Kentucky is 43rd among the states in health rankings report

Kentucky is near the bottom of the list in a ranking that determines which states are the healthiest. It came in 43rd, up from 44th last year.

Kentucky's low ranking is attributed to its unusually high numbers of people who smoke, are obese, die of cancer and are hospitalized for preventable reasons, according to America's Health Rankings, funded by the United Health Foundation.

"As it has for the last decade, Mississippi was ranked 50th on this year's list, which was topped by Vermont at No. 1," Louisville's Business First reports.

"Kentucky's rank of 43rd is a reminder that, while are making progress, as Kentuckians we still have much to do to keep ill health from holding us down," said Susan Zepeda, president/CEO of the Foundation for a Healthy Kentucky. "The good news is there are many concerned civic leaders working to reduce rates of smoking and obesity in the state and keep young people from starting to smoke."

Highlights of the report show:

• While smoking has decreased from 30.5 percent to 24.8 percent of Kentucky adults in the past 10 years, 822,000 still smoke. Recently, Kentucky ranked 36th in the nation for its smoking cessation efforts.

• Almost 1.1 million Kentuckians are obese, 353,000 more than 10 years ago.

• Diabetes decreased from 11.5 percent to 10 percent of the populations in the past year, but there are still 322,000 adults in Kentucky with diabetes.

• In the past five years, the percentage of people without health insurance increased from 13 percent to 15.4 percent.

• In the past 10 years, the percentage of children living in poverty increased from 15.2 percent to 24.7 percent.

As for the entire country, overall health has not improved this year over 2010. "Between 1990 and 2000, the overall health of the nation ... improved by an average of 1.6 percent each year. After 2000, however, the upward trend slowed to 0.5 percent annually," until this year, Health.com reports.

"Physical activity, nutrition, and tobacco: If we could get people focused on those three, we could take a huge bite out of the chronic-disease epidemic," said Georges Benjamin, the executive director of American Public Health Association. "This is not an infinite list of things that people have to address."

America's Health Rankings has been assessing health data for the past 22 years, making it the longest-running health assessment report in the country. For its methodology, researchers look at four groups of health determinants: behaviors, such as smoking and obesity rates; community and environment, such as children living in poverty, violent crime and infectious disease; public and health policies, such as lack of health insurance and public health funding; and clinic care, such as prenatal care, the number of primary care physician and preventable hospitalization rates.

Each of these four determinants are intimately connected with one other, researchers contend. "For example, an initiative that addresses tobacco cessation requires not only efforts on the part of the individual but also support from the community in the form of public and health policies that promote non-smoking and the availability of effective counseling and care at clinics," the report reads.

Data sources include the Centers for Disease Control and Prevention; American Medical Association; Federal Bureau of Investigation; U.S. Census Bureau; and National Center for Health Statistics.

Number of sleep-disorder facilities growing as Kentuckians admit they're tired

The number of sleep-disorder facilities in Kentucky doubled from 25 to 52 in the past 10 years, part of a nationwide trend to help the 70 million Americans who have trouble getting some shuteye.

"Demand growth is a result of more physicians being better educated to recognize sleep deprivation symptoms as well as the public having more and better access to information and advertising that focuses on it," reports Anne Charles Doolin in an in-depth piece for The Lane Report. "Changes in insurance reimbursement also is playing a major part in the accredited facility surge."

Estimates show Americans suffer from more than 80 kinds of sleep disorders, though 85 percent of people are undiagnosed. "When we look at the most common sleep disorder, sleep apnea, we have evidence that demonstrates 25 percent of men are at risk and 9 percent of women are at risk," said Kathryn Hansen, executive director of the Kentucky Sleep Society.

In general, people don't think sleep problems can be fixed. "A typical patient is a male, in his 50s, slightly overweight," said Dr. Pam Combs, a cardiologist who has been studying sleep issues since the 1990s. "They don't think about sleep problems as the problem. They just think they're getting old and tired."

But not getting a good night's rest "is associated with a myriad of health conditions, and mental health conditions, and it undoubtedly affects productivity," said Dr. Ryan Wetzler, a clinical psychologist at Louisville's Sleep Medicine Specialists. "When you get a patient who has taken two hours to go to sleep for years or even decades, getting maybe four hours of sleep a night, and then with treatment they fall asleep quickly and get seven hours a night, it's a huge difference."

"Addressing the problem means less illness, less missed work and more productivity," said neurologist James M. Thompson. It's also less costly. Sleep disorders, sleep deprivation and sleepiness add up to about $15.9 billion to the national health care bill, the National Center on Sleep Disorders Research has found. "Other costs to society for related health problems, lost worker productivity and accidents can't be calculated, but educated guesses begin at 10 times NCSDR's health care cost tally," Doolin reports.

The assessment of sleep disorders has become more widely accepted as a field of study, with a recognized board exam, formal training programs and journals, said Dr. Barbara Phillips, director of the Sleep Center at the University of Kentucky Good Samaritan Hospital. But not all changes have been positive, with some fly-by-night "apnea mills" popping up "where the focus is on lucrative testing, and actual patient care and follow-up get shortchanged," Phillips said. (Read more)

Passport to lose exclusive contract for Louisville-area Medicaid at end of 2012; more choice needed, federal agency says

The exclusive contract the state has with Passport Health Plan, which provides Medicaid coverage for 170,000 people in Jefferson and 16 neighboring counties, has been extended until the end of next year. But after that, the state must adopt a different "delivery model that ensures adequate choice for Medicaid beneficiaries" in that area, a letter from the federal Centers for Medicare and Medicaid Services reads.

