In program is funded in part by grants from the foundation for a healthy Kentucky and the Kentucky Medical Association through a grant from the anthem foundation.

♪ ♪ ♪ ♪ Welcome to fighting to breathe, a KET forum.

I'm Renee Shaw.

This forum is the culmination of our three-part series fighting to breathe, which explores the undertold story of lung disease and the burden of lung cancer, C.O.P.D., and asthma in this state.

We encourage everyone to watch it on our website ket.org/ respiratory.

In our discussion today, we want to pull back the lens and look at the policy and system solutions that can make an impact and move us forward as a state.

I'm joined in our lect studio by Dr. Ellen Hahn, professor and Director of Breathe, and U.K. cares at the U.K. College of Nursing.

Shannon baker, Director of Advocate sip for the American lung association in Kentucky.

And Dr. Connie white, deputy Commissioner for clinical services, Kentucky Department of Public health.

Welcome to you all.

Thank you for being a part of this program and our others as well.

It's good to see you all.

So I want to start here.

We know that Kentucky leads the nation in lung cancer rates and in deaths, chronic lower respiratory disease is the number four cause of death in our state.

Why are we not talking about respiratory issues, Dr. Hahn, more than we are and maybe perhaps these series of programs will make a difference.

>> Big industry.

Like the big tobacco industry spends millions of dollars marketing their products in Kentucky and elsewhere, so we don't talk about it because we don't invest in tobacco control and in lung health.

>> Renee: Dr. White, what do you think?

>> I agree with Dr. Hahn, our funding is low.

We try to be as efficient as we can with the funding that we have to reach as many people as we can, but the reach that other interests have vastly outdo anything we can manage to balance against that.

>> Renee: Ms. Baker, your association really tries though, to bring this to the forefront?

>> Right.

>> Renee: How would you rate how we've come in our acknowledgment of lung health issues and our standing when it comes to lung cancer rates and death?

Do you think that we are getting better about understanding where we are and doing something about it.

>> I think we've made some progress.

We have miles and miles to go yet.

At the lung association, you may have heard when you can't breathe, nothing else matters.

And that's certainly becoming more prominent in the conversation, particularly during a respiratory pandemic, there is a lot more conversation about lung health but you are absolutely right, when it comes to tobacco, when it comes to radon policy, we have a lot more education to do and we are working on it.

>> Renee: I know Dr. Hahn, you have talked to us a lot about smoking and smoking dization and I want to you talk to us again about the toll it can headache on our health?

>> Smoking is the single most preventible cause of death in the world actually.

And Kentucky is one of the leaders in that, sad to say,.

Our adult smoke, at really high rates.

Our children are smoking electronic cigarette products at high rates.

It takes its toll and around 10,000 people in our state die every year need necessarily really from this addiction.

It's a severe addiction and we spend billions of dollars in healthcare costs trying treating people who are smokers.

And it's staggering.

And employers spend millions a month and billions a year, not only in healthcare costs but the productivity losses as well.

>> Renee: What role does public policy play?

>> Huge.

>> Policy makes the easy choices, the healthy choices, the easy choices.

People don't have to think when they go to work am I going to breathe fresh air today.

If your workplace is smoke free, you don't have to think about it.

Poll policy is the most effective leaver we have and unfortunately in Kentucky we haven't done all the things that we need to do that other states do.

We do have some good news though.

>> Renee: I was going to say we have some victories, right?

>> We do.

We have 41 communities in Kentucky that have strong smoke-free protections.

>> Renee: I remember when it was just a handful.

>> Slect was the first in the south and the midwest and we have 41.

The most recently.

So really it's not just in the big cities.

Rural communities are taking it on.

Local officials know what's good for people and they're doing right thing, they're covering everybody.

We have fewer lung cancer cases in communities with strong smoke-free laws.

We have lower asthma rates, lower C.O.P.D.

rates, you name it, we are able to show that it's a good investment.

>> Renee: Tell us where we stand when it comes to funding for smoking cessation programs.

>> The Centers for Disease control and prevention recommend Kentucky invest $56.4 million toward smoking cessation programs.

In fact our current funding level is $2 million.

It's a long and sad story of cuts year after year.

We are at a 14 year low right now and we need to do something fast to reveres verse-- to reverse that.

So the legislature right now is considering the next biennial budget and as we said at $2 million, it's just not enough Our kids deserve better and our legislators need do better so at a minimum, we need to go back to the pre-pandemic level of $3.3 million.

It doesn't sound like a lot.

Just an incremental $1.3 million but it does make a big difference.

It puts educators in schools, tobacco control coordinators in our local health departments and helps prevent our kids from ever initiating.

So with these E-cigarette products we have been talking about, one in four high schoolers, probably more than one in four, is now using an E-cigarette.

We can prevent that.

>> Renee: Middle schoolers are using them as well at pretty alarming rates, right?

>> That's true.

>> Renee: You are with the state Dr. Connie white, how is the state using the funds they have and what do you think about a high appropriation for this upcoming biennium.

Is it possible it could happen?

>> We have programs that we could expand or start if we had new funding.

We are focusing on young people and keeping them from keeping them from starting to smoke.

As most people start smoking before 18, we are looking at smoke free environments so you can learn, work and play in a smoke-free place and looking at helping people who are smoking already to quit because most people who are smokers say they want to quit if they just had that easy choice, an opportunity to do that.

We have the quit line which is free to all Kentuckians and most people qualify for nick-- most people qualify for nicotine replacement.

And we have a program that focuses on vaping.

We are funding 21 of our health departments with the smoking decision programs that they have and can work with local communities to help businesses go smoke-free and to teach smoking cessation classes.

And then we work in our schools to work with training youngser kids by older kids helping them to understand the consequences of smoking.

>> Renee: And are those cessation programs successful?

When people try to quit, do they stay?

>> The American lung association programs that we do in our local health departments are very successful.

So we are very pleased with that.

It's just getting enough people to even offer the classes.

>> Renee: Miss baker, as we talked there is a bill that was introduced that has local tobacco control measures.

Why is that significant and why is that important?

>> So the bill was just introduced yesterday by Senator Schroeder and we are so pleased we are finally seeing a piece of legislation during this session that we can move forward on.

And so a little backstory.

Back in the late 1990s, at the behest of big tobacco, a number of states including Kentucky passed a statute that prohibits local communities from passing any tobacco controlled ordinances other than smoke free so we have a situation where we have effectively tied the hands of local elects officials when the community wants to address tobacco and the harmful effects it is having on their kids this new piece of legislation would reverse that.

It would repeal the STATE LAW AND RESTORE THE LOCAL OPTION WHEN STUDENTS WANT.

IT IS NOT A MANDATE.

IT JUST GIVES COMMUNITIES THE OPPORTUNITY TO DO SUCH THINGS AS, LET'S SAY, CREATE BUFFER ZONES AROUND SCHOOLS WHERE E-CIGARETTES CANNOT BE ADVERTISED, FOR EXAMPLE, IT'S AN IMPORTANT PIECE OF LEGISLATION BECAUSE IT RESTORES THE LOCAL OPTION TO DO THE RIGHT THING.

>> Renee: Dr. HAHN, I WANT TO TALK TO US ABOUT THE HARMS OF VAPING.

WE TALKED ABOUT THE RISE IN NOT JUST HIGH SCHOOLERS BUT MIDDLE SCHOOLERS AS WELL PICKING UP THIS HABIT AND HAVING SOME HARMFUL EFFECTS.

TALK TO US ABOUT THE HARMS OF THAT AND IS THERE LEGISLATION THAT WE CAN LOOK FORWARD TO THAT WOULD ADDRESS THAT?

>> RIGHT, SO ELECTRONIC CIGARETTE USE OR VAPING IS NOT HARMFUL-- IS NOT HARMLESS.

IT CAUSES LUNG DAMAGE.

AS MUCH LUNG DAMAGE AS A CONVENTIONAL CIGARETTE AND IT'S HARMFUL.

A PERSON USING ELECTRONIC CIGARETTES IS A LOT MORE SUSCEPTIBLE TO INFECTION AND, OF COURSE, IN THIS PANDEMIC, THAT'S A CONCERN.

THERE IS TWO TO THREE TIMES THE NICOTINE IN THESE PRODUCTS.

THERE ARE HARMFUL CHEMICALS IN THE PRODUCTS AND MORE IMPORTANTLY, THERE ARE TINY PARTICLES IN THE AEROSOL.

IT'S NOT WATER VAPOR.

IT'S AEROSOL.

SO IT IS NOT HARMLESS.

AND OUR KIDS, WE HAVE A DRAMATIC INCREASE AMONG YOUTH IN YOUNG ADULTS.

POLICY IS IMPORTANT.

AND A FEW YEARS AGO WE DID RAISE THE TAX, THE PRICE A LITTLE BIT ON E-CIGARETTES.

THE PROBLEM THOUGH IS THAT IT'S NOT FAIR THE WAY THAT THE PRODUCTS ARE TAXED.

THEY'RE TAXED AT REALLY LOW RATES AND DIFFERENTIALLY TAXED.

ELECTRONIC PRODUCTS ARE EITHER CLOSED OR OPEN SYSTEMS.

