CT's Rare Disease Report Card Reflects Good Grades, Not-so-Good Grades

Thanks to innovative new treatments, diseases that were once fatal are now being treated as chronic conditions. But these breakthrough treatments will be out of reach for many patients, according to the National Organization for Rare Diseases, because health plans are using deductibles and coinsurance to shift more of the cost of medication onto the patients who rely on those treatments. The national organization, which is headquartered in Danbury and Washington, DC, explains that taken together, those out-of-pocket costs are outpacing wages, and patients are left struggling. To assist patients who find themselves in this difficult situation, several states have passed legislation mandating a limit on out-of-pocket costs for medications. These limits can be applied in different forms, such as a per-drug cap or by mandating a copay-only structure in certain health plans.  Those are just some of the areas of particular interest to NORD, which advocates for patients – and their families – facing the challenges of rare diseases.

What is a rare disease? Any disease, disorder, illness or condition affecting fewer than 200,000 people in the United States is considered rare. It is estimated that 7,000 rare diseases exist, and fewer than 500 have FDA-approved treatments.  Patients with rare diseases are frequently misdiagnosed or undiagnosed. Currently, only 5 percent of rare diseases have treatments, NORD points out.

A majority of states are not measuring up on legislative solutions that reduce the burden of rare diseases affecting 30 million Americans, according to a new report released by the the NORD Rare Action Network® (NORD RAN). The 2018 “State Report Card” indicates that progress in several areas of health policy is slow, according to the report.

The third annual edition of the State Report Card rates states on the strength of policies including coverage of medical foods and newborn screening, prescription drug cost-sharing limits, policies supporting biosimilar prescriber communications, protections against step therapy protocols, and the establishment of rare disease advisory councils. New this year, according to NORD, the report also looks at Medicaid Waivers (including proposed work requirements, lifetime limits, drug formulary restrictions, and other proposed changes to benefits), storage and research consent for dried blood spot samples used in newborn screening, and state Right-to-Try laws.

Connecticut earned grades all across the scale - three A's and four B's, as well as three C's and two F's.   Overall, the report found nationally that:

• Fifteen states earned an F for failing to mandate adequate coverage of medical foods
• Thirty-six states earned an F for failing to enact prescription drug cost-sharing limits, despite third-party analysis showing these cause little to no impact on overall plan premiums for all beneficiaries
• Newborn screening has saved tens of thousands of lives, yet more than half of states fail to meet federal recommendations
• Fifteen states (including Connecticut) earned an A or B for protecting patients against step therapy, a procedure by which insurers (public or private) interfere with and delay appropriate care for patients that ultimately increases costs

“The intent with this report is to share valuable information that will enable advocates to affect change in their state,” said NORD Director of State Policy, Tim Boyd. “Our goal is to provide actionable steps for states that will improve people’s lives, so the report presents findings as well as tools for individuals to act on.”

Under the Affordable Care Act, many people with rare diseases can now access affordable health insurance. However, NORD officials point out, some insurance policies place orphan therapies on the so-called “specialty-tier” of a drug formulary. For drugs placed on this tier, enrollees often must meet cost sharing requirements that can be as much as 50% of the actual cost of the medication.

Later this month, NORD marks its 35^th anniversary with a Summit in Washington, DC.  A 501(c)(3) organization, NORD is a patient advocacy organization dedicated to individuals with rare diseases and the organizations that serve them.  NORD, along with its more than 280 patient organization members,  is committed to the identification, treatment, and cure of rare disorders through programs of education, advocacy, research, and patient services.

Suicide Numbers Increasing; Efforts Intensify to Respond, Prevent

The Centers for Disease Control and Prevention (CDC) released a report this year that suicide rates nationally jumped by 25 percent since 1999, a finding that “shocked” even experts who believed the rate had been flat. Each year, more than 41,000 individuals die by suicide, leaving behind their friends and family members to navigate the tragedy of loss, according to the National Alliance on Mental Illness. Connecticut's rate, 9.7 deaths per 100,000, rose 20 percent during that time, and 49 states saw an increase, according to the CDC. Connecticut’s suicide rate, is ranked number 46 in the country.

Suicide is the 10th leading cause of death in the U.S. with one occurring on average every 13.3 minutes. September is National Suicide Prevention Month.

