Facing budget shortfalls, many county and district health departments cut hours and staff

Reduced hours and staff will be the new reality for many health departments across Kentucky starting in July as they deal with funding shortages and changes.

Though the total amount of state funding to local health departments has not gone down, the way it is allocated has changed. “Part of the new formula took into account the population served and percentage of population below the poverty level,” reports Beth Musgrave for the Lexington Herald-Leader. Counties that serve more “working poor” — people who are employed but don’t have insurance — were hit the hardest by the reformulation.

Kentucky’s move to managed care for its Medicaid recipients also affected funding because reimbursement rates went down. Meanwhile, retirement and health insurance costs continue to go up.

There are 59 county and district health departments in Kentucky, all of which are funded partly by local property taxes, ranging from 1.8 cents to 4 cents per $100 worth of property. With the recession, local tax revenues have decreased, contributing to funding shortfalls.

Musgrave reports of furloughs, staff cuts and program cuts in various counties surrounding Lexington. Local news outlets should look at what is happening to health departments in their areas. (Read more) 

Reduced hours and staff will be the new reality for many health departments across Kentucky starting in July as they deal with funding shortages and changes.

Though the total amount of state funding to local health departments has not gone down, the way it is allocated has changed. “Part of the new formula took into account the population served and percentage of population below the poverty level,” reports Beth Musgrave for the Lexington Herald-Leader. Counties that serve more “working poor” — people who are employed but don’t have insurance — were hit the hardest by the reformulation.

Kentucky’s move to managed care for its Medicaid recipients also affected funding because reimbursement rates went down. Meanwhile, retirement and health insurance costs continue to go up.

There are 59 county and district health departments in Kentucky, all of which are funded partly by local property taxes, ranging from 1.8 cents to 4 cents per $100 worth of property. With the recession, local tax revenues have decreased, contributing to funding shortfalls.

Musgrave reports of furloughs, staff cuts and program cuts in various counties surrounding Lexington. Local news outlets should look at what is happening to health departments in their areas. (Read more) 

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Black lung affects Kentucky surface miners more than those in other states, CDC study finds and Courier-Journal reports

Photo by Getty Images.

Nearly 4 percent of surface coal miners who work in Central Appalachia who were tested for a study by the Centers for Disease Control and Prevention have black lung disease, compared to 2 percent of all U.S. surface miners and 3.2 percent of underground coal miners.

Though the study didn't test Kentucky separately from the 14 other states assessed, Laura Ungar of The Courier-Journal in Louisville asked about it and found that "13 of 230 Kentucky surface miners tested — or 5.7 percent — had black lung," she reports, quoting Cara Halldin, a CDC epidemic intelligence service officer, as calling that number " a disproportionate burden."

It's not clear why the incidence is higher in Central Appalachia than other parts of the country, but Halldin suspects it has to do with "more years spent mining, area geology or the safety culture at mines," Ungar reports. One study showed miners who work in Central Appalachia typically work 28 years in the mines while non-Appalachian miners work average 20 years.

Black-lung disease, or coal workers' pneumoconiosis, is the result of miners repeatedly inhaling the dust that comes from extracting coal. That dust occurs whether the miner is under- or above-ground. "Coal mining is really, really dusty. Don't matter what you do, you're in the dust," said John Bud Ritchie, a retired surface miner who has black lung disease. "It's real rough. You can't hardly keep the dust down on hot days."

The federal exposure limit for "respirable dust" in underground and surface mines is 2 milligrams of coal dust per cubic meter of air. That limit was set in 1969, along with a law that set up "a surveillance system for assessing prevalence of black lung among underground coal miners," Ungar reports. "But the requirement for surveillance doesn't extend to surface miners." Haldin said, "Industry should recognize this is a problem and their workers are at risk and bring down the levels." (Read more)

Photo by Getty Images.

Nearly 4 percent of surface coal miners who work in Central Appalachia who were tested for a study by the Centers for Disease Control and Prevention have black lung disease, compared to 2 percent of all U.S. surface miners and 3.2 percent of underground coal miners.

