Marijuana, Cellphones May Increase Pedestrian Fatalities, Federal Report Suggests; Fewer Deaths in CT as 23 States See Increase

Connecticut is one of 20 states that saw a decline in the number of pedestrian deaths in the first half of 2017, as compared with the first half of the previous year.  The trend nationally, however, is in the opposite direction, as 23 states saw pedestrian deaths increase.  Seven states were virtually unchanged.  And the trend in recent years has also been a rising death toll. The number of pedestrian fatalities increased 27 percent from 2007 to 2016, while at the same time, all other traffic deaths decreased by 14 percent. A new national study raises the possibility of a number of factors for the increase – an increase in the number of cars on the road, the increasing use of cell phones, and the use of marijuana, which has been legalized for recreational use in some states, including neighboring Massachusetts. The report suggests that it "provides an early look at potential traffic safety implications of increased access to recreational marijuana for drivers and pedestrians."

The Governors Highway Safety Administration (GHSA) released a 38-page study this week estimating that just under 6,000 pedestrians lost their lives last year, essentially the same death toll as 2016. The projected total in both years represent the highest levels seen since 1990, Governing magazine reported.  The number of states with pedestrian fatality rates at or above 2.0 per 100,000 population has more than doubled, from seven in 2014 to 15 in 2016. From 2015 to 2016, pedestrian fatalities in the nation’s ten largest cities increased 28 percent (153 additional fatalities), according to the GHSA report.

The number of miles traveled by vehicles increased nationally by 2.8 percent between 2015 and 2016 then rose another 1.2 percent the first half of last year, according to Federal Highway Administration data  The GHSA report noted that nearly 6,000 pedestrians died in motor vehicle crashes in 2016 and 2017, coming after a spike in the number of pedestrian deaths in 2015. "It has been more than 25 years since the U.S. experienced this level of pedestrian fatalities. Because both 2015 and 2016 saw large increases in pedestrian fatalities, the continuation of pedestrian fatalities at virtually the same pace in 2017 raises continued concerns about the nation’s alarming pedestrian death toll," the report stated.

“We’ve plateaued at a very bad place,” Richard Retting, who authored the report, told Governing. “This should not be a new normal.”

While pedestrian deaths have increased over the past decade, other types of traffic fatalities declined. Pedestrians accounted for 16 percent of all motor-vehicle related deaths in 2016, up from 11 percent in 2007. Federal data suggests nighttime collisions are a major problem -- three quarters of fatal crashes occurred after dark.

In Connecticut, there were 31 pedestrian fatalities in the first half of 2016; 20 in the first half of 2017, a decrease of 35 percent. Connecticut was one of 11 states, 2014-2016, where 20 percent or more of the pedestrian deaths were among people age 70 or older.  Connecticut's pedestrian fatality rate in 2016 was 1.73 per 100,000 population, which ranked 20th in the U.S.  In the first half of 2017, the state ranked 31st.

Retting told Governing that he suspects cellphone use by drivers and pedestrians could also be a culprit. The GHSA report stated that "Without stating a direct correlation or claiming a definitive link, more recent factors contributing to the increase in pedestrian fatalities might include the growing number of state and local governments that have decriminalized recreational use of marijuana (which can impair judgment and reaction time for all road users), and the increasing use of smart phones (which can be a significant source of distraction for both drivers and pedestrians).

The total number of multimedia messages sent has more than tripled since 2010.  The report also suggests a possible link with marijuana use.  According to the report, the seven states (Alaska, Colorado, Maine, Massachusetts, Nevada, Oregon, Washington) and  DC that legalized recreational use of marijuana between 2012 and 2016 reported a collective 16.4 percent increase in pedestrian fatalities for the first six months of 2017 versus the first six months of 2016, whereas all other states reported a collective 5.8 percent decrease in pedestrian fatalities.

One example cited is Washington state, where marijuana was legalized in late 2012 and the first dispensaries opened in mid-2014.  According to data from the Traffic Safety Commission, Governing reported, Washington state saw an increase in 2015 and 2016 in fatal crashes where THC, the primary psychoactive chemical in marijuana, was present in blood tests of either the pedestrian or driver.