For every suicide, there are 30 people who made the attempt, Dr. James F. O'Dea, vice president of the Behavior Health Network of Hartford Healthcare, recently told the Meriden Record-Journal.  The U.S. Health Resources & Services Administration reports that “approximately 45% of suicide victims had contact with primary care providers within 1 month of suicide.”

“Connecticut suicide rates may have not have increased as much in comparison to other states, but isn’t the real question, ‘Why is it increasing at all?’” Luis Perez, president and CEO of Mental Health Connecticut, told The Hartford Courant earlier this year.

“It’s been well-researched that most people who die by suicide do so because they want the pain to stop — and they don’t see any other way,” Perez said. “Prevention is critical. Knowing the safe and right way to talk to someone who may have thoughts of suicide and letting people know they are not alone, that millions of people struggle with suicide ideation is key.”

According to the state Department of Public Health, approximately 31 percent of victims had a history of treatment for mental illness and 42 percent had previously attempted or thought about suicide or disclosed their intent to commit suicide. The CDC offers 5 steps to help someone at risk: 1. Ask. 2. Keep them safe. 3. Be there. 4. Help them connect. 5. Follow up.

The U.S. government’s anti-bullying website, stopbullying.com, points out that “many issues contribute to suicide risk, including depression, problems at home, and trauma history. Additionally, specific groups have an increased risk of suicide, including American Indian and Alaskan Native, Asian American, lesbian, gay, bisexual, and transgender youth.”  The site indicates that “this risk can be increased further when these kids are not supported by parents, peers, and schools. Bullying can make an unsupportive situation worse.”

Matt Riley, Chief Operating Officer of the Connecticut-based Jordan Porco Foundation, recently told WTNH-TV that suicide is the second leading cause of death for Americans ages 15 to 24. One in ten college students and one in five high school students consider suicide. Young people considering suicide are most likely to talk to peers, so the Jordan Porco Foundation focuses on peer-to-peer outreach and awareness, with a series of successful program initiatives on college campuses in Connecticut and across the country.

In recent years, a new student-driven primary prevention program was piloted to help high school students develop positive coping skills and enhance protective factors in preparation for life beyond high school. Schools and organizations participating included Manchester High School, Immaculate High School in Danbury, Enfield Public Schools, Capital Preparatory High School in Hartford, Institute of Living in Hartford, Jewish Family Services in West Hartford, Wilton High School, Boys & Girls Club of Bristol, and Guilford Youth & Family Services.

Numerous organizations across Connecticut offer Mental Health First Aid, an 8-hour training to teach participants how to help someone who is developing a mental health problem or experiencing a mental health crisis. The evidence behind the program demonstrates that it helps trainees identify, understand and respond to signs of mental illnesses and substance use disorders.  The course is often offered to participants free of charge.

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Cigna Looks to Invest in Start-up Insurance Ventures, Establishes $250 Million Fund

Health services organization Cigna has launched Cigna Ventures, a corporate venture fund with an infusion of $250 million in capital to be invested in healthcare technology startups and early-stage companies. Cigna has committed $250 million of capital to Cigna Ventures, according to officials, to invest in promising startups and growth-stage companies that are unlocking new growth possibilities in health care and will bring improved care quality, affordability, choice, and greater simplicity to customers and clients. Cigna Ventures is focused on companies across three strategic areas: insights and analytics; digital health and retail; and care delivery/management.

“Cigna’s commitment to improving the health, well-being and sense of security of the people we serve is at the front and center of everything we do,” said Tom Richards, senior vice president and global lead, strategy and business development at Cigna. “The venture fund will enable us to drive innovation beyond our existing core business operations, and incubate new ideas, opportunities and relationships that have the potential for long-term business growth and to help our customers.”

Cigna Ventures was created to help Cigna identify, assess and sponsor early-stage innovation ideas that warrant deeper exploration through focused pilot and test-and-learn activities with the goal of realizing meaningful business value.  The initiative’s newly launched website suggests that “Cigna Ventures is the strategic corporate venture capital partner of choice in the health care industry. We work closely with entrepreneurs to accelerate growth and innovation through strategic use of capital and deep partnerships.”

