs of the family, some will receive continued home visits.  This program is available not only to first-time Kentucky moms and/or dads, but also to expectant parents. The premise of the program is that early family intervention improves the well-being of the entire community.

Middle- and high-school students invited to create 30-second videos discouraging prescription drug abuse, win prizes in contest

Attorney General Jack Conway and his Keep Kentucky Safe partners invite Kentucky middle- and high-school students to compete in the annual Prescription Drug Abuse Prevention Public Service Announcement contest.

Contestants create a PSA to warn Kentucky kids about the dangers of prescription drug abuse. "I want our young people to know that it is never okay to take a prescription pill that was not prescribed to them by their doctor,"  Conway said in a press release.  "These are some of the most addictive substances on the planet, and if taken in the wrong combination, or with other substances, they can kill you."

Participating students should produce a 30-second video showing the perils of prescription drug abuse and submit it by Dec. 6.  Winners will be announced Dec. 13. The first place winner will receive an Apple iPad, donated by the National Association of Drug Diversion Investigators, and the runner-up will receive a $100 Amazon.com gift card donated by the Kentucky Pharmacists Association.

Other partners in the contest are the Kentucky Office of Drug Control Policy, Operation UNITE and concerned parents, Dr. Karen Shay and Mike Donta.

Instructions for submission can be found here.  Examples of  winning videos can be found by clicking here for the 2012 winning video and here for the 2012 second place video.

Fewer teens report using tobacco and abusing prescription drugs, but some attribute latter trend to increase in heroin use

By Melissa Patrick and Melissa Landon
Kentucky Health News

Fewer Kentucky teenagers said last year that they used prescription drugs without a doctor's direction, or tobacco, than in the last such survey. But some addiction experts worry that prescription-drug abuse has dropped since 2010 because young people are using heroin instead.

According to a state survey of young people in 88 percent of Kentucky's school districts, their improper use of prescription drugs has declined steadily since 2004, with the greatest decrease between 2010 and 2012.

In 2012, prescription-drug abuse among high-school seniors dropped almost a third, to 9 percent from 13.1 percent in 2010. Among sophomores, it dropped to 7.6 from 11.3 percent; among eighth graders, to 2.9 from 5.3 percent; and among sixth graders, to 0.7 from 1.8 percent.

Some feel there's a disconcerting reason for the decline in prescription-drug abuse. "My concern is the unintended consequence is that people have switched to heroin," Karyn Hascal, president of The Healing Place recovery program in Louisville, told Laura Ungar of The Courier-Journal. "The problem is addiction, not the drug of the day." Hascal said The Healing Place has seen addicts who started out using other types of drugs but eventually turned to heroin as a cheaper option.

Although the survey didn't measure heroin use among teens, it asked if any of their four best friends had used illegal drugs in the past year. The results showed a continued slow decline, to 12.2 percent and 15 percent, respectively, among high-school sophomores and seniors.

"Over the past four years we have significantly stepped our efforts to address prescription-drug abuse," Connie Smith, manager of the Substance Abuse Prevention Branch of the state Division of Behavioral Health, said in a news release. "All of our regional prevention centers have been working very hard with their local coalitions to plan and implement effective programs to reduce illegal use of prescription drugs among youth."

The federally funded survey measures use of drugs, tobacco and inhalants; mental health; school safety issues; and gambling. The division said 153 of the 174 school districts at the time took part, with 122,718 students participating. The survey also measures concerns such as school safety issues and gambling. The report said that almost every other area studied had lower numbers in 2012 than in 2008

The survey asked several questions about tobacco. Among high-school seniors, 25.6 percent reported smoking in the previous 30 days, down from 29.4 percent in 2010. Among sophomores, smoking dropped to 18 percent from 21.7 percent; among eighth graders, to 8.7 from 10.7; and among sixth graders, to 2 percent from 2.5 percent in 2010.

