National Affordability Summit Sets the Stage for Local Healthcare Affordability Event

KHC representatives at the NRHI National Affordability Summit pledge to “do my part by collaborating with others to improve health, reduce price, and eliminate waste.”

“I’ll do my part by collaborating with others to improve health, reduce price, and eliminate waste” was the pledge that purchasers, payers, providers, patients, and policymakers across the country committed to at our nation’s capital at the Network for Regional Healthcare Improvement’s (NRHI) National Affordability Summit earlier this month. Several KHC members attended the summit, including Teresa Couts, UAW/Ford and KHC; Don Lovasz, KentuckyOne Health Partners; Amanda Elder, LG&E; Emily Beauregard, Kentucky Voices for Health; Stephanie Clouser, KHC; and myself.

Dr. Stuart Altman kicked off the event; he is an economist with five decades of experience working on federal, state, private, and academic health policy. His humorous keynote kept folks engaged despite the bleak prediction of family premiums rising to 100% of the US median household income by 2033 if trends continue on this trajectory. The current average family health insurance premium is approaching $20,000 per year. He gave examples of how America can change this trend by collectively eliminating the 33% waste that is estimated in medical spending. He encouraged consumers to become more engaged and employers to better control their healthcare spending. He used Massachusetts as an example of how states should track healthcare spending as total spending to include Medicare, Medicaid, and commercial payments, not just their Medicaid spending. Since 2012, Massachusetts went from one of the highest healthcare spending states to among the lowest.

Mylia Christensen of HealthInsight, also the NRHI affordability chair, presented the amazing work that is happening across the country to reduce healthcare spending by improving health, reducing price, and eliminating waste. The KHC and KY Medicaid’s Kentucky Core Healthcare Measures set was one of the projects featured by regional healthcare improvement collaboratives as a way of eliminating administrative waste. The KHC team was proud for our work to have been featured among the dozen or so strategies featured across the nation to address healthcare affordability.

At lunch, I had an enjoyable conversation with a very, soft-spoken woman with kind eyes and a quick smile. I liked her immediately. It was to my surprise when she joined the stage that afternoon as the self-described “tough negotiator grandma” who reduced Montana’s employer healthcare spending and returned big funds to the state’s budget. Marilyn Bartlett was tough indeed, and she had just proven what employers and states can do to reduce healthcare spending through referenced-based pricing and drug pricing transparency. She was my favorite speaker of the day, and I hope one day we can have her come to Kentucky to speak about her work.

One of the main takeaways from the event was that communities should not blame any healthcare sector for the current healthcare spending issues but should rather come together to solve the issues collectively. That’s what the KHC has planned for its affordability summit on Tuesday, December 4. Any stakeholder is invited to attend, and the group will identify at least two to three solutions that we can implement around healthcare affordability at this event. We invite you to join us and be part of the solution.

QPR Reflections: Suicide Prevention Training Hits Home

A couple of weeks ago, the Kentuckiana Health Collaborative held its September Community Health Forum. The topic was youth mental health, and the date coincided with National Suicide Prevention Week. After the Forum, the KHC hosted a Question, Persuade, Refer (QPR) training as part of a goal to set a record for people trained in one week. Similar to CPR, QPR is a 90-minute training course designed to support an emergency response to someone in crisis. It was designed to equip individuals with the tools they need when someone in their life is facing a suicide crisis.

I was in that position last year, trying to convince the person I loved most in the world not to take their own life. It’s an experience I don’t wish on my worst enemy. I’m at a year of therapy and counting, and although I am a much stronger person for the experience, I wish I had never been through it.

In the end, my loved one didn’t take their life, and they got the talk therapy and medication needed to push through. Multiple people have credited me with that outcome. I’m not sure if I agree with that, but I do admit that my involvement might have had a positive impact and recognize now the power that even one individual can have in moments of crisis.