Though the study didn't test Kentucky separately from the 14 other states assessed, Laura Ungar of The Courier-Journal in Louisville asked about it and found that "13 of 230 Kentucky surface miners tested — or 5.7 percent — had black lung," she reports, quoting Cara Halldin, a CDC epidemic intelligence service officer, as calling that number " a disproportionate burden."

It's not clear why the incidence is higher in Central Appalachia than other parts of the country, but Halldin suspects it has to do with "more years spent mining, area geology or the safety culture at mines," Ungar reports. One study showed miners who work in Central Appalachia typically work 28 years in the mines while non-Appalachian miners work average 20 years.

Black-lung disease, or coal workers' pneumoconiosis, is the result of miners repeatedly inhaling the dust that comes from extracting coal. That dust occurs whether the miner is under- or above-ground. "Coal mining is really, really dusty. Don't matter what you do, you're in the dust," said John Bud Ritchie, a retired surface miner who has black lung disease. "It's real rough. You can't hardly keep the dust down on hot days."

The federal exposure limit for "respirable dust" in underground and surface mines is 2 milligrams of coal dust per cubic meter of air. That limit was set in 1969, along with a law that set up "a surveillance system for assessing prevalence of black lung among underground coal miners," Ungar reports. "But the requirement for surveillance doesn't extend to surface miners." Haldin said, "Industry should recognize this is a problem and their workers are at risk and bring down the levels." (Read more)

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Almost half of Americans did not receive routine preventive care before 2010, study finds

Los Angeles Times graphic by Mel Melcon

Though preventive medicine is considered a cornerstone in improving health, nearly half of Americans did not receive routine preventive care before 2010, a report by the Centers for Disease Control and Preventionhas found.

The findings show “there are large disparities by demographics, geography, and health care coverage and access” when it comes to receiving preventive clinical services, said CDC Director Dr. Thomas Frieden.

The analysis looked at “how many people with vascular heart disease were prescribed aspirin or antiplatelet therapy to prevent heart disease (just 46 percent) and how many adults with hypertension had their blood pressure under control (just 43 percent). Only 28 percent of adults between 18 and 64 had received the seasonal influenza vaccine. Only 7.6 percent of tobacco users were prescribed tobacco cessation medication,” reports Eryn Brown for the Los Angeles Times.

When it came to cholesterol testing the results were more positive, with 70 percent of men and women considered at risk receiving screening in the last five years. Preventive care to manage diabetes was also more readily accessible.

The goal of the study was to establish a baseline of preventive care before the implementation of the Affordable Care Act, which “gave 54 million Americans at least one new free preventive service through private health insurance plans,” Brown reports. (Read more)

Los Angeles Times graphic by Mel Melcon

Though preventive medicine is considered a cornerstone in improving health, nearly half of Americans did not receive routine preventive care before 2010, a report by the Centers for Disease Control and Preventionhas found.

The findings show “there are large disparities by demographics, geography, and health care coverage and access” when it comes to receiving preventive clinical services, said CDC Director Dr. Thomas Frieden.

The analysis looked at “how many people with vascular heart disease were prescribed aspirin or antiplatelet therapy to prevent heart disease (just 46 percent) and how many adults with hypertension had their blood pressure under control (just 43 percent). Only 28 percent of adults between 18 and 64 had received the seasonal influenza vaccine. Only 7.6 percent of tobacco users were prescribed tobacco cessation medication,” reports Eryn Brown for the Los Angeles Times.

When it came to cholesterol testing the results were more positive, with 70 percent of men and women considered at risk receiving screening in the last five years. Preventive care to manage diabetes was also more readily accessible.

The goal of the study was to establish a baseline of preventive care before the implementation of the Affordable Care Act, which “gave 54 million Americans at least one new free preventive service through private health insurance plans,” Brown reports. (Read more)

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States with helmet laws have far fewer motorcycle-related deaths; Kentucky doesn't require bikers to wear protective headgear

Petersburg (Tex.) Volunteer Fire Dept. photo

“Fewer motorcyclists die in states that require helmets, and the costs to society are lower too,” reports Mike Stobbe for The Associated Press. About five times as many no-helmet biker deaths occur in states with less restrictive laws.