THEY'RE DIFFERENT KINDS OF ELECTRONIC PRODUCTS AND SO FOR SOME REASON, THEY CHOSE TO TAX THEM DIFFERENTIALLY SO SOME OF THOSE SYSTEMS ARE TAXED AT DIFFERENT RATES.

ESSENTIALLY WHAT HAPPENS IS THE USER USES THE ONE THAT'S GOING TO BE LESS EXPENSIVE, RIGHT?

AND YOUTH, PARTICULARLY, ARE VERY PRICE SENSITIVE.

SO WE KNOW THAT PARITY, AND THAT'S THE TERM FOR ALL THE PRODUCTS BEING TAXED AT THE SAME KIND OF RATE, WE ARE ONE OF THE LOWEST STATES IN THE NATION FOR TAXING CONVENTIONAL PRODUCTS.

IT'S $1.10 A PACK.

WE ARE ONE OF THE LOWEST.

EVEN IF WE RAISE THE E-CIGARETTE TAX TO MEET THE PRICE OF CONVENTIONAL PRODUCTS, WE WOULD HAVE TO INCREASE IT BY 23% OF THE WHOLESALE PRICE SO WE HAVE A LONG WAY TO GO.

AND INCREMENTAL PROGRESS.

>> WE NEED TOBACCO CONTROL FUNDING SO WEEK GIVE THE RIGHT MESSAGES BECAUSE DAVID AND GOLIATH, THE INDUSTRY SPENDS MOST OF MONEY MARKETING THEIR PRODUCTS.

WE ARE RUNNING TO KEEP UP BEHIND THEM IN PUBLIC HEALTH WE DON'T HAVE THE FUNDING TO PUT POWERFUL ADS ON TV OR POWERFUL ADS ON SOCIAL MEDIA OR OTHER MEDIA RADIO.

SO SO CHRN AND YOUNG AHOA-- SO CHILDREN AND YOUNG ADULTS ONLY GET THE MESSAGES FROM THE TOBACCO COMPANIES BECAUSE THEY HAVE THE MONEY TO MARKET THE MESSAGES.

WE HAVE A LONG WAY TO GO.

>> Renee: WE'LL TURN OUR ATTENTION TO TALK ABOUT LUNG CANCER AND SOMETHING THAT'S GETTING A LOT OF ATTENTION, AND THAT IS LOW DOSE C.T.

SCANS FOR LUNG CANCER SCREENING.

TO HELP US LEARN MORE ABOUT THAT LIFE SAVING TOOL AND OTHER ISSUES RELATED TO LUNG CANCER, I SPOKE WITH Dr. JENNIFER KNIGHT BY SKYPE, WITH THE KENTUCKY CANCER CONSORTIUM AND KENTUCKY LEADS CLAB COLLABORATIVE THAT STANDS FOR LUNG CANCER AWARENESS DETECTION AND SURVIVORSHIP.

THANK YOU VERY MUCH FOR HAVING GUS-- THANK YOU FOR GIVING US A FEW MUNTS OF YOUR TIME TODAY.

>> THANK YOU FOR HAVING ME.

>> Renee: TELL US ABOUT THE PREVALENCE OF LUNG CANCER IN KENTUCKY AND WHY IT IS SUCH A CONCERN.

>> LUNG CANCER IN KENTUCKY, UNFORTUNATELY WE ARE NUMBER ONE IN LUNG CANCER.

WE HAVE THE HIGHEST NUMBER OF NEW CASES AND THE HIGHEST NUMBER OF DEATHS FROM LUNG CANCER IN THE WHOLE COUNTRY AND THIS IS REALLY RELATED TO A LOT OF DIFFERENT THINGS.

WE HAVE A LONG HISTORY OF TOBACCO AND SMOKING AND SO THAT ELEVATES OUR RATES.

BUT ALSO WE HAVE GOT A LOT OF ENVIRONMENTAL EXPOSURES SO, WHEN COMBINED TOGETHER WITH SMOKING, REALLY MAKE IT HIGH, HIGH RISK IN TERMS OF LUNG CANCER.

>> Renee: LET'S TALK ABOUT SCREENING TOOLS.

WHAT IS A LOW DOSE C.T.

SCAN AND WHY IS IT SUCH AN EFFECTIVE SCREENING TOOL?

>> BASICALLY, IT'S A SCREENING THAT ALLOWS PEOPLE TO LAY DOWN IN A BIG TUBE THAT COMES AROUND YOU AND YOU GO THROUGH IT AND IT DOES A LOW DOSE SCAN OF YOUR LUNGS AND IN THE RIGHT POPULATION WITH INFORMED AND SHARED DECISION MAKING, IT CAN REALLY DETECT LUNG CANCER AT ITS EARLIEST STAGES AND REDUCE DEATHS FROM LUNG CANCER.

SO IN TERMS OF WHO IS ELIGIBLE, IT'S THOSE AGE 50-77 OR 80, DEPENDING ON THE GUIDELINES AND A CONVERSATION WITH YOUR DOCTOR, THOSE WHO HAVE WHAT IS KNOWN AS A 20 PACK YEAR SMOKING HISTORY.

SO YOU'VE SMOKED A PACK A DAY FOR 20 YEARS, THOSE WHO ARE CURRENTLY SMOKING AND THOSE WHO HAVE QUIT SMOKING WITHIN THE LAST 15 YEARS.

>> AND SHOULD NOSE WHO HAVE NEVER SMOKED BE SCREENED?

>> NO, ACTUALLY AT THIS POINT IN TIME, WE DON'T KNOW THE RISK BENEFIT RATIO.

WE KNOW LUNG CANCER SCREENING AND THE FOLLOWUPS CAN HAVE BENEFIT AND HAVE HARMS.

AND WE KNOW THAT THOSE WHO FALL INTO THIS RISK PROFILE HAVE MORE BENEFITS THAN HARMS BUT THEY NEED TO TALK TO THEIR DOCTOR TO FIGURE OUT THEIR SPECIFIC SITUATION.

THOSE WHO HAVE NEVER SMOKED REALLY HAVE MORE HARMS THAN BENEFITS FOR GETTING A SCREENING.

WE DON'T WANT FOLKS TO DON'T FIT THE PROFILE.

THERE ARE BIOMARKER TESTINGS AND THOSE WHO WERE NEVER SMOKERS, LUNG CANCER SCREENING AT THIS POINT IN TIME IS NOT QUITE RIGHT FOR THEM EVEN IF THEY HAVE OTHER EXPOSURE.

>> Renee: IT APPEARS KENTUCKY IS DOING QUITE WELL WHEN IT COMES TO SCREENING.

THE RATES OF SCREENING ARE PRETTY HIGH IN KENTUCKY.

WHY IS THAT?

>> ABSOLUTELY.

IT IS REALLY EXCITING.

A SUCCESS STORY THAT WE DON'T OFTEN GET TO HAVE AROUND A HEALTH RELATED ISSUE.

THIS HAS HAPPENED BECAUSE OF MULTIPLE THINGS.

MULTILEVEL COORDINATED ENGAGEMENT AND PARTNERSHIPS AROUND LUNG CANCER SCREENING SINCE 2013.

THE KENTUCKY LUNG CANCER CONSORTIUM CAME TOGETHER.

THE KENTUCKY CANCER PROGRAM KICKED OFF COMMUNITY OUTREACH IN 2013.

WE HAVE THE KENTUCKY LEADS COLLABORATIVE, LUNG, EDUCATION, DETECTION AND SURVIVORSHIP THAT REALLY FOCUSED ON PRIMARY CARE, EDUCATION, HIGH QUALITY LUNG CANCER SCREENING, SURVIVORSHIP CARE AND THEN WE'VE GOT THE TERMINATE LUNG CANCER PROJECT THAT KICKED OFF IN EASTERN KENTUCKY AND ALL OF THESE THINGS COMING TOGETHER AND PEOPLE WORKING TOGETHER HAVE DONE WHAT NO OTHER STATE HAS DONE.

WE HAVE PEOPLE LOOKING AT KENTUCKY SAYING WHAT HAVE YOU GUYS DONE.

THIS IS INCREDIBLE AND HOW CAN WE DO IT TOO.

>> Renee: IT'S A SUCCESS STORY WE DON'T TOUT ENOUGH.

IS THERE ROOM TO MAKE IT MORE WIDESPREAD?

>> ABSOLUTELY.

SO EVEN THOUGH WE ARE KIND OF SECOND IN THE COUNTRY IN TERMS OF LUNG CANCER SCREENING, OUR RATES OF SCREEN AGO MUNG THOSE ELIGIBLE ARE STILL LIKE 17%.

SO IF YOU THINK ABOUT OTHER SCREENING MAMMOGRAPHY AND COLON CANCER SCREENING, UP IN THE 70s AND 80s, WE HAVE A WAY TO GO IN TERMS OF GETTING THE PEOPLE TO GO AND THERE ARE A LOT OF THINGS WE CAN DO.

WE CAN EXPAND ACCESS TO HIGH QUALITY LUNG CANCER SCREENING THROUGHOUT STATE AND INCREASE COMMUNITY ENGAGEMENT.

