Health-care costs are a serious problem, nine of 10 adults say

Nearly nine of 10 American adults say the cost of health care is a serious problem (chart) and about two-thirds of the general public believe that cost has gone up in the last five years.

These are the results of a poll released by the Robert Wood Johnson Foundation, the Harvard School of Public Health and National Public Radio.

The poll asked additional questions of Americans who said they have had a serious illness, medical condition, injury or disability in the past year. More than 40 percent said the cost of their medical care caused a "very serious" (20 percent) or "somewhat serious" (23 percent) problem for their or their family's finances.

"The rising cost of medical care affects everyone, but people who have been unwell know firsthand that an illness or injury can mean financial hardship or ruin," said Risa Lavizzo-Mourey, president and CEO of the RWJF. "These findings confirm how thinly individuals and families have been stretched. Having access to high-quality, affordable, comprehensive health coverage is crucial, but we know that even with insurance, rising health care costs leave many Americans with the burden of higher out-of-pocket spending." (Read more)

Healthy food is less expensive than junk food, study finds

Though it's widely believed that healthy food is more expensive than junk food, a new government analysis shows that does not have to be the case.

"In fact, carrots, onions, pinto beans, lettuce, mashed potatoes, bananas and orange juice are all less expensive per portion than soft drinks, ice cream, chocolate candy, French fries, sweet rolls and deep-fat fried chicken patties," reports Nanci Hellmich for USA Today.

"We have all heard that eating a healthy diet is expensive, and people have used that as an excuse for not eating a healthy diet . . . but healthy foods do not necessarily cost more than less healthy foods," said Andrea Carlson, an economist and co-author of the report from the U.S. Department of Agriculture's Economic Research Service. "The price of potato chips is nearly twice as expensive as the price of carrots by portion size."

Carlson and colleague Elizabeth Frazão analyzed national pricing data on more than 4,000 foods and ranked them according to price based on calories, weight and portion size. The foods were placed in five food groups: grains, dairy, protein, fruit and vegetables. Another category was added for unhealthy items, which did not fall into any of the other calories or were high in sugar, sodium and/or saturated fat such as cookies, desserts, granola bars and many cereals. They found:

• Given portion size, the ranking from least expensive to most expensive is: grains, dairy, vegetables, fruit, protein and less healthy foods. Protein and less healthy foods cost nearly the same.

• Meat, chicken and fish are the most expensive sources of protein but there are low-cost options like eggs and beans.

• Fruit and vegetables are lower in cost overall than unhealthy foods.

• Grains, such as bread, oatmeal, pasta and rice, are the cheapest foods no matter how the portion is measured. (Read more)

National effort to combat Alzheimer's disease begins; as research continues, there are preventive steps you can take

Country singer Glen Campbell, who has Alzheimer's disease,
stands with wife Kim during a national conference Tuesday.
Associated Press photo by Charles Dharapak.

With numbers expected to jump to 16 million Americans by 2050, research is being conducted in earnest to find a way to ward off Alzheimer's disease.

One plan of attack is testing therapies before people show symptoms of memory loss, since the disease starts attacking the brain at least 10 years before memory problems appear. An international study will see if an experimental drug can halt the disease in "people who appear healthy but are genetically destined to get a type of Alzheimer's that runs in the family," reports Lauran Neergaard for The Associated Press. In another study, researchers will see if a nasal spray that shoots insulin to the brain can help patients with early memory problems.

Part of the challenge in combatting the disease is researchers are still not sure what causes it. "The chief suspects are a sticky gunk called bata-amyloid, which makes up the disease's hallmark brain plaques, and tangles of a protein named tau that clogs up dying brain cells. One theory: "Amyloid may kick off the disease while tau speeds up the brain destruction," Neergaard reports.

Given the expected increase in the number of people with Alzheimer's, the Obama administration has adopted a national strategy to fight the disease, part of which is a website that is a "one-stop shop for families" to offer information about dementia and links to community resources. Today, there are 5.4 Americans with Alzheimer's or related dementias.

