Wednesday, January 17, 2018

Ky. crunches data to help fight opioid epidemic

Kentucky has been hit hard by the opioid epidemic, but the state is trying to fight it with innovative efforts to gather more specific data about overdose deaths. The Kentucky Injury Prevention and Research Center, a partnership between the state Public Health Department and the University of Kentucky College of Public Health, built a "drug overdose fatality surveillance system" that combines information sources like death certificate information, post-mortem toxicology analysis, and the prescription drug history of the victims to get a better picture of which drugs are killing people and under what circumstances.

"The efforts that KIPRC and the state have made to improve this data have led to crucial findings, including that Kentucky’s crisis isn’t one crisis, but many," Kathryn Casteel reports for FiveThirtyEight. "Different parts of the state are afflicted with different drugs. Northern Kentucky, for example, has a high prevalence of heroin and fentanyl — a synthetic opioid that is more deadly than heroin and other types of opioids — while in the eastern part of the state, prescription opioids are still the main concern.

KIPRC chart; click on the image to enlarge it.

"We’re not doing this for the sake of research," Svetla Slavova, a biostatistician working with KIPRC, told Casteel. "We provide actionable data for policymaking, treatment and prevention. We’re trying to be responsive and provide data that will help make these decisions."

Because of KIPRC's research, Van Ingram, the executive director of the Kentucky Office of Drug Control Policy said he was able to push legislation to increase the availability of anti-overdose drug naloxone; Gov. Matt Bevin signed the bill into law in 2015.

One of KIPRC's biggest efforts is to make death certificate information more uniform across the state, because "even the smallest differences in language can leave overdose deaths uncounted," Casteel reports. Sarah Hargrove, a data management analyst for KIPRC and former autopsy technician for the state, is spearheading the effort. It's tough going, since some coroners have limited resources and funding, and some have little medical experience.

But KIPRC is making headway. "Using the state’s DOFSS system, the researchers were able to determine the specific drugs that were involved in 97 percent of drug overdose fatalities in 2016; that’s compared with 82 percent using deaths certificates alone," Casteel reports. "Additionally, the researchers used DOFSS to find which drugs were most commonly involved in deaths linked to a combination of substances, as well as which drugs were involved in overdose deaths among people of different age groups and genders."

Sunday, January 14, 2018

HIV cases among N.Ky. drug users jump, sparking fear of an outbreak; health officials renew calls for syringe exchanges

Health officials in Northern Kentucky have renewed their cry for syringe exchanges following a huge surge in cases of the human immunodeficiency virus among intravenous drug users in Kenton and Campbell counties.

"HIV cases were up nearly 50 percent to 37 in 2017; the HIV cases among drug users rose 260 percent to 18," reports Terry DeMio, who covers drug abuse for the Cincinnati Enquirer.

The 50 percent increase in the two counties was mirrored across the Ohio River, where Hamilton County, which includes Cincinnati, reported a 50 percent jump in HIV cases.

Local health officials asked the federal Centers for Disease Control and Prevention to determine whether the increase amounted to an outbreak of HIV, like those they and the CDC have predicted. One expert says an outbreak in Appalachian Kentucky is only a matter of time.

Dr. Jeffrey Howard, Kentucky's acting health commissioner, told Terry DeMio of the Cincinnati Enquirer, "We do not want to give the impression of widespread community risk for HIV in Northern Kentucky." However, local officials and advocates were not so sanguine.

Dr. Lynne Saddler, director of the Northern Kentucky Health Department, "cautioned that 2017's rise in reported cases may only be the tip of the iceberg, since many people aren't tested for HIV and injection drug users generally don't the proper health care," the Enquirer reports. "Kimberly Wright, leader of the private Facebook group Kentucky Parents Against Heroin, said the threat isn't just to injection drug users or health and safety workers."

