When immigrant families bring their children to the Yale Children’s Hispanic Clinic, it’s just not about check-ups and vaccinations. Clinicians help them deal with everything from teething to nutrition to finding a place to live. But these days when front-line clinicians encourage families to use the many services offered through federal public programs, parents have questions—and misgivings. “They are hesitant because they are afraid,” said Patricia Nogelo, a clinical social worker at the Yale Children’s Hispanic Clinic. A proposed change in immigration law is making immigrants in Connecticut and nationally wary of utilizing federal programs that cover health, food and housing assistance.
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.
Throughout the past seven years, the number of children and teens in New England with developmental or emotional disorders has increased exponentially, the Kids Count Data Center reports. Developmental disorders are conditions that interrupt a child’s development. They include Autism Spectrum Disorder, Down syndrome, cerebral palsy and spina bifida. Emotional disorders affect a person’s ability to be happy, control their emotions and pay attention in school. They include attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, anxiety, depression and bipolar disorder.
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.
Tens of thousands of adolescents in Connecticut still do not have access to effective mental health care, despite the passage of a 2008 federal law requiring health insurers to provide equal benefits for mental health. Poor access to care leads to undiagnosed or misdiagnosed mental illness in children and adolescents, an increase in use of emergency rooms for psychiatric issues, and is a risk factor for severe mental illness, substance abuse, failure in school, and entering the juvenile justice system. National studies show that about 1 in 5 children and teens have mental illness, but only one quarter of them receive services. “That leaves about 125,000 children without mental health care in Connecticut,” said Susan Kelley, director of the Alliance for Children’s Mental Health. Some say that estimate is low, partly because it doesn’t capture mental illness misdiagnosed as behavioral problems. “I think that’s a very optimistic figure,” said Eliot Brenner, PhD, president and CEO of the Child Guidance Center of Southern Connecticut.
With Connecticut children testing positive for lead at consistently high numbers, and millions of dollars thrown at the problem with tepid results, lawmakers may finally be stepping up to seek an effective solution. The Banking Committee is considering a bill that would create a task force to study better ways to finance the removal of the toxin from thousands of homes around the state. The task force would also investigate how to enforce abatement measures, including rental property inspections, and look into increasing workforce training in the specialized process needed to remove lead. State Department of Public Health (DPH) numbers from 2015, the latest available, show more than 72,000 children under the age of 6 testing positive for some level of lead in their blood. More than 900 children were at levels two to four times the baseline at which a child is considered poisoned.
On a snowy Saturday morning in January, Selvin, 13, and his mother were in the basement of the First and Summerfield United Methodist Church in New Haven, to support a friend in sanctuary. As they sat there, the boy tried to push away thoughts of how it would be when ICE came to take away his own mother, who is also under a deportation order. “I’m going to be alone with my little brother and my dad,” Selvin said. “Sometimes I feel I don’t want to talk to anybody. I just go to my room, lock the door, and I feel depressed.”
Selvin – whose family asked that his last name be withheld – is among thousands of immigrant children in Connecticut and nationally feeling the effects of prolonged stress, which can become so toxic it can damage the developing brain.
The number of low-income Connecticut children receiving dental sealants, a treatment to prevent tooth decay, has grown in recent years and the state’s participation rate outpaces the nation. In 2016, 44,497 (19.6 percent) of the 226,111 children ages 5 to 16 enrolled in the Connecticut Dental Health Partnership had sealants placed on molars, up 9 percent from 2011, according to the state Department of Social Services. Nationally, in the 2015 fiscal year, 14.9 percent of eligible children – 2.7 million out of more than 17 million – received sealants, according to the Centers for Medicare and Medicaid Services. State officials and dental providers make a concerted effort to educate families about the importance of sealants, said Donna Balaski, director of dental services at DSS. “Sealants are shown to be an effective treatment for preventing disease,” she said, and is part of a broader DSS strategy to teach families about overall dental health.
On the surface, it looks as if Connecticut children fare pretty well. According to the annual Kids Count report from The Annie E. Casey Foundation, the state ranks fourth in education, third in health, and sixth in overall well-being for children. The foundation pointed to nearly universal health insurance—97 percent—for Connecticut’s children as a major contributor to the state’s high ranking. Of all the states, Connecticut also had the lowest rate of deaths among children ages 1 to 19: 15 deaths per 100,000 children. But that’s not the entire story, not by half.