There are steps people can take to protect their brains from the disease, including intellectual and social stimulation to help build "cognitive reserve." Doing crossword puzzles, for example, can help. So can physical activity. "Any time your heart is healthier, your brain is healthier," said Dr. Elizabeth head of the University of Kentucky. Diet is another consideration, since foods that are heart healthy are brain healthy, including omega-3 fatty acids found in fish. (Read more)

Tobacco virus may be used to combat Parkinson's disease

A tobacco crop affected by drought. Courier-Journal photo
by David R. Lutman.

University of Louisville researchers say a virus that attacks tobacco plants may be used to develop a vaccine for Parkinson's disease.

The answer lies with the tobacco mosaic virus, which causes antibodies that "may be protective against Parkinson's," said Dr. Robert Friedland, a clinical and research neurologist at U of L.

Friedland's findings come after more than 60 studies have shown that smokers seem to have a reduced risk for developing Parkinson's, a motor system disorder that can cause tremors, stiffness and impaired balance. 

But Friedland and Dr. Honglei Chen, an investigator with the National Institute of Environmental Health Sciences, part of the National Institutes of Health, warn the findings should not be considered an excuse to smoke. Friedland's research is partly funded by the NIH, but not by any tobacco companies, reports Laura Ungar for The Courier-Journal. (Read more)

U of L researcher gets $3.4 million to replicate studies of stem cells for heart treatment

Dr. Roberto Bolli of the University of Louisville has received a $3.4 million grant from the National Institutes of Health to test the validity of several recent studies by replicating them. The studies examine whether certain types of stem cells are safe and effective in treating heart failure, heart attacks and other cardiovascular disorders.

"Replicating studies in several locations with a large number of patients is necessary for researchers to ultimately determine which ones can be submitted to the Food and Drug Administration for approval," Jill Scoggins reports in a U of L press release.

Bolli has received more than $100 million in grants for basic research for NIH. This is the first grant he has been awarded for clinical research. (Read more)

Two gene variants identified as risk factors for childhood obesity

The largest ever genome-wide study has identified two new gene variants that increase the risk of common childhood obesity.

"We have definitively identified and characterized a genetic predisposition to common childhood obesity," said lead investigator Struan F.A. Grant, associate director of the Center for Applied Genomics at The Children's Hospital of Philadelphia.

The analysis included 14 previous studies "encompassing 5,530 cases of childhood obesity and 8,300 control subjects, all of European ancestry," reports research-reporting service Newswise.

The study team identified two novel loci, or specific locations of a gene or DNA sequence on a chromosome. One is near the OLFM4 gene on Chromosome 13, the other in the HOXB5 gene on Chromosome 17. There was a degree of evidence for two other gene variants as well. "The known biology of three of the genes hints at a role of the intestine, although their precise functional role in obesity if currently unknown," Newswise reports. (Read more)

Obesity adds more health-care costs than smoking, study finds

Obesity costs the health care system more than smoking does, a new study has found. The annual health costs for someone who is obese average $1,850 more than for a person a normal weight. The excess costs were up to $5,500 per year for people who are morbidly obese. Smokers' health costs averaged $1,275 more than those of nonsmokers.

Researchers studied the additional costs "of smoking and obesity among more than 30,000 Mayo Clinic employees and retirees. All had continuous health insurance coverage between 2001 and 2007," reports research-reporting service Newswise. The findings were published in the Journal of Occupational and Environmental Medicine.