"We're all at risk now," Wright told DeMio. "Here's the thing I think people don't get about users: We have males and females who are prostituting out here. …You know, we have strip clubs where these girls are going to dance to earn their money. We have married men going into these places that are leaving with them."

Advocates and health officials redoubled their calls for syringe exchanges where IV drug users can get clean needles, preventing the spread of infection and providing an opportunities to recruit them into treatment. Local officials, feeling political pressure from both sides, have dithered.

"Kenton County commissioners have approved an exchange there, but Covington has resisted unless a neighboring county gets an exchange, too," DeMio notes. "Campbell County gave a thumbs up, but Newport hasn't acted on the issue."

Approval is required from the county government and the city where an exchange is placed. At a news conference, advocates and heath officials turned up the heat on politicians.

"We must act immediately," Garren Colvin, president and CEO of St. Elizabeth Hospital, said at a news conference with other health officials. "More than ever, Northern Kentucky now needs comprehensive syringe access-exchange programs."

Brent Cooper, president and CEO of the Northern Kentucky Chamber of Commerce, said "It's about lowering our collective health-care costs, improving the health of our community and attracting and retaining workers and business." The chamber "has been at the forefront of fighting the heroin epidemic for more than five years," DeMio notes.

Opponents of syringe exchanges say they enable drug use, but research has debunked that notion.

Saturday, January 13, 2018

Bill requiring sex-ed classes to teach abstinence until marriage clears first committee; critics want comprehensive curriculum

A bill requiring sex education classes in Kentucky to include abstinence until marriage passed out of a Senate committee, despite the pleas of four women who urged the legislators to create a more comprehensive bill.

Atherton High School senior Sophia Letson-Ettin told the Education Committee Jan. 11 that she had no objections to abstinence and monogamy being part of the curriculum, but said it should also be required to include discussions about sexual abuse, consent, contraception and healthy relationships, Deborah Yetter reports for the Courier Journal.

"I hope you will join us in support of a comprehensive sex education program," said Letson-Ettin, 18.

Sen. Steve Meredith
The bill, sponsored by Sen. Stephen Meredith, a Leitchfield Republican, says that sex education classes in Kentucky would be required to teach: "Abstinence from sexual activity outside of marriage is the expected standard for all school-age children."

Meredith argued that his bill does not say schools can't teach a comprehensive sex-ed program, only that it must teach this component. The bill passed on a 7-2 vote, with seven men on the committee voting for it.

The only woman at the hearing, Sen. Julie Raque Adams, R-Louisville, voted no. She said after the meeting that she had been assured that abstinence was already being taught in these classes.

Sen. Reginald Thomas, D-Lexington, voted no, and said a better bill would be one that offers a comprehensive set of sex-ed guidelines for the state. Sen. Gerald Neal, D-Louisville, passed, saying the panel needed more information about the current requirements and what is already being taught.

State law currently has no requirements for sex education, and curriculum on the topic is determined by each school-based decision-making council. A representative from the state Department of Education told the committee that it is working on guidelines for such classes.

Sen. Danny Carroll, a Paducah Republican who voted for the bill, said teaching abstinence and monogamy until marriage is important, "arguing that societies that don't set standards are doomed to fail," Yetter reports.

Critics of the bill said it doesn't take into account the realities of modern society.

Sara Choate, a Louisville sex educator who works with students, pointed out that most high-school students have had sexual relations by their senior year, and many have been sexually abused, Yetter reports: "Lecturing them to abstain from sex does not provide the help or information they need, she said."

Rev. Lauren Jones Mayfield, a pastor at Highlands Baptist Church in Louisville, added that the bill doesn't account for people with different faiths and sexual orientations or those who have different views about sex outside of marriage. "This assumes sex is between a married man and woman in a Christian home," she said.

Several foes of the bill noted that efforts to promote abstinence and monogamy often end up shaming or blaming women for engaging in sex, without the same consequences for their male partners.

Men on the committee said the bill was not intended to shame anyone. Mayfield said this concern is likely something the men on the panel don't understand.

