Overdose deaths in Ky. workplaces tripled in 2019-2021; in the latter year they were the 2nd leading cause of occupational fatality

Graph by Kentucky Injury Prevention Research Center

Drug-overdose deaths in Kentucky workplaces tripled from 2019 to 2021, according to the latest annual report from the Kentucky Fatality Assessment and Control Evaluation program.The program, part of the Kentucky Injury Prevention and Research Center, found that from 2017 to 2021, the state had 47 overdose fatalities in the workplace, reaching its highest number ever of 18 fatalities in 2021. That was a 260 percent increase from 2017.

Of the 96 occupational fatalities recorded in Kentucky in 2021, drug-overdose deaths accounted for 19%, an increase from 13% in 2020 and 8% in 2019. That put overdose deaths second to motor-vehicle crashes, which were 29% of the total. In third place (17%) were "struck by" and "striking against" injuries, forcible contact or impact with an object that creates an injury.

Most of the occupational drug-overdose deaths in 2017-2021 occurred in the trade, transportation and utilities industries (38%), followed by manufacturing (19%), construction (19%) and the leisure and hospitality industry (11%). The remaining 13% took place in services and public administration.

The report notes that all of the occupational overdose deaths in the leisure and hospitality industries happened in 2020 and 2021.

It also points to the jump of occupational-overdose deaths in Jefferson County. In 2021, seven of the state's occupational overdose deaths, nearly 40% of the total, occurred in Jefferson County. That was one short of the total for the previous four years combined.

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Drinking while pregnant can have long-lasting effects on children; almost half of pregnant Kentuckians report alcohol consumption

Centers for Disease Control and Prevention illustration

Did you know that children of mothers who drink alcohol during pregnancy can undergo changes to their facial features, accompanied by a variety of lifelong mental and physical challenges? And some of those changes may not be visible. Exposure to alcohol before birth can also affect systems throughout the body and have lasting impact, Emma Yasinski reports for National Geographic.

"Studies have estimated that fetal alcohol spectrum disorders, or FASD, affect between 1 and 5 percent of the population, though experts suspect the prevalence is even higher," Yasinski reports. 

The FASD United Policy and Training Center website says FASD is the "most commonly known cause of developmental disabilities in the United States," and recent research shows up to one in 20 first graders have a disability from it.

Almost half of Kentucky women with a recent live birth consumed alcohol during the three months before pregnancy. The figure was 48.7% in 2019, according to the America's Health Rankings report from the United Health Foundation. The national rate was even worse, 56.7%.  

FASD-related problems

It wasn't until the early 1970s that researchers found a pattern among babies born to mothers with severe alcohol-use disorders, including hallmark facial features such as a smooth upper lip, a small head, and a flat nasal bridge. These features were generally accompanied by a variety of lifelong mental and physical challenges such as learning disabilities, difficulty reasoning, growth deficiencies, and heart and kidney problems," Yasinski reports.

Since then, researchers have found that prenatal alcohol exposure can disrupt development of the brain and body even without affecting the face, and include a broad range of conditions that are often inconsistent from one patient to another. Yasinski also delves into the details of how FASD changes the brain. 

The FASD center says people with the disorder often have difficulty learning and remembering, understanding and following directions, shifting attention, controlling emotions and impulsivity, communicating and socializing, and performing daily life skills. It says FASD cases are seriously under-diagnosed and often hard to distinguish from other developmental disorders. 

Further, Yasinski reports that diagnosis requires complex tests and treatments that, due to limited resources and awareness, many patients never get.

“Alcohol affects the brain in different ways, depending on when the brain is exposed in pregnancy and how much it's exposed, and what else is going on, like nutritional factors, genetic factors, other things about the mom and the fetus,” Jeffrey Wozniak, a neurobehavioral development researcher at the University of Minnesota, told Yasinski. “So there's a lot of variety in terms of the brain effects.”

How prevalent is drinking during pregnancy? 

According to Kentucky's 2020 births report from the Public Health Neonatal Abstinence Syndrome Reporting Registry, "Alcohol use was reported by mothers of 4.8% of infants with NAS in Kentucky, which may be lower than the actual rate of use."

Centers for Disease Control and Prevention data show that in 2018-20, 13.5% of pregnant U.S. adults reported that they were currently drinking and 5.2% reported they had engaged in binge drinking.

Many women drink without knowing they are pregnant, and that harm a fetus. About half of all U.S. pregnancies are unintended, and most women don't know they are pregnant until four to six weeks into the pregnancy.

