Annual health policy forum set Sept. 28 in Bowling Green

This year's annual Howard L. Bost Health Policy Forum "will offer new insights and opportunities from a range of civic sectors for a shared vision, policies, and actions for community health," says its lead sponsor, the Foundation for a Healthy Kentucky.

"Local, regional, and national speakers will share their knowledge and experiences in building healthy communities, with a focus on transportation and housing, education, food systems and policy, and employers and workplaces," the foundation says. "TED style" speakers will make presentations on each of the forum's four focus areas: education, food systems and policy, employer/workplace, and transportation/housing.

The forum will be held at the Sloan Convention Center in Bowling Green on Monday, Sept. 28. For the registration website, click here.

Lake Cumberland District Health Department using polls in an effort to get school boards to make campuses tobacco-free

Countywide smoking bans are unlikely to pass anytime soon in most of rural Kentucky, but more county school districts are making their campuses tobacco-free. Now a multi-county health department is trying to get rural school boards to do that, with public-opinion polls showing that county residents overwhelmingly favor the move.

Department logo has been altered to
show Clinton County in yellow.

The Lake Cumberland District Health Department conducted the poll in Clinton County, and said it found that 86.55 percent were in favor and 7.16 percent were opposed. The rest had no opinion.

Making a campus tobacco-free means that members of the public are not free to smoke at school athletic events, so the poll also asked, “Would you like to see our school become tobacco-free at all events?” The results were virtually the same: 85.3 percent answered yes and 8.7 percent answered no, even though one-fourth to one-fifth of the county's residents smoke and it has a long history of raising tobacco.

"The results are perhaps surprising to some, considering the rate of tobacco usage in the county," reports the Clinton County News. The poll of 749 residents has an error margin of plus or minus 3.6 percentage points.

The department also surveyed 100 teachers in the school system and found that 77 percent would "definitely" support making the schools 100 percent tobacco-free.

The health department presented the survey and other findings to the Clinton County Board of Education June 15, but the board took no action. The department noted that a recent survey found that 28 percent of the county's students in eighth through 12th grades had used smokeless tobacco in the previous 30 days. "That level was the highest in the Lake Cumberland District," the Clinton County News reports.

The Casey County Board of Education adopted a smoke-free policy after a poll by the health department showed 70 percent of the county's residents favored it, the Casey County News reported.

Clay County 4th and 5th graders participate in UK research of circadian rhythms and obesity, little studied in children

The University of Kentucky recently partnered with over 100 fourth and fifth grade students in two Clay County schools to study the relationship between circadian rhythms and weight in children.

Sydney Sester, a fifth grade student at Manchester Elementary School, said in a UK news release that in addition to learning more about science and helping others by contributing to research, participating in the study showed her the importance of maintaining a healthy weight and eating well.

"It made me want to be more responsible with food and be patient with what I eat and only eat when I'm hungry," she said.

The project, "Circadian Rhythm Parameters and Metabolic Syndrome Associated Factors in Young Children," also known as the Clay County Clock Study, is led by Dr. Jody Clasey, associate professor of kinesiology and health promotion, and Dr. Karyn Esser, professor of physiology.

The research team says it hopes to learn about the relationship between circadian rhythms, eating, and activity behaviors and the incidence of overweight and obesity in children.

And while the team is in the process of analyzing the data, Esser told a group at the 10th annual Center for Clinical and Translational Science conference in March that early data show 33 percent of the students in the study are considered obese, their initial blood pressure measurements are on the high end of normal, and the students are less active on weekends and nights than during the school week.

The data was gathered through electronic devices that the students wore for seven days to measure activity, heart rate and skin temperature. The students also kept a daily journal to record their sleep and eating activities each day.

Previous studies have shown that disrupting an adult's circadian rhythm is associated with increased risk for metabolic disease, which is a combination of chronic health conditions that puts a person at a higher risk of heart disease and diabetes. Similar research with children has been limited.

Esser noted that "Clay County and many of the counties in Appalachia have a much higher rate of these chronic diseases."

She also said that while it is known that light exposure affects the body clock, recent findings show that the time that we do activities, like exercising and eating, also contribute to circadian health, and that this is also likely true in children.

This research "could not only influence an individual, but school start times, activity intervention, just so many different areas from personal practice or behavioral choices to public policy, all for the metabolic or physiological good of the individual or collective body," Clasey said.

Kentucky gets an $8.1 million federal grant to help teachers, other school personnel recognize students' mental-health needs

The Kentucky Department of Education has been awarded a five-year, $8.1 million federal grant to teach school personnel how to identify mental-health issues and get students the help they need, Brenna R. Kelly reports for Kentucky Teacher.

KDE was one of 120 state and local education agencies to get an Advancing Wellness and Resilience in Education grant last fall as part of President Obama's "Now Is The Time" initiative to decrease gun violence, increase access to mental health services and increase school safety.

