Survey suggests Great Recession has harmed the health of Kentuckians

A recent poll shows continuation of a trend threatening Kentucky's overall health: as the number of Kentuckians living in poverty goes up, the percentage of adults who report their health as excellent or very good goes down.

Just over four in 10 Kentucky adults in the latest Kentucky Health Issues Poll described their health as excellent or good. In 2008, almost half used those descriptions.

People with higher incomes have consistently reported better health since the poll began tracking the health status of Kentucky adults 2008. Since research has shown a strong link between higher income and better health, the Great Recession and the resulting increases in unemployment, underemployment and poverty appear to be harming the overall health of Kentucky’s population.

In the accompanying graph, showing responses by income categories, FPL stands for federal poverty level, which in 2011 was a yearly household income of $22,350. Among the categories, 58 percent in the highest category said their health is excellent or good, but only 25 percent of those living in poverty used those descriptions.

Although the health status for each income category has remained fairly constant, the poll reflects federal data that show more people living in poverty. More than 33 percent in the latest poll were earning less than the federal poverty level; in 2008, that was only 19 percent. The polls, which used self-reporting of income and survey methods that differ from federal methods, showed much higher poverty rates than federal data.

“We know there is a direct relationship between income and good health, and these data reflect that,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, a sponsor of the poll. “While changes in our health-care delivery system may provide more health-care opportunities for low-income Kentuckians, these results show how vital a strong economy, and jobs that pay well, are to our population’s health.”

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points.

A recent poll shows continuation of a trend threatening Kentucky's overall health: as the number of Kentuckians living in poverty goes up, the percentage of adults who report their health as excellent or very good goes down.

Just over four in 10 Kentucky adults in the latest Kentucky Health Issues Poll described their health as excellent or good. In 2008, almost half used those descriptions.

People with higher incomes have consistently reported better health since the poll began tracking the health status of Kentucky adults 2008. Since research has shown a strong link between higher income and better health, the Great Recession and the resulting increases in unemployment, underemployment and poverty appear to be harming the overall health of Kentucky’s population.

In the accompanying graph, showing responses by income categories, FPL stands for federal poverty level, which in 2011 was a yearly household income of $22,350. Among the categories, 58 percent in the highest category said their health is excellent or good, but only 25 percent of those living in poverty used those descriptions.

Although the health status for each income category has remained fairly constant, the poll reflects federal data that show more people living in poverty. More than 33 percent in the latest poll were earning less than the federal poverty level; in 2008, that was only 19 percent. The polls, which used self-reporting of income and survey methods that differ from federal methods, showed much higher poverty rates than federal data.

“We know there is a direct relationship between income and good health, and these data reflect that,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, a sponsor of the poll. “While changes in our health-care delivery system may provide more health-care opportunities for low-income Kentuckians, these results show how vital a strong economy, and jobs that pay well, are to our population’s health.”

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points.

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28% of Ky. adults 18-64 say they lack health coverage; 41% lacked it sometime in last year; employer coverage down since '08

Nearly three in 10 working-age adults in Kentucky are not covered by any form of health insurance, and the number who get health insurance from their employer, or their spouse’s employer, has plummeted since 2008, the first year of the Great Recession, according to the latest Kentucky Health Issues Poll. The decline accelerated in the last year, and was accompanied by a big jump in the percentage on public insurance.

The poll, taken Sept. 20 through Oct. 14, found that 28 percent of adults aged 18 to 64 said they had no health insurance at the time they were interviewed, and 41 percent said they had been uninsured at some point in the previous year.

The survey found that 37 percent get their insurance from an employer or spouse’s employer, well below the 55 percent figure in a similar poll in 2008. Conversely, 27 percent are now covered by some form of public insurance, way up from the 10 percent in 2008.

Medicaid in Kentucky covers households with incomes up to 70 percent of the federal poverty threshold; 43 percent of working-age adults living at or below that level reported being uninsured last fall. Among those with incomes more than double the poverty level for their size household, 15 percent said they were uninsured.

The poll was conducted for the Foundation for a Healthy Kentucky and the Health Foundation of Greater Cincinnati by the Institute for Policy Research at the University of Cincinnati. Pollsters contacted a random sample of 1,680 adults throughout Kentucky by telephone, including landlines and cell phones. The poll questioned only working-age adults about insurance because 98 percent of seniors have some form of health coverage. The poll has a margin of error of plus or minus 2.5 percentage points.

Nearly three in 10 working-age adults in Kentucky are not covered by any form of health insurance, and the number who get health insurance from their employer, or their spouse’s employer, has plummeted since 2008, the first year of the Great Recession, according to the latest Kentucky Health Issues Poll. The decline accelerated in the last year, and was accompanied by a big jump in the percentage on public insurance.

