School nurses in Fayette cut as public-health dollars shrink

Takirah Sleet, 7, and school nurse Michelle Marra assess her
lunch to manage Takirah's diabetes. (H-L photo by Pablo Alcala)

As public health and education dollars shrink, school nurses are caught in the middle. The Lexington-Fayette County Health Department is among those scaling back its school-nurse program due to cuts, even as "more students with greater medical needs are appearing in classrooms," reports Mary Meehan for the Lexington Herald-Leader.

The cuts and the need present a difficult scenario: "In order to be educated, a student has to be healthy. How do you make that happen?" asked Mary Burch, president of the Kentucky School Nurse Association.

Schools nurses are not mandated in Kentucky, and the way school districts address the issue varies widely. Some districts use a nurse consultant to train school staff. The National Association of School Nurses recommends one school nurse for every 750 students. With 40,000 students, Fayette County falls short of meeting that level of care. The Fayette County school board helps to increase funding to keep nurses in place. About $600,000 would need to be reallocated. (Read more)

HPV-linked cancers on rise, more prevalent in Kentucky

The human papillomavirus, which is generally blamed for causing cervical cancer, is being linked to the formation of several other kinds of cancer, and Kentuckians are getting these diseases in unusually high numbers, reports Laura Ungar of The Courier-Journal.

HPV is being linked to cancers of the vagina, vulva, penis, anus and lung, as well as the head and neck. "It's turning out to be a pretty bad actor ... an extensive health problem," said Dr. Daniel Metzinger, a gynecological oncologist with University of Louisville Physicians.

Kentucky's rates for HPV-related cancer are among the highest in the country. Part of the reason may be that smoking is a risk factor and Kentucky has the nation's highest smoking rate, Ungar reports. "I'm seeing more of it for sure," said Metzinger. "It used to be a disease we'd see in older people. Now, we see it in younger and younger people."

One way to protect against the virus is to be immunized with the HPV vaccine. A federal committee recommends vaccinating 11- and 12-year-old girls through to women up to age 26. Boys and men should also be immunized from age 11 to age 21. The immunization must occur before the patient is sexually active, since HPV is sexually transmitted.

In 2010, just 49 percent of adolescent girls nationwide received at least the first of the vaccine's three doses, and only a third had gotten all three, which are required for full effectiveness. In Kentucky that year, only 25 percent of adolescent females had gotten the first dose, and fewer than 11 percent have received all three doses, according to Cervical Cancer-Free Kentucky.

National Cancer Institute numbers show more than half of sexually active people are infected with HPV at some point. Usually, it goes away on its own within a few years. "But it can also set the stage for cancer," Ungar reports. "Across the nation, about 26,000 new cancers attributed to HPV occur each year, with 18,000 in women and 8,000 in men." (Read more)

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)

HBO's 'Weight of the Nation' examines the obesity epidemic

A compelling four-part documentary delving into the obesity epidemic sweeping the country is being aired on HBO and can be watched free by clicking here. A reporter wanting to write a series of stories on the issue would find "weight of the Nation" a good reference.

The program is divided into four parts. The first segment, "Consequences," looks at the scope of the epidemic and the ramifications of being overweight or obese. "Choices" looks at the science behind how to lose weight, how to maintain weight loss and prevent weight gain. The third part, "Children in Crisis," looks at how the problem is affecting American children, exploring the decline of physical activity, school lunch, the demise of school recess and how marketing of unhealthy food targets children. The final segment, "Challenges," looks at the major forces driving obesity, including agriculture, economics, evolutionary biology, food marketing, racial and socioeconomic disparities, physical inactivity, American food culture, and the influence of the food and beverage industries.

The documentary is on a detailed website that answers questions that range from "What is obesity?" to "How do I know if I'm overweight or obese?"

The project is a presentation of HBO and the Institute of Medicine in association with the Centers for Disease Control and Prevention and the National Institutes of Health, with support from the Michael and Susan Dell Foundation and health insurer Kaiser Permanente.