Companies in the portfolio, according to published reports, include Omada Health, a digital therapeutics company treating chronic diseases; Prognos, a predictive analytics company for healthcare; Contessa Health, a home-patient care service; Mdlive, which provides remote health consultations; and Cricket Health, a special kidney care provider.

CIGNA’s interest in the rapidly-evolving health care field is also reflected in the company’s membership, presence, and investment in insurance technology start-ups at Upward Hartford, the co-working and innovation center in Hartford that was the site of the city’s inaugural Insurtech Hub earlier this year, and is now home to the winning participants in Hartford’s first annual insurance accelerator, held in April.

Amidst the start-ups are a number of Hartford’s longstanding insurance giants, including Cigna.

Bloomberg reported last week that overall investment in health-care startups has increased this year. According to the MoneyTree Report from PricewaterhouseCoopers and CB Insights, $10.6 billion was invested in health-care deals in the first half of this year. Two of the seven largest venture-capital rounds in the second quarter involved health-care firms, the report shows.

“Our partnership with Cigna has been about so much more than capital,” said Sean Duffy, co-founder and CEO of Omada. “The ability to collaborate with, learn from, and integrate deeply with a health services company so dedicated to delivering a 21st-century care experience to its customers and clients has enabled us to accelerate innovation, advance our capabilities, and grow our customer base.”

Cigna Corporation and Express Scripts received approval this week from the Antitrust Division of the United States Department of Justice for their pending $50 billion plus merger, which is expected to close by year’s end. “Quality health care and competitive pricing for health care services and pharmaceutical drugs is critical to U.S. consumers,” said Makan Delrahim, the head of the antitrust division, in a statement announcing approval of the deal.

CT Has 10th Lowest Obesity Rate in the Nation, Research Finds

Connecticut has a lower adult obesity rate than most other states, according to new national data, which found that 26.9 percent of adults living in Connecticut have obesity, ranking the state 42nd among the 50 states and the District of Columbia.  The state has slipped slightly from four years ago - the obesity rate was 25 percent and ranking was 9th lowest in the nation in the 2014 edition of the annual survey. The state's top 10 least obsese status was in the new report came in the 15th annual State of Obesity: Better Policies for a Healthier America report  by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).  Findings include:

• Adult obesity rates vary considerably from state to state, with a high of 38.1 percent in West Virginia and a low of 22.6 percent in Colorado. No state had a statistically significant improvement in its obesity rate over the past year.
• Adult obesity rates are at or above 35 percent in seven states; for the first time in Iowa and Oklahoma, and at least the second time in Alabama, Arkansas, Louisiana, Mississippi, and West Virginia.
• Six states — Iowa, Massachusetts, Ohio, Oklahoma, Rhode Island, and South Carolina — saw their adult obesity rates increase significantly between 2016 and 2017.
• Adult obesity rates are between 30 and 35 percent in 22 states and 19 states have adult obesity rates between 25 and 30 percent.
• Over the past five years (2012 – 2017), 31 states had statistically significant increases in their obesity rate and no state had a statistically significant decrease in its obesity rate.
• There continue to be striking racial and ethnic disparities in obesity rates. In 31 states, the adult obesity rate among Blacks is at or above 35 percent.  Latino adults have obesity at a rate at or above 35 percent in eight states.  White adults have obesity rates at or above 35 percent in one state. Nationally, the adult obesity rates for Latinos, Blacks and Whites are 47.0 percent, 46.8 percent and 37.9 percent respectively.

The least obese states are Colorado (22.6 %),District of Columbia (23.0%),  Hawaii (23.8 %), California (25.1%), Tie Montana and Utah (25.3%), New York (25.7%), Massachusetts (25.9%), Nevada (26.7%) and Connecticut (26.9%).

“Obesity is a complex and often intractable problem and America’s obesity epidemic continues to have serious health and cost consequences for individuals, their families and our nation,” said John Auerbach, president and CEO of Trust for America’s Health. “The good news is that there is growing evidence that certain prevention programs can reverse these trends.  But we won’t see meaningful declines in state and national obesity rates until they are implemented throughout the nation and receive sustained support.”

