AMA Policy, UConn Professor Raise Concerns About Municipal Conversions to LED Lighting

An article authored by UConn professor of Community Medicine and Health Care Richard G. Stevens, which highlights red flags being raised by the American Medical Association regarding the safety of LED lighting being installed in cities around the country, is gaining notice.  The article first appeared on an international website, theconversation.com, which features articles researched and written by college faculty from the U.S. and around the world.  The site’s tagline, “Academic rigor, journalistic flair,” reflects its approach.  The article has since been re-published on the CNN website, and it gaining traction on dozens of other internet sites. The article revolves around a policy statement issued by the AMA this month that suggests “conversions to improper LED technology can have adverse consequences.” Stevens, who has written about the health risks of electric lighting for more than two decades,  indicates that the policy statement comes "in response to the rise of new LED street lighting sweeping the country.” 

The new "white" LED street lighting which is rapidly being retrofitted in cities throughout the country has two problems, according to the AMA, Stevens highlights. “The first is discomfort and glare. Because LED light is so concentrated and has high blue content, it can cause severe glare, resulting in pupillary constriction in the eyes. Blue light scatters more in the human eye than the longer wavelengths of yellow and red, and sufficient levels can damage the retina. This can cause problems seeing clearly for safe driving or walking at night.” The AMA goes on to point out that blue-rich LED lighting can decrease visual acuity and safety, resulting in concerns and creating a road hazard.

In addition to its impact on drivers, the AMA notes that blue-rich LED streetlights operate at a wavelength that most adversely suppresses melatonin during night. It is estimated that white LED lamps have five times greater impact on circadian sleep rhythms than conventional street lamps, the AMA indicated. Recent large surveys, according to the AMA, found that brighter residential nighttime lighting is associated with reduced sleep times, dissatisfaction with sleep quality, excessive sleepiness, impaired daytime functioning and obesity.

The AMA points out that “converting conventional street light to energy efficient LED lighting leads to cost and energy savings, and a lower reliance on fossil-based fuels. Approximately 10 percent of existing U.S. street lighting has been converted to solid state LED technology, with efforts underway to accelerate this conversion.”

Although no comprehensive list is available, among the communities in Connecticut making the switch to LED lighting are Stamford, Plainville, East Hartford, Southington, and Berlin, according to published reports. Cheshire launched a streetlight replacement program earlier this year, indicating that “the new LED fixtures will provide the appropriate amount of lighting for locations across the town and will focus light directly downward on the sidewalks and roadway.  The fixtures have a ten-year product warranty, but are anticipated to have a much longer life. The project is expected to be completed in July 2016.”

"Despite the energy efficiency benefits, some LED lights are harmful when used as street lighting," AMA Board Member Maya A. Babu, M.D., M.B.A. "The new AMA guidance encourages proper attention to optimal design and engineering features when converting to LED lighting that minimize detrimental health and environmental effects."

The AMA encourages communities to minimize and control blue-rich environmental lighting by using the lowest emission of blue light possible to reduce glare. Stevens, however, says that “the AMA's recommendation for CCT below 3000K is not quite enough to be sure that blue light is minimized. The actual spectral irradiance of the LED -- the relative amounts of each of the colors produced -- should be considered, as well.”

Stevens concludes that “there is almost never a completely satisfactory solution to a complex problem. We must have lighting at night, not only in our homes and businesses, but also outdoors on our streets. The need for energy efficiency is serious, but so too is minimizing human risk from bad lighting, both due to glare and to circadian disruption. LED technology can optimize both when properly designed.”

The Hartford Courant reported last year that ESCO Energy Services is working with the Connecticut Conference of Municipalities to implement its municipal Street Light LED Conversion Program to buy the current streetlights from utilities and replace them with more efficient LED fixtures.

Stevens proposed in 1987 what was then seen as a radical new theory that use of electric lighting, resulting in lighted nights, might produce "circadian disruption" causing changes in the hormones relevant to breast cancer risk, according to the UConn Health website. Accumulating evidence has generally supported the idea, the site indicates, and it has received wide scientific and public attention. For example, his work has been featured on the covers of the popular weekly Science News (October 17, 1998) and the scientific journal Cancer Research (July 15, 1996). His most recent paper, “Shift work as a harbinger of the toll taken by electric lighting,” was published in Chronobiology International, The Journal of Biological and Medical Rhythm Research, in January 2016.

The Conversation website is a collaboration between editors and academics to provide "informed news analysis and commentary that’s free to read and republish." It launched as a pilot project in the U.S. in October 2014 after starting in Australia in March 2011 and​ the UK in May 2013. Boston University’s College of Communication is are hosting the operation in the U.S.

PHOTO:  Traditional street lighting (left) vs. LED lighting (right).

Bridgeport-Based Wholesome Wave Receives $500,000 USDA Grant to Increase Food Access in Hartford and Vermont

The announcement of the second round of funding for the U.S. Department of Agriculture’s Food Insecurity Nutrition Incentive (FINI) Program, included the selection of national nonprofit Wholesome Wave to receive nearly $500,000 designated to increase affordable access to healthy food in Hartford, Connecticut, and the Northeast Kingdom of Vermont (the northeast corner of the state, comprising Essex, Orleans and Caledonia counties). The funds will flow through an innovative Farm-to-Grocery Nutrition Incentive model, which funds coupons for fresh fruits and vegetables that match the value of SNAP spent at participating grocery stores and increases locally-grown food those stores procure from nearby farmers.