While binge drinking and regular heavy drinking put a fetus at the greatest risk for sever problems, even lesser amounts can also cause damage, says the National Institute on Alcohol Abuse and Alcoholism. 

"In fact, there is no known safe level of alcohol consumption during pregnancy" says the institute. 

Looking forward

The good news is that in the early 2000s, "Studies started to show that targeted therapies could help people who were prenatally exposed to alcohol," Yasinski reports.  

For example, Julie Kable, a neurodevelopmental exposure researcher at Emory University in Atlanta, told Yasinski that she and her team found with the CDC that offering adaptive support helped people with FASD better learn and understand math. Yasinski says researchers have also found ways to help people with FASD with executive function and decision making. 

Kanle told Yasinski, “No longer could we allow pediatricians to say, Well, why should I diagnose it when there's nothing we can do about it?”

But Yasinski reports that the U.S. has too few places that can diagnoise FASD, "and some states don’t even have a single FASD diagnostic center. Since diagnosis requires comprehensive evaluations, the centers that do exist have limited capacity to complete them. Many will only see patients who they know were very likely to have been exposed to alcohol in utero, which accounts for a fraction of those believed to be affected."

She adds,, "While most experts agree on the basic characteristics of FASD, there are also minor differences in diagnostic criteria between states, countries, and clinics, with slightly different cutoffs."  And this, she reports "can create challenges for researchers working to build large data sets, but it also has more immediate impact." For example, one FASD specialist told her that individuals with FASD in some states don't qualify for disability services because " the CDC only has consistent diagnostic criteria for fetal alcohol syndrome, not the whole spectrum of disorders." 

Some in Congress are working to provide resources for screening, research and other supportive services for people with FASD, in a bill called the FASD Respect Act. The FASD United Policy and Training Center says a new version of this bill is to be introduced.

Susan Shepard Carlson, who was a district court judge and first lady of Minnesota, told Yasinski that she is advocating for this bill largely because she realized in 1997 that a many children coming through the courts "had the same kind of profile [as] someone with FASD . . . but we weren't really looking at the underlying cause." 

Because of this, Carlson convened a task force that led to the state funding FASD research and treatment. "The court was able to screen children suspected of having an undiagnosed FASD, and she says about 25 percent of the kids they chose to screen did have an undiagnosed disorder," writes Yasinski.

Kable told Yasinski, “It’s really important to know that we can still have dramatic differences in the developmental outcome of these children, if we get them recognized, and get them services as early as possible.” 

Information for this story was also gathered by Melissa Patrick of Kentucky Health News.

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Medicare Advantage TV ads and other marketing will have to follow new rules aimed at stopping deception of beneficiaries

Cover of report asking Medicare to act

Kentucky Health News

Those incessant ads and phone calls about Medicare, and other marketing devices that the federal government considers deceptive, are about to get makeovers. At least that's what the feds have in mind.

On April 5, the Centers for Medicare and Medicaid Services "finalized a slew of Medicare Advantage marketing reforms for the upcoming 2024 Medicare open enrollment season, including plans to crack down on general television advertisements after concerns over such marketing kicked into high gear last year, Michalle M. Stein reports for Inside Health Policy.

CMS said last fall that it was worried about marketing practices, particularly concerned about TV commercials for Medicare Advantage, which most Medicare beneficiaries now have. Private insurance companies run MA plans, making money by getting a flat fee from Medicare for covering each beneficiary, then controlling costs by limiting claims payments and taking other measures.

"The Senate Finance Committee fanned those flames with a report that alleged bad actors in 14 states were taking advantage of loopholes and lax rules around marketing and enrollment, “badgering seniors on the phone, confusing them on television, and inundating them with mountains of mail,” and noting complaints to CMS doubled between 2020 and 2021.

"Widespread television advertisements with celebrities claim that seniors are missing out on benefits, including higher Social Security payments," the report said, calling the ads deceptive. It urged CMS to act.

CMS said, “The proliferation of certain television advertisements generically promoting enrollment in MA plans has been a specific topic of concern. To address these concerns, CMS is prohibiting ads that do not mention a specific plan name as well as ads that use words and imagery that may confuse beneficiaries or use language or Medicare logos in a way that is misleading, confusing, or misrepresents the plan.”