Obesity is a problem in virtually every city and town, and every income and social sector.  But its impact is most serious in communities where conditions make access to healthy foods and regular physical activity more difficult, such as lower income and rural areas, including many communities of color.  The national costs of obesity are enormous, officials point out.  Obesity drives an estimated $149 billion annually in directly related healthcare spending, and an additional $66 billion annually in lowered economic productivity. Also, one in three young adults is ineligible for military service, due to being overweight, officials noted.

The report offers 40 recommendations for federal, state and local policymakers; the restaurant and food industries; and the healthcare system.  Among them:

• Medicare should encourage eligible beneficiaries to enroll in obesity counseling as a covered benefit, and, evaluate its use and effectiveness. Health plans, medical schools, continuing medical education, and public health departments should raise awareness about the need and availability of these services.
• Food and beverage companies should eliminate children’s exposure to advertising and marketing of unhealthy products.
• Hospitals should no longer sell or serve sugary drinks on their campuses; they should also improve the nutritional quality of meals and promote breastfeeding.

Report: Medicaid's Impact Goes Beyond Health Care to Economy

Medicaid is, at its core, a health insurance program that provides coverage to low-income Connecticut residents.  A new report in Connecticut finds that the program also plays a key role in the state’s economy, budget, and ability to weather economic challenges. The report was developed for, and released by, the Connecticut Health Foundation. In Connecticut, Medicaid is known as HUSKY and covers approximately one in five state residents – close to 800,000 people. HUSKY covers more than one third of Connecticut children, nearly 47 percent of non-elderly adults with disabilities, 15 percent of seniors, and 70 percent of nursing home residents.

The report, developed by the Georgetown University Center for Children and Families, finds that the program is deeply woven into Connecticut’s health care system and plays a major role in a sector of the economy that has been central to job growth in the state. Health care makes up nearly 15 percent of the state’s gross domestic product. Medicaid finances about 20 percent of health care expenditures in Connecticut.

“It is important for policymakers to understand the full impact of Medicaid in the state, particularly as they face difficult budget decisions,” said the report’s author, Edwin Park, research professor at the Georgetown University Center for Children and Families. “Medicaid plays a key role in the state’s economy and is linked to long-term positive outcomes for children like better health, obtaining a college degree, and higher earnings.”

Among the report’s other key findings:

• Research has linked Medicaid coverage of children and pregnant women to long-term health and economic benefits when children reach adulthood: better health outcomes, greater educational attainment such as completing high school and obtaining a college degree, and higher employment and earnings.
• Medicaid can help states cope with recessions and economic downturns because it automatically increases federal funding in response to higher state costs, such as those resulting from enrollment increases as people lose their jobs and health insurance.
• Medicaid contributes the majority of the federal funding spent through Connecticut’s state budget – 58 percent in the 2016 fiscal year. The federal government pays more than half of the state’s Medicaid costs. For every $10 spent on Medicaid in Connecticut, approximately $5.92 comes from the federal government.

“Connecticut invests significant resources in HUSKY and the findings of this report underscore the impact of this investment,” said Patricia Baker, president and CEO of the Connecticut Health Foundation.

The report also indicted that “research has found that Medicaid eligibility during childhood is tied to higher wages and cumulative higher tax payments made as young adults. It also increases employment and reduces the need for public assistance, especially assistance needed due to disability. According to the report, in 2016 Medicaid covered:

• 4 percent of the nearly 400,000 hospital discharges and 12.9 percent of hospital payments.
• 63 percent of the 373,200 patients who received care at community health centers.

The Connecticut Health Foundation is the state’s largest independent health philanthropy dedicated to improving health outcomes for people of color. Since its creation in 1999, the foundation has awarded more than $62 million to nonprofit organizations and public entities to expand health equity, reduce health disparities, expand health coverage, and improve the health of all Connecticut residents.

Occupational Illnesses Remain High in Connecticut, Report Finds

Occupational illnesses remain a serious and under-reported issue in Connecticut, with a rate 6 percent higher than the national average, according to a new report issued by UConn Health.  The latest data shows a reporting of over 7,500 occupational illnesses, with up to an estimated 25,000 cases going unreported. The highest number of cases reported were in Farmington, Hartford and Cromwell. The newly published Occupational Disease in Connecticut, 2018 report examined the latest 1997-2016 data, based on reports of individuals filing for workers’ compensation, physician reports to the Occupational Injury and Illness Surveillance System, and the ConnOSHA/BLS survey of employers.

