There’s a “heightened sense of wellbeing, a feeling of connectedness,” he said of spending time outside at the nearly 693-acre park in Hartford’s North End. “There are portions of the park that you can visit that completely make you feel like you’re in another place, in another world. Not only in another city, but in a completely different ecosystem.”
Virgo is the founder and executive director of Keney Park Sustainability Project and is dedicated to helping others have similar experiences through the project’s Urban Ecology Wellness Center at Keney Park initiative. The wellness center, housed at the 693-acre park in Hartford’s North End, was formed to connect North End community members to the healing power of nature through a variety of programs, including forest and horticulture therapy, workshops in urban forestry and farming and group hikes. Other programs use the sustainability project’s facilities, which include five greenhouses and are home to a variety of animals, including bees, goats and chickens.
As part of his efforts to connect people with nature, Virgo has begun working closely with Dr. Della Corcoran, a West Hartford pediatrician and founder of OutdoorRX CT. Corcoran has witnessed firsthand in her practice what she already knows from medical literature: when people spend time in nature, good things happen.
“Depression scores go down. If you have kids that can get outside and run around a little bit before school, their attention levels are higher. They have fewer symptoms of ADHD. Access to meaningful green space, or even sometimes just pictures of nature, lowers heart rate, lowers blood pressure, and improves diabetes. The health benefits are obvious and also evidence-based.”
— Dr. Della Corcoran
For instance, a 2019 study found that a $100 increase in parks and recreation spending was associated with a decrease in mortality of 3.9 to 3.4 deaths per 100,000 people. Other research suggests additional benefits for outdoor exercise over indoor exercise.
In theory, access to nature for all would be easy in Connecticut, where public parks and forests are abundant. Still, in reality, historic inequities around this access persist, and city greenspaces could be utilized more.
Desegregating Nature
According to Connecticut’s 2020 Forest Action Plan, more than 60% of the state is forested, and the state’s cities have the most urban tree cover in the nation. In Hartford, 99% of residents live within a 10-minute walk to a quality park, according to the Trust for Public Land. In New Haven, that number is 96% of residents, while in Bridgeport, it drops to just 73% percent, but that’s still well above the national average of 55%. Beyond city parks, there are 110 state parks and 32 state forests in Connecticut.
In recent years, the state has launched various programs and initiatives to promote access to the outdoors. For example, the state’s Passport to the Parks, program provides any vehicle registered in Connecticut free entrance to parks year-round. In addition, ParkConneCT launched last summer, providing free bus fare to select state parks. The Connecticut Department of Energy and Environmental Protection’s No Child Left Inside® initiative promotes these types of programs and other outdoor initiatives.
Programs designed to help people get to parks are important because, research shows, proximity to green spaces alone can’t ensure equitable access to nature for people of color.
“In many areas, people of color are less likely to use greenspace amenities even when they have geographic access,” Don Rakow of Cornell University, and Laura Brown, executive director of New Haven’s City Plan Department, wrote in a report titled Anti-Racism in the Outdoors.
“These inequities are the result of complex social and economic factors that include explicit racism and segregation. As an example, Central Park, the first urban park in America, was envisioned and largely driven by powerful white businessmen for the benefit of white elites, and its construction involved eviction of a community of African American and immigrant residents.”
Pediatric APRN Amanda Elizabeth DeCew still sees the impact of some of these policies in New Haven. She works at the Fair Haven Community Health Care, and the majority of her patients are low-income and uninsured. “Most of the kids that I see spend a lot of their time indoors,” she said. “Most Americans spend a lot of their time indoors, about 90% of it, but I would say the children that I see spend more time indoors than children in the suburbs and the surrounding areas of New Haven.”
APRN Amanda DeCew
DeCew added, “We haven’t done a study, but from my own experience, and from the experience when talking to other providers about it, what patients report is that safety is a barrier,” DeCew said. “I think that people don’t want to take their children to the park if there are, quote-unquote, questionable people in the park they don’t feel comfortable with.”
Another barrier is time constraints due to work schedules. DeCew is working to understand these barriers and help overcome them for her patients and others by participating in collaborative community efforts. For instance, she is working with Yale Office of Sustainability’s New Haven Nature & Health Initiative, which brings together health care workers and others in the community to share knowledge about engaging New Haven residents in ways they can improve their health through experiences in nature.
A Prescription For Nature And Other Efforts
Corcoran and DeCew offer their respective patients nature prescriptions, which include handwritten prescriptions and follow-up texts to remind people to get outside. “It’s very similar to prescribing any other prescription,” DeCew said of the process.
Corcoran hopes to encourage more health care providers to give patients these types of prescriptions and have conversations with them about spending time outside.
“I do that with every newborn that comes into my office,” Corcoran said. “I look at the parents, and I say, ‘Look, we’re big fans of fresh air. Take this baby outside. Don’t go out in blizzards, don’t go out if there are wind chill advisories, but you know what, dress this baby appropriately for the weather; go outside. Take a walk, be out in nature, be outdoors.'”
If more health care providers started having these conversations, it would be beneficial to their patients and could influence the larger conversation, Corcoran said.
“The more you educate providers and talk about getting people outside, the more likely you are to have people at the state and the insurance payer level pay attention to the importance of that green space and developing that green space,” Corcoran said. “Maybe your doctor’s prescription to go for a hike, you can use to get on the bus and go to Auerfarm, which is in Bloomfield, or to Winding Trails out in Farmington or to the MDC Reservoir in West Hartford.”
Bringing Nature To The City And People To Nature
Melanie Stengel Photo.
Virgo feeds the goats at the Keney Park Sustainability Project, Hartford.
Another way to increase access to nature for those who live in cities is to plant more trees and create more green spaces. New Haven Urban Resources Initiative (URI), a community not-for-profit affiliated with the Yale School of the Environment, has helped plant more than 10,000 trees with community partners since 1995.
Trees can help cool cities and reduce asthma risk, said Colleen Murphy-Dunning, program director of the Hixon Center for Urban Ecology/Urban Resources and the New Haven Urban Resources Initiative.
“There’s a term called biophilia. It basically said humans have an innate need for nature,” Murphy-Dunning said. “There’s been studies of if you have trees at the hospital, it can reduce people’s hospital stay.”
Planting trees and other beautification efforts can also help encourage residents to engage with parks, DeCew said.
“I think there’s certainly a lot of brownfields that we could turn into green fields and a lot of neighborhoods in New Haven,” she said. “And we know from studies that just greening a vacant lot can reduce depression for residents who live around that area.”
Healing Nature
At Keney Park, Virgo continues looking for new ways to get more community members into the park. He is working with Corcoran to develop a nature passport with different requirements depending on the season and let the younger generation use their phones as they discover and interact with nature.
In the meantime, he wants to make one thing clear. “People like to say that the park is not being utilized, which is incorrect,” he said. “There’s a community of folks that use this park every single day, families, children and adults, all demographics. So, it all depends on your perspective. Do we want to see more people utilizing it? Absolutely.”
As for Virgo’s favorite part of the park, it’s a section called 10 Mile Woods. Some years back, the roads running through it were closed due to the city’s lack of funds to maintain them. “In that kind of sectioning it off and blocking off the roads through it, it has actually been preserved,” he said. “So, it’s very fascinating to watch nature kind of reclaim roads and reclaim signs and kind of just heal itself from human interaction.”
Healing is, after all, what nature does.
Below are some nature resources:
Urban Ecology Wellness Center at Keney Park
New Haven Nature & Health Initiative
Trust for Public Land tool the percentage of residents in your town or city with easy access to a quality park
OutdoorRX CT’s Facebook and Instagram
Connecticut’s No Child Left Inside Initiative®
Connecticut’s 2020 Forest Action Plan
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Dunn’s mother, Maria Cotto, has long had severe asthma. Dunn inherited the condition, though she has mostly grown out of it as an adult. Now, Dunn’s 12-year-old son also has severe asthma.
