What is being done to fight child obesity in Kentucky, which ranks third nationally in the problem? (second in a series)

Students in Kenton County Schools sample kale chips
as part of an effort to incorporate more fruit and
vegetables into their diets. (School district photo)

By Tara Kaprowy
Kentucky Health News

Now that all schools are back in session, cafeterias in every corner of Kentucky are bustling with students sweeping through lunch lines, sitting down with their best friends and sampling their meal.

It's in these loud, boisterous rooms that the fight against childhood obesity, which is higher in Kentucky than in all but a few states, is beginning to take shape.

Many children eat more than half their calories at school, but schools are just one of the battlegrounds. Across the country and the state, there are initiatives that are gaining traction to take a bite out of the problem.

When school started this year, the 556,000 Kentucky kids who get their lunch from school cafeterias may have noticed a more apples and oranges on their plates. With the goal of creating a healthier school environment, the United States Department of Agriculture has revamped school lunch regulations for the first time in 15 years. Many of the changes involve what some see as the saviors of kids caught in the obesity epidemic: fruit and vegetables.

In order for lunches to qualify for School Lunch Program funding, students now must have at least one serving of fruit or vegetables on their plate by the time they reach the cash register. And "vegetable" no longer just means French fries. And at least once each week, schools must serve a green, leafy vegetable like broccoli or spinach, plus an orange or red vegetable like carrots, and a legume like lentils or chickpeas, which are a good blend of protein and carbohydrates with very little fat.

Food service directors are optimistic elementary students
will adjust to school lunch changes, but high schoolers
are a different story. (Kenton County Schools photo)

Will students actually eat those foods? Julia Bauscher, food service director at Jefferson County Public Schools, is optimistic about elementary school students. So is Ginger Gray, director of food services in Kenton County, who has been serving such vegetable dishes as broccoli parmesan and kale chips for several years.

"Kids are more open to trying new things than adults realize." Gray said, but "It takes persistence. You can't just say I tried it once and kids didn't eat it so you don't try it again." 

High school students are a harder sell. Sylvia Moore, child nutrition and food service director at Mercer County Schools, said lunch participation rates have dropped by about 5 percent since the beginning of the school year. "Just this week I was up at the high school to stand at the garbage can. I was just there a minute when a girl came and tossed her totally-untouched orange in front of me," she said. "We are already making healthier garbage cans," not healthier students, she added.

The media angle

Another nationwide effort involves what children see on TV, which could have a big impact. A 2009 study found they average more than 32 hours a week. Excessive TV viewing is linked to a sedentary lifestyle, and American children see about $1.6 billion a year worth of food and beverage marketing. "It's a double-whammy," said Josh Golin, associate director for the Campaign for Commercial-Free Childhood. "It's the combination of not moving, and being urged to consume unhealthy food."

(Kentucky  Health News photo)

By 2015, that will change on channels of the Walt Disney Co., which will no longer put ads for products like Capri Sun and Kraft Lunchables (left), as well as a variety of candy, sugared cereal and fast food.

The television show iCarly, popular on Nickelodeon, is approaching the issue differently, encouraging viewers to create their own wacky veggie dish and submit the recipe for the "iCarly iCook with BirdsEye" intiative. Spots on the channel show the kinds of dishes the contest wants, like a "veggie sundae," which consists of a scoop of carrots, cauliflower and broccoli in a banana split dish.

A 2006 study showed 88 percent of the food ads on Nickeldeon promoted unhealthy food. A year later the channel announced its characters like Dora the Explorer and SpongeBob SquarePants would be licensed to sell only healthy foods; that's why Dora appears on packages of frozen edamame -- green soybeans, often in their pods.

Teaching the basics, and behaviors

Statewide programs are also infiltrating directly into communities. One involves cooking classes, with teachers from the University of Kentucky's Nutrition Education Program setting up demonstrations everywhere from public housing to women's crisis centers to church basements.

For 10 weeks, the teachers educate low-income adults about the basics of cooking with the hope they will change the way they feed their families. "We talk to them about how to use coupons, how to use dried beans instead of canned beans, how to use those leftovers and how to stretch their food dollars so they can provide good-tasting and nutritious food," said Debra Cotterill, the program's director.

The 43-year-old program was created to teach people how to use government commodities, like big blocks of cheese, that they received in the 1970s. Since obesity has become so prevalent, Cotterill said the emphasis has changed and interest in classes is up dramatically. In fact, Cotterill said the extension program's whole mission has expanded.

"It is not enough to share information, we also have a responsibility to help change behaviors," she said. "Now, all agents do some type of nutrition education in their work somewhere or other, even the ag agents, because it's become such a problem in our counties."

State regulations lack some specificity

Since many children entering kindergarten are already overweight, state government is examining preschools and daycare centers to see what policies they have in place when it comes to nutrition and physical activity. Though there are state regulations for licensed child care centers, "the language is not specific," explained Elaine Russell, the state's obesity prevention coordinator. For example,  regulations say bread should be served with meals, but don't specify the type of bread, such as whole grain or whole wheat, and don't prohibit high-fat snacks or sugar-sweetened beverages.

As part of a pilot program, state workers went to nine facilities each in Northern Kentucky, the lower Green River region and the Barren River region to assess their policies, teach directors and staff about obesity in Kentucky and discuss goals with directors and staff about their goals.

They also taught them the program 5-2-1-0, a catchy way of reminding students they should have five servings of vegetables each day, no more than two hours of screen time, at least one hour of physical activity and drink zero sugary beverages. The program is being pushed by pediatricians and at offices where poor mothers sign up for the Women, Infants and Children nutrition program. "Our goal is to make sure our parents hear this from more than one spot," Russell said. "We can change these policies but unless parents understand why we're making them, they probably won't stick."

Many facilities in the pilot program didn't have wellness policies before the process, but all did afterward. However, Russell would also like to see child-care centers adopt the standards for nutrition and physical activity as suggested in Caring for Our Children: National Health and Safety Performance Standards, which have stronger guidelines that promote active play every day and follow minimum standards as recommended by the USDA's Child and Adult Care Food Program. "Some states require at least two hours of physical activity a day, she said. "Physical activity is encouraged in Kentucky, but it's not specified. Kentucky rules do limit screen time, but kids are still allowed to watch two hours a day."

