Herald-Leader reporter wins Nieman fellowship to study at Harvard; her goal is to help other papers cover Obamacare

Photo by Pablo Alcala,
Lexington Herald-Leader

Mary Meehan, a reporter for the Lexington Herald-Leader, has been selected for the 2016 class of Nieman fellows at Harvard University.
She is one of 24 journalists chosen for this prestigious honor and will begin her year of study at Harvard in September.

"I am going to Harvard to study for nine months. I hope to learn things I didn't know I yearn to learn, learn about healthcare and the massive social experiment underway." Meehan said in her shared blog, Menopausal Moms of Kentucky. "I also hope to learn something that can help in some small way to keep the newspaper industry upright."

Meehan has been with the Herald-Leader for 15 years, but began her career as a journalist 34 years ago as a columnist for The Voice of St. Mathews in Louisville at the age of 16. Before returning to Kentucky, she worked for the Tribune Newspapers in Phoenix, AZ, The Orlando Sentinel in Florida, and also as a freelance journalist in Florida.

She said that her "life changing" experience as a Blue Cross Blue Shield of Massachusetts Foundation Health Coverage Fellow last year is what prompted her to apply for the fellowship. She said she returned from the first fellowship energized to write about health, and has written "as many stories as I could" with information from that experience.

Still, she said, "I just came across stories that I couldn't get to, that were too complicated because I didn't have a good, deep foundation of health-care reform and the complex issues involving how people access health care, or what makes them seek it out even if they have insurance, and so that prompted me to file an application for the Nieman fellowship."

Meehan said that she made it clear on her application that she is not a full-time health journalist and that during any given week she has covered "a tractor parade, monster trucks and Salem the wonder cat." But she also said that while covering health, she has found that the Patient Protection and Affordable Care Act has accountability measures that apply everywhere, but are "very difficult to digest on the fly."

Each Nieman fellow proposes a study project. Meehan plans to examine the impact of the law and barriers to sustained health improvement among the previously uninsured.

"My goal is to help mid-size and small papers cover the Affordable Care Act in a meaningful way," she said. "The other part is highlighting positive things that are happening in communities, with a critical eye. Looking at not only what works, but also the challenges."

Meehan said being selected for the top fellowship in journalism hasn't really "soaked in yet," but she anticipates, based on previous fellows' comments, that she will discover "something that is amazing" that can't be predicted yet.

She said she is looking forward to working with the other fellows, half of whom will come from all over the world, and going back to college.

"I am a 50-year-old woman with white hair; I just love the visual of me sitting in a Harvard class," she said with pure joy in her voice. She earned her bachelor's degree at Western Kentucky University where she majored in political science and journalism.

In addition to taking classes, fellows attend Nieman seminars, workshops and master classes and work closely with Harvard scholars and other leading thinkers in the Cambridge, Mass., area.

The Nieman Foundation for Journalism has educated more than 1,400 accomplished journalists from 93 countries since 1938.

Kentucky's suicide rate is above the national average; experts say we need to ignore the stigma and become educated about it

Kentucky's suicide rate is higher than the national average, and an expert says we must create an open dialogue about it and provide more education if we want this rate to decrease, Kat Russell reports for The Paducah Sun.

"People commit suicide when they see no way out from whatever the situation is," Dr. Laurie Ballew, medical director at Paducah's Lourdes Behavioral Health Institute, told Russell. "Usually people feel hopeless, they see no light at the end of the tunnel, and that hopelessness is a key factor in someone following through with the act of killing themselves."

Russell did an in-depth look at suicide in McCracken County, where the newspaper and its owner, Paxton Media Group, are based. "McCracken County is ranked 13th in the state as far as suicide, so if you take into consideration all of the (120) counties in Kentucky, we're pretty high," Ballew said. Click here to find out where your county ranks.

Kentucky has 15.5 suicides per 100,000 people, compared to 12.5 nationwide. It is the 10th leading cause of death in Kentucky and the second leading cause of death in people 15 to 34, according to the according to the federal Centers for Disease Control and Prevention, Russell reports.