Connecticut’s illness rate ranked 15th highest out of 41 states with publishable data (fourteen states had higher rates and 26 had lower rates). Maine had the highest rate of 38.8 and Texas had the lowest at 9.8. Private sector rates for occupational illness were 15.0 in Connecticut and 14.1 nationally. Connecticut’s public sector rate was 35.7; the U.S. public sector rate was 31.6, according to the report.

The Connecticut data revealed reports of 7,675 unique occupational illnesses.  Most frequent were 3,430 musculoskeletal cases (such as sprains, Carpal Tunnel Syndrome, and tendonitis), and 2,408 infectious diseases (such as bloodborne diseases and exposures, meningitis, and Lyme Disease).  In addition, the data indicated there were 431 respiratory illnesses (such as chemical exposures, asthma, and poisonings), 313 skin disorders (such as poison ivy and chemical dermatitis), 115 cases of hearing loss, and 978 “other illnesses” (such as heart conditions, stress, and dizziness).

The OSHA/BLS survey shows a rate of 17.4 cases per 10,000 workers in Connecticut, 6 percent higher than the national rate of 16.4. The report focuses on chronic job-related illnesses, and does not include acute traumatic injuries. Overall, approximately 49% were for women, but this varied by type of case, with women accounting for 66% of infectious cases. Based on workers’ compensation reports of occupational illnesses, there were similar proportions (between 20%-25%) for workers in their 20’s, 30’s, 40’s and 50’s.

Rates of occupational illnesses varied widely across Connecticut towns and cities. Based on workers’ compensation reports from towns with at least 25 cases, the 10 highest rates were found in Farmington (126 cases per 10,000 workers - almost 4 times the rate as the state average), Hartford (89), Cromwell (89), Groton (85), Westbrook (84), Windsor Locks (73), East Windsor (63), Cheshire (61), Stratford (60), and Middletown (58). The town average across the state was 33 cases per 10,000 workers.

These higher town rates often reflect the locations of large employers in higher hazard industries, and may also reflect better reporting of cases, since cases of occupational illness are often not reported, the study points out.

Based on workers’ compensation reports, the highest rates of occupational illnesses were found in the industries of beverage and tobacco product manufacturing (170 cases per 10,000 workers), computer and electronic product manufacturing (131), primary metal manufacturing (112), state government (103), local government (81), transportation equipment manufacturing (59), electrical equipment manufacturing (57), miscellaneous retail stores (51), fabricated metal product manufacturing (49), and hospitals (46).

The highest specific sector rate, according to the report, was State Government with 41.8, with the highest rates for skin conditions (17.7) and lung conditions (7.9).  Local Government was second with 32.1, and Utilities third highest rate with 31.8.

Each year the report is prepared for the Connecticut Workers’ Compensation Commission by occupational and environmental health expert Tim Morse, professor emeritus at UConn Health. The 53-page report is part of the Occupational Injury and Illness Surveillance System, a cooperative effort of the Connecticut Workers’ Compensation Commission, the Connecticut Department of Public Health, and the Connecticut Labor Department.

The system is designed to track occurrences of work-related disease, with an eye to understanding patterns and developing approaches to prevent occupational illness.

“We must take stronger actions to improve the employee work safety experience and environment, with improvements in ergonomics, safe needle devices in health care, reducing mold and increasing fresh air flow in indoor environments, providing education on toxic chemicals, and increasing the recognition of such hazards as poison ivy,” Morse told UConn Today.

Morse and UConn Health researchers analyze survey responses and occupational illness reports from the State Labor Department/Bureau of Labor Statistics (BLS) survey; the first reports of injury to the Connecticut Workers Compensation Commission; and health provider reports to the Connecticut Departments of Labor and Public Health under the Occupational Illnesses and Injury Surveillance System.

