It’s a disparity that is playing out in courtrooms across the state, according to public defenders who contend that Black and brown women often face harsher penalties and longer court proceedings to gain a favorable outcome.

“This is real, it is very real,” said Jassette Henry, a senior assistant public defender in New Britain and a tri-chair of the Racial Justice and Cultural Competency Committee within the state’s Division of Public Defender Services. “The question is, what are we going to do about it?”

“Black people are overrepresented in arrests,” Henry said. “It’s not surprising that Black women are getting arrested in a domestic violence incident at a higher rate. They call police and wind up arrested. It’s also about how they are treated in the system and what kind of hoops they have to go through to get a favorable disposition. It’s very disturbing. This is a real issue.”

According to Judicial Branch figures analyzed by C-HIT, in 2020, Black women were charged in 2,118 domestic violence cases, and Hispanic women were charged in 1,525 cases compared with white women, who were charged in 2,963 domestic violence cases during the same period.  The cases include females 18 years and older.

The inequality is not new, the data show. Black and Hispanic women made up an average of 49% of the domestic violence cases filed against adult women from 2016 to 2019, even as overall domestic violence cases involving females dropped from 8,160 to 6,772.

The demographic data was compiled from police arrest reports, Judicial Branch officials said. The cases range from disorderly conduct to murder, officials said.

Adult white women make up about 75% of the state’s female population, according to estimates provided by the U.S. Census American Community Survey. Adult Black women make up 10.8%, and adult Hispanic women make up about 14.4% of the population.

“The domestic violence arrests are a microcosm of what you’re seeing in the wider system,” said Christine Rapillo, the state’s chief public defender who runs the Division of Public Defender Services. “Poverty drives a lot of this. We see higher rates of arrest in poorer communities, which tend to be communities of color.”

Lack Of Diversity In Criminal Justice, Understanding The Culture

One problem is that there isn’t much employee diversity in the state’s criminal justice system positions that deal with defendants of color, Henry said.

“There are offices in the division that have no Black or Hispanic public defenders,” Henry said. “If attorneys don’t understand our culture, how can they advocate for their clients? How do we deal with this inside the courtroom when we are in front of a white judge or a white prosecutor? And how do we educate our public defenders who are not people of color to understand our culture?”

The key is hiring a more diverse workforce and educating law enforcement and court staff, including judges, in cultural competency, Rapillo said.

“If you have never stood in the shoes of a Black woman, you aren’t going to know what cultural factors are driving the situation. We need a more diverse workforce, and we can educate people to be more aware. Diversity brings different perspectives to the work.”

— Christine Rapillo

The Division of Criminal Justice, which encompasses the state’s prosecutors, is committed to hiring people of diverse backgrounds, thoughts and experiences, according to a statement issued by the agency. “The Division is continually working to assemble a staff that reflects the communities we serve because we believe diversity strengthens the Division and bolsters trust in the criminal justice system,” the statement said.

The agency said decisions about whether to pursue criminal cases are based on the facts of the case, the evidence and the law. “Prosecutors in Connecticut strive every day to achieve justice for all parties involved in a case, making sure to consider the needs of the victims and the safety of society,” the agency said.

New Approaches: Connecting Women To Services

Service providers contend that they serve victims of domestic violence in a culturally competent way. But many acknowledged that the coronavirus pandemic highlighted inequities in the system and forced providers to seek ways to engage more women of color to seek services.

Black women may be more hesitant to call police or seek services because the arrest of a partner could mean a loss of income, or a protective order could bar a partner from contact, which could lead to childcare issues for the victim, some providers said.

“Overall, our services are pretty evenly split among demographic groups,” said Maria Guzman, director of Safe Connect, a program offered by the Connecticut Coalition Against Domestic Violence (CCADV). But disparities in the way cases are handled can still exist “in ways we don’t recognize,” Guzman said.

New Britain Herald Photo.

Barbara Damon, executive director of the Prudence Crandall Center, said that the pandemic highlighted areas where service providers need to do better.

CCADV is the umbrella organization for the state’s 18 providers that offer shelter and counseling to victims of domestic violence. Statewide, about 60% of clients are white, 30% are Hispanic and 20% are Black, according to Tanya Johnson, CCADV’s vice president of operations.

“We recognize that there are many people who will not come through traditional brick-and-mortar service providers,” Johnson said. “They go to faith-based and smaller providers. It’s very formidable for people to seek help when English isn’t their first language or if they are experiencing extreme poverty.”

Women of color are perceived as strong and able to take care of themselves and their families, Guzman said. “That can lead to some hard decisions,” she said. “Do I ask law enforcement to intervene when communities of color are being incarcerated at higher rates? Communities of color are much more conscious of police brutality. Law enforcement may not always be the best option. We have to offer options that are relevant for them.”