WE CAN ALSO HELP CHANGE THE CONVERSATION AND CONTINUE THAT CONVERSATION THAT REDUCES STIGMA AROUND LUNG CANCER RATHER THAN SAYING YOU DESERVE IT OR BLAME OR SHAME KIND OF THINGS, MOVING TO THESE ARE OUR COMMUNITY MEMBERS.

THESE ARE OUR BROTHERS AND SISTERS AND OUR FRIENDS AND HOUR NEIGHBORS AND BEING COMPASSIONATE AND EMPATHETIC AND REALLY ENGAGING FOLKS IN A POSITIVE WAY AND A WAY THAT BRINGS HOPE.

THERE IS MORE HOPE THAN EVER.

>> Renee: WHAT ELSE COULD WE BE DOING TO HELP REDUCE THAT STIGMA?

>> WELL, THERE IS A LOT OF THINGS WE CAN DO.

ONE OF THE TOOLS WE ARE USING OFTEN IS FROM THE INTERNATIONAL ASSOCIATION OF THE STUDY OF LUNG CANCER.

SAY THAT THREE TIMES.

BASICALLY THEY HAVE CREATED A ELECTRICS LEXICON THAT HELPS US CHANGE OUR CONVERSATION AND OUR LANGUAGE.

SO, FOR INSTANCE, SOME OF THE RECOMMENDATIONS ARE PERSON FIRST LANGUAGE.

SO RATHER THAN SAYING A LUNG CANCER PATIENT, A PERSON WHO HAS LUNG CANCER.

RATHER THAN SAYING A SMOKER, A PERSON WHO SMOKES.

AND THEN THE OTHER PIECE OF THAT IS CHANGING THE CONVERSATION FROM ALWAYS SAYING PREVENTION TO SAYING RISK REDUCTION.

I HAD THE OPPORTUNITY TO LEARN FROM SOME LUNG CANCER SURVIVORS WHO SAID WE DON'T KNOW THAT WE CAN PREVENT IT AND WHEN YOU SAY PREVENTION, YOU ARE SAYING IT'S YOUR FAULT.

IF YOU SAY RISK REDUCTION, THR THINGS WE CAN DO TO REDUCE OUR RISK.

WE DON'T KNOW IF WE CAN PREVENT IT.

BUT IT TAKES THE BLAME OFF THE MID VERNE.

>> Renee: INTERESTING HOW IMPORTANT LANGUAGE IS IN ALL OF THIS.

THANK YOU VERY MUCH, JENNIFER KNIGHT FOR THAT VERY INSIGHTFUL INFORMATION THAT YOU SHARED WITH US.

WE APPRECIATE IT.

>> ABSOLUTELY.

GLAD TO HELP.

>> Renee: SHANNON BAKER, I WANT TO ASK YOU ABOUT ANOTHER PIECE OF LEGISLATION.

I BELIEVE THIS IS HELD BY THE HEALTH AND FAMILY SERVICES CHAIR, HOUSE BILL 219.

CAN YOU TELL US WHY THIS IS IMPORTANT WHEN IT COMES TO THE CONVERSATION ABOUT SCREENING?

>> ABSOLUTELY.

AND SO THE PROBLEM WITH LUNG CANCER IS THAT IT IS TYPICALLY ASYMPTOMATIC UNTIL IT IS IN ITS MOST ADVANCED STAGES.

SO YOU DON'T KNOW YOU HAVE IT UNTIL TREATMENT IS LESS EFFECTIVE AND OUTCOMES ARE NOT AS GOOD AS THEY SHOULD BE SHOULD WE HAVE EARLY DETECTION.

SO THIS PIECE OF LEGISLATION IS CRITICALLY IMPORTANT.

WE HAVE DONE WELL IN KENTUCKY WITH ADVANCES IN LUNG CANCER SCREENING BUT THERE IS STILL DISPARATE COMMUNITIES AND THERE IS STILL HUGE OPPORTUNITIES TO EXPAND ACCESS IN RURAL KENTUCKY COMMUNITIES WHERE THERE ARE SO MANY BARRIERS TO ACCESS TO QUALITY LUNG CANCER SCREENING AND THIS BILL WOULD HELP ADDRESS THAT BY ESTABLISHING AN ADVISORY GROUP, IF YOU WILL, A PANEL OF EXPERTS WHO WOULD COME TOGETHER AND TALK ABOUT THE WAYS TO ADDRESS THOSE BARRIERS, TO OVERCOME THEM AND TO EXPAND LUNG CANCER SCREENING IN ALL THOSE COMMUNITIES ACROSS ACT SO THAT WE CAN GET TO EARLIER DETECTION, BETTER TREATMENTS AND BETTER OUTCOMES.

>> Renee: WE WANT TO END THIS PORTION OF THE DISCUSSION WITH A MESSAGE FROM SOMEONE WHOSE LIFE WAS SAVED BY A LOW DOSE C.T.

SCAN.

>> YOU CAN SEE THIS TINY SPOT THERE AND THAT WAS YOUR CANCER.

IT WAS JUST A QUARTER OF AN INCH, A LITTLE BIT OF LIKE SOME-- >> INITIALLY I WENT IN FOR AN ANNUAL EXAM WITH MY FAMILY PHYSICIAN AND HE REQUEST THE THAT I GET THE LOW DOSE C.T.

SCAN AS A BASELINE RECORD FOR ANY FUTURE ONES.

AND WE HAD A FOLLOWUP IN A YEAR AND THAT'S WHEN THEY SPOTTED SOMETHING.

AND WE WAITED FOR THREE MONTHS TO SEE IF THAT LITTLE SPOT WOULD GROW ANY, AND IT DID.

SO THAT'S WHEN WE DECIDED TO DO THE SURGERY.

AND THE THORACIC SURGERY AND THEY WENT IN AND DID A WEDGE AND IT WAS CANCEROUS.

THEY GOT IT ALL AND I DID NOT HAVE TO TAKE RADIATION AND CHEMOTHERAPY DUE TO THE FACT THAT I DID THE EARLY LUNG SCREENING TEST.

I TELL EVERYBODY THAT I KNOW TO GO GET THE SCAN.

IT'S WELL WORTH IT.

YOUR LIFE WILL BE PROTECTED BY HAVING IT.

>> Renee: SO NOW WE WANT TO TALK ABOUT WE KNOW SMOKING AND THE ILL EFFECTS IT CAN HAVE BUT RADON MANY.

TALK ABOUT SOMETHING WE DON'T OFTEN TALK ABOUT ALTHOUGH THERE SEEMS TO BE MORE TRACTION TOWARD THIS ELLEN HAHN.

TALK TO US ABOUT WHAT WE SHOULD BE CONCERNED ABOUT WHEN IT COMES TO RADON?

>> SO RADON IS A COLORLESS, ODORLESS TASTELESS GAS MEANING IT IS INVISIBLE.

THE INVISIBLE ENEMY WHAT IS WE CALL IT.

IT IS NOBODY'S FAULT.

IT'S IN THE GROUND.

IT INS-- IT'S IN THE ROCK.

WE COLLABORATE WITH GEOLOGISTS BECAUSE WE NEED TO LEARN MORE ABOUT THE ROCK AND THE SOIL UNDER OUR HOMES AND OUR BUILDINGS.

THIS RADIOACTIVE GAS GETS IN OUR HOME AND WE BREATHE IT AND WE DON'T KNOW IT.

THE ONLY WAY TO KNOW IT IS TO TEST FOR IT.

IT IS THE SECOND LEADING CAUSE OF LUNG CANCER, WE ESTIMATE ABOUT 700 OR ALMOST A THOUSAND RADON-INDUCED LUNG CANCERS A YEAR IN KENTUCKY ACTUALLY.

A LOT OF PEOPLE DON'T REALIZE IT'S THAT HIGH.

SO AFTER FIRST AND SECOND HAND TOBACCO SMOKE, RADON IS THE SECOND LEADING CAUSE OF LUNG CANCER SO IT IS AN IMPORTANT ISSUE.

WE DEFINITELY CAN DO SOMETHING ABOUT IT, WE CAN TEST BUT ONLY 13 OUT OF 10,000 HOMES IN KENTUCKY HAVE BEEN TESTED FOR RADON.

>> Renee: I WANT YOU TO REPEAT THAT STATISTIC AGAIN.

I THINK THAT'S WORTH HEARING TWICE.

>> ONLY 13 OUT OF 10,000.

SO IT'S LESS THAN 1%.

SO 13 HOMES OUT OF 10,000 HOMES HAVE BEEN TESTED FOR RADON EVER.

>> Renee: EVER.

>> EVER.

>> Renee: AND THERE IS A MEANS BY WHICH WEEK ALL IMPROVE THOSE NUMBERS AND PROTECT OURSELVES.

YOUR PROGRAM, Dr. HAHN, IS CONDUCTING A STUDY CALLED RADON ON THE RADAR, WHICH IS TARGETED TO FOUR KENTUCKY COUNTIES WITH HIGH RADON LEVELS, LOW LOW BEGAN-- LOGAN COUNTY, PULASKI.

WE ARE WENT TO LOGAN TO SEE HOW IT IS WORKING TO REDUCE RADON IN THESE COMMUNITIES.

