Does gum disease indicate future joint problems? Study links gum-disease bacterium to collagen-caused rheumatoid arthritis

Although researchers and clinicians have long known about an association between two prevalent chronic inflammatory diseases - periodontal disease and rheumatoid arthritis - the microbiological links have been unclear; a new study suggests this link is causative and that the bacteria responsible for gum disease leads to a faster progression of rheumatoid arthritis.

In a recent article published in PLoS Pathogens by University of Louisville School of Dentistry researchers say, "The bacterium responsible for periodontal disease, Porphyromonas gingivalis, worsens rheumatoid athritis by leading to earlier onset, faster progression and greater severity of the disease, including increased bone and cartilage destruction," according to a U of L news release.

The study says the bacterium produces an enzyme that worsens collagen-induced arthritis, a form of arthritis similar to rheumatoid arthritis produced in the laboratory.

The study was led by Oral Health and Systemic Diseases Group researcher Dr. Jan Potempa and a team that also studied another oral bacterium for the same effect, and found it did not affect collagen-induced arthritis or suggest a link to rheumatoid arthritis.

“This ground-breaking conclusion will need to be verified with further research,” said Potempa. Although the specific cause for the disease remains unknown, Potempa said he hopes these findings will shed new light on the treatment and prevention of rheumatoid arthritis.

An estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition, says 2010 data from the Center for Disease Control and Prevention; this represents approximately 1 in every 250 children in the U.S. An estimated 1.5 million adults had rheumatoid arthritis in 2007. Click here for more information from the CDC.

Seven Ky. communities get grants to reduce risks for chronic diseases among children and 'Invest in Kentucky's Future'

Seven diverse Kentucky communities are getting money to reduce the risk of chronic disease among Kentucky's youth. The initial grants announced Thursday are part of the Foundation for a Healthy Kentucky's new Investing in Kentucky’s Future initiative, a five-year, $3 million program.

“The health of our next generation is at stake,” said Susan Zepeda, CEO and president of the foundation. “Our goal is to help communities make positive changes in policies and service access that will help our children grow into healthy, productive adults. Regardless of the challenges, we want to help communities find new pathways to positive solutions.”

Community groups will use their initial grants to collect and analyze local health data. That analysis will guide development of innovative strategies for effective, sustainable measures to improve children's health. Those communities chosen for the initiative are:

• Clinton County School District, Albany: initial grant of $27,755 for the Clinton County Healthy Hometown Coalition. “We are thrilled that our community was chosen to participate in this important initiative,” Asst. Supt. Paula Little said. “The members of the Healthy Hometown Coalition are committed to helping children grow up in a physical, social, and cultural environment that supports good health habits. With help from the foundation, we can develop our capacity to make a lasting, positive change in our community.”

• Fitness for Life Around Grant County, Williamstown: initial grant of $21,643 for FFLAG and the Northern Kentucky Health Department. “We are pleased and excited to be given the opportunity to work with the Foundation for a Healthy Kentucky,” FFLAG Chairman Jeff Walters said. “We are a small group that has been working on improving the health of our community and we believe we’ve had a positive impact thus far. This grant will accelerate the process and the work that’s been started.”

• Foundation for Appalachian Kentucky, Hazard: initial grant of $32,558 for Perry County Wellness Coalition. “We’ve been working for several years to improve the menu and encourage better eating habits in and out of school,” said Linda Campbell, nutrition director at Perry County Schools. “It’s not as easy as changing a menu or just buying whole wheat bread. We’re changing a culture, and that’s not a simple thing. Working together, as a community, we can really start to make a difference. This grant from the Foundation for a Healthy Kentucky allows us to take the next steps toward helping our kids to become healthier.”

• Green River Area Development District, Owensboro: initial grant of $40,483 for Partnership for a Healthy McLean County. “The Partnership for a Healthy McLean County realizes the impact community organizations, schools, work sites and health care have on the health of families,” said Jiten Shah, executive director of the district. "Obesity is a major factor for many chronic diseases which can begin in childhood and continue into adulthood. "

• Kentucky Heart Foundation Inc., Ashland: initial grant of $19,245 for Healthy Kids, Healthy Communities in Ashland. “Investing in Kentucky’s Future is a perfect fit for the work of the Healthy Kids Coalition and gives us the opportunity to continue to work on policy, system and environmental changes to improve the health of children in Boyd and Greenup counties,” said Laura Patrick, coordinator of Healthy Kids, Healthy communities. “We know that this approach will help sustain change for years to come and what is great about it is that it is sustainable.”

• Kentucky River Community Care, Inc., Jackson: initial grant of $34,156. “This foundation grant will help Breathitt County plan more opportunities for youth and families to participate in healthy lifestyle activities,” said Bridget Turner, KRCC director of clinical services. “We need to develop a strategic plan to specifically address the many barriers that face our children and threaten their future. Education, prevention, behavioral health, physical health, nutrition, employment, substance abuse are a few of the issues that we are trying to deal with in our county.”