“People kind of shrug it off as not that big of a deal,” said Dunn, who lives with her family in East Harford. “But I see what it’s done to my mother, and I see what it’s doing to my son, and what it has done to me.”
In Connecticut, 10.6% of children and 10.5% of adults have asthma, according to state data from 2019. According to DataHaven’s 2021 Community Wellbeing survey, 12% of adults have asthma.
Asthma does not impact all people equally.
“In the state of Connecticut, similarly to other states in the country, this condition disproportionately affects minority populations, including African Americans and Hispanics,” said Dr. Mario Perez, an assistant professor of medicine at UConn Health who studies asthma disparities and who Cotto sees for her asthma.
DataHaven’s survey found that 11% of white, 13% of Black, and 21% of Latino adults have asthma.
Economics also seems to play a role. Only 6% of adults in wealthy towns have asthma, while 16% of adults in cities like New Haven, Waterbury, Hartford and Bridgeport have the condition. In addition, 19% of adults earning less than $30,000 per year have asthma, compared to only 9% of those earning $100,000 per year.
“Residents in city centers are typically three to four times more likely to visit the emergency room with an asthma diagnosis than residents of outer suburban areas,” said Mark Abraham, executive director, DataHaven.
Air Quality And Geography
Connecticut has long been known as the “tailpipe of the nation” due to pollution that drifts in from other states. The 2022 State of the Air report from the American Lung Association gave every Connecticut county a poor grade for ozone levels. Fairfield, Middlesex, New Haven and New London all received a grade of F, while Tolland and Windham counties received D grades, and Hartford and Litchfield were each given a C.
“We know that environmental factors, particularly factors such as air pollution, can be associated and contribute to the disease and to disease flare,” Perez said.
A 2009 study of New Haven County children recruited from the Yale Asthma Care Center found an increased risk of symptoms and inhaler use in children with asthma who had exposure to traffic-related fine particles.
Additionally, some research has suggested a link between crime and asthma rates, which highlights the need for healthier communities overall. “Having the sense that your neighborhood is more secure actually decreases the rate of asthma and asthma exacerbations,” Perez says.
City Risk Factors And Glimmers Of Hope
Melanie Stengel Photo.
Robert Carmon shows off his basketball skills on the court off Glade Street near his West Haven home. His asthma has improved since he was diagnosed as an infant.
Robert Carmon, 11, who recently moved from New Haven to West Haven, developed asthma as an infant and was rushed to the hospital by his parents on a near-weekly basis during the early years of his life. Robert has improved since C-HIT first reported on him in 2018, but the condition still impacts his life. He’d like to play on the basketball team at school but can’t because he worries his asthma will flare up. “I can play pickup games as long as I don’t play too hard,” he said.
The frequency of his trips to the emergency room has decreased, but he still goes to the hospital about once every month or so, said Robert’s father, Chaz Carmon.
Stories such as Robert’s are common in Connecticut cities. In recent years they have ranked high in the Asthma and Allergy Foundation of America’s annual Asthma Capitals Report, but this year saw marked improvement. Hartford moved from 17th worst to 69th on the list, Bridgeport dropped to 85th, from 29th in 2021, while New Haven dropped from 5th to 90th.
“New Haven saw the biggest positive jump in rank of all the 100 metropolitan statistical areas that we analyze,” said Hannah Jaffee, a research analyst with the Asthma and Allergy Foundation.
However, people shouldn’t read too much into the improved rankings because this year’s list was created based on different data sources than previous years. For example, insurance claims were examined instead of the self-reported surveys used previously. In addition, more localized data was utilized rather than the county-level data used for the report in previous years.
Even still, Jaffee said, the three most populous counties have seen some improvement.
“When we do look at the county-level data that we previously used asthma prevalence rates for Fairfield, Hartford and New Haven county, they’ve all declined over the past five years,” she said. The death rate has also generally declined in those three counties over the past 20 years, Jaffee added.
Improving Asthma Rates
Proven strategies for reducing asthma incidence and severity include working to ensure all residents have access to culturally competent health care and improving indoor and outdoor air quality for those in cities.
“Asthma triggers can be mitigated through housing quality improvements like better air conditioning filters and education for families about what the triggers might be. If you’re running a gas stove for cooking, and you don’t have good ventilation, it’s producing a lot of air pollution inside.”
— Mark Abraham, executive director, DataHaven
The Connecticut Asthma Program is a state-run initiative attempting to decrease asthma disparities through partnerships with health care providers while providing education about the condition and expanding access to Connecticut’s asthma home visiting program. The state has also promoted the Centers for Disease Control and Prevention’s (CDC) EXHALE framework for asthma management.
Perez says that the most effective interventions will take place before a patient ever arrives in front of him. “I think we as a society have to address everything from the environmental pollution and climate that we’re creating as humans to improving education and access to health care, but also improving the socio-economic status of the population in general.”
In the meantime, some say more can be done individually to help those with asthma. For instance, while Robert’s current school allows him to keep his asthma pump on hand, he wasn’t allowed to do that in the past. “They always said you have to keep your bag in your locker,” he said. That could cause asthma attacks to get out of control before he could get to his pump.
His father adds that each school should have a nebulizer in the nurse’s office with staff trained to administer asthma medication. That way, a student “can be on the nebulizer at least until the parents get there,” Carmon says, and if the nebulizer helps enough, the student might be able to return to class.
Cotto says it’s important for medical staff to remember that each patient is different. Cotto horrifyingly learned this when she was given epinephrine during an emergency asthma flare. While the medication can be helpful to some patients, it nearly killed her.
“I’m allergic to it. When they administered it to me, my heart stopped,” she said. When this happened in 2013, she ended up in a coma for 22 days.
After Cotto’s coma, her asthma worsened, and she could not leave the house without oxygen for many years. In 2014 she began seeing Perez, who took the time to figure out her specific triggers and a treatment plan that worked for her. Though she struggles at times, her asthma is more under control than it has been in years.
“He tried a whole bunch of different medications and finally found one that works for me,” Cotto says. “I’m actually able to leave the house without oxygen.” That’s something she hasn’t done for nearly a decade.
You can find out more about asthma in Connecticut and asthma management in general by visiting the following sites:
- The Connecticut Asthma Program
- Connecticut’s asthma home visiting program
- The CDC’s EXHALE framework for asthma management
- The Asthma and Allergy Foundation of America’s annual Asthma Capitals Report
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Take one of the many tough situations Serna handled during the COVID-19 crisis: A young Hispanic mother in New Haven had just lost her job. Her husband left. She was pregnant. Her son faced behavioral health and disability issues. And she was being evicted from her apartment. The first thing Serna did was get the mom a lawyer. Then she reached out to the school and social service agencies for help. “The mom didn’t know how to connect, so I connected the family to the help they needed,” says Serna, who is bilingual.
The story has a happy ending—at least so far. During the six months that Serna worked with the family, the eviction was stopped, the mom enrolled in a program for people reentering the workforce, and the son was placed in a school for kids with special needs and received the necessary counseling.
Across the nation, the number of adolescents reporting poor mental health is increasing. A U.S. Centers for Disease Control and Prevention 2021 survey released in March showed that 37% of high school students experienced poor mental health during the pandemic and 44% said they persistently felt sad or hopeless during the previous year.
Separation from school and friends, the threat of becoming seriously ill, and family stresses—including lost jobs and income—sent kids to hospital emergency departments in record numbers. Other social stresses fuel crises, including domestic violence, gun violence and racism. The pain is most acute in disadvantaged communities.
“Many of my patients were at home doing virtual school, but they were also tasked with taking care of the younger kids because their parents are essential workers. The kids were overwhelmed.”
— Dr. Deepa Camenga, associate professor of emergency medicine at Yale School of Medicine.
