CaldWELL County group campaigns for smoking ban

A committee dedicated to the wellness of Caldwell County, which makes the most of the county's name, is pushing for a smoking ban. The CaldWELL Committee's internal acronym stands for Wellness Education through Local Leadership, and members did some of that Tuesday when the group asked the county Fiscal Court for an ordinance banning cigarette smoking indoors in public buildings. The group was joined by representatives from the local health department, housing authority, Extension office, law enforcement, education, emergency services, mental health, senior services and other public and private agencies, reports Jared Nelson of The Times Leader.

The committee has been collecting survey data from residents about their health perceptions and needs. Their request to the fiscal court is a direct result of that data, said Allison Beshear, health educator and public information officer with the Pennyrile District Health Department. In Caldwell County, about 27 percent of adults are identified as smokers. That number is down from 34 percent reported in the results of a 2008-10 survey. The Times-Leader is behind a paywall. To credit an account, go here.

Wellness programs looking good as business investments

Businesses should like these numbers a lot: Invest $1, get $3 back. That's the latest math on the return on employee wellness programs and experts are saying that may just be the start for the financial returns they can expect from targeted prevention efforts. Mark Green of The Lane Report writes that no less of an expert than Dr. William Frist of Nashville -- doctor, policy specialist, former U.S. Senate majority leader and venture capitalist -- has said: “No question in my mind, if we are to invest a dollar to have the greatest value in terms of outcome and results, we should put that dollar in prevention and wellness."

Frist, reports Green, "is a strong advocate of wellness -- as a business practice to adopt and a business sector to be in. Individual doctors, hospitals and the entire healthcare industry need to get involved, he said." Frist broke down for Green what factors most determine how long someone lives: “The numbers break down 30 percent genetic, 5 percent environmental, 15 percent socioeconomic, which is surprising to a lot of people, and then 40 percent behavioral: wellness, prevention. And then what is left (10 percent) is who your doctor is, what hospital you go to, what your emergency room is.” Those numbers  are important to Frist because to impact longevity healthcare spending over time, he said, resources should be on the 40-percent sector: behavior, wellness and prevention. Think smoking programs, weight loss, exercise, nutrition, seatbelt use. (Read more)

Sharp Women's Health Conference 2012 - San Diego

Photo Source: Flickr Sharp Healthcare

I was one of about a dozen area Bloggers that received an invitation to attend the Sharp Women's Health Conference.  The conference was such a wonderful experience.  I was inspired, uplifted, humored, and humbled.  I made new friends, I was pampered, educated, motivated, entertained, and FED! The experience nourished my soul, my imagination, and my tummy! I laughed out loud, I danced, and I bled (health screenings & it was just a drop).  I even discovered my DHARMA! Well...that part is a work in progress, but I have been shown the way!  Oh, I could go on and on about how much I gained from my experiences from this day.  I couldn't tell it as well as I lived it.  I will be back next year and I hope to bring many of you with me!  Thank you Sharp Healthcare and to our wonderful blogger liaison Tracey Black who brought us all together!

Bloggers

Tracey, Dorothy, and Angela

Colleen Murphy, RN Sharp Healthcare

Our Wonderful Emcee Kimberly Hunt

Shivani Singh Author of Discover Your Dharma

Disclosure: I was not compensated for this post. All opinions are my own. I partnered with Sharp to attend the conference and received admission to the event.

For more event photos please visit the Life by Cynthia page on facebook. 

Annual report for Cincinnati-Northern Kentucky region shows employee health care costs there will go up about $400 next year

In an continuing effort to move health costs off the shoulders of employers and onto employees, workers in Greater Cincinnati and Northern Kentucky will likely pay an average $4,775 out of their own pockets for health care in 2013 -- about $400 more than this year. That's nearly $2,000 more than they paid in 2007. The payments include premiums through their employer, as well as office co-pays and deductibles, said Aon Hewitt, the consultant that produced its annual cost report. These payments are slightly less than the national average of $4,814.

The trend toward "more employee accountability" means that nearly all companies are adjusting the designs of their employee plans, adding wellness programs and moving more employees to high-deductible plans with health savings accounts, reports Cliff Peale of the Cincinnati Enquirer. Penalties are now common for workers who smoke or who don’t take required health screenings.