Use of smokeless tobacco by high-school students declined in 2012, after rising in each survey from 2006 to 2010. Among seniors, it fell to 15.7 percent from 17.5 percent in 2010; among sophomores, it dropped to 13.4 percent from 15.9 percent. Among younger students, an eight-year decline continued, but at a sharper rate since 2010.

Marijuana use among high-schoolers declined slightly after increasing in 2008 and 2010. The survey also showed a steady decrease in the risk that teenagers associate with occasional use of marijuana. For the full report, click here.

Kentucky Health News is an independent service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Study says obese children (Kentucky's a leader in that) may have quadruple the risk of having high blood pressure as adults

By Molly Burchett
Kentucky Health News

A new study shows that being obese in childhood may quadruple the risk of having high blood pressure risk as an adult, highlighting the need for Kentucky to curb its high rate of childhood obesity.

Eighteen percent of Kentucky high schoolers are obese, tying Mississippi for the highest percentage among the states, says a report by Kentucky's Task Force on Childhood Obesity. In the age range of 10 to 17, Kentucky trails several other states but remains a national leader.

One in three U.S. children and teens are overweight or obese, meaning their body mass index is at least the 85th percentile or at least the 95th percentile for their age and gender, respectively, says the American Heart Association. And, even more children are at-risk of becoming obese adults by the year 2030, says new report from Trust for America’s Health and the Robert Wood Johnson Foundation.

This study adds to concern about the long term impact of childhood obesity by linking it with increased risk for high blood pressure. High blood pressure, if left untreated, can damage the heart and coronary arteries that can ultimately lead to a heart attack, heart disease or congestive heart failure, says the AHA.

The findings, which were presented at the American Heart Association High Blood Pressure Research Scientific Sessions 2013, are also part of the growing body of evidence that heart disease may start in childhood, said Dr. Sara E. Watson, study author and a pediatric endocrinology fellow at Riley Hospital for Children at Indiana University in Indianapolis.

Study researchers tracked the growth and blood pressure of 1,117 healthy adolescents from Indianapolis for 27 years, starting in 1986, finding that 6 percent of normal weight children and 26 percent of obese children had high blood pressure as adults.

“It is important that pediatricians counsel patients on the risk of high blood pressure associated with overweight and obesity, and stress that a healthy diet, including reducing salt intake and exercise, may help reduce this risk,” Watson said. “Interventions to prevent and treat obesity will play an important role in decreasing the significant burden of high blood pressure in adulthood.”

Ensure children's eye safety during fall sports season

Children are back in school, playing sports, and parents can take precautions to ensure their children's eye safety as they compete.

Although many parents are unaware of the risks posed to their child's eye safety, about 40,000 eye injuries take place in the United States during sports or recreational activities each year, says Prevent Blindness America. Some sport-related eye injuries lead to vision loss, with almost one-third of them occurring in children between the ages of 5 and 14, says the Kentucky Optometric Association.

“Eye injuries are the leading cause of blindness in children in America, and most injuries occurring in school-aged children are sports-related,” Benton optometrist Dr. Laurel Van Horn said in a KOA release. “The results of an eye injury can range from temporary to permanent vision loss, so it’s important that parents take the proper steps when their children play sports.”

Almost 90 percent of these injuries are preventable with proper use of eye protection on the playing field, says Van Horn. To prevent such injuries, the KOA provides the following tips for eye and vision safety while playing sports: Always wear protective eyewear, do not rely on street eyewear for protection, and refer to the American Society for Testing and Materials standards when shopping for protective eyewear. Click here to learn more or find an optometrist in your area.

Effort for kids' dental health in Clark, started by volunteers and continued by health department with tax, earns national award

"A community effort to fight tooth decay in children in Clark County has been named a model for the nation," veteran journalist Al Smith reports in an op-ed for the Lexington Herald-Leader. The Clark County Dental Health Initiative received the award for model practice last month at the annual conference of the National Association of City and County Health Officials, and the county health board recently raised taxes to pay for it.