WE HAVE A SHORT CLIP.

>> HOW IS SCHOOL?

>> NATALIE DAVENPORT IS ONE HOMEOWNER WHO NEVER SUSPECTED HER HOME COULD BE FILLED WITH RADON.

>> THIS IS THE DREAM HOUSE.

MY HUSBAND AND I MOVED HERE ABOUT THREE YEARS AGO.

THIS IS HIS FAMILIESLY'S FARM.

HE GREW UP ON THIS FARM AND WE DECIDED WE WANT TO LEAVE THE CITY LIFE.

SO WE BUILT THIS HOUSE AND LOVE EVERY MINUTE.

OUR CONTRACTOR ASKED FUSS WE WANTED TO PUT IN A RADON MITIGATION SYSTEM AS THEY WERE BUILDING THE HOUSE AND I DECLINED.

P IT WAS EXTRA MORE THAN AND RADON WAS NOT ON MY RADAR AT THE TIME.

I TOLD THEM NO, WE WOULD BE FINE.

>> THANKFULLY NATALIE FOUND OUT ABOUT A NEW STUDY DESIGNED BY THE UNIVERSITY OF KENTUCKY CALLED RADON ON THE RADAR.

TARGETED TO FOUR KENTUCKY COUNTIES WITH HIGH RADON LEVELS.

>> THE MAIN GOAL OF THE RADON ON THE RADAR STUDY IS TO MAKE IT EASIER FOR PEOPLE LIVING IN THESE FOUR RURAL COUNTIES TO BE ABLE TO TEST THEIR HOME AND AFFORD RADON MITIGATION WHEN HIGH LEVELS OF RADON ARE FOUND.

>> NATALIE SIGNED UP TO BE A CITIZEN SCIENTIST WITH THE STUDY.

AS A CITIZEN SCIENTIST, SHE RECEIVED EDUCATION ABOUT RADON, ALLOWED HER SOIL TO BE TESTED BY GEOLOGISTS FROM THE KENTUCKY GEOLOGICAL SURVEY AND RECEIVED A DIGITAL MONITORING DEVICE TO MONITOR HER LEVELS.

>> THE FIRST RADON TEST WAS A LOT HIGHER THAN I THOUGHT.

THE TESTING SHOULD BE LESS THAN 4.

THAT'S KIND OF WHEN YOU ARE IN THE SAFE ZONE.

BUT OUR FIRST TEST WAS OVER 30.

SO THE FIRST THING I THOUGHT OF WAS I BROUGHT MY CHILDREN TO THIS HOME, I BUILT THIS GREAT HOME, GOT THEM OUT OF THE CITY, GROW UP WITH ALL THIS FRESH AIR IN THE COUNTRY AND OUR HOUSE IS FILLED WITH RADON.

SO I PANICKED A LITTLE BIT.

EVERYBODY FROM THE UNIVERSITY OF KENTUCKY, THEY WERE SO KIND AND, YOU KNOW, TALKED ME OFF THE LEDGE AND THEY HELPED US FIND A MITIGATION SYSTEM.

I WAS CALLING TO TELL YOU ABOUT A RADON STUD AGREE NATALIE'S RADON LEVELS ARE NOW WITHIN NORMAL LIMITS AND SPREADING THE WORD THROUGHOUT HER COMMUNITY ABOUT THE IMPORTANCE OF RADON TESTING.

YOU KNOW,.

>> WE LIVE IN KENTUCKY AND WHEN YOU THINK ABOUT LUNG CANCER, YOU THINK ABOUT SMOKING AND SMOKING IS SUCH A BIG THING IN KENTUCKY.

BUT RADON IS RIGHT THERE WITH IT.

>> I UNDERSTAND YOU GUYS HAVE SOME RADON... >> AS PART OF THE RADON ON THE RADAR STUDY, DIGITAL RADON DETECTORS ARE BEING PLACED IN COMMUNITY LIBRARIES IN EACH OF THE OUR COUNTIES.

>> WE HAVE 25 KITS AVAILABLE.

OUR GOAL IS TO HAVE THE GOOD PROBLEM OF NOT HAVING ANY KITS AVAILABLE AND PEOPLE HAVING TO WAIT TO GO IT THEM THAT THEY'RE THAT POPULAR ONE DAY.

I THINK AN IMPORTANT PART OF WHAT WE HAVE TO DO IS MAKE SURE THE COMMUNITY UNDERSTANDS THE IMPORTANCE OF RADON'S DANGER TO THEM AND THEIR FAMILIES.

>> THIS IS OUR RADON MITIGATION SYSTEM.

>> NATALIE RECEIVED A VOUCHER FROM THE RADON ON THE RADAR STUDY TO REDUCE THE COST OF MITIGATION OF HER HOUSE.

BUT SHE KNOWS THE MITIGATION COSTS ARE A BARRIER FOR MANY.

>> I WOULD LIKE TO SEE IT AFFORDABLE FOR EVERYONE SO THAT EVERYONE HAS THE OPPORTUNITY TO HAVE THEIR HOME MITIGATED.

>> WE ARE WORKING REALLY HARD AND CONTACTING ALL KINDS OF COMMUNITY PARTNERS TO FIND WAYS TO MAKE RADON MITIGATION AFFORDABLE AND ACCESSIBLE TO EVERYONE.

WE ARE UP FOR THAT CHALLENGE AND UNTIL WE CAN MAKE RADON MITIGATION THE EASY AND AFFORDABLE CHOICE FOR EVERYONE, WE WON'T STOP.

>> THAT'S WHAT IT'S ALL ABOUT, RIGHT.

WE WANT TO THANK NATIONALLY FOR ALLOWING US TO COME INTO HER HOME AND THE VOICE YOU HEARD ON THAT PIECE, Dr. WAYNE TUCKSON, HOST OF KENTUCKY HEALTH.

WE THANK HIM FOR HELPING US OUT.

I WANT TO GO TO YOU, Dr. HAHN, BECAUSE FIRST OF ALL, NATALIE IS IN A SEEMINGLY NEW BUILD HOME AS WE WOULD SAY, RIGHT?

THAT HOME PROBABLY ISN'T FIVE, SIX, SEVEN YEARS OLD.

SO WE WOULD THINK THAT HOMES WOULD COME, NEW BUILDS WOULD COME WITH RADON DETECTION AUTOMATICALLY.

THAT'S A WRONG ASSUMPTION, RIGHT?

>> RIGHT.

SOME STATES, VERY FEW, BUT SOME REQUIRE BUILDERS TO USE RADON RESISTANT NEW CONSTRUCTION.

NATALIE MENTIONED SHE SAID NO WHEN THE BUILDER ASKED HER, BUT IT'S ACTUALLY LESS EXPENSIVE IF YOU DO IT FROM THE BEGINNING, IT'S SOMETHING LIKE $400 VERSUS 800 TO ABOUT 2500 IF YOU DO IT LATER.

BUT WE DON'T HAVE THAT POLICY, THAT LAW IN KENTUCKY.

WE DON'T REQUIRE BUILDERS, SOME DO AND ARE VERY RESPONSIBLE AND THEY DO.

BUT THEY GIVE THE HOMEOWNER THE OPTION AND IT WOULD BE GREAT IF THERE WASN'T AN OPTION.

IF THEY JUST PUT THE PIPE IN THE HOME SO YOU COULDN'T SEE IT FROM THE OUTSIDE.

WHAT THEY DO THEN IS JUST HAVE THE OPTION TO PUT THE FAN IN THE PIPE LATER IF THEY HAVE RADON.

THE THING IS, YOU DON'T KNOW WHEN YOU ARE BUILDING IF THERE IS RADON THAT IS GOING TO BE IN YOUR HOME UNTIL YOU CLOSE UP THE HOME AND TEST IT.

>> Renee: WE HEARD NATALIE SAY THAT FOUR IS THE AVERAGE AND SHE REGISTERED AT 30?

I MEAN WE CAN'T CONCEPTUALIZE WHAT THAT MEANS IN TERMS OF SEVERITY OR HARM THAT COULD BE CAUSED.

PUT THAT IN PERSPECTIVE FOR US.

>> RIGHT.

SO THE ENVIRONMENTAL PROTECTION AGENCY IN OUR COUNTRY USED 4 PK/LTR AS ACTIONABLE.

MEANING IF YOU HAVE FOUR OR ABOVE, YOU SHOULD FIX IT.

THE WORLD HEALTH ORGANIZATION THOUGH SAYS 2.7 OR ABOVE YOU SHOULD CONSIDER FIXING IT.

SO I THINK WE ARE GOING TO SEE THAT NUMBER OF FOUR EVENTUAL VENTLY GOING DOWN BECAUSE WE KNOW THAT EVEN LOW LEVELS, PARTICULARLY WHEN YOU ARE BREATHING TOBACCO SMOKE, THAT YOUR RISK OF LUNG CANCER IS 10 TIMES HIGHER.

SO BREATHING RADON IS DANGEROUS FOR EVERYONE.

BUT IT'S MORE HARMFUL IF YOU ALSO HAVE TOBACCO SMOKE EXPOSURE.

>> Renee: TALK ABOUT THE COST OF MITIGATION, RIGHT?

