THE HEADLINES GO TO THE NEW MEDICATION OR SURGICAL TREATMENT.

BUT IT IS THE SMALL THINGS THAT HAVE THE BIGGEST IMPACT ON HEALTH OUTCOMES.

STAY WITH US AS WE TALK TO KENTUCKY MEDICAL ASSOCIATION PRESIDENT Dr. EVELYN MONTGOMERY JONES ABOUT SMALL STEPS, BIG IMPACT NEXT ON "KENTUCKY HEALTH."

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.

IN SHAKESPEARE PLAY JULIUS CAESAR, CASHES SPEAKING TO BRUTUS SAYS THE FAULT DEAR BRUTUS IS NOT IN THE STARS BUT IN OURSELVES THAT WE ARE UNDERLINGS.

THIS IS AN APT QUOTE WHEN IT COMES TO OUR HEALTH AS FAR TOO MANY OF US DO NOT EXERCISE OR HAVE FULLY ABDICATED OUR RESPONSIBILITY AND CONTROL FOR OUR HEALTH.

THERE ARE MANY FACTORS THAT HAVE BOTH DIRECT AND INDIRECT IMPACT ON OUR HEALTH.

THESE MAY BE INHERITED, REFLECTIVE OF WHERE WE LIVE AND WORK, THE STRESSES IN OUR LIVES, EDUCATIONAL ATTAINMENT, INCOME, AND THE AVAILABILITY AND ACCESS TO RESOURCES THAT MAY AFFECT THE QUALITY OF OUR LIVED EXPERIENCES.

MANY OF THOSE FACTORS THAT LAY OUTSIDE OF OUR DIRECT CONTROL ACT MORE AS OBSTACLES TO BE NAVIGATED RATHER THAN A SOCIETAL BENEFIT FROM WHICH WE MAY PARTAKE.

STILL, THERE IS STILL SOME LOW HANGING FRUIT THAT IS WELL WITHIN REACH FOR MOST OF US FROM WHICH WE MAY DERIVE GREAT BENEFIT.

TODAY WE ARE GOING TO TALK ABOUT SOME OF THE THINGS THAT WE AS INDIVIDUALS CAN DO EITHER ALONE, WITH OUR FAMILIES, AND IN SOME CASES AS A COMMUNITY TO IMPROVE OUR OVERALL HEALTH STATUS.

TO TELL US ABOUT SMALL STEPS, BIG IMPACT, WE HAVE AS OUR GUEST TODAY Dr. EVELYN MONTGOMERY JONES.

Dr. MONTGOMERY JONES IS A GRADUATE OF THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE SHE DID BOTH AN INTERN INTERNSHIP IN EARN TERM MEDICINE AND RESIDENCY IN DERMATOLOGY AT THE UNIVERSITY SCHOOL OF LOUISVILLE SCHOOL OF MEDICINE, OWNER OF WELL SPRINGS DERMATOLOGY AND WELL SPRINGS SKIN CARE IN PADUCAH KENTUCKY AND SHE IS THE 174th PRESIDENT OF THE KENTUCKY MEDICAL ASSOCIATION.

LET ME SAY YOUR SKIN LOOKS MAGNIFICENT.

>> WHAT DO WE TELL THE YOUNG WOMAN WHO IS SITTING OUT THERE AND SAYS I WANT TO BE JUST LIKE Dr. MONTGOMERY JONES.

WHEN DO THEY NEED TO START PREPARING TO BE A DOCTOR AND HOW DO THEY GO ABOUT DOING THAT.

>> THAT IS A GREAT QUESTION BECAUSE WE NEED MORE PHYSICIANS AND WE HAVE A PHYSICIAN SHORTAGE IN KENTUCKY SO IT'S VERY IMPORTANT THAT WE ARE CONTINUALLY TALKING TO YOUNG PEOPLE ABOUT IF THIS IS AN INTEREST OF YOURS, AND WE HAVE THE STEM PROGRAMS, WHICH ARE, I THINK, A GREAT OUTLET FOR THAT.

BUT I THINK WITHIN OUR COMMUNITIES IT'S IMPORTANT FOR US TO TALK TO SCHOOLS, LET PEOPLE KNOW, WE WILL BE A MENTOR.

WE WILL BE A MODEL FOR LETTING PEOPLE KNOW WHAT THEY NEED TO DO IN HIGH SCHOOL.

THE CLASSES THEY NEED TO TAKE, HOW TO NAVIGATE APPLYING TO COLLEGES, AND NAVIGATING THE PREMED STRATEGIES AND PROGRAMS.

SO I THINK IT'S IMPORTANT THAT PEOPLE LOOK FOR A MENTOR, FIND A PHYSICIAN IN YOUR LOCAL COMMUNITY.

AND IF YOU DON'T KNOW ONE, A LOT OF SCHOOL SYSTEMS WILL HELP YOU FIND ONE AND ALLOW YOU TO SHADOW AND HAVE OPPORTUNITIES WITHIN THE PHYSICIAN'S OFFICE.