The nation’s patchwork health care system isn’t built to handle this kind of crisis. There aren’t nearly enough behavior health caregivers and facilities to address demands for service, especially for poor people, says Dr. Andrew Ulrich, who is in charge of the EDs at Yale New Haven Health’s hospitals in New Haven. In addition, says Alice M. Forrester, CEO at Clifford Beers, Medicaid reimbursement levels don’t even cover the basic costs of the care organizations like hers provide, forcing them to depend on philanthropy to make ends meet.
The Connecticut General Assembly made a down payment on addressing some of these issues this session when it passed bills, which the governor signed into law recently, that expanded mobile crisis programs throughout the state and created grant programs to hire more school-based counselors.
Despite the depth of the crisis and dearth of funding, there is a glimmer of hope. In communities across the state, groups are collaborating and experimenting with innovative approaches to improving health and well-being. One example is how Serna of Clifford Beers helped the New Haven woman and her children. The idea is that when the social determinants of health are considered and community resources are coordinated, the well-being of individuals and entire communities can improve. The approach also involves families and neighborhood organizations in decisions affecting them.
Ultimately, these experiments could change how our society thinks about and delivers health care. Following this model, health care and social service organizations aren’t competing with one another or operating in isolation but are working together to achieve common aims. “We’re shifting from short-term self-interest to long-term shared interest,” says Rick Brush, the CEO of Wellville, a national nonprofit health advisory group that assists local collaboratives in five U.S. communities, including north Hartford neighborhoods.
The community-health-collaboration idea is taking hold in Connecticut. Just before the pandemic, Connecticut’s Office of Health Strategy (OHS) launched its Health Enhancement Community (HEC) initiative. So far, nine HECs have been established across the state. All are focused on community-led collaborations aimed at addressing social, economic, and physical conditions to improve general well-being. OHS is also encouraging the HECs to change the incentives in the health care system—from pay-for-service to paying for better health outcomes. “Our strategy is around driving community-directed and community-led initiatives to address specific needs in each community, reducing disparities and ensuring communities are engaged for the long game,” says Victoria Veltri, OHS executive director.
Steve Hamm Photo.
Rick Brush, the CEO of Wellville, supports the work being done in north Hartford neighborhoods to bring together residents and community organizations to improve their quality of life.
In Hartford, for instance, a HEC was organized under the auspices of the North Hartford Triple Aim Collaborative, whose goal is to improve individual and community health while lowering health care costs. The group includes representatives from the city of Hartford, the United Way, Trinity Health, Connecticut Children’s, and Hartford Hospital, but it also invites community organizations and individuals to the table.
In addition, Connecticut Children’s has partnered with the City of Hartford, Hartford Public Schools, and other organizations to develop a signature new project, the North Hartford Ascend Pipeline. They landed a $30 million federal grant to be matched by local contributions that will fund an array of interlocking services to improve the well-being of young people from prenatal into young adulthood. “The key is getting to children and supporting families early,” says Dr. Paul H. Dworkin, director of Connecticut Children’s Office for Community Child Health. “That way, we can achieve much better outcomes for these children as they grow to be adolescents and adults.”
Community health innovators in Connecticut aren’t shy about adopting and adapting approaches that have been piloted elsewhere. For instance, the community outreach program at Clifford Beers is based on the Wrap-Around Milwaukee model for coordinating social and health care services.
Clifford Beers plans to take its community engagement to another level with a resilience center it hopes to locate in New Haven’s Newhallville neighborhood, offering early childhood services, mental health programs, after-school programs, and community health and disease prevention activities.
Health experts say the closer these coordinated service programs get to neighborhoods and families—really listening to what people want rather than dictating to them—the more likely they will have positive effects.
When Cynthia Cruz, a bilingual coordinator serving the communities of northwest Connecticut for Wellmore Behavioral Health, gets assigned to a new youth behavioral health case, the first thing she does is visit the family in their home.
They discuss what’s going on and what they would like changed. Her program only lasts six months, so she also reaches out to others in the community to see if they can help on a longer-term basis, including pastors, sports coaches, and extended family members. Wellmore refers to these human networks as “natural resources.”
Steve Hamm Photo.
The North End of Hartford.
Cruz recalls one situation involving a boy and his family in the far northwest corner of the state. Earlier in the COVID crisis, the boy had retreated to his room and spent much of his time playing video games. He withdrew from his family, barely talking to his mother. During sit-downs with the family, Cruz learned that the boy loved to watch football on TV, but he didn’t play the game. So, in addition to finding a counselor for him, she recruited his uncle to toss a football around with him once a week. That broke the ice. She got the family a membership at the local YMCA. The boy began socializing with other people. He and his mom reconciled. “You know what they say,” says Cruz. “It takes a village to raise a child.”
A program launched by a team at Yale’s Child Study Center, Supportive Parenting for Anxious Childhood Emotions (SPACE), puts parents at the center of their offspring’s care. Clinicians train parents to deal directly with children who have anxiety disorders, rather than depending on professional therapy sessions.
“There are young people who can’t or won’t engage with cognitive therapy, so we were driven to find another tool,” says Eli R. Lebowitz, an associate professor at the Child Study Center whose team developed the technique. Their approach has been adopted by therapists worldwide and really took off after Lebowitz published a best-selling book in 2021 about it, “Breaking Free of Child Anxiety and OCD.”
In one of Lebowitz’s cases, a 12-year-old Milford girl had developed such severe anxiety that she would not speak to anyone outside her home. Lebowitz helped the parents understand they were hampering her recovery by speaking for her in such situations. They changed their behavior, which gradually led to their daughter regaining confidence and speaking for herself once again.
COVID triggered the youth behavioral health crisis, but it has also encouraged innovative approaches that could help address the problems young people face going forward.
“It has been a deep, deep couple of years, and, for the clinic, it has been in some ways revolutionary,” says Forrester of Clifford Beers. “We have emphasized the outreach work in the communities. Now we’re seeing the aftereffects, and we know what needs to be done.”
To connect with the Anxiety and Mood Disorders Program at the Yale Child Study Center, where free care is available in certain circumstances, call (203) 737-4644.
Information on Wellmore is available here.
You can reach Clifford Beers, which is changing its name to Clifford Beers Community Care Center on July 1, here.
]]>The state will direct most of its efforts — and most of $30 million in federal money — toward its cities, whose children have borne the brunt of this epidemic. In announcing the allocation recently, Gov. Ned Lamont pointed to lead’s “catastrophic” effects on children’s health and development, noting that lead poisoning is “a problem that impacts most deeply minority and disadvantaged communities of our state.”
Nearly half of the 1,024 children reported as lead poisoned in 2020 lived in New Haven, Bridgeport, Waterbury, Hartford, or other cities, according to state Department of Public Health numbers.
DPH Photo.
“The money is necessary to address a problem that is a wrong of the past,” said Manisha Juthani, MD, commissioner of the state Department of Public Health. “We need to do better in the state of Connecticut.”
The more enduring thrust of the state’s new actions, however, is the strengthening of its outdated lead laws, starting in 2023. The changes will increase early interventions by:
• Gradually lowering the blood lead levels that trigger parental notifications.
• Lowering the blood lead counts requiring home inspections.
• Requiring more frequent testing of children who live in areas where lead exposure is more common.
Under current law, parental notifications aren’t required unless a child’s blood lead level is 5 micrograms per deciliter or higher. Starting Jan. 1, 2023, the trigger for parental notifications will be 3.5 micrograms, the standard adopted by the American Academy of Pediatrics and the U.S. Centers for Disease Control and Prevention. If the state had used the CDC’s new measurement of 3.5 micrograms in 2020, the number of Connecticut children considered lead poisoned would triple to 3,000.
More significantly, perhaps, is that by Jan. 1, 2025, investigations into where and how a child has been poisoned will drop from the current trigger of 20 micrograms per deciliter to 5 micrograms per deciliter.
