Robert Carmon had a rough start to life. Shortly after birth he developed asthma, a chronic disease that causes inflammation in the lungs and difficulty breathing. His attacks were so severe as an infant that his parents rushed him to the emergency room practically every week. They were terrified he might die. Today, at age 7, Robert’s asthma has stabilized.
The number of Medicaid-insured children treated in Connecticut emergency rooms for behavioral health crises rose 20 percent between 2014 and 2016, mirroring a national trend – despite efforts to provide non-ER treatments. In 2014, Connecticut ERs recorded 12,100 Medicaid-insured youth visits compared to 14,448 in 2016, according to a study of Medicaid-eligible patients ages 18 and younger commissioned by the Child Health and Development Institute of Connecticut (CHDI). Most of the children who go to emergency rooms with behavioral health issues go to one of five hospitals, according to data collected by consultant Beacon Health Options, which manages behavioral health care for the state’s Medicaid population. Connecticut Children’s Medical Center in Hartford saw the most behavioral health-related ER visits, with 3,962 visits by Medicaid-insured youth in 2016. Yale New Haven Hospital and Yale New Haven Children’s Hospital had a combined total of 2,263 visits, followed by St.
The Connecticut Childbirth & Women’s Center in Danbury is a 50-minute drive from Evelyn DeGraf’s home in Westchester. Pregnant with her second child, the 37-year-old didn’t hesitate to make the drive—she wanted her birth to be attended by a midwife, not a doctor. DeGraf believed midwifery care to be more personal and less rushed than that delivered by obstetrics/gynecologists (OB/GYNs). She also knew an OB/GYN would deem her relatively advanced maternal age and previous cesarean section history too high-risk to attempt a VBAC, or vaginal birth after cesarean section. But she had to drive roughly 35 miles to find a midwife because there aren’t many of them.
The United States’ maternal mortality rate is abysmal, and women of color are particularly vulnerable. No amount of fame or fortune can run interference when it comes to mothers dying or at-risk during pregnancy, childbirth, or early motherhood. And that holds especially true for African American women. At 26.4 per 100,000 live births, the U.S. has the worst rate of maternal death in the developed world—by several times over. Even more disquieting, the U.S. rate rose by 136 percent between 1990 and 2013.
Consumers will have the shortest open enrollment period yet to shop for 2019 health insurance plans – 45 days — but they can “window shop” and compare plans beginning today. Open enrollment for health plans effective Jan. 1, 2019, will run from Nov. 1 to Dec. 15, giving consumers the least amount of time to enroll in or renew plans since the Affordable Care Act (ACA) became law.
Cancers linked to the human papillomavirus (HPV) rose dramatically in a 15-year period, even as the rates of young people being vaccinated climbed, the Centers for Disease Control and Prevention (CDC) reported. The 43,371 new cases of HPV-associated cancers reported nationwide in 2015 marked a 44 percent jump from the 30,115 cases reported in 1999, according to a CDC analysis. HPV vaccination rates have improved over the years, but not fast enough to stem the rise in cancers, the CDC said. Oropharyngeal (throat) cancer was the most common HPV-associated cancer in 2015; accounting for 15,479 cases among males and 3,438 among females, the CDC data show. HPV infects about 14 million people each year and between 1999 and 2015 rates of oropharyngeal (throat) and vulvar cancer increased, vaginal and cervical cancer rates declined, and penile cancer rates were stable, according to the CDC.
New Haven resident Kimberly Streater was pregnant with her third of six children when she called her friend for a ride to the hospital after sustaining a hit to her stomach by her then-husband. When she reached the hospital, Streater, not yet 28 weeks pregnant, alerted personnel that her baby was coming—now. “They said, ‘No, no, he’s not coming,’ after I told them he was,” she recalled. Minutes later, Howie was born at 3 pounds and 1.5 ounces in the admitting area of the hospital, just as Streater had predicted. Statistically, the preterm birth of Streater’s baby does not come as a surprise.
It’s a summer afternoon and parents with their young children have gathered to hear what a nutritionist with Women, Infants and Children (WIC) has to offer. They watch with intrigue as Mary Paige demonstrates how to make yogurt dots from frozen Greek yogurt and French fries from roasted parsnips and carrots. After a 10-minute demo in the WIC office at Yale New Haven Hospital’s Primary Care Center, Stephany Uriostegui of West Haven is sold. She can’t wait to try the recipes at home for her 10-month-old son and 5- and 7-year-old daughters. “I always buy the [yogurt dots] from Walmart,” she said.
Among women, those who are low-income or minority are less likely to get treatment for depression, according to multiple studies. A report by the Connecticut Behavioral Health Partnership found that women were underrepresented in Medicaid-funded behavioral health services in the state even though research shows that women suffer from the most commonly diagnosed mental health disorders more frequently than men. Racial and ethnic disparities, while still considerable, are decreasing in some physical illnesses. “But in mental health care, in the last 10 years, we see those disparities widening,” said Megan Smith, associate professor in the Departments of Psychiatry and in the Child Study Center in the Yale School of Medicine, who runs the Mental health Outreach for MotherS (MOMS) Partnership®, a program that offers mental health services to “overburdened and under-resourced mothers.”
In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses the hurdles to mental health care and the programs breaking barriers to care with Yale’s Megan Smith and UConn Health’s Dr. Sarah Nguyen. Lack of insurance coverage, the cost of treatment, a shortage of qualified clinicians, stigma and even fear of losing custody of their children can keep women from seeking help, Smith said.
Iasiah Brown, 25, of New Haven, said he does not see a need for a primary care doctor for himself and his daughter, opting to visit clinics in the area instead of waiting up to two weeks for an appointment at a doctor’s office. Brown is among the 83 people who said they didn’t have a primary care doctor in response to a health-care usage survey by the Conn. Health I-Team and Southern Connecticut State University. The team surveyed 500 people and interviewed dozens statewide between January and March. About 83 percent of respondents said they had a primary care doctor, but the rate was lower for African American (78 percent) and Hispanic respondents (75 percent).