>> NEVER TOO EARLY TO THINK ABOUT BEING A DOC, IS IT?

>> ABSOLUTELY NOT.

>> I THINK IT'S ONE OF THE GREATEST THINGS ONE CAN DO, ISN'T IT?

>> IT'S A BLESSING.

>> IT IS WHEN WE THINK ABOUT KENTUCKY, WELL, WE USED TO THINK ABOUT KENTUCKY BEING NUMBER ONE IN BASKETBALL.

I GUESS THAT IS STARTING TO COME BACK AT U OF L AND U.K. NOW, BUT UNFORTUNATELY WE ARE NUMBER ONE IN MANY OF THE MORE NEGATIVE HEALTH STATISTICS.

TELL ME ABOUT SOME OF THAT.

>> SO IN 2023, AMERICA'S HEALTH RANKINGS RANKED KENTUCKY BE 41st THE HEALTHIEST STATE AND WE BEEN IN THE 40S REALLY EVERY YEAR SINCE 1990 EXCEPT FOR 2008 AND WE WERE 39th.

SO WE ARE IN THE 40s WHEN IT COMES TO OBESITY, TOBACCO USE, PHYSICAL DISTRESS, EXERCISE, MOVEMENT THROUGHOUT THE DAY.

AND MANY OTHER STATISTICS.

I THIS I THERE ARE A LOT OF REASONS FOR THAT-- I THINK THERE ARE A LOT OF REASONS FOR THAT THAT ARE IMPORTANT TO UNDERSTAND; HOWEVER, IT IS ALSO VERY IMPORTANT TO KNOW WHAT WE CAN OWN OURSELVES AND HELP OURSELVES ON A DAY-TO-DAY BASIS TO IMPROVE OUR HEALTH.

>> IS IT SOMETHING THAT WE ALL HAVE THE ABILITY OR TO ACCESS AND DO THINGS FOR OUR HEALTH?

OR DO HAVE YOU TO LIVE IN CERTAIN AREAS?

>> WE DO THINK IT IS IMPORTANT.

WE KNOW THE SOCIAL DETERMINANTS OF HEALTH, FOOD INSECURITY AND POVERTY LEVELS ALL FACTOR INTO MAKING IT MORE CHALLENGING FOR SOME PEOPLE THAN OTHERS TO MAKE THE HEALTHY LIFESTYLE CHOICES AND AS FAR AS THAT GOES.

I THINK IT'S VERY IMPORTANT FOR PHYSICIANS IN GENERAL TO BE ADVOCATING FOR POLICIES THAT MAKE A DIFFERENCE IN OUR STATE, TO HELP ALL KENTUCKIANS HAVE ACCESS TO A HEALTHY LIFE.

AND THAT'S WHERE, I DO BELIEVE EVERY PHYSICIAN SHOULD BE A MEMBER OF THE KENTUCKY MEDICAL ASSOCIATION BECAUSE WE ARE IS BUSY PEOPLE IN OUR SERVICES SEEING-- IN OUR OFFICES SEEING OUR PATIENTS AND THEY CAN ADVOCATE, LEGISLATE, DRAFT POLICIES AND CONVERSATIONS WITH OUR LEGISLATORSES TO LOOK AT POLICIESES, POLICIES FOR QUALITY FOOD IN OUR SCHOOL SYSTEMS, WALKABLE, BIKABLE, SAFE ENVIRONMENTS SO PEOPLE CAN WALK IN.

FOOD INSECURITIES, MANY OF THOSE ARE POLICIES THAT NEED TO BE TAKEN CARE OF AT A LEVEL BEYOND AN INDIVIDUAL.

>> OFTEN TIMES WE HEAR A PERSON IS NOT DOING ENOUGH.

WE PUT THE RESPONSIBILITY ON THE PATIENT AND IT'S ALMOST THE SCARLET LETTER OF SAYING YOU ARE NOT DOING WHAT YOU SHOULD BE DOING, THEREFORE HERE IS WHY YOU HAVE THIS DISEASE.

IS THAT A FAIR THING FOR US TO BE DOING TO PATIENTS?

>> I LIKE TO ELEVATE THE CONVERSATION ABOVE BLAME OR MAKING IT THAT RIGID OR SIMPLE.

IT'S NOT SIMPLE.

I THINK OUR HEALTH-- I LIKE TO LOOK AT OUR HEALTH AS AN UMBRELLA.

WE HAVE MULTIPLE PILLARS AND FACETS THAT SUPPORT OUR HEALTH.

WE HAVE PRIMARY CARE PHYSICIANS.

WE HAVE SPECIAL PHYSICIANS THAT HAVE BEEN EDUCATED AND TRAINED THAT SUPPORT US IN THE STATE OF KENTUCKY.

WE HAVE MEDICATIONS THAT WE SOMETIMES NEED.