"As four women sitting here saying shame is very much a part of this, you as men are so confident saying that's not the intent," she said, drawing applause from the audience. "I feel like our realities are different from yours because that hasn't been your experience."

Friday, January 12, 2018

Federal officials approve Gov. Bevin's plan for work requirements, premiums and penalties in Medicaid; changes start July 1

Bevin makes the announcement.
(Photo: Alex Slitz, Lexington Herald-Leader)
By Al Cross
Kentucky Health News

Some Kentuckians on Medicaid will have to work, perform community service or take job training to keep their health-care benefits, under a plan proposed by Gov. Matt Bevin and approved by federal officials. It would also require some to pay small, income-based premiums and co-payments.

Bevin announced the approval Friday, saying the changes would be "transformational." Kentucky is the first state to establish requirements for work-related activities, under a new policy of the Trump administration.

"I am excited by the fact that Kentucky will now lead the nation," Bevin said at a Capitol news conference. "We're ready to show America how this can and will be done." Critics predicted legal action, saying federal law doesn't allow work requirements.

The plan is called Kentucky HEALTH, for "Helping to Engage and Achieve Long Term Health." It mainly affects the 480,000 or so Kentuckians who are on Medicaid by virtue of its 2014 expansion, under the Patient Protection and Affordable Care Act, to people in households with incomes up to 138 percent of the federal poverty level: $16,643 for a single person and about $34,000 for a family of four.

The plan requires beneficiaries to spend a total of 80 hours a month working, looking for work, doing volunteer work, taking job training, going to school, or taking care of someone with a disabling health condition. The rule would not apply to pregnant women, the chronically homeless or the "medically frail," which includes people with a substance-abuse disorder.

“There is dignity associated with earning the value of something that you receive,” Bevin said. “The vast majority of men and women, able-bodied men and women … they want the dignity associated with being able to earn and have engagement.”

Nationally, most beneficiaries of Medicaid work, mostly in low-wage jobs that don't offer health insurance, according to the Kaiser Family Foundation. Kentucky figures indicate likewise for the state.

Medicaid covers about 1.4 million Kentuckians. A list of enrollment by type and county in June 2017 is at

Premiums and co-payments

A bigger and broader change is that most Kentuckians on Medicaid will be required to pay small monthly premiums, initially $1 per person to $15 per family, depending on income. People with disabilities, pregnant women, children, caregivers and former foster children under age 26 won't have to pay.

Failure to pay premiums would result in suspension of benefits for those above the poverty line; those with less income would be required to make co-payments. When Indiana implemented such a program, 55 percent of those affected missed at least one premium payment in the first 21 months.

The financial part of the plan would go into effect July 1, but the work requirements are to be phased in, starting in areas where more jobs are available. Medicaid members are to get 90 days advance notice that the new requirement applies to them.

Members will be required to report changes in their income, employment or community-service status within 10 days, and failure to do so would result in a six-month disqualification. Disenrolled members could re-enroll earlier if they complete a financial- or health-literacy course, unless they have defrauded Medicaid.

Details of the program are at

Critics and politics

One of the most-criticized aspects of the plan is its removal of dental and vision benefits from the basic benefit package for people in the Medicaid expansion. They could qualify for coverage by getting preventive physical, dental or vision exams. State oral-health leaders have said the change would cost more money than it would save.

Another major criticism of the plan is that many Medicaid members will find the reporting requirements hard to meet, be dropped from the program and be discouraged from re-enrolling.

The Bevin administration estimated in its proposal that with it, the Medicaid rolls in five years will have 95,000 fewer people than without it. It gives two reasons: "program non-compliance" and "participants are expected to transition to commercial coverage," but doesn't explain how they will be able to afford that.

Bevin has said the state can't afford to pay its share of the expansion, which is is gradually rising to the health-reform law's limit of 10 percent in 2020. The program was expanded by his predecessor, Democrat Steve Beshear.

