By BRUCE SCHREINER The Associated Press
Health educator Sue Brunk sees the warning signs of unhealthy lifestyles — the junk food, smoking and inactivity — in tiny Owsley County, ranked Wednesday as Kentucky’s unhealthiest place.
Diabetes, cancer and heart disease are common afflictions, she said, and many in the sparsely populated Appalachian county fight a losing battle of the bulge — brought on by lack of exercise and fondness for fatty foods.
“We always get pegged as being the worst of the worst,” Brunk, health educator for Owsley County public schools, said in a phone interview. “It’s not like we aren’t aware we have problems. We are aware.”
Tracing Kentucky’s least healthy counties cuts a wide swath through Kentucky’s Appalachian region, a new survey found.
Among the 20 counties ranked as Kentucky’s unhealthiest, 19 are situated east of Lexington and most are in the heart of the mountainous region, according to the annual County Health Rankings, released by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.
The report ranks Letcher County as the ninth least healthy county in Kentucky. Martin County was ranked second- worst to Owsley County, followed by Wolfe, Fulton, Magoffin, Perry, Pike, and Harlan counties. Knott County is ranked as the 10th least healthy.
The report ranks the overall health of nearly every county in all 50 states. It found a huge gap between Kentucky’s healthiest and unhealthiest counties.
In Owsley County, residents are more than three times likely to die prematurely than in Boone County, ranked as Kentucky’s healthiest county. Boone is in Kentucky’s prosperous northernmost tip, across the Ohio River from Cincinnati.
The 10 counties rated as Kentucky’s healthiest are mostly clustered in the central portion of Kentucky, though two — Calloway and Lyon — are in far western Kentucky.
The bottom 10, with the exception of Fulton County, are in eastern Kentucky.
State Public Health Commissioner Dr. William Hacker said the report offers a broader understanding of health issues in Kentucky, which consistently ranks at or near the top nationally in obesity, smoking, lung cancer and heart disease.
“ We have known for some time that Kentucky has many issues that affect the health of our state,” he said. “It is equally important to understand issues that affect different parts of the state in different ways.”
Hacker, an eastern Kentucky native, said the region faces a number of longstanding issues in trying to improve its overall health, including persistent poverty, low education levels and other cultural contributors to poor nutrition and lifestyle choices.
Access to health care is a big obstacle in many of the counties ranked as the unhealthiest, said Karen Cooper, public health director for the Kentucky River District Health Department, based in Hazard.
In Owsley County, there’s one doctor and three nurse practitioners, county health coordinator Deana McIntosh said.
Cooper, whose health district includes Owsley and other counties ranked near the bottom of the survey, said many people in the region tend to avoid preventive tests and won’t set foot in a doctor’s office until they’re sick.
“A lot of times, our folks don’t go until it’s too late,” she said.
Brunk is among those at the forefront of encouraging healthier lifestyles, starting with some of Owsley County’s youngest residents. Every public school student there takes physical education classes through sixth grade, she said. Sixthgraders take a health class stressing healthy eating and exercise, and put on a health fair for fellow students.
“We’ve kind of dubbed them our health ambassadors,” Brunk said.
School meals have been altered to minimize fried foods. Pizza remains on the menu, but it’s topped with turkey sausage, she said. Vending machines have been emptied of sugary treats. Afternoon snacks at the elementary school consist of fresh fruit. And the only sodas sold at the high school are diet drinks. In the fall, there’s an after-school running club for children in third through sixth grades, she said.
But she’s skeptical those good eating habits at school are continued at home for some students.
“What they eat here is what they eat here,” she said. “If they go home where there aren’t parents watching them, they grab what they can feed themselves, and that will be junk.”
Cooper said her agency offers classes on proper nutrition, disease prevention and smoking cessation in the region. The message gets through to some, she said, but has failed to reach many others.
“You do feel like you’re sometimes just beating your head against the wall trying to get that message out there,” she said.
In Owsley County, another problem is that many people don’t work up a sweat, Brunk said.
“Kids do not play outside because we have lots of snakes, and parents are afraid to let them out,” she said. “And so when they go home, they sit. And parents sit. It’s a very sedentary lifestyle here.”
More opportunities for year-round exercise are on the way in the county.
A new community center under construction will include a gym and spacious exercise facilities. A local church is building a family life center that will include a gym.
“We’re working hard at it,” Brunk said of efforts to improve the county’s overall health. “We’re not sitting here saying, ‘Oh poor us.’” But she added: “It takes a long time to turn a ship.”
Ten healthiest counties in Kentucky, starting with the most healthy are: Boone, Oldham, Calloway, Woodford, Scott, Lyon, Washington, Owen, Franklin, Fayette.