WE HAVE SURGERIES THAT PROCEDURES THAT NEED TO BE PERFORMED.

WE HAVE HOSPITALS THAT ALLOW THAT.

WE HAVE OUR INFRASTRUCTURE AND OUR COMMUNITY.

BUT WE ALSO HAVE THE PIECE WHERE WE MAKE OUR DAY-TO-DAY CHOICES THAT EITHER SUPPORT OUR HEALTH OR ARE DETRIMENTAL TO OUR HEALTH.

SO THAT IS-- WE CAN'T MAKE IT AS SIMPLE AS IT IS YOUR FAULT OR IT IS SOMEONE ELSE'S FAULT.

ALL OF THAT PLAYS A ROLE IN OUR HEALTH.

>> YOU KNOW, I'VE HEARD YOU SAY THAT YOU, AS A DERMATOLOGIST AND AS OR SPECIALTY, YOU SEE THE WHOLE PERSON, LITERALLY AND FIGURATIVELY.

>> UH-HUH.

>> HOW DO YOU GET INVOLVED IN THIS ISSUE ABOUT IMPROVING OUR HEALTH AS OPPOSED TO-- IS THAT HOW YOU GOT IT INTO BECAUSE YOU ARE LOOKING AT EVERYTHING THERE IS TO KNOW.

WE CANNOT HIDE FOR THE DERMATOLOGIST.

WE ARE LITERALLY AND FIGURATIVELY LIKE I SAID, NAKED BEFORE THE WORLD.

>> YES.

>> IS THIS HOW YOU GET INVOLVED IN TREATING US?

>> IT'S INTERESTING.

I HAD MY OWN HEALTH CRISIS IN 2000 AND THAT STARTED ME ON A JOURNEY OF LIVING WITH A CHRONIC DISEASE THAT I HAD TO LEARN HOW TO LIVE AND BE PAIN FREE, TO LEARN HOW TO EAT AND MOVE AND MANAGE MY STRESS TO BE THE PHYSICIAN AND MOTHER AND WIFE THAT I WANTED TO BE.

AND SO THAT WAS A VERY PERSONAL JOURNEY FOR ME.

BUT OUT OF THAT, WHEN I SAW HOW I FELT, I WAS SO MOTOR-- I WAS SO MOTIVATED TO TALK TO MY PATIENTS.

PEOPLE SEE THE ORGAN I'M TREATING.

THEY SEE THEIR SKIN.

THEY DON'T LIKE SOMETHING ABOUT THEIR SKIN OR IT'S UNCOMFORTABLE AND IT'S A WONDERFUL OPPORTUNITY FOR ME TO SAY, THE INFLAMMATION ON YOUR SKIN OR THIS PART OF YOUR SKIN DISEASE CAN BE IMPROVED BY MAKING THESE OTHER CHOICES.

CAN I GIVE YOU A TREATMENT.

I CAN PERFORM A SURGERY THAT NEEDS TO BE PERFORMED BUT ALSO ONE OF THE BEST THINGS I CAN DO IS GIVE YOU RESOURCES AND INFORMATION ON THE DAY-TO-DAY THINGS YOU CAN DO TO IMPACT YOUR HEALTH.

>> THIS IS A PERFECT SEGUE THEN.

EVERYONE WHO COMES IN IS PRESIDENT OF KMA, KENTUCKY MEDICAL ASSOCIATION HAS SOMETHING THEY WANT TO PUSH FOR, AN AGENDA.

I'M FASCINATED BY THIS PARTICULAR AGENDA OF SMALL STEPS, BIG IMPACT.

TELL ME ABOUT THAT.

HOW DID YOU COME UP WITH THAT AND WHAT DOES IT REALLY PEEN?

>>-- WHAT DOES IT REALLY MEAN?

>> WHEN THERE IS AN OBSTACLE LOOKING AT HEALTH CAN FEEL OVERWHELMING.

I THINK IT IS VERY POWERFUL TO HELP KENTUCKIANS KNOW THERE ARE SOME SMALL TEPS THAT YOU CAN TAKE THAT CAN LEAD TO A BIG IMPACT ON YOUR HEALTH.

SO THIS IS A TWO-YEAR CAMPAIGN.

IT'S A COLLABORATION WITH THE KENTUCKY MEDICAL ASSOCIATION, THE KENTUCKY FOUNDATION FOR MEDICAL CARE WITH A GRANT FROM THE KENTUCKY DEPARTMENT OF DEPARTMENT OF PUBLIC HEALTH THAT WILL ALLOW US TO REACH KENTUCKIANS THROUGH PUBLIC-- PSAs AND WEBS AND ADS AND DIFFERENT MEDIA OUTLETS TO HELP PEOPLE KNOW THAT THERE ARE DAY-TO-DAY THINGS THAT YOU CAN DO THAT FEEL SMALL, THAT YOU MAY NOT EVEN KNOW WOULD BE HELPFUL FOR YOUR HEALTH BUT CAN, OVER TIME, LEAD TO A BIG IMPACT.