Hence the need for trainings like QPR. Suicide is the 10th leading cause of death in the United States, and it’s estimated that for every death by suicide, there are 25 more attempts. It happens more commonly than we’d like to believe. During National Suicide Prevention Week, more than 2,200 people in Louisville were trained in suicide prevention in 50 locations across the city.

I’ll admit that I was slightly disappointed by the QPR training. I guess I thought that it would reveal one magic thing that I could have said or done differently, to make the situation turn out more smoothly than it did in my case. I was disappointed to find that there is no magic bullet to be had. People are complex. These situations are complex. There is no one-size-fits-all approach to suicide prevention. It all comes down to being persistent, really listening to what someone else is telling you either with their words or actions, and not being afraid to have the tough conversations.

There is no one-size-fits-all approach to suicide prevention. It all comes down to being persistent, really listening to what someone else is telling you either with their words or actions, and not being afraid to have the tough conversations.

I don’t think I was prepared for the traumatic memories that QPR would bring up. Much of the 90-minute session was devoted to recognizing the signs and behaviors of distressed loved ones. I can say that from my personal experience, what was taught in QPR related to this was almost word-for-word what I experienced. I had to leave the room more than once in tears. But I always returned, determined to see it through. Then came the disappointing part of the training. The part where I discovered that there is no perfect phrase that can talk someone off the proverbial ledge. But that doesn’t mean that we can’t have an impact on the situation. We can all create safe spaces for our loved ones to talk to us when they are struggling, and we can together get through the tough times.

I had nightmares that evening about those past traumas. But then, a funny thing happened. The nightmares that I’d been accustomed to having for the last year stopped. Situations and places that used to trigger me no longer did. And I realized that it was a direct result of the QPR training. I had long ago forgiven myself for what I had seen as failings when I was faced with the crisis, but it turns out that I didn’t need to be forgiven at all. By participating in the training, I realized that I did probably more in that situation than I should have been able to. It wasn’t blind luck that prevented my loved one from taking their life. And that was the closure that I didn’t know that I needed.

It sounds like a cliché to say that you never think it will happen to you until it does. But that’s exactly how it is. And I would recommend that anyone learn how to have that conversation and develop that vocabulary, through QPR or a similar program. Because you never know when you might need those skills.

Louisville’s Multi-year Focus on Suicide Prevention Ramps up to Set a World Record, Save Lives

(Note: This guest post was written by London Saunders Roth, Local Integration Leader, Louisville Bold Goal, Humana. London is a member of the Louisville Health Advisory Board Behavioral Health committee.) 

A community-wide coalition focused on suicide prevention is organizing a broad-based community effort centered around National Suicide Prevention Week: September 9-15, 2018. The Louisville Health Advisory Board (LHAB) Behavioral Health committee seeks to help Louisville set a world record by training the most individuals in one week in the technique of Question, Persuade, Refer (QPR). Similar to CPR, QPR is a 90-minute training course designed to support an emergency response to someone in crisis, and it can save lives.

According to recently published data from the Centers for Disease Control and Prevention (CDC), suicide rates are on the increase, and more than half of people who died by suicide did not have a known mental health condition. For the years 2008-2014, Jefferson County ranked 11th out of 50 peer counties in terms of highest rates of suicide. This is a change from the prior ranking of 8th; however, the suicide mortality rates were higher nationally. Essentially, while other counties increased at a higher level, Louisville’s suicide mortality rate still increased. These statistics are what inspired a cross-sector of community partners to come together and set an objective to design and implement a community-wide, evidence-based and data-driven program to eliminate suicides in Louisville.

Many people are uncomfortable discussing suicide, even when family or friends may be in crisis. However, the technique of “Question, Persuade, Refer” (QPR; www.qprinstitute.com) can improve a person’s comfort and confidence in broaching this difficult subject. QPR is an intervention that can improve the “Chain of Survival,” similar to CPR’s impact on increasing public’s confidence to provide life-saving interventions. QPR focuses on three things: how to recognize warning signs of suicide, how to offer hope, and how to refer to resources to help to save a life. Early recognition of suicide warning signs is key to saving a life.