An early start

Some programs focus on even younger children, including infants, and pregnant women. "A lot of times when we talk about childhood obesity, we kind of default into talking about school-age kids," said Amy Swann, senior policy analyst for Kentucky Youth Advocates. "But if we're going to take a really multi-faceted approach, what we now know is it actually starts with the mother's nutrition while she's pregnant."

(University of Louisville Hospital photo)

That idea is behind the Kangaroo Care Initiative, which promotes skin-to-skin contact with new mothers and their babies in order to promote breastfeeding and bonding. Among other benefits, breastfeeding can help reduce the risk of obesity. One study showed children who were breastfed were 22 percent less likely to be overweight by age 14, said Marlene Goodlett, Kentucky's breastfeeding coordinator.

The effort started in 2007 with the University of Louisville's Hospital Center for Women and Infants. This year, U of L partnered with the WIC program to train all 51 birthing hospitals in the state. Now, 84 percent of them have implemented Kangaroo Care. One of the first hospitals on board was Flaget Memorial Hospital in Bardstown, where breastfeeding rates increased to 61 percent from 49 percent.

Community lessons

From a walking trail mowed on land owned by the community hospital in Winchester, to the Hopkinsville farmers' market accepting food stamps, there are local efforts to combat obesity in place that, inch by inch, are causing change.

(Photo by Steve Patton, UK College of Agriculture)

These success stories are detailed in the report "Shaping Kentucky's Future: A Community Guide to Reducing Obesity," funded in part by the state health department, which illustrates ways Kentucky communities are making policy, environmental and systems changes.

One of these is the Better Bites program in Lexington, a revamp of how food is sold at swimming-pool concession stands in Lexington. "We learned you could exercise at the pool for two hours, go to the concession and get a standard hamburger, fries and soft drink combo and you would actually take in more calories that you're burning. That was a shocking statistic for us and really propelled us along," said Brian Rogers, deputy director of enterprise at Lexington Parks and Recreation. Organizers introduced menu items like yogurt and fresh fruit, replaced hot dogs with turkey dogs, standard popcorn with low-fat popcorn and sold only baked chips at two public swimming pools in the city starting last year. This summer, candy sales went down 20 percent. and the Better Bites menu items constituted 15 to 20 percent of all sales, up from 10 percent last summer, Rogers said.

Berea is concentrating its efforts on environmental change with its Complete Streets project, which is aimed at making the city's streets more accessible to walking and biking. Two major projects — a bridge project that includes sidewalks and bike lanes and a three-mile trail that connects downtown with the Indian Fort Theatre — are opening up much more territory to pedestrians. The city has coupled these efforts with simple changes like making walkways more visible, installing bike racks around town, and changing the timing on lights to give pedestrians more time to cross the road.

Mayor Steve Connelly said the effort is about culture change. "I do think that we have perhaps by accident created these barriers to walk and bike largely since the 1950s when America really fell in love with the Interstate, franchise restaurants, the suburbs and the automobile," he said. "Really, we need to get back to walking as second nature." With each installation of more sidewalks and trails, though, that is exactly what is happening, Connelly said. "It's the classic when you build it, they're out there using them," he said.

Still a way to go

While progress is being made, experts say the nation is just beginning to round the corner on the problem. Though some studies show childhood obesity and overweight rates may be leveling off, many kids are simply graduating from the overweight to the even more unhealthy obese category, said Dr. Christopher Bolling, a Kenton County pediatrician.

After a visit this fall to school cafeterias to document changes that are happening there, perhaps reporter Lenny Bernstein said it best in The Washington Post: "If we don't yet know how well we're doing in this battle, we are at least figuring out how to develop our weapons."

NEXT: Why the obesity epidemic is such a difficult problem to solve.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Students in Kenton County Schools sample kale chips
as part of an effort to incorporate more fruit and
vegetables into their diets. (School district photo)

By Tara Kaprowy
Kentucky Health News

Now that all schools are back in session, cafeterias in every corner of Kentucky are bustling with students sweeping through lunch lines, sitting down with their best friends and sampling their meal.

It's in these loud, boisterous rooms that the fight against childhood obesity, which is higher in Kentucky than in all but a few states, is beginning to take shape.

Many children eat more than half their calories at school, but schools are just one of the battlegrounds. Across the country and the state, there are initiatives that are gaining traction to take a bite out of the problem.

When school started this year, the 556,000 Kentucky kids who get their lunch from school cafeterias may have noticed a more apples and oranges on their plates. With the goal of creating a healthier school environment, the United States Department of Agriculture has revamped school lunch regulations for the first time in 15 years. Many of the changes involve what some see as the saviors of kids caught in the obesity epidemic: fruit and vegetables.

In order for lunches to qualify for School Lunch Program funding, students now must have at least one serving of fruit or vegetables on their plate by the time they reach the cash register. And "vegetable" no longer just means French fries. And at least once each week, schools must serve a green, leafy vegetable like broccoli or spinach, plus an orange or red vegetable like carrots, and a legume like lentils or chickpeas, which are a good blend of protein and carbohydrates with very little fat.

Food service directors are optimistic elementary students
will adjust to school lunch changes, but high schoolers
are a different story. (Kenton County Schools photo)

Will students actually eat those foods? Julia Bauscher, food service director at Jefferson County Public Schools, is optimistic about elementary school students. So is Ginger Gray, director of food services in Kenton County, who has been serving such vegetable dishes as broccoli parmesan and kale chips for several years.

"Kids are more open to trying new things than adults realize." Gray said, but "It takes persistence. You can't just say I tried it once and kids didn't eat it so you don't try it again." 

High school students are a harder sell. Sylvia Moore, child nutrition and food service director at Mercer County Schools, said lunch participation rates have dropped by about 5 percent since the beginning of the school year. "Just this week I was up at the high school to stand at the garbage can. I was just there a minute when a girl came and tossed her totally-untouched orange in front of me," she said. "We are already making healthier garbage cans," not healthier students, she added.

The media angle

Another nationwide effort involves what children see on TV, which could have a big impact. A 2009 study found they average more than 32 hours a week. Excessive TV viewing is linked to a sedentary lifestyle, and American children see about $1.6 billion a year worth of food and beverage marketing. "It's a double-whammy," said Josh Golin, associate director for the Campaign for Commercial-Free Childhood. "It's the combination of not moving, and being urged to consume unhealthy food."

(Kentucky  Health News photo)

By 2015, that will change on channels of the Walt Disney Co., which will no longer put ads for products like Capri Sun and Kraft Lunchables (left), as well as a variety of candy, sugared cereal and fast food.