YOU MENTIONED IF YOU DO IT ON THE FRONT END, BITS EITHER THAN THE BACK END THE COST OF MITIGATION?

>> IT 10S HOW BIG THE HOUSE IS WHAT KIND OF FOUNDATION YOU HAVE, A CRAWL SPACE?

BUT IT IS A LAW IN KENTUCKY THAT HAVE YOU TO USE A CERTIFIED RADON MITIGATION PROFESSIONAL TO FIX YOUR HOME AND THERE IS A WEBSITE THAT YOU CAN GO TO SEE WHO IS ACTUALLY CERTAIN SFIED TO DO THIS WORK.

>> YOU WANT TO MAKE SURE YOU GET THAT, RIGHT?

>> DEFINITELY BECAUSE YOU DON'T WANT JUST, YOU KNOW, YOU DON'T WANT TO DO IT YOURSELF.

YOU DON'T WANT TO D.I.Y.

IT.

YOU DON'T WANT TO ASK JUST TO, YOU KNOW, A PLUMBER OR AN H ACC PERSON.

YOU WANT TO ASK SOMEONE WHO HAS BEEN STRAINED TO DO IT THE RIGHT WAY.

WE UNFORTUNATELY HAD A BAD EXPERIENCE WITH A HOME, NOT IN THE CURRENT STUDY BUT IN ANOTHER STUDY, WHERE THE HOMEOWNER SAID OH THEY PUT THAT SYSTEM IN MY HOUSE ALREADY AND SO HE SAID I HAVEN'T TESTED IT IN A WHILE.

WE RECOMMEND EVERY TWO YEARS, REGARDLESS.

AND HE TESTED AND IT WAS 40.

SO IT WAS REALLY HIGH.

BUT THE PERSON THAT HAD PUT IT IN WAS NOT CERTIFIED AND SO THE PIPE, INSTEAD OF GOING OUT THE ROOF WENT INTO THE CHILD'S ROOM, SO ACTUALLY THE LEVELS OF RADON WERE VERY HIGH EVEN UP IN THE CHILD'S ROOM.

IT'S A MYTH THAT RADON STAYS IN YOUR BASEMENT AND IF YOU DON'T HAVE A BASEMENT, YOU DON'T HAVE TO WORRY.

NOT TRUE.

WE HAVE PEARNLTS PARTICIPANTS IN OUR STUDIES WHO HAVE BEEN IN MOBILE HOMES AND THEY HAVE RADON EVEN THOUGH THEY'RE UP IN BLOCKS.

SO DON'T ASSUME THAT YOU WON'T HAVE RADON.

IF YOUR NEIGHBOR HAS IT, GUESS WHAT, YOU MAY NOT HAVE IT OR YOUR NEIGHBOR MAY NOT HAVE IT AND YOU HAVE IT.

>> Renee: RIGHT.

IT'S A GAS.

THE ROCK IN THE SOIL BELOW YOUR HOME DEPENDS ON HOW MUCH IS EVEN AVAILABLE TO GET IN YOUR HOME.

>> Renee: TALK TO BUS WHERE WE STAND ON THE POLICY FRONT WHEN IT COMES TO RADON DETECTION AND ALL OF THESE OTHER ISSUES?

>> SO MORE THAN ONE IN THREE HOMES IN KENTUCKY HAS ELEVATED LEVELS OF RADON.

AND ELEVATED LEVELS ARE PRESENT IN EVERY COUNTY ACROSS THE STATE, ALL 120.

SO THIS IS A PLACE WHERE WE CAN TALK ABOUT SOME POLICIES SUCCESS AND POLICY OPPORTUNITY.

AND SO A FEW YEARS AGO, WE WERE SUCCESSFUL IN AMENDING THIS SELLERS DISCLOSURE FORM IN THE EVENT OF A RESIDENTIAL REAL ESTATE TRANSACTION TO INCLUDE LANGUAGE ABOUT THE RISKS ASSOCIATED WITH RADIOACTIVE RADON IN YOUR HOME.

AND THE LANGUAGE ALSO SUGGESTS THAT IF THE SELLER HAS TESTED, THEY SHOULD DISCLOSE THAT INFORMATION TO A POTENTIAL BUYER.

AND NOW THE LUNG ASSOCIATION WITH A GRANT FROM THE ENVIRONMENTAL PROTECTION AGENT ENVIRONMENTAL PROTECTION AGENCY HAS LAUNCHED AN EXTENSIVE AND COORDINATED EDUCATION CAMPAIGN TO REACH REALTORS AND TO EXPLAIN TO THEM THE RISKS ASSOCIATED WITH RADON, THE IMPORTANCE OF TESTING AND THE IMPORTANCE OF FIXING YOUR HOME JUST AS YOU WOULD IF YOU HAD YOUR HOME INSPECTED AND YOUR WATER HEATER NEEDED REPLACING, YOU WOULD REPLACE THE WATER HEATER.

THAT LANG IJ IS IN THE SELLER'S DISCLOSURE FORM.

THE CAMPAIGN IS AFOOT TO REACH REALTORS SO THAT THROUGH THEM, THE MESSAGE CAN BE AMPLIFIED TO HOMEBUYERS AND SELLERS.

WHAT MORE COULD WE DO?

WE SHOULD BE TESTING K-12 SCHOOLS.

WE SHOULD BE TESTING DAYCARE CENTERS BECAUSE RADIOACTIVE RADON EXPOSURE IS CUMULATIVE AND SO WE ARE SENDING OUR CHILDREN OFF TO SCHOOL TO SPEND HOURS AND HOURS AND THEN THEY COME HOME AND MAYBE THEIR HOME HASN'T BEEN TESTED AND AS YOU HEARD Dr. HAHN SAY, THAT'S TYPICALLY THE CASE.

WE SHOULD BE TESTING IN SCHOOLS.

AND WE ARE HOPING TO INCLUDE LANGUAGE IN THE UPCOMING BUDGET TO REQUIRE TESTING AND TO FUND TESTING IN K-12 SCHOOLS.

>> Renee: AND MITIGATION?

DO YOU GO AS FAR AS FUNDING THE MITT BASE FOR SCHOOLS THAT NEED SOME TYPE OF REMEDIATION OF RADON?

>> SO THAT'S THE NEXT STEP POTENTIALLY AND AS Dr. HAHN MENTIONED, RADON RESISTANT NEW CONSTRUCTION TECHNIQUES THAT WE COULD BE TALKING ABOUT DOWN THE ROAD AS WELL.

THERE IS A LOT TO BE ACHIEVED IN THE LEGISLATURE AROUND RADON.

>> Renee: Dr. SCOON-- Dr. CONNIE WHITE, TELL BUS THE STATE PROGRAM.

>> THE STATE GETS A GRANT FROM THE ENVIRONMENTAL PROTECTION AGENCY ALSO SO WE HAVE FREE RADON KITS IN HEALTH DEPARTMENTS ACROSS THE STATE.

THE LIST IS ON THE WEBSITE.

THERE ARE OVER 40 OF OUR COUNTIES HAVE THESE AS LONG AS THE SUPPLY LASTS.

IF YOU GO TO THE RADON WEBSITE AND YOUR COUNTY IS NOT ONE OF THOSE COUNTIES AND THE HEALTH DEPARTMENT DOESN'T HAVE ONE TO GIVE YOU FOR FREE, THERE IS A FORM THAT YOU CAN CLICK AND APPLY FOR A FREE RADON KIT.

THEY CAN BE PURCHASED IN STORES IF YOU NEED ONE.

>> Renee: GOOD INFORMATION.

SO NOW LET'S MAKE ANOTHER TRANSITION.

TALK ABOUT ASTHMA, Dr. CONNIE WHITE, LET'S PICK UP THERE.

WHAT CAN YOU TELL US ABOUT THAT AND THE STATE'S EFFORTS.

>> THE STATE OF KENTUCKY HAS A HIGHER ASTHMA RATE THAN THE UNITED STATES DOES.

11.5 VERSUS THE U.S. HAS 8% ASTHMA.

IT'S DIFFERENT IN DIFFERENT PARTS OF THE STATE.

CENTRAL KENTUCKY ACTUALLY HAS A HIGHER ASTHMA RATE THAN THE REST OF THE STATE DOES.

WE KNOW IT'S THE NUMBER ONE CHRONIC DISEASE IN SCHOOLS WHEN YOU LOOK AT CAMPUS SO CHILDREN MISSING SCHOOL, HAVING DIFFERENT KINDS OF HEALTH ISSUES IN SCHOOL BECAUSE OF ASTHMA.

WE KNOW THAT IF YOU LIVE IN A SCHOOL, IN A HOME THAT HAS AN INCOME OF LESS THAN 25,000, YOUR ASTHMA RATE IS ABOUT 18.5%.

>> Renee: 18.5%.

>> IF YOUR HOME, YOUR INCOME IS 50,000 OR MORE, IT'S 6.5.

>> Renee: WHY DOES INCOME MATTER HERE?

>> INCOME MATTERS BECAUSE OF THE HOME THAT YOU LIVE IN, WHETHER THERE IS MOLD THERE, WHETHER THERE IS INSECT INFESTATION.