Please join Louisville, and the Louisville Health Advisory Board, in saving lives this September. If you are interested in getting involved in this effort to increase public awareness and the community’s skills in suicide prevention, please visit www.qprlou.com to sign up for a FREE training or email LouisvilleZeroSuicide@gmail.com with questions.

Additionally, LHAB and Kentuckiana Health Collaborative will offer QPR training immediately following the KHC Community Health Forum on September 11, which will examine findings of new, rigorous qualitative research that evaluated unique youth perspectives on mental health, as well as those of adult allies. You can register for the complimentary Community Health Forum here. Space is limited for the following QPR training session. If you would like to join in on this life-saving training, click here.

Please remember that there are resources for you, family, and friends related to suicide prevention. The national suicide prevention hotline is 1-800-273-8255 and a local (Louisville) crisis line number at Centerstone (formerly Seven Counties) is 502-589-4313.

The Louisville Health Advisory Board is a cross-sector group of community organizations and leaders working to improve physical, mental and social well-being where residents of Kentuckiana live, work, worship, learn and play. The Behavioral Health committee is a part of this board, and its mission is to design and implement a community-wide, evidence-based and data-driven program to eliminate suicides in Louisville.

 

Regarding Youth Mental Health: Parents Appreciate Sharing of Ideas, Emphasize Communication with Schools

(Note: This guest post was written Stephen O’Connor, PhD, Assistant Professor, Associate Director, University of Louisville Depression Center, Director of Faculty Research Development, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine)

The Student Alliance for Mental Health Innovation and Action (StAMINA) team recently wrapped up a series of focus groups and interviews with youth, parents, and stakeholders from across the Commonwealth of Kentucky in order to identify factors that contribute to mental health stigma and the unmet needs regarding youth mental health. We are excited to share these results at an upcoming community discussion on September 11 at the University of Louisville Clinical & Translational Research Building. For this blog post, I aim to share several observations from my experience as part of the research team.

Aside from providing research mentorship to the StAMINA team, I also facilitated the parent focus groups. Why is capturing the parents’ voices such an important aspect of a youth-driven mental health organization? Because parents have a major impact on how their children understand their own personal experiences and the degree to which it is safe to share said experiences with others. In a nutshell, family sets the stage as to whether a stigma will be associated with mental health concerns. The impact of parental attitudes towards mental health starts early and continues through an individual’s lifetime. We think that by reducing the presence and impact of stigmas applied to mental health concerns, more students will feel comfortable communicating their needs to their support network.

We purposely selected research sites that were as heterogeneous as the citizens of our state; focus groups were conducted in urban and rural counties with parents whose children attend either public or independent high schools. A few focus groups occurred in high schools, whereas others occurred at youth drop-in centers or a public organization in the Louisville community.

One powerful lesson from the focus groups is that many parents appreciate sharing ideas and having concentrated discussions on the topic of mental health. While they tended to lump the terms mental health and mental illness together, reflecting an internalized view of mental health as indicating something negative, they did believe strongly in the concept that one cannot be considered to be in good health without attending to mental health. Although we dealt with a powerful and emotional topic, parents were eager to speak with one another about mental health stigma and areas in need of improvement for youth.

I was honestly surprised by the extent to which parents formed a sincere group cohesion with one another even though we made clear that we were not intending to create a support group environment. Several groups even asked if they could meet again to continue their conversation! What a concept – as parents shared their views on mental health stigma and barriers to accessing care, they felt a sense of belongingness and helped each other consider alternative ways to support their children. Several times we had parents speak with each other afterwards about specific resources that might be helpful in supporting their children. I really got the sense that many people need a greater amount of support in their role as a worried parent, either through guidance on available services or through facilitated discussions with others who can relate.