Friday, Bevin downplayed the possible cost savings and said the plan is needed to improve the health of Kentuckians because the four-year-old expansion of Medicaid hasn't improved the state's health status. Four years ago, officials said that would take longer than four years.

When he was seeking the Republican nomination for governor, Bevin said he would do away with the expansion, but after being nominated said he would seek approval for a plan like Indiana's. The Indiana plan was drafted by Seema Verma, now director of the Centers for Medicare and Medicaid Services, which approved Bevin's plan as a waiver from federal rules under Section 1115 of the 1965 law that created Medicare and Medicaid.

Bevin proposed the plan when Barack Obama was president, and said that if it wasn't approved, he would end the expansion. While the Donald Trump administration welcomed the plan, it might run into trouble in court, and Bevin's press release referred to that possibility and renewed his threat.

"Gov. Bevin has consistently said since submitting the 1115 application that these are the terms under which Kentucky is able to maintain expanded Medicaid," the release said. "Accordingly, Gov. Bevin has signed an executive order directing the commissioner of Medicaid to take necessary actions to terminate Kentucky’s Medicaid expansion in the event that a court decision prohibits one or more of the components of the Section 1115 waiver from being implemented."

Insure Kentucky, a coalition of groups favoring health reform and opposing the waiver, said such waivers are supposed to "demonstrate that a state can expand coverage, improve access and provide better, more efficient care than under standard federal rules." It noted what it called "overwhelming" objections from citizens and groups.

Senate Majority Leader Mitch McConnell said in a press release, “I applaud CMS and Gov. Bevin for recognizing the unaffordable mess left behind by his predecessor and responding with innovative, common-sense steps to engage patients, improve health, and reduce the burden on Kentucky taxpayers. Today’s announcement by CMS is a step toward taking the power out of Washington and sending it back to the state while also ensuring the long term fiscal sustainability of the Medicaid program.”

Democratic U.S. Rep. John Yarmuth of Louisville said, “During the campaign, Bevin pledged to end Kentucky’s highly successful Medicaid expansion, but as governor, he did not have the courage to do it. Instead he is sabotaging it by raising premiums for families who can’t afford them and creating new barriers to coverage that will—by the governor’s own admission—force tens of thousands of Kentuckians to lose access to life-saving health care. Make no mistake: people will die because of this. Thousands of Kentucky families will face financial ruin. Gov. Bevin and President Trump are creating an entirely unnecessary crisis in our commonwealth for entirely political reasons.”

Health department reports first flu deaths of children this season, continues to urge vaccinations; disease widespread across U.S.

A flu patient in Escondido, Calif. (Photo: Gregory Bull, AP)
At least 36 Kentuckians have died from influenza this season, and the number includes two children, who died in the past few weeks, according to the state Department for Public Health. The average age of the adults who died is 75, health officials said in their weekly flu report. They did not release other information about the two children, citing privacy reasons.

“We extend our deepest sympathies to the families. These personal losses are a reminder for all of us that flu can be a serious illness, for young and old alike,” said Dr. Jeffrey D. Howard, the acting health commissioner. “We strongly encourage people to protect themselves, particularly children 6 months and older and those people at high risk for complications related to the flu. Stay at home if they have the flu or flu-like symptoms and avoid contact with others.”

The department reports that there have been 49 outbreaks of flu in Kentucky nursing homes and other long-term care facilities.

Flu is widespread across the continental U.S., the first time that has happened in the 13 years of the current national tracking system. "Officials said that this flu season is shaping up to be one of the worst in recent years," Helen Branswell reports for Stat, the health-and-science news site of The Boston Globe. "The rate of flu hospitalizations nearly doubled last week." But officials said this flu season still isn't as bad as the one in 2014-15.

