Report Provides Guidance for School Districts and State Policymakers to Address Students’ Trauma & Mental Health Needs

It is described as a “framework to advance policy and strategic school district planning to more effectively address the mental health and trauma needs of students and promote student success.”  A new report, driven by research highlighting the connection between mental health and educational outcomes, is aimed at school districts looking to increase integration of student mental health services and supports. The 40-page report, developed by The Child Health and Development Institute of Connecticut (CHDI), a subsidiary of the Children’s Fund of Connecticut, in partnership with the national Center for School Mental Health at the University of Maryland, provides a framework for policymakers and school districts interested in improving outcomes by addressing the mental health and trauma needs of students. The report indicates that “in a typical classroom of 25 students, approximately five will meet criteria for a mental health disorder but most of them are not receiving appropriate mental health treatment or support. Among those who do access care, approximately 70 percent receive services through their schools.”

Connecticut is cited as an example of how states can promote collaborations within and across the behavioral health, education, and juvenile justice systems to provide an array of trauma-informed, evidence-based, and tiered services for students.  It notes that school principals indicate that mental health is one of the most challenging unmet needs among their students and schools are increasingly seen as a critical setting for the delivery of mental health services.

The report provides “a blueprint and resources to guide state policymakers and school district leaders," including:

• an overview of core components of the Comprehensive School Mental Health
• Systems (CSMHS) model structured around family-school-community partnerships and the delivery of evidence-based mental health services within a multi-tiered system of supports;
• examples of best practice strategies to develop, implement, and sustain CSMHS;
• a model for a trauma-informed multi-tiered system of supports for school mental health;
• creative approaches to advance policy and funding structures to sustain CSMHS; and
• recommendations for state-level policymakers, districts, and schools to advance a comprehensive statewide system of school mental health to improve outcomes for all students.

“Approaching student mental health with a comprehensive lens that integrates health promotion, prevention, early intervention, and more intensive treatments leads to better school, student and community outcomes," said Dr. Sharon Hoover, Co-Director of the Center for School Mental Health at the University of Maryland and lead author of the report.

National prevalence rates indicate that approximately 20 percent of children meet criteria for a mental health disorder; however, many children’s mental health needs are not identified and the majority of children with identified challenges do not receive services, the report explained.  Among those who do access care, approximately 70 percent receive services through their schools. Linking children to services through their schools reduces many traditional barriers to care. School mental health services are also associated with higher completion rates than treatment delivered in traditional outpatient community-based settings.

The report uses Stamford Public Schools (SPS) as a” local model for improving outcomes by adopting a trauma informed approach to school mental health.” CHDI began working with SPS in 2014 to conduct a review of the district’s mental health system and to develop a plan to enhance trauma-informed mental health services district-wide.  That plan was subsequently implemented, and “lessons learned in Stamford are being used to engage other Connecticut districts to … integrate school and community-based mental health services, and promote quality and sustainability of these enhancements.”

“Schools are well positioned to promote wellness and social emotional competence for all students, as well as identify and address mental health concerns for students in need,” said Dr. Jeana Bracey, Director of School and Community Initiatives at CHDI and report co-author. “However, the responsibility is not on schools alone to integrate or fund these supports. This framework helps districts connect to and collaborate with Connecticut’s robust network of trauma-informed state and community-based services and programs so all students can be successful.”

The report concludes that a “systematic and streamlined partnership between families, schools, and communities to support a continuum of mental health supports in schools can lead to better behavioral health for all students, as well as increased access, earlier identification and intervention, and ultimately better outcomes for students with mental health challenges.”

[Visit wwws.chdi.org to download the IMPACT report or to read more about CHDI’s work related to school mental health.]

New Haven, Bridgeport at Bottom of Ranking for Disability-Friendly Cities

Connecticut’s two largest cities are not particularly hospitable for individuals with disabilities, according to a new national analysis.  New Haven and Bridgeport are at the bottom of a list of 182 cities that were included in the review, released this month to coincide with National Disability Employment Awareness Month The personal-finance website WalletHub compared the largest U.S. cities – including at least two from each state - across 31 key indicators of disability-friendliness. The data set ranges from wheelchair-accessible facilities per capita to rate of workers with disabilities to quality of public hospital system. The 31 indicators were grouped into three categories:  Economy, Quality of Life and Health Care.

The report on 2018’s Best & Worst Cities for People with Disabilities placed New Haven at the bottom of the list, and Bridgeport just two positions higher.  They were the only Connecticut cities evaluated in the analysis.

According to the Centers for Disease Control and Prevention, one in four U.S. adults, or 61 million total, have a disability that impacts their major activities. And among Americans age 65 and older, that number rises to two in five. In 2017, nearly 5.7 million people with disabilities were employed.

New Haven, which ranked number 182 overall, ranked 180 in Economy, 134 in Quality of Life and 173 in Health Care.  Bridgeport, just above New Haven at number 179 in the overall ranking, placed 164 in Economy, 128 in Quality of Life and 163 in Health Care.