The proposed regulations would, also require insurers to:

• Notifying enrollees annually and in writing of their ability to opt out of phone calls regarding Medicare Advantage and Part D;
• Explain the effect of an enrollee’s enrollment choice on their current coverage when they make an enrollment decision;
• Simplifying plan comparisons by requiring medical benefits be in a specific order and listed at the top of plans’ Summary of Benefits;
• Ban marketing of savings information based on a comparison of typical expenses for uninsured individuals or the unpaid costs of beneficiaries eligible for both Medicare and Medicaid;
• Limit the use of the Medicare name, logo and card in ads.

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UK is ‘Centering and Celebrating Cultures in Health’ during National Public Health Week, which runs through Sunday

Advocates celebrated a National Public Health Week at the University of Kentucky.

By Grace Colville

University of Kentucky

From fostering collaborations to increase lifesaving cancer screenings, to examining the impact of an environmental disaster, to shedding light on vaccine hesitancy in Eastern Kentucky, experts in public health are all around us, seeking ways to improve and health and well-being of the population.

April 3 marks the beginning of the annual National Public Health Week, a time to recognize the contributions of public health and highlight issues that are important to improving our nation's health. This week, organizations across the country — including the University of Kentucky College of Public Health — are hosting events to promote public health's passion, purpose and pathway for a healthier life.

Each year, a different theme is chosen to recognize and celebrate public health in a different capacity. This year, the theme is "Centering and Celebrating Cultures in Health." The goal of this theme is to celebrate how we learn from the communities we are born in and the ones we build together.

“This year’s theme means inclusiveness and coming together,” said Acting College of Public Health Dean Heather Bush. “We feel strongly that community is a big part of what we do in public health and we see essential value in hearing from communities.”

“Everyone belongs here,” said Jonathan Gent, chief of staff at the college and organizer of UK’s National Public Health Week events. “Inclusive excellence is only possible with diversity of thought and creating a welcoming atmosphere — for everyone. We aim to be a champion of diversity, equity and inclusion, in line with our vision to be the catalyst of positive change for population health for all.”

The UK College of Public Health has been celebrating National Public Health Week for nearly 20 years. Its mission of developing health champions, conducting multidisciplinary and applied research and collaborating with partners to improve health in Kentucky and beyond is furthered by awareness of the field and support of its patrons.

“National Public Health Week is about celebrating our public health heroes and champions. It’s about taking time to say thank you,” said Bush. “Communities matter and what happens in our communities is important. We are all part of coming together for a solution. We recognize that groups of people are different and what makes them different is beautiful. We want to celebrate and recognize those differences, and use that for our understanding in what makes public health great.”

This week, UK has multiple events open to all students, faculty, staff and community members. These virtual and in-person events will allow attendees to explore the role of strong communities on physical and mental health. The events include:

Tuesday, April 4: Music Bingo | 3:30-5:30 p.m. College of Public Health, Room 115
Music bingo is very popular for relaxation and mental health. It's just like regular bingo, but instead of shouting out numbers, songs are played. Each round takes on a different genre of song choices; these could be based on either a decade, theme or just a random quirky topic (for example, movie theme tunes or Disney songs). Prizes are available for winners.
Facilitated by the Office of Student Engagement and Academic Success (SEAS) within the College of Public Health.

April 4: Mennonite Population of Kentucky and Celebrating Care | 2-3 p.m., Virtual (Zoom Link)
Facilitated by Jenn Harris, director of the Todd County Health Department, and M. Susan Jones, professor emerita, School of Nursing, Institute for Rural Health at Western Kentucky University.
Kentucky's Mennonite populations is listed as the eighth largest in North America, one of the fastest growing in the past 20 years. What is it like to work with such a unique culture within our own borders? What can health care students learn from this population? How can we celebrate the care given to this population?

Wednesday, April 5: Yoga Therapy | 3-4 p.m. Wethington Commons, Room 127
Enjoy this therapeutic experience, which empowers individuals to progress toward improved health and well-being through the application of the teachings and practices of yoga. No experience? No problem! Bring your mat and move at your own pace for a stress-busting round of yoga.
Facilitated by UK Campus Recreation and Wellness.

Thursday, April 6: Express Your Culture Through Art | 8:30 a.m.-4 p.m. CPH Room 120
Using the materials provided, express how your culture has shaped your health. Think about the foods you eat, the traditions you have with your family and friends or your community, the activities and hobbies you engage in, or how you unwind and decompress.

April 6: Move Your Body Today | 11 a.m.-noon, Bradley Bowman Quad
Stop by for a fun, body-weight workout that you can do anywhere. Also, learn ways to engage and motivate others into daily physical activity. Facilitated by Ketrell McWhorter, assistant professor, UK College of Public Health, American Council on Exercise certified personal trainer.

