November 10, 2013Lee T. Todd, Jr.Professor of Electrical EngineeringUniversity of Kentucky

Friedell Committee Fall Conference

Outline

How “ugly” are the “Kentucky Uglies”? Why is it important we address them? Can anything be done? What are the hurdles to overcome? How do we proceed? Are we ready to take the challenge?

How “ugly” are the “Kentucky Uglies”?

Issues we have heard over and over First in smoking, cancer deaths and

preventable hospitalizations Second in heart disease and poor physical

health days Third in heart attacks and poor mental-health

days In the Top 10 in obesity, diabetes,

cholesterol and sedentary lifestyles

How “ugly” are the “Kentucky Uglies”?

Issues we don’t hear as often Kentucky life expectancy is 73.3 years, three years

less than national average Jefferson County, 14-year difference in life

expectancy between East End (83) and in the heart of Louisville (69)

Only Oldham County, at 77.2, exceeds the national average

Perry County, at 68.3, is the lowest and 15 other counties are less than 70 years

How “ugly” are the “Kentucky Uglies”?

Issues we don’t hear as often Economic development impact

• San Antonio, Texas, lost potential corporate client• Mayor met with CEO of the company and asked

why San Antonio was not selected• CEO, “We looked at the Body Mass Index for your

sixth grade students and realized that you are going to have a very unhealthy workforce in the future.”

Why is it Important We Address Them?

Poor health status Costs all of us in higher taxes Limits our ability to attract and retain jobs Gives the perception that Kentucky is a less

attractive place to live and work for families

Increasing Medicaid expenses Constrain needed public services Reduce investments in all stages of education Will increase further as we expand Medicaid

eligibility

Can Anything be Done? San Antonio chose to reduce obesity

Received $1.5M grant from Coca-Cola Foundation Reduced from 35.1% to 28.5% from 2010 to 2012 19% drop meant 70,000 citizens no longer obese

Closer to home Grant County changed their county health ranking in

three years from 89th to 60th in Kentucky Clark County varnished teeth of 3,000 6th graders

and reduced cavities from 50% to 14.5% in 3 years Hopkins County reduced pre-term births from 16%

to 6.6% in 12 months and saved 38 PTBs which would have resulted in $2,000,000 in Medicaid costs

What Are the Hurdles to Overcome? “Leadership is taking people to where they need to go

weather they know it or not” Previous lack of political leadership must be overcome

Education – unwillingness to raise and properly distribute necessary funds

Tobacco – continued promises to be able to provide subsidies for a product that others deemed harmful

Coal – willing to ignore affect on environment that others in the market recognize

How do we create urgency – Need a “market driver” Prefer “enlightenment” but “fear” seems to be required

• Sputnik – focus on math, science and engineering education• 9/11 – development of Homeland Security• Educational funding system unconstitutional – KERA

How Do We Proceed? “We must stop tolerating ill health!” Initiate a campaign: “Get Well Kentucky with the

slogan, “Kentucky: Healthier, Wealthier and Wiser” Someone needs to “own the problem”

Must keep the issue “top of mind” for all of the active groups Play a coordinating role for all of the good efforts taking place

Effort must be “community led”, not top-down Many potential partners: business and education

leaders, extension agents, and other organizations County Health Departments State Chamber of Commerce Economic Development Cabinet – Work Ready Communities Kentucky Department of Education

How Do We Proceed?

Cannot be viewed as “outsiders” Must involve community leaders and groups who

recognize the need to change Support them with data and reference examples of

how others brought change Ernesto Sirolli: TED Talk

• Consulting company: Shut Up and Listen• Zambian Project

How Do We Proceed? Need to convince many more people to become

involved Must have a well developed process “Crossing the Chasm” by Geoffrey Moore

Find the people/county with the greatest need Need a “Market Driver” to speed movement to action

How Do We Proceed? Do we have a potential “Market Driver”?

Kentucky has 640,000 uninsured residents Affordable Care Act provides an opportunity

• Kentucky Health Exchange is a leader• 32,485 enrolled the first month• 318,000 accessed the Exchange but did not enroll

Can the newly enrolled be encouraged to get their A1C measured to begin an assault on diabetes?

Provide recognition for those Work Ready Communities that include health improvement

Develop an awards program to give exposure to positive community accomplishments

Are We Ready for the Challenge?