Another observation is that parents routinely spoke about the importance of communication with schools/teachers as a key to enhancing youth mental health. Those schools with greater resources or smaller teacher to student ratios tended to have an easier time with communication. Parents were astute at identifying subtle signs that their children might be having difficulty related to mental health concerns, but they also recognized the importance of hearing teachers’ observations so that they could be as proactive as possible. The concept of embedding mental health programs into school curriculums, such as mindfulness practice or emotion regulation skills acquisition programs, was seen as a way to reduce mental health stigma and prevent normal adjustment concerns from developing into more severe forms of anxiety and depression.

The good news is that there are great examples in our state of schools that use innovative programming to support students’ mental health. The drop-in centers such as TAYLRD also offer a non-traditional alternative to mental health treatment that appeals to many youth and families. However, when less than 50% of adolescents with major depression in Kentucky report receiving treatment, there is clearly room for improvement. The barriers to treatment engagement don’t rest solely with parents; however, they are an obvious point of emphasis when trying to address mental health stigma. I am hopeful that by providing a larger platform for parents and students to share their experience and contribute to mental health programming, we can continue to create innovative approaches to enhance youth mental health and overall quality of life.

 

 

 

 

What is Functional Medicine?

(Note: This blog post was written by Carl Paige, MD, independent health care practitioner at Medical Transformation Center. Dr. Paige will speak on a panel at the KHC June Community Forum, “Obesity Fatigue.” This post first appeared on the Medical Transformation Center website.) 

Throughout the twentieth century and the beginning of the twenty-first, medical care in the western world has often revolved around attributing symptoms to a single disease and prescribing medication or more serious interventions to eliminate those symptoms. While modern advancements have allowed humans to transcend many pathogens, they have also created a new way of living that results in many of the chronic diseases experienced by those in industrialized nations. Daily life is fraught with stress and pollution. Most lead sedentary lives and consume too much food with little nutritional value. Personally, I grew weary of what seemed to be a never-ending cycle of writing prescriptions and then seeing the same patients a few months later needing help with side-effects or different manifestations of the same root cause.

Functional medicine offered me an alternate approach. It seeks to prevent disease by understanding the effects an individual’s genes and lifestyle have on health and the power of deficiencies to fuel illness and vulnerability to it. Instead of fixating on “what” the disease is, functional medicine asks “why” it is manifesting. Physicians that choose to practice in this way employ a variety of tests for genetic markers and chemical imbalances or deficiencies. They look for disorder in these core areas:

  • Immune surveillance
  • The inflammatory process
  • Digestion, absorption and barrier integrity
  • Detoxification and biotransformation
  • Oxidation and reduction
  • Hormone and neurotransmitter regulation
  • Psychological and spiritual equilibrium
  • Structural integrity

These doctors seek to use diet, exercise, supplementation and lifestyle changes when applicable, and defer to medication as a last resort. Their methods are rooted in evidence-based medicine, placing high importance on randomized controlled clinical trials. They understand and take advantage of cutting-edge discoveries from the latest research in biochemistry, physiology, immunology and nutrition. Such innovations are revealing the ways in which diseases originate at the molecular level and are influenced by the interaction of genes and the environment.

One of these breakthroughs is the discovery of Single Nucleotide Polymorphisms (SNP), often called “snips.” DNA is made up of individual nucleotides that, when taken in groups, provide the directions for the body. They are akin to the letters that make up a word, and those words comprise the book that is the human genome. When an SNP is present, a person has two different letters serving the same function in a word. For instance, should the word be hop or hip in the sentence: I broke my ? Which version of the gene is expressed depends on environmental factors. “Snips” are the most common genetic anomaly in humans. Many are benign, while others can make one more susceptible to disorders. They can change the actions of chemicals in the body, like those that bind to various vitamins and nutrients, just as the choice of hop or hip would change the above sentence, one even rendering it meaningless. By pinpointing these SNPs, a physician employing functional medicine could determine genetic inability to process essential nutrients, which can predispose a patient to certain symptoms and illnesses. He can then treat this, consequently eliminating or reducing the bothersome side effects. This approach allows the patient to truly heal instead of just masking or mitigating presenting symptoms with a drug. By administering a series of tests tailored to the individual patient’s symptoms, the functional medicine practitioner can identify biomarkers for health and disease.