This point on the calendar is typically the peak of flu season, but it extends well into the spring, and health officials still urge those who haven't had a flu shot to get one. The vaccination takes about two weeks to generate immunity. Meanwhile, they recommend these precautions:
·        Try to avoid close contact with sick people.
·        While sick, limit contact with others as much as possible to keep from infecting them.
·        If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone for 24 hours without the use of a fever-reducing medicine).
·        Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
·        Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
·        Avoid touching your eyes, nose and mouth. 
·        Clean and disinfect surfaces and objects that may be contaminated with germs like the flu.

Foundation for a Healthy Ky. gave out almost $900,000 in 2017, with 40% of it going to initiatives to reduce exposure to tobacco

The Foundation for a Healthy Kentucky says it awarded grants in 2017 totaling almost $900,000, with more than $361,000 of it on efforts to reduce tobacco use and secondhand-smoke exposure.That brought the foundation's total investments to nearly $27.4 million since it was created in 2001.

For example, the foundation gave a total of $126,400 to Kentucky Voices for Health, the Kentucky Center for Smoke-Free Policy, the Kentucky Equal Justice Center and Kentucky Youth Advocates. That was 43 percent of the $291,700 of the total grants given for health-policy advocacy.

Nearly $35,000 in foundation grants and sponsorships supported educational conferences about tobacco-related policy changes, including a proposal to increase the tax on cigarettes by $1. The rest of the foundation's tobacco-use reduction funding was dedicated to the launch of the new Coalition for a Smoke-Free Tomorrow, which the foundation staffs.

"We're climbing uphill against an industry that spends an estimated $250 million marketing its products in the commonwealth," Ben Chandler, president and CEO of the foundation, said in the news release. "Advocates can't fight dollar-for-dollar against that kind of consumer influence, so we have focused our efforts on policy changes that research shows will have the broadest impact possible. . . . Kentucky's greatest health gains are going to come at the county and statewide policy levels when elected officials enact policies that have been shown over and over to reduce tobacco use and improve health across entire population groups."

In addition to tobacco-reduction grants, the foundation gave slightly more than $323,000 to seven local health coalitions across Kentucky that are working to improve the health of school-age children in their communities.

The foundation also invested $128,000 in research in 2017, including its annual Kentucky Health Issues Poll, educational events such as its Health for a Change training webinars and workshops , the biennial Data Forum and its annual Howard L. Bost Memorial Health Policy Forum, and obtaining and reporting data valuable to understanding health policy implications.

The foundation also invested nearly $103,000 in grants to expand health journalism in Kentucky, $35,000 of which went to the Institute for Rural Journalism and Community Issues at the University of Kentucky, to publish independent journalism in Kentucky Health News.

The foundation was created in 2001 from the charitable assets of Anthem Inc., recovered in a lawsuit by Chandler when he was state attorney general after the company converted from a mutual insurance firm to a stock company. Under the settlement, the $45 million was invested and only earnings from it may be spent.

Thursday, January 11, 2018

Federal government paves the way for Kentucky to impose Medicaid work requirements; approval expected soon

By Melissa Patrick
Kentucky Health News

The Trump administration announced a new policy Jan. 11 that allows states to establish the first work requirements for Medicaid beneficiaries, paving the way for Gov. Matt Bevin's plan for the Kentucky program.

The Centers for Medicaid and Medicare Services policy guidance authorizes work and community engagement among able-bodied adults who are not pregnant, elderly, disabled or medically frail, and Bevin's request for a waiver from the usual rules requests exactly that.

The Bevin administration calls its plan Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) and says is designed to encourage participants to have what Bevin calls "skin in the game" through co-payments, premiums and a higher level of involvement in their care.

A key component of the plan is a requirement for able-bodied adults who are not primary caregivers to work or volunteer 20 hours a week to get the free health insurance -- a requirement that has never been part of any state's Medicaid program, but is now specifically authorized.