CCADV started a program last year to provide training in English and Spanish to faith-based communities so the organizations can recognize domestic violence and connect victims with resources since many women of color will not turn to regular channels for help.

“We train faith-based leaders in how to have the difficult conversation about domestic violence and how to do outreach to break the silence of domestic violence,” said Wanda Gaines, director of diversity and accessibility for CCADV, who conducts the training in Spanish. “We know that different cultures don’t want to talk about domestic violence. We are teaching leaders what domestic violence is and how to bring this into their conversations with people.”

The Center for Family Justice, which provides shelter and domestic violence services in Bridgeport and surrounding towns, also offers outreach through a Latinx team that goes to churches and into the community.

“When we think about who we trust, women of color are not going to be walking into the police department to seek help,” said center CEO and President Debra Greenwood. “You have to ask women of color, what are your experiences? Some have sons, and they say I’m afraid they can’t be out on the street. When you are afraid, you have a mindset that immediately puts a wall up.”

The pandemic and the social justice issues that came to the forefront in 2020 highlighted areas where domestic violence service providers needed to do better, said Barbara Damon, executive director of the Prudence Crandall Center in New Britain.

Sometimes it means crafting a safety plan that doesn’t include police, she said. “It’s easy for us to think we know what the best thing is in any situation,” Damon said. “But that’s not always true. Now we’re talking about how you can be as safe as possible. The key for us is not to give in to stereotypes and meeting people where they are and taking the time to understand white privilege and the built-in racism in our society. We can’t do this work without that understanding.”

After a quiet period during the first months of the pandemic, when much of the state was locked down, domestic violence shelters started running at about 150% capacity during the summer months. When providers ran out of room for social distancing, clients had to be placed in hotels and fed.

It’s been a complex time, said Verano, the executive director of Safe Futures, a New London-based nonprofit dedicated to providing counseling, services and shelter to victims of domestic violence in 21 southeastern towns. Safe Futures’ budget for hoteling clients has increased steadily this year.

“Everyone is overtaxed. Everybody needs resources. The effect on nonprofits has been dramatic. It’s very challenging, very stressful.”

Katherine Verano

Throughout the state, the 18 nonprofits that make up a network of service providers for domestic violence victims are seeing a combined $350,000 gap in their budgets as of Sept. 1, primarily due to increased hotel costs, according to Liza Andrews, director of Public Policy and Communications for the Connecticut Coalition Against Domestic Violence (CCADV).

“Shelter utilization has been up for everyone,” particularly in urban areas, Andrews said.

Anecdotal evidence also suggests that domestic violence incidents have been more violent during the pandemic, shelter managers say. But at the same time, the number of deaths due to intimate partner violence has dropped this year from an average of 14 a year to six confirmed and two unconfirmed as of the end of last week, state officials said.

CCADV Chief Executive Officer Karen Jarmoc is working on ways to fill the budget gap. But Andrews said nonprofits throughout the state that also have been impacted by the public health crisis are competing for the same federal funding and private donation dollars.

iStock Photo.

The 18 nonprofit domestic violence shelters are seeing a combined $350,000 gap in their budgets.

Safe Futures and the Prudence Crandall Center in New Britain racked up more than $60,000 each in hotel costs through the end of August, Andrews said. The tally doesn’t include money to feed the victims who are being housed at hotels. Interval House in Hartford has spent over $50,000 in hotel costs.

Barbara Damon, who heads the Prudence Crandall Center, is calling on private donors to help close the organization’s $70,000 budget gap.

“It’s been an interesting time,” Damon said. “Calls for our services in March, April and the beginning of May were flat or decreased, including those people who were looking for shelter.”

But as the state opened up in May, “all of that changed,” Damon said. “We have a 22-bed shelter and had 37 people who needed shelter. We had 18 in hotel rooms just to keep up.”

Damon also said that incidents appear to be getting more serious. “We’re seeing much more severe abuse and really high-risk cases,” Damon said. “These folks really don’t have any other place to go.”

Like at other shelters, calls for service at The Center for Family Justice in Bridgeport had dropped at the start of the pandemic, said Debra Greenwood, president and chief operating officer. But the number of new clients has increased by 58% since then, Greenwood said. The Bridgeport center has spent more than $20,000 for hotels and food.

“There was a point where we weren’t getting phone calls back because people were afraid to. Communication dropped by 40%. But they started coming to the front door and talking to us through the intercom.” 