The poll, taken Sept. 20 through Oct. 14, found that 28 percent of adults aged 18 to 64 said they had no health insurance at the time they were interviewed, and 41 percent said they had been uninsured at some point in the previous year.

The survey found that 37 percent get their insurance from an employer or spouse’s employer, well below the 55 percent figure in a similar poll in 2008. Conversely, 27 percent are now covered by some form of public insurance, way up from the 10 percent in 2008.

Medicaid in Kentucky covers households with incomes up to 70 percent of the federal poverty threshold; 43 percent of working-age adults living at or below that level reported being uninsured last fall. Among those with incomes more than double the poverty level for their size household, 15 percent said they were uninsured.

The poll was conducted for the Foundation for a Healthy Kentucky and the Health Foundation of Greater Cincinnati by the Institute for Policy Research at the University of Cincinnati. Pollsters contacted a random sample of 1,680 adults throughout Kentucky by telephone, including landlines and cell phones. The poll questioned only working-age adults about insurance because 98 percent of seniors have some form of health coverage. The poll has a margin of error of plus or minus 2.5 percentage points.

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Kentuckians think their children's generation will be less healthy and worse off economically than current working-age generation

Forty percent of Kentucky adults think their children's generation will be less healthy than the current generation of working-age Kentuckians, and 61 percent think the newer generation will be worse off economically, according to a statewide poll conducted last fall.

The Kentucky Health Issues Poll also found that 54 percent think their parents' generation was better off economically, and 42 percent thought that generation was healthier than the current generation of Kentuckians.

“It is a cornerstone of the American Dream that, if we work hard, we will get ahead and be better off than our parents were,” said Dr. Susan Zepeda, President and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll. “Our polling suggests that optimism for a better future may be slipping away.”

Zepeda added, “Policymakers in Kentucky and Washington are grappling with economic and health policy issues that have long term impacts. Our polling clearly indicates the concern Kentuckians have, on the need to do better for our kids.”

For details of the poll, go to the foundation's website, www.healthy-ky.org.

The poll was conducted for the foundation and the Health Foundation of Greater Cincinnati from Sept 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by landline and cell telephones. The margin of error for each figure is plus or minus 2.5 percentage points.

Forty percent of Kentucky adults think their children's generation will be less healthy than the current generation of working-age Kentuckians, and 61 percent think the newer generation will be worse off economically, according to a statewide poll conducted last fall.

The Kentucky Health Issues Poll also found that 54 percent think their parents' generation was better off economically, and 42 percent thought that generation was healthier than the current generation of Kentuckians.

“It is a cornerstone of the American Dream that, if we work hard, we will get ahead and be better off than our parents were,” said Dr. Susan Zepeda, President and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll. “Our polling suggests that optimism for a better future may be slipping away.”

Zepeda added, “Policymakers in Kentucky and Washington are grappling with economic and health policy issues that have long term impacts. Our polling clearly indicates the concern Kentuckians have, on the need to do better for our kids.”

For details of the poll, go to the foundation's website, www.healthy-ky.org.

The poll was conducted for the foundation and the Health Foundation of Greater Cincinnati from Sept 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by landline and cell telephones. The margin of error for each figure is plus or minus 2.5 percentage points.

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Health care is strong second to economy among concerns of Ky. registered voters; candidates compared on handling of issues

Health care ranks high among the concerns of Kentucky voters, according to the latest Kentucky Health Issues Poll taken for the Foundation for a Healthy Kentucky.

The poll, taken Sept. 20 through Oct. 14, asked registered voters to name the two most important issues in the Nov. 6 presidential election. The economy was mentioned by 65 percent; health care was second, with 42 percent. Foreign policy was a distant third, at 21 percent. The error margin on the sample of 1,160 voters is plus or minus 2.88 percentage points.

The poll did not ask voters whom they favored for president, but did ask which candidate they trusted to do a better job on certain issues. Romney, who is considered certain to win Kentucky, had a clear advantage on two issue areas, listed first:

• Dealing with the federal budget deficit: Romney 49%; Obama 36%

• Dealing with the economy and jobs: Romney 48%; Obama 36%

• Dealing with the future of the health reform law: Romney 45%; Obama 40%

• Addressing terrorism: Romney 43%; Obama 42%

• Dealing with the situation in Afghanistan: Romney 42%; Obama 40%

• Improving education: Obama 45%; Romney 40%

• Looking out for the best interests of women: Obama 42%; Romney 40%

• Making decisions about women's reproductive health choices and services: Obama 41%; Romney 38%

"This poll gives us a reliable snapshot of the issues most important to Kentucky voters as they decide who they will vote for on Nov. 6," said Dr. Susan Zepeda, president/CEO of the foundation. "Regardless of the outcomes of the election, our foundation believes it is essential for our elected officials to know what Kentuckians think about these issues." To download the full report by the Institute for Policy Research at the University of Cincinnati, click here.

