Jose DeJesus pulls his silver minivan out of a parking lot in back of a row of historic houses on New Haven’s Congress Avenue. He points with pride to the flowers he planted around the lot. Then he grimly spins a commentary as he gives a tour of the surrounding Hill neighborhood. • There’s the John C. Daniels School, where parents are dropping off kids and where a man overdosed and died near a rear stairwell over the summer. • Across the street, there’s the APT Foundation clinic, where clients in recovery from opioid use come every morning for methadone.
HUSKY members in a person-centered medical home (PCMH) practice are more likely to get recommended preventative health services and less likely to visit the emergency room, according to Department of Social Services (DSS) data. A PCMH is a medical practice that provides comprehensive and coordinated care. That can mean helping a child get an appointment with a behavioral health clinician; making sure a patient’s apartment is free of asthma triggers; and many other services hard to get in time-crunched primary care offices. Medical homes must also provide a high level of accessibility through measures like extended hours, electronic or telephone access or rapid appointment scheduling. The state instituted HUSKY PCMHs in 2012 with an eye toward improving care for patients with chronic conditions, according to Kate McEvoy, director of the Division of Health Services at DSS.
The death rate from heart disease plummeted nationally over several decades for all racial and ethnic groups, but the rate of decline has slowed slightly and African Americans and low-income individuals are still at a higher risk of developing the disease and dying from it, according to a report from the National Center for Health Statistics. The report isn’t surprising to Dr. Edward Schuster, medical director, Stamford Health Cardiac Rehabilitation Program. “In the United States, there’s a lot of talk about income disparity, which is a political hotcake,” Schuster said. “But what we are seeing is a life expectancy disparity. According to a recent Journal of American Medical Association, if you’re a man in the top 1 percent of income, you can expect to live 13 years longer than someone in the 1 percent at the bottom.”
Heart disease is largely preventable by maintaining a balanced diet, a healthy weight and moderate exercise, with only 20 percent of cases involving genetics, said Dr. David L. Katz, who heads the Yale-Griffin Prevention Research Center, which works with communities to develop programs to control chronic diseases. But significant groups in lower income and urban areas don’t—or can’t—act on the message, Katz said.
In West Haven, 24% of white residents reported their health as fair or poor, a rate worse than whites statewide and in New Haven. Fifty miles east, 19% of white New London residents reported feeling depressed or hopeless, higher numbers than statewide and in Bridgeport. And 39% of white New Britain residents reported that financially, they were just getting by or were worse off. That’s higher than in Hartford and statewide. A C-HIT analysis of the results from the recent DataHaven Community Wellbeing Survey found that residents in a number of midsize, blue-collar cities reported lower health ratings than residents of the state’s largest cities.
You can have prayers. Or you can have teeth. After two mass shootings within 16 hours stunned the nation earlier this month, conversation turned to how best to remove guns from the wrong hands. Seventeen states—including Connecticut—and the District of Columbia have “red flag” laws, also known as “extreme risk” laws, that, depending on the state, allow family members, household members, or law enforcement officials to petition the courts to remove guns from the hands of someone who might do harm to himself or herself, or to others. It’s an approach that is supported by 85% of registered voters, according to a 2018 Washington Post/ABC poll.
During 2018, members of the advocacy group CT Equality traveled around the state to listen to members of the lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) community talk about their challenges and concerns about life in Connecticut. The conversations, said Rep. Jeffrey Currey, D-East Hartford, deputy majority leader who attended one of the meetings in Hartford, had common themes, including a need for additional services and programs.
Among other tangible efforts during the legislative session that ended June 5, such as a ban on the so-called “gay panic defense,” the conversations moved Connecticut legislators to create an LGBTQ Health and Human Services Network, which is charged with creating a safe environment for members of the community. This comes at a time when the Trump administration is rolling back rights at a historic rate. In June, the administration announced it would cut funding for a University of California HIV and AIDS research program. Trump has announced plans to allow “religious exemptions” to adoption agencies that want to deny services for LTBTQ couples.
Wanda Perez considers the price and nutritional value of everything she puts in her shopping cart, as the New Haven woman relies on the Supplemental Nutrition Assistance Program (SNAP) to buy groceries and is trying to eat healthy to manage multiple chronic illnesses. Just over 364,000 people receive SNAP benefits in the state, a number that has decreased about 4.7% in the past year. “I try to stay on top of everything that’s going on,” said Perez, a member of Witness To Hunger, which organizes SNAP users to speak about food policy and poverty. Perez lives on just over $700 in disability assistance a month, plus $192 in SNAP. Though her SNAP benefits are safe for now, proposed federal rule changes could push other Connecticut users off SNAP.
Shawn was 4 years old when he watched his dad, Jonathan Whaley, keel over at their doorstep from a gunshot wound to his back. He remembers the pool of blood, the paramedics, and the police. Whaley, 34, didn’t make it. Shawn is now 8 years old. He lives with his grandmother and five siblings in one of Hartford’s rundown neighborhoods.
The racial disparity between white and black cancer patients in accessing timely treatments has virtually disappeared in states where Medicaid expanded under the Affordable Care Act (ACA), according to a new study. Yale Cancer Center researchers analyzed more than 30,000 health records and found that, prior to Medicaid expansion, black adults with advanced or metastatic cancer were 4.8 percentage points less likely than white adults to begin treatments within 30 days of being diagnosed. But in states where Medicaid was expanded, in 2014 or later, the percentage of black patients getting timely treatment rose from 43.5 percent to 49.6 percent. There also was a small improvement in expansion states among white patients receiving timely treatment – from 48.3 percent to 50.3 percent – bringing the post-expansion difference between the two racial groups to less than one percentage point. “Our results suggest that Medicaid expansion led to improved health equity,” said study author Amy Davidoff, a senior research scientist at Yale School of Public Health and in Yale Cancer Center’s Cancer Outcomes, Public Policy, and Effectiveness Research Center (COPPER).
Slowly—but perhaps surely—the country is beginning to address maternal mortality, both through legislation and through initiatives on the part of health care providers. This is critical. We have lost countless women to pregnancy and childbirth, and the majority of those deaths didn’t have to happen. This holds true especially for mothers of color. Black and American Indian/Alaska Native women are about three times as likely to die from pregnancy as white women, according to a study released earlier this month by the Centers for Disease Control and Prevention.