The television show iCarly, popular on Nickelodeon, is approaching the issue differently, encouraging viewers to create their own wacky veggie dish and submit the recipe for the "iCarly iCook with BirdsEye" intiative. Spots on the channel show the kinds of dishes the contest wants, like a "veggie sundae," which consists of a scoop of carrots, cauliflower and broccoli in a banana split dish.

A 2006 study showed 88 percent of the food ads on Nickeldeon promoted unhealthy food. A year later the channel announced its characters like Dora the Explorer and SpongeBob SquarePants would be licensed to sell only healthy foods; that's why Dora appears on packages of frozen edamame -- green soybeans, often in their pods.

Teaching the basics, and behaviors

Statewide programs are also infiltrating directly into communities. One involves cooking classes, with teachers from the University of Kentucky's Nutrition Education Program setting up demonstrations everywhere from public housing to women's crisis centers to church basements.

For 10 weeks, the teachers educate low-income adults about the basics of cooking with the hope they will change the way they feed their families. "We talk to them about how to use coupons, how to use dried beans instead of canned beans, how to use those leftovers and how to stretch their food dollars so they can provide good-tasting and nutritious food," said Debra Cotterill, the program's director.

The 43-year-old program was created to teach people how to use government commodities, like big blocks of cheese, that they received in the 1970s. Since obesity has become so prevalent, Cotterill said the emphasis has changed and interest in classes is up dramatically. In fact, Cotterill said the extension program's whole mission has expanded.

"It is not enough to share information, we also have a responsibility to help change behaviors," she said. "Now, all agents do some type of nutrition education in their work somewhere or other, even the ag agents, because it's become such a problem in our counties."

State regulations lack some specificity

Since many children entering kindergarten are already overweight, state government is examining preschools and daycare centers to see what policies they have in place when it comes to nutrition and physical activity. Though there are state regulations for licensed child care centers, "the language is not specific," explained Elaine Russell, the state's obesity prevention coordinator. For example,  regulations say bread should be served with meals, but don't specify the type of bread, such as whole grain or whole wheat, and don't prohibit high-fat snacks or sugar-sweetened beverages.

As part of a pilot program, state workers went to nine facilities each in Northern Kentucky, the lower Green River region and the Barren River region to assess their policies, teach directors and staff about obesity in Kentucky and discuss goals with directors and staff about their goals.

They also taught them the program 5-2-1-0, a catchy way of reminding students they should have five servings of vegetables each day, no more than two hours of screen time, at least one hour of physical activity and drink zero sugary beverages. The program is being pushed by pediatricians and at offices where poor mothers sign up for the Women, Infants and Children nutrition program. "Our goal is to make sure our parents hear this from more than one spot," Russell said. "We can change these policies but unless parents understand why we're making them, they probably won't stick."

Many facilities in the pilot program didn't have wellness policies before the process, but all did afterward. However, Russell would also like to see child-care centers adopt the standards for nutrition and physical activity as suggested in Caring for Our Children: National Health and Safety Performance Standards, which have stronger guidelines that promote active play every day and follow minimum standards as recommended by the USDA's Child and Adult Care Food Program. "Some states require at least two hours of physical activity a day, she said. "Physical activity is encouraged in Kentucky, but it's not specified. Kentucky rules do limit screen time, but kids are still allowed to watch two hours a day."

An early start

Some programs focus on even younger children, including infants, and pregnant women. "A lot of times when we talk about childhood obesity, we kind of default into talking about school-age kids," said Amy Swann, senior policy analyst for Kentucky Youth Advocates. "But if we're going to take a really multi-faceted approach, what we now know is it actually starts with the mother's nutrition while she's pregnant."

(University of Louisville Hospital photo)

That idea is behind the Kangaroo Care Initiative, which promotes skin-to-skin contact with new mothers and their babies in order to promote breastfeeding and bonding. Among other benefits, breastfeeding can help reduce the risk of obesity. One study showed children who were breastfed were 22 percent less likely to be overweight by age 14, said Marlene Goodlett, Kentucky's breastfeeding coordinator.

The effort started in 2007 with the University of Louisville's Hospital Center for Women and Infants. This year, U of L partnered with the WIC program to train all 51 birthing hospitals in the state. Now, 84 percent of them have implemented Kangaroo Care. One of the first hospitals on board was Flaget Memorial Hospital in Bardstown, where breastfeeding rates increased to 61 percent from 49 percent.

Community lessons

From a walking trail mowed on land owned by the community hospital in Winchester, to the Hopkinsville farmers' market accepting food stamps, there are local efforts to combat obesity in place that, inch by inch, are causing change.

(Photo by Steve Patton, UK College of Agriculture)

These success stories are detailed in the report "Shaping Kentucky's Future: A Community Guide to Reducing Obesity," funded in part by the state health department, which illustrates ways Kentucky communities are making policy, environmental and systems changes.

One of these is the Better Bites program in Lexington, a revamp of how food is sold at swimming-pool concession stands in Lexington. "We learned you could exercise at the pool for two hours, go to the concession and get a standard hamburger, fries and soft drink combo and you would actually take in more calories that you're burning. That was a shocking statistic for us and really propelled us along," said Brian Rogers, deputy director of enterprise at Lexington Parks and Recreation. Organizers introduced menu items like yogurt and fresh fruit, replaced hot dogs with turkey dogs, standard popcorn with low-fat popcorn and sold only baked chips at two public swimming pools in the city starting last year. This summer, candy sales went down 20 percent. and the Better Bites menu items constituted 15 to 20 percent of all sales, up from 10 percent last summer, Rogers said.

Berea is concentrating its efforts on environmental change with its Complete Streets project, which is aimed at making the city's streets more accessible to walking and biking. Two major projects — a bridge project that includes sidewalks and bike lanes and a three-mile trail that connects downtown with the Indian Fort Theatre — are opening up much more territory to pedestrians. The city has coupled these efforts with simple changes like making walkways more visible, installing bike racks around town, and changing the timing on lights to give pedestrians more time to cross the road.

Mayor Steve Connelly said the effort is about culture change. "I do think that we have perhaps by accident created these barriers to walk and bike largely since the 1950s when America really fell in love with the Interstate, franchise restaurants, the suburbs and the automobile," he said. "Really, we need to get back to walking as second nature." With each installation of more sidewalks and trails, though, that is exactly what is happening, Connelly said. "It's the classic when you build it, they're out there using them," he said.