Functional medicine has several key tenets that a physician seeks to apply when using this approach. They are:

  • An understanding of the biochemical individuality of each human being, based on the concepts of genetic and environmental uniqueness
  • Awareness of the evidence that supports a patient-centered rather than a disease-centered approach to treatment
  • Search for a dynamic balance among the internal and external body, mind, and spirit
  • Interconnections of internal physiological factors
  • Identification of health as a positive vitality, not merely the absence of disease, and emphasizing those factors that encourage the enhancement of a vigorous physiology
  • Promotion of organ reserve as the means to enhance the health span, not just the life span, of each patient
  • Taken from The Institute of Functional Medicine(Institute of Functional Medicine)

From these principles and using the information retrieved from tests and a detailed medical history and lifestyle questionnaire, the physician creates an individualized therapy plan to suit that particular patient’s needs, symptoms and lifestyle. These usually seek to eliminate triggers and ameliorate mediators (like age, sleep, hygiene and social interaction) and antecedents (factors that predispose an individual to illness). In the process, a higher level of health and function is obtained.

Our Community’s Obesity Fatigue and a Forum to Renew Discussions

Despite spending billions on obesity efforts, the adult obesity rate for Kentucky continues to rise. Source: Trust for America’s Health and Robert Wood Johnson Foundation

When the Kentuckiana Health Collaborative (KHC) was formed in 2003, obesity was one of its first three community health priorities selected by members. Over the last 15 years, the KHC has lead a comprehensive worksite wellness pilot program and a worksite fitness tracking program called Kentuckiana Metro on the Move to address obesity. In recent years, the KHC has focused much of its efforts around healthcare quality and cost but has never lost sight that obesity contributes to many of the health issues facing our community.

Obesity has been one of Kentucky’s top priorities for two decades. With the seventh highest adult obesity rate in the nation, according to “The State of Obesity: Better Policies for a Healthier America,” Kentucky’s rate has increased from 13 percent in 1990 to 34 percent in 2016. There has been an enormous amount of effort by many stakeholders on this issue with few improvements. Employers and communities have spent billions on wellness initiatives, yet few feel their investment has produced results.

No one disputes that tackling obesity is an important issue, but there is fatigue on the topic. To renew the conversation, eight business coalitions across the country, including the KHC, are hosting events on obesity through a grant from the National Alliance of Healthcare Purchasing Coalitions (NAHPC).

The KHC will be hosting its community forum, Obesity Fatigue: The Myths, Facts, Treatments, Benefits Coverage, and Paths Forward, on June 5, 2018 at the Foundation for a Healthy Kentucky from 7:30 a.m. to 11:30 a.m. Dr. Andrew Brown, Assistant Professor of Indiana University’s School of Public Health, will discuss how to separate obesity hype from fact. His recent work involves investigating myths and presumptions in nutrition and obesity literature. The event will also feature a panel of experts discussing the following treatment perspectives:

  • Functional Medicine – Dr. Carl Paige, MD, Medical Transformation Center
  • Bariatric Surgery –John S. Oldham, Jr., MD, Baptist Health
  • Pediatrics – Julia Richerson, MD, Pediatrician, Family Health Centers
  • Diabetes Prevention – Steve Tarver, CEO, YMCA

The panelists will also discuss benefits coverage of obesity treatment and community dialogue about paths forward.

Be sure to register for the forum here.