Combined with an additional $500,000 from other funding sources, this project will amount to a $1 million investment in Connecticut and Vermont’s local food economies, according to Wholesome Wave.

Wholesome Wave plans to work with two community nonprofits, Hartford Food System and Green Mountain Farm to School, and eight local grocery stores, to help an estimated 5,000 people purchase more fresh produce. Participating stores will purchase approximately $122,000 worth of regional produce from nearby farmers in Connecticut and Vermont.

The USDA award to Wholesome Wave was one of only 15 community-based initiatives across the country to be selected to receive multi-year grants.  The project is expected to trigger $920,000 in SNAP and incentive purchases in its first three years, officials project.  Overall, the initiative is aimed at  increasing food access for low-income residents, supporting grocery stores as healthy food providers, strengthening local economies, and driving revenue to nearby farms.

“Wholesome Wave is thrilled by the innovations that USDA is supporting through the new FINI grants, which are taking the work of increasing affordable access to healthy food to even greater levels of impact,” said Michel Nischan, CEO & Founder of Wholesome Wave. “So many SNAP shoppers are working parents with limited time to source healthier food choices. Through the new Farm-to-Grocery model, our partners in Connecticut and Vermont will be able to expand affordable access to SNAP consumers in a way that allows them to find and purchase more healthy food from a variety of retailers.”

The areas selected both face high levels of poverty and are home to farmers seeking new markets for their healthful crops, according to Wholesome Wave.  They point out that 40 percent of Hartford’s children live in poverty and 42 percent of the city’s residents use SNAP, formerly known as food stamps.

In the first iterations of healthy food incentives – which also match the value of SNAP spent – Wholesome Wave worked with local partners to offer them at farmers markets. By expanding healthy food incentives to grocery stores where many families already shop, this project is designed to offer a promising solution to each community’s food access challenges.

Wholesome Wave’s expertise in facilitating and scaling successful food access projects, combined with the local nonprofits’ experience within the communities, represents an ideal partnership to move this work forward, according to the organization.

This project builds on Wholesome Wave’s existing work across 40 states, including expansion through the large-scale FINI grant received last year, a $3.77 million grant from the USDA through the new Food Insecurity Nutrition Incentive (FINI) grant program.   Wholesome Wave began in Bridgeport in 2008; a 501(c)(3) nonprofit that strives to create a vibrant, just and sustainable food system. By making fresh, locally grown fruits and vegetables affordable and available, it enables underserved consumers to make healthier food choices.

In particular, this year’s FINI grant expands on the successes of Wholesome Wave’s and partners’ efforts to pilot nutrition incentives in grocery stores in Connecticut and Vermont.

In the first few months of 2016, Wholesome Wave invested in the Hartford food system by providing SNAP consumers with $23,000 in nutrition incentives to spend on fresh fruits and vegetables at two locally-owned grocery stores. During the program period, attributable at least in part to this project, SNAP sales at the local C-Town supermarket increased 7 percent and produce sales increased by 19 percent over the same period in 2015.

Executive Director of Hartford Food System, Martha Page, said: “As demonstrated in the pilot program, the SNAP Up! nutrition incentives are an excellent way to get more fresh fruits and vegetables on Hartford dinner tables. The enthusiastic response to the incentives by Hartford SNAP participants clearly shows that there is a demand for affordable, high quality produce.  For our local farmers, this will represent a new customer base that they have not been able to easily access. We are so excited at the opportunity to bring Hartford area farmers and Hartford consumers together; we believe that we will prove that good food is good business!”

National leaders emphasize how this new model will benefit their state’s economies, while increasing access to produce for low-income residents and improving the bottom line for regional farmers.

“Increasing access to fresh, healthy food for the low-income residents of food deserts will help move our communities one step closer to ending food insecurity. The federal funding awarded to Bridgeport’s Wholesome Wave to help provide fresh produce to Hartford’s local grocers is an investment in an incredible partnership that will help ensure the well-being and health of Hartford’s residents,” said U.S. Sen. Richard Blumenthal.

“Just a few days ago, I was at Hartford Regional Market talking to local farmers and Hartford community leaders about better connecting local food to city grocery stores,” recalled U.S. Sen. Chris Murphy. “This grant for Wholesome Wave is a great opportunity to make that happen. It just makes sense—we should help families afford locally-grown, fresh food at the grocery stores they already shop at. We worked so hard to get North Hartford its Promise Zone designation so that the city can hop to the front of the line when it comes to getting federal grants. This shows why that’s so important.”

“Food deserts correlate very highly with areas of poverty across our country, and a lack of healthy and affordable food options can have a very detrimental effect, especially on children,” said U.S. Rep. Jim Himes, who represents the Congressional District that includes Bridgeport. “With this grant, we will be able to help more families eat nutritiously in Hartford and also support the excellent work that Wholesome Wave is doing right here in Bridgeport, creating innovative ways to bring healthy, local produce into more stores and kitchens.”

In the initiative, neighborhood grocery stores will become access points for fresh local produce, and experience increased revenues. Beyond direct impact to the community, Wholesome Wave expects to use this project in the two states to develop a replicable Farm-to-Grocery Nutrition Incentive model that the organization hopes can spread nationally through their national network of over 110 organizations in 40 states – including 12 in Connecticut - with the promise of impact on a national scale.