The report notes that companies continue to bear most of the cost of their employees’ health insurance. It also predicts that, counting the portion paid by both companies and workers, the cost of a health care policy will increase 6.4 percent next year to $11,566. That should return the region to numbers more aligned with the national average. About half of all Americans still get benefits through their employers, and there are nearly 50 million without health insurance at all. (Read more)

Study: Small business owners see bottom-line benefit from employee health and wellness programs

A study of small businesses has found that three out of four offering health and wellness programs to their employees believe the initiatives are good for their bottom line. The study, conducted by the National Small Business Association and Humana Inc., asked more than 1,000 small-business owners about their employees' health and wellness needs and what barriers they face in supplying them.  An overwhelming 93 percent said they considered their employees’ physical and mental health to be important to their financial results.

However, only one-third expressed confidence in their ability to help employees manage their well-being with initiatives aimed at encouraging them to make healthier choices such as getting preventative care, eating right and exercising.

Another key finding was that more than half of the small-business owners reported that they did not have sufficient information to introduce health and wellness programs to their employees. On the other hand, startups -- those companies less than 10 years old -- found ways to do so, with 63 percent having already adopted health and wellness programs.

“Wellness solutions likely will be an increasingly important part of the employee value proposition,” said Jerry Ganoni, President of Humana’s Small Business Division. “It will be crucial for the industry to focus on providing small-business owners with the information they need to make the wellness decisions necessary to recruit and retain employees while making an a meaningful impact on their bottom lines.”  (Read more, from The Lane Report)

Government says health-reform law to save average Kentuckian with Medicare coverage $5,000 through 2022

The U.S. Department of Health and Human Services says the Patient Protection and Affordable Care Act will likely save the average person with traditional Medicare coverage $5,000 from 2010 to 2022, and people with Medicare who have high prescription drug costs will save more than $18,000 over the same period, based on the agency's estimates.

The department also announced that seniors and people with disabilities in Kentucky have already saved $85.5 million on prescription drugs since the law was enacted. Nationwide, the report states that over 5.5 million people have saved nearly $4.5 billion on prescription drugs since the law was enacted. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year.

Kentucky ranks next to last, Fifth Congressional District dead last in national healthiness and happiness survey

(Click on images for larger versions)

Kentucky was again next to last among the states in happiness and healthiness of its residents in 2011, ranking above only West Virginia, though precise rankings are uncertain. Eastern Kentucky's Fifth Congressional District ranked at the very bottom of the 436 districts — falling in last place in the categories of life evaluation, emotional health and physical health.

The Gallup-Healthways Well-Being Index is based on a continuing national survey that asks respondents about their overall sense of well-being, physical health, happiness, job satisfaction and other factors related to quality of life.

Of the 190 cities ranked, Lexington was 95th and Louisville 152nd. Kentucky's well-being score was 63.3 out of a possible 100 points. Hawaii again ranked first, at 70.2. West Virginia's score was 62.3. Because there were fewer than 10 points between first and last place, the rankings are not precise. Kentucky ranked lowest in the country in emotional health, which is based on feelings of happiness and sadness. Respondents were also asked about "physical health (chronic health conditions, obesity); lifestyle behaviors (smoking, diet and exercise); emotional health (feelings of happiness, sadness); work environment (relationship with supervisors); basic access (health care, food); and life evaluation (how they rate their lives)," reports Nanci Hellmich of USA Today.

Results were based on telephone interviews conducted between Jan. 2 and Dec. 29, 2011, producing a random sample of 353,492 adults. The margin of sampling error for most states is plus or minus 1 to 2 percentage points, but as high as plus or minus 4 points for states with small populations such as Wyoming, North Dakota, South Dakota, Delaware and Hawaii. (Read more)

Tips for maintaining your weight this holiday season

The average American gains five to seven pounds between Thanksgiving and New Year's Day, but maintaining healthful eating habits can help them avoid packing on the weight, diabetes nutrition educator Sheri Setser-Legg, right, writes in the Lexington Herald-Leader.

In the face of overwhelming cheese balls, eggnog and shortbread, she advises you:

• Be realistic. "Don't expect to lose weight during the holiday season," Setser-Legg writes. "Simply maintaining your weight is a sign of success."

• Build in time for exercise, which can also help reduce stress. "Chances are that you have time off work, so develop a regular exercise program or pick up the pace of your current exercise schedule."

• Incorporate healthy dishes into your holiday meal.

• Don't skip meals. "For parties, don't starve yourself in anticipation. You'll likely arrive ravenous and eat everything ... By eating regularly, you are less likely to overindulge."

• Eat only until you are satisfied, not stuffed.

• Have a healthy snack before you attend a holiday party, and keep healthy snacks like fruit, vegetables and cereal bars handy.

• Watch alcohol intake. "Alcohol contains many empty calories and lowers inhibitions, leading to overeating."

• Tell your friends and family you are trying to stay healthy when pressed to try their dishes.

