LOUISVILLE, Ky. – Thousands of Kentuckians classified as able-bodied adults without dependents are losing Supplemental Nutritional Assistance Program or SNAP benefits, according a new report.

Researchers at the Urban Institute found at least 13,122 Kentuckians lost food assistance between January 2017 and September 2018, after the state put back into place a rule limiting SNAP benefits to 3 months, unless individuals meet certain work requirements.

Lauran Hardin, a nurse living in Maysville, has a family member who has bipolar schizoaffective disorder and lost his SNAP benefits.

"He couldn't work at a regular job from his illness, the stress and the external stimuli is too much,” she relates. “So to actually find a job you can do, that has that kind of criteria or that kind of supportive environment, is almost non-existent."

Hardin says because her family member was, in eyes of the state, an able-bodied adult without dependents, he was denied food assistance.

Hardin says the classification does not account for people like her relative who have mental health issues or other impairments that make it difficult to work but who do not have children or receive federal disability benefits.

"He was dropped off of SNAP, and you can't get it back,” she states. “Like, it takes a waiting period before you can get it back. So it was a three-month waiting period."

Federal rules require able-bodied adults without dependents to work 80 hours per month if they receive SNAP benefits for more than three months in a three-year period.

However, the work-related limits were waived until 2017, when Kentucky reinstated them for most counties.

Jon Tew, a senior program manager for policy and advocacy with the Camden Coalition of Healthcare Providers, says losing SNAP means losing access to food, and food insecurity leads to bad health outcomes.

"What we see as a direct effect of this, is, patients of ours who are making progress are going to stop making progress,” he states. “Patients that would otherwise make progress aren't going to. I mean, this is negative health effects – both physical and mental health – are going to be a result of this."

The federal government has proposed changing a rule that allows states to waive SNAP work requirements for able-bodied adults without dependents in areas with levels of high poverty or unemployment.

According to Kentucky Voices for Health, there are more than 500,00 individuals and more than 250,000 households in Kentucky currently receiving SNAP benefits.


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September is Health Literacy Month, and a Denver-based group is working to help health professionals break a persistent pattern of discrimination linked to high disparities in maternal death rates.

Danyelle Gilbert, CU Nursing alumna and a member of the Colorado Council of Black Nurses, points to research showing that between 2016 and 2020, nearly all pregnancy-related deaths of Black women could have been prevented through timely interventions - at the patient, provider or system level.

"That report specifically found that discrimination played a role in over half of pregnancy-associated deaths. And approximately 90% of those pregnancy-related deaths were identified as preventable," she said.

Black women in Colorado are twice as likely to die - during their pregnancy, or within one year of giving birth - than the state's overall pregnant population. The leading cause of maternal death overall is self-harm and unintentional overdose. But for Black women, the number one cause of death is heart failure.

Gilbert added that common forms of discrimination facing Black women include simply being dismissed, or not being taken seriously, by health care providers. She says their pain and symptoms are routinely minimized, and there are delays in their care.

"They may face a lack of shared decision making, and poor communication from their health care provider. They just don't feel educated, they are not able to make informed decisions. And all of that is leading to negative health outcomes," she continued.

Gilbert recalls one Black woman experiencing contractions who was turned away to fill out paperwork, even though her information was already on file, and ended up giving birth in a hallway. She said health professionals can do better, in terms of showing patients they are valued.

"And when we value someone, we pour life into them. So when caring for a Black woman, see her. Empathize with her, connect with her. Feel her pain, her joys, her cries. Hear her, because she is both strong and fragile," she added.


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In North Carolina, the gap between Medicaid reimbursement rates and the actual cost of dental care has reached a crisis point, impacting both patients and providers.

Dr. Rafael Rivera, a member dentist with the North Carolina Dental Society and owner of Smile Starters, said the gap is impacting quality dental care around the state.

"It's about 30 cents on the dollar, about 30% of what we should be getting paid for the procedures. And that's not exact, but 30 to 35% somewhere in that range. It's actually a lot worse if you're an oral surgeon in the state treating the patient population," he said.

Those reimbursement rates haven't been updated since 2008. Rivera added that a lack of funding hinders dental practices from attracting and retaining skilled professionals. He said as a result, Medicaid patients often resort to emergency rooms for dental issues-an option that is both more expensive and less effective.

To address these challenges, Rivera suggested expanding the network of Community Dental Health Coordinators. He believes these coordinators could play a crucial role in bridging the gap between patients and dental providers, particularly for those who face language barriers or lack knowledge about available services. He also called for increased funding and safeguards that help dental offices keep up with inflation.

"Our legislator ideally will find a way to not only just put an increase in place, but more importantly have a mechanism that requires them to reevaluate it on a regular basis so that we don't have to go another 16 years before an increase is in place again," he said.

Rivera underscored that this issue extends beyond just dental care, pointing out that data show strong dental health is linked to better overall well-being. Since the expansion of Medicaid, the program has enrolled over 500,000 people.

September is Self-Care Awareness Month and the American Heart Association in Missouri is urging caregivers to take some much-needed time for themselves.

Missouri has around 600,000 family caregivers, many of whom provide unpaid care to loved ones with heart disease, cardiac events and other debilitating illnesses. The emotional and physical toll can be severe, with 21% of caregivers reporting their own health has declined.

Dr. Ravi Johar, chief medical officer for UnitedHealthcare and a board member of the American Heart Association of St. Louis, wants caregivers to understand proper self-care is not selfish.

"It's really important that after an acute event, whenever you've had a chance to kind of catch your breath, sit down and think about exactly what they need and exactly what you need and how much you can give," Johar recommended. "That's not being selfish. That's not, not taking care of them. That's doing the right thing for both of you."

According to the American Heart Association, it is important for caregivers to have someone they can confide in about their fears and doubts; a person who can offer reassurance and emotional support.

A 2023 AARP survey showed nearly 40% of family caregivers spend more than 20 hours a week assisting their loved ones from driving to appointments to providing direct care, many while also working and raising children. Johar stressed the importance of caregivers using time off from work wisely, which includes new mothers with babies in neonatal intensive care.

"The baby's getting the best care in the hospital and there's nothing you can do to help," Johar pointed out. "Go ahead and go back to work. Save that time, go in every evening. Spend all night or as much time as you want with the baby. But save your time off, because when this baby comes home, then you're really going to need to be there."

Doctors also emphasized the critical role of regular exercise, like brisk walks and the need for caregivers of all ages to maintain a heart-healthy diet. The habits help manage stress and boost energy levels.