The additional costs associated with obesity appeared to be lower after they were adjusted for other related health problems. "This may lead to underestimation of the true incremental costs, since obesity is a risk factor for developing chronic conditions," said James P. Moriary and his fellow researchers. (Read more)

Growing up on farm helps immune system, study of pigs shows

For the first time, there is conclusive evidence that growing up on a farm is good for the immune system. Researchers from the University of Bristol's veterinary sciences school have published a study showing that "spending early life in a complex farm environment" increases the number of T-cells one has, reports Sarah Muirhead of Feedstuffs. T-cells have been identified as universal regulators of immune systems, with low numbers increasing risk of developing allergies, autoimmune and inflammatory diseases. Researcher Marie Lewis said it wasn't previously known whether farm life increased immunity to allergies, or if people more prone to allergies weren't living on farms.

Piglets were used in the study since they share many aspects of human physiology, metabolism, genetics and immunity. Some of the piglets were nursed by their mother on the farm, while the others were kept in an isolator unit under hygenic conditions and fed formula milk to reflect the "extremes of environment" in which many humans are raised. Farm-raised piglets had increased levels of T-cells compared to those raised in the isolator. Lewis said it's not clear yet exactly what caused the increase in T-cells in farm-reared piglets, but said previous work shows that intestinal bacteria "plays a pivotal role." (Read more)

U of L spinal cord center brings in $13.7 million in 2011, $64.1 million since 2000

The University of Louisville's spinal cord scientists attracted more than $13.7 million in outside funding in 2011 alone, and have brought in a total of $64.1 million since 2000.

"This is tangible evidence of our effort to become a nationally recognized premier metropolitan research university," said U of L President James Ramsey. "We have taken the investment that the state has made in our program, brought in the best researchers to work on spinal cord injury, and begun to help people."

One major success story was that of Rob Summers, who played college baseball in Oregon and was paralyzed below the chest after a car accident in 2006. "In May, a team from U of L and two California universities announced that they had used electrical stimulation and rehabilitation to help (him) stand and take steps with assistance — a breakthrough with implications for millions of paralyzed people around the world," reports Laura Ungar of The Courier-Journal. (Read more)

Child abuse rates have risen significantly since the economy went into recession, survey in Ky. and 3 other states shows

Child abuse rose as the economy went into recession, shows a study of reported abuse to children under 5 in Kentucky, Ohio, Pennsylvania and Washington.

From 2004 to December 2007, before the financial meltdown, the rate of abusive head trauma in the four states was 8.9 per 100,000 children. During 2008 and 2009, the number jumped to 14.7 per 100,000. Though the study established no cause-and-effect relationship between financial difficulties and an increase in abuse, "earlier research has tied parental stress to child maltreatment," Frederik Joelving of Reuters Health reports.

The study "showed that from 2004 to 2009, there were 422 children diagnosed with what doctors call 'abusive head trauma.' The majority ended up in intensive care units, and 16 percent died of their injuries," Joelving reports. The average child examined in the study was 9 months old.

"The number-one perpetrators are fathers and male caretakers; very few perpetrators are mothers," said Rachel Berger, a child-abuse expert at nationally recognized Children's Hospital in Pittsburgh and co-author of the study. "It's the people that mothers give their kids to that end up being the perpetrator(s)." (Read more)

U of L prof earns $11.8 million grant renewal; has helped glean $100 million in federal grants in 17 years

A University of Louisville researcher has been awarded a $12.8 million grant to keep his adult stem cell project going.

The funds are from the National Institutes of Health and will allow Dr. Roberto Bolli, right, to continue to investigate how introducing genes into stem cells might improve stem-cell therapies; look at how diabetes affects stem cells; look at how proteins called cytokines affect stem cells during heart failure; and investigate the signaling pathways of stem cells in the body.

Bolli's project was granted $11.7 million in 2006. Since Bolli started working at U of L in 1994, he and his team have brought in more than $100 million in NIH grants. In one project, patients have reached the two-year mark after being infused with their own processed adult stem cells. That project is looking to find a way to use a patient's own cardiac stem cells to regenerate dead heart muscle after a heart attack.