‘It’s A Start’
The $30 million for lead poisoning relief is from the state’s share of the 2021 American Rescue Plan Act (ARPA), the Biden administration’s COVID-19-relief legislation.
Department of Public Health Commissioner Manisha Juthani, MD, said the funds will be spent largely on remediating housing found to be the source of a child’s poisoning.
Abating a single home or apartment can cost between $12,000 and $15,000, Juthani said, adding that the ARPA money will remediate more than 1,500 housing units.
“It’s a start,” she said. “This may not remove the problem altogether, but the hope is that we can make a … dent.”
“We’re going to continue to explore funding opportunities that may be federal, that may be with other partners,” Juthani said. “This is always going to be an ongoing priority.”
DPH Photo
Lori Mathieu, DPH public health section chief, discusses the state’s lead abatement plans with Commissioner Juthani.
The federal government approved a bipartisan infrastructure measure in 2021, allocating $3 billion over the next five years to cover the costs of replacing lead-lined water pipes throughout the country.
Connecticut and the other states are conducting inventories to identify pipes that need to be replaced. “Right now, we have about 18,000 on a list of possible lead service lines,” said Lori Mathieu, DPH public health section chief.
Leaded water pipes cause about 20% of all lead poisoning cases in the state; nearly every other case is linked to leaded paint.
Lead Paint In Housing
Until it was banned in 1978, for more than a half-century, lead was added to house paint to boost its durability. Even painted over, it remains on the walls of older apartment buildings and homes. As the paint inevitably deteriorates, leaded chips and paint dust can be ingested by crawling babies and toddlers who, during this peak period of brain development, typically explore their new worlds using hand-to-mouth activities.
Once in the bloodstream, the heavy metal can cause permanent cognitive problems, including a measurable loss in IQ points, hearing loss, developmental delays, learning disabilities and hyperactivity.
For years, Connecticut law lagged behind the scientific findings that ever-smaller amounts of lead can cause irreversible harm to young children.
In testimony before the Public Health Committee in March, doctor after doctor described the dire and discriminatory landscape of lead poisoning.
“As a pediatrician who cares for children with lead toxicity, I have seen firsthand the devastating and long-term health effects that lead poisoning has on the physical and mental health of young children, in particular those under the age of 6.”
— Erin Nozetz, MD, chair of the New Haven Lead Task Force
“Right now, in Connecticut,” Nozetz said, “the risk of a child being poisoned and the response to that poisoning depends on the town that the child lives in. We also know that children from underrepresented minority populations are disproportionately affected by lead toxicity. I don’t know about you, but this infuriates me.”
Waterbury’s Efforts
Connecticut cities have some of the oldest housing in the country. Larger cities may each have well over 10,000 housing units built before lead paint was outlawed.
Waterbury has more than 14,500 such units, and the city consistently has some of the highest numbers of lead-poisoned children in the state, state DPH reports show.
The Brass City reported 81 lead-poisoned children under 6 in 2020, which is certainly an undercount because of the pandemic, said Public Health Director Aisling McGuckin. In 2018, the year before COVID-19 hit, Waterbury reported twice as many lead-poisoned children.
“Waterbury is predominantly a renter city,” McGuckin said. Healthy Homes, the federal program created to eliminate housing-related environmental hazards, has done a lot of work in the city, she said. But much work remains, as well as challenges, she said.
“Landlords can be hard to contact” if an apartment unit or home needs lead remediation, McGuckin said, so “families don’t have a lot of control.”
And there are the logistics involved in the numbers of children and families needing help.
In testimony urging passage of the lead legislation, McGuckin wrote, “Currently in Waterbury, we have two staff managing the lead case management work. In FY 2021, we had over 1,000 cases that under the proposed blood lead level limits would have provoked an investigation and follow-up.”
A Modernized System
New Haven was embroiled in a class-action lawsuit for over two years after the city quietly changed its criteria for investigating lead-poisoned children. Two top health officials, including the department’s director, left. Last summer, a state judge agreed with the New Haven Legal Assistance Association, which had brought the lawsuit, that New Haven was in the wrong.
When the new mayor, Justin Elicker, hired Bridgeport’s public health director to fix the embattled health department, Maritza Bond said she would involve a broad spectrum of the community in her efforts, including lawyers from New Haven Legal Assistance.
“We’re in an excellent position,” Bond said. “We’ve modernized systems. We have a lead dashboard. We’re tracking cases, updating them daily.” The department’s website contains maps highlighting areas with high numbers of lead cases.
The lead program is almost fully staffed. “In two years, we’ve gone from two inspectors to five, and we’re hiring for a sixth,” said Bond, who is running for secretary of the state.
And New Haven is inspecting the homes of lead-poisoned children whose blood lead levels are 5 micrograms per deciliter or higher. The state won’t require that until 2024.
To view the 2018 and 2019 childhood lead reports go here.
Scroll below to read the 2020 childhood lead poisoning report.
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Open in new tab Of the children tested that year, 649 were new cases.
As has been the case for many years, nearly half of the 1,024 lead-poisoned children lived in the state’s cities. New Haven had the highest number of lead-poisoned children, with 171, followed by Bridgeport, 148; Waterbury, 81; Hartford, 71; and Meriden, 35. These five cities had 49% of all lead-poisoned children in Connecticut in 2020.
Following suit, health disparities also continued. Black and Hispanic children continued to have higher rates of lead poisoning than non-Hispanic white children. Non-Hispanic Black children were 2.6 times more likely to be poisoned than white children, according to a report on the 2020 lead poisoning numbers on the state’s Open Data website.
Melanie Stengel Photo.
In October 2020, Charles Tate, a Bridgeport lead inspector, scanned the peeling side of a second-floor porch and found high levels of lead in the paint.
DPH Commissioner Manisha Juthani, M.D., said Tuesday, “Protecting the youngest residents of our state from lead poisoning is a priority for DPH. And even though the numbers show that we are heading in the right direction, our work — including linking families to vital resources and building awareness in our inner cities — is far from done.”
But these latest numbers are based on a calculation that the U.S. Centers for Disease Control and Prevention (CDC) and the state have used since 2012. That calculation defines lead poisoning as 5 micrograms of lead per deciliter of blood in a child’s body.
In October, the CDC lowered its definition of lead poisoning to 3.5 micrograms per deciliter.
If the state had used the CDC’s new measurement, or “reference value,” the number of Connecticut children considered lead poisoned would triple, to 3,000.
Even without the CDC’s adjustment, the pandemic complicates how to compare the numbers released to those from earlier years.
The DPH says in its report that “there was a sharp decline in screening” in April 2020, a month after the country started shutting down. A total of 61,700 children in Connecticut received lead blood tests in 2020, compared with 72,000 in 2019 and 73,000 in 2018. In addition, less than 60% of the state’s children under 3 years old were tested twice, as required by state law.
Although lead poisoning is notoriously linked to the water crisis in Flint, Mich., in 2014, lead poisoning in the Northeast and in other older parts of the country is usually the result of deteriorating interior and exterior house paint.
For close to a century, before the federal government finally banned its use in 1978, lead was added to paint to increase its durability. Although walls may be painted over, chips from the degrading paint can be leaded. Of particular concern is leaded paint dust, created as paint breaks down and is left behind when doors and windows of older homes are opened and shut.
Babies and toddlers are particularly vulnerable to deteriorating paint because they are close to the ground and their breathing rates are higher than that of adults. And, as any parent knows, young children typically explore their new worlds, quite literally, through hand-to-mouth activities, turning a floor with leaded paint chips and leaded dust into dangerous terrain.
Exposure to the heavy metal, particularly during these early years when children’s brains are developing, can cause permanent cognitive damage, including an irreversible loss in IQ points. The toxin is also linked to speech and developmental delays, hearing loss and hyperactivity.