AND THEN WE USE THE STEPS ACRONYM, TO PICK OUT REALLY WHAT THE MOST IMPORTANT THINGS THAT WE WANT TO FOCUS ON.

>> LET'S START.

S. >> S IS SCREENING.

EARLY DETECTION OF CANCER IS THE BEST AVENUE THAT WE HAVE TO HELP PEOPLE COMBAT ANY LONG-TERM IMPACT OF CANCER.

EVERYONE IS ELIGIBLE FOR DIFFERENT SCREENINGS, DIFFERENT AGES.

AND SO IT'S VERY IMPORTANT FOR PEOPLE TO HAVE THOSE CONVERSATIONS WITH THEIR PRIMARY CARE PHYSICIANS OR THEIR SPECIALTY PHYSICIANS TO KNOW WHAT SCREENING FOR EARLY DETECTION OF CANCER THEY'RE ELIGIBLE FOR.

WHAT AGE THEY'RE ELIGIBLE TO TAKE THOSE AND DO THOSE.

WE HAVE MADE GREAT STRIDES IN COLORECTAL CANCER SCREENING AND LUNG CANCER CREEN SCREENING SO THE FOCUS IS TO REALLY GROW THAT AND HELP PEOPLE KNOW WHAT THEY CAN BE SCREENED FOR.

>> DO YOU ENCOURAGE PEOPLE TO THINK BEYOND CANCER WHEN IT COMES TO SCREENING, THINGS LIKE DIABETES AND HYPERTENSION, TOO?

>> YES.

ABSOLUTELY.

AND THAT IS SOMETHING THAT, YOU KNOW, WE HAVE HEARD THE TERM INSULIN RESISTANCE OR PREDIABETES, AND SO I THINK THOSE ARE TERMS THAT HELP PEOPLE SAY OH I CAN CATCH SOMETHING EARLY ON TO KNOW.

HEY, THIS IS GOING THE WRONG DIRECTION.

AND I WANT TO DO SOMETHING ABOUT IT NOW.

>> I THINK KENTUCKY WAS ONE OF THE LEADERS IN GETTING INSURANCE COMPANIES TO COVER THE COST OF CANCER SCREENINGS.

>> YES.

>> IS THAT SOMETHING THAT IS A BENEFIT?

I'M SURE PATIENTS WILL SAY YOU WANT ME TO GET SCREENING BUT HOW AM I GOING TO PAY FOR THIS?

>> YES.

THAT HAS BEEN VERY IMPORTANT LEGISLATIVE POLICY WORK TO ENCOURAGE INSURANCE COMPANIES TO COVER THE SCREENINGS AND THAT'S WHY IT'S VERY IMPORTANT FOR PEOPLE TO KNOW AT WHAT AGE THEY'RE ELIGIBLE BECAUSE THAT WILL BE DETERMINED BY WHAT IS GOING TO BE COVERED.

>> SO THIS IS ONE OF THOSE THINGS THAT THE KENTUCKY MEDICAL ASSOCIATION IS DOING BEHIND THE BACK THAT IS SIGNIFICANT BENEFIT FOR ALL OF US GOING FORWARD?

>> YES.

>> I JUST WANT TO MAKE SURE WE GET A PLUG IN THERE FOR THAT.

I'M A MEMBER OF THE KMA.

>> VERY IMPORTANT.

>> ALL RIGHT.

WE ARE A BIG TOBACCO PRODUCER.

>> YES.

>> OR AT LEAST WE ARE A BIGGER TOBACCO PRODUCER IN THE PAST.

HOW DOES TOBACCO FACTOR INTO THIS.

>> THE T IS FOR TOBACCO USE AND THERE ARE MULTIPLE DETRIMENTAL HEALTH ASPECTS OF TOBACCO USE.

AND SO THE IMPORTANT PART IS THAT WE NEED TO HELP PEOPLE UNDERSTAND TO NOT BEGIN THAT JOURNEY OF USING TOBACCO IN ANY ASPECT, BUT ALSO, IN KENTUCKY, KENTUCKY-BASED INSURANCE COMPANIES WILL COVER MEDICATION, PROGRAMS TO HELP PEOPLE STOP SMOKING.

AND SO I THINK IT'S IMPORTANT TO HAVE THOSE CONVERSATIONS WITH YOUR PRIMARY CARE DOCTOR ABOUT WHAT YOU CAN USE, WHETHER IT'S SUPPORT GROUPS OR MEDICATION ASSISTED CESSATION PROGRAMS.

THERE ARE OTHER TECHNIQUES EVEN.

THERE HAS BEEN HYPNOSIS AND ACUPUNCTURE AND THINGS THAT HAVE BEEN SHOWN TO HELP PEOPLE STOP SMOKING.

