Molly Burchett is new chief writer for Kentucky Health News

Kentucky Health News welcomes a new reporter, writer and blogger: Molly Burchett, a master's student in health communication at the University of Kentucky.

Burchett graduated from Transylvania University in 2009 where she studied business and communication.  She was president of the Student Government Association and a yearbook editor.  Her jobs before UK included development director for a Lexington medical practice. She started her master's program in August 2012 and is focused on raising awareness about community health issues in ways that can encourage positive changes in health behavior.

She is from Prestonsburg, where her father and mother are the lead physician and manager of Prestonsburg Primary Care. She is a graduate of Prestonsburg High School. At KHN she follows Tara Kaprowy and Amy Wilson, who have both returned to freelance journalism.

Kentucky Health News is funded by the Foundation for a Healthy Kentucky but is independently reported and edited by UK's Institute for Rural Journalism and Community Issues.

HBO's 'Weight of the Nation' examines the obesity epidemic

A compelling four-part documentary delving into the obesity epidemic sweeping the country is being aired on HBO and can be watched free by clicking here. A reporter wanting to write a series of stories on the issue would find "weight of the Nation" a good reference.

The program is divided into four parts. The first segment, "Consequences," looks at the scope of the epidemic and the ramifications of being overweight or obese. "Choices" looks at the science behind how to lose weight, how to maintain weight loss and prevent weight gain. The third part, "Children in Crisis," looks at how the problem is affecting American children, exploring the decline of physical activity, school lunch, the demise of school recess and how marketing of unhealthy food targets children. The final segment, "Challenges," looks at the major forces driving obesity, including agriculture, economics, evolutionary biology, food marketing, racial and socioeconomic disparities, physical inactivity, American food culture, and the influence of the food and beverage industries.

The documentary is on a detailed website that answers questions that range from "What is obesity?" to "How do I know if I'm overweight or obese?"

The project is a presentation of HBO and the Institute of Medicine in association with the Centers for Disease Control and Prevention and the National Institutes of Health, with support from the Michael and Susan Dell Foundation and health insurer Kaiser Permanente.

Study finds doctors often overestimate how well they communicate in English as a second langauge

A study appearing in Health Services Research shows physicians who speak English as a second language, an increasing phenomenon in the U.S. and parts of Kentucky, often overrate how well they are communicating with patients.

The finding is the result of a language scale adopted by the Palo Alto Medical Foundation, which rates language proficiency in five levels: poor, fair, good, very good and excellent.

After the new scale was introduced in 2009, out of four of physicians who participated changed their rating. Of the 258 participants, 31 who had considered themselves "fluent" downgraded to "good" or "fair." Just 11 percent deemed their proficiency "excellent." "Seventeen percent used 'very good' and 38 percent said they were 'fair,'" reports Glenda Fauntleroy of research-reporting service Newswise. "Being 'fair' was defined as 'can get the gist of most everyday conversations but has difficulty communicating about health care concepts.'"

"This is a very tricky area as this demonstrates how many providers overestimate their proficiency in another language," said Joseph Betancourt, director of the Disparities Solutions Center at Massachusetts General Hospital in Boston. "This can lead to miscommunication and even medical errors." (Read more)

Nine breast cancer programs get total of $360,000 from Komen

Nine programs in Central and Eastern Kentucky will share $360,000 for breast cancer screening, treatment, education and patient navigation.

The grants go to breast cancer-specific projects of the Lexington-Fayette County Health Department; the Kentucky Pink Connection; Central Baptist Hospital; St. Joseph Breast Center; King's Daughters Medical Center; Mountain Comprehensive Health Corp.; Our Lady of Bellefonte Hospital; Dayspring Family Health Center; and North Central Area Health Education Center. Programs chosen were determined to have the greatest impact on underserved women in a 58-county service area, the Lexington Herald-Leader reports.

The grants were awarded by the Lexington affiliate of Susan G. Komen for the Cure. Another $100,000 raised in Kentucky went to the Susan G. Komen for the Cure National Grants Program to fund research. (Read more)

People with low health literacy are more likely to get sick, die

Health literacy rates are increasingly gaining the attention of providers, organizations and lawmakers. A new report based on study of medical literature says people who are unable to understand and act on issues related to their own health care have poorer health and a higher risk of death.

Adults with low health literacy are less likely to get a flu shot, understand medical labels and instructions, and have a greater likelihood of taking medicine incorrectly, the report says. Also, women with low health literacy are less likely to get mammograms. Overall, the report indicates that minorities have lower health literacy rates than the rest of the population.

More than 75 million English-speaking adults across the nation have difficulty understanding and using basic health information. That was the focus of the second annual Kentucky Health Literacy Summit last week.

The report, which was released Monday, updates 2004 literature that reviewed the findings of more than 100 studies. It was compiled by the Agency for Healthcare Research and Quality in the U.S. Department of Health and Human Services.

In May 2010, the department launched an action plan that asks stakeholders to simplify their health-related handouts, forms and websites by removing jargon and complicated explanations. It also calls for improving patient-provider communication. (Read more)

Health literacy is 'at a tipping point' as an issue to be confronted, federal official tells second Kentucky Health Literacy Summit

By Tara Kaprowy, Kentucky Health News

BOWLING GREEN, Ky. – The idea that people will be healthier if they can better navigate the boggy, confusing landscape of health care and insurance is gaining traction in Kentucky – which, relatively speaking, has poor health and low literacy.