In addition to the 2020 numbers, DPH this week issued the numbers of lead-poisoned children in 2019 – 1,188; and 2018 — 1,333.
To view the 2018 and 2019 childhood lead reports go here.
Scroll below to read the 2020 childhood lead poisoning report.
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Between March 19 and June 30, a group of scientists tested waste that had previously been used to detect COVID-19, looking for drugs and chemicals. The researchers found significant increases in three opioids, four antidepressants, and other chemicals in sludge from New Haven.
The analysis, by scientists from the Connecticut Agricultural Experiment Station (CAES) and Yale University, offered the first glimpses of how the pandemic’s stay-at-home orders affected people’s behavior. It also underscored how important human waste can be as a resource for understanding public health and society’s habits. Diseases, drugs and chemicals all show up in feces, providing a major tool for public health studies.
Sara L. Nason, a CAES scientist, is leading the waste analysis, which found increases in fentanyl, hydromorphone and methadone in sludge taken from primary settling tanks in New Haven.
Nason said the goal is to understand how the pandemic changed people’s habits and health.
“We hypothesize that the changes in chemical concentrations will reveal interesting trends that correlate with public health outcomes.”
— Sara L. Nason
Fentanyl’s increase in the New Haven population reflected “both increased use in hospitals for patients on ventilators, and the nationwide trend of increases in accidental overdose deaths from illegal use,” Nason said.
Five years ago, the testing of human feces for substances “was something that I would talk to other people about, funding agencies, and they would kind of roll their eyes and say, ‘Yeah…’ It was not too much on the radar back then,” said Jordan Peccia, a professor of chemical and environmental engineering at Yale University. Peccia is working with Nason on the analysis using frozen samples from another project on which Peccia is working, a COVID-19 testing effort that analyzes sludge from six Connecticut treatment plants. Peccia’s Yale laboratory collects data and publishes the information on a public website. The lab tests the concentrated substance found at the bottom of the tanks where waste entering sewage plants in New Haven, Bridgeport, Hartford, New London, Norwich and Stamford goes to settle.
Peccia and at least eight other scientists hope to expand the sludge testing “to other diseases, to other viruses, to other locations around the world where they don’t have testing,” he said. They have applied for National Institutes of Health funding.
Rising Drug Levels
Besides the opioids, the scientists found six antidepressants in the sludge, and six disinfectants. Sertraline (Zoloft) increased in March, before there were reported shortages of that drug. Three other drugs showed a clear rising trend over the spring: doxepin (Silenor), citalopram (Celeva), and amitriptyline (Elavil). Tracking these drugs during the pandemic was important, Nason said, because studies have linked psychiatric illnesses and COVID-19.
Nason explained it this way: studies have shown “people with psychiatric illnesses are at risk for being diagnosed with COVID-19, and that COVID-19 infection is associated with new diagnoses of psychiatric illnesses.”
Steven Geringer/Yale University Photo
Sludge samples are placed into test tubes at Yale University.
Three of the six cleaners they found in the sludge are common wipes and sprays with quaternary ammonium disinfectants, known as quats, which scientists in the last decade have linked to reproductive and developmental problems in animals.
Nason said the CAES/Yale team’s research focused on “substances whose use we expect to be affected by the pandemic, such as antidepressants, opioids, and antiviral drugs.” They compiled their key findings in a poster presented last fall to the Society for Environmental Toxicology and Chemistry. They plan to submit research papers for publication this winter.
The findings were mostly detected using a technique called suspect screening, in which a mass spectrometer collects molecular information and matches it through large databases. “Suspect screening is a very powerful technique because you don’t necessarily need to know what chemicals you are looking for ahead of time,” Nason said. “You find whatever signals in your data match the database entries. For example, we did not initially decide to look at disinfectants in the sludge, but we found several of them through our suspect screening analysis.” She added that they used other analytical standards to confirm their key findings, “so we are quite confident in our results.”
Peccia said the expansion of sludge testing could be used to study infectious diseases like norovirus; adenoviruses, which cause fevers, diarrhea, and more; all of the coronaviruses that cause colds; and bacterial diseases like tuberculosis and legionella, which causes legionnaire’s disease.
Sewage As A Resource
The long but spotty history of testing sewage for disease dates to the 1960s and a Yale study of the polio vaccine in Middletown. For at least 20 years scientists have been studying sewage, but much of their work focused on environmental issues. Human waste can reveal whether industry is following environmental regulations, and scientists can test for banned chemicals, such as fire retardants, linked to cancer.
These studies analyze the sludge left in the bottom of primary tanks after the water has settled. Scientists can also collect human waste by sampling the diluted soup of water and solid waste that flows under the streets.
Yale University Photo
Jordan Peccia
Peccia maintains that sampling the concentrated sludge is the most efficient method. Sewage treatment “takes in wastewater and it separates the bad stuff from the water. It puts out clean water, and then you have tons and tons and tons of material that was separated from that wastewater. Most of the bad stuff in the wastewater treatment plant gets left behind in the sludge,” he said.
However they are found — whether in the water known as “influent” or the settled sludge — Peccia said he estimates that more than half of infectious diseases show up in waste.
He said testing sewage could transform how doctors recognize and treat diseases where diagnosis is difficult and not always accurate, such as Lyme disease and other tick-borne illnesses, and Eastern equine encephalitis and other mosquito-carried diseases.
Tracking substances like nicotine, alcohol, heroin and opioids in sewage sludge shows how drug uses changes on weekends. “Those pieces of information are hard to come by otherwise,” Peccia said.
These studies will provide information that will correlate with other studies of human illness and behavior. “If hospital prescriptions and disposals of fentanyl increase over the same period of time as fentanyl concentrations in sludge increase, we can start to put together a story,” Nason said.
“But if that is not the case, the sludge data could be a sign for public health officials that illegal use needs to be further investigated,” Nason continued. “Overall, the sludge findings are most valuable when they can be supported with data from other sources that relate them to public health.”
]]>The paint around a window at the back of the house was deteriorating. Beneath the window was Rocio’s favorite play area, a sloping basement door that was the perfect ramp for an energetic toddler. Next to the basement door was a patch of dirt where she loved to scratch with sticks. White chips of paint were visible in the dirt.
The U.S. Centers for Disease Control and Prevention (CDC) says 5 micrograms or higher of lead per deciliter of blood constitutes lead poisoning.
Rocio’s mother, Fanny Quille, said her daughter’s blood tests show a lead count of over 70.
Lead poisoning, a major systemic crisis, damages the health and development of hundreds of thousands of children across the U.S. every year, including thousands in Connecticut.
Although Connecticut has worked hard in its fight against COVID-19, its efforts against the much older plague of lead poisoning have been halfhearted.
“Unfortunately, Americans, in typical style, tend to react to very dramatic things, but they don’t tend to react to the chronic stories,” said Yale pediatrician Carl R. Baum, M.D., director of Yale’s Lead Poisoning And Regional Treatment Center.
“For the most part, lead is an ongoing problem, and some of the lead levels that were seen in [the Flint water crisis of 2014] are nothing compared to what we see in New Haven,” Baum said.
He referred to one young patient the Yale clinic has been treating for over a year whose peak lead level was 118 micrograms. “And we still haven’t gotten it down to an acceptable level.”
Melanie Stengel Photo.
Investigator Charles Tate prepares to scan a doorway to a second-floor porch on Wood Avenue. The ceiling and railings are also peeling. Tate found high levels of lead in the paint.
The Connecticut Department of Public Health (DPH) has reported 14,000 cases of lead-poisoned children under 6 since 2012.
At least 2,000 children were poisoned every year from 2012 through 2016, DPH numbers show, with fewer cases reported in 2017 (1,665) and 2018 (1,332).
However, testing deficiencies and gaps in reporting by municipalities and medical providers mean the true number of lead-poisoned children in Connecticut is unknowable and almost certainly higher than DPH’s figures.