McCracken County Sheriff Jon Hayden told Russell that his department investigated 31 suicides in each of the last two years and five so far this year. The Paducah Police Department reported 31 suicides in 2013 and 35 in 2014, and six suicides this year. The local 911 dispatch center told Russell that it had fielded more than 540 calls threatening suicide and more than 130 attempted suicides since Jan. 1, 2013.

"We get calls multiple times per week, threatening suicide either with medication or a weapon of some sort," Hayden said, noting that most of the calls do not result in suicide and the individual usually gets the help they need.

WebMD lists these warning signs of suicide, which are especially concerning if a person has attempted suicide in the past:

• Always talking or thinking about death
• Clinical depression that gets worse
• Having a "death wish," tempting fate by taking risks that could lead to death.
• Losing interest in things one used to care about
• Making comments about being hopeless, helpless, or worthless
• Putting affairs in order, tying up loose ends, changing a will
• Saying things like "it would be better if I wasn't here" or "I want out"
• Sudden, unexpected switch from being very sad to being very calm or appearing to be happy
• Talking about suicide or killing one's self
• Visiting or calling people to say goodbye

Drug and alcohol abuse also can be factors, Ballew told Russell. "What do those things do? They decrease our inhibition, they decrease our filter that tells us 'Oh no, you don't want to do that.'"

Ballew told Russell if a person's behavior changes are milder, "sometimes showing that person support and compassion can alleviate some of his or her suffering and encourage them to get help," but it is important to seek medical attention for "severe cases."

"If you have an individual who just gets more and more depressed, who won't get out of bed or gets to the point where they can't get out of bed, then you (should) call an ambulance or get them to a hospital and have them admitted," Ballew said, stressing the importance of education and open discussion.

"Emotional illness can hit anybody," she told Russell. "We're all humans. ... Anybody can feel hopeless or helpless at any time. If we could reduce the stigma that is attached to depression and mental illness and suicide, then I think people who are suffering might see that maybe there is some hope. But the only way to prevent something is to be educated about it."

Burgin, in heart of Kentucky, is state's 40th school district to go tobacco-free; ban, won by students, applies to vapor products

Burgin Independent Schools, in the heart of Kentucky, will be the latest 100 percent tobacco-free schools in the state, and the first in Mercer County, which has a strong tobacco heritage.

The Burgin Board of Education voted April 8 to ban all tobacco use, including vapor products, on school grounds and during school-related student trips, Robert Moore reports for The Harrodsburg Herald. The policy becomes effective July 1 and includes any building or vehicle owned or operated by the board and applies to any renters of school property.

Burgin will be the 40th Kentucky school district to become fully tobacco-free. Kentucky has 173 public- school districts, with 1,233 public schools, according to the state Department of Education.

The Kentucky 100 percent Tobacco-Free Schools website says, "Studies show that schools with 100 percent tobacco-free school policies for three years of more have 40 percent fewer smokers than those in non-tobacco free school districts." The 2013 Kentucky Youth Risk Behavior Survey found that 18 percent of Kentucky youth smoke, and 47 percent of them have smoked at least once.

"I’m really proud we’re going to be a tobacco free campus," board member Priscilla Harris told the Herald after the meeting. "We want to set a good example." The independently owned weekly newspaper recently did a three-part series on tobacco in the county, including Burgin students' efforts to get tobacco banned.

Kentucky 100 percent Tobacco Free Schools map, with Burgin added

Fate of rural hospitals rests in the hands of community members, writes publisher of weekly Crittenden Press in Marion

Just like country grocery stores in rural areas often have to close because community members drive past them to chain stores to save a few cents, rural hospitals will also suffer and eventually disappear if citizens do not use them, Publisher Chris Evans writes for The Crittenden Press in Marion.

When Evans was growing up in northwest Tennessee, his grandparents had to close their grocery store, which had been the center of the community, because too many people chose to purchase their food and other items from the new Walmart eight miles down the road. "Our rural hospitals are headed down the same path of extinction unless we recognize and reverse the trend," Evans writes.

Charlie Hunt, volunteer chairman of Crittenden Health Systems, which owns the local hospital, told Evans, "The only way for rural hospitals to survive is through community support."

In Kentucky, one-quarter of the 66 rural hospitals are in danger of closing, according to state Auditor Adam Edelen. In general, "Country hospitals do not have a good record for making money or breaking even, for that matter," Evans writes in a front-page column for the weekly he and his wife own.