Still a way to go

While progress is being made, experts say the nation is just beginning to round the corner on the problem. Though some studies show childhood obesity and overweight rates may be leveling off, many kids are simply graduating from the overweight to the even more unhealthy obese category, said Dr. Christopher Bolling, a Kenton County pediatrician.

After a visit this fall to school cafeterias to document changes that are happening there, perhaps reporter Lenny Bernstein said it best in The Washington Post: "If we don't yet know how well we're doing in this battle, we are at least figuring out how to develop our weapons."

NEXT: Why the obesity epidemic is such a difficult problem to solve.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Read More

Child obesity is a complex problem, intimidating to those who are fighting it (last in a series)

Dr. Christopher Bolling prepares to see a patient.

By Tara Kaprowy
Kentucky Health News

Nearly every weekday, pediatrician Christopher Bolling starts his day by scooping up his lap top and stepping into one of his cheerfully-appointed exam rooms. After greeting his young patients, who are generally passing the time by playing games on their parents' cell phones, Bolling begins his examinations. During his 21 years of practice, those exams have increasingly ended with Bolling counseling parents about their children's weight.

"I tell them I'm not worried about this as a cosmetic issue, I'm worried about this as a health issue," he said in an interview. "This isn't about your child being ugly or undesirable, we talk about them being healthy and not healthy."

But, though dedicated to his cause, Bolling, of Crestview Hills in Kenton County, said he is keenly aware that his counseling is not nearly enough to help his patients overcome the weight that is impeding their health. "What makes this problem unique is it is so multifactorial, there are so many pieces to it," he said. "It's food, it's activity, it's portion size, it's fruit and vegetables, it's screen time and safety. And it makes it really intimidating to know what to do with it."

"We're swimming upstream in a flooded river," agreed Debra Cotterill, director of the Nutrition Education Program at the University of Kentucky. "Even for people who know it, it's still hard. Weight is an issue I have to address every single day of my life and I understand how it is for people. You're talking about change of behaviors."

It's like smoking, but it's different

But a sweeping change in behavior is going to be what it takes to turn the tide of the obesity epidemic, experts say, and that is one reason fighting obesity is often likened to the battle against smoking. The fact that it is just as, if not more, deadly is another parallel, as is the fact that it is just as, if not more, far-reaching.

But there are key differences in battling the two problems, Judith Graham noted in a story for Kaiser Health News. First, other than an increase in health-care costs, there is no compelling argument that implies that another person's weight adversely affects others, like second-hand smoking does for smoking, or drunk driving does for drinking to excess. "The notion that my behavior as a smoker can have an effect on you and can make you sick was critically important in accelerating people's intolerance of smoking and their willingness to see the government take action," Michael Ericksen, director of the Institute of Public Health at Georgia State University, told Graham.

Compounding the issue is there is nearly no end to the variety of food that can contribute to the problem. Unlike Big Tobacco, the food industry also cannot be demonized as easily, Graham points out. But most importantly, "unlike alcohol and tobacco, you can't go cold turkey on food," Bolling said. "You have to keep eating."

But if there is consensus on how to approach the issue, it is to take a lesson from the battle against smoking, which is to focus on changing the environment that encourages bad habits. "It's about changing our culture," explained Elaine Russell, Kentucky's obesity prevention coordinator. "We need an environment where the healthy choice is the easy choice."

That involves policy change, setting up systems that support the policy changes, and environmental change, Russell said, all of which have to happen together. "There's no one solution that's going to do it," she said. "If we embed it in our policies, but we don't embed it into our environment, how do we make the healthier choice? If we just educate people but we don't provide them with a healthy environment, then how do they make those healthy choices? We could do an educational campaign at our worksite, but if we have unhealthy vending machines there, how can you make the changes?"

Local action is needed

Russell said change needs to happen at the local level, since every community has different needs and "starts with high-level partners really being engaged," she said. "We need to pull together those leaders and ask them what the highest priority is, ask them what feasibly can be done and start checking them off."

Some of those changes can be as easy as placing bananas and apples at the front of the pool concession stand so children see them first, as they did in Lexington. The same is being done in school cafeteria lines. But others cost money that communities don't necessarily have, as the Healthy Children's Task Force learned in Laurel County when trying to assess students' body-mass index, a rough measure of fat to weight.

In 2005, the task force started collecting BMIs of a select group of children in kindergarten to see where the county stood. It found 37 percent were either overweight or obese, and quickly decided the goal should be to bring that number down to 31 percent, the statewide average at the time. Using a grant from the parent company of the local hospital, they talked to parents, hired gym teachers, had schools incorporate 10 minutes of physical activity in the classroom periodically during the day, talked to kids about nutrition, and got them to cook and sample fruit and vegetables from a mobile demonstration kitchen.

The overweight rates of the children, who were repeatedly assessed each year, did decrease by the targeted 6 percent, but when funding ran out, the program faltered. For a few years, part of the effort was restored, but the task force has disbanded. "You get real gung-ho on it and something else comes along," said school nurse Duff Holcomb, who led the effort. "It makes me feel terribly guilty, but that is just the way it is. We proved what works."

After a recent analysis showed 12 states, including Kentucky, have adult obesity levels over 30 percent, Jeffrey Levi, executive director of Trust for America's Health, acknowledged the financial problem: "We're not investing anywhere near what we need to in order to bend the obesity curve and see the returns in health and savings."

(Photos by Tara Kaprowy)

More regulation is one option, a move that is generally cheap in cost but can be politically expensive. New York City Mayor Michael Bloomberg is learning that, after proposing a ban in New York City on the sale of supersize sodas and other sugary drinks by restaurants, movie theaters and street carts. Residents are deeply divided on the issue — 60 percent oppose the ban — and critics have lambasted Bloomberg, accusing him of running a "nanny state."

But limiting food and drink choices may have an effect on people's health, a recent study indicates. The removal of trans fats from many processed and fast foods like French fries and cookies probably reduced the proportion of kids with high cholesterol in the past decade, researchers think.

More regulation, particularly in how food is marketed to children, is what Josh Golin, associate director for the Campaign for Commercial-Free Childhood, would like to see. "We can't rely on the companies to self-regulate or develop their own policies," he said. "We see a lot of self-serving regulations that vary from company to company. What we really need is to level the playing field and make the rules enforceable."