On Thursday and Friday, scores of health professionals and their allies in the health-literacy cause gathered in Bowling Green for the annual Kentucky Health Literacy Summit. It was the second such gathering, but the first was by invitation, so this was the first opportunity for anyone interested in health literacy to attend a statewide conference about it. The first conference resulted in the formation of Health Literacy Kentucky, an alliance of more than 35 groups.

Health literacy is the "degree that an individual can obtain, communicate, process and understand" basic health information, said Dr. Linda Harris, a Bowling Green native who leads the health communication unit in the U.S. Department of Health and Human Services. Only 12 percent of U.S. adults are considered proficient in health literacy, while 21 percent have basic knowledge and 14 percent are below basic. About half of adults have intermediate knowledge, between basic and proficient.

Health literacy has become an increasing problem as health care has become more technical and complex, and as America has more people for whom English is a second language. If people can't understand what they're being told about their health, they are more likely to get sick -- and less likely to get better once they're ill, Harris said.

She illustrated her point with the story of "Mrs. Jones," a composite individual with issues requiring health literacy: a 62-year-old woman with diabetes, heart failure, low income and a history of depression. She gets sick, goes to the doctor, is prescribed several medications she doesn't know how to take, avoids taking them and eventually needs to be hospitalized. Then she is given a second set of prescriptions that she also doesn't understand. She is re-hospitalized "and the cycle continues," Harris said.

Harris said the issue is at a "tipping point" because it has gone from simply being discussed among advocates to being made policy in legislation like the Patient Protection and Affordable Care Act; the National Action Plan for Health Literacy, the Plain Writing Act of 2010; and Healthy People 2020. "We really think this is the moment," Harris said. "It's not just those people who have been laboring in the vineyards for so long."

Insurance companies making headway

Some of the most innovative health-literacy work is being done by insurance companies, most of which are taking steps to make sure their policyholders understand the forms and documents they're sending them, Humana Inc. marketing consultant Betsy Shirey said. In the past year, Humana has simplified more than 400 of its documents, most of which have been rewritten at a sixth-grade level, as determined by a computerized assessment tool, she said.

To test the rewritten materials, Humana had some of its Medicare members look at the new documents. One person said a form could be simplified if it only had a date at the bottom of it. "They told us about really simple things, and yet we hadn't done it," Shirey said.

The new forms are better designed, with headlines and age-appropriate photography, and "always have a P.S., because everyone always reads the P.S," Shirey said. The document that gives patients a rundown of their to-date expenses, medications and doctors' visits looks like a credit-card statement. "You have a complete picture both financial and medical," Shirey said.

(Humana was the major sponsor of the summit, along with the University of Kentucky and Western Kentucky University.)

Revelations among providers

Simplifying documents was also the goal at People's Community Clinic in Texas, when Special Projects Supervisor Dana Carpenter came across a form that detailed how to take birth control pills. "Someone with a Ph.D. would have trouble understanding it," she said. With help from patients, Carpenter simplified the form, adding photos and "plenty of white space."

About 80 percent of the clinic's patients are Hispanic, so Carpenter was shocked to learn that, when she called the clinic, there was no telephone prompt asking the caller if they wanted to converse in Spanish. "You had to listen to the entire English menu before it would roll into Spanish," she said, and the clinic's directional signs were all in English and hidden by clutter. New signage is bilingual and prominently displayed.

Christine Nagy and Diane Sprowl said they went through a similar process in a joint venture between Western Kentucky University and the Barren River District Health Department. The goal was to get participants in the Women, Infants and Children food program to eat more fruits and vegetables. Patients were asked to fill out surveys, which needed to be designed for people who did not speak English well. Nagy, Sprowl and WKU students designed materials with bullet points, white space and culturally appropriate graphics. They kept the reading level low by using words with few syllables. They also met with patients face to face to help avoid communication breakdown.

Oral communication

More than just rewriting forms, health literacy involves making sure people understand what they're being told. To that end, insurance firms like Humana and providers like the People's Community Clinic are teaching employees how to communicate in a simple, uniform way. Often this involves the "teach-back technique," where you "have them explain back what you've gone over," said Dr. David Susman, psychology services coordinator at Eastern State Hospital.

Susman said it's important to look for clues that a person is having difficulty understanding, such as incomplete forms, lack of adherence to directions, or even looking in a pill bottle to determine what pill they're taking rather than reading the label.

Ultimately, the goal is to keep patients from the fate of Mrs. Jones. "No one is going to say, 'Oh by the way, I have limited health literacy,'" Susman said. "And no one complains about information being too simple."

For a list of advance registrants for the summit, click here.

Second summit will shed light on health literacy

The second annual Kentucky Health Literacy Summit will be held in Bowling Green Thursday and Friday.

"The event will raise awareness about low health-literacy skills," The Courier-Journal's Darla Carter reports. "Skills include the ability to fill out forms, find health providers and services, and take medications correctly." It will also shed light on available resources, the patient perspective and practices at work.

Called "Health Literacy in Action," the event will run from noon Thursday to noon Friday at the Holiday Inn University Plaza. It is sponsored by Humana Inc., the University of Kentucky and Western Kentucky University. (Read more) The event's website is here.