"Its five-year campaign for change by volunteer dentists, hygienists and engaged citizens should inspire all Kentuckians in a state further scandalized by its own Diane Sawyer in her '20/20' program on ABC in 2009 when she showed 11 million viewers shocking scenes of Appalachian kids with disfigured teeth called Mountain Dew Mouth," writes Smith, former federal co-chair of the Appalachian Regional Commission and co-founder of the University of Kentucky's Institute for Rural Journalism and Community Issues, which publishes Kentucky Health News.

The Clark County program was inspired by Winchester dentist Rankin Skinner, after he and his wife, Ruthi, had started a preventive program for poor children in Ecuador, Smith writes: "He developed a similar plan for Clark County, became its unpaid director and persuaded all 16 other Winchester dentists and 116 volunteers to apply dental fluoride varnish to children in preschool through fifth grade. Every Winchester dentist donated service and staff to take the initiative inside the schools.

Five years later the decay rate in sixth graders has dropped to 11 percent, a decline of 78 percent since 2008 when Kentucky's decay rate for children was reported in national media to be a shameful 50 percent, the country's worst."

Smith notes that the effort was boosted by "a local banker who raised money with help from the Clark County Community Foundation and First Lady Jane Beshear, who urged Gov. Steve Beshear to use the Clark initiative as an example in organizing treatment for underserved children in Eastern Kentucky." The Beshears' permanent home is in Clark County.

Volunteerism only lasts so long, but the Clark County Health Department is now funding the program with a tax increase that will let it hire the state's first public-health dental hygienist. "With continued help from the local dentists and citizen volunteers, [it hopes to] eventually extend the program to students through high school," Smith reports.

The Clark County Board of Health voted this month to raise its tax rate to 4.6 cents per $100 of assessed property value from last year's 4 cents, to generate about $150,000 in additional revenue for the program. Public Health Director Scott Lockard "estimated that funding the program would take $127,531 per year, but the board wanted a cushion in the budget to help pay for dental care for students not covered by Medicaid, KCHIP or private insurance," Rachel Gilliam reports for The Winchester Sun. Lockard told the board, “I can think of nothing better to invest in other than our children.”

Harlan County Schools look for school-nurse help after county health department, which had done it for free, asks for $10,000

http://www.harlandaily.com/view/full_story/23219874/article-Board-tackles-nurse-issue?
Update: http://www.harlandaily.com/view/full_story/23250170/article-School-district-asked-to-pay-for-nursing-services?

U.S. News gives Kosair Children's Hospital a national ranking; 11 other Kentucky hospitals make 'high-performing' list

Each year, U.S. News and World Report publishes its "Best Hospitals" guide for people seeking a high level of specialty care. The only Kentucky hospital to be nationally ranked in the report for 2014 is Kosair Children's Hospital in Louisville. It received national rank in these areas of specialty care: heart, lung, neurology, cancer, orthopedics and urology.

While no Kentucky hospitals were nationally ranked in adult specialty categories, 11 Kentucky hospitals made the cut for meeting standards of strong performance within the state:
     1. St. Elizabeth Edgewood - 11 high-performing specialties
     2. Baptist Health Louisville - 10 high-performing specialties
     2. University of Kentucky Albert B. Chandler Hospital - 10
         high-performing specialities
     4. Baptist Health Lexington - 9 high-performing specialties
     5. Jewish Hospital in Louisville - 7 high-performing specialties
     6. Norton Hospital in Louisville  - 5 high-performing specialties
     7. University of Louisville Hospital - 2 high-performing specialties
     8. King’s Daughters Medical Center in Ashland - 1 high-performing specialty
     8. St. Elizabeth Florence - 1 high-performing specialty
     8. St. Elizabeth Fort Thomas- 1 high- performing specialty
     8. St. Joseph East- 1 high-performing specialty

To read more about specialty rankings for each hospital, click here for an article in The Lane Report or here for the U.S. News report.

Community-based solutions to childhood obesity show signs of progress elsewhere; will Kentucky pick up on them?