Photo Gallery: June Forum

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Community Event Focuses on Healthcare Measurement in Action

Mylia Christensen

Next Tuesday, join the Kentuckiana Health Collaborative for an interactive Community Health Forum centered on healthcare measurement action and alignment.

To kick off the event, Mylia Christensen, Executive Director, Oregon Health Care Quality Corporation (Q Corp), will provide an overview of Q Corp’s work to drive improvements through performance measurement of health plans and providers. She will also discuss the tools they provide consumers to compare healthcare results, costs, and patient experience. After Christensen’s presentation, participants will participate in small group discussions to brainstorm barriers to effective health measurement in our community and identify the next steps for aligning health measurement.

For more information on Q Corp’s efforts, read Oregon’s white paper, “Aligning Health Measurement in Oregon,” which details the project, key findings, and recommendations to achieve the Triple Aim goals of improving the patient experience, improving the health of populations, and reducing the per capita cost of healthcare.

The June 6 event will begin at 7:30 a.m. with breakfast and networking. Christensen’s discussion will begin at 8 a.m. The event is free to employees of KHC member organizations (click here to see if your organization is a member) and $35 for non-members. To register, click here.

 

 

 

Employer Health Forum September 2017

The Kentuckiana Health Collaborative will host its second annual healthcare conference to help shape the future of health and healthcare value. Hear from national healthcare thought leaders on the latest measurement and payment reform updates, how each sector can drive more value, how patient outcomes can be optimized through medication adherence, and how communities can come together to catalyze these changes. Join a force of great minds that will inspire and challenge you on March 16, 2016, in Louisville, KY. This conference is more than a chance to network with key healthcare professionals; it’s also an opportunity to play a part in affecting real change in healthcare value.

Our Diabetes Data Points Us to Top Priorities

5 Priorities for Diabetes in KentuckianaLast week’s Community Forum focused on diabetes care in our Kentuckiana region. At the Forum, we got to hear the best practices of providers who are providing benchmark-level care for their patients with diabetes. To kick off the morning, the KHC team (with the help of many of our partners) put together an infographic on priorities for diabetes prevention, care and control in our region.

We have a unique perspective at the KHC, since we work with many different stakeholders – payers, providers, employers and consumers. Our stakeholders help lead our focus, and that is reflected in the Five Priorities we have outlined for diabetes.

Although priority is labeled with a number (it is a list, after all!), they are not listed in order of importance. Rather, it is imperative that we address all of these priorities to improve outcomes in diabetes care.

Five Priorities for Diabetes in Kentuckiana

priority-1Our first priority is to reduce Incidence of diabetes and prediabetes rates in Kentuckiana. Nationally, one in 10 individuals has diabetes. Here in the Kentuckiana region, one in 10 people also has diabetes, but the local rate is slightly higher than the national rate, 10.8 percent in Kentuckiana compared to 9.3 percent nationally. On top of that, 37 percent of the U.S. population has prediabetes, and 90% of those estimated 86 million people don’t even know they have it. And without lifestyle changes, 15 to 30 percent of people with prediabetes will develop type 2 diabetes within the next five years. Prevention is key with these folks.

Diabetes is the seventh most common cause of death in Kentuckiana, and we know that there are many deaths that are related to diabetes but not necessarily attributed to diabetes. Comorbidities include hypertension, hyperlipidemia, obesity and depression, and nearly half of individuals with type 2 diabetes in Kentuckiana had at least one complication last year.

priority-2We also want to improve the care that patients with diabetes receive, including receiving recommended screening for A1c (average level of blood sugar over the past two to three months), nephropathy and retinopathy. Diabetes is the number one cause of blindness in Kentucky, and just 44 percent of individuals with diabetes in Kentuckiana receive the recommended retinal eye exam for detecting and monitoring retinopathy.