Then there’s the COVID-19 factor. Connecticut law requires children to be tested for lead twice before 3 years old. But Kaiser Health News recently reported “massive” reductions in lead testing in many parts of the country, including the Northeast. Lead blood tests are usually given at children’s 1- and 2-year-old checkups. Not only did the virus force many families to postpone or skip those visits, but people have also spent more time indoors, where children are most likely to be exposed to degrading leaded paint and lead dust.
One of the most poignant aspects of this crisis is that children are often poisoned by their own homes. The interior and exterior walls of hundreds of thousands of homes have undercoats of leaded paint, which wasn’t banned until 1978. As paint degrades, it chips and creates invisible leaded dust that can be inhaled or ingested by babies and toddlers as they become more active.
Connecticut children are also victims of the state’s weak lead inspection statutes, which reflects an extraordinary lack of urgency and concern for a problem that can cause permanent cognitive damage and neurological issues.
In 2012, in a major shift, the CDC stopped advising investigations into sources of poisoning based on a child’s lead level. Instead, the agency said, preventing any exposure to lead should be the priority because “No safe blood lead level in children has been identified.” It did, however, recommend case management if a child’s lead level was 5 micrograms or higher.
Melanie Stengel Photo.
Using an X-ray fluorescence (XRF) instrument, Bridgeport lead inspector Charles Tate prepares to scan an interior doorway of a multifamily Wood Avenue apartment. Looking on are Rocio Valladares, 2; and her brother Angel Valladares, 14.
In response, the other New England states toughened their laws and their actions.
In Maine, Vermont and Rhode Island, a 5-microgram lead test result now triggers an active investigation into how and where a child is being exposed. New Hampshire’s 7.5-microgram trigger is slated to drop to 5 in July, while Massachusetts requires investigation at 10 micrograms.
In an emailed statement, Jim Vannoy, an environmental health section chief at DPH, pointed out that Connecticut, in fact, adopted the CDC’s more stringent 5-microgram standard for action in lead-poisoning cases.
But state law doesn’t require active inquiry until a child’s lead blood count is at least three times — 15 micrograms in two tests given three months apart — or four times that level — 20 micrograms in a single test.
If a child shows 5 to 14 micrograms of the neurotoxin in a blood test, the state only requires a local health official to call the family or send them educational material about the dangers of lead.
Racial Inequities
Just as COVID-19 has spotlighted racial inequities in housing and health care nationwide, the lack of a concerted campaign against lead poisoning has racial and racist undertones.
Black children are poisoned at more than twice the rate of white children, and Hispanic children at 1½ times the rate, in part because Black and Hispanic families are more likely to live in older, substandard housing.
Despite Connecticut’s mandatory screening laws, and despite DPH efforts to reach Black and Hispanic families, just 13% of all children tested in 2017 were Black, its latest available breakdown of race and ethnicity numbers show. Twenty-six percent were Hispanic, and 61% were white.
Jennifer Haile, M.D., pediatrician at the Hartford Regional Lead Clinic, run by Connecticut Children’s Medical Center, said, “Just because we have [state] screening mandates doesn’t mean the pediatricians are actually doing it. The numbers are getting better, but they’re not great.”
David Rosner, professor at Columbia University and coauthor of “Lead Wars: The Politics of Science and the Fate of American Children,” said, “Lead is a major indicator of a much larger problem we have in our culture and the racism that pervades it.”
He added in an email,
“Do you think we’d allow this outrage to continue if it were suburban white children who were its primary victims?”
— David Rosner
An Insidious Enemy
For most of the 20th century, lead was added to paint to increase water-resistance and durability.
When ingested, lead’s damage can be irreversible. It’s especially harmful to babies and young children, who are at their peak period of brain development.
“Even low-level lead exposure can negatively impact a wide range of cognitive functions, such as attention, language, memory, cognitive flexibility, and visual-motor integration,” says a study on the website of the CDC’s Agency for Toxic Substances & Disease Registry.
In June, social scientists at Case Western Reserve University in Ohio published the results of their 20-year study into the “downstream” effects of lead exposure.
After following more than 10,000 Cleveland children from birth through early adulthood, the scientists concluded, “[C]hildren with elevated lead levels in early childhood have significantly worse outcomes on markers of school success, and higher rates of adverse events in adolescence and early adulthood, compared to their non-exposed peers.”
Exposed babies and toddlers are lead sponges.
“Kids who are younger absorb lead at [many] times the rate adults will absorb it,” said Dr. Hilda Slivak, founder and former director of the Hartford Regional Lead Clinic.
They’re closer to the ground, and their breathing rates are higher than that of adults. Because they learn by crawling, touching and tasting, a floor with leaded paint chips and leaded dust is hazardous terrain.
One City Does It Right
Residents in poorer cities are particularly at risk. Indeed, New Haven, Bridgeport and Hartford consistently have some of the state’s highest numbers of reported cases.
Hartford’s streets are lined with older, poorly maintained homes, quintessential sources of lead poisoning. From 2012 through 2018, the DPH reported nearly 1,150 lead-poisoned children in the Capital City.
Yet because investigations are required only when children’s lead blood levels hit 15 or 20 micrograms, Hartford’s lead program looked into less than 12% of those cases, its own numbers show. In 2018, when DPH reported 109 children with lead poisoning, the program conducted 7 investigations.
Melanie Stengel Photo.
Rocio Valladares, 2, lies on the couch in the Bridgeport home her family rents. She was found to have elevated levels of lead in her blood. High levels of lead were found in the peeling exterior paint near what had been her favorite play area.
New Haven invariably has the highest number of cases, with 2,266 children reported lead-poisoned from 2012 through 2018.
It reported investigating 24% of properties linked to children with elevated lead levels in that period. New Haven’s lead program has been mired in controversy over the past few years, and has been sued for inadequate inspection and enforcement of lead laws. The longtime program director and the city’s public health director have resigned.
Typically, investigations and lead abatement actions in Connecticut are triggered only by reports of a poisoned child.
Except in Bridgeport.
“We don’t have to wait till kids hit 15 or 20 [micrograms],” said Audrey Gaines, who, as Bridgeport’s code enforcement officer, manages environmental health, housing code and lead prevention.
“If it’s not supposed to be there, why are you waiting for it to get higher before you help them?” Gaines said.
DPH reported 2,000 cases of lead-poisoned children in the state’s largest city from 2012 through 2018.
But after 2013, numbers dropped annually, and dramatically. In 2013, the city reported a high of 402 cases. In 2018, the city reported 137, a 66% decrease.
This accomplishment so surprised Tsui-Min Hung, the longtime epidemiologist of the DPH lead program, that she called Gaines to ask what her secret was.
Rather than relying on a child’s blood test to point inspectors toward a contaminated home, inspectors focus on “what the actual problem is, and that is the housing stock,” Gaines said.
The city reported inspecting nearly 1,900 buildings from 2012 through 2018.
“If our housing code inspectors find something that is in violation, and if there are children in those houses, they report it to my lead inspectors,” Gaines said. “It’s not rocket science. It’s just simply working cohesively together.”
Gaines also uses Connecticut’s Uniform Relocation Assistance Act to move families when necessary.
Melanie Stengel Photo.
Lead investigator Charles Tate shows the XRF results after scanning wood trim on the house. Levels above 1.0mg/cm squared are actionable. Levels here are 31mg/cm squared.
“If … a landlord is not capable or not willing or cooperative enough to want to make the repairs in that unit, to make that unit lead-safe, then we start sending him to court,” she said. “And, according to that Relocation Assistance Act, that family can be moved.
“You’ve got to go beyond state [lead] law,” Gaines said. “It’s not going to create the culture to be progressive, to get what you want done.”
She said the city is working to enroll the owner of Rocio’s Wood Avenue home into a federal housing program that will cover the cost of lead abatement or removal. “Once the enrollment process is completed, all work will be completed within a week,” she said.