It is estimated that up to one out of five children living in the U.S. experience a mental disorder in a given year, according to the National Research Council and Institute of Medicine.

Gretta Hylton of KDE’s Office of Next Generation Learners believes "that both KDE and local districts will be in a better position to get students the mental health help that they need," Kelly writes.

The grant program, Kentucky AWARE, will also create social media marketing campaigns, community events to promote mental health awareness and offer training on trauma-informed care in each of the pilot districts, to be provided by the Center on Trauma and Children at the University of Kentucky.

“More people will be able to recognize and respond appropriately to mental health issues in children,” Hylton told Kelly, “and will know how to connect those individuals with services in their hometown.”

Kentucky AWARE will be piloted in Jefferson County, Fayette County and Pulaski County schools and then move statewide. Hylton told Kelly that the three districts were chosen partly because they already have some mental-health and behavioral-intervention programs.

In addition to KDE, AWARE grants were awarded to Jefferson County, Fayette County, Bullitt County, Corbin Independent, Covington Independent and Henderson County school districts and to the Northern Kentucky Cooperative for Educational Services, Kelly reports.

School personnel, first responders, parents and anyone who interacts with youth in the pilot counties will be offered Youth Mental Health First Aid training, Kelly writes. Hylton told Kelly that she expected more than 10,000 people across the state to be trained at the end of the five-year grant.

School nutritionists' lobbying group, freshly funded by grocery makers, wants more funding and flexibility with school-lunch rules

School nutrition officials want more flexibility with new school lunch rules to cut down on the waste of unwanted food, Spencer Chase reports for Agri-Pulse, a Washington newsletter. Julia Bauscher, president of the School Nutrition Association, told the House Education and Workforce Committee that the organization supports the rules, but needs more funding to enforce them  and more flexbility to serve foods students will eat. (USDA graphic)

"SNA is requesting 35 cents more in federal funding for each lunch and breakfast that is served in the school lunch program, up from the additional six cents the government provided when the new standards were put in place," Chase writes. Bauscher told the committee, “That will help school food authorities afford the foods that we must serve, but unfortunately that won't make students consume it.”

Bauscher, who said SNA wants Congress "to soften the bill's target levels for more whole grains and less sodium in school meals," said that "in many cases, the new requirements have forced school lunch programs outside of budgetary constraints, forcing them to ask school districts to make up the difference. According to SNA, school districts will absorb $1.2 billion in new food and labor costs in 2010," Agri-Pulse reports. SNA has drawn major funding from some food manufacturers.

Chase writes that 51 percent of students qualify for free or reduced lunches, the first time the number has topped 50 percent in at least 50 years.

Crittenden County Elementary School is latest school in area to restrict nuts to protect the health of those with nut allergies

This story has been updated to include information about other Western Kentucky schools with nut restrictions.

Peanut butter and jelly sandwiches are a lunchbox staple for many American children, but they can also pose a serious health risk to those with peanut and tree-nut allergies, especially in the young. The risk has prompted the Crittenden County school district to become the latest in the area to restrict the use of nuts at the Crittenden County Elementary School in Marion.

"Peanut and tree nut allergies plague an estimated 19 million Americans and the number of children with peanut allergies in the U.S. has nearly doubled in just over a decade," The Crittenden Press noted.

After researching the issue and how other schools have dealt with it, the school's parent-teacher council and wellness committee created a policy that restricts but doesn't ban nuts, the Press reports.

The policy asks everyone to be aware that nut products are dangerous to some of the students and asks them to not send those products to school, Principal Melissa Tabor told the Press. She said at least five students have proven nut allergies.

Several other Western Kentucky schools have peanut restrictions,Genevieve Postlethwait reports for The Paducah Sun, including Carlisle County and Fulton County schools, with Paducah and Hickman County schools having restricted peanuts for varying periods of time in the past. (Story is behind a pay wall.)

"We do it on a case-by-case, year-by-year basis," Penny Holt,the district's nutrition director, told Postlethwait of Paducah schools' approach to restricting peanuts and other allergens. "If a child has an allergy that is that serious, we're not going to risk it," she said, noting that they are seeing an increase in all kinds of food allergies.

Another school, Heath Elementary, has a child with an airborne peanut allergy so the school does not serve any peanut products or cook with any peanut products, Sara Jane Hedges, food services director for McCracken County schools. told Postlethwait. Students are still allowed to bring peanut butter products, but " "It's just taken care of very carefully," Hedges said.

Crittenden County Elementary school's policy does not require school personnel to check backpacks or lunchboxes for nut-containing products, but if they see children have one of these products, they ask them to sit at a designated table for that day, where they can ask a friend to join them.

The school sent home a list of nut-free snacks, including safe name brands that do not contain peanut oil, to help parents re-think what to pack in their child's lunch or to send for school snacks or for school parties.

So far, the principal said, parents have been receptive to the policy, and one parent told her that they had successfully switched to a soy butter that tastes like peanut butter because their child wants peanut-butter sandwiches for lunch.