Kentucky once had a helmet law for motorcyclists, but repealed it several years ago. Nationwide, 20 states had universal motorcycle helmet laws in 2010, but Michigan has since reversed course and allowed helmets to be optional for riders over 21.

The study, conducted by the Centers for Disease Control and Prevention, looked at 14,283 motorcycle-related deaths from 2008 to 2010. Of those, 6,027 bikers did not wear a helmet. “Only about 12 percent of those deaths occurred in the 20 states that required everyone on motorbikes to wear helmets,” Stobbe reports.

The study also found that helmet use saved $3 billion in U.S. medical expenses. Another $1.4 billion could have been saved if all states had helmet laws, the CDC concluded. Motorcycles account for about 3 percent of vehicles on the road, but 14 percent of deaths caused by traffic accidents. (Read more)

Petersburg (Tex.) Volunteer Fire Dept. photo

“Fewer motorcyclists die in states that require helmets, and the costs to society are lower too,” reports Mike Stobbe for The Associated Press. About five times as many no-helmet biker deaths occur in states with less restrictive laws.

Kentucky once had a helmet law for motorcyclists, but repealed it several years ago. Nationwide, 20 states had universal motorcycle helmet laws in 2010, but Michigan has since reversed course and allowed helmets to be optional for riders over 21.

The study, conducted by the Centers for Disease Control and Prevention, looked at 14,283 motorcycle-related deaths from 2008 to 2010. Of those, 6,027 bikers did not wear a helmet. “Only about 12 percent of those deaths occurred in the 20 states that required everyone on motorbikes to wear helmets,” Stobbe reports.

The study also found that helmet use saved $3 billion in U.S. medical expenses. Another $1.4 billion could have been saved if all states had helmet laws, the CDC concluded. Motorcycles account for about 3 percent of vehicles on the road, but 14 percent of deaths caused by traffic accidents. (Read more)

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Lexington physician will lead American Medical Association

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A Kentucky physician has been chosen to head the American Medical Association.

Dr. Ardis Hoven of Lexington, an infectious-disease specialist, ran unopposed and will be the AMA's 168th president and the third woman to hold the position.

"The honor here is that I've been given a large responsibility, of which I'm very aware," she said. "We have the opportunity to take medicine, to take health care, to a better place."

Hoven was at the forefront in battling the first wave of the AIDS epidemic, reports Cheryl Truman of the Lexington Herald-Leader.

Hoven, a Cincinnati native, was president of the Kentucky Medical Association from 1993-94 and was elected to the AMA Board of Trustees in 2005. (Read more)

Add caption

A Kentucky physician has been chosen to head the American Medical Association.

Dr. Ardis Hoven of Lexington, an infectious-disease specialist, ran unopposed and will be the AMA's 168th president and the third woman to hold the position.

"The honor here is that I've been given a large responsibility, of which I'm very aware," she said. "We have the opportunity to take medicine, to take health care, to a better place."

Hoven was at the forefront in battling the first wave of the AIDS epidemic, reports Cheryl Truman of the Lexington Herald-Leader.

Hoven, a Cincinnati native, was president of the Kentucky Medical Association from 1993-94 and was elected to the AMA Board of Trustees in 2005. (Read more)

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New resource guide and school curriculum aimed at expanding farm-to-school programs in Kentucky

A resource guide and school curriculum are the latest efforts to expand farm-to-school programs in Kentucky. With fewer than 30 percent of Kentuckians consuming the recommended amounts of fruits and vegetables every day, farm to school is a “win-win for students, school food service, farmers and local economies,” said Elaine Russell, coordinator for Kentucky Obesity Prevention Program and chairwoman of the Kentucky Farm-to-School Task Force.

The guide includes advice from Kentuckians who have already participated in projects; resources to connect farmers and school food service directors, how to follow procurement rules; recipes; a produce calculator; funding sources; and how to get kids to eat their vegetables.

The curriculum helps students recognize the sources of the food they eat and explains how eating locally-grown food can improve their diet and nutrition.

