The impact of health on Kentucky's economy.

All states are strongly committed to economic development policies and activities as participants in national and global competition. However, a sometimes overlooked and perhaps under appreciated influence on economic development is the health of a state's citizens. This study focuses on how the health status of Kentucky profoundly influences its economy, workforce, productivity, and general quality of life. If Kentucky's economy is to improve significantly, as compared to other states, significant improvements in the health status of its citizens must be achieved in the near future and sustained over time. In an era of growing concern about rising health insurance costs and maintaining a reliable and productive workforce, employers are increasingly likely to locate in communities where measures of health status are strongly positive. The latest report from the United Health Foundation indicates that in 2007 Kentucky had the 8th worst health status in the nation based on a set of risk factors and outcomes. These risk factors include personal behaviors, community and environment, and public health policies that culminate in key health outcomes related to quality of life and longevity. While it is a serious challenge, our research demonstrates that many of these risk factors can be lowered through relatively low cost and effective interventions that produce substantial improvements in health and Kentucky's rank. Health education is very effective when it begins early in life and continues to emphasize the importance of healthy behaviors, such as not smoking, healthy diets and exercise, and weight control. Preventive health services that identify and treat diseases and conditions that lead to premature death increase both longevity and economic growth through lower treatment costs for chronic diseases and an increase in human capital. Policy changes, such as primary enforcement of motor vehicle seat belt use and encouragement of the use of safety equipment at work, also saves lives and contributes to economic development. Kentucky has already implemented many programs to begin the necessary transformation to a healthier Commonwealth. Creation of additional programs and expansion of those successful ones in place are keys to producing both significant health change and economic growth.

Physician computer skills: a prerequisite to the future in healthcare services.

Physicians in Kentucky have been slow to endorse and implement electronic medical records and other forms of information technology (IT), although this technology is available to them. Information was ob tained from medical relicensure data for all licensed Kentucky physicians and through two sample surveys to assess the use of IT in Kentucky medicine. Sixty-eight percent of licensed physicians recorded an e-mail address on their annual relicensure application, but more physicians were knowledgeable about IT than indicated by this relicensure response. A recorded e-mail address was more likely for younger physicians, physicians in hospital-based specialties, and those in larger medical specialty or academic physician groups. Those entering an email address were more likely to use IT for e-mail, word-processing, searching medical literature, and even consulting with other physicians. Only 10% of physicians with an e-mail address and 4.5% ofj those who did not list an e-mail address used e-mail to communicate with patients. Physicians entering an e-mail address were also more likely to employ an electronic medical record in their practice. Increased use of IT in medical practices is likely only if it can be associated with an increase in reimbursement or an improvement in quality of care.