Debra Greenwood

There are a couple of explanations for the decrease in the number of calls for help as families were required to stay home in close quarters during the state’s prolonged shutdown, providers said. Victims may have been unable to call because the abuser has been home due to restrictions or reduced work hours, some providers said. It’s nearly impossible to file for a restraining order online while the abuser is home every day, Verano said.

“Some people are saying things are getting worse because of the stress put on families. Financial issues are always a big trigger for an abuser who feels the need to control things,” Andrews said. “We’ve heard from others that it’s been better because the abuser feels completely in control because everyone is home.”

But Verano also thinks it was because victims were making sure to tread more carefully so as not to anger an abuser. “As a victim, I’m going to minimize me so much. I’m not going to fight back, and I’m not going to leave,” Verano said.

People were afraid to go to a shelter during the height of the pandemic since it meant a congregate living situation where the virus can easily spread, Verano said. “There were so many factors for a victim in leaving at that time,” she said.

Statewide shelters are now at 122% capacity, which is on par with the months before the pandemic. But Andrews cautioned that the $350,000 shortfall as of Aug. 31 might increase by the end of the year if the need to hotel more victims rises again, Andrews said.

Verano was still in the process of digging out from the $60,000 deficit when New London recently became a hot spot for increasing COVID-19 infections.

State officials issued an alert last Thursday asking New London residents to take extra precautions, such as limiting trips outside the house and using masks, as positive tests for COVID-19 and hospitalizations are on the rise.

Last year, from March to August, Verano spent $7,220.47 in hotel costs. This year during the same period, she spent $67,202—nearly an 830% increase.

“We’re seeing much more severe abuse and really high-risk cases. These folks really don’t have any other place to go.”

 

Barbara Damon

 

The increased hotel costs were due in part to Verano’s inability to transfer clients to other shelters throughout the state as the pandemic made its way through Connecticut. By August, when the number of COVID-19 cases had gone down, she was able to send some clients to other towns. But now she’s looking at the potential for a wave of new victims seeking shelter who can’t be placed in other parts of the state because of the uptick in cases in New London.

It’s “very concerning,” she said. “What this means is that our hotel costs will escalate once again.”

Verano has received some federal, grant and foundation funding and private donations to make up the difference and Safe Futures hosted a fundraiser recently. But it’s not going to be enough, she said.

“We had our walk. Unfortunately, we did not reach our goal as everyone is pretty tapped out,” Verano said.

Need to connect to a domestic violence advocate?  Call or text: 1-888-774-2900 or go to CTSafeConnect.org

In 2005, Ebony Murphy-Root totaled her car coming home from the Big E.

The timing was horrible. Murphy-Root had been on her parents’ insurance plan until just two weeks before, when she’d aged out. At the time, Connecticut was one of a handful of states that allowed young adults to stay on their parents’ policies beyond age 18.

Growing up, Murphy-Root’s father was a Teamster truck driver, and the family enjoyed robust coverage, and this was her first time as an uninsured patient in a hospital emergency room, waiting to be told she was OK, if shook up.

It was also the first time Murphy-Root, now a sixth-grade literacy teacher at Hartford’s Jumoke Academy Charter School, said she felt “shabbily treated at a hospital or medical facility. I had to wait hours on a stretcher in a hallway to be seen, and it was clear it was because I was uninsured.”

Her bill was $2,000, and with early annual salaries hovering around $25,000, she was years paying it off, at $20 and $25 at a time.

These days, because of the Affordable Care Act (ACA), Murphy-Root, whose current insurance plan covers both her and her husband for about $250 a month, will enjoy birth control without co-pays, and she won’t have to pay more for insurance simply because she is a woman.

Because of the ACA, Connecticut’s women are stepping onto a new health care landscape, when after Aug. 1, a host of preventive health care services for women—such as mammograms and domestic violence counseling and screening—are offered without cost-sharing on all new insurance policies.

A study released in July by The Commonwealth Fund estimates that 18.7 million women between ages 19 and 64 were uninsured in 2010 prior to the implementation of the ACA – nearly 6 million more than a decade earlier.

The report said an additional 16.7 million had such high out-of-pocket costs that they were significantly underinsured.

That meant a higher percentage of U.S. women went without health care than in Canada, France, and the United Kingdom combined. Prior to the implementation of the ACA, says the report, 12.2 percent of Connecticut’s women were uninsured, compared to 5.2 percent once it’s fully implemented.

But even among women fortunate enough to be insured, things are not entirely rosy. A recent study from the National Women’s Law Center says the newly insured among Connecticut’s women are mostly black and Latina/Hispanic—and that’s a good thing. But according to the law center, insurance plans in Connecticut and elsewhere practice gender rating, or charging substantially more for women’s coverage, sometimes as much as 150 percent.