It was noted, however, that the totals, while higher, still remain relatively small. THC levels can be detected days or even weeks after marijuana use, and Washington state’s data also indicates that between 70 and 80 percent of drivers found to have THC also tested positive for alcohol or other drugs, according to that report.

The federal report also indicates that Connecticut DOT recently completed a statewide overhaul to replace old signage, including signs for pedestrian safety. "These are new, bright signs that are up to code," the report explained.  "The Highway Safety Office also launched an outreach and advertising campaign titled 'Watch for Me CT' which focuses primarily on pedestrian safety but also includes bicyclists."  Law enforcement training for this issue is currently being developed, the report said.

Nationally, there were 4,457 pedestrian fatalities in 2011 and 5,987 in 2016.  The data for the first half of 2017 is considered preliminary, and may rise higher as some state records are updated with additional data, the report indicated.

Report Reflects Good News, Continuing Challenges for Women, Girls in Eastern CT

Women and girls in Eastern Connecticut are progressing in many ways, but gender equity is elusive in many others, according to a new report.  The Community Foundation of Eastern Connecticut commissioned DataHaven to develop a report on the Status of Women and Girls in Eastern Connecticut, and the findings provide an insightful snapshot of disparities that persist, and challenges that remain and may increase, as well as diminish, in the years ahead. The purpose of the 26-page report, explains the Community Foundation’s President and Chief Executive Officer Maryam Elahi, is “to help inform and guide thoughtful conversations and inspire local ideas for social and policy advancements and investments.”   It is designed to be a “platform for action” to increase opportunity, access and equity for women and girls in Eastern Connecticut, officials indicated.  It is the first time that such a report was developed.

Among the key findings:

• Young women are achieving in school, but greater educational attainment has yet to translate to economic equality.
• Positive educational outcomes and economic equality are further out of reach for women of color.
• Many occupations remain segregated by gender, and women make up a majority of part-time workers.
• Women are at greater risk of financial insecurity, with single mothers at the greatest risk. 25% of all children in Eastern Connecticut live with a single mother, and 90% of single-parent households are headed by a mother.
• Women in Eastern Connecticut are healthy, with a life expectancy of about 82 years—slightly above the national average, but below the state average.

The report also found that:

• The opioid epidemic continues to ravage our communities, with deaths of women in 2016 more than double those of 2012.
• Young women are at heightened risk for many mental health conditions. 35% of female students reported feeling hopeless or depressed vs. 19% of male students, and women are three times more likely to attempt suicide than men.
• Violence against women continues to be a major public health problem. Almost 5,000 women in Windham and New London counties received services from domestic violence shelters.

The report defines Eastern Connecticut as the Community Foundation of Eastern Connecticut service area:  42 towns that include 453,000 people, 227,000 women.  The population of the region is 80% white, 9% Latina, 4% Black and 4% Asian.  Approximately 33,700 residents, or 7 percent, are foreign born.  Looking ahead, the report noted that the population of women ages 65 and up is projected to grow significantly over the next decade; estimated to increase 44 percent by 2025.

Continuing racial disparities are highlighted by the finding that among 90 percent of girls in the region’s class of 2016 graduated high school within four years, yet nearly 20 percent of women in New London and Windham/Willimantic lack a high school diploma.

The report noted that “a persistent gap” exists for women with degrees in STEM fields. Overall, 51 percent of men vs. 30 percent of women majored in science and engineering fields. Encouragingly, of 25-39 year-old women with degrees, 37 percent majored in the sciences. This is higher than previous generations.

Although women comprise 76 percent of educators, only 11 out of 41 superintendents in the region are women.  The report also found that 25 percent of businesses are women-owned.

“Women’s equality,” Elahi said, “is not just a women’s issue. It affects the wellbeing and prosperity of every family and community.”

The Community Foundation has organized public forums to discuss the report findings.  The first was held last week in Hampton, the next is February 15 in New London.

New Haven-based DataHaven’s mission is to improve quality of life by collecting, sharing, and interpreting public data for effective decision-making. The Community Foundation of Eastern Connecticut serves 42 towns and is comprised of over 490 charitable funds, putting “philanthropy into action to address the needs, rights and interests of the region.”