Ultimately, the time is now to start "working toward a happy, healthy 2012," Setser-Legg concludes. (Read more)

Smokers should pay more for health insurance, but obese should not, national poll finds

Nearly 60 percent of people in October's Thomson Reuters-NPR Health Poll said smokers should pay more for their health insurance than those who don't smoke, but 69 percent said "no" when asked if people who are overweight or obese should pay more.

Support for punishing smokers was greatest among groups less likely to smoke. Almost three-fourths of people in households with an annual income of $100,000 or more felt smokers should pay more than nonsmokers, Sarah Kliff of The Washington Post reports. There was nearly as much support — 70 percent — among people asked with at least a college degree.

But when it came to the weight-related question, the majority of people, regardless of education or household income, did not support having people who are overweight or obese pay more. Just 31 percent supported the idea.

Overwhelmingly, nearly 85 percent of respondents felt people who eat right and do not smoke should receive a discount on their health insurance premiums.

Each month, the poll surveys 3,000 Americans to gauge opinions on a variety of health-care topics. The poll, which is independently funded, has a margin of error of 1.8 percent. (Read more)

The poll results were released at a time when many mid- and large-scale companies are asking their smoking, obese employees to pay higher premiums than their more healthy colleagues. In 2012, almost 40 percent of these companies, including Walmart, will start using penalties to control unhealthy behavior. That's up from 19 percent this year and just 8 percent in 2009. (Read more)

Haven't quit smoking, lost weight? Pay more for health insurance, more companies say

In an effort to keep health-care costs down, companies across the country, including Walmart, are opting to charge workers who smoke or are obese higher premiums than their more healthy colleagues. (Reuters photo by Lucas Jackson)

The move is the follow-up to a strategy many companies have already tried: to encourage workers to take better care of their health by offering benefits like weight-loss programs or smoking-cessation classes. But with few signs of the health-care landscape changing, "They're replacing the carrot with a stick and raising costs for workers who can't seem to lower their cholesterol or tackle obesity," reports Jillian Mincer of Reuters.

One example is Walmart, which in 2012 will start charging its smoking workers higher premiums. It will also offer cessation classes. A company spokesman said people who use tobacco use about 25 percent more health-care services than people who don't: "These decisions aren't easy, but we need to balance costs and provide quality coverage."

Critics say the move will limiting people's freedoms, create employee resentment and hut the lowest-paid workers hardest. "It's not inherently wrong to hold people responsible," said Lewis Maltby, president of the National Workrights Institute. "But it's a dangerous precedent."

Though well-intentioned, these policies can create bitterness. Mark A. Rothstein, a lawyer and professor at the University of Louisville School of Medicine, said having a colleague call to ask about a person's weight loss can be seen as intrusive. That's part of the reason why the janitors at the school participate, but "the professors on campus consider it a privacy tax, so we don't get some stranger calling us about how much we weigh."

Nevertheless, many companies are moving forward with the option. In 2012, almost 40 percent of large and mid-size companies will start using penalties to control unhealthy behavior. That's up from 19 percent this year and just 8 percent in 2009, an October survey by consulting firm Towers Watson and the National Business Group on Health shows. "Nothing else has worked to control health trends," said NBGH Vice President LuAnn Heinen. "A financial incentive reduces that procrastination."

Cleveland Clinic, with a staff of 40,000, has implemented a comprehensive program and seen its health-care costs grown just 2 percent this year. "The effort began several years ago when it banned smoking at the medical center and then refused to hire smokers," Mincer writes. "It later recognized that having a gym and weight -oss classes wasn't enough to get people to participate. It made these facilities and programs free and provided lower premiums to workers who maintained their health or improved it." Paul Terpeluk, medical director of occupational health at the clinic, said employers have to develop a program and change the culture: "You don't do this overnight." (Read more)

Lexington council turns to wellness center to cut insurance costs

Following a national trend to improve employee health so companies can cut health-insurance costs, the Lexington-Fayette Urban County Council agreed Tuesday to set up a wellness center for city employees.

The center will "be voluntary and free for employees, retirees and dependents covered by the city's health insurance plan," reports Beverly Fortune of the Lexington Herald-Leader. Acute and primary care, chronic-disease management and preventive screenings will be among the services provided at the center, the location of which has not yet been chosen. It is estimated to cost $1.3 million.