By Molly Burchett
Kentucky Health News

For decades, researchers reported with alarm the increasing trend of overweight children in America, with one in three kids on the way to developing Type 2 diabetes. Across the country, action has been taken to address this problematic trend, and now some preliminary, scattered results indicate that obesity rates have plateaued or dropped in some areas. Is Kentucky part of this success, and if not, will it learn from it?

The first set of positive signs came last year, with falling child obesity rates in New York City and Philadelphia, reports Lydia DePillis of The Washington Post. And, a recent Robert Wood Johnson Foundation brief shows similar progress in states with a large rural population as well:

• Mississippi posted a decrease from 43.9 percent of kids being overweight and obese in 2005 to 40.9 percent in 2011, three years after passage of the Mississippi Healthy Students Act. 
• In North Carolina, Vance and Granville counties saw significant declines after implementing healthy living programs based on the Centers for Disease Control’s community guide.
• Kids in Kearney, Neb., in grades one through five saw a 13.5 percent decline in obesity rates between 2005 and 2011.
• West Virginia fifth graders posted a 8.6 reduction in obesity rates over a six-year period.

Overall, progress was made through community-based solutions, including changes to make healthy foods available in schools while eliminating fried foods and working to integrate physical activity into people's daily lives while educating them about the importance of doing that, says the brief.

Kentucky, which suffers from one of the highest childhood obesity rates in the country, could learn from these successful programs. The state ties Mississippi for the highest percentage of youth in grades 9 to 12 that are obese (18 percent) and has the third highest percentage of children ages 10 to 17 who are obese (21 percent), compared to 16.4 percent nationally, says a report by Kentucky's Task Force on Childhood Obesity.

The Kentucky General Assembly has not enacted legislation regarding healthy eating and physical activity like many other states, notes a National Conference of State Legislatures report, but established a task force that made various recommendations to the legislature in September for strategies that address the problem of childhood obesity and that encourage better nutrition and increased physical activity among Kentucky children.

Some of the task force's recommendations include: requiring schools to improve nutritional content of school food, including promoting the use of school gardens, adopting a statewide standard for physical activity initiatives and nutrition education in schools and encouraging physical activity through a coordinated school health program. To view that report, click here.

Kentucky has no requirements for physical activity in schools. About 65 percent of Kentucky's youth did not attend physical-education classes in 2010, and 80 percent did not attend such classes five days per week, says a 2011 Center for Disease Control and Prevention survey.

However, the state does have several programs to promote physical activity or healthy eating. They includes the Farm to School program, which has been adopted by 1,243 schools and 174 school districts and is a collaborative effort between federal and state agencies to bring local agricultural products to schools and to educate students about local food production, says the report.

Using the success of other state programs and existing Kentucky programs as a guide, Kentuckians and "the members of the Task Force on Childhood Obesity are encouraged to continue their advocacy efforts to address Kentucky’s health crisis in ways that have the greatest likelihood of preventing and reversing chronic diseases associated with childhood obesity," says the report.

Eye exams are now required for children ages 3 to 6 when first starting public school or preschool

Add eye exams to your back-to-school checklist, because state law now requires children aged 3 through 6 who are entering a public school or preschool program for the first time to have a vision exam.

“Studies show that vision problems are a major factor in limiting children’s abilities to learn and succeed,” said Dr. Tonia Batts, a Mayfield optometrist, said in a news release from the Kentucky Optometric Association. “Having children’s eyes examined is one of the most important things parents can do to support their children’s education and good health. . . . Many problems may not be obvious to them or their children’s teachers.”

Early diagnosis and treatment can prevent loss of sight from amblyopia, which most people call "lazy eye." Half of amblyopia cases are not diagnosed until after age 5, when it is difficult to correct, Batts said. Amblyopia the leading cause of vision loss in people under age 40, more than injuries or any other disease, but if detected early, is 100 percent treatable.

Batts said an eye examination is particularly important if your child loses place while reading; avoids close work; tends to rub his or her eyes; complains of frequent headaches; squints to use only one eye or consistently performs below academic potential.