In addition, Bolling suggested "there are several organizations that advocate that we could make a big impact on childhood obesity by placing an excise tax on sodas." A report by the Rudd Center for Food Policy and Obesity at Yale University indicated that a 10 percent tax on soft drinks would result in about an 8 percent reduction in consumption. Studies on alcohol and tobacco taxes indicate similar findings. A Rudd Center calculator shows a 1-cent tax on each ounce of sugar-sweetened beverages sold in Kentucky could result in nearly $200 million in revenue for the state.

Whether regulation or investing more money in the problem are part of the solution, Bolling said solving the problem will take time and a variety of efforts. "We have to solve everything together," he said. "It's about personal responsibility, but it's also about supportive families, it's about primary care medical people knowing what to say to their patients, it's about workplaces and schools creating good environments and it's communities providing opportunities to be healthy. I think we're going to turn the tide. We've done it before with seat belts, with bicycle helmets, with smoking. While this problem is complicated, we already see people really waking up to it."

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Dr. Christopher Bolling prepares to see a patient.

By Tara Kaprowy
Kentucky Health News

Nearly every weekday, pediatrician Christopher Bolling starts his day by scooping up his lap top and stepping into one of his cheerfully-appointed exam rooms. After greeting his young patients, who are generally passing the time by playing games on their parents' cell phones, Bolling begins his examinations. During his 21 years of practice, those exams have increasingly ended with Bolling counseling parents about their children's weight.

"I tell them I'm not worried about this as a cosmetic issue, I'm worried about this as a health issue," he said in an interview. "This isn't about your child being ugly or undesirable, we talk about them being healthy and not healthy."

But, though dedicated to his cause, Bolling, of Crestview Hills in Kenton County, said he is keenly aware that his counseling is not nearly enough to help his patients overcome the weight that is impeding their health. "What makes this problem unique is it is so multifactorial, there are so many pieces to it," he said. "It's food, it's activity, it's portion size, it's fruit and vegetables, it's screen time and safety. And it makes it really intimidating to know what to do with it."

"We're swimming upstream in a flooded river," agreed Debra Cotterill, director of the Nutrition Education Program at the University of Kentucky. "Even for people who know it, it's still hard. Weight is an issue I have to address every single day of my life and I understand how it is for people. You're talking about change of behaviors."

It's like smoking, but it's different

But a sweeping change in behavior is going to be what it takes to turn the tide of the obesity epidemic, experts say, and that is one reason fighting obesity is often likened to the battle against smoking. The fact that it is just as, if not more, deadly is another parallel, as is the fact that it is just as, if not more, far-reaching.

But there are key differences in battling the two problems, Judith Graham noted in a story for Kaiser Health News. First, other than an increase in health-care costs, there is no compelling argument that implies that another person's weight adversely affects others, like second-hand smoking does for smoking, or drunk driving does for drinking to excess. "The notion that my behavior as a smoker can have an effect on you and can make you sick was critically important in accelerating people's intolerance of smoking and their willingness to see the government take action," Michael Ericksen, director of the Institute of Public Health at Georgia State University, told Graham.

Compounding the issue is there is nearly no end to the variety of food that can contribute to the problem. Unlike Big Tobacco, the food industry also cannot be demonized as easily, Graham points out. But most importantly, "unlike alcohol and tobacco, you can't go cold turkey on food," Bolling said. "You have to keep eating."

But if there is consensus on how to approach the issue, it is to take a lesson from the battle against smoking, which is to focus on changing the environment that encourages bad habits. "It's about changing our culture," explained Elaine Russell, Kentucky's obesity prevention coordinator. "We need an environment where the healthy choice is the easy choice."

That involves policy change, setting up systems that support the policy changes, and environmental change, Russell said, all of which have to happen together. "There's no one solution that's going to do it," she said. "If we embed it in our policies, but we don't embed it into our environment, how do we make the healthier choice? If we just educate people but we don't provide them with a healthy environment, then how do they make those healthy choices? We could do an educational campaign at our worksite, but if we have unhealthy vending machines there, how can you make the changes?"

Local action is needed

Russell said change needs to happen at the local level, since every community has different needs and "starts with high-level partners really being engaged," she said. "We need to pull together those leaders and ask them what the highest priority is, ask them what feasibly can be done and start checking them off."

Some of those changes can be as easy as placing bananas and apples at the front of the pool concession stand so children see them first, as they did in Lexington. The same is being done in school cafeteria lines. But others cost money that communities don't necessarily have, as the Healthy Children's Task Force learned in Laurel County when trying to assess students' body-mass index, a rough measure of fat to weight.

In 2005, the task force started collecting BMIs of a select group of children in kindergarten to see where the county stood. It found 37 percent were either overweight or obese, and quickly decided the goal should be to bring that number down to 31 percent, the statewide average at the time. Using a grant from the parent company of the local hospital, they talked to parents, hired gym teachers, had schools incorporate 10 minutes of physical activity in the classroom periodically during the day, talked to kids about nutrition, and got them to cook and sample fruit and vegetables from a mobile demonstration kitchen.

The overweight rates of the children, who were repeatedly assessed each year, did decrease by the targeted 6 percent, but when funding ran out, the program faltered. For a few years, part of the effort was restored, but the task force has disbanded. "You get real gung-ho on it and something else comes along," said school nurse Duff Holcomb, who led the effort. "It makes me feel terribly guilty, but that is just the way it is. We proved what works."

After a recent analysis showed 12 states, including Kentucky, have adult obesity levels over 30 percent, Jeffrey Levi, executive director of Trust for America's Health, acknowledged the financial problem: "We're not investing anywhere near what we need to in order to bend the obesity curve and see the returns in health and savings."

(Photos by Tara Kaprowy)

More regulation is one option, a move that is generally cheap in cost but can be politically expensive. New York City Mayor Michael Bloomberg is learning that, after proposing a ban in New York City on the sale of supersize sodas and other sugary drinks by restaurants, movie theaters and street carts. Residents are deeply divided on the issue — 60 percent oppose the ban — and critics have lambasted Bloomberg, accusing him of running a "nanny state."

But limiting food and drink choices may have an effect on people's health, a recent study indicates. The removal of trans fats from many processed and fast foods like French fries and cookies probably reduced the proportion of kids with high cholesterol in the past decade, researchers think.

More regulation, particularly in how food is marketed to children, is what Josh Golin, associate director for the Campaign for Commercial-Free Childhood, would like to see. "We can't rely on the companies to self-regulate or develop their own policies," he said. "We see a lot of self-serving regulations that vary from company to company. What we really need is to level the playing field and make the rules enforceable."