Michelle Obama Influences Children's Trick-or-Treat Choices, Yale Study Says

The conclusion is striking:  Michelle Obama’s initiative to reduce childhood obesity has influenced children’s dietary preferences. Researchers estimated that viewing a photograph of Michelle Obama’s face caused children to be 19 percent more likely to choose fruit over candy, on Halloween.  The experiment – Yale University researchers - was conducted on a New Haven porch over three consecutive Halloweens, and the results are published this month in a journal of the Public Library of Science (PLOS). The participants were 1,223 trick-or-treaters in New Haven over three years; on average, 8.5 years old and 53 percent male (among children whose gender was identifiable). To be eligible for inclusion in the study, trick-or-treaters had to be over the age of three.

The porch of a home had photographs clearly visible in front of the trick-or-treating children.  One was of Michelle Obama.  The other side, the “comparison” side in the study, “had a photo of Ann Romney (2012), a photo of Hillary Clinton (2014, 2015), or no photo (2014, 2015).”

At both sides of the porch, children were asked their age and whether they would prefer to receive fruit (a box of raisins) or candy (a more typical small packaged piece of name-brand chocolate such as Snickers or Milky Ways). Each child was given the option (fruit or candy) that they requested.

“The experimental set-up allows us to measure what proportion of children chose fruit instead of candy when in the presence of an image of Michelle Obama’s face, as well as the proportion of children who chose fruit instead of candy when not in the presence of an

image of Michelle Obama’s face,” the researchers pointed out.

Publishing the research are Peter M. Aronow, Dean Karlan, Lauren E. Pinson.  Peter Aronow is Assistant Professor of Political Science and in the Institute for Social and Policy Studies and of Public Health at Yale University; Dean Karlan is a Professor of Economics at Yale; Lauren Pinson is a Ph.D. candidate in Political Science at Yale University.

The experiment was conducted in the East Rock neighborhood of New Haven, which is about one mile from the Yale University campus, and contains many single family homes owned by Yale faculty, as well as some multi-family homes in which many graduate students live, the study explained. “There are also low income neighborhoods within a mile of this neighborhood,” and “due to the high level of activity during Halloween, many families drive from further away in order to trick-or-treat in this neighborhood.”

The study provides background, explaining that “During her tenure as First Lady of the United States, Michelle Obama has spearheaded one of the largest public health initiatives focused on childhood obesity. In 2010, Obama unveiled her Let’s Move Initiative, aimed at fostering a healthy lifestyle and reducing childhood obesity. As the public face of the campaign, Obama urged healthy eating and exercise in a variety of classic and social media venues accessible to minors and their parents, including appearances on Sesame Street and Oprah and posts of online videos.”

In regards to the results, the researchers caution that “we ran the experiment on a day where candy is readily available, the influence on children’s dietary preference for fruit instead of candy may differ from other days of the year; for instance, perhaps children are more willing to choose fruit since it is unique for the holiday, or children are less willing to choose fruit because they are under the influence of sugar consumption.”

PLOS was founded in 2001 as a nonprofit Open Access publisher, innovator and advocacy organization with a mission to accelerate progress in science and medicine by leading a transformation in research communication.

Colorado's Hickenlooper Reconnects to Middletown Years, Discusses Key Healthcare Issues

John Hickenlooper, mentioned in national political circles as a potential presidential candidate in 2020, is a graduate of Wesleyan University in Middletown, class of 1974, and the incumbent Governor of Colorado. His current career and Middletown roots come full circle this week, as Hickenlooper is the guest on the weekly podcast hosted by the leaders of Middletown-based Community Health Center, Mark Masselli and Margaret Flinter.

The podcast, Conversations on Health Care, has a national following and is also aired on more than a dozen radio stations across the country, including Atlanta, Chicago, Michigan and Minnesota.  The program focuses on the opportunities for reform and innovation in the health care system.  In addition to health care headlines, the centerpiece of each show is a feature story and conversation with an innovator in the delivery of care from around the globe.  Guests are drawn from healthcare organizations, policy makers, researchers, educators, nonprofit leaders and individuals breaking new ground in scientific research and the delivery of health care services in the U.S. and abroad.