The second-round USDA funding award to Wholesome Wave, announced this month, is for $499,720.  The programs in Hartford and Vermont’s Northeast Kingdom are expected to launch in August.

https://youtu.be/BU0sOg9GhWA

Four CT Community Health Centers Earn $1 Million Federal Grants to Expand Care

The federal Department of Health and Human Services (DHHS) has awarded Charter Oak Health Center, Inc. (COHC), located in the south end of Hartford, with a federal grant of $1 million to increase its capacity for patient care, one of four community health centers in the state to receive the federal grants. Grants of $1 million were awarded to three additional Connecticut community health centers:

• Fair Haven Community Health Clinic in New Haven
• Cornell Scott-Hill Health Corporation in New Haven
• First Choice Health Center in East Hartford

The grants to the four facilities in Connecticut are anticipated to extend program services to an additional 18,776 patients, according to DHHS.  Nationally, over $260 million in funding is to be provided to 290 health centers in 45 states, the District of Columbia, and Puerto Rico for facility renovation, expansion, or construction.

Health centers will use this funding to increase their patient capacity and to provide additional comprehensive primary and preventive health services to medically underserved populations.

"We are truly excited about the award," said Nichelle A. Mullins, President and CEO of COHC. “It is an honor and a great responsibility to serve our patients and community.  It is a significant accomplishment to be recognized on a national level for our quality of care. Our mission since 1978 is to offer health care services to our community and with the funding from this grant we will be able to improve and expand our specialty services.”

COHC currently offers a wide range of services from primary medical care, to specialty services including women’s health and gynecology, pediatric care, podiatry, dental and eye care as well as nutrition and wellness therapy. The center offers urgent care services where the patients can be seen quickly rather than in hospital emergency departments. There is also an on-site pharmacy and bilingual services in all areas of care.

According to Health and Human Services Secretary Sylvia M. Burwell, “With these awards, health centers will be able to do things like increase their hours of operation, hire more behavioral health providers, add dental facilities, better treat patients with opioid use disorders, and help people get coverage through the Health Insurance Marketplace and make the journey from coverage to primary care.”

In 2015, Charter Oak Health Center was one of 12 community health centers in the state to receive Expanded Service Awards from the Health Resources and Service Administration (HRSA) Health Center Program within the Department of Health and Human Services.

“Health centers are cornerstones of the communities they serve,” said Secretary Burwell.  “These awards will empower health centers to build more capacity and provide needed health care to hundreds of thousands of additional individuals and their families.”

The national grant was initiated in 2009, allowing health centers to add 6 million more patients. Health centers provide high quality preventive and primary health care to patients regardless of their ability to pay. Approximately 1 in 14 people in the U.S. relies on a HRSA-funded health center for medical care.

Nearly 1,400 health centers operate 9,800 service delivery sites in every U.S. state, D.C., Puerto Rico, the Virgin Islands and the Pacific Basin; these health centers employ more than 170,000 staff who provide care for nearly 23 million patients across the nation.

Charter Oak Health Center, Inc.  (COHC) was founded in 1978 and is an urban, 501(c) (3) federally qualified, Joint Commission-accredited, nonprofit community health center that serves the Greater Hartford, Connecticut Metropolitan Area and surrounding communities - Hartford itself being the poorest of the nation's cities with a population of greater than 100,000.

COHC is located in a medically underserved area (MUA) with an underserved population (MUP) and a health professional shortage area (HPSA). COHC is the only community health center located in southern Hartford and provides Medical, Dental, and Behavioral Health services to over 18,000 patients annually.

Cornell Scott-Hill Health Center is a federally qualified community health center established in 1968 in a collaboration between the community and Yale School of Medicine. The first community health center in Connecticut, the Cornell Scott-Hill Health Center has a long history of serving New Haven neighborhoods, which are among the most disadvantaged in the State. Cornell Scott-Hill Health Center also provides health care services to those from West Haven, Ansonia, Derby, Seymour, Shelton, Naugatuck and Oxford.

East Hartford Community HealthCare changed its name to First Choice Health Centers in recognition of growth as a regional provider of primary care services.  First Choice provides health care to 17,453 patients who made 67,663 visits in 2014. First Choice provides comprehensive primary care from newborn through adult and elderly services. The Center offers family practice, internal medicine, pediatrics, dentistry, nutrition, sonography, and in 2011 added podiatry followed by optometry in 2012 and behavioral health services in 2014.

With locations in New Haven and East Haven, Fair Haven Community Health Clinic provide comprehensive primary health care, delivered through innovative and alternative systems of health delivery.  Healthcare teams provide access to ongoing care throughout our patients' lifetime, including preventative health services, chronic disease management, and acute illness treatment. Fair Haven began in August 1971, under the leadership of a community advocacy agency called the Alliance for Latin American Progress, opening in a local elementary school two evenings a week.  The Clinic, also renamed, grew steadily in the decades since, expanding services and patients served.

link to FOX 61 news story.

https://youtu.be/j80B4ckjOT8

Connecticut Is 2016’s 2nd Best State for Working Dads; Two Norwalk Businesses Earn Spot Among Nation’s Top 50 for New Dads

Working fathers in Connecticut are in a great place, according to a newly released analysis.  Connecticut is ranked only behind only Minnesota as the 2^nd Best State for Working Dads, a glimpse of good news as Father’s Day approaches. Nearly 93 percent of dads with kids younger than 18 in the labor force, according to the personal-finance website WalletHub, which conducted an in-depth analysis of the Best & Worst States for Working Dads.