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Fentanyl test strips will no longer be drug paraphernalia under law

By Sarah Ladd
Kentucky Lantern

Fentanyl test strips will no longer be considered drug paraphernalia in Kentucky.

Gov. Andy Beshear on Friday signed a bipartisan bill decriminalizing fentanyl test strips in Kentucky after it easily passed both legislative chambers.

The state Senate passed House Bill 353 Thursday night. The House concurred unanimously in the final hours of the legislative session. It will take effect July 8, 90 days after the session's adjournment.

How one type of fentanyl test strip works

Fentanyl test strips are paper strips that can detect the presence of fentanyl in pills and other drugs within minutes. Fentanyl is a powerful synthetic opioid that contributed to 73% of Kentucky’s 2,250 overdoses in 2021. Using the test strips can help prevent overdoses, the Centers for Disease Control and Prevention says.

“Unwitting individuals may think they are ingesting one substance and unaware that it also contains fentanyl,” Jennifer Hancock, president and CEO of Volunteers of America Mid-States, said in a statement.

“With police departments and other emergency responders already carrying and administering Narcan, a medicine used for the treatment of a known or suspected opioid overdose emergency, it makes sense to prevent these overdoses on the front end,” she said. “It may afford another day where we can get an individual into recovery.”

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Appalachian Nursing Academy for high school juniors and seniors in Appalachian counties extends application deadline to April 15

The Appalachian Nursing Academy, for high school students in Appalachia who are wondering if they would like to pursue a career in health care, has extended its application deadline to April 15. 

The academy is a free, two-week summer program at the University of Pikeville July 10-21. It is available to rising junior or senior high school students who reside in one of Kentucky's 54 Appalachian counties. 

Those counties are Adair, Bath, Bell, Boyd, Breathitt, Carter, Casey, Clark, Clay, Clinton, Cumberland, Edmonson, Elliott, Estill, Fleming, Floyd, Garrard, Green, Greenup, Harlan, Hart, Jackson, Johnson, Knott, Knox, Laurel, Lawrence, Lee, Leslie, Letcher, Lewis, Lincoln, McCreary, Madison, Magoffin, Martin, Menifee, Metcalfe, Monroe, Montgomery, Morgan, Nicholas, Owsley, Perry, Pike, Powell, Pulaski, Robertson, Rockcastle, Rowan, Russell, Wayne, Whitley, and Wolfe. 

Participants of the academy are required to attend the entire program and participate in a year-long mentorship program following the academy. Those who complete the program will also receive a $1,500 scholarship to any college or university of their choice.

Participants will receive housing, three meals a day, interactive programming and trips to see regional attractions and activities. 

To apply, students will need to submit a permission form, a completed application, a copy of their unofficial transcript and a letter of recommendation. Click here for more information. Click here for answers to frequently asked questions. Applications will close Saturday, April 15 at 11:59 p.m. ET.

The academy is sponsored by Shaping Our Appalachian Region in partnership with the state Department for Public Health and the university. This is the second time the academy has been offered. 

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Every Kentucky county has a low risk of Covid-19 transmission

CDC map shows all Kentucky counties and all but one adjoining county (Scott County, Tennessee)
at low risk, with the closest high-risk counties in northeast Missouri and West Virginia.

By Melissa Patrick
Kentucky Health News

Every county in Kentucky has a low risk of Covid-19 transmission, according to the latest weekly analysis of risk based on new cases and hospital capacity by the Centers for Disease Control and Prevention. 

The latest map shows the whole state is in green, a level that comes with recommendations to stay up to date with your Covid-19 vaccines and to avoid contact with people who have suspected or confirmed Covid-19. 

So does that mean the pandemic is over? The answer is, not yet. However, the leader of the World Health Organization said mid-March that he expects that the organization will declare an end to it later this year, WebMD reports. President Biden is letting the public-health emergency expire in May 11.

“I am confident that this year we will be able to say that Covid-19 is over as a public health emergency of international concern,” WHO Director General Tedros Adhanom Ghebreyesus told reporters at a Geneva briefing.

CDC map shows transmission levels of the virus.

The CDC also provides a community level transmission map, largely used by health-care facilities and researchers, that shows the level of virus in each county, at one of four levels. The latest map shows six counties with a low level of transmission and 53 with a medium level; the rest are either substantial or high. The state says residents should take their guidance from the other map.

On March 31, The New York Times, using CDC data, found Kentucky's new-case rate to be the 19th highest in the nation, at 46 coronavirus cases per 100,000 residents in the last seven days. 

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