Outside of the Golden Triangle of Lexington, Louisville and Covington, Kentucky has problems. Lots of serious problems.
And most of them connect back to poor health care and eating habits, both contributors to the fact Kentucky stays stuck at No. 48 in nearly every socioeconomic category.
Though we don’t see any conventional media coverage locally, Kentucky is sort of a microcosm of national health trends, which led Salon.com to dedicate a three-part series on health care issues by Frank Browning to Appalachia.
The first installment, “Diabetes in Appalachia: Just give me a pill,” ran Wednesday.
The post subhead reads, “In Appalachia, fighting diabetes means battling a culture where even vegetables tend to be covered in bacon fat,” and it sets up no-win situations where patients do little or nothing to help themselves stay healthy while federal and state programs spend millions to battle diabetes.
One diabetes administrator estimates 15,000 of Magoffin County’s 45,000 people are diabetic, with trends indicating half the population will be diabetic by mid-century.
Dietitians try to get Appalachian residents to change their diets, which involve liberally coating everything in bacon grease. But residents either can’t work the complicated diabetes diets, which involves measuring carbohydrates, fats and proteins, into routines, or they’re fatalistic, asking for “a pill” so they can continue unhealthy habits.
From “Diabetes in Appalachia”:
“Our people,” she says, “have a disconnect between cause and effect, what the consequences are of what they do. Many people have been in poverty so long they’ve never practiced delayed gratification. It’s like I want it now — whether it’s a piece of pie or a new television. It doesn’t matter if I have to pay extra (on a credit card). It’s a cultural kind of thing. Any good results [from waiting] are so far out there they don’t matter. We’re so present-oriented that’s too hard to see.”
Thursday’s installment, “Dying for Ride,” looks at the arcane rules on Medicaid, which groups patients and caregivers in categories. Unfortunately, patients may cross categories (psychiatric patients who are also in long-term care homes), which makes it nearly impossible not to violate Medicaid rules, even when it comes to how patients get to clinics.
Browning interviews Louisville banker Republic Bank and Trust Co. executive Michael Ringswald, who sits on the Seven Counties board of directors. Ringswald insists greater flexible policies would actually save Kentucky’s Medicaid program money.
The third segment debuts today, but wasn’t up as of this posting.
If Browning’s work seems exceptional, it is. It’s funded by a grant, in this case from Kaiser Health News, a non-profit effort funded by the Menlo Park, Ca.-based health-policy think tank Henry J. Kaiser Family Foundation – probably the only model that will support future media coverage of anything other than sports and celebrities.
More importantly, Browning’s reporting doesn’t look for the easy and sensational. It’s a long, hard slog through the grim reality we as a nation face as we refuse to acknowledge how all sides – government, insurers, patients and medical professionals – contribute to an unsustainable health care system.