The top 10 states were Minnesota, Connecticut, Vermont, Massachusetts, New Jersey, Wisconsin, Iowa, Kansas, Virginia and North Dakota.  At the bottom of the list were Mississippi, West Virginia, Alaska and Nevada.

WalletHub analyzed the work-life balance, health conditions, financial well-being and child-rearing environments for working dads in the 50 U.S. states and the District of Columbia, using 20 key metrics, which range from day care quality to male life expectancy.

To identify the best and worst states for working dads, WalletHub analyzed the various factors in the work-life balance that affect paternal roles in the 50 states and the District of Columbia, focused on four key dimensions of fatherhood: 1) Economic & Social Well-Being, 2) Work-Life Balance, 3) Child Care and 4) Health.  Among the 20 factors included were parental leave policy, commute time, day care quality, pediatric services, median income, unemployment rate, and mental health.

Leading to its overall ranking of second in the analysis, Connecticut was 13^th in “economic and social well-being,” third in “work-life balance,” eighth in “child care,” and third in “health.”  Among the sub-categories, Connecticut was:

• 2nd – Male Life Expectancy at Birth
• 2nd – % of Kids Younger than 18 with Dad Present Living in Poverty
• 2nd – “Parental Leave Policy” Score
• 6th – Access to Pediatric Services
• 6th – % of Men Who Report Adequate or Any Physical Activity
• 7th – Male Uninsured Rate
• 14th – Average Freshman Graduation Rate for Men
• 16th – Mortality Rate due to Heart Disease per 100,000 Men
• 17th – Mean Hours Worked per Day Among Males
• 19^th - Median Income for Families (Dad Present) with Kids Younger than 18 Years, Adjusted for Cost of Living

Among the nation’s top businesses for new dad, an analysis by the website Fatherly, determined that two Connecticut-based companies – alcoholic beverages producer Diageo and financial data and analysis provider FactSet, earned slots in the top 50.  Fatherly is a digital lifestyle guide for men entering parenthood.

Just a handful of states had companies on the list:  California (18), New York (9), Oregon (4), Massachusetts (3) and Georgia, North Carolina, Washington DC, and Connecticut, with two each.

Norwalk’s Diageo ranked 34^th, and was praised for policies that include “employees receive up to 8 hours of school activity leave (up to 40 hours per year) so you won’t have to miss your kid’s big game or school play.”  FactSet, headquartered in Norwalk, ranked 46^th.  The company was praised because it “recently upped it’s paternity leave from one week to 4.”  FactSet has 8,000 employees in 21 countries.  Diageo is a global leader in beverage alcohol with iconic brands in spirits, beer and wine, producing well-known brands from more than 200 sites in over 30 countries.

The top companies were Netflix, Spotify, Facebook, Patagonia, Bank of America, Pinterest, Google, Microsoft, Twitter, Airbnb, Johnson & Johnson, Accenture, MasterCard, Intuit and Intel.

In addition, nine small businesses described as “leading the way,” were change.org (San Francisco), Laughing Planet Café (Portland), Upworthy (New York), Blue Corona (Maryland),  Badger Balm (New Hampshire), Square Root (Austin), Able Lending (Austin), Happy Family (New York) and ustwo (New York).

When Fatherly’s 50 Best Places To Work For New Dads was a year ago, nearly half the companies featured offered between one and 2 weeks of paid leave to fathers. Twelve months later, 7.5 weeks is the average, 35 percent of companies offer between 6 and 8 weeks, and another 12 companies offer between 10 weeks and a full year, the website pointed out, attributing much of the increase to tech companies, which make up nearly a third of companies on the top 50 list.

Data used to create the WalletHub report were obtained from the U.S. Census Bureau, the U.S. Bureau of Labor Statistics, the Council for Community and Economic Research, the Centers for Disease Control and Prevention, the National Center for Education Statistics, the National Partnership for Women & Families, the American Urological Association, the Social Science Research Council, Child Care Aware of America and WalletHub research.

Nine in Ten CT Residents Have a Usual Source of Care, But 3 in 10 Haven’t Seen Doctor in Past Year

A new federal report finds that all but 10.1 percent of Connecticut residents had a usual source of medical care during 2014 – tied for the sixth lowest percentage among the states.  The same report found great variation among states but, on average, 17.3 percent of Americans lacked a usual source of care. Vermont led the country with only 2.8 percent of residents reporting they do not have a regular care site, according to data compiled by the Centers for Disease Control and Prevention’s National Center for Health Statistics, followed by Delaware at 6.8 percent.

Even in Connecticut there remains room for improvement as nearly 3 in 10 – 29.6 percent - of Connecticut residents had not seen or talked to a general doctor during the last year, slightly better than the national average. Vermont also led the country in that statistic, with 84 percent having seen or spoken with a physician during the previous year.

The percentage of adults without a usual place of medical care ranged from 2.8 percent in Vermont to 26.7 percent in Nevada.  The percentage of adults who did not have a general doctor visit in the past 12 months ranged from 15.9 percent in Vermont to nearly have the state’s population - 48.1 percent - in Montana.

