Blacks and Hispanics are less likely than whites to get flu vaccines, have a preventive health care visit, or receive follow-up care after being hospitalized for a mental health disorder, according to a first-of-its kind federal report that looks at health disparities among people on Medicare Advantage plans. “While these data do not tell us why differences exist, they show where we have problems and can help spur efforts to understand what can be done to reduce or eliminate these differences, ” said Dr. Cara James, director of the Centers for Medicare & Medicaid Services (CMS) Office of Minority Health, which released the report. The report looks at 27 clinical care measures and eight patient experiences to gauge differences in treatment among whites, blacks, Hispanics, and Asians or Pacific Islanders. It has some bright spots: Blacks and Hispanics reported slightly better communication with doctors than whites did. Hispanics had higher rates than non-Hispanic whites of colorectal screenings, blood sugar testing for diabetes, and treatment for osteoporosis (among women) after a fracture.
Several times every month, protesters come to the New Haven Planned Parenthood of Southern New England office to hold signs and pray the rosary. Planned Parenthood serves about 64,000 Connecticut patients a year, though according to a recent annual report, abortions are only about six percent of its services. Most of the services revolve around providing contraceptive services and testing for sexually transmitted diseases. Last month, the federal Food and Drug Administration eased restrictions on the so-called abortion pill, also known as RU-486. The new rules allow women to use the drug later in their pregnancies with less visits to the doctor.
The high cost of insulin, which has risen by triple-digit percentages in the last five years, is endangering the lives of many diabetics who can’t afford the price tag, say Connecticut physicians who treat diabetics. The doctors say that the out-of-pocket costs for insulin, ranging from $25 to upwards of $600 a month, depending on insurance coverage, are forcing many of their low-income patients to choose between treatment and paying their bills. “Some of my patients have to make the choice between rent or insulin,” said Dr. Bismruta Misra, an endocrinologist with the Stamford Health Medical Group. “So they spread out taking insulin [injecting it less frequently than a doctor has prescribed] or don’t take it.”
Experts and recent studies point to drug companies’ long-standing patents and the lack of generic or “biosimilar” insulin as key reasons why the drug is so expensive. A study by Philip Clarke, a professor of health economics at the University of Melbourne in Australia, reported that the price of insulin has tripled from 2002-2013.
Thousands of Connecticut residents are prediabetic but don’t know it and if they did, doctors say, early detection and lifestyle changes could prevent diabetes from developing in most people at risk. The state Department of Public Health reports that 83,000 adults in Connecticut have prediabetes, which occurs when a person’s blood sugar level is higher than normal but not high enough to be classified as Type 2 diabetes. Nearly 9 percent of adults in the state—about 257,000 people—have been diagnosed with Type 2 diabetes. Prediabetes has few early warning signs, but a blood test by a primary care doctor can detect at-risk patients. Once detected, changes in diet and exercise, sometimes with medication, can stave off the disease, doctors say.
Emerson Cheney has survived drug addiction, an abusive relationship, years of cutting and burning himself, and multiple suicide attempts. Now a student at Tunxis Community College, Cheney, 22, recalls how he struggled as a teenager with rejection by friends, school administrators and even doctors, after he came out as transgender. Advocates for LGBT youth say that Cheney’s story is all too common—rejection often pushes young people to risky behaviors that result in health challenges. For LGBT youth, finding health care professionals who can fully address their medical and psychological needs at a critical time in their psychosocial development can be difficult. Several recent studies have highlighted discrimination and mistreatment of sexual and gender minority individuals seeking health care. In Connecticut, a 2008 study that surveyed pediatricians to examine health barriers among LGBT adolescents found that 31 percent of doctors expressed reservations about discussing sexual orientation or gender with patients.
Medicaid will reimburse some health centers in the state for providing patients with access to medical specialist through electronic consultations, which some providers believe will increase low-income patients’ access to care. “The impact is potentially huge,” said Dr. Daren Anderson, director of the Weitzman Institute, which is the research and quality improvement arm of Community Health Center Inc. (CHC). CHC is a Middletown-based network of 13 health centers that includes facilities in New Britain, Stamford, Norwalk, Clinton, and Old Saybrook. An e-consult enables a primary care doctor to contact a specialist—for a second look at patient’s echocardiogram, for instance—and securely send part or all of a patient’s medical records electronically. The specialist then replies to the primary care doctor within a few days (but more typically within just a few hours), reducing the need for a patient visit to the specialist.
For those living with diabetes, eating healthy and knowing how foods affect blood sugar levels is crucial to managing the disease. The Conn. Health I-Team, (www.c-hit.org) in collaboration with ConnectiCare and the Hispanic Health Council, is hosting a panel discussion on Thursday, April 7, in Hartford, where experts will discuss the latest developments in early screening and treatment of diabetes and offer advice about how adopting a healthy lifestyle can help combat the disease. The free event, called “Beating Diabetes: Food, Fitness and Focus,” will include a social hour and food tasting starting at 5 p.m. featuring famed local chef Jay Lewis, who will present healthy foods choices. Lewis, who was nominated as “best chef” in the state in 2012 by Hartford Magazine, has been a sous chef, as well as the banquet chef for the Goodwin Hotel.
For more than 20 years, the Citadel of Love, a Pentecostal church, has anchored one of Hartford’s most economically-challenged neighborhoods in the city’s North End. In its outreach ministries, the church offers clothing giveaways and free meals. Under the leadership of Pastor Marichal Monts, a Hartford native who grew up just down the street, a church committee met recently to discuss some of the flock’s health challenges. Many of the members come from the area, where the U.S. Census says the median household income is just $20,434. (Compare that to the state’s median household income that hovers around $70,000.)
High on the list of health challenges discussed by the leaders was Type 2 diabetes, which was once called adult-onset diabetes.
Nearly 40 percent of all black kindergartners are overweight or obese, and nearly 40 percent of all Hispanic kindergartners in Connecticut are, too. A new policy brief by the Child Health and Development Institute says the best way to fight numbers like these is to "require action in a child's earliest years -- from birth to 2." The numbers also indicate that 25 percent of all white kindergartners are overweight or obese also. “The numbers are staggering, and the health implications are so big,” said Judith Meyers, president and CEO of the Farmington-based CHDI, whose brief is based, in part, on research by UConn’s Rudd Center for Food Policy & Obesity. “Connecticut’s rates [of childhood obesity] are among the highest in the country,” she said.
Black women in Connecticut remain more likely than white or Hispanic women to deliver preterm babies, despite efforts to reduce the disparity, newly released data show. In 2014, 12 percent of all births by black women in the state were preterm, meaning they occurred before 37 weeks gestation, according to data compiled by the Henry J. Kaiser Family Foundation. That compares with 9 percent of all births by white women and 10 percent of all births by Hispanic women that were preterm during the same year. Nationally, the trend was similar with 13 percent of births by black women occurring preterm compared with 9 percent of white women’s births and 9 percent of Hispanic women’s births. In the vast majority of states, black women experience a higher rate of preterm births than whites or Hispanic women, according to the state-by-state comparison of the Kaiser data.