IT'S TIME FOR OUR CHECKUP

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If you live in Louisville, you have been exposed to healthy lifestyle options. We are, after all, a city on the forefront of the farm to table movement. We are a community with an active cycling population. Bike paths. Walking bridges. Walk-a-thons. Marathons.
But, like most urban areas, Louisville is also struggling with the social and economic factors that lead to illness and premature death: poverty, lack of education, access to healthcare, air quality, nutrition, violent crime.
And one statistic leaps off all the pages, placing Louisville – and all of Kentucky – behind the national curve. In Louisville, 23 percent of the population are smokers. That’s better than the nearly 27 percent throughout the commonwealth. But it’s still far above the national average of 17 percent.
“We bounce back and forth between being the worst state in the country, and next-to-worst,” says Bonnie Hackbarth, director of communications for the Foundation for a Healthy Kentucky. “In some years, we’re slightly better than West Virginia; in other years, West Virginia is a little better than we are.”
Every other state has left these two behind.
Louisville’s health profile is in no way dominated by cigarettes.  It’s not all horrible news. But the numbers suggest that there are many things we could and should be doing to improve our national standing and our quality of life.  


LIFE—AND DEATH—BY THE NUMBERS
Life expectancy
77.6 in Louisville
79 in the US
69 in Iraq
67.8 in the California-Parkland neighborhood

Deaths due to poverty
367 in Louisville
5% of all metro deaths

Infant mortality
7 per 1,000 live births

Heart disease deaths
181 per 100,000 in Louisville
194 in the US

Cancer deaths
190 per 100,000 in Louisville
186 in the US
65.5 percent of the Louisville population lives in high-risk areas for cancer
38 percent of the Louisville population lives in in high-risk areas for chronic disease
death from lung cancer: 60 per 100,000
colorectal cancer: 16 per 100,000
breast cancer: 23 per 100,000
prostate cancer: 20 per 100,000

Heart disease deaths
181 per 100,000 in Louisville
194 in the US

Diabetes deaths
28 per 100,000 in Louisville
22.4 in the US


4 HEALTH FEARS
Kentucky adults were asked what they think the most severe health issues are. The Top Four responses:
 Obesity
Cancer
Heart disease
Access – they can’t get the healthcare they need; they can’t afford the healthcare available; they can’t get to healthcare facilities when they need it.


According to the “Metro Health Equity Report”:
10.2 percent of Louisvillians have no access to their own vehicles
8.9 percent – the US average
 51.2 percent – residents of the Russell neighborhood
in eight Louisville neighborhoods, that percentage is greater than 20 percent.


UP IN SMOKE
Finally, the rate of smoking in Louisville (and in Kentucky) is going in the right direction: downward. But it’s still higher than the national average. (Courtesy of Foundation for a Healthy Kentucky.) Here’s who’s lighting up and some repurcussions.

Adult smokers
Currently: 26.6 percent
Five years ago: 29.5 percent
National average: 17.5 percent

High school smoking
Currently: 16.9 percent
Five years ago: 26.1 percent
National average: 10.8 percent

COPD sufferers
11.6 percent of adults diagnosed with prevalence toward COPD
10.4 percent five years ago
6.1 percent national average
Kentucky ranks 48th out of 50 states.


THE GOOD NEWS
The cancer rate for the state is decreasing.
Cancer mortality – 202.6 per 100,000
Five years ago: 211.9 per 100,000
The heart disease rate for the state is decreasing.
Currently: 200.5 per 100,000
Five years ago: 210.1 per 100,000
Louisville is above the national average in immunization of children. Children 19-35 months in Louisville: 84 percent; U.S.: 81 percent
Louisville is below the national average in numbers of infectious diseases. Louisville: 16.2 per 100,000; US: 23 per 100,000
Kentucky was one of the first states to introduce a “quit line” for those who need help, advice and resources to stop smoking. “The Centers for Disease Control tell us 70 percent of current smokers would like to quit,” says the Foundation’s Hackbarth.
This will be an even bigger resource,” she says,” following the passage of FB89 by the federal government, requiring health insurers to cover FDA-approved cessation programs.” The federal program goes into effect in July, and the state has planned an informational campaign to assure consumers, insurers and providers understand the tools available.