Health care ranks high among the concerns of Kentucky voters, according to the latest Kentucky Health Issues Poll taken for the Foundation for a Healthy Kentucky.

The poll, taken Sept. 20 through Oct. 14, asked registered voters to name the two most important issues in the Nov. 6 presidential election. The economy was mentioned by 65 percent; health care was second, with 42 percent. Foreign policy was a distant third, at 21 percent. The error margin on the sample of 1,160 voters is plus or minus 2.88 percentage points.

The poll did not ask voters whom they favored for president, but did ask which candidate they trusted to do a better job on certain issues. Romney, who is considered certain to win Kentucky, had a clear advantage on two issue areas, listed first:

• Dealing with the federal budget deficit: Romney 49%; Obama 36%

• Dealing with the economy and jobs: Romney 48%; Obama 36%

• Dealing with the future of the health reform law: Romney 45%; Obama 40%

• Addressing terrorism: Romney 43%; Obama 42%

• Dealing with the situation in Afghanistan: Romney 42%; Obama 40%

• Improving education: Obama 45%; Romney 40%

• Looking out for the best interests of women: Obama 42%; Romney 40%

• Making decisions about women's reproductive health choices and services: Obama 41%; Romney 38%

"This poll gives us a reliable snapshot of the issues most important to Kentucky voters as they decide who they will vote for on Nov. 6," said Dr. Susan Zepeda, president/CEO of the foundation. "Regardless of the outcomes of the election, our foundation believes it is essential for our elected officials to know what Kentuckians think about these issues." To download the full report by the Institute for Policy Research at the University of Cincinnati, click here.

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Reports show impact of health-care industry in each of Kentucky's 120 counties

It's not often that such detailed data is broken down to the county level, but a new report looks at the economic impact of the local health-care system in each of Kentucky's 120 counties.

The reports, compiled at the University of Kentucky, look at the number of health-care jobs, as well as the revenue and income generated by the local health-care system. In many rural counties, the authors note, health care is the second largest industry, second only to local government.

The most important economic role of the health-care sector is to "keep local health-care dollars at home," the report says. If private insurance, consumer out-of-pocket payments and Medicare and Medicaid transfer payments aren't kept local, an outmigration of health-care services can take place. "This bypass of local health care remains an important issue for many rural health care providers and rural communities."

Conversely, if the local health-care sector can attract patients from outside the area, health care "can act as an export industry," the authors note. Because doctors and other providers can help improve the health and productivity of the local workforce, the health-care sector can also help an area recruit new and retain existing business.

The county reports include a comparison of household income with the state and nation, and indicates how that income is earned. In Boyle County, for example, 55.6 percent was earned through place-of-work earnings, while 22.6 percent was from transfer payments, such as those from Social Security, Medicare and Medicaid. The reports also break down how much income is generated according to industry type, from 2000 to 2008.

Income earned by Boyle County residents working in the health-care sector increased 42 percent in those years, one of the largest areas of gains in the county. In all, health care accounted for 13 percent of industry in Boyle and generated more than $322 million in sales, more than $151 million in labor income and nearly 3,500 jobs in the area.

The report, available here, was compiled by Dr. Alison Davis, director of the Community and Ecomomic Development Initiative in Kentucky, part of UK's College of Agriculture. It was funded by the Foundation for a Healthy Kentucky.

It's not often that such detailed data is broken down to the county level, but a new report looks at the economic impact of the local health-care system in each of Kentucky's 120 counties.

The reports, compiled at the University of Kentucky, look at the number of health-care jobs, as well as the revenue and income generated by the local health-care system. In many rural counties, the authors note, health care is the second largest industry, second only to local government.

The most important economic role of the health-care sector is to "keep local health-care dollars at home," the report says. If private insurance, consumer out-of-pocket payments and Medicare and Medicaid transfer payments aren't kept local, an outmigration of health-care services can take place. "This bypass of local health care remains an important issue for many rural health care providers and rural communities."

Conversely, if the local health-care sector can attract patients from outside the area, health care "can act as an export industry," the authors note. Because doctors and other providers can help improve the health and productivity of the local workforce, the health-care sector can also help an area recruit new and retain existing business.

The county reports include a comparison of household income with the state and nation, and indicates how that income is earned. In Boyle County, for example, 55.6 percent was earned through place-of-work earnings, while 22.6 percent was from transfer payments, such as those from Social Security, Medicare and Medicaid. The reports also break down how much income is generated according to industry type, from 2000 to 2008.

Income earned by Boyle County residents working in the health-care sector increased 42 percent in those years, one of the largest areas of gains in the county. In all, health care accounted for 13 percent of industry in Boyle and generated more than $322 million in sales, more than $151 million in labor income and nearly 3,500 jobs in the area.