The federal data indicated that nine states (Nevada, Idaho, Texas, Oregon, Wyoming, Kentucky, Arizona, Alaska, and Florida) had a higher percentage of adults without a usual place of medical care compared with the national average (17.3%).

Conversely, Vermont, Delaware (6.8%), Massachusetts (7.5%), Wisconsin (9.5%), Hawaii (10%), Connecticut (10.1%), Rhode Island (10.1%), New Hampshire (11.6%), North Dakota (11.9%), South Dakota, New York, Alabama, Iowa, Maine, and Pennsylvania had a lower percentage of adults without a usual place of medical care compared with the national average.

Eleven states (Montana, South Dakota, Alaska, Nevada, New Mexico, South Carolina, Idaho, Nebraska, Texas, Florida, and California) had a higher percentage of adults who had not seen or talked to a general doctor in the past 12 months compared with the national average (34.0%).  Vermont, Delaware, Virginia, Pennsylvania, Michigan, Wisconsin, New Hampshire, Oklahoma, and Ohio had a lower percentage of adults who had not seen or talked to a general doctor in the past 12 months compared with the national average.

Connecticut, at 29.6 percent, ranked just outside the top 10 states in the second quartile, but just below the national average.

Also of note, the study found little impact on these metrics of states’ decisions to expand Medicaid or create a state-based health insurance exchange. The federal analysis concluded that “continued state-specific monitoring will be helpful in identifying and tracking state and regional disparities in health care utilization over time.”

The National Health Interview Survey is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics (NCHS). Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone. The federal report was authored by Lindsey I. Black and Jeannine S. Schiller, with the National Center for Health Statistics, Division of Health Interview Statistics.

CT An Also-Ran Among States in Entrepreneurial Growth, Despite Some Gains

Connecticut ranks 13^th among the nation’s 25 smaller states – and 36^th overall - in the growth of entrepreneurship, according to a new study and state-by-state analysis by Kauffman Foundation.  A year ago, the state ranked 17^th among the smaller states, slightly improving its ranking in the latest data.  The rate of start-up growth in Connecticut increased to 45.5 percent in the 2016 report, compared with 23.6 percent the previous year. The “share of scale-ups” also increased, from 1.29 percent in last year’s analyses to 1.33 percent this year.  Scale-ups measures the number of firms that started small but grew to employ fifty people or more by their tenth year of operation as a percentage of all employer firms ten years or younger.

One metric that dropped slightly measured high-growth company density – the number of private businesses with a least $2 million in annual revenue reaching three years of 20 percent annual revenue growth normalized by total business population.  Connecticut moved from 55.1 a year ago to 48.8 in the 2016 report.  Both researchers and entrepreneurs have suggested density as a key indicator of vibrancy in entrepreneurial ecosystems, and there is high variation on this indicator across U.S. states, according to the report.

The Kauffman Index of Growth Entrepreneurship, released this week,  is an indicator of business growth in the United States, “integrating several high-quality sources of timely information into one composite indicator of entrepreneurial business growth.”

In rankings by industry, Connecticut ranked in the top five among the 25 smaller states in two five categories – 3^rd in Business Products & Services and 3^rd in Software.  The state was ranked outside the top five in high-growth companies in the IT Services, Advertising & Marketing and Health industries.

Overall, the Growth Entrepreneurship Index rose in 2016 in thirty-nine states in the last year, indicating a continued return of broad-based business growth, the report concluded.

• Among the twenty-five largest states, the five states with the highest Growth Entrepreneurship Index were Virginia, Maryland, Arizona, Massachusetts, and Texas.
• Among the twenty-five smallest states, the five states with the highest Growth Entrepreneurship Index were Utah, New Hampshire, Delaware, North Dakota, and Oklahoma. (Connecticut ranked 13^th)

While most states experienced an increase in growth entrepreneurship activity, changes in state rankings— which measure relative yearly performance across states, as opposed to performance relative to a state’s own growth entrepreneurship rates in the previous year—were different. Twenty-three states ranked higher than they did last year, seven experienced no changes in rankings, and twenty ranked lower, the report pointed out.

"Growth entrepreneurship directly contributes to the economy through creating jobs, innovation and wealth," said Arnobio Morelix, senior research analyst at the Kauffman Foundation, which conducts the annual study.

Virginia took first place in growth entrepreneurship activity among the 25 largest states, followed by Maryland, Arizona, Massachusetts and Texas. Kauffman researchers said it is no coincidence that two of the top states include the highly entrepreneurial Washington, D.C., metro area. Among larger states, 12 ranked higher than they did last year, four experienced no change in rankings and nine ranked lower.

Among the 25 largest states, the five that experienced the biggest increase in rank from 2015 to 2016 were North Carolina (15 to 8), Alabama (13 to 9), Ohio (16 to 12), Tennessee (18 to 14) and Arizona (6 to 3).

The five large states that saw the greatest decrease in rank in 2016 were, with a tie for fifth place, New Jersey (8 to 20), Pennsylvania (10 to 16), Illinois (14 to 17), Wisconsin (20 to 23), Louisiana (4 to 6) and South Carolina (11 to 13).

Among the 25 smallest states, Utah led growth entrepreneurship activity, followed by New Hampshire, Delaware, North Dakota and Oklahoma. Eleven states ranked higher than they did last year, three experienced no change in rankings and 11 ranked lower.

