Disparities

Telemedicine A Blessing For Some, Inaccessible For Others

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When the pandemic began, LaVita King of Bridgeport worried about how she would continue to see her behavioral health therapist and primary care physician at Southwest Community Health Center. She lives close enough to walk to the federally qualified health center but didn’t feel comfortable leaving her home in those early days, let alone venturing into a medical office. But she’s been able to access care through phone and video chats. “For me, it’s been such a lifesaver, such a blessing,” said King, 69. “Otherwise, I would not have been able to talk to my behavioral health therapist for this whole entire time.

I-Team In-Depth

Pandemic Fuels Continued Rise In STDs Among Youngest Sexually Active Adolescents

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The fallout from the pandemic has run the gamut from an unstable economy to an uptick in social-emotional problems. Experts suggest the pandemic may also be responsible for a continued upward trajectory in sexually transmitted diseases among Connecticut’s youngest sexually active residents. Conditions during the pandemic, including less access to sexual health care and more free time, have helped to exacerbate the trend among young people, say health care providers. “Most parents are working. Students are home alone. They are having friends over,” said Ceri Burke, a nurse practitioner at Danbury High School’s on-site health center.

I-Team In-Depth

Yale Study Combining Opioid Use Disorder Treatment With OB-GYN Care Offers Hope To Pregnant Women Struggling With Addiction

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When Amanda, 28, found out that she was pregnant with her second child, she was in the middle of the COVID-19 pandemic and struggling with opioid use disorder. “I was pretty heavy into my drug use,” said Amanda, whose last name is being withheld due to patient confidentiality. “I had given up hope and was figuring out a way to use drugs and get away with the consequences. But it doesn’t work like that.”

Now, however, Amanda is feeling “really good.” That’s because she is in a clinical trial for pregnant women run by the Yale School of Medicine, through which she receives medication-assisted treatment (MAT) for her opioid use disorder (OUD). Amanda’s OB-GYN is among a group of physicians at 12 clinics in Connecticut and Massachusetts who are training with Yale to offer OB-GYN care and treatment for substance use disorder under one roof to pregnant patients.

I-Team In-Depth

Can Independent Primary Care Doctors Survive Dominance of Hospital Health Systems?

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Every day, Dr. Leslie Miller of Fairfield thinks about selling her practice to a hospital health system. “Everybody who is in this environment thinks every day of throwing in the towel and joining a hospital,” said Miller, a sole practitioner in primary care for 20 years. “The business side is the problem,” she said, referring to expensive and time-consuming requirements of medical insurance and government regulations. Dr. Khuram Ghumman took the unusual route of working in a hospital system first, then going into private primary care practice because he objects to the “corporatization” of health care. He said conflicts of interest can arise if an owner and its employed physicians have different objectives.

Disparities

With Demand For Community Health Workers Rising, So Does Need For Sustainable Funding

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New Haven Community Health Worker (CHW) Katia Astudillo helps dozens of her clients navigate the logistics of getting vaccinated and connects them with other health services. She even helps them find rental assistance. In and around New London, CHW Lizbeth Polo-Smith hands out flyers about COVID-19 safety and vaccinations at churches, laundromats, stores, warming centers for the homeless—anywhere she can. As COVID-19 laid bare Connecticut’s health care deserts, it now highlights the efforts of CHWs who labored in forgotten neighborhoods for years. In many ways, they have become a key factor in the state’s public health response for marginalized communities during the pandemic.

Disparities

Physicians’ Biases, Lack Of Knowledge Are Partly To Blame For Health Care Disparities Among People With Disabilities

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Jennifer Lortie is accustomed to facing obstacles to health care. The 37-year-old assistive technology specialist for United Cerebral Palsy of Eastern Connecticut has cerebral palsy. As she describes it, her condition, which resulted in quadriplegia, means “pretty decent use of my left arm, very limited [use] of right arm, and no use of my legs.”

Lortie has worn glasses since she was a young girl; when she was smaller, her father would carry her up the steps of the eye doctor’s office, which wasn’t handicap accessible. When that became unfeasible, she had to find another eye doctor. People with disabilities have long experienced inadequate access to health care.

I-Team In-Depth

Plan To Expand Child Tax Credit Offers Hope Along With Direct Payments

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When her car started making a noise more than a year ago, Chinara Johnson parked the vehicle and hasn’t used it since. As a New Haven mother of 5-year-old twin boys, one of whom is on the autism spectrum, and an 8-year-old daughter, Johnson doesn’t have the money to get the car running properly again. She also didn’t have money for childcare as she underwent breast cancer treatments, including surgery and chemotherapy, and is now struggling with increased utility and food bills since the kids are home during the pandemic. Over the past few years, Johnson has not been eligible for federal child tax credits because she doesn’t make enough money. But under the American Family Act—sponsored by U.S. Rep. Rosa DeLauro, D-3rd District, and others—Johnson would qualify to receive direct payments of $3,600 each for the boys and $3,000 for her daughter in federal child tax credits.

I-Team In-Depth

Medical Providers Are Taking Nature Therapy Seriously

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Schools were closed and online learning was in full swing last March when a teenager and her mom arrived at Fair Haven Community Health Care in New Haven. The girl had been experiencing chest pains and her worried mother thought she should go to the emergency room, recalled Amanda E. DeCew, a Fair Haven clinic director and pediatric nurse. The girl “was spending her entire day inside and had been inside for like two weeks,” DeCew said. “But the more we got into her symptoms, the more I really felt like this was anxiety and nothing that she needed to go the emergency room for.”

But DeCew also knew that some kind of medical intervention was needed. “I’m going to write a park prescription for you,” she told the girl.

Disparities

Education, Across All Demographics, Is An Effective Prescription To Combat Diabetes

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Since Nydia Rodriguez met Wanda Santiago about a year ago, the New London resident has lost 20 pounds and gotten her Type 2 diabetes under control. That’s because Santiago, Lawrence + Memorial Hospital’s bilingual diabetes educator, has taught Rodriguez, a former nurse from Puerto Rico, about portion control, sugar substitutes and how to cut back on bread and pasta. Santiago, who was also a nurse in Puerto Rico, has even connected Rodriguez with food banks that offer fresh fruit and vegetables. “I talk to her almost every day,” Rodriguez, 64, said in Spanish, with her daughter Yolanda Mejias translating. “If I need anything, I’ll call her.”

Diabetes is the seventh leading cause of death in the U.S. and the main cause of kidney failure, lower-limb amputations and adult blindness.

Medical Practices Become Another Pandemic Casualty

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After 35 years as an oral surgeon, Dr. Arthur Wilk closed his practice in Clinton following “daunting challenges” caused by the COVID-19 pandemic. In Darien, Dr. Cecile Windels sold her pediatric practice to a hospital health system after enduring significant income losses. They are among thousands of physicians and other health care professionals across the country who have made coronavirus-prompted career changes such as closing practices, joining larger health systems and retiring early.  The reasons for the moves vary from declines in income due to fewer inpatient visits to increased operational costs for personal protective equipment (PPE) and fears of contracting the coronavirus known as SARS-CoV-2. Health care advocates say the changes will exacerbate physician shortages, further erode the existence of private practices, decrease patient choice of doctors and obstruct continuity of patient care. A January report in Health Affairs, a peer-reviewed journal of health policy research, said: “Consolidation tends to lead to higher prices without strong evidence of quality improvements.”

“The national trends are definitely happening in Connecticut,” said Dr. Gregory Shangold, president of the Connecticut State Medical Society.