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)

Will birth-control mandate cost more or less? Yet to be seen

Will requiring insurance companies to provide contraception be cost-neutral, as the Obama administration claims? It is unclear, and so is whether insurance companies will make Catholic institutions pay more. These were the findings of FactCheck.org, a nonpartisan, nonprofit, consumer-advocate project funded by the Annenberg Public Policy Center of the University of Pennsylvania.

In support of its claim, the administration cites data from Hawaii's birth-control mandate, which shows health insurance premiums "did not appear" to increase. The study also found the number of pregnancies increased after contraception coverage was required.

But when Pennsylvania considered imposing a similar mandate, a state agency found "the amount of possible savings relative to the cost of the legislation is unclear." Findings were also unclear in Connecticut when officials there looked at whether or not insurance plans saved enough because there were fewer pregnancies to offset the cost of providing coverage. A Texas study found insurance companies would not save enough because women would buy contraception on their own.

A recent survey of 15 insurance companies found six thought costs would increase and another three felt the move would be neutral in cost. None felt they would save money because of the mandate.

"Until better data are available, we're unable to conclude whether the Obama birth-control mandate is likely to result in a net cost increase or not," FactCheck reports.

ER at Louisville's University Hospital says it is pushed to brink; many other hospitals seeing more emergency patients

Louisville's University Hospital is straining to meet the vastly increased demand of patients coming to the emergency room. Last year, there were 58,010 visits to the ER to the facility, which is meant to act as a safety net for indigent care. That's way up from 33,058 in 2006.

"The safety net is frayed and getting ready to break completely," said Bill Wagner, executive director of Family Health Centers and ex-officio member of the Louisville Metro Board of Health. "The current situation isn't sustainable ... The system is broken and it's gonna get worse."

"The rising number of uninsured patients is a major driver" of the exploding ER volume, reports Laura Ungar of The Courier-Journal. Between 2008 and 2010, 663,000 Kentuckians — or 15.5 percent of the population — lacked health insurance. In 2010, University Hospital received almost $69 million from federal, state and local governments to pay for indigent care, but it fell short by $20 million of the actual cost.

The strain has strapped the facility for cash to make improvements such as adding beds — to deal with overflow, 12 have been installed in the facility's hallways — or upgrading technology. Recently, University tried to merge with Jewish Hospital & St. Mary's HealthCare and Catholic Health Initiatives to gain an influx of funds, but Gov. Steve Beshear blocked the move, since it would mean losing University as a public asset. University is now looking for other merger options.

Some of the increase in visits is due to the fact that fewer people are leaving the ER without being treated because of long waits. In 2009, 15 percent left for that reason, but "That's down to 1.7 percent this year, after a push to attend to patients immediately and get physicians to see them more quickly," Ungar reports.

But there's evidence there are just more patients coming to the hospital for treatment, as is the case in a program called First Care, meant for patients with less serious ailments, such as tooth abscesses. "Two-thirds or more of First Care patients are uninsured, and in recent years increased demand has led the hospitals to expand its beds from six to 13, become a 24-7 facility and hire a handful of new nurse practitioners," Ungar reports. "First Care cases, which are not included in the hospital's ER volume totals, rose from 8,353 in 2006 to 20,546 last year." Of those patients two-thirds or more were uninsured.

Other area hospitals have also seen increases in ER visits. From 2006 to 2010, visits increased from 45,377 to 49,462 at Kosair Children's Hospital; from 27,836 to 29,357 at Norton Hospital; and from 29,779 to 33,508 at Jewish Hospital. Some hospitals have seen slight declines, such as Baptist Hospital East, but that may be due in part to its retail clinics in Walmart and increased numbers of urgent-care centers. (Read more)