Eye exams are covered by many private insurance plans, Medicaid and the Kentucky Children's Health Insurance Plan. Private programs may also help families with eye exam expenses. The Kentucky Vision Project, sponsored by the Kentucky Optometric Association, has donated millions of dollars in vision care, says the group's news release. Sight for Students and the Lions Club have other programs that can help. To find an optometrist in your area, click here.

Chief of cardiothoracic surgery and pediatric heart program at UK, suspended from surgeries, takes job in Florida

Dr. Mark Plunkett, the chief University of Kentucky cardiothoracic surgeon whose surgery program was suspended last year for unspecified reasons, has accepted a new job a the University of Florida.

The internal review of UK HealthCare's pediatric cardiothoractic program is ongoing and should be completed in the next few weeks, Michael Karpf, UK's executive vice president for health affairs, told Linda Blackford of the Lexington Herald-Leader.

In December, Brenna Angel, reporter for university radio station WUKY, identified Plunkett as the surgeon at the center of the program review. At the time, Plunkett was on a leave of absence but remained on staff with a $700,000 salary, Angel reported. WUKY requested data under the Kentucky Open Records Act about Plunkett's most recent surgery and his patient mortality rate, but UK denied such requests. Attorney General Jack Conway ruled that UK must release the mortality rates and other data, but UK Has appealed to Fayette Circuit Court, citing privacy rules in the federal Health Insurance Portability and Accountability Act, even though Conway said HIPAA doesn't preempt the Open Records Act, as Angel reported. Angel has since left the station for Lexington city government but the station and the Herald-Leader are defending the appeal.

In addition to being chief of UK's Division of Cardiothoracic Surgery, Plunkett was director of its pediatric cardiac program and a co-director of UK's Gill Heart Institute, says his UK biography. He came to UK in 2007 from the UCLA medical center, where he worked with Karpf. His resignation is effective Aug. 14, UK officials told Blackford.

Tips to keep children safe from the dangers of summer heat

While enjoying time with family on the boat, at church picnics, in the backyard or at the beach, be sure to keep kids safe during the summer heat.

Heat can trigger three major illnesses, says Dr. Eric Kirkendall of Cincinnati Children's Hospital Medical Center. “Heat stroke, heat exhaustion and heat cramps are reactions caused by exposure to high temperatures combined with high humidity.”

The most serious reaction is heatstroke, which is a life-threatening emergency that should be treated immediately by parents and then by medical professionals. Symptoms can include hot, flushed skin, high fevers (over 104° F), confusion, and even seizures.

If you notice signs of heatstroke, call 911 immediately, cool off the child as quickly as possible by sponging the entire body with cool water, elevate feet to counteract shock and have the child drink cool, not cold water, while waiting for Emergency Medical Services to arrive, said Kirkendall. Do the same if treating the child for heat exhaustion, although it is not necessary to call 911 or a physician unless symptoms continue.

Heat exhaustion is less severe, but also requires medical attention. Symptoms include lots of sweating, nausea, dizziness, fainting or weakness. Heat cramps occur mostly in the child's abdomen and legs, especially the calf or thigh muscles, but symptoms do not include a fever.

Parents can take many steps to keep children safe by keeping them hydrated with water, limiting their time outside during extremely hot weather and encouraging inside breaks when they do play outside, said Kirkendall. Click here for more information.

Summer lunch programs promote healthy eating habits for students, their families and the entire community

Carol Greenwell, who runs the summer lunch
program for Bardstown City Schools, hands
Brennen Maddox a carton of fat-free milk after
he picks up lunch. (Photo by Jennifer Corbett)

Both school districts in Nelson County are whipping up a magic solution to childhood obesity, using a key ingredient to promoting healthy eating habits in children: their parents.  The summer school lunch programs not only serve healthy foods while providing education about them, but also establish partnerships with parents in the community to do the same.

School officials say the summer lunch programs are a way to instill healthy eating habits at an early age, in collaboration with parents.  If parents don’t encourage healthy eating habits early on, children's health could suffer long-term and they are at greater risk for developing chronic diseases like heart disease and type two diabetes, writes Jennifer Corbett of The Kentucky Standard.