Chattanooga opened a similar center in 2006. Its health insurance costs were increasing about 20 percent annually, with health benefits costing the city $16 million that year. Today, the city is saving about $5 million a year, said Madeline Green, director of risk management and incentives for the city. (Read more)

Four state agencies give employees time to exercise at work

Update, Sept. 2: A new study has shown giving employees time to exercise during their work day could lead to increased productivity, as reported in the Journal of Occupational and Environmental Medicine. The study involved employees at a large public dental health organization in Sweden. On group of employees was required to do 2.5 hours of exercise per week during regular hours. "Another group received the same reduction in work hours, but with no exercise program," research-reporting service Newswise reports. Employees assigned to the exercise program said they felt productive while at work and were absent less often due to illness. (Read more)

Four state agencies allow their employees to take time to exercise as part of their work day, part of an effort to improve morale and productivity. The Department of Financial Institutions, Department of Military Affairs, Department of Veterans Affairs and the Personnel Cabinet have instituted the policies with varying degrees of participation.

"Some workers are limited to 90 minutes of paid exercise per week, while others can exercise up to five hours while on the clock," reports Valarie Honeycutt Spears of the Lexington Herald-Leader. "On any given day, employees can exercise from 30 to 60 minutes, depending on which agency they work for." (Photo of state employee Lisa Clark by H-L's David Perry)

It is unclear how many state employees take advantage of the policies, but officials feels it is cost effective. "A wellness break is just like any other break time," said Crystal Pryor, spokeswoman for the Personnel Cabinet. "The difference is that this break results in reduced absenteeism, increased productivity, higher employee morale and lower health care costs for the Kentucky Employees' Health Plan, the state's self-funded insurance program."

One 2010 Harvard University study showed medical costs fall about $3.27 for every dollar spent on wellness programs. Absentee day expenses drop by $2.73 per dollar spent. Despite the savings, Kentucky is one of the only states to have such exercise policies in place. Montana also does, allowing employees two 15-minutes exercise breaks a day.

"Often these employees are discussing work issues while they are exercising so we really don't see this as cutting back on productivity," said Dick Brown, spokesman for the Department of Financial Institutions. "There are no hard facts around the impact of the program on reduction of sick leave, but certainly that is one of the benefits and trade-offs we hope to see over time." (Read more)

Medicaid matters, and makes people healthier, study finds, contradicting argument that it's worse than no coverage

Though the overhaul of Kentucky's Medicaid program has its critics and could potentially be confusing to patients, the program itself is very important, acording to a new study. It found that people on Medicaid, compared to those with no insurance, "had better access to and used more health care; they were less likely to experience unpaid medical bills; they were more likely to report being in good health; and they were less likely to report feeling depressed," National Public Radio's Julie Rovner reports.

"What we found in a nutshell is that having Medicaid makes a big difference in people's lives," said Amy Finkelstein, a Massachusetts Institute of Technology economist and one of the study's main researchers. "We report almost a one-third increase in the probability that you report yourself as being happy."

The study also concluded that Medicaid recipients got outpatient care 35 percent more often than those who don't have insurance. They also responded their had own doctor 55 percent more often and a regular office or clinic they went to 70 percent more often than people without Medicaid coverage.

The findings run counter to arguments by critics of Medicaid, including Scott Gottlieb, who wrote an opinion piece in the Wall Street Journal headlined, "Medicaid Is Worse Than No Coverage At All."

While conservatives have long been critical of the program and liberals supportive of it, the study, being published as a working paper by the National Bureau of Economic Research, seems above political gaming; one of its researchers was an economic advisor to President George W. Bush and another an advisor to the Obama administration. (Read more)

Well-being index gives rankings for Kentucky's congressional districts and metropolitan areas; some are very bad

In keeping with its second-to-last state ranking in the 2010 Gallup-Healthways Well-Being Index, which assessed people's physical and emotional health across the country, one of Kentucky's congressional districts and its major metropolitan area have also ranked low.

Of 436 congressional districts nationwide, Kentucky's 5th District ranked 435th overall, and was dead last in the emotional-health and physical-health categories. The other districts' rankings were: 1st, 383rd; 2nd, 404th; 3rd, 312th; 4th, 415th and the 6th, 388th. Here's a table with breakouts and the 2009 rankings:

Of the 188 metropolitan areas assessed, Louisville ranked 170th, not much different from its 151st ranking in 2009. Lexington ranked 115th, way down from 15th. Among metro areas centered in other states, Cincinnati was 123rd; Clarksville, Tenn., was 162nd; Evansville was 172nd; and Huntington was 188th, dead last in the nation. It has scored poorly on several other health measurements.



The well-being index assessed respondents on their emotional health, physical health, life evaluation, work environment, healthy behaviors and basic access. Respondents answered a large spectrum of questions that pertained to their life now and how they expect it to be in five years. In the emotional-health category, for example, they were asked about how often they laugh, if they were treated with respect and if they experienced sadness, anger or depression. In the work-environment category, people were asked about how they are treated by their supervisor, if they are able to use their strengths while at work and if they're satisfied with their job.