IF YOU RENT AND YOU CAN'T GET MITIGATION FROM YOUR LANDLORD, THOSE KINDS OF ISSUES TEND TO AFFECT PEOPLE IN LOWER INCOMES.

THAT MEANS THEY MISS MORE WORK.

KIDS MISS MORE SCHOOL.

WHICH THEN PUSHES THAT INCOME DOWN EVEN FURTHER.

WE KNOW THAT PEOPLE WITH ASTHMA HAVE MORE ENGINE DEPARTMENT VISITS, MORE HOSPITALIZATIONS, MORE DIABETES.

49% ARE OBESE 40% WITH DEPRESSION.

WE HAVE 17.5% OF PERSONS DIAGNOSED WITH ASTHMA REPORT THEY HAVE AT LEAST ONE DISABILITY.

SO IT AFFECTS US ALL ACROSS THE LIFESTYLE BECAUSE IF YOU CAN'T BREATHE, YOU DON'T DO A LOT OF ACTIVITIES THAT WE WOULD LIKE FOR YOU TO BE ABLE TO DO WITH YOUR LIFE.

>> Renee: Dr. HAHN, I CAN'T IMAGINE HOW COMPLICATED COVID MAKES THOSE WHO DEAL WITH ASTHMA?

>> ABSOLUTELY.

ANYONE WITH LUNG DISEASE CANNOT FIGHT OFF ANY TYPE OF VIRUS OR ANY KIND OF INFECTIVE AGENT AND COVID, WE HAVE ALL BEEN DOING WITH IT.

I'M ASTHMATIC AND I WILL TELL YOU, YOU WANT TO AVOID ANY INFECTION IF YOU CAN.

>> Renee: SO WHAT ABOUT YOUR ORGANIZATION'S PRIORITIES WHEN IT COMES TO ASTHMA?

>> YEAH, ASTHMA IS KEY AND AS Dr. WHITE SAID, IT'S SO PREVIOUS DENT AND PREVALENT PRIMARILY IN LOW INCOME.

WE WORK A LOT WITH LOW INCOME AND HISTORICALLY MARGINALIZED POPULATIONS AND BECAUSE MANY OF THEM LIVE IN HOUSING THAT MAY BE RENTING AND THEY DON'T HAVE ACCESS TO SMOKE FREE ENVIRONMENTS, A LOT OF THEM DON'T, AND SO WE ACTUALLY, KNOWING ALL THAT, WHEN WE EVALUATE AND HAVE EVALUATED AND DONE RESEARCH ON SMOKE FREE LAWS, WE LOOKED AT EMERGENCY ROOM VISITS FOR ASTHMA AND WE EXPECTED AND HYPOTHESIZED THAT LEXINGTON WOULD SEE A DECLINE IN VISITS FOR ASTHMA AND THAT'S EXACTLY WHAT WE FOUND.

AND WE HAVE PUBLISHED THAT AND WE FOUND A SIGNIFICANT DECLINE IN ASTHMA VISITS, VISITS TO EMERGENCY DEPARTMENTS FOR ASTHMA, NOT ONLY AMONG ADULTS WHO ARE GOING TO BE PROTECTED BY OUR LAW BUT EVEN CHILDREN.

THAT'S WHAT WE DO.

OUR PROGRAMS ARE BROADER THAN ANY ONE DISEASE BECAUSE TOBACCO AFFECTS EVERY ORGAN IN THE BODY, OUR PROGRAM, EVERYTHING WE DO, ACTUALLY, EVERYTHING WE ADVOCATE FOR AND EVERY COMMUNITY THAT GOES SMOKE FREE IS PROTECTING THEIR PUBLIC, THEIR CHILDREN AND THEIR ADULTS FROM ASTHMA.

>> Renee: I WANT TO ASK YOU THE SAME QUESTION ABOUT HOW THE LUNG ASSOCIATION IS TAKING ON ASTHMA.

>> SO THIS IS ANOTHER AREA WHERE WE CAN TALK ABOUT SOME SUCCESS IN KENTUCKY.

SO DURING THE LAST LEGISLATIVE SESSION, WE WERE ABLE TO INTRODUCE LEGISLATION, IN FACT SENATOR MAX WISE, CHAIR OF THE EDUCATION EDUCATION COMMITTEE INTRODUCED LEGISLATION TO ALLOW SCHOOLS TO STOCK RESCUE MEDICATIONS FOR CHILDREN EXPERIENCING RESPIRATORY DISTRESS.

SO NOW SCHOOLS CAN STOCK AND ADMINISTER RESCUE MEDICATIONS TO ANY KID WHO IS HAVING TROUBLE BREATHING AND THAT IS AN ENORMOUS LIFE SAVER AND WE ARE THRILLED ABOUT THAT SUCCESS HERE IN KENTUCKY.

>> Renee: GREAT STEP.

NOW LET'S TURN OUR ATTENTION TO TALK ABOUT AIR POLLUTION.

WHILE WE HAVE AS A SOCIETY, MADE A LOT OF PROGRESS ON AIR POLLUTION, THAT YOU CAN SEE, SCIENTISTS ARE LEARNING THAT THERE IS A LOT OF AIR SOLUTION THAT WE CANNOT SEE THAT'S DOING HARM TO OUR HEALTH.

WE WANT TO SHARE A STORY ABOUT A UNIQUE STUDY FROM THE CHRISTINA LEE BROWN ENVIRON INSTITUTE LOOKING AT HOW TREES AND BUSHES CAN BE NATURAL AIR PURIFIERS SUFFERING FROM POLLUTED AIR AND THEN WE'LL SEE MY INTERVIEW WITH THE CHIEF INVESTIGATOR.

>> FRIDAY MORNING IN NOVEMBER AND A GROUP OF VOLUNTEERS ARE GATHERED PREPARING TO PLANT TREES IN THE NEIGHBORHOOD OF SLEWVILLE.

THIS IS NOT A BEAUTIFICATION PROGRAM.

RATHER IT'S PART OF THE GREEN HEART LOUISVILLE STUDY WHICH PLANS TO PLANT 10,000 TREES OVER THE NEXT FIVE YEARS.

>> NATURE UNITES US.

NATURE IS ALSO NOT A NICE TO HAVE THING.

KNEW TUR IS A MUST HAVE FOR LIFE TO THRIVE AND TO SURVIVE.

RIGHT NOW WE ARE IN SOUTH LOUISVILLE, ARGUABLY SOME OF THE MOST DIVERSE NEIGHBORHOOD IN THE NEIGHBORHOODS OF KENTUCKY.

IF YOU ARE SOUTH OR WEST LOUISVILLE NEIGHBORHOODS, YOU HAVE A LIFE EXPECTANCY 13 YEARS ON AVERAGE SHORTER THAN EAST LOUISVILLE NEIGHBORHOODS A FEW MILES AWAY FROM WHERE WE STAND TODAY.

>> THE STUDY'S CHIEF INVESTIGATOR ONCE PROVED THAT HEALTH INEQUITIES AND DISPARITIES IN GREENNESS ARE INTIMATELY CONNECTED.

HE AND HIS TEAM INTENSIVELY ANALYZED THE STUDY AREA AND PLOT OUT THEIR STRATEGY.

>> WE HAVE AT LEAST, IN SOME PARTS OF THE CITY, VERY LOW URBAN CANOPY AND OUR TREE PLANTATION EFFORTS HAVE ALSO LAGGED AND PARTICULARLY WE HAVE FOCUSED ON AREAS THAT ARE MORE AFFLUENT THAN AREAS THAT HAVE NOT BEEN SO AFFLUENT AND THEY HAVE BEEN SYSTEMATICALLY NEGLECTED OVER DECADES THAT HAVE BUILT UP TO THIS DEPLETED TREE CANOPY IN AREAS WHERE WE NEED THEM THE MOST.

THE MOST POLLUTED AREAS AND AREAS OF HIGH TRAFFIC AND HIGH INDUSTRY PRESENCE THAT WE SEE THE LOWEST AMOUNT OF TREES.

>> THE PROJECT HAS A CLINICAL COMPONENT AS WELL.

700 LOCAL RESIDENTS HAVE AGREED TO LET RESEARCHERS TRACK THEM OVER TIME AS THE STUDY PROGRESSES.

NOISE POLLUTION MONITORS ARE PLACED IN RESIDENTS YARDS.

AND AIR QUALITY MONITORS ARE PLACED STRATEGICALLY THROUGHOUT THE NEIGHBORHOOD.

>> THIS IS A COMMUNITY PROJECT.

IF WE ARE GOING TO BE IN THE COMMUNITY, WE CAN'T JUST SUPER IMPOSE OURSELVES LIKE WE ARE COMING IN, WE ARE GOING TO DO SOMETHING.

WE NEED TO BE A PROJECT THAT WE ARE WORKING ALONGSIDE OUR COMMUNITY PARTNERS, THAT WE ARE WORKING BESIDE THE RESIDENTS THAT WANT TO IMPROVE THIS NEIGHBORHOOD.

>> ONE OF THE PARTNERS IS LOUISVILLE GROVESSA A LOCAL NON-PROFIT DEDICATED TO TREE PLANTING IN LOUISVILLE OFFERING FREE TREES TO RESIDENTS WHO ARE CALLED TREE-CIPIENT.