Medicaid boss Stephen Miller
“We are excited about the new guidance issued by CMS to allow states the flexibility to pursue innovative approaches to improve the health and well-being of Medicaid beneficiaries," state Medicaid Commissioner Stephen Miller said in a statement. "This guidance is a critical step to moving the Kentucky HEALTH program forward and we eagerly anticipate a quick approval."

The plan will largely affect the 478,000 Kentuckians who are covered by the expansion of Medicaid under the Patient Protection and Affordable Care Act to those who earn up to 138 percent of the federal poverty level.

Medicaid covers about 1.4 million Kentuckians. A list of enrollment by county in June 2017 is at

If implemented, the proposal estimates there will be 95,000 fewer Kentuckians on Medicaid in five years than there would be otherwise. The Bevin administration has said this will be a result of people moving to better-paying jobs that offer employer health insurance, but critics say the new requirements create barriers to access that will cause people to lose coverage

U.S. Rep. John Yarmuth, a Louisville Democrat and a vocal supporter of the Affordable Care Act, said in a press release, "Work requirements do not make it more likely low-income individuals will find employment, but they will result in struggling families becoming poorer and sicker. . . . My only hope is that the chaos caused by this policy and the desperation of the Kentucky families who will soon lose their only access to health coverage will force Gov. Bevin to demonstrate some level of compassion and reverse this disgraceful policy."

Despite obstacles, more Kentuckians enrolled in Obamacare health insurance this year; many were automatically re-enrolled

Despite an open enrollment period that was half as long as last year's, 9,000 more Kentuckians signed up for federally subsidized health insurance under the Patient Protection and Affordable Care Act, commonly called Obamacare.

Kentucky enrollment for the 2018 open enrollment period, which ended Dec. 15, was 90,625, compared to 81,155 for 2017. That was an increase of 12 percent, the highest of any state, Dustin Pugel reports on the blog of the left-leaning Kentucky Center for Economic Policy.

Pugel, an analyst for the center, said the increase was likely due, in part, to Kentuckians being re-enrolled into either the same health plan or a similar one if they already had a plan and didn't pick a new one, compared to last year's full re-enrollment process.

"While more detailed data will become available later this year, it is very likely that auto-enrollment heavily contributed to the 43,000 signups in the final week of open enrollment, putting this year’s total above last year’s – though still below two of the three years when Kentucky used the Kynect," he wrote.

Kynect was Kentucky's state-based exchange, which lost its name in 2016 after the state moved to a hybrid exchange facilitated through, the federal Obamacare website. For 2014, the first year of the exchanges, 82,792 Kentuckians signed up for health insurance through Kynect. That number increased to 109,377 for 2015 and dropped to 93,666 for 2016.

Pugel calls Kentucky's move to the federal exchange was a "setback" for enrollment because doesn't allow states to extend enrollment periods, as state-based exchanges allow. He reports that nine states and Washington D.C., with their own exchanges, extended open enrollment periods.

Pugel also says more people in Kentucky and the nation would have purchased coverage through the federal exchange if it hadn't been for efforts by the Trump administration that discouraged enrollment.

They include: an open enrollment period that was cut to seven weeks from 14; a 90 percent cut in the national marketing budget; a 40 percent cut in the budget for navigators, who help people with the system; ending contracts with two outreach firms and other organizations that helped identify people who needed coverage and get them sign up; federal field staff being told to not attend outreach events; closing down the federal exchange for 12 hours every Sunday for maintenance; and the creation of 23 videos attacking the ACA.

Pugel adds that the executive order directing agencies to ease some of the insurance restrictions and the confusion caused by the numerous attempts to repeal the ACA also likely contributed to lower enrollment. In addition, he says the end of the individual mandate will likely lead to a 10 percent increase in premiums next year, "further undermining the individual insurance market."

"The robustness of the marketplace in Kentucky suggests that people continue to need and value the coverage offered through to the ACA," he concludes. "But despite this year’s success, the intentional and unintentional degradation of the individual insurance market may put an even greater damper on coverage in the future."