>> PERHAPS THIS ISN'T THE BEST REASON FOR SOMEONE NOT SMOKING BUT DOESN'T IT ALSO IMPACT OUR SKIN AND AGES US A LITTLE ABOUT I.T.?

>> OH YES, YES.

SIGNIFICANTLY.

AGES THE SKIN, EVERY PUFF.

>> IF FOR NO OTHER REASON, FOR THE ESTHETICS ALONE, GET RID OF SMOKING.

>> YES.

>> SOMEWHAT MORE CONTROVERSIAL I WOULD SAY ONLY BECAUSE OF BEING ABLE TO FIND A PLACE TO DO IT, BUT TELL ME ABOUT EXERCISE AND NUTRITION.

HOW DOES THIS FACTOR IN?

>> MULTIPLE STUDIES HAVE LINKED SEDENTARY LIFESTYLE WITH DISEASE AND LACK OF RESILIENCY.

EVEN THE MENTAL HEALTH COMPONENT IS CONNECTED TO LACK OF PHYSICAL ACTIVITY THERE.

WAS A STUDY THAT CAME OUT A FEW YEARS AGO THAT SHOWED ONLY 15% OF TEENAGE GIRLS AND 12% OF ADULT WOMEN RECEIVED THE RECOMMENDED AMERICAN MEDICAL ASSOCIATION AMOUNT OF PHYSICAL ACTIVITY A WEEK.

>> 15 AND 20%?

>> 12.

>> 15 AND 12%.

>> SO WE ARE A VERY IMMOBILE PEOPLE.

AND THERE ARE SIGNIFICANT HEALTH IMPACTS TO THAT.

IN FACT, A STUDY CAME OUT A FEW YEARS AGO THAT SHOWED IF YOU WERE SITTING OR SEATED FOUR HOURS A DAY, YOU INCREASE YOUR RISK OF HEALTH PROBLEMS EQUIVALENT TO SMOKING A PACK OF CIGARETTES A DAY.

SEDENTARY LIFESTYLE IS VERY UNHEALTHY FOR US.

BUT PEOPLE SOMETIMES THINK I NEED A GYM MEMBERSHIP BUT THAT IS NOT TRUE.

THEY HAVE SHOWN IN THE BLUE ZONE AREAS, MOVEMENT THROUGHOUT YOUR DAY, DECONVENIENCING YOUR LIFE A LITTLE BIT.

IF YOU WORK AT A DESK THAT YOU ARE SEATED, ASK YOUR BOSS FOR A STANDING DESK SO THAT YOU CAN STAND.

TAKE LITTLE MOVEMENTS, DO SOME PUSHING OR ASSISTED PUSHUPS OFF YOUR DESK COUNTER EVERY HOUR.

MOVEMENT THROUGHOUT THE DAY MAKES SUCH A BIG DIFFERENCE.

AND WE DON'T EVER WANT TO STOP DOING THAT.

>> YOU USED THE TERM BLUE ZONE.

WHAT IS THAT?

>> BLUE ZONE WAS I BOOK WRITTEN SEVERAL YEARS AGO WHO WAS COMMISSIONED TO FIND THE POCKETS OF PEOPLE IN THE WORLD THAT HAD THE HIGHEST CONCENTRATION OF FUNCTIONAL CENTENARIANS, PEOPLE THAT LIVED IN THEIR 90s AND 100S BUT WERE VERY FUNCTIONAL, HEALTHY, ACTIVE VIBRANT PEOPLE.

AND WHEN THEY FOUND THOSE PLACES, THEY THEN LOOKED AT NINE COMMONALITIES BETWEEN THEM.

AND ONE OF THOSE WAS THAT THEY MOVED THROUGHOUT THEIR DAY.

THROUGHOUT THEIR ENTIRE LIFE.

>> INTERESTING.

WHAT ARE SOME OF THE THINGS, THOUGH, THAT ARE IMPEDIMENTS TO EXERCISING AND EATING PROPERLY?

>> I THINK WHEN WE TALK ABOUT OUR INFRASTRUCTURE.

AND WE TALK ABOUT THE FACT THAT RURAL AREAS AND SUBURBAN AREAS ARE VERY DIFFERENT.

WE DON'T LIVE IN IN A COMMUNITY-- WE DON'T LIVE IN A STATE WHERE WALKING AND HAVING PUBLIC TRANSPORTATION IS EASILY ACCESSED.

SO I THINK HAVING SAFE INFRASTRUCTURE WHERE PEOPLE CAN WALK AND MOVE AND GET PLACES THEY NEED TO IS IMPORTANT.

AND THAT IS A POLICY ISSUE THAT I THINK WE NEED TO WORK ON IN THE STATE OF KENTUCKY.

BUT I DO THINK PEOPLE NEED TO GET OUT OF THEIR MINDS THAT MOVEMENT HAS TO BE AN ORGANIZED ATTEMPT AT GOING TO A GYM AND LIFTING CERTAIN WEIGHTS.

