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.
As fertility rates fall nationwide, Connecticut continues to rank among the lowest in the country—a trend doctors attribute to women here delaying childbearing. In 2016, the most recent year for which state-level data is available, Connecticut had 53.4 births per 1,000 women ages 15 to 44, compared with a national average of 62 per 1,000 women, according to data from the Centers for Disease Control and Prevention (CDC). Just four states had lower rates than Connecticut in 2016, and all are in New England: Vermont at 50.3 births per 1,000 women, New Hampshire at 50.9, Rhode Island at 51.8 and Massachusetts at 51.9. The states with the highest fertility rates in 2016 were South Dakota at 77.7, North Dakota at 77.3, Utah at 76.2 and Alaska at 76.1, the CDC reports. Unlike birth rates, which take an entire population into account, fertility rates reflect the share of babies born to women of childbearing age. Connecticut typically ranks low on the list, along with other “high achievement, high education states,” said Dr. Harold J. Sauer, chairman of obstetrics and gynecology at Yale New Haven Health’s Bridgeport Hospital.
Depression is the leading cause of disability worldwide, according to the World Health Organization, and affects women at about twice the rate that it does men. In Connecticut, 21.4 percent of women report experiencing depression, compared with 13.4 percent of men, according to 2015 Department of Public Health data. Millennial women in the state experience depression four more days in an average month than their male counterparts, the Status of Women data project reported this year. Women are more likely to use mental health services than men, but studies consistently show that the majority of Americans with depression go untreated. In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses depression and pathways to better mental health with Yale’s Carolyn Mazure, and NYTimes best-selling author Luanne Rice.
While the prevalence of strokes in Connecticut has essentially remained the same in recent years, progress in slowing the number of deaths from stroke has declined in the state, a development the Centers for Disease Control and Prevention (CDC) calls “disturbing.”
The spike reverses a national decades-long trend that brought stroke death rates down. From 1999 to 2014, deaths from strokes were on the decline in the state and nationally. But a recent CDC report found that Connecticut was among 39 states in which the decline in stroke deaths has slowed or the number of stroke deaths has started to increase. From 2012 to 2015, the number of stroke deaths in Connecticut increased 9.5 percent, from 1,263 to 1,384. Stroke deaths were highest in the northeast and northwest regions of the state, CDC data show.
Veterans’ mental health and housing improved when they accessed free legal services in a Veterans Affairs facility, according to a study of veterans in Connecticut and New York City. The more legal services they had, the better they fared, experiencing reduced symptoms of Post-Traumatic Stress Disorder (PTSD) and psychosis, spending less money on abused substances and having better housing situations, the study found. In addition, the study concluded that mental health was improved even if veterans lost their legal battles. The study analyzed the legal/medical partnerships between the nonprofit Connecticut Veterans Legal Center (CVLC) and VA Connecticut Healthcare and between New York Legal Assistance and two VA hospitals. It looked at free legal help given to 950 veterans from 2014 through 2016 and its effects on the mental health, housing, and income of 148 of those veterans followed closely for a year.
An ever-increasing number of women in the state are drinking to excess, state and federal data show. Statewide, female admissions to acute hospital emergency departments for alcohol-related reasons rose by 4.8 percent between fiscal years 2012 and 2016, according to the Connecticut Hospital Association. The female-only Eden Hill Recovery Retreat in Canaan fills an average of 10 to 12 beds per month; earlier in the center’s eight-year history, rarely were there more than eight beds occupied at a time. Researchers at the Yale School of Medicine note an increase in the number of women enrolling in studies that examine the effectiveness of a medication to curb one’s desire to drink alcohol. The uptick in problem drinking among women in Connecticut mirrors a national trend.
Millions of Americans will have a hard time falling or staying asleep tonight, and research says most of them will be women. “Insomnia is definitely more common in females, and it seems to begin fairly early on,” said Dr. Meir Kryger, a professor at the Yale School of Medicine who studies sleep. Sleep problems can appear in women as early as their teens or 20s, he said. Various research shows women are more likely than men to experience the sleep disorder. Women are about 1.5 times more likely to have insomnia, said Kryger, who has written several books on the topic, including “The Mystery of Sleep,” which was published in March.
The rate of infants dying suddenly and unexpectedly has dropped in recent years, but data show that racial disparities persist. Babies born to American Indian and Alaska Natives and African American families suffer much higher rates of sudden unexpected infant deaths (SUID) than other races and ethnicities, data from the Centers for Disease Control and Prevention (CDC) show. Between 2011 and 2014, 194.1 American Indian and Alaska Native infants and 170.2 African American infants per 100,000 live births died from SUID nationwide. Those rates are significantly higher compared with 83.8 for whites, 51.1 for Hispanics and 32.1 for Asian or Pacific Islander babies per 100,000 live births, during the same time period. SUID encompasses sudden infant death syndrome, commonly known as SIDS, as well accidental suffocation and strangulation in bed, and other unspecified causes of death in children up to a year old.
A genetic test that helps doctors determine how best to treat breast cancer—and whether chemotherapy is likely to help—is significantly more likely to be administered to white women than blacks or Hispanics, a Yale study has found. The test, called Oncotype Dx (ODx), uses gene expression to gauge how early-stage breast cancer is affecting patients’ gene activity. It uses the information to determine how likely cancer recurrence would be, and physicians and their patients can use that knowledge to decide how to proceed with treatment. Yale researchers retrospectively analyzed a group of more than 8,000 Connecticut women who were diagnosed with hormone receptor positive breast cancer between 2011 and 2013, and found “significant racial and ethnic disparities in use of this new gene test,” said study leader Dr. Cary Gross, a member of Yale Cancer Center and professor of medicine and epidemiology at Yale School of Medicine. “It reinforces that, at the same time we are investing in developing new treatments and new testing strategies and we’re promoting them with great excitement, we really need to double-down our efforts to eliminate disparity,” Gross said.
In less than eight hours last June, Yale New Haven’s emergency department treated 12 patients who had overdosed on opioids. Three died; nine were saved. With opioids in wide circulation, Dr. Gail D’Onofrio, chief of emergency medicine at the hospital and chair of emergency medicine at Yale School of Medicine, isn’t sure that one-day spike will stand as a record. “To be honest, no, I don’t expect the numbers to get better,” D’Onofrio said. “We’re going to have more treatment options in Connecticut, I think, more safe prescribing — but I don’t know that we’ll see improvements in the numbers of people using.”
D’Onofrio’s concerns are borne out in a recent report by the Agency for Healthcare Research and Quality (AHRQ) that ranks Connecticut the 5th highest among 30 states in the rate of opioid-related emergency department (ED) visits — 254.6 per 100,000 population in 2014, well above national rate of 177.7.