Based on the results of Obamacare, Evans opines, it appears that America is moving toward a single-payer health care system like Canada's. Then instead of the government paying for 85 percent of Crittenden Hospital's services, it will pay for 100 percent. "When that happens, hospitals will have to play solely by government rules or get completely out of the game," Evans writes. Most of the 50 rural hospitals that have been shuttered in the past few years have been in the rural South.

"Hunt, who chairs the board, said that approximately 10 percent of the future of this hospital rests in the hands of its leaders. The other 90 percent falls squarely on the shoulders of this community," Evans writes. The column is not online, but PDFs of the pages on which it appears are posted here.

Harrodsburg Herald, a weekly newspaper, does three-part series on tobacco issues in Mercer County and statewide

In a state where more than one of every four adults smoke, tobacco is an issue in every county, but it's rare for weekly newspapers to take a detailed look at the issue. The Harrodsburg Herald did that recently, in a three-part series by Robert Moore.

Moore explored why Mercer County and the state have relatively little money for tobacco prevention, writing, "Kentucky doesn't seem all that interested in fighting tobacco. In 2014 the state will receive $158.7 million in tobacco settlement money and spend only $2.5 million to help smokers quit and prevent kids from starting, according to the Kentucky Center for Smoke-free Policy."

The states' lawsuit against cigarette manufacturers, and the Master Settlement Agreement that followed, was ostensibly to recover their costs for treating illnesses due to smoking. However, most of the money has gone to general purposes, and in Kentucky half the money was dedicated to improving the agricultural economy — but the legislature steered some of that money elsewhere, mainly for rural water lines, Moore noted.

"The largest single use of tobacco funds now is debt service," he wrote. "Every year, $28 million of the MSA payment goes to pay interest on $434,883,200 in outstanding municipal bonds. The bonds financed various construction projects over the last decade—$20 million for construction of the UK Veterinary Diagnostic Center in Lexington and $2 million for renovations to the FFA Leadership Training Center in Hardinsburg, both in 2008."

Another story explored the growing phenomenon of electronic cigarettes, and the other looked at efforts to curb smoking, statewide and locally. Moore looked at lobbying and campaign-finance reports from Altria Group, the leading cigarette manufacturer, and wrote about efforts by the Burgin High School chapter of Teens Against Tobacco Use to have smoking banned on their campus.

In a more recent story, Moore updated the Burgin issue, concluding, "Until something changes in the state legislature, schools like Burgin will be the most important battlegrounds in the fight against tobacco-related deaths."

At least 14 counties had vaccination rates in 2011-12 below level experts say is needed to protect kindergartners from measles

As concern about the spread of measles from lack of vaccination grows, many Kentucky counties probably have vaccination rates below the minimum that experts say is needed to create "herd immunity" and prevent spread of the highly contagious disease among students in kindergarten.

At least 14 Kentucky counties had measles vaccination rates below 90 percent in the 2011-12 school year, according to state data analyzed by USA Today, in a survey of states that track vaccination rates and make them public. The Courier-Journal published the Kentucky figures in an online database.

The counties under 90 percent were Bath (89%), Boyle (83%), Bullitt (88%), Christian (89%), Harlan (88%), Jefferson (86%), Laurel (85%), Lawrence (88%), Lee (80%), Nelson (82%), Robertson (88%), Rowan (86%), Taylor (82%) and Webster (86%). Data from several counties was not available. For the database with county-by-county figures, click here.

The statewide vaccination rate was 93 percent, pulled down by a rate of 86 percent in Jefferson County, the state's most populous. The lowest rates were 80 percent in Lee County and 82 percent in Nelson and Taylor counties.

Jefferson County officials told The Courier-Journal that the county's rate rose above 90 percent in the last two to three years. Bullitt County school-health coordinator Lesa Bodine told the Louisville newspaper that her data show 94.3 percent of the county's kindergarten students "have been properly immunized," The C-J's Darla Carter reports. "However, she said there are some parents who choose not to immunize their children. She also noted that there can be a delay in receiving proof of vaccination because a child has, for example, transferred from another county or state."