The policy states that those with severe allergies to peanuts or nut products may be at great risk of anaphylactic shock, "an allergic reaction causing swelling, difficulty breathing, itching, unconsciousness, circulatory collapse and sometimes death," if they ingest or are exposed to these products.

"Because of the possibility of cross-contamination, a campus-wide, comprehensive avoidance of foods containing nuts was deemed to be the best solution to reduce the health risks to students with allergens," Tabor told the Press.

Crittenden County School Supt. Vince Clark told the weekly newspaper that he supports the school's policy, despite the argument that it creates a burden to parents of students who love peanut butter.

“There are valid points on each side of the issue,” he told the Press. “Ultimately, we have to support efforts to offer a safer learning environment for the children.” (Read more)

Kentucky is one of three states to get Walmart Foundation money to expand farm-to-school programs

Kentucky will use money from The Walmart Foundation to partner with the National Farm to School Network to expand efforts to get more local foods into schools.

A project called Seed Change will “jump start” programs that get local foods into schools and enhance food education for more than 1.8 million school children at 100 sites in Kentucky, Louisiana and Pennsylvania, the network said in a news release. Each site will get $5,000 grants, with applications to be accepted later this spring.

The state Department of Agriculture’s farm-to-school program connects schools with local farmers and food producers and helps students "learn to appreciate the importance of local foods and grow into well-informed consumers who demand local foods as adults," the release said. The program served an estimated 364,000 children in about 700 schools in 84 districts in the 2011-12 school year. For more information on the program, go to www.kyagr.com or contact Tina Garland at 502-382-7505 or tina.garland@ky.gov.

Casey County High School, which will be smoke-free next year, curbs smoking by locking the restrooms most used by smokers

For two weeks in February, Casey County High School students who wanted to smoke in one of the restrooms were unable to do so because they were locked, Editor Larry Rowell reports for the Casey County News. Principal Josh Blevins said he locked restrooms "most frequented by the students who chose to smoke."

In September, the Casey County School Board passed a prospective tobacco-free rule, so students and staff will not be allowed to smoke in school buildings next year. Locking the restrooms was a way of sending a message. "That was not my long-term plan," Blevins said. "I was using this as a launch pad saying it [smoking] wouldn't be tolerated."

Blevins started a policy requiring students to ask permission and use a sign-out sheet to use the bathroom during class. The restrooms located near the administrative offices are never locked. he said students have the option of reporting to class and asking to use the restroom.

At least one parent did not agree with the new rules. Ellena Hussey, whose daughter attends the school, told Rowell that the students should have bathroom access between classes. She said her daughter has received 10 tardy slips because she had to wait in line to use the only unlocked restroom. Blevins said he had not heard from any parents who had a problem with his actions.

Local building contractor Kenneth Blevins said one restroom with four stalls is enough for the 200 students who attend the school. "The building code says you have to have one facility for the first 49 people and an additional one for every 50 you have," he said.

Breathitt County High School employed another method to curb student smoking. "We open all bathrooms at break time between classes," Supt. Larry Hammond told the Casey County News. "They are locked during class, and they can go to the bathroom between classes, before school, during lunch and after school. They are supervised by teachers." Students who need to use the bathroom during class get a pass and use the restroom in the principal's office.

"It at least controls the smell of smoke in the school building," Hammond said. "You don't smell it down the hallway." (Read more)

Students in poor Louisville neighborhoods learn healthful behaviors in Farm to Family Initiative

A program to fight childhood obesity and foster healthy habits in Louisville’s under-served youth has seen positive results since its launch in October 2013, says KentuckyOne Health. Results include:

• 41 percent of students now eat at least five servings of fruits and vegetables daily, up from 23 percent.
• 91 percent of students engage in at least 60 minutes of daily physical activity, up from 63 percent.
• 90 percent of students have eaten a vegetable they harvested or picked themselves, up from 59 percent.
• 93 percent of students know how to prepare a healthy recipe, up from 63 percent.

The Farm to Family Initiative is a collaboration between the Food Literacy Project and Sts. Mary & Elizabeth Hospital, part of KentuckyOne. It aims to influence long-term health and food literacy for students at Hazelwood and Wellington elementary schools, where more than 90 percent of students qualify for free or reduced-price lunches.

The project is funded by a $200,000 grant from the Johnson & Johnson Community Health Care Program Award for the Prevention of Childhood Obesity.

Newport school board's smoking ban, which includes e-cigarettes, would be 38th among 173 Kentucky school districts

The Newport Independent Board of Education passed the first reading of a proposed smoking ban Wednesday, Jan. 28 after adding electronic cigarettes to the ban.

The ban would prohibit smoking on any school campus, including parking lots, cars and the bus garage, and no smoking will be permitted by any groups who rent or meet on any school properties.

The second reading of the ban will be in February and if passed will go into effect July 1, Patricia A. Scheyer reports for The River City News.