In addition, Bolling suggested "there are several organizations that advocate that we could make a big impact on childhood obesity by placing an excise tax on sodas." A report by the Rudd Center for Food Policy and Obesity at Yale University indicated that a 10 percent tax on soft drinks would result in about an 8 percent reduction in consumption. Studies on alcohol and tobacco taxes indicate similar findings. A Rudd Center calculator shows a 1-cent tax on each ounce of sugar-sweetened beverages sold in Kentucky could result in nearly $200 million in revenue for the state.

Whether regulation or investing more money in the problem are part of the solution, Bolling said solving the problem will take time and a variety of efforts. "We have to solve everything together," he said. "It's about personal responsibility, but it's also about supportive families, it's about primary care medical people knowing what to say to their patients, it's about workplaces and schools creating good environments and it's communities providing opportunities to be healthy. I think we're going to turn the tide. We've done it before with seat belts, with bicycle helmets, with smoking. While this problem is complicated, we already see people really waking up to it."

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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Census data show every county's numbers of uninsured and those who would be covered by Medicaid expansion

For county-by-county data, see below.

The U.S. Census Bureau released data this week showing 2010 estimates of health insurance coverage for all 50 states and each of the nation’s counties. The data are exactly what journalists need to do their own stories about the problem of the uninsured and the potential impact of Medicaid expansion under federal health reform. Laura Ungar of The Courier-Journal in Louisville used the data to show what parts of Kentucky have the most uninsured and which would benefit most from Medicaid expansion.

The census report "looked at how many of the uninsured fall into an income category that would make them eligible for Medicaid under the Affordable Care Act -- which would be expanded to cover those who earn up to 138 percent of the federal poverty level ($15,415 for one person and $31,809 for a family of four)," Ungar reports.

"The U.S. Supreme Court’s June ruling upholding the health care law forbade the federal government from withholding current Medicaid funds from states that refuse to expand the program in 2014 -- and Kentucky and Indiana leaders haven’t yet decided whether to opt in or out," writes Ungar.

The greatest area of need in Kentucky was in the state's south-central region which is part of Appalachia but has no coal. Ronald Wright, judge-executive in Casey County, told Ungar that his hilly county depends largely on industries such as timbering and farming, and many residents don’t have employer-sponsored health coverage. “I don’t know how we correct it,” Wright said. “Most people just can’t afford (insurance.) It’s getting so expensive.” He said the uninsured often seek care in emergency rooms that can’t turn them away or at the local health department, which “is always busy.”

Michael Price, Kentucky state demographer, said the state’s poorest counties, generally in the Appalachian region, don’t usually have the highest rates of uninsured residents. “In the poorest areas of Kentucky, there’s a fair amount of participation in federal programs, so they’re covered,” Price said. “It’s the marginal folks who aren’t qualifying for federal programs who are falling through the cracks.”

The web page with Ungar's story has a list of Kentucky counties and the number of uninsured. To read it, click here. The Census Bureau press release has a link to a list of every U.S. county with estimates of the number of people who would be covered if Medicaid were expanded to 138 percent of the poverty level.

For county-by-county data, see below.

The U.S. Census Bureau released data this week showing 2010 estimates of health insurance coverage for all 50 states and each of the nation’s counties. The data are exactly what journalists need to do their own stories about the problem of the uninsured and the potential impact of Medicaid expansion under federal health reform. Laura Ungar of The Courier-Journal in Louisville used the data to show what parts of Kentucky have the most uninsured and which would benefit most from Medicaid expansion.

The census report "looked at how many of the uninsured fall into an income category that would make them eligible for Medicaid under the Affordable Care Act -- which would be expanded to cover those who earn up to 138 percent of the federal poverty level ($15,415 for one person and $31,809 for a family of four)," Ungar reports.

"The U.S. Supreme Court’s June ruling upholding the health care law forbade the federal government from withholding current Medicaid funds from states that refuse to expand the program in 2014 -- and Kentucky and Indiana leaders haven’t yet decided whether to opt in or out," writes Ungar.

The greatest area of need in Kentucky was in the state's south-central region which is part of Appalachia but has no coal. Ronald Wright, judge-executive in Casey County, told Ungar that his hilly county depends largely on industries such as timbering and farming, and many residents don’t have employer-sponsored health coverage. “I don’t know how we correct it,” Wright said. “Most people just can’t afford (insurance.) It’s getting so expensive.” He said the uninsured often seek care in emergency rooms that can’t turn them away or at the local health department, which “is always busy.”

Michael Price, Kentucky state demographer, said the state’s poorest counties, generally in the Appalachian region, don’t usually have the highest rates of uninsured residents. “In the poorest areas of Kentucky, there’s a fair amount of participation in federal programs, so they’re covered,” Price said. “It’s the marginal folks who aren’t qualifying for federal programs who are falling through the cracks.”

The web page with Ungar's story has a list of Kentucky counties and the number of uninsured. To read it, click here. The Census Bureau press release has a link to a list of every U.S. county with estimates of the number of people who would be covered if Medicaid were expanded to 138 percent of the poverty level.

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Back at school and already got the sniffles or other ailment? Here's a pediatrician's advice to battle back-to-school bugs

With school back in session, it probably won't be long before children are coming home with sniffles and sore throats. The average child gets six or more infections each year, reports Dr. Jacqueline Kaari, chair of the Department of Pediatrics at the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, who also offers advice.

"Every parent has experienced it — the hectic morning maneuvering of getting the household fed, dressed and out the door is suddenly interrupted by an inconsolable child who has a sore throat, upset stomach, sniffles or something worse," she said. "When that happens, parents need to be able to quickly assess their child and determine if he or she is well enough to go to school or needs to stay home, or if it's time to call the pediatrician. Sometimes, parents will guess wrong, but if there's one rule of thumb, it should be to always err on the side of caution."

Kaari recommends the following guidelines for what do when it comes to:

Colds: Use child-strength, over-the-counter medicines and a cool mist humidifier to treat symptoms. Because they are caused by viruses, do not treat colds with antibiotics. Children can go to school if the symptoms won't impede them from participating in school activities.

Conjunctivitis (pinkeye): Go to the doctor for treatment, which is generally antibiotic eye drops. Children can usually go to school 24 to 48 hours after treatment starts.