Like many states, Kentucky allows parents to exempt their children from required vaccinations for medical or religious reasons. Measles outbreaks in other states have been blamed at least partly on parents who still believe discredited reports that vaccines cause autism or other disorders. Generally, the stricter the laws, the higher the vaccination rate, Stateline reports. Here's a Stateline map showing how states differ:

Are nutrition rules for schools and day-care centers too much regulation, or steps in the right direction, toward better health?

Commentary by Melissa Patrick
Kentucky Health News

The Paducah Sun's editorial on Jan. 20 said the Obama administration has overstepped its bounds by expecting child day-care centers to follow stricter nutrition standards. The newspaper also called for relaxation of the requirements of the 2010 Healthy, Hunger-Free Kids Act, as Republicans hope to to when the law comes up for reauthorization this year. (The editorial is behind a paywall.)

The editorial does what any good editorial should do: stirs up a bit of controversy and makes you think a bit harder. Do you agree with the editorial's views that these nutrition standards impose "too much regulation," or are you thinking,"We have to try something to combat obesity and the best place to change health behaviors is with children?"

What most everyone probably agrees on is that we have a problem: too many fat, unhealthy children who will become fat, unhealthy adults, perpetuating a chronic health epidemic that is sweeping across Kentucky and the nation. "The heaviest children are getting even heavier" and "overweight or obese preschoolers are five times more likely than normal-weight children to be overweight or obese as adults," says the Obesity Society website.

Nationwide, one in five children is overweight and more than one in three adults are obese, according to the Centers for Disease Control and Prevention. Kentucky leads the nation in both adult and child obesity, ranking fifth for adult obesity; first for high-school obesity; eighth in obesity of 10- to 17-year-olds; and sixth in obesity among 2- to 4-year-olds in low-income families, according to the States of Obesity report. These statistics don't even include the number of adults or children who are simply "overweight."

The World Health Organization says chronic disease is the leading killer in our world, with two-thirds of all deaths worldwide a result of conditions such as heart disease, cancer, diabetes and respiratory infections in 2012. Kentucky, once again, leads the way in each of these conditions.

Kentucky ranks eighth in the nation for heart-disease deaths; 17th for diabetes; fifth for high blood pressure; and first for smoking, lung cancer and lung cancer deaths.

The editorial says, "The food police are on the march again." Is it too much regulation, or could these "police" represent a concerned government trying to solve a major health-crisis that is only getting worse?

In making the day-care proposal, Agricuture Undersecretary Kevin Concannon wrote, "Providing children access to nutritious food early in life helps instill healthy habits that can serve as a foundation for a lifetime of healthy choices.”

The Department of Agriculture proposal calls for new nutritional guidelines for child and adult day-care programs, after-school programs and people who live in shelters that are part of USDA's Child and Adult Day Care Food Programs.

The guidelines would follow the Healthy, Hunger-Free Kids Act guidelines followed in schools, which require more fruits and vegetables, more whole grains, less fat and sugar, and limit calories according to age.

What seems to aggravate Sun Editor Jim Paxton the most are the proposal's suggestions to ban on-site frying and the qualification of tofu, a soybean curd, as a meat alternative. It said that while the program was originally set up to combat malnutrition, it now has decided "a little starvation is not a bad thing; ergo, tofu instead of fried chicken."

The editorial suggests that day-care facilities could no longer have french fries or fried chicken, but it fails to mention that both items could be offered with a more healthful preparation in the oven. And tofu, a cheap, low-fat protein source, would be added as an option, not a requirement.

The recommended way to lose weight is to decrease calories, eat healthful foods, and increase activity. The nutritional requirements suggested in this program include two of these efforts.

The editorial reminds us that some students are "turning up their noses at the new offerings," that "student participation in school meal programs is down," and says pre-school programs are concerned that the same thing will happen to them.

However, schools say they are tweaking their menus to find healthful foods that the kids like and purchase newer whole grain products that don't taste any different than the processed grains the kids are used to.

So, is it too much regulation or a new way to improve the health of children that will take time and tweaks to perfect?

The editorial says the Sun supports nutrition education and healthy choices on the school menu, but that the "primary responsibility for combating childhood obesity lies with parents and the rules they set in the home."