Looking at the “benchmark” providers in the area (the top performing docs who make up the care for 10 percent of the population for each measure), A1c screening and nephropathy screening rates are 100 percent, compared to region’s total rate of 92 percent and 86 percent for A1c and nephropathy screenings, respectively. Eye exam rates for the benchmark providers are 67 percent.

priority-3Our next priority is to reform payment to improve quality, cost and experience. Payment reform isn’t about just paying for things – it’s about changing incentives to improve quality while wisely using resources and paying for services not currently covered, such as using care managers, registered dieticians, social workers, etc., that improve diabetes care. One way to do that is through patient education. The National Diabetes Prevention Program (DPP) can reduce the risk of developing diabetes by 58 percent, but few patients have this as a covered benefit. The Kentucky Employer Health Plan is an exception (they cover about 265,000 members). Medicare will cover DPP in 2018. There are only three organizations in the area that participate in Medicare’s Shared Savings Program. Our understanding is that there is only one organization in the area that is applying under Medicare Access and CHIP Reauthorization Act (MACRA) as an Advanced Alternative Payment Model. We believe payment reform is critical to improving diabetes care. We know that many of the services that are needed to improve care are not currently paid for in the fee-for-service world.

priority-4Affordable solutions are imperative to manage costs and improve outcomes in diabetes. The Health Care Cost Institute (HCCI) recently released the 2015 Health Care Cost and Utilization Report, which showed that national spending per privately insured person grew by 4.6 percent – faster than in previous years. HCCI indicates that healthcare costs have increased three times faster than wages over the past decade and continues to strain government, employer and family budgets. According to the report, Kentucky had higher than national average out-of-pocket spending.

Consumers throughout the region are feeling the strain. And this is amplified for individuals with diabetes, who have more than 3.5 times the healthcare spend of their neighbors without diabetes. The Health Care Incentives Improvement Institute (HCI3) and Catalyst for Payment Reform(CPR) Report Card on State Price Transparency Laws gave Indiana and Kentucky an “F” in transparency.

priority-5Our final priority, but certainly not the least important, is to address social determinants of health by providing resources and support to those in need. Most of us know why this makes our priority list for diabetes outcomes. An estimated 80 percent of what impacts a person’s health is outside the clinical care they receive. In order to address diabetes, you have to address health equity. Where you live matters when it comes of diabetes outcomes, including mortality. Zooming in on just Jefferson County, for which we have detailed information from the Louisville Metro Department of Public Health and Wellness (LMPHW), many of the neighborhoods with high diabetes mortality are also neighborhoods with socioeconomic challenges. Dr. Sarah Moyer, medical director for LMPHW, and Dr. Brandy Kelly Pryor, director of the Center for Health Equity at LMPHW, suggested that we look at education, food and housing security, and community safety among some of the most important factors to look at when examining the effect of social determinants of health. Some providers, including some we heard from at last week’s Community Forum, are beginning to make those community-clinical linkages to unmet social needs.

Final thoughts

Those are some of the data points that we, with a great amount of help from our partners, identified to illustrate where our gaps are and where we are doing well as a community. Now we want your feedback. Which of these priorities are you most interested in focusing on? What is your organization doing around these priorities? Where do you see the greatest opportunity for improvement? Fill out this form and let us know.

Really, we put this together to help focus our attention to areas where we can concentrate to have better diabetes outcomes in Kentuckiana. With greater healthcare transparency, we can manage costs. With better care, we can reduce complications such as retinopathy and amputations. And with a focus on patient education, we can delay or even prevent a diabetes diagnosis.

Last week we heard the personal story of Jeri McCullough, who in 2009 was diagnosed with type 2 diabetes and struggled with her weight, a sedentary lifestyle, and out-of-control eating habits. But in 2014, she was hit with some harsh realities, when her eyesight was altered and a trip to the doctor revealed scary blood sugar levels. Jeri took control of her health, involved her family, and today her A1c levels are under control and her diabetes is controlled without the use of medication. If we focus our attention to the right areas, such as the ones we have outlined above, we can have many more Jeri stories.