Hickenlooper, who took office in 2011 and is term-limited and in his final year as Governor, discusses how expanded coverage under the Affordable Care Act has improved access to health care in his state, how embedding behavioral health in primary care is improving outcomes, and how they're fighting the opioid crisis in Colorado.  He addresses lessons learned from the state's marijuana legalization, and his bipartisan campaign with Governor John Kasich of Ohio, a past presidential hopeful, to promote sound health policies on the federal level including funding for CHIP, Community Health Centers and expanded coverage.  Kasich is a Republican; Hickenlooper a Democrat.

“States are the laboratories of democracy,” Hickenlooper said on the program. “We’re the ones that have to be doing the experiments and coming up with the innovations and then finding out whether they work or not.”

Masselli, founder and president/CEO of CHC, and Margaret Flinter, Senior Vice President and Clinical Director, each bring four decades of experience in overcoming the barriers that block access to care in their work at community health centers.  Their conversations with “creative thinkers and doers from all parts of the field” are aimed at “all who believe that Health Care is a Right, Not a Privilege,” according to the podcast’s website.

The program is recorded at WESU at Wesleyan University, and is underwritten by Community Health Center, Inc. Conversations on Health Care episodes are also broadcast by ReachMD, which can be heard on iHeartRadio. Past guests with Connecticut connections include former Middletown Mayor Paul Gionfriddo, CEO of Mental Health America; Save the Children CEO Carolyn Miles; and Aetna Foundation President Dr. Garth Graham.  Topics in recent months have include cancer therapy breakthroughs, telemedicine, innovations in caring for an aging population, obesity and efforts to transform healthcare through big data.

Hickenlooper graduated from Wesleyan University with a bachelor’s degree in English and a master’s degree in geology.  He began his career as a geologist and later opened a series of restaurants and brewpubs across the country, including the Wynkoop Brewing Co. in downtown Denver, which helped spark the revitalization of the city’s now-thriving Lower Downtown (“LoDo”) district.  He served as the mayor of Denver, Colorado, from 2003 to 2011.  He is a past chair of the National Governor’s Association.

CHC serves 145,000 patients statewide, providing medical, dental and behavioral health services, and is a nationally recognized innovator in the delivery and the development of primary care services to special populations.

Planning Underway for Nation’s Next Decade of Public Health Goals, to be Unveiled in 2020

In fiscal year 2017, the State of Connecticut received $373,921 from the Centers for Disease Control and Prevention for childhood lead poisoning prevention programmatic activities. The funding arrived, at least in part, because one of the goals of the federal government’s Healthy People 2020 initiative, launched in 2010, is the elimination of childhood lead poisoning as a public health problem.

The Center for Disease Control and Prevention (CDC), the Department of Housing and Urban Development (HUD), U.S. Environmental Protection Agency (EPA), and other agencies have developed a federal interagency strategy to achieve this goal by 2020.   The key elements of this interagency strategy include:

• Identification and control of lead paint hazards;
• Identification and care for children with elevated blood lead levels;
• Surveillance of elevated blood lead levels in children to monitor progress; and
• Research to further improve childhood lead poisoning prevention methods.

The U.S. Department of Health and Human Services unveiled Healthy People 2020 in December 2010, laying out the nation’s new 10-year goals and objectives for health promotion and disease prevention. Healthy People provides science-based, 10-year national objectives for improving the health of all Americans, according to the program’s website.

Childhood lead poisoning prevention was one item on a lengthy list of national priorities.   Chronic diseases, such as heart disease, cancer and diabetes, are responsible for seven out of every 10 deaths among Americans each year and account for 75 percent of the nation’s health spending, officials said as the agenda was announced.  Topics added in 2010 included Dementia’s, including Alzheimer’s Disease; Early and Middle Childhood; Sleep Health; Social determinants of Health; and Adolescent Health.

For three decades, since 1979, Healthy People has established benchmarks and monitored progress over time in order to encourage collaborations across communities and sectors, empower individuals toward making informed health decisions and measure the impact of prevention activities.  The initiative is housed in the federal office of Disease Prevention and Health Promotion, part of the Department of Health and Human Services (HHS). Approximately three-quarters of the goals of the previous decade-long Healthy People agenda had been achieved, officials said in 2010.