WE CAN REALLY GET MOVEMENT IN ALL DAY LONG IN JUST NORMAL ACTIVITY.

FINDING WAYS TO DO THAT.

>> THERE ARE MANY THINS THAT CONTRIBUTE TO OUR OBESITY AND DIABETES PROBLEMS.

DO YOU FIND THE NUTRITIONAL ISSUE IS A SIGNIFICANT FACTOR?

>> IT IS.

IT IS.

AND YOU KNOW, FOOD IS ONE OF THOSE WORDS THAT PEOPLE DON'T WANT TO DISCUSS BECAUSE, HONESTLY FOOD IS VERY PERSONAL.

IT'S CULTURAL, IT'S WHAT WE HAVE ALWAYS EATEN.

IT CAN BRING COMFORT.

BUT EXTENSIVE RESEARCH HAS SHOWN THAT ALL CHRONIC DISEASE, ALL CHRONIC DISEASE IS DIRECTLY RELATED AND IMPACTED BY THE FOODS WE EAT.

AND ALL OF THOSE ARE IMPROVED BY MOSTLY EATING REAL FOOD, MOSTLY PLANTS, SO LOTS OF FRUITS AND VEGETABLES AND LEGUMES AND NUTS AND FIBER AND THAT ACROSS THE BOARD DEVIATE SIGNIFICANTLY FROM THE STANDARD AMERICAN DIET.

SO I THINK IT'S IMPORTANT THAT WE JUST PAUSE AND THINK ABOUT, I WANT TO CONSUME MORE REAL FOOD.

THE OTHER BIG PIECE OF THAT IN KENTUCKY AND THE UNITED STATES IS PORTION SIZE.

THERE IS A CONCEPT THAT WE WILL BE A LOT HEALTHIER IF WE, HE WOULD SIT DOWN TO A MEAL, AND I LITERALLY MEAN WE NEED TO SIT TO EAT OUR MEALS AND NOT BE WATCHING SCREENS OR DOING THINGS OTHER THINGS, BE PRESENT WHEN YOU ARE EATING AND DECIDE BEFORE YOU START, I'M GOING TO EAT UNTIL I'M 80% FULL.

AND WHEN YOU ARE 80% FULL, YOU GET UP AND YOU GO DO SOMETHING.

YOU CAN DO THE DISHES, TAKE A SMALL WALK, TAKE YOUR PET OUT.

DO SOMETHING AWAY FROM FOOD AND THAT DOES DECREASE THE AMOUNT OF FOOD THAT WE EAT.

>> I HAVE ALWAYS HEARD THAT THE SINGLE BEST EXERCISE IS THE ONE WHERE WE PUSH THE PLATE AWAY FROM US.

>> I LOVE THAT!

I HAVE NEVER HEARD THAT.

>> NOW YOU MENTIONED THAT WE HAVE A PHYSICIAN SHORTAGE OR WE HAVE AN IMPENDING PHYSICIAN SHORTAGE AT LEAST HERE IN KENTUCKY.

WHERE DOES THE PHYSICIAN FIT INTO YOUR SMALL STEPS, BIG IMPACT.

>> SO WE ALL NEED, TRULY, A PRIMARY CARE PHYSICIAN THAT WE SEE ON AN ANNUAL BASIS AT LEAST THAT HELPS US NAVIGATE AND LEARN OUR INDIVIDUAL HEALTH AND NAVIGATE THE JOURNEY OF THE CHOICES WE NEED TO MAKE, THE SCREENINGS WE NEED TO MAKE SURE WE ARE ON TOP OF GETTING, AND TRYING TO THEN HAVE THOSE CONVERSATIONS ABOUT YOU ARE ON THIS HYPERTENSION OR BLOOD PRESSURE MEDICINE BUT THE GOAL IS CHANGE SOME OF THESE THINGS IN YOUR LIFE AND LET'S GET YOU OFF OF THAT.

WE DON'T NEED TO BE ON A MEDICINE PARTICULARLY FOR LIFE.

THE GOAL WOULD BE TO COME OFF THOSE THINGS.

THE PRIMARY CARE PHYSICIAN IS THE ONE THAT ADVOCATE THAT FOR YOU, WITH YOU, I DO BELIEVE IT IS IMPORTANT WHEN PATIENTS GO INTO A ROOM WITH THEIR PHYSICIANS THEY GO PREPARED WITH A LIST AND THEY ALSO WRITE THINGS DOWN.

WE REMEMBER BY A STUDY, 10% OF WHAT WE HEAR IN AN EXAM ROOM AS A PATIENT.

SO WRITE THINGS DOWN, ASK QUALITY QUESTIONS.

BE YOUR OWN HEALTH ADVOCATE WHEN YOU CAN.

BUT WE NEED THOSE PRIMARY CARE PHYSICIAN ANNUAL APPOINTMENTS AND MAKE YOUR FOLLOWUP APPOINTMENT WHEN YOU LEAVE.