• Louisville Metro Department of Public Health and Wellness: initial grant of $34,160. “If we are ever going to realize a healthier future for our citizens, we must improve the health of our young people,” said Dr. LaQuandra Nesbitt, director of the department. “These funds from the Foundation for a Healthy Kentucky will facilitate a coordinated, systemic approach to overcome the health barriers that many of our youth face. The grant will allow us to formulate policies and strategies to improve health that are based on accurate data with buy-in from stakeholders across the community.”

Reducing chronic diseases to improve Kentuckians' health
 
Chronic diseases such as cancer, diabetes and heart disease, are those that last over time, decrease quality of life, increase the risk of early death and occur at higher rates in Kentucky than in surrounding states; substance abuse and some mental illnesses are also chronic diseases.

Kentucky’s children are at greater risk than most for chronic diseases, including high rates of obesity and smoking. When children grow up, they are at an increased risk for heart disease, cancer or stroke, and Kentucky is above the national average in deaths from these diseases.

The Investing in Kentucky's Future initiative will help Kentucky communities confront this cycle of problems. The foundation is encouraging local leaders to identify how best to engage the community in order to have the biggest impact.

“This is the first step in our multi-year approach, which will lead to implementation of permanent solutions for healthier communities,” said Zepeda. “We believe that by working together on the local level, civic leaders with vision can develop innovative strategies to improve the health of our children.”

More than 50 interested organizations responded to the foundation’s request for proposals in October last year, and 22 were invited to submit a full proposal. The foundation’s board of directors approved funding for seven as part of the initiative. Click here to read more about the foundation.

Working with a local, regional or state health coalition? A simple step can help make healthy changes in Kentucky

The Foundation for a Healthy Kentucky is asking you to help update last year's Kentucky Health Coalitions Directory, a list of local groups working to better Kentucky's health, so that additional coalitions can be identified and groups can work together toward their shared goal of bettering the state.

“These are local residents working on solutions to health issues in their cities and towns,” said Susan Zepeda, CEO and president of the foundation. “These groups have differing levels of organization and are pursuing various goals. The Coalitions Directory is a resource for them and allows them to connect with other groups working to make their community a healthier place to live, work, and play.”

Now, across the state's 120 counties, there are 143 coalitions with varying health interests: some are increasing access to healthy food and physical activity, others focus on education about risk-factors for serious health problems like diabetes and other chronic diseases and others are improving working conditions through smoke-free ordinances.

All groups are working to positively change Kentucky's health, and an updated directory will help the foundation raise awareness of the coalitions' local efforts, foster collaboration, build local capacity and provide assistance to groups. Follow this link to submit new or revised information to the Coalitions Directory.

U of L dean says $50 billion in annual health costs could be saved if Americans just walked more

Small changes in health behavior can have a huge impact on the public's overall health and well-being, and during National Public Health Week discussions last week, Dr. Craig Blakely, the new dean of the University of Louisville School of Public Health and Information Sciences, talked about the important role played by public health in promoting healthy behavior, preventing disease and saving both lives and money.

Blakely pointed to obesity as an example of an emerging health-related crisis, which can be addressed with behavioral changes that make a significant difference like adding more physical activity to your day, according to a U of L release.

“If we all took exercise seriously by just walking, we could save $50 billion in cardiovascular disease-related costs,” Blakely said. “A 10 percent weight loss equals a $5,000 savings in health-related complications. A typical desk worker could lose a pound a month by standing two hours a day.”

Blakely also addressed smoking bans, which are becoming popular in Kentucky, even though the state has the highest share of smokers (29 percent) of any state, leads the nation in high-school smokers (24 percent) and spends only a minuscule portion of its tobacco revenues to fight tobacco use, according to the Centers for Disease Control and Prevention.

If every state adopted comprehensive smoke-free policies, said Blakely, $2 billion would be saved in smoking-related deaths, lung cancer treatments and care for related health complications over the course of several years, says the release.

Blakely highlighted several other examples of public health’s potential return on investment. For example, says the release, every dollar spent on childhood immunizations saves $18 on vaccine-preventable disease-related costs, every dollar spent in prenatal care translates to $6 in health care cost savings and for every dollar spent on fluoridated water saves $20 in dental care.

Public health research will continue to find effective ways to generate these cost savings, such as finding researching how to modify environments to encourage exercise or how to send strong messages that promote regular physical activity (Read more)

Foundation for a Healthy Kentucky looking for grant applications for programs that cut chronic disease risk for school-age kids

The Foundation for a Healthy Kentucky is looking for applications for grants that will fund innovative programs to reduce chronic disease risk for school-aged children. Because chronic disease occurs at higher rates in Kentucky than in surrounding areas, the foundation sees this new "Investing in Kentucky’s Future" initiative is seen as having particular urgency. It anticipates awarding grants to five to 10 communities statewide.