Even as federal and state authorities work to achieve the 2020 goals, work has begun on the next set of national objectives.

The planning process for Healthy People 2030, the fifth edition of Healthy People, is already underway.  Federal agencies sought comments from the public last fall on a proposed framework, which “aims at new challenges and builds on lessons learned from its first four decades.”  In December, officials indicated that “The foundational principles and overarching goals of the proposed framework for 2030 include a call to attain health literacy, achieve health equity and eliminate health disparities, improve the health and well-being of all populations.”

Once the framework is finalized, the agency “will begin the development and selection process for Healthy People 2030 objectives. We anticipate that the public will be invited to comment on proposed objectives as part of this process.”  It is expected that four regional “listening” sessions will be held.  Connecticut is included in the New England region, one of 10 regions across the country.  A session held in Atlanta in November was attended by 77 people.

The imperative to improve public health has not lessened over time.

“The United States lags behind other Organisation for Economic Co-operation and Development (OECD) countries on key measures of health and well-being, including life expectancy, infant mortality, and obesity, despite having the highest percentage of GDP spent on health,” the website points out.

Climate Change, Children and Pollutants: Recipe for Health Concerns

The environmental damage caused by continuing to burn fossil fuels affects children most, with one study indicating that an estimated that about 88 percent of the disease from climate change afflicts children. In an article this month in the web-based science publication Massive, Renee Salas, an academic emergency medicine physician at Massachusetts General Hospital and Harvard University Medical School, says that while studies on climate change are still emerging, there has been enough research to result in a broad scientific agreement that climate change is negatively affecting children’s health.

The article points out that Frederica P. Perera, a professor of environmental health sciences and director of the Columbia Center for Children’s Environmental Health, recently released a review article “showing yet again how air pollution and climate change interact to multiply the negative health effects children face.”  The combination of air pollutants and warmer temperatures creates a perfect storm where chemicals emitted into the atmosphere interact to multiply the effects that each would have alone, the article states.

“People of all ages are exposed to this myriad of air pollutants in the changing climate, but children are more at risk of a wide spectrum of negative health effects because their developing bodies can suffer permanent damage from interference with their growth, Salas explains.

Investigators at the Yale Center for Perinatal, Pediatric and Environmental Epidemiology (CPPEE) at the Yale School of Public Health are engaged in a number of population-based studies in the U.S. and China intended to give us a better understanding of the health risks associated with exposure to relatively low and high levels of air pollution in childhood and during pregnancy.

The Center’s website points out that environmental factors are estimated to account for 24 percent of global diseases (WHO – Preventing Disease through Healthy Environments). In terms of the environmental contribution to disease, respiratory infections are ranked second, perinatal conditions seventh, and asthma fifteenth.  Air pollution is a major environmental risk factor in all three diseases.

Asthma is a major chronic disease in the US, accounting for more than two million emergency room visits and $14 billion in health care costs and lost productivity per year, the website indicates. Asthma is the most common chronic illness of childhood, accounting for more absenteeism (14 million missed school days per year) than any other chronic disease.  Absenteeism impacts academic performance, participation in extracurricular activities, and peer acceptance.

The Yale School of Public Health also points out that “underserved populations are especially affected by asthma.” In Connecticut, for example, asthma prevalence of 9.9 percent is among the highest in the U.S., they report. The rate among children enrolled in Connecticut’s HUSKY program (health insurance program for uninsured children) is 19.5 %. Increases in asthma and allergy are likely due to a combination of factors--genetic, environmental, socioeconomic, lack of access to care, and differential treatment.

The Massive article goes on explain that the potential harm starts early.  Once a child is born, the brain, lungs, and immune system aren’t fully formed until the age of six, the article states. “Even their air and food exposure in proportion to their size is much higher than adults – the amount they eat in relation to their body weight is three to four times greater than that of adults.”

She goes on to state the “Children also have an increased risk for being developmentally delayed, having lower intelligence scores, and less of a certain part of the brain called white matter, the stuff that helps you walk and talk. Their mental health is also at risk as children exposed to air pollution have higher rates of anxiety, depression, and difficulty paying attention.”