Angel Valladares, Rocio’s 14-year-old brother, says his sister, who will be 3 in February, “knows a few random words, but is not really speaking.”
Their mother worries, he said, because Rocio cries a lot. “She’s always crying,” Angel said.
And these days, he said, his mother “barely brings her outside.”
This story was supported by the Fund for Investigative Journalism in Washington, D.C.
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But more children showed higher levels of the toxin in their blood than in 2016, the report says. In 2016, there were 105 children whose blood lead level was 20 micrograms per deciliter of blood or higher, at least four times the measure at which they’re considered poisoned. In 2017, the number had risen to 120 children.
DPH epidemiologist Tsui-Min Hung said the improved overall numbers were at least partially due to the department’s more aggressive prevention activities, which 42 local health departments took advantage of, as well a social media campaign.
The report also shows that there were 1,034 new cases of young children with lead poisoning in 2017. That was 16% fewer than the 1,231 new cases in 2016, and nearly 30% fewer than the 1,473 reported in 2015.
The 2017 report is the DPH’s fifth since the Centers for Disease Control and Prevention (CDC) tightened its standards defining lead poisoning. CDC’s previous standard was 10 micrograms per deciliter of blood. The CDC now says that a child whose blood test shows 5 micrograms of lead per deciliter or higher is poisoned. It always adds that no level of lead in the blood is safe. Connecticut amended its own standard to mirror the CDC’s in 2013.
New Haven, Bridgeport, Waterbury and Hartford, in that order, had the highest numbers of children with elevated blood lead levels in 2017. Nearly half of all Connecticut children with lead poisoning in 2017 lived in those four cities.
New Haven’s rate was significantly higher than the other three cities’ rates, including Bridgeport, the state’s largest city. There were 290 New Haven children under age 6 who were lead poisoned in 2017. Forty percent—or 175 children—were new cases.
Although Bridgeport had the second-highest number of lead-poisoned children, 2017 was the city’s fifth consecutive year of declining numbers. Bridgeport reported 209 children with lead poisoning in 2017, compared with 402 children in 2013.
Hartford’s numbers also improved. Whereas 170 children under age 6 in the capital city had lead poisoning in 2016, that number fell to 145 in 2017, a 17% decrease.
Waterbury’s numbers fell 35% from 2016 to 2017, the report shows, from 218 young children with lead poisoning to 162 the next year.
Racial and ethnic disparities in lead-poisoning numbers decreased somewhat, according to the report, especially among young Hispanic children. DPH officials said the state’s lead program and the Latino and Puerto Rican Affairs Commission partnered in a media campaign that targeted the Hispanic population in 2016 and 2017. This resulted in lower numbers, although Hispanic children are still 1.4 times as likely to be poisoned as non-Hispanic children.
Black children remain more than twice as likely to have lead poisoning as white children.
CT Department of Public Health, 2002-2017
Number of lead-poisoned children under 6 years of age, by calendar year, and by blood lead levels.
Exposure to the heavy metal can damage cognitive ability, including an irreversible loss in IQ points. Lead poisoning is linked to speech and developmental delays, hyperactivity, hearing loss and behavioral problems, although these may not show up until years later.
The continuing lead problems in Flint, Mich., started several years ago when the city switched its public water source. Lead poisoning in older cities in the Northeast is usually attributable to lead paint, which was widely used before being banned by the federal government in 1978.
Even when older homes are painted over, paint chips can be leaded. Babies and toddlers, the most likely victims of lead poisoning, are also especially developmentally vulnerable to its harmful effects. These vital developmental years are defined by children’s hand-to-mouth exploring, making them more liable to ingest flaking paint chips. Another hazard is lead paint dust, created by doors and windows in older housing opening and shutting, grinding down the paint. Soil near the base of older, dilapidated buildings is also frequently contaminated.
The DPH report said that every Connecticut child had at least one lead test before turning 3, but state law requires two tests, one annually. Connecticut has struggled to reach its testing goal, although its numbers inched up to 57.4% in 2017.
The town-by-town results for lead-poisoned children.
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At the most inland tip are Santa Energy’s oil tanks. On the east side stretch asphalt runways at Pratt & Whitney’s test airport and a city landfill. On the west side stand O & G Industries sand and stone yard, an empty industrial building, a city landfill, a trash-to-energy plant, the regional aquaculture high school, a seaport, shops, a restaurant and sailing teams’ docks.
Last on this list is the Bridgeport West Side Water Pollution Control Facility, the city’s largest sewage treatment plant, which began work this year on a 20-year plan to correct chronic overflows.
All those buildings lie at the end of Bostwick Avenue, near the constant hum of I-95, a short distance from Seaside Park and within view of a historic lighthouse and beautifully restored park called St. Mary’s by the Sea.
Sewage filters and breaks down at the West Side plant. The treated effluent pours through a 72-inch discharge pipe into Black Rock Harbor. Several times a year, stormwater mixed with sewage overwhelms the system of pipes leading to the plant. Then untreated sewage and rain diverts directly into the harbor through combined sewer overflow (CSO) pipes. Although the city has shut down some of its CSO pipes, 30 of them still are active, including the five in the Black Rock area.
Graphic by Wes Rand.
Storms also regularly threaten the plant itself. Instead of flooding, the plant will speed that waste through a partial treatment called a plant bypass. Waste also bypasses treatment when equipment fails. Like the CSOs, the bypasses are legal and will remain so for decades.
The Legal Overflows
Every 10 days, on average, a sewage discharge flows into the harbor, according to July 2014-July 2019 data from DEEP. During that time span, CSO pipes in the Black Rock area discharged 99 times, and the West Side plant bypassed waste 85 times. CSO overflows were estimated between 100,000 gallons and 500,000 gallons. Bypasses ranged from 1 million to 16 million gallons each.
Of the five pipes in Black Rock reported overflows include:
• One at Admiral and Harbor Streets, at Santa Energy, which has overflowed 26 times since 2014.
• A CSO at St. Stephen’s Road and Anthony Street—the location of the Bridgeport Regional Vocational Aquaculture School—which has overflowed 22 times.
• The CSO nearest the neighborhood beach, Seabright Beach, sends untreated waste off Brewster Street and Seabright Street, overflowing four times in late October 2017.
The 85 bypasses of partially treated sewage over the last five years—varying from 1 million gallons to 16 million gallons—discharged from the plaint’s main pipe below the Captain’s Cove Seaport office and next to its restaurant deck.
Reports of bypasses from 2019 include:
• Between April 26 at 4:40 p.m. and April 27 at 3:45 a.m., nearly 12 million gallons
• July 12 between 1:25 and 4:15 a.m., 11 million gallons
• Between July 17 at 5:50 p.m. and July 18 at 2 a.m., 11 million gallons
• Between July 22 at 6:30 p.m. and July 23 at 1:30 a.m., nearly 10 million gallons
Christine Woodside Photo.
This CSO pipe is closest to Seabright Beach overflowing four times in five years, all in late October 2017.
Lauren McBennett Mappa has been the city’s water pollution control authority manager since January. She maintains that during heavy rainstorms, CSO pipes can overflow, but that the raw sewage being released is “very diluted,” and that it happens rarely.
The Orders
The state issued two orders to the city to correct its sewage overflow problems. Those orders cite violations of the federal discharge permit, issued through the National Pollutant Discharge Elimination System (NPDES).
Bridgeport’s required long-term control plan is designed to bring its sewage treatment into compliance with federal laws. By Nov. 30, 2020, the city must submit a report to the state detailing a schedule for completing upgrades to the plant. By May 31, 2022, “100% design plans shall be submitted” to the state. Construction on the upgrades must begin 4½ years from the date of the order, or September 2023, and must be finished by September 2026. The city and DEEP spent six years negotiating this plan, which requires new sludge storage tanks, odor control units and dryers. DEEP said chlorination and dichlorination of wastewater should have been automated a decade ago. The project is estimated to cost hundreds of millions of dollars to complete.