A recent Kids Count report says that in 2010, 17.4 percent of Nelson County children were considered obese, up by one-sixth since 2006, when the figure was 14.9 percent, notes Corbett.

Experts say that in order to encourage kids to take healthy steps to lose or maintain weight, or improve health, the whole family should be involved. For example, parents should think of fun, physical activities the whole family can do together, such as walking the dog or hiking.

“The best thing parents can do is be a good role model,” Jessica Bickett, a registered dietitian with the Lincoln Trail District Health Department, told Corbett. “If Mom and Dad walk around with a Mountain Dew in their hand all day, well guess what? The child will want to do it as well. If Mom says, ‘Go ride your bike’ while she sits on the couch watching TV, that doesn’t go too well.”

Schools also play a vital role in establishing a healthy lifestyle for students, says the Centers for Disease Control and Prevention., and Nelson County School Supt. Anthony Orr agrees. “We know nutrition is a really important part of growing up,” he told Corbett, adding that the summer lunch program “is a really good opportunity for the schools to serve the community.”

As part of the summer school lunch program, both Bardstown and Nelson County schools serve free breakfast and lunch to students, and adults can pay a small amount to eat, too. Orr is working to get the program into more schools because serving kids and their families introduces healthier choices to the students. This month, Bardstown established a district coordinated school health council focused on providing opportunities for all students to be active and to ensure that school food meets nutritional guidelines. These initiatives could serve as a model for a state that suffers from high childhood obesity and low health rankings. (Read more)

Kentucky will soon require simple screening at birth to detect silent killers of newborns

A new state law taking effect in January will require all babies born in Kentucky to be screened for critical congenital heart disease, which is often a silent killer of newborns who appear to be healthy and who are discharged from the hospital with the unrecognizable disease.

Since Indiana became the first state in the nation to get such mandatory screening signed into law in May 2011, more than 20 states have passed legislation requiring a non-invasive, inexpensive screening test called pulse oximetry at birth, reports Laura Ungar of The Courier-Journal. The test can detect this life-threatening disease and allow health care providers to act quickly to save the baby's life.

Don Shieman, Kentucky state director of the March of Dimes, who helped lobby for the law with the state legislature, said about 65 infants are born with CCHD in Kentucky each year. “If we can detect the problem soon enough, we can save lives,” Shieman told Ungar. State Sen. Dennis Parrett, an Elizabethtown Democrat who helped sponsor the state’s new law, said this requirement is a simple solution to a deadly problem he know something about.

“My wife and I have some experience with this,” Parrett told Ungar. “Our younger daughter was born with a severe heart defect” called tricuspid atresia, and underwent surgery at Kosair Childen's Hospital and her heart is doing fine, Parrett told Ungar. “There’s a lot of infants whose heart defects are not caught,” Parrett said. “What we wanted to do is make it a part of normal infant screening.”

Each test costs about $4, so Parrett said there’s no real fiscal impact to adding pulse oximetry to the list or required screenings for newborns, says Ungar. In general, hospitals already have the equipment for the test, many of which are already doing the test.

The legislation could lead to success stories similar to that of Shooter Bratcher of Caneyville, right, who was treated for infection and underwent surgery for CCHD recently at Kosair. Shooter was born full-term and and seemed normal at birth, but about five days after going home, things just didn't seem right, and he kept getting worse. Shooter's parents took him to the ER at their local hospital, Twin Lakes Regional Medical Center in Leitchfield, where doctors didn't pick up on his CCHD, Ungar reports. A day later, he went by ambulance to Kosair, and could have died if his parents didn't notice the little signs of a problem. Unfortunately, such signs sometimes show up at night, when parents are asleep or not paying close attention. Other times, the disease isn't caught quickly enough, leading to serious serious problems such as infections, brain damage, disability or death, Ungar reports.


Pulse oximetry will allow health care providers to detect seven types of CCHD. For more information about the test, the law or to watch a video in which Shooter's parents share their story, click here.