Compared to the rest of the country, Kentucky as a whole ranked 49th, surpassing only West Virginia. Hawaii had the highest well-being index in the country.

It bears noting that the rankings are based on very narrow margins of difference, with many states' scores just a few tenths of 1 percentage point apart. While Kentucky's overall well-being index was 61.9 out of a possible 100 points, Hawaii, which ranked first in the country, had a score of 71. The 2010 score for the nation was 66.8. West Virginia's score was 61.7 points. Because the scores were so close together, precise rankings are uncertain. The ranges for congressional districts and cities are greater, but the error margins are larger.

The survey was based on random-digit dial telephone interviews with 352,840 adult Americans living in all 50 states and the District of Columbia. There were 5,881 Kentuckians who participated in the study. Of those, 1,046 live in the 5th Congressional District and 1,632 live in the Louisville area, which includes Jefferson County and the Indiana border. Interviews were conducted every day from January to December 2010.

The margin of sampling error for most states is plus or minus 1 to 2 percent, but is as high as plus or minus 4 percent for the smallest states. For results based on the total sample size, "one can say with 95 percent confidence that the maximum margin of sampling error is plus or minus 1 percentage point," says Elizabeth Mendes of Gallup.

Kentuckians among least happy and least healthy in U.S.

Kentuckians are among the least happy and healthy citizens in the country, with the state ranking second lowest in a survey that rates the emotional and physical health of Americans.

Only West Virginia had a lower well-being score, according to the 2010 Gallup-Healthways Well-Being Index. West Virginia ranked lowest in three of six measured categories, while Hawaii got the highest well-being scores in three of the six categories.

Kentucky ranked lowest in the country in the "healthy behaviors" category, which measures smoking rates, weekly consumption of fruit and vegetables and frequency of exercise. Of course, people who engage in unhealthy behaviors may not necessarily be unhappy.

The other categories include life evaluation, emotional health, work environment, physical health and basic access. Respondents answered a large spectrum of questions that pertained to their life now and how they expect it to be in five years. In the emotional-health category, for example, they were asked about how often they laugh, if they were treated with respect and if they experienced sadness, anger or depression. In the category of work environment, people were asked about how they are treated by their supervisor, if they are able to use their strengths while at work and if they're satisfied with their job.

The survey was based on random-digit-dial telephone interviews with 352,840 adult Americans living in all 50 states and in the District of Columbia. Interviews were conducted every day from January to December 2010. The margin of sampling error for most states is plus or minus 1 to 2 percent, but is as high as plus or minus 4 percent for the smallest states. For results based on the total sample size, "one can say with 95 percent confidence that the maximum margin of sampling error is plus or minus 1 percentage point," says Elizabeth Mendes of Gallup.

The range of scores was less than 10 points, and many states were close together, so precise rankings are uncertain. Kentucky's well-being score was 61.9 out of a possible 100 points. The 2010 score for the nation was 66.8. West Virginia's score was 61.7 points; Hawaii's was 71. Results for congressional districts and major cities will be released later this month. (Read more)

Humana reinvents itself again, to adapt to U.S. health-care reform

Humana, Kentucky's largest corporation, says it is reinventing itself in the wake of the federal health reform law, focusing on becoming a "well-being" company rather than just a provider of health insurance.

Of the notable changes, the Louisville-based corporation that started life almost 50 years ago as a nursing-home company, then ran hospitals, is now back in the business of providing medical care directly, The Courier-Journal's Patrick Howington reports. That change is due to the $790 million purchase of Concentra, which operates occupational and urgent-care clinics (photo of Dr. J. Shawn Standridge and Danny Murphy by C-J's Michael Hayman). Humana Chairman and CEO Michael McCallister said similar purchases in fields like home health and information technology are expected.

Humana is also involved with development of products such as fitness games that can be played online and a water bottle that tells its owner when it's time to rehydrate. The company is also planning to market diabetic supplies to consumers, and is selling research to health-care companies about the effectiveness of certain drugs. "It's a significant change in our strategy," McCallister said.

Part of the change is due to the new health law, which will mean a $136 billion federal cutback in Medicare Advantage, a supplemental coverage program. Humana is the program's second-largest provider with 1.9 million members, and half its revenue comes from the program.

Though Humana laid off 750 Louisville workers early last year, analysts predict the company will weather the changes. Though Medicare Advantage cuts will likely mean there will be a predicted 5 million fewer seniors enrolled in the plan by 2019, other, smaller providers will likely stop offering it. Humana will be there to pick up those lost customers, analysts contend. (Read more)