"U of L has a mandate to become a national recognized metropolitan research university," President James Ramsey said. "One gauge is our faculty's ability to attract competitive grant fund from the NIH." Ramsey said the overall mission of the medical school is to improve the health of Kentuckians.

UK Hospital gets below average marks on patient satisfaction, infections; data on your local hospital are available online

Despite $900 million being invested in expanding the University of Kentucky Chandler Hospital, its patients at do not seem all that happy with the care they receive there.

In an op-ed piece in the Lexington Herald-Leader, Dr. Kevin Kavanagh of Somerset highlights the results of a survey on patients' hospital experiences. That survey ranked UK's hospital below state and national averages in nine of 10 measures. "Especially disturbing, only 66 percent said they would definitely recommend the institution, and only 56 percent stated their room and bathroom were 'always clean'," writes Kavanagh, chairman of Health Watch USA.

The UK hospital also did not fare well when it came to its assessment by the Centers for Medicare and Medicaid Services on hospital-acquired conditions. "UK had the highest reported rate of deadly vascular catheter infections in the state," Kavanagh writes. "UK also had an unacceptably high rate of falls and deep bed ulcers. These latter conditions should be zero."

Kavanagh concluded, "If there are quality problems at UK, it is of paramount importance that they are corrected since not only current patients are at risk but also the quality of the training experience of our future clinicians, which can affect care for years to come." (Read more)

Newspapers can access information about their area hospitals by clicking here. Viewers can choose up to three hospitals and see how they compare to one another in categories like: how well nurses communicate with patients; how quiet the areas around patients are; if patients would recommend the hospital; and if patients always received help as soon as it was wanted.

Newspapers can also see the results of the CMS assessment on hospital-acquired conditions for their area hospitals by clicking here and downloading the Hospital-Acquired Condition Rates zip file (scroll down to Kentucky hospitals). The file contains data on eight hospital-acquired conditions reported between Oct. 1, 2008 and June 30, 2010. Among the conditions reported are air embolism; blood incompatibility; catheter-associated infections; falls and trauma; foreign objects left in the body after surgery; pressure ulcers; uncontrolled blood sugar levels; and urinary tract infections.

Free conference on Alzheimer's in Louisville Sept. 17

A Washington-based geriatric researcher will join University of Louisville researchers and clinicians a free conference examining Alzheimer’s disease from 9 a.m. to 3 p.m., Saturday, Sept. 17, at the Crowne Plaza Louisville Airport Hotel, 830 Phillips Lane, near the state fairgrounds.

“The Journey: Alzheimer’s Disease and Caregiving” will provide information on the risk factors for Alzheimer’s disease, the reasons why certain populations are at greater risk for developing it, and current practices in caregiving. Admission, parking and lunch are free to participants at but pre-registration is required by Sept. 15 to info@alz.org or 1-800-272-3900.

Thomas Obisesan, M.D., chief of geriatrics at Howard University Hospital, will open the meeting. His research is focused on finding a cure for Alzheimer’s and "disentangling the overlap of cardiovascular disease with Alzheimer’s disease risk," a U of L release says. The conference is supported with grants from Eisai Co. Ltd. and the Signature Research Institute. It is co-sponsored by the university and the Greater Kentucky and Southern Indiana Chapter of the Alzheimer’s Association.

UK center probes the science of muscles and exercise

Exercise is good for you. But it's not that simple. "Doctors and scientists have a lot of questions about why exercise is so beneficial, how muscles work and the role muscle strength plays in overall health," columnist Tom Eblen writes on the front page of today's Lexington Herald-Leader, and reports that some of those questions are being addressed by the University of Kentucky Center for Muscle Biology, which was created three years ago. "With outside grants of more than $12 million, center researchers are looking at everything from injury prevention in young athletes to rehabilitation for elderly stroke patients," he writes.