"I do expect that it will pass," Superintendent Kelly Middleton told Scheyer. "I haven't had anyone say anything against passing it, and in fact, I have had a couple of comments in favor of it."

If passed, the "Newport school district will be the 38th school district out of Kentucky's 173 districts to become smoke free, joining Beechwood and Dayton Independent schools locally," Scheyer reports.

Scheduling lunch after recess, very unusual in elementaries, may lead to less food waste and better nutrition, study says

Scheduling school lunch later in the day could help children to eat more nutritious foods and reduce food waste, according to a study at seven schools in Utah. Researchers found that children threw away more food when they ate lunch before recess instead of afterward, and much of the food they threw away was fruits and vegetables, Roberto A. Ferdman writes for The Washington Post.

Cornell University and Brigham Young University researchers spent 14 days studying the behavior of children during lunch. Three schools served lunch after recess, and the other four before recess. The researchers kept track of how many fruits and vegetables children discarded and how many they ate.

"Students who ate lunch after recess ate 54 percent more fruits and vegetables than those who ate it before," Ferdman reports. The number of students who ate at least one serving of fruit and vegetables was 45 percent greater at the schools that served lunch after recess than the schools who served it beforehand. This is because students are hungrier for lunch after playing, and if they have already had recess, they will not rush eating their lunch so they can go play.

"If recess is held before lunch, students come to lunch with healthy appetites and less urgency and are more likely to eat their fruits and vegetables," David Just, one of the study's authors, told Ferdman.

A 2014 study also concluded, for about the same reasons, that providing lunch before recess leads to more food waste. It is unknown how many schools currently serve lunch before recess, but in 2011, only 4.6 percent of elementary schools reported serving lunch after recess. (Read more)

Study finds students with heavy fast-food diets have test scores about 20% lower than those who don't east fast food

Eating fast food may cause lower test scores in school, says a recent study of U.S. school children.

The study, published online in the journal Clinical Pediatrics, found that "The more frequently children reported eating fast food in fifth grade, the lower their growth in reading, math and science test scores by the time they reached eighth grade," says an Ohio State University news release.

Specifically, the study found that children who ate fast food four to six times per week, or every day, had test-score gains in all three achievement areas that were about 20 percent less than those of children who did not eat any fast food in the week before the survey.

“There’s a lot of evidence that fast-food consumption is linked to childhood obesity, but the problems don’t end there,” said Kelly Purtell, lead author of the study and assistant professor of human sciences at Ohio State. “Relying too much on fast food could hurt how well children do in the classroom.”

The study included 11,740 students who were tested in reading/literacy, mathematics and science in both fifth and eighth grades. They were also given a food consumption questionnaire in fifth grade.

The researchers tried to accounted for many other reasons that might have influenced the results, including how much children exercised, how much television they watched, what other foods they ate, their family’s socioeconomic status, and characteristics of their neighborhood and school, according to the release.

While this study establishes a correlation between fast-food consumption and lower grades, it does not establish the cause of lower grades. However, Purtell said she and the other authors are "confident fast food explains some of the difference in achievement gains over time."

Other studies have suggested that it may be related to a lack of nutrients found in fast food, such as iron, and another study suggests that diets high in fat and sugar, found in most fast food, hurt immediate memory and learning processes, the news release says.

“We’re not saying that parents should never feed their children fast food, but these results suggest fast-food consumption should be limited as much as possible,” Purtell said.

Casey joins Adair and Russell as longtime tobacco counties where schools are going tobacco-free; Clinton defers action

The schools in another longtime tobacco county in Southern Kentucky are going tobacco-free. With only one member in opposition, the Casey County Board of Education recently enacted a tobacco-free school policy beginning with the 2015-16 academic year, Abigail Whitehouse reports for The Casey County News.

Jelaine Harlow, health educator for the Lake Cumberland District Health Department, presented the board with letters from community partners supporting a tobacco-free school policy, and results from surveys that showed 70 percent of school parents in the county school support a tobacco-free school policy, Whitehouse reports.

The surveys included ones given to parents and students across the school district including a ninth-grade student survey, a teacher-opinion survey, and a parent survey. It also included opinion results from attendees at a Casey County basketball game that showed overwhelming support for tobacco-free policy.

Following Harlow’s presentation, Beverly Hoskins, who taught at Casey County High School for 30 years, voiced her support for a tobacco-free campus. She said her father's tobacco crop put her through college, but "has lost the two men she loved the most to smoking, first her father and then her husband," Whitehouse writes.

Board Chairman Ken Coffman first said the issue would be decided later, but member Marilyn Coffey said, “Ken, I believe some of us are ready to vote. I think we’ve had a year to think about this and I’d like to make a motion to pass it and phase it in.” the motion carried, with only Vice Chairman John Cox opposed.  

The school board in Clinton County also heard a similar plea from the same health department, including a report that high-school sophomores' use of smokeless tobacco had increased, but took no action, the Clinton County News reports. The high-school principal noted that many school employees smoke.