Tanning Beds in Gyms Is Concerning Trend, UConn Study Finds

"By pairing exercise with tanning beds, gyms send the message that tanning is part of a healthy lifestyle. It is not," according to University of Connecticut researcher Sherry Pagoto in a study published this month in the Journal of the American Medical Association Dermatology. Pagoto is a professor of allied health sciences and president of the Society of Behavioral Medicine.  “The presence of tanning beds in gyms is a concerning trend.” Pagoto and her colleagues surveyed more than 600 people who had used a tanning bed at least once in their life. Nearly one-quarter (24%) had tanned in a gym at least once, the findings showed.  Those who had tanned at a gym tended to be heavier tanners overall, and were more likely to be what the researchers called "addictive" tanners.

Nearly half the gyms in the U.S. contain tanning beds.  Two of the largest American gym chains (Planet Fitness and Anytime Fitness) with total combined membership of more than 13 million people offer indoor tanning, the study pointed out.  Anytime Fitness and Planet Fitness each have 26 Connecticut locations.

Exercise and tanning are both activities people use to improve their appearance; and people who tan in gyms tan more often – and more addictively – than other people who use tanning beds, according to the study. Exercise reduces the risk of every cancer except one – melanoma, the deadliest form of skin cancer. People who exercise heavily are at greater risk of skin cancer, and yet many gyms in the U.S. have tanning beds. In other words, tanning beds in gyms are targeting people who are already at higher risk of skin cancer, UConn Today explained recently in highlighting the study.

“Exercise and tanning are both things people use to look better, which may be why we see a connection between these two behaviors, and why gyms are providing tanning beds to patrons,” Pagoto said.

The study also found that greater tanning was associated with more frequent exercise, which is especially concerning, because of the connection between heavy exercise and skin cancer risk. Researchers don’t know why exercise is associated with an increased risk of skin cancer. But they do know that the majority of skin cancers are caused by exposure to ultraviolet light, which is what tanning beds produce.

Ongoing, occasional use of tanning beds triples a person’s lifelong risk of melanoma, according to the Melanoma Research Foundation, and the incidence of skin cancer has been rising for 30 years in the U.S. About 91,000 people will be diagnosed with melanoma in 2018, and about 9,000 will die from it, according to the American Cancer Society.

“Indoor tanning is the same class of carcinogen as tobacco, radon, and arsenic,” says Pagoto. “Those are not things you’d want around you while you’re working out.”

Pagoto is also Director of the UConn Center for mHealth and Social Media. She is also a licensed clinical psychologist her research focuses on leveraging technology in the development and delivery of behavioral interventions targeting diet, physical activity, and cancer prevention behaviors. She has had federal funding for her program of research for 14 consecutive years, totaling over $11 million, and has published over 170 papers in peer-reviewed journals, according to the UConn website.

Among the statements from survey respondents: “My urges to indoor tan keep getting stronger if I don’t indoor tan,” and “at times, I have used money intended for bills to pay for my tanning sessions.”

Pagoto was joined in the study by researchers from the University of Mississippi Medical Center, Lincoln memorial University in Tennessee, University of Massachusetts Medical School, Pennsylvania State University and East Tennessee State university.  The study was funded by the Centers for Disease Control and Prevention, Division of Cancer Prevention and Control.

Connecticut Children's, Yale New Haven Ranked Among Best in Neonatology

Two of the nation’s top 50 hospitals for neonatology are in Connecticut.  Connecticut Children’s Medical Center ranked #25 and Yale New Haven Children’s Hospital ranked #36 in the latest analysis by US News & World Report, which publishes hospital rankings in various medical specialties. Atop the rankings in the pediatric specialty were Children’s National Medical Center (Washington, DC), Children’s Hospital of Philadelphia, Boston Children’s Hospital, Children’s Hospital Colorado, Cincinnati Children’s Hospital Medical Center, Rainbow Babies and Children’s Hospital (Cleveland), UCSF Benioff Children’s Hospital of San Francisco and Oakland, New York-Presbyterian Morgan Stanley-Komansky Children’s Hospital, St. Louis Children’s Hospital-Washington University, and C.S. Mott Children’s Hospital – Michigan Medicine (Ann Arbor).

Fifty pediatric centers were ranked for care of fragile newborns. Breast milk at discharge, patient volume, infection rates in the NICU and other data collected from a detailed U.S. News clinical survey of children's hospitals, produced 85 percent of each hospital's score. The other 15 percent reflects nominations from pediatric specialists and subspecialists who responded to surveys in 2016, 2017 and 2018 and recommended the hospital for serious cases in their specialty.