The five small states that saw the biggest increase in rank were Mississippi (22 to 10), Wyoming (23 to 15), North Dakota (11 to 4), Nevada (15 to 8) and Connecticut (17 to 13).

Most CT Residents Concerned About Loss of Jobs, Access, Care in Aetna-Humana Merger, Poll Shows; Missouri Decision Points to Adverse Impact

The State of Missouri raised a red flag today, waving it directly into the headwind that is the pending merger between health care giants Aetna and Humana.  Missouri’s action came just as a public poll was released in Connecticut by consumer advocates opposing the merger which indicated a general lack of public awareness about the merger plan and substantial concern about potential job losses and adverse health care affordability and choices here if the merger goes forward. The Missouri Insurance Department issued an order banning Aetna and Humana from selling certain types of insurance in the state if the companies’ planned $37 billion merger comes to fruition. The order states that Aetna and Humana should “cease and desist from doing business” throughout Missouri with respect to individual and small group insurance and the group Medicare Advantage market if Aetna’s acquisition of Humana is completed.

In Connecticut, the Connecticut Campaign for Consumer Choice coalition released results of a recent poll which found that most Connecticut voters “didn’t know that the five major national health insurance companies – UnitedHealth, Anthem, Cigna, Aetna, and Humana - are attempting to merge down to three companies from five. The new research found that only 27 percent of respondents were aware of the plans.

After they were given more information about the consequences of the mergers among the five national health insurance providers (Aetna-Humana and CIGNA-Anthem), 71 percent of Connecticut voters were opposed to State Insurance Commissioner Katherine Wade approving the mergers in Connecticut.

Nine in ten state voters (91 percent) think that it’s either very or somewhat important that Commissioner Wade “considers the impact of these mergers on the affordability of insurance premiums and out-of-pocket costs, and their potential to limit health care choices, in her decision making process.” And those surveyed were overwhelmingly concerned that the proposed mergers will lead to job losses in Connecticut.

The Connecticut survey, conducted earlier this month by Public Policy Polling, found that 89 percent of Connecticut voters are either very or somewhat concerned that the proposed mergers will lead to job losses in Connecticut. Additionally, 89 percent of those polled believe it’s either very or somewhat important that the impact of these mergers on job losses in Connecticut be considered by state regulators.

Missouri is the first state regulator to release findings against the proposed deal, announced last year, published reports indicated. The deal is being reviewed by the U.S. Department of Justice, as well as state regulators and antitrust authorities, who are also reviewing competitor Anthem’s plan to buy Cigna Corp. Aetna has filed for regulatory approval in the 20 states where Humana is domiciled and of those, 15 have approved the deal thus far, including Connecticut.  Because of Humana's limited footprint in Connecticut, the review was more form than substance.  The Cigna-Anthem merger, however, is to receive a much fuller review, according to state insurance officials, as Cigna is a state-domiciled company.

Regarding Aetna-Humana, the Missouri Insurance Department “found that in its current, unmodified, form – as to a few specified lines of insurance – that the proposed acquisition would violate the competitive standard set forth in Missouri law, meaning that as to those lines the acquisition would substantially lessen competition in this state.”

The Missouri Insurance Department stressed that the decision “is not a final order. The statute provides that Aetna and Humana may submit a plan to remedy the anticompetitive effect of the merger as to those specified lines.”  If that step is taken, the department “would evaluate the plan and may modify or vacate” the order issued today banning the merged company from certain lines of insurance in the state.

"The Missouri order does not impede the Department of Justice approval process," Aetna said in a statement. "We're disappointed, but expect to have a constructive dialogue with the state to address their concerns."

In addition to the public poll, Connecticut Campaign for Consumer Choice – a coalition that includes the Universal Health Care Foundation, Connecticut Citizen Action Group and Connecticut State Medical Society -  released a letter to Commissioner Wade signed by 17 state legislators calling for multiple public hearings on the merger, intervenor status for interested consumer advocates, and a study that would “analyze the potential impact on cost, access, and the Connecticut economy, including jobs” and warning that if the merger is approved, “the resulting mega-insurer will cover 64 percent of covered lives in Connecticut, with an even greater concentration in some regions of our state.”

The Missouri decision comes following a public hearing held on May 16.  In testimony provided as part of the public record, Consumers Council of Missouri expressed “profound concern,” warning that the merger would result in a “significant reduction in competition (that) will most certainly result in increased cost to consumers,” adding that “the results will be catastrophic and we will have no power to undo it.”

The Missouri Hospital Association, in offering a detailed 21-page analysis, indicated that “Consolidation will affect the ability of hospitals and other health care providers to bargain competitively for contracts containing appropriate fees for medical services. In turn, such providers are less able to invest in the resources to maintain and improve the quality of care. An anticompetitive suppression of healthcare payments will suppress innovation, to the detriment of consumers.”

CT Has Nation's 11th Lowest Adult Obesity Rate, Survey Says

One quarter of Connecticut’s adult population is obese, according to data compiled by Gallup, the 11^th lowest rate in the nation.  The state-by-state analysis indicates that at 18.5 percent, Hawaii has the lowest adult obesity rate in the U.S., closely followed by Colorado at 19.8 percent. They are the only two states in which the obesity rate is below 20 percent. On the other end of the spectrum, West Virginia has the highest adult obesity rate, at 37.0 percent. In addition to West Virginia, at least one in three adults are obese in Mississippi, Delaware, Arkansas and Oklahoma. The obesity rate exceeds 30 percent in 18 states.

