Beshear spares some health-related funding in harsh budget

Though Gov. Steve Beshear recommended harsh, nearly across-the-board cuts in his state budget proposal yesterday, some areas relating to health were exempt.

Though the budget for Cabinet for Health and Family Services could be cut by 8.4 percent, its social service department would actually gain $21 million in the next two years. "Cabinet officials said that would allow them to hire about 300 new workers, about one-third of them front-line social workers," reports Tom Loftus of The Courier-Journal. The child welfare department has been under fire due to its handling of children who died or nearly died from child abuse.

Beshear's budget would also spare Medicaid, a $600 billion per year health plan paid for mainly by the federal government. The proposal would add $108 million in the next two years to the state's investment in the plan, which provides health care to the poor and disabled. "That's because of projected growth in the program, which already serves about 800,000 Kentuckians," Loftus reports.

The budget also protects mental-health programs, and, for the first time, adds funding for substance-abuse treatment as part of a Medicaid benefit. (Read more)

Kentucky center helps more than 1,000 providers get electronic health records

The Kentucky Regional Extension Center has helped more than 1,000 health care providers transition to electronic health records, with specialists advising providers so they can meet the federal standards of "Meaningful Use."

"Quick access to electronic health records can make the difference in a provider's ability to treat the patient, whether it means checking a patient's cholesterol during a routine examination or identifying a medication allergy during an emergency," said Dr. Carol Steltenkamp, who directs the KY-REC and is the chief medical officer and pediatrician at UK HealthCare.

The adoption of EHRs by providers doubled from 17 percent in 2008 to 34 percent in 2011, the National Center for Health Statistics reports. As of Nov. 30, 2011, the Centers for Medicare and Medicaid Services had paid out more than $920 million in Medicare EHR incentives and $916 in Medicaid incentives, UKNow reports. The use of electronic prescribing, which allows physicians to generate, transmit and file patient prescriptions, has increased from 0.8 percent in December 2006 to 40.2 percent in September 2011, the nation's largest e-prescribing network Surescripts reports. (Read more)

Kentuckians binge drink more often than residents of any other state, national survey for federal health agency finds

By Tara Kaprowy
Kentucky Health News

Kentuckians binge drink an average of about six times per month, more often than people living in any other state, a report by the Centers for Disease Control and Prevention found.

Binge drinking is defined as consuming four or more drinks for women and five or more drinks for men on one occasion. Nationwide, 17 percent of adults binge drink, up from 15 percent in a 2009 survey. That's one in six people, averaging four binges a month and eight drinks per binge (CDC graphic).

Excessive and binge drinking "causes more than 80,000 deaths in the United States each year, making it the third leading preventable cause of death," reports MSNBC. Binge drinkers are at an increased risk for liver disease, heart disease, of being in a car accident and engaging in violent behavior.

The report analyzed data from a 2010 telephone survey of 458,000 adults who described their previous 30 days of drinking. "Although the percentage of people reporting binge drinking was highest among young people, it was binge drinkers ages 65 and older who over-consumed the most often: this group reported an average of five to six episodes a month," MSNBC reports.

Though Kentuckians binge drink most often, residents of Wisconsin drink the most alcohol — up to 9 drinks on one occasion — and had the highest percentage, 25.6, of people who said they binge drink. Utah and West Virginia has the lowest share of people who say they binge drink, 10.9 percent. New Jersey had the lowest frequency, 3.6 times per month. (Read more)

Meanwhile, a study found drinking alcohol leads to the release of endorphins in parts of the brain that are responsible for feelings of pleasure and reward, says research-reporting service Newswise. "This is something that we've speculated about for 30 years, based on animal studies, but haven't observed in humans until now," said lead author Jennifer Mitchell, clinical project director at the Gallo Center at the University of California-San Francisco. "It provides the first direct evidence of how alcohol makes people feel good."

Excessive alcohol consumption costs the country about $223.5 billion per year, "mostly due to lost workplace productivity and increased health care costs," reports Sarah Kiff for The Washington Post. (Photo by Uselei Marcelino, Reuters)

A study by Canadian researchers has found that setting a minimum alcohol price can drive down those costs — and is more accepted by the public than imposing taxes. The researchers found "for every 10 percent hike in minimum alcohol price, they found people drank 3.4 percent less alcohol," Kiff reports. "For certain drinks, the effect was even more pronounced: Increasing the minimum price of wine by 10 percent correlates with an 8.9 percent drop in consumption. Beer, however, appeared relatively resilient to price fluctuations, with a 10 percent bump lowering consumption a paltry 1.5 percent."

England and Wales have passed legislation that prohibits the sale of below-cost alcohol. Scotland is considering a similar move. (Read more)

Kentucky Health News is a 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.