>> WE ARE PLANTING 30 TO 40 TREES IN A PERSON'S YARD AND THEY'RE ALREADY SIX, SEVEN, EIGHT FEET TALL.

THAT SAVES THE RESIDENT MONEY, TIME, RESOURCES, BUT ALSO WE SEE THAT EFFECT ON GREENNESS AND WELLNESS IN THE NEIGHBORHOOD IMMEDIATELY.

>> THE BIG TREES ARE CAREFULLY CHOSEN FOR THEIR EFFECTIVENESS IN FILTERING BAD AIR AND STRATEGICALLY PLACED.

>> A LOT OF THE TREES THAT WE PLANT ARE USED IN THIS PLANTING STUDY BECAUSE THEY'RE VERY HEAT TOLERANT, THE LONGEVITY OF THEM AND ALSO THEY HOLD THEIR FOLIAGE ALL YEAR ROUND WHICH ALLOWS THEM TO DO THEIR JOB ALL YEAR ROUND.

I LOVE TO PLANT TREES AND A LOVE LANDSCAPING BUT WHEN I FOUND OUT THE SCIENTIFIC IMPACT OF THIS AND HOW THIS CAN CHANGE PEOPLE'S LIVES, THAT'S WHAT REALLY MOTIVATED ME.

>> ALTHOUGH WE CANNOT CHANGE THE ENTIRE WORLD, THE WHOLE SOCIOECONOMIC STRUCTURE MAY BE CHANGING GREENNESS CAN ADDRESS ONE LITTLE PART OF THE DISPARITY BUT IT WILL BE WELL WORTH IT.

ONE PART OF PLANTING TREES IS NOT ONLY THAT IT MAKES AN IMMEDIATE DIFFERENCE, BUT IT'S FOR MANY MORE GENERATIONS.

THAT'S WHAT WE ARE ATTEMPTING TO DO TO DO SOMETHING THAT ITSELF FUNDAMENTAL AND ENDURING SO THAT WE WILL BE ABLE TO, AT LEAST IN SOME SMALL MEASURE, OVER COME THE DISPARITIES PERPETUATED FOR GENERATIONS.

>> THANK YOU VERY MUCH FOR YOUR TIME TODAY.

>> THANK YOU FOR HAVING ME ON YOUR SHOW.

>> Renee: WE WANT TO TALK ABOUT THE GREEN HEART STUD NECESSITY A MINUTE BUT FIRST I WANT TO TALK ABOUT THE ENVIRON INSTITUTE.

TELL US WHAT IT IS AND WHY IT'S AN IDEA WHOSE TIME HAS COME?

>> THE ENVIRON INSTITUTE IS PART OF THE UNIVERSITY OF LUL LOUISVILLE, MULTIDISCIPLINARY COLLECTION OF FACULTY AND STUDENTS AND STAFF WHO ARE DEDICATED TO THE IDEA THAT WE NEED TO UNDERSTAND OUR ENVIRONMENT IN ORDER TO UNDERSTAND HEALTH AND DISEASE.

AND WE THINK THAT IF WE CAN MAKE INROADS IN UNDERSTANDING THE NATURAL AND SOCIAL ECOSYSTEMS, THEN WE MIGHT BE ABLE TO FIND NEW WAYS OF PROMOTING HEALTH HEALTH AND LONGEVITY AND DELAYING AGING.

SO THAT'S THE FUNDAMENTAL PRINCIPLE.

THE MAIN DIFFERENCE THAT THE WAY IT'S DIFFERENTIATED FROM OTHER INSTITUTIONS IS THAT IN THE ENVIRON INSTITUTE, WE ARE WORKING TOWARDS THE IDEA THAT IT WOULD BE BETTER TO ACTIVELY PROMOTE HEALTH THAN TO PASSIVELY PREVENT DISEASE.

BECAUSE YOU SEE, IF YOU PROMOTE HEALTH, YOU INCREASE RESILIENCE TO MULTIPLE DIFFERENT DISEASES RATHER THAN TO TRY A GAME OF WACK A WHOLE, LET'S PREVENT CANCER AND ASTHMA.

BUT IF YOU PROMOTE HEALTH AND MAKE PEOPLE HEALTHIER AND MORE RESILIENT, THEN YOU KNOW, YOU CAN WARD OFF A NUMBER OF DIFFERENT ILLNESSES.

AND I THINK THE HAVE HAD IS RIGHT BECAUSE WE HAVE SO MANY CHRONIC DISEASES THAT WE DO NOT REALLY KNOW WHICH TYPE AND FORM OF MULTIPLE AFFLICTIONS CAN AFFECT PEOPLE AT THE SAME TIME.

INCREASING HEALTH RESILIENCE RATHER THAN CHASING EVERY DISEASE MAKES SENSE AND THE SECOND THING WE HAVE LEARNED FROM THE COVID PANDEMIC IS THAT IF WE DO NOT KNOW WHAT IS GOING TO BE THROWN AT US NEXT, RIGHT?

SO ALL WE CAN DO IS TO PREPARE OURSELVES AND BE MORE HEALTHY AND MORE RESILIENT.

>> Renee: MAKES A LOT OF SENSE.

YOUR STUDY IS FOCUSED ON CARDIOVASCULAR DISEASE BUT TALK TO US ABOUT THE CONNECTION TO RESPIRATORY HEALTH AND HOW TO LOOK AND TREAT THE BODY AS A SYSTEM.

THE PART OF THE IDEA OF THE INSTITUTE IS THAT ALL OF THE DIFFERENT COMPONENTS OF OUR ENVIRONMENT ARE LINKED TOGETHER IN THE SAME WAY AS THE GENOME IS WITH ALL OF OUR GENETICS AND OUR GENES ARE LINK GD TOGETHER.

SO ARE ALL THE BODY SYSTEMS, LUNG, HEART, LIVER, KIDNEY, THEY WORK IN UNISON TO CREATE HEALTH.

AND IF EVEN ONE ASPECT OF PHYSIOLOGICAL FUNCTION FALLS APART OR DYSFUNCTIONS, THEN WE HAVE ISSUES IN THE OVERALL SYSTEMIC HEALTH AND SO LUNG AND HEART HAVE A VERY INTIMATE CONNECTION AND WE KNOW THAT ONE OF THE STRONGEST PREDICTOR OF CARDIOVASCULAR DISEASE AND LONGEST IS LUNG CAPACITY.

THERE ISN'T ANYTHING ELSE THAT IS A STRONG PREDICTIVE VALUE.

HAVING HEALTHY LUNGS IS VERY CRITICAL TO HAVING LEGISLATEY EVERYTHING ELSE, INCLUDING A HEALTHY HEART, HEALTHY BLOOD VESSELS.

FOR SECOND THICK WE KNOW, PEOPLE WHO ARE EXFOESED-- EXPOSED TO DIFFERENT TOXINS AND INHALATION, HAVE PROBLEMS WITH THEIR BLOOD PRESSURE REGULATION AND WITH THEIR CARDIOVASCULAR FUNCTION.

WE KNOW THAT AIR PAR TICK LATES, THINGS LIKE C.O.P.D.

AND ASTHMA HAVE PROFOUND EFFECTS ON CARDIOVASCULAR FUNCTION BUT MOST IMPORTANTLY POLLUTION EXPOSURE, PEOPLE EXPOSED TO AIR POLLUTION AND BREATHE THEIR PARTICLES THROUGH THEIR NOSE AND LUNG DIE FROM HEART DISEASE.

SO THERE IS THIS WHAT DO YOU CALL CARDIO RESPIRATORY ACTION AXIS THAT IS ONE OF THE PRINCIPAL DETERMINANTS OF HEALTH.

>> Renee: LET'S RETURN TO THE GREEN HEART STUDY.

WHAT ARE SOME OF THE BENEFITS YOU ARE SEEING ALREADY?

>> RIGHT.

SO GOING TO THE CONNECTION THAT IN ORDER FOR US TO HAVE HEALTHY HEARTS, WE MUST HAVE HEALTHY LUNGS AND WE MUST HAVE HEALTHY AND PURE AIR TO BREATHE AND THE PROJECT WAS LAUNCHED WITH THE IDEA TREES CAN REMOVE AIR POLLUTION, TREES CAN REDUCE NOISE AND ABOUT BUFFER ALL THE EXPOSURES TO PEOPLE AND SO IF WE INCREASE GREENNESS WITH THAT, WOULD IT PROMOTE HEALTH AND PARTICULARLY CARDIOVASCULAR HEALTH?

ALTHOUGH WE HAVE DONE SOME INITIAL ROUNDS OF STUDIES IN THE AREA AND STARTING TO PLANT THE TREES BUT WE HAVE LEARNED FROM THERE AND OTHER AREAS IN LOUISVILLE THAT PEOPLE WHO LIVE NEXT TO TREES OR LIVE IN MORE GREEN AREAS ARE LESS LIKELY TO BE EXPOSED TO DIFFERENT TOXIC CHEMICALS FROM THE AIR, RIGHT?

WE STUDY SOME CHEMICALS LIKE BENZINE AND OTHER VOLATILE COMPOUNDS.