Fever: Give acetaminophen (Tylenol) or ibuprofen (Advil) for low-grade fevers. Have the child drink lots of fluids and avoid fatty or fried foods, since fevers decrease stomach activity and make digestion more difficult. Keep children at home if the fever is above 100.4 degrees Fahrenheit. Call the doctor if a high fever lasts more than 24 hours or does not respond to medicine.

Flu: Have the child vaccinated. If he or she has not been vaccinated, keep the child home for several days and make sure he or she gets lots of rest and drinks lots of fluids.

Head lice: Kill with over-the-counter or prescription lotions and shampoos. Keep the child at home until all lice have been killed.

Ringworm: Look for small patches of skin that are scaly and red. They can also blister and ooze. Apply anti-fungal ointments or powders. Call the doctor if the infection is severe or does not go away.

Sore throat: If parents suspect strep throat, they should call the doctor. If drinking water relieves symptoms somewhat, the child likely has a viral infection that should go away in a few days.

Stomach ache: Children who have been vomiting should stay home from school. An hour after the child vomits, parents should start introducing small drinks of water. Clear liquids and bland food should be introduced throughout the day. If vomiting lasts more than 24 hours or if the child vomits blood or green or yellow bile, call the doctor.

Whooping cough (pertussis): Have the child vaccinated. If parents suspect whooping cough, characterized by a "whooping" sound when the child tries to breathe, call the doctor. (Read more)

With school back in session, it probably won't be long before children are coming home with sniffles and sore throats. The average child gets six or more infections each year, reports Dr. Jacqueline Kaari, chair of the Department of Pediatrics at the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, who also offers advice.

"Every parent has experienced it — the hectic morning maneuvering of getting the household fed, dressed and out the door is suddenly interrupted by an inconsolable child who has a sore throat, upset stomach, sniffles or something worse," she said. "When that happens, parents need to be able to quickly assess their child and determine if he or she is well enough to go to school or needs to stay home, or if it's time to call the pediatrician. Sometimes, parents will guess wrong, but if there's one rule of thumb, it should be to always err on the side of caution."

Kaari recommends the following guidelines for what do when it comes to:

Colds: Use child-strength, over-the-counter medicines and a cool mist humidifier to treat symptoms. Because they are caused by viruses, do not treat colds with antibiotics. Children can go to school if the symptoms won't impede them from participating in school activities.

Conjunctivitis (pinkeye): Go to the doctor for treatment, which is generally antibiotic eye drops. Children can usually go to school 24 to 48 hours after treatment starts.

Fever: Give acetaminophen (Tylenol) or ibuprofen (Advil) for low-grade fevers. Have the child drink lots of fluids and avoid fatty or fried foods, since fevers decrease stomach activity and make digestion more difficult. Keep children at home if the fever is above 100.4 degrees Fahrenheit. Call the doctor if a high fever lasts more than 24 hours or does not respond to medicine.

Flu: Have the child vaccinated. If he or she has not been vaccinated, keep the child home for several days and make sure he or she gets lots of rest and drinks lots of fluids.

Head lice: Kill with over-the-counter or prescription lotions and shampoos. Keep the child at home until all lice have been killed.

Ringworm: Look for small patches of skin that are scaly and red. They can also blister and ooze. Apply anti-fungal ointments or powders. Call the doctor if the infection is severe or does not go away.

Sore throat: If parents suspect strep throat, they should call the doctor. If drinking water relieves symptoms somewhat, the child likely has a viral infection that should go away in a few days.

Stomach ache: Children who have been vomiting should stay home from school. An hour after the child vomits, parents should start introducing small drinks of water. Clear liquids and bland food should be introduced throughout the day. If vomiting lasts more than 24 hours or if the child vomits blood or green or yellow bile, call the doctor.

Whooping cough (pertussis): Have the child vaccinated. If parents suspect whooping cough, characterized by a "whooping" sound when the child tries to breathe, call the doctor. (Read more)

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State task force will look at substance abuse, mental health care for military members, veterans and families

To help the increasing number of veterans and military service personnel who are needing treatment for substance abuse and mental health issues in Kentucky, a task force has been assembled to come up with strategies that show the most promise in providing care.

The team, made up of military personnel as well as health care experts, will go to a conference in Washington, D.C., to gain learn what is working elsewhere. The goal is to strengthen statewide behavioral health care systems and services, a press release from Gov. Steve Beshear's office says.

Over the past three years, the number of veterans seeking mental-health care has risen dramatically, according to the U.S. Department of Veterans Affairs. About 335,000 veterans live in Kentucky. There are also 45,000 active-duty personnel in Kentucky and about 8,400 members of the Kentucky Army National Guard and Kentucky Air National Guard.

"This is an extremely important and timely topic that requires collaboration across federal, state and local lines," said Col. David Thompson, executive director of the Kentucky Commission on Military Affairs. Task force members include Thompson; Maj. Gen. Edward W. Tonini, Kentucky adjutant general; state Rep. John Tilley, D-Hopkinsville; representatives from the Cabinet for Health and Family Services, the Kentucky Department of Veterans Affairs, military and civilian health facilities and the Kentucky court system. (Read more)

To help the increasing number of veterans and military service personnel who are needing treatment for substance abuse and mental health issues in Kentucky, a task force has been assembled to come up with strategies that show the most promise in providing care.

The team, made up of military personnel as well as health care experts, will go to a conference in Washington, D.C., to gain learn what is working elsewhere. The goal is to strengthen statewide behavioral health care systems and services, a press release from Gov. Steve Beshear's office says.

Over the past three years, the number of veterans seeking mental-health care has risen dramatically, according to the U.S. Department of Veterans Affairs. About 335,000 veterans live in Kentucky. There are also 45,000 active-duty personnel in Kentucky and about 8,400 members of the Kentucky Army National Guard and Kentucky Air National Guard.

"This is an extremely important and timely topic that requires collaboration across federal, state and local lines," said Col. David Thompson, executive director of the Kentucky Commission on Military Affairs. Task force members include Thompson; Maj. Gen. Edward W. Tonini, Kentucky adjutant general; state Rep. John Tilley, D-Hopkinsville; representatives from the Cabinet for Health and Family Services, the Kentucky Department of Veterans Affairs, military and civilian health facilities and the Kentucky court system. (Read more)

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Female life expectancy in several Eastern Ky. counties declined

The life expectancy of the average U.S. female increased 1.7 years from 1999 to 2009 -- 79.6 to 81.3 years. Good news on the whole, but Daily Yonder reporters Bill Bishop and Robert Gallardo went a little farther in their analysis of the data from the Institute for Health Metrics and Evaluation at the University of Washington. They found that rural women hardly kept up, and some even lost ground in the decade while their urban sisters obviously gained from widespread health advances.