Trump order aims to reduce suicide among new veterans

Trump before signing the executive order Tuesday
(Associated Press photo by Evan Vucci)
President Trump signed an executive order Jan. 9 to expand mental health care for veterans who are transitioning from military to civilian life in an effort to reduce suicides in that group.

"The order will take effect March 9 and is expected to provide all new veterans with mental-health care for at least a year after they leave the military," Dan Lamothe reports for The Washington Post. "Trump gave the Defense Department, the Department of Homeland Security and the Department of Veterans Affairs 60 days to iron out details and develop a joint plan, Veterans Affairs Secretary David Shulkin said in phone call with reporters."

New veterans are particularly at risk of suicide, and 60 percent of the 265,000 service members who transition out of the military each year don't qualify for care until the government establishes that a medical issue is related to their military service. Shulkin told Lamothe that people who have been out of military service for less than a year are 1 1/2 to two times more likely to commit suicide than any other age group. About 20 veterans a day commit suicide.

The full details of the plan aren't yet clear, but will likely include making peer-group therapy sessions available at all VA Whole Health facilities; such sessions are now only available at 18 of the facilities. An anonymous source told Lamothe that the Defense Department will expand the services of its Military OneSource program to allow veterans to access its counseling and 24-hour call line services for a full year after leaving the military instead of the current 180 days. The source said that the Pentagon will look for ways to start the transition process for service members while they are still in uniform.

Shulkin said the program is expected to cost a few hundred million dollars a year from the Defense and VA budgets, but will be paid for with existing money.

Wednesday, January 10, 2018

Two campaigns encourage smokers to keep trying to kick the habit; one emphasizes the importance of Mondays

Many New Year's resolutions have already been abandoned, but a new campaign says when it comes to kicking the smoking habit, every Monday offers the 25 percent of Kentuckians who smoke a new opportunity to try again -- giving you 52 chances a year to succeed.
The Monday Campaigns, a nonprofit public health organization associated with Johns Hopkins, Columbia and Syracuse universities, promotes the idea of using Monday as a day to commit to healthy behaviors.

“Studies show that Mondays are a natural opportunity to engage smokers and reduce their likelihood of relapse. It’s the January of the week, the day that smokers are looking for help," Joanna Cohen, director of Johns Hopkins' Institute for Global Tobacco Control, said in a news release.

A review of the research on the "Quit and Stay Quit Monday" website shows that Monday is the day smokers are most likely to choose as a quit date; people seek cessation services and information more on Mondays than other days; people are more engaged with online quit programs on Monday, and choosing Monday as a quit day increases confidence and success rates for quitters.

To be part of the "Quit and Stay Quit Monday" movement, the campaign suggests these steps: Quit on Monday; make a quit plan; connect with others; do a Monday check-in; celebrate progress; and quit again if you relapse until you are finally smoke-free. Its website also offers free resources and tips to help smokers quit.

Approximately two of three adult smokers, more than 22 million Americans, say they would like to quit. However, in 2015, of the 55 percent of adult smokers who made a quit attempt, only 7 percent were successful, according to the "Every Try Counts" campaign, also created to help people quit smoking.

The campaign is a two-year Food and Drug Administration initiative in 35 counties, including Kenton in Kentucky, to encourage cigarette smokers to quit through messaging that emphasizes the health benefits of quitting. The messages are being placed in and around gas stations and convenience stores, places that typically feature cigarette advertisements.

“The ‘Every Try Counts’ campaign encourages smokers to rethink their next pack of cigarettes at the most critical of places — the point of sale,” FDA Commissioner Dr. Scott Gottlieb said in the news release. “Tobacco companies have long used advertisements at convenience stores and gas stations to promote their products, and we plan to use that same space to embolden smokers to quit instead.”

The news release says, "Research shows those who have tried quitting before are more likely to try again, and those who have tried to quit multiple times have a higher likelihood of quitting for good."