Melanie Stengel Photo.
Marcelo Borges, the West Side water treatment plant supervisor, explains the plant’s operations.
Those who work or relax near the plant’s discharge pipe, and near the five combined sewer overflow pipes that empty into this harbor, describe ugly-looking waste coming from the West Side plant at 205 Bostwick Ave. even on days when it is not raining.
Just ask Gail Robinson, who sells local real estate. Several years ago, she took a potential buyer to visit the open-air restaurant deck of Captain’s Cove Seaport. They stood admiring the view over the harbor. Then Robinson heard a gushing noise, and an ugly brown discharge rushed into the water just below her and her client. “I lost the sale,” said Robinson, who later founded the Ash Creek Conservation Association to advocate for clean water in that tributary of Black Rock Harbor.
Captain’s Cove Seaport manager Bruce Williams’ office overlooks the West Side’s discharge pipe. Often the discharge looks like chocolate mousse, he said. “There’s particle matter in that outflow. It settles and settles and settles, covering the bottom with a brown slurry a foot thick.”
Problems Persist In Other Cities
Melanie Stengel Photo.
Treated waste rushes through the chlorination channel at the West Side plant while Pollution Control Authority Manager Lauren McBennett Mappa, center, talks with two staffers.
Sewage problems aren’t unique to Bridgeport. The problem persists in three other Connecticut cities: New Haven, Hartford, and Norwich. “It went from 13 cities to four remaining,” said Jennifer Perry, assistant director of infrastructure management in the water bureau of DEEP. “We’ve been working with [all four] for a pretty extended period of time.”
In Hartford, a $300 million project to store untreated sewage underground during storms is under construction. New Haven’s 80-year-old sewage plant—also serving East Haven, Hamden, and Woodbridge—overflows regularly. A 2009 consent order dictated plant upgrades, separating storm and sewage pipes, and bioswales. The predicted completion date is 2036.
By permit—until they fix the problems over the next few decades—these cities may divert raw sewage mixed with rainwater directly into rivers, inlets and Long Island Sound.
Anyone spending time in Black Rock, smelling the plant and seeing the discharges and overflows, might ask: Why in an age of robots and space travel can’t society treat its own human waste without polluting its beloved waterways in a time frame faster than over 20 years?
Part of the reason is that the work involves undoing a century-old infrastructure in the state’s largest city, costing hundreds of millions of dollars. Perry said Bridgeport had resisted separating sewer from stormwater pipes because it costs so much. But the city has begun separating some of the pipes. For other areas, its plan is to build underground storage tanks that would hold waste during storms.
The city itself admits its sewage treatment plants fail. In a pamphlet Bridgeport distributes, it says its two plants don’t always properly operate, can’t handle flow from common storms and fail to meet the federal standard of “nine minimum controls” that include a ban on discharging waste on days when it isn’t raining.
Perry said she’s not sure people realize what happens in Bridgeport when it rains. “We as an agency talk about it, but I’m not sure many people pay that much attention,” she said. “It happens when it’s raining and no one’s outside.”
Since 2012, by law, the Department of Energy and Environmental Protection records sewage outflows on maps. You can view the maps here.
Coming tomorrow Part 3: Black Rock area residents, including high school students, spent the spring and summer cruising the harbor and Long Island Sound gathering water samples for testing. They’re part of the Long Island Sound Unified Water Study, and like many living and working in the area they’re tired of the smelly, brown-slick water and beaches closed to swimming.
This project was supported by a grant from the Society of Environmental Journalists – Fund for Environmental Journalism.
How C-HIT’s Christine Woodside reported this project: Christine Woodside had long wanted to understand why sewage overflows regularly in some of Connecticut’s cities. She settled on the Bridgeport neighborhood of Black Rock, on Black Rock Harbor and near the promenades of Seaside Park. There she found recreation, industry, and local people who were getting tired of pollution. She went to Black Rock at least a dozen times between late March and late July. She read sewage plan documents. She scouted. She tagged along with citizen scientists collecting water. She sought out the overflow pipes with diver/boat cleaner Kevin Blagys. She wandered around the docks, streets, beaches, and markets. This gave her a sense of the residents’ anxieties and the enormity of the project to stop overflows.
The Banking Committee is considering a bill that would create a task force to study better ways to finance the removal of the toxin from thousands of homes around the state. The task force would also investigate how to enforce abatement measures, including rental property inspections, and look into increasing workforce training in the specialized process needed to remove lead.
State Department of Public Health (DPH) numbers from 2015, the latest available, show more than 72,000 children under the age of 6 testing positive for some level of lead in their blood. More than 900 children were at levels two to four times the baseline at which a child is considered poisoned. Significant gaps in screening across the state mean those numbers could be even higher. The health disparities for lead poisoning among races and between Hispanic and non-Hispanic ethnicities remain, according to DPH.
Banking committee co-chairman and the bill’s author, Rep. Matthew L. Lesser, D-Middletown, said in an email, “My hope is that we can bring stakeholders together to identify financing models to help landlords and homeowners upgrade our existing housing units and tackle this health crisis systematically.”
Dr. Mark A. Mitchell, an environmental health physician and founder of the Connecticut Coalition for Environmental Justice, said in public hearing testimony on the bill that exposure to lead “causes damage to a child’s brain and nervous system, slowing growth and development.
“These effects are permanent and lead to hearing and speech problems, lower IQ, decreased ability to pay attention, learning disabilities and underperformance in school,” he said. “[L]ead poisoning has long-term costs on health care, lifetime earnings, tax revenues and future criminal activity,” Mitchell said.
In just the past five years, the U.S. Department of Housing and Urban Development has funneled nearly $40 million to Connecticut for lead abatement and related activities. That includes $12.6 million this year. Since 2003, the nonprofit Connecticut Children’s Healthy Homes Program, which is based at Connecticut Children’s Medical Center in Hartford and focuses on 15 towns, has received more than $31 million in federal money to remediate more than 2,200 homes.
In addition to state agencies and Healthy Homes, money goes directly to municipalities. New Haven, for example, received more than $3 million in a multiyear grant in 2015. Bridgeport, the state’s largest city, however, has received nothing from Washington since its $2.5 million allocation ran out in October 2016, said the lead program’s director, Audrey Gaines, although it received $2.5 million in HUD’s latest round of funding and will restart lead abatement work May 1.
Lead-based paint was not outlawed until 1978. The National Center for Healthy Housing shows 61 percent of Connecticut housing, or tens of thousands of homes and housing units, was built before then.
Mitchell told the banking committee that in just the past few years, scientists have come to understand that much lower levels of lead than previously thought are harmful to children.
Helen Li, a fellow at Connecticut Legal Services in New Haven, said Connecticut is behind other states, and the science, in its legal trigger for official action. Health officials in Maine, Massachusetts, Rhode Island and New Hampshire, for example, must investigate if a child’s blood test shows 5 micrograms per deciliter of lead or more. This corresponds with the U.S. Centers for Disease Control and Prevention’s definition of lead poisoning.
Li noted that Connecticut law doesn’t require an investigation unless a blood test shows 20 micrograms of lead or more, or if two separate tests taken at least three months apart show 15 to 20 micrograms of the toxin.
Lead most frequently endangers young children, whose exposure risk coincides with their peak period of brain development.
Babies and toddlers are unstoppable movers and explorers. Through frequent hand-to-mouth activity, they may ingest lead through peeling lead paint chips, which taste sweet, and lead dust, created as doors and windows in older housing open and close over the years, grinding down the paint.
Its immediate impact can be subtle or even imperceptible, since the symptoms of lead poisoning are not uncommon: loss of appetite, fatigue, abdominal pain, constipation or diarrhea, irritability.
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