This five-year, $3 million program seeks to find ways to limit those diseases that decrease quality of life and increase the risk of early death. These include conditions like cancer, diabetes, heart disease, even substance abuse and some mental illness.

Susan Zepeda, CEO of the foundation, explains that the organization's "goal is to help communities make positive changes that will help children start and sustain healthy habits to last a lifetime. Whether the challenge is access to needed routine medical check-ups, safe places to play or nutritious foods, or caring adults to show ways to communicate and avoid risky behaviors, we want to help communities find new pathways to positive solutions.”

The deadline to submit a letter of intent to apply for grant funding is Nov. 16. Following a letter of intent, the foundation will invite applicants to submit a full proposal. The deadline for the receipt of the full proposal is Feb. 28, 2013. For a complete copy of the Request For Proposal, and additional information regarding grant opportunities through the Foundation for a Healthy Kentucky, visit www.healthy-ky.org or call (toll-free) 877-326-2583.

Expert: Health care landscape already changed, despite what Supreme Court decision is this week

Whether or not the federal health-care reform law is upheld by the U.S. Supreme Court tomorrow, initiatives are already in place that will change the way health care is delivered, an expert said at a Lexington conference Tuesday. Gregg Nunziata, senior director at research and consulting firm The Advisory Board in Washington, D.C., "said the burgeoning number of baby boomers entering retirement, the ever-accelerating advances in technology and the increasing public health crisis that finds more and more Americans with chronic illness such as diabetes, are fundamentally changing how health care works in America," reports Mary Meehan for the Lexington Herald-Leader. As people age, they are "demanding a different kind of care, and they will be living long into their golden years," he said. When they become seniors, who already tend to cast their vote, they will become a powerful voting bloc.

Health officials are looking at ways to cut down on costs, which is necessary because "the government is the major funding source, and the major funding source is broke," Nunziata said. To cut costs, the government and insurers are looking at new ways to pay for health care. One example is the Centers for Medicaid and Medicare scoring hospitals based on their performance and paying them accordingly. "A low score could reduce payments by only 1 percent or 2 percent," Meehan reports, but that can translate to a multi-million dollar loss. "Every hospital is being judged and Washington is keeping score," he said.
Bundling payments is another method being tried, in which one flat fee covers all of the care that is provided in a procedure. "The idea would be to force more efficient and cost-effective care by encouraging cooperation," Meehan reports. (Read more)

143 groups in state working to improve health, directory lists

A directory that lists all the local groups working on health-related issues in the state has been released by the Foundation for a Healthy Kentucky. It identifies 143 groups — at least one impacting each county — and lists the primary contact person at each location.

"These are local residents working on solutions to health issues in their cities and towns," said Susan Zepeda, CEO of the foundation. "As these groups work to make their community a healthier place to live, work, study and play, they are improving the overall health of our state."

Whether in the form of coalitions, collectives, consortia, associations or networks, the groups are working to improve the health of their communities. Some are looking at ways to increase access to healthy food and physical activity, others are planning screenings and education for people with chronic diseases like diabetes, and others are working toward getting smoke-free ordinances passed.

The directory can be viewed by clicking here. It will be updated periodically.

Primary care and management of chronic diseases could soon be coming to your local Walmart store

Just weeks after announcing part-time employees would no longer receive health insurance benefits, Walmart said Monday it is planning to offer extended medical services in its stores, report NPR's Julie Appleby and Sarah Varney. Since many of its stores are in rural areas, this move could extend medical coverage to people who often can't afford transportation to a doctor. The retailer "sent out a request for partners to help it 'dramatically lower the cost of health care by becoming the largest provider of primary health care services in the nation.'"

In a 14-page request, Walmart asks health-care providers to define their expertise in a variety of medical areas, including managing patients with chronic health problems like asthma, HIV, arthritis, depression and sleep apnea. The retailer is also trying to find health partners who can monitor patients with diabetes and high blood pressure. Appleby and Varney say "The move would capitalize on growing demand for primary care in 2014, when the federal health law fully kicks in and millions more Americans are expected to have government or private health insurance." This effort could also capitalize on "collaborations between doctors and hospitals to streamline care and lower costs," they report.

Though expansion of medical services in Walmarts "could help lower costs for some patients and increase access to primary care services," it has its fair share of nay-sayers. Glen Stream, president of the American Academy of Family Physicians, tells Abbleby and Varney that Walmart's "proposal takes health care in the wrong direction by further fragmenting care. Ann O'Malley, physician and senior researcher at the Washington think tank Center for Studying Health System Change, said she's not sure Walmart's approach will work. She said she "would be surprised if this were a model that could truly attack cost problems." Colin McGranahan, retail analyst for Sanford C. Bernstein & Co., said this could simply be a move to boost foot traffic and sales in Walmarts: "If you get someone in the door, you can also sell them milk and a shotgun." (Read more)