The health department noted that school boards in Somerset, Adair County and Russell County had recently enacted tobacco-free policies. Since the end of the federal tobacco program in 2004, tobacco production in the area has sharply and steadily declined, leaving tobacco with little of the political support that once insulated it from government controls.

With school-board elections held this month, and not to be held for another two years, there may be more such votes in the near future.

Kentucky School Boards Association spokesman Brad Hughes said in an e-mail that as of June, 33 of the state's 173 school districts had adopted all-encompassing tobacco-free campus policies; 12 have adopted policies that only affect students and staff, with no restrictions for visitors and groups renting district facilities. Four have adopted tobacco-free policy language with exceptions, such as allowing smoking in personal vehicles or at outdoor events; and four have asked KSBA to draft tobacco-free policy language, but have not yet reported final adoption of those policies. Hughes noted that smoking by underage students is prohibited by law anywhere, including in schools, in buses and anywhere on campus.

As Ky.'s teen-birth rank rises, mother objects to Casey Co. child-development class's baby shower for five pregnant students

Kentucky's ranking for births to females aged 15 to 19 is going up, and five students at Casey County High School are pregnant. A joint baby shower for them during class time recently sent the wrong message about teenage pregnancy, a mother of a teenager at the school told the Casey County News.

Carmen Foster gained custody of her daughter three years ago, but not before the girl heard her biological mother say she enjoyed being pregnant because of all the attention she received. The biological mother left her and six other children with an abusive ex-boyfriend until Foster gained custody, Abigail Whitehouse reports.

"Some of these kids come from situations we can't even imagine," Foster said. "They need daily positive examples to help them reach their potential. I don't want my daughter thinking that being a pregnant teen will get her tons of positive attention from everyone at school."

Foster, who was a teenage mother, said she has spent years instructing her daughter that she doesn't need approval from boys to have self-confidence. "I want better for our girls," she said. "I believe in love and acceptance and helping in any way that I can, but I also believe in doing so responsibly. This was not a message to be sent out at school."

CCHS Principal Josh Blevins told the newspaper that the baby shower, in a Human and Child Development class, "was a way of saying, here are some things to help get them on their feet. We are just simply addressing the fact that this has happened, and now it's our responsibility to educate these women on how to care for their children." Blevins said the class is an elective, and participation isn't required.

Jackie Allen, who teaches the class, said the students were working through a unit on pregnancy and childbirth unit, and asked if they could throw a surprise baby shower for the five students. "I think it was a positive experience for my students and for the girls they invited," Allen said. "I think that students who are pregnant need all the support they can get. I don't think there was any kind of glorifying teen pregnancy."

Kentucky ranked seventh out of 51 (50 states and the District of Columbia) in 2011 birth rates among females 15-19, according to the U.S. Department of Health and Human Services. In 2008, the state Kentucky ranked 19th.

Kentucky schools teach nutrition with hands-on-learning

Visiting dairy cows, growing food in the air and being the first school in the state to grow its own garden on school grounds are just some of the efforts Kentucky schools are making to help their students learn more about nutrition.

Shelby County's Heritage Elementary School joined schools in 40 countries in the 15th annual World School Milk Day on Sept. 24, where they learned about the nutritional importance of milk, Ashley Wilkins reports for The Sentinel-News of Shelbyville.

The students learned from the Southeast United Dairy Industry Association in the cafeteria, which was decorated in a cow-related theme while the cafeteria employees wore cow costumes and provided milk to the students. The students also enjoyed stick-on milk mustaches and were able to pet and view calves outside on the playground.

“Lots of kids don’t have a lot of opportunities to see dairy cows up close,” SUIDA's Kathy Belcher told Wilkins.

Students in the Eastern Elementary School Wellness Club in Barren County are learning about nutrition not only in this club, but with its hydroponic tower garden, adding a second one this week, Bobbie Hayse reports for the Glasgow Daily Times.

The Wellness Club meeting was led by fourth-grade teacher Cathy Bishop, who asked the students if they had talked to their parents about what they had been learning about health. They also talked about who had met their goal of not drinking any sodas that week, and also about the importance of making healthy choices such as getting plenty of sleep, drinking plenty of water, making good food choices, exercising and limiting screen time.

“We need to try to make healthy choices, and try to take care of our bodies the best we can because this is the only body we get,” Bishop said. “The habits we start today are going to make a difference for the way our body feels a long time down the road from now."

Nutritional learning in the club is reinforced with growing plants in the tower gardens, which are vertical systems that grows food hydroponically with aeroponics, a process for growing food in an air and water environment, Hayse reports.

Jennifer Turner, a dietitian who helped the students plant seeds and build the tower garden, told Hayse, "Research shows that if kids have a hand in growing and making food, they are more likely to try it."

Beaver Dam Elementary School in Ohio County is the first school in the state to have a garden on school grounds, through donations from businesses and individuals, Lisa Autry reports for WKU Public Radio.

