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

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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)