The report, available here, was compiled by Dr. Alison Davis, director of the Community and Ecomomic Development Initiative in Kentucky, part of UK's College of Agriculture. It was funded by the Foundation for a Healthy Kentucky.

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Hopkinsville hospital's credit rating downgraded; part of national trend, but only Kentucky hospital nicked by rating agency lately

Following a national trend stemming from a slowly recovering economy, the hospital in Hopkinsville has had its credit rating downgraded, a possibility many Kentucky hospitals may be facing. "This means the hospital may have to pay a higher interest rate if it needs to borrow money in the near future," reports Nick Tabor, senior staff writer for theKentucky New Era.

Loss of business, a small revenue base and lots of debt were among the reasons Jennie Stuart Medical Center's rating dropped from BBB+ to BBB, Tabor reports. Fitch Ratings, one of the global agencies whose ratings guide investors, said uncertainty about the expansion of Kentucky's Medicaid system and how federal health reform will affect the hospital's finances were other reasons for the downgrade. The hospital has lost money in two of the last four years. Last year, it had a 1.9 percent loss.

Tabor explains there are eight ratings above the BBB level. If the facility's rating "were to slip two levels lower, to BB+, it would be on the level of 'junk bonds,' no longer considered investment grade," he reports.

There are three major rating companies in the U.S.: Fitch, Moody's and Standard and Poor's. Moody's expects downgrades of nonprofit hospitals to outnumber upgrades by the end of 2012, reports Jeffrey Young for The Huffington Post. Fitch expects the same will happen, said Senior Director Emily Wong. Smaller hospitals will especially feel the pinch since they "don't have as much ability to offset expense, inflation or reimbursement reductions," Wong said.

Since October 2011, Fitch has reviewed seven nonprofit hospitals in Kentucky. Five were affirmed, one was upgraded and Jennie Stuart was the lone downgrade. The other facilities reviewed were:
• Norton Healthcare, Louisville: affirmed at A-

• Owensboro Medicald Health System: affirmed at BBB+

• Appalachian Regional Healthcare: upgraded BB from BB-

• King's Daughters in Ashland: affirmed at A+

• Baptist Health Systems: affirmed at AA-

• St. Elizabeth Medical Center: affirmed at AA-

AA- and A-rated facilities are reviewed every two years. BBB and BBs are reviewed once a year, and B- and below-rated facilities are reviewed every six months. This type of story can be localized for any hospital. The easiest way to check ratings for hospitals in your area is to get an account at each of the three major rating companies. "These accounts are free and easy to set up," Tabor said. (Read more)

Following a national trend stemming from a slowly recovering economy, the hospital in Hopkinsville has had its credit rating downgraded, a possibility many Kentucky hospitals may be facing. "This means the hospital may have to pay a higher interest rate if it needs to borrow money in the near future," reports Nick Tabor, senior staff writer for theKentucky New Era.

Loss of business, a small revenue base and lots of debt were among the reasons Jennie Stuart Medical Center's rating dropped from BBB+ to BBB, Tabor reports. Fitch Ratings, one of the global agencies whose ratings guide investors, said uncertainty about the expansion of Kentucky's Medicaid system and how federal health reform will affect the hospital's finances were other reasons for the downgrade. The hospital has lost money in two of the last four years. Last year, it had a 1.9 percent loss.

Tabor explains there are eight ratings above the BBB level. If the facility's rating "were to slip two levels lower, to BB+, it would be on the level of 'junk bonds,' no longer considered investment grade," he reports.

There are three major rating companies in the U.S.: Fitch, Moody's and Standard and Poor's. Moody's expects downgrades of nonprofit hospitals to outnumber upgrades by the end of 2012, reports Jeffrey Young for The Huffington Post. Fitch expects the same will happen, said Senior Director Emily Wong. Smaller hospitals will especially feel the pinch since they "don't have as much ability to offset expense, inflation or reimbursement reductions," Wong said.

Since October 2011, Fitch has reviewed seven nonprofit hospitals in Kentucky. Five were affirmed, one was upgraded and Jennie Stuart was the lone downgrade. The other facilities reviewed were:
• Norton Healthcare, Louisville: affirmed at A-

• Owensboro Medicald Health System: affirmed at BBB+

• Appalachian Regional Healthcare: upgraded BB from BB-

• King's Daughters in Ashland: affirmed at A+

• Baptist Health Systems: affirmed at AA-

• St. Elizabeth Medical Center: affirmed at AA-

AA- and A-rated facilities are reviewed every two years. BBB and BBs are reviewed once a year, and B- and below-rated facilities are reviewed every six months. This type of story can be localized for any hospital. The easiest way to check ratings for hospitals in your area is to get an account at each of the three major rating companies. "These accounts are free and easy to set up," Tabor said. (Read more)

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