Kindergarten teacher Becky Gaither, who helped start the garden project, told Autry that "students learn the value of hard work by maintaining the garden and they get to enjoy the harvest." She said that the students had already made pizzas in the classroom with cherry tomatoes and herbs harvested from the garden.

Kentucky Agriculture Commissioner James Comer visited the school on Thursday to recognize the school as having the state’s first certified “Ready, Set, Grow” garden and said he hoped the "concept will expand statewide," Autry reports.

Carroll County schools will make campuses tobacco-free in 2015, even including outdoor sporting events

The schools in Carroll County, once one of Kentucky's tobacco strongholds, have begun preparing students, parents, teachers and football fans for smoke-free school campuses starting July 1, 2015.

"This ban will apply on district property at all times, in all places and to all people, including at sporting events and inside vehicles," schools spokesman Carl Roberts writes for The News-Democrat in Carrollton. "The ban also will apply to electronic cigarettes. . . . The district is making every effort to inform students, staff and community members of the transition."

That includes signs, social media, print publications, district memos, and announcements at sporting events, Roberts writes. "At sporting events throughout this school year, cards will be distributed to spectators that provide information about the tobacco-free policy. The cards also will include information on smoking/tobacco cessation classes."

Only 35 of the state's 173 school districts are tobacco-free, but some others are planning to impose bans next year, and more may after this year's school-board elections are out of the way.

Carrollton, which once had several tobacco warehouses, was visited in 1998 by then-President Bill Clinton to explain what his administration wanted to about smoking and help tobacco farmers.

Kids Count report says hard times in early childhood are more likely in Ky. than rest of U.S.; bad times have long-term effects

By Melissa Patrick
Kentucky Health News

One of every five children in Kentucky, by the time they are 5 years old, has experienced two or more adverse childhood experiences such as child abuse, economic hardship, exposure to violence, living in a household with mental illness or substance abuse, or where a family member has been incarcerated.

That is one of the major points of the 24th annual Kids Count report, released Tuesday by Kentucky Youth Advocates. The report is part of a state-by-state effort with county-by-county data; nationally, only one in eight children by age 5 have had two adverse experiences, defined as events or circumstances that can affect the quality of the child's adult life, including their health and length of life.

"The higher the total number of these events a child experiences, the higher the risk of obesity, chronic illness, substance abuse, smoking and mental health problems," the report says. Another study cited in the report found that "Children who had experienced four or more adverse events had lower incomes, lower education attainment and lost more days of work or school as adults due to problems with physical or mental health."

“We know when children experience traumatic events such as abuse and neglect or having an incarcerated parent, it negatively impacts their health and often causes barriers to success later in life. Kentucky leaders need to enact solutions to prevent these experiences in the first place and when they do happen, help children successfully recover,” Dr. Terry Brooks, executive director of Kentucky Youth Advocates, said in a press release.

This report by Kentucky Youth Advocates measures 16 indicators to determine the overall well-being of children in Kentucky counties and focuses on four areas considered critical to well-being: economic security, education, health, and family and community strength.

The Kentucky counties with the highest overall child well-being rankings are Oldham, Boone, Spencer, Woodford, and Calloway; the lowest are Martin, Owsley, Wolfe, Clay and Elliott.

Overall Child Well-Being, based on four factors:
economic security, education, health, and family and community.

The 2011-12 survey said that Kentucky children are more likely to experience two or more adverse events  (30 percent) than children are nationally (22.6 percent). The four most common adverse events among Kentucky's children, says the report, are economic hardship, living with a parent or guardian who got divorced or separated, living with anyone who had a problem with alcohol or drugs, and living with a parent or guardian who was incarcerated.

This study evaluated four indicators of health: smoking during pregnancy, low-birthweight babies, children and young adults without health insurance and teen births.  Oldham and Boone counties scored higher than the other counties on health and Elliott County ranked last.

Overall Health: County Comparisons.  Based on county
scores for the four indicators in the report.  

The study found Kentucky has the highest rate of mothers who smoke during pregnancy, one in five, compared to states with comparable data, reporting that the county rates varied widely in this area with less than 14 percent of expectant mothers in Fayette, Jefferson, and Oldham counties smoked, compared to 40 percent or more of mothers in Clay, Elliot, Lee, and Owsley counties.

The percentage of low-birthweight babies in Kentucky, often a result of smoking during pregnancy, between 1994-2012 (8.7 percent) was found to be consistently higher than the U.S. percentage (8.0 percent).

“All parents want what is best for their children, and we know that smoke is bad for kids,” Bethany Hodge, a pediatrician in Louisville, said in the release. “Kentucky needs an indoor smoke-free law so working mothers-to-be do not have to choose between their jobs and protecting their unborn babies.”

One in eight under 26 lacked health insurance in this study, but this number is expected to decline.