But what the editor fails to consider is that one out of three adults, many whom are parents, are obese, and are the ones responsible for teaching these lessons.

Too much regulation or a step in the right direction? You decide.

Weekly paper in Carter County runs voluntary-response survey about statewide smoking ban, finds slim majority in favor

Wikipedia map: Carter County

The Journal-Times, the weekly newspaper in Carter County, is running an online "poll" of reader opinions about the proposed statewide smoking ban and finding a slim majority in favor of it. At 4:20 p.m. Sunday, 52.3 percent of the voluntary respondents said they favored the legislation, while 45.4 percent said they opposed it and 2.3 percent said they didn't care.

Despite those numbers, reporter Leeann Akers writes that the idea "seems to be unpopular in Carter County," based on "overwhelming opinion on social media." She cites the Facebook page of the Carter County Citizens For a Better Way and this post from Brandon Boggs: “If a business wants to prohibit smoking they have that right, however, we have the right to support that business or not depending on our personal preferences.”

Some posters on the page favor the ban. Travis Horton wrote: "I as a nonsmoker think people that smoke in restaurants or in businesses are showing disrespect for people with health issues and other things."

A continuing national survey by the federal Centers for Disease Control has found that between 31 and 46 percent of Carter County residents smoke, with the most likely number being 38 percent, well above the statewide figure of 29 percent in the same survey.

Akers reports that the county's two state legislators, "Sen. Robin Webb and Rep. Jill York, both say they remain undecided on how they will vote if it comes to the floor but both have a history of following their voters." She gives the legislators' email addresses and the telephone number to leave a message for them.

"This is the sort of story that most local newspapers with websites can do," said Al Cross, director of the Institute for Rural Journalism and Community Issues, publisher of Kentucky Health News. "But I suggest that they avoid calling any voluntary-response survey a poll, because that word implies that the results are from a scientific, random sample, and that they remind readers of that in giving the results."

'This kind of sloppy defiance reeks of a Podunk attitude,' Hopkinsville paper says after fair doesn't enforce smoking ban

It's been a while since we read an editorial as clear, blunt and well-taken as the one the Kentucky New Era ran about the flouting of Hopkinsville's smoking ban at the Western Kentucky State Fair, so here it is, in its entirety:

The Hopkinsville ordinance that bans smoking at most indoor public places is not enforced at the Western Kentucky State Fairgrounds convention center. That became clear last week during the fair. Despite assurances from the fair board’s leadership that smoking ban violations would be addressed, at least a few people continued to smoke cigarettes throughout fair week inside the convention center.

This is a shame on so many counts.

First, it makes a joke of the smoking ban that is intended to ensure the city’s indoor public places are healthier for everyone, especially for children and for adults who don’t smoke and don’t want to be exposed to secondhand smoke. If the fair board cannot get in line with a smoking ordinance 18 months after it went into effect, why should any store, office or restaurant in the city that’s opposed to the ban go along with it?

Second, by refusing to enforce the ban, the fair board is ignoring the fact that hundreds of people who do not smoke and do not want to be exposed to secondhand smoke will now see the convention center as one of the most undesirable places in the city. It seems to say something about the fair board’s opinion of the building. Is it that negative?

Third, the smoking violations put the fair board in conflict with the no-smoking signs the board itself must have authorized for the building’s front and rear doors. What was the purpose of the signs? It looks like window dressing to anyone who passes the threshold and then finds someone smoking in the middle of the building in the middle of the day.

Fourth, the smoking violations put the fair board in conflict with city government. The convention center and the fairgrounds are inside city limits. The smoking ban applies to the convention center. The building is not an island or a special place set off to itself.

During fair week, the convention center is one of the most public places in the city. Thousands of people, including children, pass through the building for pageants, talent shows and gardening and home goods competitions.

The fair board ought to play by the rules and respect the process that resulted in Hopkinsville City Council’s approval of the smoking ban.

If the fair board won’t obey the ordinance, city officials need to enforce the ban. If they don’t, they will risk having more people behave as if the law does not apply to them.

This kind of sloppy defiance reeks of a Podunk attitude.

That’s not the reputation Hopkinsville wants or deserves.