Local medical professionals believe that results of a 2011-13 study, the latest data available, by the Foundation for a Healthy Kentucky are different now because of progress made under the Affordable Care Act.

“Health Disparities in the Commonwealth, A Report on Race and Ethnicity and Health in Kentucky” revealed that multiracial and black Kentuckians tend to report higher rates of smoking, obesity, asthma and poor mental health than white Kentuckians, and black Hispanic Kentuckians are less likely to have health insurance than white Kentuckians.

Despite their lower insurance access, Hispanic Kentuckians are less likely than white Kentuckians to report poor physical health or a diabetes diagnosis, although they are significantly more likely to forgo medical care due to cost, according to the report.

The study looks at access to health care and preventive services, a variety of social and behavioral health indicators and health outcomes among Kentucky adults of different racial and ethnic groups. The groups are white, black, multiracial and other, all non-Hispanic; and Hispanic of any race.

“One thing we have noticed at the health department in working with patients in family planning was that most of our patients didn’t have insurance,” said Barren River District Health Department Health Educator Joyce Adkins. “After the Affordable Care Act, most of our patients did. It went up a lot. I think some of this information, if we talked to people today, might be different.”

Fairview Community Health Center Executive Director Chris Keyser said the data isn’t a surprise.

“I think it certainly represents the status of access to health care prior to the implementation of the Affordable Care Act,” she said. “It will be interesting what the report will look like in 2014, 2015 and 2016 to show how the Affordable Care Act benefited Kentucky. If (Gov. Matt Bevin’s) waiver is approved or if it’s not, he eliminates the Medicaid (expansion) altogether.”

Kentucky HEALTH would replace kynect, Kentucky’s health insurance marketplace. Kentucky HEALTH stands for Helping to Engage and Achieve Long Term Health. The plan is designed to help people move off Medicaid and into commercial health insurance.

Kentucky HEALTH offers members two pathways to coverage – an employer premium assistance program or a high deductible consumer-driven health plan. It targets those in the Medicaid expansion, particularly those with an income up to 138 percent below the poverty level.

Kentucky HEALTH will mirror the state plan, which does not include vision and health, but participants can gain those in the My Rewards Account, where they can earn incentive dollars to purchase enhanced benefits, by doing health assessments, volunteering, employment or job training.

Kentucky HEALTH will require monthly premiums. The plan will also address the state’s drug problem by encouraging members to seek treatment by providing My Rewards incentives and helping members receive job training and obtain steady employment. The plan also addresses some of the other problems prevalent in Kentucky, including diabetes, obesity and smoking.

Keyser doesn’t believe Kentucky HEALTH would be good for the state.

“The report states the obvious,” she said. “Because of the Affordable Care Act, Kentucky has made great strides. That could all get undone as we wait.”

Kentucky never comes out looking good in health reports, Keyser said.

“Overall, Kentuckians recorded they had to forgo medical care due to cost. We increased access. Kentuckians who benefited from that access were getting more preventive services and means to manage diabetes and obesity,” she said. “They had more resources available to them. Those costs were eliminated from 2014 to 2016. We had more Kentuckians who had access who were using that access to get treatment plans to manage their conditions.”

Obesity, tobacco use and mental health are the top three issues in Kentucky, Keyser said.

“They’re still consistent,” she said. “They’re what we work with on a daily basis for improvement.”

Tobacco use is higher across the board, Adkins said. Kentuckians’ use has gone down over the years, but when you compare it across the country it’s still high.

“Overall, 27.9 adults in Kentucky are current smokers. Forty-one point three percent of multiracial people smoke. That’s close to the percentage of people who are mentally ill who smoke,” she said. “I don’t know why multiracial people are more likely to smoke unless it is the societal pressures. Gay, lesbian, transgender and bisexual people also smoke at higher rates, and I believe it’s because of societal stress.”

Obesity can happen in communities that are low socioeconomic status where there tends to be fewer large grocery stores, Adkins said.

“A lot of times there’s no place to buy nutritious food. Nutritious food is often more expensive than fast food,” she said. “It affects the obesity rate, which is also pretty high in Kentucky. In pockets of Appalachia there is low economic status across the board.”

While the report’s data is old, it should serve as a baseline, Keyser said.

“What I think you’ll see is it will substantiate what the primary care center has been saying. I think that it will show that we have moved the needle and reduced disparities,” she said. “It could be completely undone if the governor’s waiver is put into place or he dismantles Medicaid expansion.”

– Follow features reporter Alyssa Harvey on Twitter @bgdnfeatures or visit bgdailynews.com.