Bishop and Gallardo report, "The solid gain in longevity was matched in only 168 rural or exurban counties, or 6.5 percent of all the counties outside the cities." That is, while women in most of the nation were living longer lives, in many rural counties -- some 622 of them, in fact -- their longevity shortened in the same decade. Several of those counties were in Eastern Kentucky. The 622 counties represent some 24 percent of rural counties and exurban counties (or counties in a metro area where more than half live in rural census tracts), women lived shorter lives in 2009 than in 1999. You can see a similar map and charts for rural men here. (Click on the above map for a larger image)

As the Yonder writers point out, "The map shows that rural and exurban women are not keeping up with the health advances enjoyed in the rest of the country. In more than 95 percent of rural and exurban counties, changes in female longevity in the last 10 years failed to match the gains experienced in the rest of the country." The largest decreases in female life expectancy between 1999 and 2009 were clustered in Oklahoma, Eastern Kentucky, West Virginia, Alabama and Georgia. (Read more)

The life expectancy of the average U.S. female increased 1.7 years from 1999 to 2009 -- 79.6 to 81.3 years. Good news on the whole, but Daily Yonder reporters Bill Bishop and Robert Gallardo went a little farther in their analysis of the data from the Institute for Health Metrics and Evaluation at the University of Washington. They found that rural women hardly kept up, and some even lost ground in the decade while their urban sisters obviously gained from widespread health advances.

Bishop and Gallardo report, "The solid gain in longevity was matched in only 168 rural or exurban counties, or 6.5 percent of all the counties outside the cities." That is, while women in most of the nation were living longer lives, in many rural counties -- some 622 of them, in fact -- their longevity shortened in the same decade. Several of those counties were in Eastern Kentucky. The 622 counties represent some 24 percent of rural counties and exurban counties (or counties in a metro area where more than half live in rural census tracts), women lived shorter lives in 2009 than in 1999. You can see a similar map and charts for rural men here. (Click on the above map for a larger image)

As the Yonder writers point out, "The map shows that rural and exurban women are not keeping up with the health advances enjoyed in the rest of the country. In more than 95 percent of rural and exurban counties, changes in female longevity in the last 10 years failed to match the gains experienced in the rest of the country." The largest decreases in female life expectancy between 1999 and 2009 were clustered in Oklahoma, Eastern Kentucky, West Virginia, Alabama and Georgia. (Read more)

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2012 Veterinary scholarship awarded

The Winn Feline Foundation and the American Veterinary Medical Foundation (AVMF) announced their annual joint Student Scholarship Award to Alison McKay, a fourth year student at the College of Veterinary Medicine at Oregon State University, during the American Veterinary Medical Assoc. convention in San Diego. Ms. McKay intends to become board certified in small animal internal medicine and hopes to work in a university teaching hospital or feline clinic. Alison McKay is the secretary for the Shelter Medicine Club at the College of Veterinary Medicine at Oregon State University, and has helped organize several low-cost pet wellness clinics for senior citizens in her community.

Long committed to volunteerism, Ms. McKay has worked with a number of rescue organizations and free clinics for the pets of the homeless including the Feral Cat Coalition of Oregon, Portland Animal Welfare Team, Salem Friends of Felines, and Pro-Bone-O of Eugene, Oregon. She will be traveling to Nicaragua this summer on a veterinary service trip where she will provide surgical and basic wellness care to animals and investigate the prevalence of toxoplasmosis, internal parasites, feline leukemia virus, and feline immunodeficiency virus in cats on Ometepe Island.

She is currently working to organize a run/walk event which will benefit animal welfare in Uzhgorod, Ukraine.

Asked about plans for her continuing studies, Ms. McKay stated “During my clinical year of veterinary school, I will be completing my preceptorships at Corvallis Cat Care and West Vet, an internal medicine and emergency practice near Boise, Idaho. I also plan to spend two weeks at Angell Animal Medical Center in Boston, spending one week on cardiology and one week on internal medicine. I am very interested in feline medicine, therefore my senior project will focus on CT imaging of cats with feline asthma.”

Previous Winn/AVMF scholarship winners include:

• Adam Breiteneicher, Auburn University (2010)
• Jessica Balter, Cornell University (2011)

Winn Feline Foundation and the American Veterinary Medical Foundation are pleased to collaborate in this effort to focus attention on care for “Every Cat, Every Day.”

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+

The Winn Feline Foundation and the American Veterinary Medical Foundation (AVMF) announced their annual joint Student Scholarship Award to Alison McKay, a fourth year student at the College of Veterinary Medicine at Oregon State University, during the American Veterinary Medical Assoc. convention in San Diego. Ms. McKay intends to become board certified in small animal internal medicine and hopes to work in a university teaching hospital or feline clinic. Alison McKay is the secretary for the Shelter Medicine Club at the College of Veterinary Medicine at Oregon State University, and has helped organize several low-cost pet wellness clinics for senior citizens in her community.

Long committed to volunteerism, Ms. McKay has worked with a number of rescue organizations and free clinics for the pets of the homeless including the Feral Cat Coalition of Oregon, Portland Animal Welfare Team, Salem Friends of Felines, and Pro-Bone-O of Eugene, Oregon. She will be traveling to Nicaragua this summer on a veterinary service trip where she will provide surgical and basic wellness care to animals and investigate the prevalence of toxoplasmosis, internal parasites, feline leukemia virus, and feline immunodeficiency virus in cats on Ometepe Island.

She is currently working to organize a run/walk event which will benefit animal welfare in Uzhgorod, Ukraine.

Asked about plans for her continuing studies, Ms. McKay stated “During my clinical year of veterinary school, I will be completing my preceptorships at Corvallis Cat Care and West Vet, an internal medicine and emergency practice near Boise, Idaho. I also plan to spend two weeks at Angell Animal Medical Center in Boston, spending one week on cardiology and one week on internal medicine. I am very interested in feline medicine, therefore my senior project will focus on CT imaging of cats with feline asthma.”

Previous Winn/AVMF scholarship winners include:

• Adam Breiteneicher, Auburn University (2010)
• Jessica Balter, Cornell University (2011)

Winn Feline Foundation and the American Veterinary Medical Foundation are pleased to collaborate in this effort to focus attention on care for “Every Cat, Every Day.”

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+

Read More