Salas notes that in addition to caring for patients who have negative health impacts from climate change, she uses her masters in Clinical Research and masters in Public Health in Environmental Health for research, education, and advocacy in this field. Says Salas, “I believe that climate change is the biggest public health issue facing our globe and am dedicating my career to making any positive difference I can.”

Better Outcomes from Female Surgeons, Study Finds; Local Hospital Highlights Their Own

In a study that has gained international attention and peaked interest locally, the patients of female surgeons tended to have lower death rates, fewer complications and lower readmissions to the hospital a month after their procedure, compared to the patients of male surgeons. The study, published in the BMJ (British Medical Journal), and highlighted in TIME magazine, was conducted in Ontario, Canada, and included all of the people in the province who had operations between 2007 and 2015.  The results are bringing some attention to female surgeons, and Connecticut Children’s Medical Center is shining a spotlight on their surgical staff in the aftermath of the study’s publication.

Connecticut Children’s which has nine female surgeons, including the surgeon-in-chief, is stressing not only that they are “leaders in this field,” but they are also “moms at home.”  They’re using the two roles to launch a social media campaign called #momsurgeons, and will be profiling each of the surgeons on social media, website and billboards in greater Hartford this week.

“We wanted to bring attention to the fact that we are moms too. We truly understand what our patient families are experiencing when their child is heading into surgery,” said Christine Finck, Surgeon-In-Chief at Connecticut Children’s. “We also understand the daily struggles many moms face trying to find that work-life balance.  It’s hard.  We get it.”

Finck, appointed surgeon-in-chief in 2016, previously served as Chief of the Division of Pediatric Surgery since 2007 and is an associate professor of pediatrics and surgery at UConn Health.  In announcing her appointment, Connecticut Children’s pointed out that through her research, Finck “revolutionized outcomes of pediatric and neonatal diseases, most specifically leading efforts focused on identifying and treating those that affect the lungs, esophagus and brain.” She was honored by The Group on Women in Medicine and Science, who awarded her the Outstanding Clinical Scientist Woman Faculty Award, last year.

After accounting for patient, surgeon, and hospital characteristics, the study concluded that “patients treated by female surgeons had a small but statistically significant” decrease in 30 day mortality and similar surgical outcomes (length of stay, complications, and readmission), compared with those treated by male surgeons.

The study’s authors noted that the findings “support the need for further examination of the surgical outcomes and mechanisms related to physicians and the underlying processes and patterns of care to improve mortality, complications, and readmissions for all patients.”

By drawing attention to this profession, officials said, “our #momsurgeons hope they can serve as role models for aspiring young ladies who also hope to one day enter the field.”

“Every time I operate, I stop and think about how I would want the operation to go if it my own child was in front of me,” said Meghna Misra, pediatric surgeon at Connecticut Children’s.

Surgery has long been a male-dominated occupation, TIME reported, “first because few women enrolled in medical school, and then because they weren’t perceived (by male surgeons, no less) to have the temperament needed to make the life-and-death decisions required in an OR.”

In the study, 104,630 patients were treated by 3,314 surgeons, 774 female and 2,540 male. Dr. Raj Satkunasivam, assistant professor of urology at Houston Methodist Hospital was leader of the study.

Connecticut Children’s Medical Center is the only hospital in Connecticut dedicated exclusively to the care of children and is ranked by U.S. News & World Report as one of the best children’s hospitals in the nation, with a medical staff of more than 1,000.

CT is 5th Healthiest State in USA; MA Ranks 1st, New Data Shows

Connecticut is the fifth healthiest state in the nation, dropping from third a year ago, but remaining in the nation’s top 10, where it has been every year since 1993. Massachusetts, Hawaii, Vermont, Utah and Connecticut rank as the five healthiest states, while West Virginia, Alabama, Arkansas, Louisiana and Mississippi rank the least healthy.

The United Health Foundation ranked America's states based on a variety of health factors, such as rates of infectious diseases, obesity, physical inactivity, smoking and infant mortality, as well as air pollution levels and the availability of health care providers. The survey has been conducted annually for 28 years.

America’s Health Rankings was built upon the World Health Organization definition of health:“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

The model reflects that determinants of health directly influence health outcomes. A health outcomes category and four categories of health determinants are included in the model: behaviors, community & environment, policy and clinical care.

