UK creates nation's first cancer-reporting system that uses electronic health records

Kentucky has the highest incidence of cancer in the United States, but it is about to be a national leader in delivering information about cancer cases to researchers.

With the help of an almost $1 million Centers for Disease Control grant, the University of Kentucky has created the nation's first working model for electronic reporting of cases to the state cancer registry. Kentucky's cancer doctors will be able to feed clinical data to the state's epidemiologists immediately so that they can see and analyze cancer statistics more quickly that ever before.

“This project is laying the groundwork for electronic reporting not only in Kentucky but across the United States,” said Eric Durbin, director of Cancer Informatics at the Kentucky Cancer Registry and one of the investigators who created the model. (Read more)

County data paint specific pictures of health; Ashland paper is one of first to pick up on it and do a story

More progress is needed to make sure children from low-income families are going to the dentist is just one of the findings of the 2011 Kentucky Kids Count County Data, released by Kentucky Youth Advocates.

The data paint a detailed portrait of each county's health for Kentucky's children, showing results of prenatal care, the percentage of mothers smoking during pregnancy, rates of preterm birth and low birthweight, breastfeeding, the number of children enrolled in Kentucky Children's Health Insurance Program and Medicaid, early-childhood obesity rates, asthma hospitalizations, and access to recreational facilities.

Statewide, the numbers show nearly one of every four children lived in poverty between 2005 and 2009, a 10 percent increase from 2000. The rates of preterm births and low-birthweight babies also increased. Overall, however, the numbers show improvement, particularly when it comes to children being covered by state or federal insurance. The number of children enrolled in KCHIP increased by 45 percent and in Medicaid more than 50 percent.

That data is supported by a reported released Tuesday by Georgetown University, which found the number of children without health insurance has dropped by 1 million nationwide in the past three years, Kelli Kennedy of The Associated Press reports. (Read more)

For an example of how to localize the data, click here. Mike James of The Independent in Ashland used it to assess the health status of children in Greenup, Carter and Boyd counties. He also spoke to a local school district and found officials will use the findings to bolster "requests for competitive grants that fund ... programs and ... identify gaps in services," he reports.

Kentucky's rates of leisure-time physical activity are among the lowest in the nation; Carter and Pike counties may be the worst

In three-fourths of Kentucky's counties, more than 30 percent of adults say they get no physical activity in their leisure time, according to new survey data from the Centers for Disease Control and Prevention. The statewide average is 30.1 percent. The problem is largely an Appalachian one; four Eastern Kentucky counties may have the highest percentage of physically inactive adults in the country.

CDC's telephone surveys indicate that 42.8 percent of adults in Pike and Carter counties were physically inactive in 2006-08. The only county with a higher figure, 43 percent, was McDowell County, West Virginia, which nearly borders Pike County. Magoffin and McCreary counties, also in Appalachia, rank fourth and fifth. The statewide rate for Kentucky is 30 percent; Kentucky Health Facts has this listing of county rates.


County figures are subject to error margins depending on the size of a county and its sample in the survey. Error margins are usually expressed in terms of a 95 percent confidence level, meaning that in 19 of 20 cases if the entire population were surveyed, the result would be within the error margin. For example, in Carter County, there's a 19 in 20 chance that the figure is between 36.3 and 50.4 percent. A less strict test is standard deviation, which gives the likely result if the data are distributed like the famous "bell curve." In Carter County, the standard deviation is 3.6 percentage points for each figure, meaning there's about a two-out-of-three chance that between 39.2 and 46.4 percent of adults in Carter County are physically inactive -- in any case, very high.

Because Pike County is larger and produces a larger sample for the survey, the error margin there is smaller, with a standard deviation of 2.6 percentage points. At the 95 percent confidence level, Pike County's physical-inactivity figure is between 37.9 and 48.2 percent. At the standard deviation it is between 40.2 and 45.4 percent -- again, very high in any case.

Magoffin County, with a likely rate of 42.2 percent, has a standard deviation of plus or minus 4.9 percentage points and a range of 33.4 to 52.7. McCreary County, at 41.6 percent, has a standard deviation of plus or minus 4.6 percentage points and a range of 33.4 to 51.2 percent.

Colors indicate level of inactivity for each county; legend below (click map for larger image)

FOR NATIONAL MAP

Fayette County was the only Kentucky county below the 2006-08 national rate of 25.4 percent, with a rate of 25.3 percent, plus or minus a standard deviation of 1.8 percentage points. It was followed by Calloway (25.5, plus or minus 2.7 points), Oldham (27.2, plus or minus 3.3), Henderson (27.5 percent, plus or minus 2.5) and Jefferson (27.6 percent, plus or minus 1.1).

Light blue/green: 21.1 to 26 percent
Medium blue: 26.1 to 31.1 percent
Dark blue 31.2 percent and above

Activity rates were higher in the northwestern quadrant of the state, in the Louisville and Evansville metropolitan areas. More than 30 percent of adults in Eastern and Southern Kentucky were physically inactive, making Kentucky adults as a whole some of the least physically active in the country. Physical inactivity rates were 29.2 percent or higher for more than 70 percent of the counties in Alabama, Kentucky, Louisiana, Mississippi, Oklahoma and Tennessee. Mississippi had the highest percentage of counties whose adults fell in the lowest of four levels measured, followed by Tennessee.

The results are based on data collected by the CDC's Behavioral Risk Factor Surveillance System, which is an ongoing telephone survey. People were listed as physically inactive if they answered "no" to this question: "During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening or walking for exercise?" Three years of data are used to compute each year's results. (Read more)

Lack of physical activity is a risk factor for developing obesity and Type 2 diabetes. CDC numbers show the proportion of U.S. adults who are obese was 33.9 percent in 2007-2008. Obesity-related medical costs were as high as $147 billion in 2008. The average annual medical costs for an obese person are $1,429 more than for someone who weighs a normal amount. In 2010, 25.6 million people had diabetes. Kentucky's obesity and diabetes rates are among the highest in the nation.


OBESITY RATES
Orange: 26.3 to 29.7 percent
Red: Above 29.8 percent

DIAGNOSED DIABETES
Orange: 8.5 to 10.1 percent
Red: Above 10.1 percent