Of the 18 states with obesity rates of at least 30.0 percent, all but one are located in the South or Midwest. Meanwhile, all 11 states with obesity rates below 25.0 percent are located in the Northeast or West.

These data, from daily interviews conducted January through December 2015 as part of the Gallup-Healthways Well-Being Index, are based on U.S. adults' self-reports of their height and weight, which are then used to calculate Body Mass Index (BMI) scores. Americans who have a BMI of 30 or higher are classified as obese.

The national obesity rate reached a new high of 28.0 percent in 2015, up significantly from 25.5 percent in 2008, when Gallup and Healthways began tracking obesity. Fourteen states had statistically significant increases in their obesity rates from 2008 to 2015, while no state registered a statistically significant decline. Maine, West Virginia, Idaho and Oklahoma experienced the sharpest upticks in obesity.

Gallup calculated the incremental cost of healthcare per year for each state by multiplying the estimated number of obese people in the state's population by the annual incremental $1,573 cost of obesity per person.

In the five most obese states, the annual incremental cost of obesity per 100,000 residents averages $54 million. By contrast, the average cost is $34 million in the five least obese states. In other words, per capita medical costs attributable to obesity are about 1.6 times higher in the five states with the highest obesity rates than in the states with the five lowest rates.  The cost in Connecticut for the obese adult population was estimated at $39 million, for the entire adult population, $1.07 billion.

Public Supports Action to Protect Youth From Weight-Based Bullying

Parental support for enactment of laws and policies to protect youth from weight-based bullying is “present, consistent, and strong,” according to a new study by the Rudd Center for Food Policy and Obesity at the University of Connecticut. All 50 states currently have anti-bullying laws, but only three states – New York, Maine and New Hampshire - include body weight as a characteristic that places youth at risk of being bullied.

Many school districts have anti-bullying policies, yet body weight is often overlooked, stating that “evidence from students, parents and teachers indicates that weight-based bullying is one of the most prevalent forms of peer harassment towards youth in the school setting.”

The study found that support for including weight-based bullying in anti-bullying laws has grown during the past two years, stressing that “the omission of body weight in existing policies has important implications for youth who face weight-based bullying.”

“Parental voices can be influential in mobilizing advocacy efforts, and enacting policy change affecting children’s health,” said Rebecca Puhl, a study author, professor in UConn’s Department of Human Development and Family Studies, and deputy director of the Rudd Center.

The study findings, published in the journal Pediatric Obesity, can inform policy discussions about remedies for weight-based bullying among youth as increasing national attention is being paid to this issue.  The study indicated that “parental support is an influential catalyst motivating political will for policy decisions affecting youth, but has received limited research attention.”

Specific findings of the study include:

• Parental support has been consistently high (at least 81 percent) over the past two years for policies to address weight-based bullying among youth at the school, state, and federal levels.
• Support appears to have increased over the past two years for measures to better protect youth from weight-based bullying through improvements to state anti-bullying laws (87.9 percent – up from 84.7 percent) and through enactment of federal legislation (86 percent – up from 81 percent).
• While previous research has shown that mothers express more support than fathers for similar types of policies, this new study found no gender difference, suggesting that fathers’ support for these measures may be increasing.

“As a next step, it will be important to communicate with policy makers and school officials to identify interest and feasibility of viable policy initiatives,” said Puhl, “and to examine potential avenues for enacting change through law.” Puhl told CT by the Numbers that Connecticut’s law includes “physical appearance” but not body weight. There is, therefore, room to strengthen the state law, she pointed out, because physical appearance is a broad category that can include everything from clothing style to hair color, and body weight could easily slip through the cracks if it is not specifically enumerated.

The study involved online questionnaires of diverse national samples of parents in 2014 and 2015, totaling 1,804 parents over the two years. The research was funded by a donation from Rudd Foundation and a grant from the Robert Wood Johnson Foundation.

The study co-authors include Young Suh and Xun Li of the UConn Rudd Center. The Rudd Center for Food Policy & Obesity is a non-profit research and public policy organization devoted to promoting solutions to childhood obesity, poor diet, and weight bias through research and policy.

West Hartford’s Newly Developed Complete Streets Policy is #2 in the Nation for 2015

West Hartford’s Complete Streets policy, adopted in 2015, has been named the second best new policy in the nation by Smart Growth America and the Complete Streets Coalition. The coalition highlighted 16 communities nationwide for their outstanding new policies, among 82 communities that adopted Complete Streets policies during the year.  Nationwide, there are now a total of 899 Complete Streets policies in place in all 50 states, the organization announced this month. A Complete Streets approach creates an integrated transportation system that supports safe travel for people of all ages and abilities. This approach redefines what a transportation network looks like, which goals a public agency sets out to meet, and how communities prioritize their transportation spending. A Complete Streets policy is one of the best ways to set this approach into motion, Smart Growth American emphasized.

The U.S. Surgeon General and Secretary of Transportation both spoke out for more Complete Streets last year and Congress passed a transportation bill that included Complete Streets language for the first time ever.

The Complete Streets laws, resolutions, agency policies, and planning and design documents establish a process for selecting, funding, planning, designing, and building transportation projects that allow safe access for everyone, regardless of age, ability, income or ethnicity, and no matter how they travel.