“Kentucky has effectively connected young people to health insurance, especially with the outreach efforts of KCHIP over the past few years and kynect over the past year,” Brooks said in the press release. “It’s important to build on those successes with innovative ways to connect all young people to coverage. One solution is to automatically enroll youth aging out of foster care in Medicaid to make sure they maintain health insurance as they leave the state’s care.”

As for teen births, in 2012, Kentucky's rate of births to teen mothers (42 per 1,000) "substantially" exceed the national rate (29 per 1000).

Many of Kentucky's children face adverse childhood experiences related to economic security.

According to the report, Kentucky has now had four consecutive years in which more than one in every four children lives in poverty, which is consistently higher than the national average. It also reports that more than two in every five Kentucky children live in a high-poverty area.

The report says, " A family's earnings and its poverty status, the level of poverty in its neighborhood and the affordability of housing can all affect how a child grows, learns and ultimately succeeds as an adult."

Boone, Oldham and Spencer counties have the highest scores for economic security, while Lee, Martin and Wolfe have the lowest.

Economic security, based on scores for the four indicators in the report.

The results of the well-being of Kentucky's children around education are concerning.

More than half (51 percent) of Kentucky's children entering kindergarten are not adequately prepared for school and more than half  (51 percent) of its fourth graders are not proficient in reading and "therefore not on the path to high school graduation," according to the report. The study also found that over half (55 percent) of Kentucky eighth graders are not proficient in math and that one in seven Kentucky high school students did not graduate on time.

Oldham and Lyon counties "stand apart" at the top of the  education county comparison, with Clinton, Knox, Menifee and Clay counties ranking last.

Education, based on scores for the four indicators in the report. 

Family and community indicators in the report found that Kentucky is not putting as many youth in jail as in previous years; nearly one in five births were to moms without a high school degree; the number of children living in a single-parent home has grown to 37 percent from 35 percent; and over the course of 2013, over 12,700 children were placed in foster care due to abuse or neglect.

Oldham, Boone, Carlisle, Ballard and Spencer counties rank at the top of the family and community county comparisons, with Powell, Clay, Elliott, Owsley and Carroll counties ranked at the bottom.

Family and Community, based on scores for the four indicators in the report. 

The report recommends implementation of strong policies to combat children's exposure to adverse childhood experiences. "The best option for Kentucky is to find ways to prevent adverse childhood experiences. Ensuring safe, stable and nurturing environments will shield children from toxic stress and its deleterious effects," says the report.

Click here for the Annie E. Casey Foundation Kids Count Data Center, which includes current and historical data. Note that the indicators included in the 2014 rankings are different than those included in the 2013 County Data Book. Therefore, current rankings should not be compared to last year’s county rankings.

Study shows students, especially those with ADHD, have improved academic performance after they exercise

Children do better in school when they aren't forced to sit still all day, especially those with attention deficit hyperactivity disorder, Gretchen Reynolds reports in The New York Times.

Recent research, published last year in The Journal of Pediatrics, suggests that even small amounts of exercise enable children to improve their focus and academic performance.

The study looked at 40 boys and girls, age 8 to 10, half of whom had ADHD. Researchers gave the students a baseline academic test and also one that tested their attention. They then gave the same tests two more times, first after they had sat and read quietly for 20 minutes and the other after they had walked briskly or jogged 20 minutes on treadmills. Brain activity was recorded as they repeated the original tests.

Little difference was found in any of the students after quietly reading, but "they all showed marked improvements in their math and reading comprehension scores after the exercise," Reynolds writes. Students with ADHD showed significant increases on their scores and had brain-wave readings that showed them better able to regulate their behavior, which helped them pay attention.

"The results should make administrators question the wisdom of cutting P.E. classes," Reynolds writes.

This information is a valuable tool for educators, especially in Kentucky, which leads the nation with 19 percent of children ages 4 to 17, compared to 11 percent nationally, who have ever been diagnosed with ADHD, according to the federal Centers for Disease Control and Prevention. The level of exercise needed to show academic and attentional improvement involves activities that can be done in the classroom throughout the day, like marching or hopping in place.

Pediatricians say middle and high schools shouldn't start class before 8:30 a.m., as a way to help sleep-deprived teenagers

The American Academy of Pediatrics recently recommended that middle and high schools not start of classes until 8:30 a.m. at the earliest.

An estimated 40 percent of high schools in the U.S. start classes before 8 a.m.; only 15 percent start at 8:30 a.m. or later. The median middle-school start time is 8 a.m., and more than 20 percent of middle schools start at 7:45 a.m. or earlier, according to the AAP release. The Kentucky Department of Education doesn't track school start times, but those are locally available.

When children become adolescents, their sleep-wake cycles begin to shift up to two hours later, meaning their bodies naturally want to go to bed and get up two hours later than before puberty hit, says the release. This makes it hard for teens to fall asleep before 11 p.m., and even more difficult to get to class by 7:30 or earlier the next day.