WE’RE NOT FLOODING THE ER
“Nearly three years into implementation of the Affordable Care Act in Kentucky, emergency room use has neither decreased nor increased substantially, despite predictions that the law might have a strong impact,” The Foundation for a Health Kentucky reported this spring, using the most recently available data. “About the same proportion of Kentuckians went to the ER in 2016 as before the ACA, although the total number of ER visits increased slightly.”


WHY WE GO TO THE ER
“There was a medical emergency”: 29.1 percent
 “Other medical facilities were not open at the time”” 28.7 percent
 “Directed to go there by my doctor”: 7.1 percent
 “I don’t have a regular doctor”: 3 percent
 “It was close”: 2.9 percent
 “I was taken there by the ambulance”: 2.6 percent


TOP 3 EMERGENCY ROOM HEALTH ISSUES
According to Ron Waldridge II, MD, physician executive at KentuckyOne Health Medical Group (and chief medical officer at Jewish Hospital), the three most frequent causes of the visits are:
Respiratory issues (asthma exacerbation, COPD)
Pain phenomena (back pain, abdominal pain)
Cardiovascular (chest pain, elevated BP, stroke)


QUALITY OF LIFE
According to the County Health Rankings by the Robert Wood Johnson Foundation, Jefferson County ranks 28th out of Kentucky’s 120 counties in terms of healthcare provided. (Oldham County is first, Breathitt County is last.) Some of the foundation’s county-related findings regarding Jefferson County’s quality-of-life issues:
18.8 percent of adult respondents reported their health as “fair or poor” (compared to 21 percent for Kentucky and 12 percent in best US counties.)
3.9 is the average “poor physical health days” reported in the previous 30 days (the statewide average was 4.7)
3.9 is the average number of “poor mental health days” reported in the previous 30 days
(the statewide average was 4.4)


WATCHING OUR WEIGHT
(from Foundation for a Healthy Kentucky)
34.2 percent of adults diagnosed with prevalence toward obesity
30.1 percent five years ago
29.8 percent national average
45th out of 50 – Kentucky ranking
18.5 percent of high school students diagnosed with prevalence toward obesity
16.5 percent five years ago
13.9 percent national average
40th out of 43 – Kentucky ranking
 

Obesity rates for Louisville/Jefferson County Metropolitan Statistical Area, from Baptist Healthcare:
Obese (Body Mass Index over 30.0): 33.6 percent
Overweight (BMI, 25 – 29.9):  33.7 percent
Normal weight (BMI, 18.5 – 24.9): 30.1 percent
Underweight (BMI, 12 – 18.4): 2.5 percent


THE DRUG EPIDEMIC
29.9 out of 100,000 deaths in Kentucky from drug overdoses
24.2 per 100,000 five years ago
16.3 per 100,000 national average
Kentucky is 48th out of 50 states
5.4 per 100,000 alcohol and drug related deaths in Louisville  
21 in the downtown-Old Louisville-university area
14 in the Portland neighborhood


BEHIND THE NUMBERS
Here’s what Ron Waldridge, II, MD, physician executive, KentuckyOne Health Medical Group; chief medical officer, Jewish Hospital had to say about our health rankings.
Why does Jefferson County, with all its resources, rank 28th out of 120 Kentucky counties in its health ranking?
Because, as with most urban areas, Jefferson County also has the most negative contributors to good health: air pollution, transportation problems, socioeconomic factors, violent crime.

Is crime a health issue?
It can be. Research has shown that children with traumatic life experiences are more susceptible, later on, to mental health issues and also to physical health issues as adults. Somebody with a violent childhood experience has two or three times the expected rate of hypertension, heart disease and diabetes.
In fact, when you look at quality of life and healthy living, 15-20 percent is related to medical care; and 80-85 percent is related to other social determinants.

Any areas where we’re really falling behind?
The opioid abuse problem is staggering. Kentucky is at the top of list in terms of numbers of overdoses being brought into the Emergency Room.

Any areas where we’re making actually making progress?
We’re having better outcomes with cancer, through early detection and better treatments that we didn’t have 15 years ago. At KentuckyOne, we have a lung cancer screening program for people with risk factors (say, those who’ve smoked two packs a day for 40 years). We’ve detected one cancer detected in every 90 patients screened.
In general, we’re getting the message out to get regular physical exams, have your blood pressure checked, and check cholesterol and blood sugar. I’d rather you come in and check your cholesterol and blood sugar, and treat that issue, rather than having to meet you in the ER having chest pains.
We’ll have a healthier population if we can provide proactive preventive care.

 


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