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The Health of Kentucky

The Health of Kentucky. Emery A. Wilson, MD October 7, 2009. University of Kentucky College of Medicine Ambassadors. Good Health. Get lots of exercise, walking is good. Get lots of fresh air. Drink clean water. Don’t eat too much or too little. Avoid red meat.

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The Health of Kentucky

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  1. The Health of Kentucky Emery A. Wilson, MD October 7, 2009 University of Kentucky College of Medicine Ambassadors

  2. Good Health • Get lots of exercise, walking is good. • Get lots of fresh air. • Drink clean water. • Don’t eat too much or too little. • Avoid red meat. • Above all avoid quarrelsome people for they induce stress and that is the worst thing for your health. Hippocrates of Chios 470 BC - 410 BC

  3. The Health of Kentucky:A County Assessment Kentucky Institute of Medicine™ www.kyiom.org www.healthyky.org

  4. Kentucky Institute of Medicine • Mission: To Improve the health of the people of Kentucky • Using unbiased, evidence based advice • Sponsor task force research, data gathering, consensus building • Membership is based on professional achievement and integrity • Collaboration with established state and national organizations

  5. Kentucky Counties with Greatest Opiate* Use Clients in Treatment, 2005 Boone Campbell Kenton Bracken Gallatin Grant Mason Carroll Pendleton Greenup Rober- tson Trimble Lewis Owen Harrison Boyd Henry Fleming Carter Oldham Nicholas Scott Franklin Bourbon Rowan Shelby Bath Elliott Jefferson Lawrence Mont-gomery Fayette Anderson Woodford Spencer Clark Menifee Morgan Bullitt Johnson Meade Jessa-mine Powell Martin Mercer Wolfe Nelson Wash- ington Wolfe Magoffin Hancock Henderson Breckinridge Madison Estill Floyd Lee Daviess Hardin Boyle Garrard Lee Breathitt Union Breathitt Pike Marion Owsley McLean Larue Lincoln Owsley Webster Knott Ohio Grayson Rock-castle Jackson Knott Perry Perry Taylor Casey Hart Clay Crittenden Green Letcher Hopkins Letcher Edmonson Leslie Livingston Muhlenburg Butler Pulaski Laurel Leslie Caldwell Adair Ballard McCracken Warren Barren Russell Knox Metcalfe Lyon Harlan Christian Logan Marshall Todd Cumb-erland Wayne Whitley Bell McCreary Carlisle Trigg Allen Clinton Graves Simpson Monroe Calloway Hickman Fulton *Opiates are mostly prescription drugs University of Kentucky Center for Drug and Alcohol Research

  6. “We have rats that die of too much of something, and we have rats that die of too little of something. What we need are healthier rats.”Lou Holts

  7. Ranking the Health of Kentucky’s Counties

  8. Median Health Ranking of Kentucky’s Counties by Rural-Urban Continuum Codes

  9. County Health Profile

  10. Health Inputs and Outcomes

  11. What Can We Do? • Establish Commissions on Macroeconomics and Health • Assess the health of Kentucky locally • Expand use of lay health workers • Create more Community Health Centers • Reallocate current health care dollars to universal coverage (U.S. or Kentucky) • Engage health science students in preventive medicine activities

  12. Current Cigarette UseAmong Kentucky Students Source: Kentucky Youth Tobacco Survey 2001

  13. Kentucky Comprehensive Statewide Physician Workforce Study

  14. 13,618 licensed 8,981 active in Ky. 24% female Race 86% Caucasian 10% Asian 2% Afr. American 1.5% Hispanic Age - 51 M, 44 F 17% in 2 counties 4% in 3 or more MD/Pop. ratio 214 National ratio 268 Ky. ranked 32nd 2.4% annual growth in licensees Current Kentucky Physician Workforce Kentucky Medical Licensure Board, 2007

  15. Kentucky’s Physician Maldistribution 43% of Kentucky’s population lives in rural areas 28% of physicians practice in rural areas Rural Urban MD (96.1%) 28% 72% DO (3.9%) 44% 56% IMG (22.0%) 36% 64% FM 56% 44% Av. Hours Worked 48 46 Male 48.3 47.0 Female 47.4 42.8

  16. Methods for Projecting Physician Supply, Need and Demand 200720072020 Supply Ky.12,846(43%) Physician U.S. Need Supply Supply13,422(49%) 8,981 11,279 (26%) Demand 14,989(66%)

  17. Prim. Care 48-60% FM 30-41% IM 73-92% Ped 37-51% Anes 49-76% Cardiol (-1)-36% EM (-2)-8% Gen Surg 62-132% Ob/Gyn 50-60% Ophth 21-81% Ortho 30-86% Radiol 39-91% Path 28-75% Psych 63-108% Urol 7-58% 2020 Projections for Specialties

  18. Recommendations • Strategies to increase physicians • Increase medical/osteopathic class size • Develop regional clinical campuses • Increase residency programs • Provide incentives for physicians to practice in underserved areas • Support expansion of NHSC • Improve medical liability environment • Inform part time/retired physicians about practice opportunies (Fed. Tort Claims Act)

  19. Recommendations • Strategies to address maldistribution • Select more students from rural areas • Educate more students in rural areas • Provide debt relief • Establish rural training curriculum tracks • Develop more community health centers • Promote higher physician reimbursement in shortage areas

  20. I can predict anything but the future.Woody Allen

  21. Supporting a Healthier Kentucky

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