“The research is clear that adolescents who get enough sleep have a reduced risk of being overweight or suffering depression, are less likely to be involved in automobile accidents, and have better grades, higher standardized test scores and an overall better quality of life,” said Judith Owens, pediatrician and lead author of the AAP policy statement. “Studies have shown that delaying early school start times is one key factor that can help adolescents get the sleep they need to grow and learn.”

Pediatricians "urge middle and high schools to aim for start times that allow students to receive 8.5 to 9.5 hours of sleep a night," the group says. In most cases, that means a school start time of 8:30 a.m. or later, depending on average commuting times and other local factors.

Many studies have documented that "the average adolescent in the U.S. is "chronically sleep-deprived and pathologically sleepy." Reasons listed for this lack of sleep include homework, extracurricular activities, after-school jobs and use of technology that can keep them up late on weeknights.

And while students, parents, and all those involved need to learn about healthy sleep habits for adolescents and about the biological and environmental factors that contribute to insufficient sleep, schools should also adjust their start times, AAP said, citing studies showing that a too-early start time "is a critical contributor to chronic sleep deprivation among American adolescents."

“By advocating for later school start times for middle and high school students, the AAP is both promoting the compelling scientific evidence that supports school start time delay as an important public health measure, and providing support and encouragement to those school districts around the country contemplating that change," Owens said in the release.

Leaders in health care and education meet on child obesity and what can be done about it, and not just in the schools

By Al Cross

Kentucky Health News

Children who are physically active are likely to be better learners, but not enough Kentucky schools seem to put that knowledge into practice, speakers suggested at last week's Kentucky Summit on Childhood Obesity and Physical Activity at the University of Kentucky.

Kentucky ranks eighth in child obesity, and nationally, adult obesity is expected to grow from 30 percent of the population now to 60 percent by 2030.

"Many of the adults who will be obese in 2030 are the children in Kentucky schools today," said Dr. Mary Lynne Capilouto, the wife of UK President Eli Caiplouto. The couple hosted an opening brunch for the conference, and at one small-group session.

The conference was an unusual gathering of people from education and health care, who don't discuss common interests enough, said Terry Brooks, executive director of Kentucky Youth Advocates, which staffed the conference. "Our intent is to put together a guiding coalition . . . and make something happen in 2015-16."

That would probably include legislation, but "We can't legislate ourselves out of this problem," educator Leon Mooneyhan told the group. "We need to change the mindset of our society," with multifaceted solutions. Mooneyhan, a former superintendent in Shelby County, is CEO of the Ohio Valley Educational Cooperative, which assists school districts.

He said each district needs a strong "wellness committee" to focus on health, nutrition and physical activity and promote such measures as integrating physical activity into the classroom and not using denial of recess as punishment for misbehavior. "We really need to focus at the elementary schools," he said. "That's where it starts."

The biggest obstacle may be the educational system itself.

An example of classroom-based physical activity,
from Dr. Heather Erwin's PowerPoint presentation

Some schools are reluctant to carve out time for physical activity because of pressure to spend time preparing students for annual achievement tests, but research shows that more physical-activity time "does not appear to to adversely impact academic performance," said Heather Erwin, Ph.D., a UK specialist in kinesiology, the study of human movement.

Erwin said some schools have started intensive math instruction lasting 90 minutes, and students could benefit from two of three physical-activity breaks in such a long classroom session. She said, "So many teachers will say after implementing physical activity, why haven't we been doing this all along?"

"If your butt is numb, your brain is, too," said Jamie Sparks, director of the School Health and Physical Education Network for the state Department of Education.

Sparks said it's unfortunate that some schools are using recess as extra study time before achievement tests. Stu Silberman, executive director of the Prichard Committee for Academic Excellence, said research has shown that students do better on achievement tests on days that they have physical activity.

"There is an achievement gap related to obesity," but many teachers don't see the connection, Silberman said. When students take part practical, in-class programs like those Erwin mentioned, "it becomes a habit for the rest of their lives. . . . Frankfort's not the answer on this.

Tom Shelton, who succeeded Silberman as superintendent in Fayette County, said asking teachers "to do one more thing is almost criminal," they are so busy, but nations such as India and China emphasize physical activity, and "It's amazing to me that we're going the other way. . . . We know for a fact that healthy students are better learners."

Shelton said "Poverty is the number-one barrier to student achievement," and part of that is "lack of good food options."

The face of poverty has changed to one of obesity, said David Jones Jr., a member of the Jefferson County school board and a Louisville venture capitalist. Poor people often eat poor food and don't get enough exercise. "The problem is, we don't know how to eat. We don't know how to deal with calorie-rich environments," Jones said.

Jones was among those who said the solution to child obesity lies in the community at large, not just in its schools.

"It has to be parents and schools and the community and legislators," said Susan Zepeda, president of the Foundation for a Healthy Kentucky, which funded the conference. "This challenge is about nutrition policies, physical-activity policies and building our environment with health in mind."