"Physical activity and muscle strength seem to contribute to everything from better memory to disease prevention. For example, even moderate exercise can help Type 2 diabetes, which has become epidemic among overweight Kentuckians. Muscles store most of the body's insulin." The center's director, Karyn Karyn Esser, told Eblen, "When you exercise and make muscles work, it creates a separate path for absorbing glucose." (Eblen photo: Caitlyn Kerins demonstrated equipment for measuring muscle control as faculty member Patrick McKeon watched.)

Two researchers are studying how to strengthen diaphragm muscles, which are essential in breathing, "to help patients get off ventilators. It is a huge problem: about 60,000 Americans are on ventilators at any given time, and it costs billions of dollars to care for them," Eblen writes. "The longer most people are on a ventilator, the more likely they are to die." And "muscle weakness is the main culprit in about 70 percent of ventilator patients." Other researchers are investigating why lifting weights can improve memory in the elderly, why certain patients lose muscle strength soon after being hospitalized, how injuries caused by repetitive motion can be avoided, and exactly how massage and ice help repair and strengthen muscles.

Eblen, who took up bicycling at 35 to lose weight and is still an enthusiast in his mid-50s, is writing a lot lately about exercise in response to Lexington's designation by Men's Health magazine as the nation's most sedentary city. And the center's Esther Dupont-Versteegden is even researching inactivity: "We know that people feel better when they exercise regularly, but why is that?" she asked. "What is inactivity doing to people?" (Read more)

Patients in isolated rural areas have higher rates of death from chronic obstructive pulmonary disease

Patients with chronic obstructive pulmonary disease living in isolated rural areas "seem to be at greater risk" of death from COPD than those living in urban areas, even when "hospital rurality and volume" are taken into account, says a new study published in the latest issue of the Annals of Internal Medicine.

Researchers from Iowa City Veterans Affairs Medical Center collected data from COPD patients at 129 veterans' hospitals measuring first, 30-day mortality and then adusting for patient rurality, hospital volume, and hospital rurality. The results indicate "mortality was significantly elevated in patients living in isolated rural areas compared with those living in urban areas," regardless of patient and hospital characteristics, reports Doctors Lounge, an online medical resource for physicians, students and allied clinical professionals. (Read more)

Website helps journalists, community planners, other Kentuckians in search of county-specific health data

A treasure trove of health data about every county in Kentucky is available to journalists and community planners looking to draw a statistical picture of their area. That was the message of a webinar hosted by the Foundation for a Healthy Kentucky Wednesday.

"We really hope the information we have on kentuckyhealthfacts.org will start a conversation," said Sarah Walsh of the foundation's "Local Data for Local Action" Initiative.

The website features a map of the state that is broken down by county. By clicking on a county, a plethora of information pops up, including information on a county's:

• demographics, such as graduation rates and per capita personal income;

• social and behavioral indicators, such as lack of physical activity and prevalence of smoking and obesity;

• health outcomes, such as infectious disease rates, motor vehicle deaths and premature death rates;

• access to care, such as flu vaccination rates, and number of available health care providers and physicians;

• maternal and child health, such as infant mortality, teen birth rates and low birthweight rates;
• senior health, such as the percentage of the senior population in a community.

The data can be compared to the rest of the state, the rest of the country or other counties, and users can create tables, bar graphs, line graphs or maps suitable for publication. "There's a lot of information here," Walsh said. (Graph created online shows obesity declining in Laurel and Pulaski counties after three years of increase, but still rising in Knox County and holding steadier in Rockcastle County. Up to six counties can be placed in one such graphic.)

The site is especially valuable to journalists, said Al Cross, director of the Institute for Rural Journalism and Community Issues at the University of Kentucky. "These are the hard facts that local news media need to report as they hold up a mirror to their communities and help them address community problems," Cross said. "In most Kentucky counties, one or more facets of health are a community problem. They need more attention." Kentucky Health News is a service of the institute, funded by the foundation.