WalletHub analyst Jill Gonzalez explained that among the metrics dragging down New Haven's overall ranking was the second lowest employment rate for people with disabilities, at 71.03 percent. This refers to the civilian non-institutionalized population aged 18-64 in the labor force. Other areas where New Haven ranked poorly, Gonzalez pointed out, were the share of people with disabilities living in poverty, which is almost 37 percent, and the relatively low number of family doctors and general practitioners per capita.

Bridgeport ranked as the fourth worst city for people with disabilities. One of the issues driving the ranking, Gonzalez said, was similar to New Haven's - a low employment rate for people with disabilities, at 74.28 percent. The other issues are mostly related to the quality of life.

“Bridgeport has one of the lowest number of wheelchair accessible art, entertainment and recreational establishments per capita, and a large number of older buildings with little to no access for disabled residents," Gonzalez said.

The analysis found that only Detroit had a lower employment rate for individuals with disabilities that New Haven.  On the overall list, Providence, RI was just one notch above New Haven, at the bottom of the rankings.

The cities ranked at the top of the list were Overland Park, KS; South Burlington, VT; Sioux Falls, SD; Scottsdale, AZ; Columbia, MD; San Francisco; Rapid City, SD; St. Louis, MO; Bismarck, ND; and Grand Rapids, MI.

Data used to create this ranking, according to WalletHub, were collected from the U.S. Census Bureau, Bureau of Labor Statistics, Department of Housing and Urban Development, Council for Community and Economic Research, Centers for Disease Control and Prevention, National Center for Education Statistics, Centers for Medicare & Medicaid Services, Trust For Public Land, Genworth Financial, United Cerebral Palsy, WalkScore, Yelp, Rails-to-Trails Conservancy, Affordable Housing Online, Kaiser Family Foundation, Eligibility.com, Redfin and WalletHub research.

Housing and Health - Foundations Fund Research in CT to Examine Relationship

Housing and health are increasingly the focus of study, to better determine how one impacts and influences the other.  Foundations at the state and national level are among those devoting resources in Connecticut to seek answers that can ultimately guide future public policy. With a $125,000 grant from the Connecticut Health Foundation, the Open Communities Alliance will work to create better links between housing and health care and set the stage for a two-year pilot program to enable interested families of children with acute asthma to move to healthier neighborhoods.

The “Healthy Housing Vouchers” project aims to use housing policy to improve health outcomes for low-income families and reduce health disparities, tying together clinical and nonclinical factors that affect people’s well-being. 

The Open Communities Alliance project will create a streamlined process for low-income families of children with asthma to help them access affordable housing in healthier communities if they choose. It will include referrals, counseling on the impact of environmental conditions on health, help identifying potential rental locations, and assistance with security deposits, moving expenses, and supportive services as they adapt to a new community. The initial participants in the pilot program will be low-income families who receive government-funded housing vouchers and have children with acute asthma.

The Connecticut Health Foundation will also be providing a $100,000 grant to support Connecticut Voices for Children’s work to promote policies that advance health equity for children and families. The work will include conducting policy research, producing educational materials and analyses to inform policymakers about issues affecting children and families, bringing together state agencies and advocates through the Covering Connecticut’s Kids and Families Coalition, and participating in state-run councils to represent research-based policy solutions.

These projects are among  11 awarded a total of $535,000 - announced this month - by the Connecticut Health Foundation, based in Hartford.  It is the state’s largest independent health philanthropy dedicated to improving health outcomes for people of color.

Earlier this year, the Connecticut Data Collaborative and the Liberal Arts Action Lab were awarded a 500 Cities Data Challenge grant by the Urban Institute and the Robert Wood Johnson Foundation. The joint proposal was one of 10 selected from a large competitive pool of applications submitted by organizations from cities across the United States.

The one-year $148,000 grant will support local research and educational outreach on housing conditions, health outcomes, and neighborhood disparities in the capital city of Hartford.

The Connecticut Data Collaborative is a nonprofit organization focused on providing public access to data, creating an ecosystem of data users, and increasing data literacy. The Liberal Arts Action Lab, launched in early 2018 by Trinity College and Capital Community College, investigates problems posed by Hartford community partners, with teams of undergraduate students and faculty fellows who conduct semester-long research projects to strengthen the city.

The Urban Institute and the Robert Wood Johnson Foundation designed this challenge grant to encourage communities to delve into the 500 Cities open-access dataset, to design innovative solutions on social factors that influence health, and to guide local organizations on how to effectively use neighborhood-level data. The broader goal is to promote more comprehensive cross-collaborative approaches to foster a broader “Culture of Health” in urban areas.

CT Office of Early Childhood Receives Global Recognition for Effective Communication

The Connecticut Office of Early Childhood (OEC) – a state agency that didn’t exist just over five years ago - has earned global recognition for success and innovation in serving the state’s youngest children and their families. The agency was chosen to receive the “Future of Feedback Award” at the annual Feedback Summit in Washington, D.C.   The award was presented last week to OEC Commissioner David Wilkinson for his agency’s efforts at effective listening to the people it serves and the nonprofit providers who serve them.