Yale’s highest ranking among nearly a dozen pediatric specialties was in Pediatric Diabetes & Endocrinology, where it ranked eighth.  Connecticut Children’s is ranked in four specialties, including Pediatric Urology (#30), Pediatric diabetes & Endocrinology (#37), and Pediatric Cardiology & Heart Surgery (#49).  Yale New Haven Children’s Hospital is nationally ranked in nine specialties. (U.S. News includes Yale New Haven Hospital and Connecticut Children's Medical Center in evaluating the performance of Yale New Haven Children's Hospital in Pediatric Cardiology & Heart Surgery and Pediatric Urology.)

Yale New Haven Children’s Hospital admits approximately 125 patients a day. With 208 licensed beds, the hospital has neonatal and pediatric intensive care units, a 24-hour pediatric emergency room and a children's surgery center, according to US News.

Connecticut Children’s reports it has established the largest newborn delivery services network in the state of Connecticut based on the number of hospitals for whom it provides neonatology care.  In addition to Connecticut Children’s two NICUs located in Hartford and Farmington, Connecticut, the Medical Center also provides newborn delivery services at nine hospitals, including five additional NICUs. Hospital partners include Hartford HealthCare (4 hospitals), Western Connecticut Health Network (2 hospitals, as of this month), Ascension (St. Vincent’s Medical Center), Eastern Connecticut Health Network (Manchester Hospital), and Day Kimball Healthcare.

“We’re excited to bring our expertise to more babies in Connecticut,” said Jim Moore, MD, Division Chief for Neonatology at Connecticut Children’s. “My goal is for Connecticut Children’s to develop a truly comprehensive, regionalized, clinically integrated network for newborn care across the state.”

Connecticut Children’s drives innovation across its newborn delivery service locations by sharing best practices and protocols across the network, and ensuring that family centered rounding is done for every patient, according to hospital officials. It also practices “family centered care” - moving patients to the right location for the care they need, but then returning them to their home hospital when they no longer need that higher level of care, officials point out.

“The recognition from U.S. News & World Report is a testament to our dedicated physicians, nurses and staff who care for the sickest children while working tirelessly on advancing research and clinical outcomes at the Medical Center,” said Jim Shmerling, President & CEO at Connecticut Children’s Medical Center. “We continue to expand our care network, making it easier than ever for our patient families to access the care they need, when they need it and most importantly where they need it; close to home.”

Bridgeport, New Haven Among Nation's 50 Most Stressful Cities, Analysis Says

Stress?  Look no further than Bridgeport and New Haven.  Both cities were ranked in the top 50 Most Stressed Cities in America, a new ranking produced by the financial website WalletHub. Bridgeport ranked 33^rd and New Haven 41^st, based on analysis that considered stress in four areas:  the workplace, finances, family, and health and safety as contributing factors.

The most stressed cities in America, according to the analysis, were Detroit, Newark, Cleveland, Birmingham, Toledo, Baltimore, Wilmington, Milwaukee Gulfport and St. Louis.  Among New England cities, Bridgeport led the list, followed by Worcester (37), New Haven, Boston (52), and Providence (57). 

Bridgeport ranked 17^th in the workplace stress category and 23^rd in financial stress; 103^rd in family-related stress. Bridgeport also had among the lowest average weekly work hours, tied for 176^th among the 182 cities included in the rankings.  New Haven ranked 168th in that category.

New Haven was 37^th in health and safety related stress; in the mid-50’s in the other categories.

WalletHub evaluated the 150 most populated U.S. cities, plus at least two of the most populated cities in each state, using the four dimensions including 37 relevant metrics.  Those metrics included job security, traffic congestion, unemployment rate, average commute time and income growth in the work stress category.  Financial stress included evaluation of annual household income, foreclosure rate, food insecurity, housing affordability and debt per median earnings.

The family stress category included the separation and divorce rate, number of single parent households, child care costs and other factors.  The ten factors considered as part of the Health & Safety stress category included mental health, smoking, obesity, inadequate sleep, crime rate and hate-crime incidents.