As part of the initiative, the FDA partnered with the National Cancer Institute to create a website that provides smokers with resources and tools to help them quit, including a free text message program that sends tips and encouraging messages, a mobile app to track smoking triggers, access to trained coaches, information on FDA-approved smoking cessation products and information on the risk of smoking. These tools are available to everyone.

Additional resources for Kentuckians can be found at and Kentucky's Tobacco Quitline is 1-800-QUIT-NOW (1-800-784-8669). Also, many local health departments offer smoking cessation classes. Kentucky has also passed a law that requires insurance companies to cover smoking-cessation treatments and counseling without imposing barriers.

Tuesday, January 9, 2018

Weekly kicked off new year with front page all about health

The week or two after Christmas is a slack time for weekly newspapers; some still take a week off. But the Adair County Community Voice took the period as an opportunity to spotlight personal stories about local residents' efforts to improve their health.

"We try to be prepared for slow weeks during the holidays by making sure we have options, but it really would have taken something pretty massive to kick these stories off the front," Editor-Publisher Sharon Burton said in an email to Kentucky Health News.

"A lot of people refocus on their health during the new year, so we knew these articles would be timely and draw interest," Burton wrote. "My assistant editor made a major healthy lifestyle change in his life several years ago and is passionate about this topic. I think it shows in these articles."

To read the stories, click here. For the "jump page" where the articles are continued, click here. For an editorial by Burton that was also a good way to begin the year, with her sharing some philosophies of life, click here.

Monday, January 8, 2018

Tobacco-settlement funds will subsidize summer meal programs' purchase of Kentucky fruits and vegetables

The state Department of Agriculture is offering a subsidy for summer meal programs in Kentucky to buy fruit and vegetables produced in the state. The program is funded by $185,000 in tobacco-settlement money awarded by the state Agricultural Development Board and administered by the Kentucky Association of Food Banks

"The program is the first of its kind in the nation," the department said in a news release about the Kentucky-grown Fruit and Vegetable Incentive Program, which it calls K-VIP.

“When we started the Kentucky Hunger Initiative two years ago, we began a conversation about how to combat the unfortunate reality that one in five Kentucky school children are food-insecure,” Agriculture Commissioner Ryan Quarles said Jan. 8 at the Kentucky Fruit and Vegetable Conference in Lexington. “The K-VIP program gives summer feeding programs an added incentive to provide fresh, locally grown fruit and vegetables for hungry kids in the summer months while expanding market access for Kentucky farmers.”

Warren Beeler, executive director of the Governor’s Office of Agricultural Policy, said the ag-development board “jumped at the chance to expand market access for farmers and feed hungry kids at the same time.” The board spends half the money from the states' 1998 settlement with cigarette manufacturers, with the goal of broadening the state's agricultural base.

Tamara Sandberg, executive director of the food-banks group, said in the release, “The summer meals program helps ensure children receive the nutritious food they need to thrive during the summer months when school is out. K-VIP will help increase the portion of local Kentucky produce served through summer meals.”

Meal programs served 2.8 million Kentucky children last summer. The U.S. Department of Agriculture "reimburses summer site sponsors for meals served at feeding sites, and claims for reimbursement are processed by the Kentucky Department of Education," the release said. "For every lunch served, the summer feeding site sponsor receives reimbursement from USDA of $3.83."

To participate in K-VIP, sponsors must be approved by the Education Department to serve as summer meal site sponsors and submit an enrollment application to the food-banks association at by April 15. Contact Cathy Gallagher ( at the Kentucky Department of Education to become an approved summer feeding site sponsor.

Enrolled sponsors will be eligible for reimbursement for up to one-third of their spending on Kentucky-grown produce. "Due to the limited number of funds, there is no guarantee of reimbursement," the release says. "K-VIP payments will be capped at 10 cents times the total number of meals reimbursed by USDA."
Kentucky growers may contact Tina Garland ( at the state Agriculture Department to connect with summer feeding site sponsors in their area.