“The Office of Early Childhood is honored to be recognized for its efforts in communicating effectively with Connecticut’s families and providers, and for finding strategies to meet their needs,” said Commissioner Wilkinson. “The parents we serve and the community providers we support are the best experts in what they need to succeed, but too often they don’t have a seat at the table.  OEC is trying a new approach to put parents and our hardworking providers at the center of our policymaking.  We’re saying, ‘nothing we plan for you should be done without you.’’

"Connecticut’s Office of Early Childhood is pioneering innovative ways of both listening and acting.  OEC’s outreach to families – and frontline service providers – is creating conversations about what matters most, and what they can all do together," said Dennis Whittle, Co-Founder of Feedback Labs and GlobalGiving.

Feedback Labs, the organizer of the Summit, is a global network of over 400 leading aid, philanthropy, and governance organizations around the world.  Feedback Labs was conceived in 2013 and launched in connection with the Obama White House. Whittle also co-founded GlobalGiving, a leading marketplace connecting social, environmental, and economic development projects to individual and corporate donors. Since its inception GlobalGiving has facilitated $335 million in funding to over 20,000 projects in 170 countries.

Established in 2014 through a bipartisan effort of Gov. Dannel Malloy and the legislature, OEC oversees and funds Connecticut’s early childhood programming – including child care, pre-K, early intervention for children with developmental delays, and family support services for at risk families – components that once were housed in five disparate state agencies.

Among the 10 largest state agencies in Connecticut, OEC’s goal is to keep the state’s children safe, healthy, learning and thriving. Through its innovative feedback efforts, the agency is acting on evidence that engaging providers and parents in policymaking yields better results.  Officials said that the agency combined data from 1,700 family surveys, another survey shared with all providers in the state, and 400 community and provider meetings in order to build a draft plan to transform the ECE system in the state, which serves 200,000 children.

Wilkinson added that “An award like this is an encouraging validation of our efforts to listen to families and providers, and then do all we can to act on their advice.  We believe that by listening and responding, we will provide better, more effective services for Connecticut families with young children – and in so doing help create a brighter future for the state.”

"OEC’s approach contains key ingredients of more responsive, innovative, and effective government.  OEC’s leadership in asking for and responding to feedback has the potential to spread widely through the public sector,” Whittle added.

“Child care centers work hard every day for children,” Said Dr. Monette Ferguson, Executive Director of ABCD, Inc., a nonprofit operating several leading child care centers in and around Bridgeport. “Usually the state tells us what to do and by the time we share any concerns, it’s too late.  I am not used to a state agency asking what I think before it acts.  It’s good to feel heard and to see OEC acting on our advice.”

David Wilkinson was named Commissioner by Gov. Malloy in April 2017 to serve as the second Commissioner of the state’s Office of Early Childhood (OEC). He previously served as Director of the White House Office of Social Innovation and Civic Participation under President Barack Obama. While at the White House, Wilkinson worked closely with the Malloy Administration on signature early childhood efforts, including a first-of-its-kind initiative – scaling a program proven to reduce parental substance use and child welfare interaction – for which the administration has achieved national acclaim.  He has also served as an advisor to the Yale Child Study Center, a leading collaborator with the state and its early childhood service providers.

Christine Johnson-Staub is the Interim Director of Child Care and Early Education at CLASP, a 50-year-old national nonprofit based in Washington, D.C., that focuses on shaping policy to support families living in poverty. She said, “OEC’s approach to setting its policy direction was unique because not only did it build on input from the community and existing research and data, but it went back to a wide range of impacted people, including parents, providers and other stakeholders, to make sure they got it right.”

“Parents and child care providers know the challenges facing the early care system better than anyone but rarely does anyone from state government ask our opinion,” said Merrill Gay, Executive Director of the nonprofit Early Childhood Alliance, a state consortium of providers and advocates. “That's why it was so refreshing to have the Office of Early Childhood ask us: ‘What are the pain points?  How do we make this system work better for you?’  I'm really excited to see OEC now turning that agenda for improvement into concrete action to better serve children and families.”

The strategy of communicating successfully with a target audience, and then acting upon that communication, is known as a “feedback loop” – an approach widely studied and increasingly appreciated by thought leaders, initially gaining traction in international development, but seen to have powerful implications for advancing more responsive, cost-effective and impactful government services in the US. The 2018 Feedback Summit was attended by over 150 feedback pioneers and leaders from around the U.S. and the world.

“They speak. We listen. We make change. It’s about being responsive to the needs of the young children in our state and, of course, their parents and caregivers,” Wilkinson said.  To contact the Office of Early Childhood, visit www.ct.gov/oec or call (860) 500-4412.

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.

https://youtu.be/TT_HLG5FkKA

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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.