The undertaking is a joint effort between the Kentucky Department for Public Health the state Department of Agriculture the state Department of Education and the University of Kentucky. The new resources will be presented to school food service personnel June 19 at the Kentucky School Nutrition Association’s conference at the Northern Kentucky Convention Center in Covington. (Read more)

A resource guide and school curriculum are the latest efforts to expand farm-to-school programs in Kentucky. With fewer than 30 percent of Kentuckians consuming the recommended amounts of fruits and vegetables every day, farm to school is a “win-win for students, school food service, farmers and local economies,” said Elaine Russell, coordinator for Kentucky Obesity Prevention Program and chairwoman of the Kentucky Farm-to-School Task Force.

The guide includes advice from Kentuckians who have already participated in projects; resources to connect farmers and school food service directors, how to follow procurement rules; recipes; a produce calculator; funding sources; and how to get kids to eat their vegetables.

The curriculum helps students recognize the sources of the food they eat and explains how eating locally-grown food can improve their diet and nutrition.

The undertaking is a joint effort between the Kentucky Department for Public Health the state Department of Agriculture the state Department of Education and the University of Kentucky. The new resources will be presented to school food service personnel June 19 at the Kentucky School Nutrition Association’s conference at the Northern Kentucky Convention Center in Covington. (Read more)

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Feline heart disease and pimobendan

Hambrook LE, Bennett PF. Effect of pimobendan on the clinical outcome and survival of cats with non-taurine responsive dilated cardiomyopathy. J Feline Med Surg 2012;14:233-239.
 
Dilated cardiomyopathy (DCM) is an uncommon form of cardiac disease in cats that can lead to congestive heart failure (CHF), aortic thromboembolism (ATE), arrhythmias, and sudden death. Taurine deficiency was found to be a major cause of feline DCM in 1987. Subsequent supplementation with taurine of cat foods has significantly reduced, yet not eliminated the incidence of feline DCM. This study looked at the effect of pimobendan on the median survival time (MST) of cats with non-taurine responsive dilated cardiomyopathy. Thirty-two client owned cats were divided into pimobendan (n=16) and non-pimobendan (n=16) treatment groups. All the cats received standard treatment of frusemide, taurine, and benazepril or enalapril. The MST of the pimobendan group (49 days, range 1 to > 502 days) was four times as long as the non-pimobendan group (12 days, 1 to 244 days). Pimobendan therapy appears to improve the survival time of cats with non-taurine responsive DCM. Pimobendan therapy was not associated with adverse effects in the cats. Hypothermia and fractional shortening (FS) of <20% were associated with a poor prognosis in cats. [VT]

See also: MacGregor JM, Rush JE, Laste NJ, et al. Use of pimobendan in 170 cats (2006–2010). J Vet Cardiol 2011;13:251-260.

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Hambrook LE, Bennett PF. Effect of pimobendan on the clinical outcome and survival of cats with non-taurine responsive dilated cardiomyopathy. J Feline Med Surg 2012;14:233-239.
 
Dilated cardiomyopathy (DCM) is an uncommon form of cardiac disease in cats that can lead to congestive heart failure (CHF), aortic thromboembolism (ATE), arrhythmias, and sudden death. Taurine deficiency was found to be a major cause of feline DCM in 1987. Subsequent supplementation with taurine of cat foods has significantly reduced, yet not eliminated the incidence of feline DCM. This study looked at the effect of pimobendan on the median survival time (MST) of cats with non-taurine responsive dilated cardiomyopathy. Thirty-two client owned cats were divided into pimobendan (n=16) and non-pimobendan (n=16) treatment groups. All the cats received standard treatment of frusemide, taurine, and benazepril or enalapril. The MST of the pimobendan group (49 days, range 1 to > 502 days) was four times as long as the non-pimobendan group (12 days, 1 to 244 days). Pimobendan therapy appears to improve the survival time of cats with non-taurine responsive DCM. Pimobendan therapy was not associated with adverse effects in the cats. Hypothermia and fractional shortening (FS) of <20% were associated with a poor prognosis in cats. [VT]

See also: MacGregor JM, Rush JE, Laste NJ, et al. Use of pimobendan in 170 cats (2006–2010). J Vet Cardiol 2011;13:251-260.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

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