Much of the data come from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance Survey, a nationwide, random telephone poll that is conducted each year. Because there may not be enough survey responses from residents in some counties, much of the data on the site have been developed by looking at three or four counties that are near each other and demographically similar, which Walsh said makes the data more "stable and robust." Statisticians have reconfigured the data so that they are all based on a population of 100,000 people, enough to have confidence in the percentages.

While encouraging community planners to use the site, Walsh said the Kentucky Cancer Registry website is "one of the best in the nation" and has cancer-specific data that may not be available on kentuckyhealthfacts.org. She also pointed listeners to the Kids Count website, an Annie E. Casey Foundation-funded project that has statewide data specific to children.

What surfers won't find, however, are Kentucky numbers on the childhood obesity or childhood diabetes. "Different school districts and communities are collecting data but in different ways and at different ages," she said, adding those disparities make comparison analysis difficult. A bill to make schools collect and report body-mass-index data failed in the last session of the General Assembly.

The goal of Wednesday's webinar was to disseminate information so community planners can identify and address health needs in their area. "At the foundation we take a lot of inspiration from the words of Arthur Ashe, 'Start where you are. Use what you have. Do what you can'," Walsh said. "We believe communities can do a lot to change their health status." The webinar was part of the foundation's "Health for a Change: Ignite — Unite — Act" initiative and was the first in an ongoing series. The next session, July 27, will focus on how to plan a community health needs assessment. For more information about the series, click here.

Overweight people tend to cluster with those who are likewise

The adage "birds of a feather flock together" seems to apply when it comes to the obesity, with a study concluding that overweight people tend to befriend others who are overweight. Obesity also tends to run in families, with obese parents raising obese children, research-reporting service Newswise reports.

The Arizona State University study didn't conclude why obese people tend to "cluster," but did provide "some important information about trends in obesity and the public health implications," said Dian and Tom Grisel, who wrote TurboCharged: Accelerate Your Fat Burning Metabolism, Get Lean Fast and Leave Diet and Exercise Rules in the Dust.

"Obese families and friends usually have two things in common: food choices and activity levels or more accurately, lack of activity. Obese parents tend to raise obese children. Obese family and friends hang out and eat the same kinds of detrimental foods and participate in the same kinds of detrimental habits," the Griesels said.

That has serious implications for Kentucky, which has the sixth highest obesity rate in the country. More than 67 percent of adult Kentuckians are either obese or overweight and Kentucky was one of just six states whose obesity rate has increased two years in a row, the recently-release report "F as in Fat" found.

Though people may tend to find others who are like-minded when it comes to food, that doesn't mean they want to be overweight. "Study participants revealed that if given the choice, they would select some pretty serious diseases like alcoholism, depression or herpes instead. In fact, 25.4 percent preferred sever depression and 14.5 percent actually preferring total blindness over obesity," Newswise reports. (Read more)

Webinar next week will spotlight county-by-county health data

How can you find by-county health statistics and other other key health resources? That will be the focus of a July 13 webinar, hosted by the Foundation for a Healthy Kentucky.

The free webinar, which starts at 3 p.m. EST next Wednesday, will teach listeners how to navigate the Kentucky Health Facts website and point listeners to other resources like the Kentucky Cancer Registry.

It will be hosted by Sarah Walsh, the senior program officer at the foundation's Local Data for Local Action Initiative. The goal of the intiative is to provide access to key state and local health data to help decision making at the local level. "At the foundation, we take a lot of inspiration from the words of Arthur Ashe, 'Start where you are. Use what you have. Do what you can'," Walsh said. "I love that the data on our Kentucky Health Facts website can help local health advocates understand where they are starting from, so they can really do something to make their community a healthier place to live."

Under the moniker "Health for a Change: Ignite — Unite — Act," this is the first in a series of webinars hosted by the foundation. On July 27, Walsh will discuss how to plan a community health needs assessment. For more information about future webinars, click here.

To register for the webinar, click here.