BECAUSE OUR CALENDARS GET FULL.

WE FORGET AND WE MOVE ON.

>> THAT IS TRUE.

GUILTY AS CHARGED ON THAT ONE MYSELF.

I MEAN TO DO BETTER.

I'M GOING TO COME BACK TO THAT ONE.

BUT TELL ME ABOUT STRESS.

MANY OF US PERCEIVE STRESS IN INTEREST IN DIFFERENT WAYS.

HOW DO YOU DEFINE STRESS AS FAR AS THIS IS CONCERNED?

>> THAT'S A GREAT QUESTION.

WELL, STRESS IS ANYTHING REALLY THAT IS GOING TO ELEVATE THE STRESS HORMONE LEVELS IN OUR BODY.

ADRENALINE AND COURT-- AND CORTISOL WHICH HAVE NEGATIVE IMPACTS ON OUR HEALTH.

75% OF OUR PRIMARY CARE VISITS ARE DIRECTLY RELATED TO STRESS AND MENTAL HEALTH DISORDERS AND SO WE THINK ABOUT STRESS IMPACTING, HONESTLY ALL ASPECTS OF OUR HEALTH IN SEVERAL DIFFERENT WAYS.

WE CANNOT CHANGE THE STRESS, THE NOISE AND THE CHAOS AND THE FEAR THAT WE FACE IN THIS WORLD.

IT'S A VERY STRESSFUL TIME, AND I THINK ALL OF THAT NOISE AND ALL OF THAT CHAOS CAN IMPACT US.

I BELIEVE WHAT WE HAVE TO DO IS PUT BOUNDARIES ON THE NEWS AND THE IMPACT OF WHAT WE ALLOW OURSELVES TO HEAR AND KNOW.

ONE OF THE OTHER BIG PROBLEMS-- AND THIS IS FROM YOUNG TEENS ALL THE WAY UP, IS THAT WE NEED TO MANAGE OUR SCREEN TIME.

STUDY AFTER STUDY SHOWS THAT SCREEN TIME, LONG-TERM ESPECIALLY, IMPACTS US NEGATIVELY.

ESPECIALLY THE TWO HOURS BEFORE YOU GO TO BED.

BECAUSE ADEQUATE SLEEP, SEVEN TO EIGHT HOURS EVERY SINGLE NIGHT IS OPTIMAL AND HONESTLY NECESSARY.

TO MANAGE OUR STRESS.

SO WE NEED TO HAVE A SLEEP ETIQUETTE, AN ENVIRONMENT IN OUR BEDROOM THAT IS SCREEN FREE.

WE NEED TO MANAGE WHAT WE DO FOR THE TWO HOURS BEFORE WE DESIRE TO GO TO SLEEP SO WE ARE NOT IN THE MIDST OF ALL THE CHAOS AND NOISE AND ADRENALINE AND CORTISOL RELEASE AND SO I DO THINK THERE ARE THINGS WE CAN DO , EVEN THOUGH WE FEEL WE CAN'T MANAGE WHAT IS GOING ON.

HE CAN'T.

EVEN DEEP BREATHING CAN MAKE SUCH AN IMPACT, CAN LOWER OUR BLOOD PRESSURE AND HAVE A POSITIVE IMPACT.

AND JUST THIS MORNING I WAS WATCHING A REPORT, IT WAS A MAN WHO HAD WRITTEN A BOOK ON HUMOR.

BUT WE LAUGH A LOT UNTIL WE ARE ABOUT 23 AND FROM 23 TO 80, WE DON'T LAUGH MUCH.

AND SO IN THE SERIOUSNESS OF THIS LIFE, SERIOUS TO BE AN ADULT, AND THE WORKFORCE, IT'S IMPORTANT TO REMEMBER TO FIND JOY AND HUMOR AND LAUGHTER.

>> INTERESTING.

IGNORANCE REMAINS BLISS.

WHEN TALKING ABOUT STRESS, AND WHEN WE LOOK AT PHYSICIAN SHORTAGES, WHERE ARE WE AS FAR AS MENTAL HEALTH PROFESSIONALS.

DO WE HAVE ADEQUATE NUMBERS?

>> WE DON'T.

WE DON'T IN THE STATE OF KENTUCKY.

SHONESTLY I DON'T BELIEVE WE DO NATIONWIDE.

I DON'T HAVE AN EXACT NUMBER FOR YOU ON THAT.

BUT I THINK THAT'S THE OTHER COMPONENT IS SUPPORTING PHYSICIAN POSTGRADUATE EDUCATION AND THAT'S A LEGISLATIVE PIECE TO TRY TO GET MORE PHYSICIANS TRAINED IN THESE AREAS WHERE WE NEED SUPPORT.