THEY'RE ABANDONED IN THE ENVIRONMENT.

SO PEOPLE WHO LIVE IN GREENER PLACES SEEM TO BE A LITTLE BIT MORE SHIELDED FROM THE INFLUENCE AND EXPOSURE TO THESE TEM CALS BECAUSE WE BELIEVE, ALTHOUGH WE HAVE NOT PROVED IT YET THAT THE TREES PURIFY THE AIR AROUND THE AREA WHERE THEY ARE.

>> FINAL QUESTION, JUST IN A FEW SECONDS, IF YOU CAN.

SO WHAT DOES YOUR RESEARCH MEAN, DO YOU THINK TO PUBLIC HEALTH AND FOR THOSE WHO ARE INVOLVED IN YOU LAID OUT A SCENARIO ABOUT PURIFICATION.

HOW DOES THAT CHANGE HOW WE DEVELOP OUR AREAS AROUND US?

>> WE ARE RADICALLY RETHINKING HOW WE LIVE AND SO PART OF THE WORK WE ARE DOING IS TO PROVIDE THAT JUSTIFICATION, NO THE THAT WE NEED STRONG JUSTIFICATION FOR HAVING GREEN THINGS AROUND WHERE WE LIVE.

I THINK THAT'S ABSOLUTELY CRITICAL.

NATURE IS SO IMPORTANT FOR US BECAUSE IT CAN LOWER ANXIETY, MAKES THE AREA MORE LIVABLE, RIGHT?

AND SO WE NEED TO WORRY ABOUT ALL THE THINGS.

BUT IF WE CAN PROVIDE REAL EVIDENCE THAT HOW MUCH GREEN IS REQUIRED TO REDUCE WHAT LEVEL OF POLLUTION, WHAT LEVEL OF GREENNESS, WHAT TYPES OF TREES AND WHERE THEY SHOULD BE PLACED, THERE IS A GENERAL ENTHUSIASM, RELATIVELY UNIVERSAL ACCEPTANCE THAT WE SHOULD ALL BE LIVING IN GREEN NEIGHBORHOODS AND EVERY NEIGHBORHOOD WANTS TO BE GREEN BUT WE SHOULD KNOW WHERE SHOULD WE BE PUTTING THE TREES, WHICH TREES ARE BETTER THAN OTHER TREES.

SOMETIMES WHEN YOU PUT LOLLIPOP TREES ON THE STREET, THEY CAN ACCUMULATE MORE AIR POLLUTION THAN DISBURSE IT.

WE NEED TO THE KNOW THE RIGHT CONFIGURATION, SPECIES, DENSITY AND ALL THESE THINGS WE HOPE TO ATTEMPT TO ANSWER DURING THE GREEN HEART PROJECT.

>> Renee: THANK YOU SO MUCH, DOCTOR.

SO INTRIGUING AND MAKES SUCH GOOD SENSE ACTUALLY.

THANK YOU VERY MUCH FOR SHARING YOUR RESEARCH WITH US.

>> SUCH IMPORTANT WORK.

WHAT HE IS SAYING AND WE ARE ALL SAYING IS OUR AIR IS IMPORTANT AND WE HAVE TO CEECH IT CLEAN, KEEP THE OUTDOOR AND INDOOR CLEAN AND A LOT OF THE DISEASES THAT KILL KENTUCKIANS ARE FROM AIR QUALITY ISSUES.

POOR AIR QUALITY.

>> Renee: OUR BEHAVIOR CAN BE PART OF THAT SOLUTION Dr. CONNIE WHITE.

>> TALKING ABOUT SMOKING CESSATION, SMOKE FREE ENVIRONMENTS, HELPING PEOPLE LEARN HOW TO TAKE CARE OF THEMSELVES, ASTHMA SELF MANAGEMENT CLASSES, ALL OF THOSE THINGS ARE CRITICAL $SHANNON BAKER, IF YOU COULD GIVE US A FEW TAKEAWAYS THAT MAYBE PERHAPS OF WHAT YOU HEARD BUT ALSO IN THE OVERALL CONVERSATION ABOUT LUNG HEALTH AND HOW WE ALL HAVE A PART TO PLAY.

>> I THINK IT'S CRITICALLY IMPORTANT TO UNDERSTAND THAT WE ALL HAVE A PART TO PLAY.

WE STARTED THE CONVERSATION AT THE VERY BEGINNING TALKING ABOUT FUNDING FOR THE STATE TOBACCO PREVENTION AND CESSATION PROGRAM AND HOW LOW THAT LEVEL OF FUNDING IS.

COMPARE TO WHAT BIG TOBACCO SPENDS ON MARKETING TO OUR KIDS I ROO ENTLY READ THE LEVEL IS SOMETHING LIKE $1 FROM US AND $117 FROM BIG TOBACCO.

THAT'S THE LEVEL AT WHICH WE ARE CURRENTLY OUTSPENT AND THE ONLY WAY TO COMPENSATE FOR THAT IS FOR ADVOCATES IN THE COMMUNITY IS TO ENSURE THEIR VOICES ARE HEARD.

ON TOBACCO, ON RADON EDUCATION, THE ONLY WAY TO REACH A LEGISLATOR AND COMBAT THAT OVERWHELMING DISPARITY IN SPENDING IS FOR VOTERS TO WEIGH IN AND TO SAY THIS IS IMPORTANT TO ME.

I WE WILL GIVE YOU ALL THE TOOLS YOU NEED TO MAKE IT HAPPEN.

>> Renee: POLICY CHANGE IS INCREMENTAL POLITICS SOMETIMES.

BUT THAT STILL MEANS THERE IS PROGRESS, RIGHT?

>> ABSOLUTELY.

>> Renee: WHERE DO YOU HOPE THINGS WILL GR FROM HERE?

>> I AGREE WITH MY COLLEAGUE THAT WE HAVE TO INVEST BECAUSE WE KNOW THE RETURN ON INVESTMENT IS HUGE.

FOR EVERY DOLLAR WE SPEND IN TOBACCO PREVENTION AND CESSATION, WE SAVE $55.

WE CAN'T AFFORD NOT TO INVEST BECAUSE WE ARE LOSING SO MANY PRECIOUS LOVED ONES IN KENTUCKY TO THESE ISSUES.

BUT THE BIGGER ISSUE IS, YES, I THINK THE LOCAL ELECTED OFFICIALS HAVE A ROLE TO PLAY AND THEY HAVE STEPPED UP.

I'M VERY PROUD OF OUR LOCAL ADVOCATES AND OUR LOCAL OFFICIALS WHO HAVE SAID WE WANT THE BEST AIR THAT WE CAN BREATHE IN OUR COUNTIES, IN OUR WORKERS AND OUR PATRONS AND RESIDENTS DESERVE IT.

>> Renee: PRODUCTIVITY OF THE CITIZENRY, RIGHT, NO THE JUST IN WORKFORCE BUT LIFESTYLES AND CONTRIBUTIONS IN SO MANY WAYS.

>> ABSOLUTELY.

AND TO THE COMMENT ABOUT LET'S JUST BE HEALTHY.

LET'S DO EVERYTHING WE CAN TO KEEP OUR LUNGS HEALTHY.

I'M ALL ABOUT THAT.

AND LIKE I SAID, LOCAL OFFICIALS HAVE STEPPED UP AND MORE NEED TO.

WE HAVE 41 COMMUNITIES.

WE ARE AT ABOUT 37% OF OUR KENTUCKIANS THAT ARE COVERED BY GOOD STRONG LAWS BUT THAT MEANS A LOT OF PEOPLE AREN'T.

MY MESSAGE TO YOU AS A LISTENER IS TO TALK TO YOUR LOCAL OFFICIALS, TELL THEM THAT YOU WANT CLEAN WEAR INSIDE YOUR RESTAURANTS, YOUR BARS, YOUR WARPLANES.

SO THAT YOU DON'T HAVE TO THINK ABOUT BEING HEALTHY.

WE CAN MAKE THE HEALTHY CHOICES THE EASY CHOICES.

>> Renee: I KNEW YOU WERE GOING TO SAY THAT.

I CAN COUNT ON YOU TO BRING THAT LINE IN.

A GREAT WAY TO WRAP THINGS UP.

THANK YOU VERY MUCH.

YOU HAVE BEEN FANTASTIC.

WE APPRECIATE YOU SO VERY MUCH AND FOR ALL OF THOSE WHO PARTICIPATED IN THE PIECES WE PLAYED EARLIER AND Dr. WAYNE TUCKSON, WE APPRECIATE YOU FOR WATCHING TONIGHT AND BEING PART OF THIS FIGHT TO HELP KENTUCKIANS BREATHE EASIER.

THANK YOU ALL FOR WATCHING.

WE ENCOURAGE EVERYONE TO CHECK OUT OUR THREE-PART SERIES, FIGHTING TO BREATHE, AVAILABLE ON OUR WEBSITE ON DEMAND AT ket.org/RESPIRATORY.

REMEMBER THAT ANYONE WITH LUNGS CAN GET LUNG DISEASE.

AND CLEAN AIR IS VITAL TO LIFE AND WELL-BEING.

FROM ALL OF US HERE AT KET, STAY