Across the country, 32 state governments or agencies, 76 regional organizations, and 663 individual municipalities have all adopted such policies to create safer, multimodal transportation networks.

West Hartford’s policy is the result of a process that began in 2009 with the adoption of the Town’s 2009-2019 Plan of Conservation and Development,” according to town Deputy Mayor Shari Cantor.  She said the plan “promote[s] an integrated and balanced “complete street” transportation system which provides the best possible service, mobility convenience and safety while reinforcing a positive social, economic, and environmental influence on West Hartford.

“Utilizing a comprehensive public participatory process, guided by the leadership of the Town Council; the advocacy efforts of various community groups in West Hartford including our Bicycle Advisory Committee, and the work of our Town staff; we were able to develop and adopt this tremendous Complete Streets Policy,” said Mrs. Cantor in response to the national recognition.

Each year, the National Complete Streets Coalition analyzes newly passed Complete Streets policies. The Coalition examines and scores policy language using the guidelines laid out in our ideal policy elements. Ideal policies state a community’s vision for transportation, provide for many types of users, complement community needs, and establish a flexible project delivery approach. Different types of policy statements are included in the Coalition’s review, including legislation, resolutions, executive orders, internal policies, and policies adopted by an elected board.

The Coalition ranks new Complete Streets policies to celebrate the people who developed exceptional policy language and to provide leaders at all levels of government with examples of strong Complete Streets policies.

Sixteen agencies led the nation in creating and adopting comprehensive Complete Streets policies in 2015. Topping the list, with the first-ever score of 100, was Reading, PA, followed by West Hartford, Park Forest, IL and South Bend, IN.  Four of the next seven slots went to communities in Massachusetts:  Longmeadow, Weymouth, Ashland, Natick and Norwell.  The others were Omaha, NE and Incennes, IN.

Of the 663 municipalities with Complete Streets policies, 239 (or 36 percent) are suburban communities. Small towns, often in rural areas, have passed 111 policies, or 17 percent of all municipal policies. On the other end of the spectrum, 12 of the 15 most populous cities in the country have committed to Complete Streets with a policy, according to the organization’s 2015 report. 

“A Complete Streets approach is about helping everyone stay safe on the road—no matter if they’re walking, biking, taking transit, using an assistive device, or driving,” said Emiko Atherton, Director of the National Complete Streets Coalition. “Passing a Complete Streets policy is one of the best actions communities can take toward achieving these goals.”

Connecticut became the 10^th state in the nation to adopt a Complete Streets law, in 2009.  The law mandates “accommodations for all users shall be a routine part of the planning, design, construction and operating activities” of all state highways. Connecticut’s Complete Streets law has evolved, and now (Conn. Gen. Stat. §13-153f) requires pedestrians, cyclists, and transit users to be routinely considered in the planning, designing, construction and operation of all roads.

In 2014, Bike Walk Connecticut released a first-of-its-kind ranking of the state’s cities and towns on how bike- and walk-friendly they are. Simsbury (1), New Haven (2), New Britain (3), Glastonbury (4), and Middletown (5) claimed top honors as the five most bike- and walk-friendly communities.

Earlier this year, the University of Connecticut released a study that shows how shared space, a design concept that encourages all users to share street space, can provide much greater vehicular capacity than conventional intersections and increases pedestrian convenience. The study found that by redesigning streets and intersections as human-scaled places and incorporating shared space concepts, communities of all sizes have successfully encouraged active transportation, stimulated their local economies, reduced accident severity, and lessened their environmental impacts. The study compared actual user delays at six shared space intersections to expected user delays using standard U.S. traffic modeling software.  The state Department of Transportation issued a policy document in 2014 consistent with the law.

The criteria used in the Complete Streets evaluation include:

1. Vision: The policy establishes a motivating vision for why the community wants Complete Streets: to improve safety, promote better health, make overall travel more efficient, improve the convenience of choices, or for other reasons.
2. All users and modes: The policy specifies that “all modes” includes walking, bicycling, riding public transportation, driving trucks, buses and automobiles and “all users” includes people of all ages and abilities.
3. All projects and phases: All types of transportation projects are subject to the policy, including design, planning, construction, maintenance, and operations of new and existing streets and facilities.
4. Clear, accountable exceptions: Any exceptions to the policy are specified and approved by a high-level official.
5. Network: The policy recognizes the need to create a comprehensive, integrated and connected network for all modes and encourages street connectivity.
6. Jurisdiction: All other agencies that govern transportation activities can clearly understand the policy’s application and may be involved in the process as appropriate.
7. Design: The policy recommends use of the latest and best design criteria and guidelines, while recognizing the need for design flexibility to balance user needs in context.
8. Context sensitivity: The current and planned context—buildings, land use, transportation, and community needs—is considered in when planning and designing transportation solutions.
9. Performance measures: The policy includes performance standards with measurable outcomes.
10. Implementation steps: Specific next steps for implementing the policy are described.

The National Complete Streets Coalition, a program of Smart Growth America, is a non-profit, non-partisan alliance of public interest organizations and transportation professionals committed to the development and implementation of Complete Streets policies and practices. A nationwide movement launched by the Coalition in 2004, Complete Streets is the integration of people and place in the planning, design, construction, operation, and maintenance of transportation networks.