Greensboro, North Carolina, residents spend the fewest annual hours in traffic congestion per auto commuter, 4, which is 25.5 times fewer than in Los Angeles, the city where residents spend the most at 102, according to the data.  Bridgeport and New Haven tied for 36th in the traffic congestion rankings.

Data used to create this ranking were collected from the U.S. Census Bureau, Bureau of Labor Statistics, INRIX, Chmura Economics & Analytics, Indeed, Federal Deposit Insurance Corporation, Renwood RealtyTrac, County Health Ranking, Zillow, Administrative Office of the United States Courts, TransUnion, Department of Housing and Urban Development, Council for Community and Economic Research, Gallup-Healthways, Numbeo, Centers for Disease Control and Prevention, Federal Bureau of Investigation and Sharecare.

Nuclear Attack on NYC Could Impact CT, Report Suggests

The illustration in a recent edition of New York magazine has drawn some attention in Connecticut.  Accompanying an article describing the anticipated aftermath in the tri-state region of a nuclear attack on New York City, the potential path of nuclear fall-out was shown to extend through Connecticut towns including Greenwich, Stamford, Wilton and others, reaching as far north as the town of Monroe. Within two hours of an attack on Times Square, the article described, a plume of radioactive fallout would “unfurl 60 miles beyond the city, lingering for weeks, contaminating food and water supplies.”

The article explains that “In the hours and days after a nuclear blast, a massive plume of fallout would unfurl past the city’s borders and up the Eastern Seaboard, scattering radioactive dust on everything in its path: people, homes, farms, animals, forests, rivers. The most radioactive region of the plume would reach its full length of 20 miles an hour after the explosion, exposing every unsheltered person in the area to toxic levels of radiation; if it were to spread north from Times Square, it would reach as far as New Rochelle. Within a day, this danger zone would shrink to about a mile in length. Within a week, it would have dissipated completely.

A much bigger but less radioactive region of the plume, called the hot zone, would reach its maximum length of 60 miles — extending, say, as far north as Monroe, Connecticut — two hours after the explosion. A week later, the hot zone would still extend 20 miles from the city, and it would take many more weeks for it to disappear altogether. Although radioactivity in the hot zone would likely be too weak to cause any acute symptoms of radiation sickness, it could still subtly damage the human body and increase the chance of cancer.

How far and in what direction a plume of fallout travels depends on the altitude of the mushroom cloud, as well as temperature, wind, and other meteorological variables. Within an hour of an explosion, FEMA’s Interagency Modeling and Atmospheric Assessment Center would begin to track the plume’s movement, providing updates and projections to federal, state, and local authorities. They would use the information to evacuate people in the opposite direction of the plume and warn people in the plume’s path to seek shelter and avoid consuming any exposed water or food.”

Nearly a decade ago, a New York Times story on the subject included this:  Suppose the unthinkable happened…Do not flee. Get inside any stable building and don’t come out till officials say it’s safe.”  That advice, the Times indicated, was “based on recent scientific analyses showing that a nuclear attack is much more survivable if you immediately shield yourself from the lethal radiation that follows a blast, a simple tactic seen as saving hundreds of thousands of lives. Even staying in a car, the studies show, would reduce casualties by more than 50 percent; hunkering down in a basement would be better by far.”

“We have to get past the mental block that says it’s too terrible to think about,” W. Craig Fugate, administrator of the Federal Emergency Management Agency at the time, told the Times. “We have to be ready to deal with it” and help people learn how to “best protect themselves.”

Connecticut's state website focuses on nuclear preparedness related to an emergency at a nuclear power plant in the state.  The Department of Emergency Management and Homeland Security site indicates "While the Dominion Energy- Millstone Station in Waterford is the main focus of emergency planning in Connecticut, the fuel storage site at the former Connecticut Yankee site in Haddam, CT and the Indian Point nuclear power plant in Buchanan, New York, are also included in Connecticut's radiological emergency preparedness and response program."

Communities near those sites are linked, and a calendar of upcoming training is provided.  The United Way also provides information related to evacuation and taking shelter on the agency's website. New Haven conducted an exercise of their host community reception center to prepare for the unlikely event of a nuclear release at the Millstone power plant in 2015; video here:  https://www.fema.gov/media-library/assets/videos/109671

(New York magazine illustration)