This is the first time Massachusetts has been named the healthiest state, ending Hawaii's five-year ranking at number one. Connecticut’s highest ranking was second, in both 2006 and 2008.

By category, Connecticut ranked fourth in Behaviors, fourth in Clinical Care, sixth in Policy, tenth in Health Outcomes and 15^th in Community & Environment.  Connecticut had the third lowest levels of infectious disease, fourth lowest prevalence of smoking and ninth lowest levels of obesity.

The Bay State won the honor in part due to having the lowest percentage of uninsured residents at just 2.7% of the population, plus a low prevalence of obesity and a high number of mental health providers.  Rhode Island moved from 14^th to 11^th; New York from 13^th to 10^th. 

This latest report shows that the nation's health overall is getting worse.  The nation's premature death rate -- the number of years of potential life lost before age 75 -- increased 3% since 2015.  That increase is driven in part by drug deaths, which increased 7% during that time, and cardiovascular deaths, which went up 2%.  Overall, the United States ranks 27th in terms of life expectancy in a comparison of 35 countries, according to the report. Long-term challenges remain — including infant mortality and low birthweight. Cardiovascular deaths and drug deaths also increased.

Connecticut’s strengths, according to the report, include the state’s low prevalence of smoking, low violent crime rate and low percentage of uninsured people.  The state’s greatest challenges include a high drug death rate, high levels of air pollution and a large disparity in health status by educational attainment.

The report also identified the following highlights:

• In the past year, primary care physicians increased 6%, from 197.8 to 209.4 per 100,000 population
• In the past two years, children in poverty increased 33%, from 12.3% to 16.3% of children
• In the past five years, cancer deaths decreased 3% ,from 179.0 to 173.7 deaths per 100,000 population
• In the past three years, drug deaths increased 67%, from 11.0 to 18.4 deaths per 100,000 population
• In the past five years, the percentage uninsured decreased 44%, from 9.9% to 5.5% of the population

Health and Safety Among Top Concerns in Choosing Childcare, Survey Finds

When choosing a childcare or preschool, many parents try to gather information to make their decision. Yet only 54 percent of parents were very confident that they could tell if a childcare option would be safe and healthy for their child, according to a new national survey.  Beyond that challenge, 2 out of 3 parents said it’s hard to find childcare options with the characteristics they want. In selecting a childcare or preschool, parents consider a variety of health, safety, educational, or practical factors. Overall, 62 percent of parents agreed that it’s hard to find childcare options with the characteristics they want. The C.S. Mott Children’s Hospital National Poll on Children’s Health asked about these factors in a national sample of parents of children age 1-5 years who attend childcare or preschool.

Nearly half of parents reported their child currently attends preschool (48%), while the other half reported their child attends either a childcare center (25%) or in-home childcare (27%) for at least 5 hours per week.  Most parents (88%) felt that childcare centers and in-home childcare providers should have the same health and safety standards.  Parents selected up to 5 factors they would consider most important when choosing a childcare or preschool. The top 5 factors differed by the child’s current setting:

• Preschool: staff background checks (45%), active play every day (40%), doors locked (38%), staff have early childhood training (30%), and safe outdoor play area (30%)
• Childcare center: staff background checks (46%), staff have early childhood training (42%), doors locked (36%), cost (33%), and location/hours (32%)
• Home childcare: healthy foods served (28%), active play every day (28%), books/educational toys (27%), kitchen area cleaned (26%), and staff background checks (24%)

Connecticut’s Office of Early Childhood provides information on its website, including a “Child Care Checklist for Parents,” to assist in choosing a child daycare program. It suggests asking if the program is licensed, ensuring that unannounced visits are permitted, that there is adequate staff and that the program is safe.  The website also includes an “online lookup tool” to determine licensing status for family child care home providers, group child care homes, child care centers, family child care home staff-substitutes and assistants and youth camps.

A report published last month by Connecticut Voices for Children indicated that for more than a decade, Connecticut has made expanding early care and education programs and wrap-around supports a priority. The state has increased funding for early childhood programs for low-income families and communities,"making a real, sustained effort to build a strong infrastructure to support the early childhood system. Increased spending has increased both the availability and the quality of care."  Those efforts, the study found, "have begun to pay off in terms of both access and quality of care." 