Spend $1 on smoking cessation, save $3 in health costs, Massachusetts study finds

Every $1 spent on smoking cessation in Massachusetts, saved $3 in health costs, a study of low-income Bay State residents found. That could bode well for the impact of a new smoking-cessation benefit in Kentucky's Medicaid program.

Massachusetts added a smoking-cessation benefit to its Medicaid program in 2006 and "let members choose from any FDA-approved options," reports Martha Bebinger for National Public Radio.

Researchers at George Washington University "found that members who quit saved three times the cost of the program in fewer heart-related hospitalizations after just over one year," Bebinger reports. "The study does not take into account the benefits of avoiding cancer or other long term smoking related illnesses."

Kentucky ranked 36th in the nation for tobacco prevention spending. Though it received $389 million in tobacco-settlment funds in fiscal year 2012, and ranks first or second in tobacco use, Kentucky spent just $2.2 million of that on prevention of tobacco use. It recently added a smoking-cessation benefit to Medicaid, a program that is funded mainly by the federal government but administered by individual states.

1 percent of population accounts for 22 percent of health-care spending, study finds

Just 1 percent of Americans were responsible for 22 percent of the nation's $1.26 trillion in health-care costs in 2009, and 5 percent accounted for 50 percent of costs, a federal report has found.

The numbers may seem shocking, but the concentration has dropped in recent years; in 1996, the top 1 percent of the population accounted for 28 percent of health-care spending.

"The report's findings can be used to predict which consumers are most likely to drive up health care costs and determine the best ways to save money," reports Kelly Kennedy of USA Today. (Read more)

Rural women are less likely to complete vaccinations for cervical-cancer virus; study finds vaccine does not increase sexual activity

Women living in rural areas of the U.S. were far less likely to return for their follow-up doses after they get the initial injection of the human papillomavirus vaccine, a study in the Journal of Rural Health has found. (Photo by Pete Rodman, Bowling Green Daily News)

The study contrasted the rates of vaccination follow-up by young women recruited from two rural locations and one urban location. "Despite being free, the researchers concluded that uptake of booster doses by rural women was problematic," states an article in the Rural Center for AIDS/STD Prevention's "RAP Time" publication. "This barrier might be resolved by providing the HPV doses at easy-to-access locations in rural communities, such as large grocery stores and area events."

The HPV vaccine requires three doses. The women who went to the rural clinic were seven times less likely to return for at least one follow-up dose.

The vaccine, which has proven to prevent most cervical cancers, has been approved for use in women ages 9 to 26 years, as well as boys. The vaccine is generally given at the age of 11 or 12 and is effective only if administered before a person becomes sexually active. As many as 80 percent of men and women become infected with HPV during their lives, but most do not develop symptoms or illness.

The vaccine has been met with reluctance by parents, some of whom fear it encourages sexual activity, but a study published in the American Journal of Preventive Medicine found girls or women who received the vaccine "were no more likely to be sexually active or have more partners than those not vaccinated."

Last year, just 49 percent of adolescent girls nationwide had received at least the first dose of the vaccine, and only a third had gotten all three. In Kentucky, just 25 percent of adolescent females had gotten the first dose and fewer than 11 percent had received all three doses.

In Kentucky, the annual death rate caused by cervical cancer is 2.9 deaths per 100,000. In the United States, it's 2.4 per 100,000. "The U.S. is remaining stable. Kentucky's is actually falling," gynecologist Dr. Mark Yurchisin told Alyssa Harvey of the Bowling Green Daily News.

The decrease is being attributed to an increase in screenings. "In certain counties in Kentucky there is a high incidence, they implemented outreach clinics because they didn't have clinics where they could get Pap screenings done," Yurchisin said. "They can diagnose it at an earlier and treatable stage." (Read more)

Shigellosis cases are on the rise in Louisville

There have been 60 confirmed cases of shingellosis in Louisville in the past three months, compared to an average of 62 per year in the area. About half of the new cases are in children who are 3 years old and younger.

"Shingellosis is caused by Shingella bacteria, which leaves the body of an infected person through the stool and enters another person's body when hands, food or objects contaminated with stool are placed in the mouth," reports Laura Ungar of The Courier-Journal. Because of the mode of transmission, maintaining personal hygiene is important.

"Hand washing is by far the most effective way to prevent shigellosis," said Dr. LaQuandra Nesbitt, director of the Louisville Metro Department of Public Health & Wellness. "We urge everyone — particularly parents, children, childcare workers and teachers — to wash their hands often."

Symptoms, which can occur one to seven days after exposure, include watery or loose stools, sudden onset of fever, nausea, abdominal cramping or vomiting. (Read more)