Since 1997, Passport has exclusively provided coverage for that population, reports Tom Loftus of The Courier-Journal. Gov. Steve Beshear said Tuesday the state will start looking at alternatives for how to provide choice for the area. In the rest of Kentucky, Medicaid recipients can choose from three managed care organizations.

Sen. Julie Denton, R-Louisville, said she is "very concerned" about the major changes that will be involved. "We don't know what's going to happen," she said.

A year ago, Passport received a scathing report from state auditor Crit Luallen, who found wasteful spending "and said it had improperly transferred millions of its reserves to the health care provider organizations represented on its board," Loftus reports. After an investigation by Attorney General Jack Conway, those providers paid $26.4 million to pay for the transfers. (Read more)

Head of state social services steps down amid controversy

In the wake of controversy about how her state agency handled child-abuse investigations, Kentucky's commissioner of social services has stepped down. No other details were confirmed about the resignation of Patricia Wilson, who was a career social-services employee. Her salary was $111,348.

"The cabinet has been buffeted by recent reports over its role in child abuse cases, most recently that of Amy Dye, a 9-year-old Western Kentucky girl fatally beaten by her brother in the adoptive home where the cabinet placed her at age 5," notes Deborah Yetter of The Courier-Journal.

Franklin Circuit Judge Phillip Shepherd ordered the Cabinet for Health and Family Services to make records pertaining to the case public, saying the cabinet turned a "blind eye" torward the abuse. The cabinet had repeatedly argued in court that it was not obligated to release the records.

Last week, Gov. Steve Beshear ordered the release of the records, calling the details of Amy Dye's death "horrifying." The cabinet immediately sought to undercut the move. "Key lawmakers also have expressed growing dissatisfaction over how the cabinet handles cases of child abuse deaths and serious injuries," Yetter reports. (Read more)

Acupuncture is actually a gentle way to treat, despite the needles

Cheryl Truman of the Lexington Herald-Leader takes a look at acupuncture, an alternative form of medicine with practitioners across the state. "It's a really gentle form of medicine, even though there's needles," said Kathleen Fluhart, a nurse who first heard about acupuncture in the 1970s. "It just made sense."

There are 362 places on the body "where an acupuncturist can insert a needle to balance the flow of xi, or body energy, which in Chinese medicine flows in meridians throughout the body," Truman reports. Acupuncture can help treat sinus infections, allergies, fatigue and other side effects from chemotherapy and radiation treatments, tendinitis and plantar fascilitis.

Treatment centers like Houston's University of Texas M.D. Anderson Cancer Center and Boston's Dana Farber Institute both offer acupuncture treatment to cancer patients. "It's not a cure-all, but it is so amazing for certain things," said Elizabeth Armstrong, who practiced internal medicine for 17 years before becoming trained, and opening a practice in, acupuncture. (Read more)

Jobs, economy top priorities for Kentuckians, poll finds; cost of health care, overall health also important

When asked what should be the state's priorities in the next year, more than nine in 10 Kentuckians responded that job creation should be at the top of the list. Heath concerns ranked slightly lower.

The 2011 Kentucky Health Issues Poll, which released the first of its series of findings Tuesday, asked more than 1,600 people, "How important is it to you that the governor and the Kentucky legislature work on each of the following issues in the next year?" Job creation ranked first, with 93 percent.

The vast majority of Kentuckians felt it was also important for policymakers to work on:

• improving Kentucky's economy (91 percent)

• improving K-12 public education (86 percent)

• reducing the cost of health care (85 percent)

• improving the health of Kentuckians (83 percent)

• reducing crime in Kentucky (83 percent)

Other priorities included making government more transparent (67 percent), improving roads and highways (66 percent) and reducing taxes (60 percent).

Regardless of political party, Kentuckians agreed on the relative importance of these policy priorities.

"We understand the challenges our elected officials face in working to meet Kentucky's needs in these difficult economic times," said Susan Zepeda, CEO of the Foundation for a Healthy Kentucky, which helped fund the poll. "We think the Kentucky Health Issues Poll provides valuable insight into the views of the public to help with the hard choices ahead."

In the coming months, the poll will reveal views on statewide smoke-free legislation, prescription-painkiller misuse and gun safety. The poll, which is also funded by The Health Foundation of Greater Cincinnati, was conducted Sept. 27 to Oct. 27 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,621 adults across Kentucky were interviewed, including 1,313 landline interviews and 308 cell phone interviews. In 95 of 100 cases, estimates will be accurate to plus or minus 2.5 percent.

Tips for maintaining your weight this holiday season

The average American gains five to seven pounds between Thanksgiving and New Year's Day, but maintaining healthful eating habits can help them avoid packing on the weight, diabetes nutrition educator Sheri Setser-Legg, right, writes in the Lexington Herald-Leader.

In the face of overwhelming cheese balls, eggnog and shortbread, she advises you:

• Be realistic. "Don't expect to lose weight during the holiday season," Setser-Legg writes. "Simply maintaining your weight is a sign of success."

• Build in time for exercise, which can also help reduce stress. "Chances are that you have time off work, so develop a regular exercise program or pick up the pace of your current exercise schedule."

• Incorporate healthy dishes into your holiday meal.

• Don't skip meals. "For parties, don't starve yourself in anticipation. You'll likely arrive ravenous and eat everything ... By eating regularly, you are less likely to overindulge."

• Eat only until you are satisfied, not stuffed.

• Have a healthy snack before you attend a holiday party, and keep healthy snacks like fruit, vegetables and cereal bars handy.

• Watch alcohol intake. "Alcohol contains many empty calories and lowers inhibitions, leading to overeating."

• Tell your friends and family you are trying to stay healthy when pressed to try their dishes.

Ultimately, the time is now to start "working toward a happy, healthy 2012," Setser-Legg concludes. (Read more)