The 39-page report indicated that: • Almost four in every five four-year-olds enroll in preschool. As of 2016, nearly 80% of four-year-olds were enrolled in preschool, an increase of six percentage points since 2005. • Disparities in preschool access have narrowed. The gap in preschool experience rates between the large urban districts and the wealthiest suburban districts has narrowed from 40 percent in 2003 to just 26 percent in 2016. • State programs are serving more infants and toddlers. Head Start and Child Day Care Centers have shifted to address more of the state’s need for infant and toddler care. Combined, they serve almost 80% more infants and toddlers in 2016 than in 2005.

The report stressed, however, that as of 2016, center-based infant/toddler care is affordable to only 25 percent of Connecticut families with a young child. Child care for two young children is affordable to only seven percent of such families.  The need for infant/toddler care "continues to vastly outstrip statewide capacity,"  and community wealth "continues to predict both preschool access and later test scores."

In the national poll, parents identified deal-breakers in selecting childcare – characteristics that would eliminate a preschool or childcare from their consideration. Over half said location in a sketchy area or a gun on the premises would be a deal-breaker; others were: non-staff adults on the premises, unvaccinated children allowed to attend, and having a staff person who smoked.

Some factors rated as most important by the Mott Poll parents may be reflected in the policies of the facility. These include whether staff undergo background checks prior to hiring, whether staff have early childhood certification or training, and whether child and staff members must be vaccinated. For many preschools and childcare centers, this type of information can be found on the facility’s website; it may be more difficult to find such information for in-home childcare providers, the poll analysis pointed out.

CT's Mattress Recycle Program Collecting 14,000 Per Month

Connecticut mattress recycling program collected more than 162,000 mattresses and diverted more than 2,300 tons of material from disposal during the 2016-17 fiscal year, according to a recently released report on the state's program. The mattress industry created the Mattress Recycling Council (MRC), a non-profit organization, in 2013 to develop and administer a recycling program, which was dubbed the Bye Bye Mattress Program.  It is  funded through a $9 fee collected from consumers on all mattress and box spring sales in the state.

The program officially began operating on May 1, 2015 in accordance with a new state law. It now averages recycling 14,000 mattresses a month. MRC collects mattresses from 125 communities and 169 public and private entities that dispose of large volumes of discarded mattresses.

On average, 70 percent of a mattress is recycled.  Officials are pushing to increase that percentage to 75 percent.  Program materials suggest that 80 percent of a mattress can be recycled.  In the program’s first two years, a total of 313,661 mattresses were collected for recycling.

Among the leading municipalities, according to the 54-page report:  Hartford - 336 tons, Bridgeport - 197 tons, Manchester - 138 tons, East Hartford - 84 tons, and Southington - 62 tons.

MRC’s education and outreach efforts are designed to inform consumers, mattress retailers, and other stakeholders about the Bye Bye Mattress Program, that the fee is mandated by state law, why the fee is needed, what the fee funds, how to recycle through the Program, and that some parties have obligations.

In addition to Connecticut, MRC operates programs in Rhode Island and California.

Among the many locations across making use of the program is the Naval Submarine Base in New London.  The Base used the program to assist with the recycling and transportation of 692 mattresses from barracks, submarines, and Navy hotel lodging facilities connected to the Base. MRC collected mattresses from the Base in New London three times during the fiscal year.

Despite the program’s achievements to date, one objective is not being met.  Based on MRC’s experience during the past two years, the report points out, it became clear that the healthcare facility goal was “impractical.”

Mattresses discarded by healthcare facilities are not recycled for two primary reasons: biological contamination and mattress residual value, according to the report. In addition, a strong secondary markets exist for specialty hospital mattresses discarded by healthcare facilities. As a result, discarded units are frequently resold domestically or exported, the report explained.

“Therefore, those units are not being landfilled or incinerated in Connecticut and are not available for recycling. Furthermore, healthcare mattresses with breached outer ticking or physical contamination may pose health risks, and are instead disposed of as solid or biological waste due to liability concerns,” the report points out.

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