>> WHEN THINKING ABOUT THINGS WE CAN DO TO PREVENT DEVELOPMENT OF CERTAIN ILLNESSES, WHERE ARE YOU STANDING NOW AND WHERE ARE WE IN ORGANIZED MEDICINE WITH VACCINATIONS?

>> OH, WELL, THE STUDIES ARE ACROSS THE BOARD SHOWING WE CAN PREVENT SO MANY DISEASES AND IMPROVE HEALTH BY THE VACCINATIONS THAT WE KNOW WE HAVE.

THEY HAVE BEEN STUDIED AND THEY KEEP US SAFE AND HEALTHY.

SO-- >> WE NEED TO MAKE SURE PEOPLE ARE TALKING TO THEIR PRIMARY CARE DOCS ABOUT THAT?

>> YES.

>> I WOULD LIKE FOR TO YOU TELL ME THREE THINGS YOU WANT TO MAKE SURE THAT COMING OUT OF THIS DISCUSSION WE ALL KNOW ABOUT THINGS THAT WE CAN DO TO KIND OF KEEP US HEALTHY.

>> WONDERFUL.

SO FIRST, I WOULD ENCOURAGE PEOPLE TO GO TO OUR WEBSITE.

IT'S SMALLSTEPSKY.ORG.

AND THAT HAS TOOLS AND RESOURCES AND INFORMATION FOR KENTUCKIANS.

SO I THINK THAT'S IMPORTANT.

BUT NUMBER 1: EAT REAL FOOD.

DO YOUR BEST TO EAT REAL FOOD.

A NEW FRUIT, A NEW VEGETABLE EVERY WEEK, LOOK AT HOW YOU CAN IMPROVE AND COOK AND FIX THAT.

SECONDLY, GET MOVEMENT THROUGHOUT YOUR DAY.

FIND WAYS TO MOVE EVERY SINGLE DAY.

TAKE THE STEPS, NOT THE ELEVATOR, WHEN YOU CAN.

PARK FURTHER AWAY BEFORE WALKING INTO A STORE.

MOVE MORE THROUGHOUT YOUR DAY.

AND THEN PROBABLY THE LAST WOULD BE TO JUST STAY CONNECTED TO A PRIMARY CARE PHYSICIAN AND ALLOW THEM TO BE YOUR ADVOCATE AND HELP YOU.

>> YOU HAVE COME BACK TO THAT A LOT.

DO WE HAVE ADEQUATE NUMBER OF PRIMARY CARE PHYSICIANS?

>> WE DON'T RIGHT NOW.

IN FACT IN 107 OF OUR 120 COUNTIES, ACROSS THE BOARD, WE HAVE A HEALTHCARE SHORTAGE.

SO THAT IS SOMETHING THAT WE NEED TO ADVOCATE FOR POLICY WISE.

BUT THERE ARE PHYSICIANS AVAILABLE AND IT'S IMPORTANT THAT PEOPLE USE THAT ACCESS INSTEAD OF URGENT CARE OR THE EMERGENCY ROOM BECAUSE THOSE CONVERSATIONS ABOUT HOW WE CAN MANAGE AND PREVENT DISEASE DECREASE CHRONIC DISEASE, DECREASE MEDICINES.

THOSE ARE NOT GOING TO BE TAKEN CARE OF IN AN EMERGENCY SETTING.

>> BOY, I THINK THAT'S-- THOSE ARE GOOD POINTS.

I'M GLAD YOU BROUGHT THOSE UP.

Dr. JONES, I WANT TO THANK YOU VERY MUCH FOR BEING WITH US TODAY.

I REALLY APPRECIATE.

AND I HOPE PEOPLE WILL GO OUT TO SMALL STEPS BIG IMPACT DOT-- SMALLSTEPSKY.ORG.

AND THANK YOU FOR BEING WITH US TODAY.

I HOPE YOU WILL BE ABLE TO IDENTIFY SOME ACTIVITIES AND/OR PROGRAMS FROM WHICH YOU MAY BENEFIT.

SPEAK TO YOUR HEALTH PROVIDERS AND WHEN YOU DO, ACT.

I HOPE THAT YOU WILL BRING YOUR POSSE ALONG WITH YOU.

IF YOU WISH TO WATCH THIS SHOW AGAIN PLEASE GO TO KET.ORG/HEALTH.

IF YOU HAVE QUESTIONS OR COMMENTS ABOUT THIS OR OTHER SHOWS, WE CAN BE REACHED AT KYHEALTH@ket.org.

I LOOK FORWARD TO SEEING YOU ON THE NEXT "KENTUCKY HEALTH," ESPECIALLY IF YOU GET OUT THERE AND EXERCISE, EAT RIGHT, GET SCREENED, STOP SMOKING, SEE YOUR PHYSICIAN AND TRY TO CHILL IF YOU CAN.

GET OUTSIDE AND ENJOY OUR WONDERFUL WILDLIFE HERE IN KENTUCKY.

SEE YOU NEXT WEEK.

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.