In fact, the March 2012 study said that 60 percent of the plans in Connecticut charged female non-smokers more than male smokers.

When they can afford it, women tend to seek health care more than men, says Jennifer Jaff, executive director of Advocacy for Patients with Chronic Illness, a Farmington-based advocacy group.

That makes gender rating that much more egregious. The health care law eliminates that practice, which the center estimated cost women $1 billion a year, and inspired their slogan three years ago, “Being A Woman Is Not A Pre-Existing Condition.”

Like many, Murphy-Root said she’d hoped for single-payer – where one entity, such as the federal government, acts as administrator of health care costs and payments – but she said, “at least the U.S. is moving toward a more humane model. The wealthiest nation in the world should not be counted as one of the very few nations not to offer her citizens protection from being bankrupted by medical costs.”

The survey found that 28 percent of women had not had an ob-gyn exam in the past year.  Among minority women, 38 percent had not had an ob-gyn exam in the past year; and for young women 18 to 29, the number was 36 percent. One in 10 minority women reported they had not seen a gynecologist or a primary care doctor in the past year. That is double the rate reported by white women. Young and minority women were also less likely to get pap smears on schedule.

The findings come from a survey of 1,000 women between the ages of 18 and 54 commissioned by Women’s Health Connecticut, a company that provides management services for physician practices.

The survey did not identify the causes of these disparities, said Dr. Mark DeFrancesco, chief medical officer for Women’s Health Connecticut and a gynecologist practicing in Waterbury.  Racial health disparities are well documented nationally, he said, but “maybe there are subtle things that happen (that contribute to the problem) and we can educate our doctors.”

DeFrancesco found it easier to explain young women’s neglect of an annual exam. “Younger people are going to feel more immortal and don’t care about health care as much,” he said.

Young women reported problems talking with their gynecologists. They are less likely than older women to strongly agree that their typical interactions with their ob-gyn are comfortable (57 percent vs. 73 percent). Sixty percent of young women said that they trusted their gynecologist, for older women it was 75 percent.

Less than half of all women said they were “very satisfied” with the information they got from their doctors about common health issues. They reported being even less satisfied with the information they got on sensitive issues, such as infertility and pain during intercourse, and also said they were less comfortable discussing those topics.

“Doctors don’t have the time they used to have to spend with patients,” said DeFrancesco. During limited office visits, physicians must “learn to be more receptive,” he said. Working with nurse practitioners and midwives can offer patients more contact, he added.

The survey also found that only 52 percent of women knew the age at which they should start getting mammograms or how often they should get pap smears. Women’s Health Connecticut CEO Nancy Bernstein pointed out that guidelines for both tests changed in 2009, perhaps creating confusion for women.

In 2009, U.S. Preventive Services Task Force, an expert panel that reviewed the literature on breast cancer screenings, recommended that most women begin mammograms at age 50. The National Cancer Institute and American Cancer Society, however, continue to recommend that the screenings begin at age 40. Also in 2009, the American College of Obstetricians and Gynecologists recommended that women have pap tests every other year beginning at age 21. Frequency can decrease with age and a series of negative tests, according to the college.

The complexity of the guidelines reinforces the need for providers to be up-to-date and to talk with their patients about health screenings, said DeFrancesco. Furthermore, they need to let women know that an exam is “not just a pap smear” but an opportunity to address issues ranging from domestic violence to weight and smoking. “We need to redesign the annual visit,” he said.

The survey underlines the need to make every doctor’s office “a judgment-free zone,” said Bernstein, and should encourage doctors to proactively ask about subjects women may be uncomfortable raising themselves. “We need to make sure they are satisfied so that they will come back,” she said.

Tony Bacewicz photo

Yanisha Claudio, 15, cuddles her son, Jordan. Jennifer Colon of the Nurturing Families Network looks on.

It’s been a tough year for Claudio, whose boyfriend broke up with her after a trip to the emergency room confirmed she was more than five months pregnant. At home for now, Claudio juggles the demands of being a mother and a student with help from a daily tutor, a case worker who visits weekly, and the baby’s grandmother, a former teen mother herself.

“I never thought this would happen to me,” said Claudio. “I don’t know anything about being a mother.”

While teen pregnancy rates have declined nationwide and in Connecticut, statistics and interviews show an intergenerational cycle of children-bearing-children puts Hispanic teens in Connecticut at risk of giving birth once, or even twice, before their twenties.

Hispanic teen birth rates in Connecticut are 8.5 times higher than whites and almost double that of African Americans for girls ages 15 to 19. Of the 2,626 teen births in 2009, almost half – 1,277 – were to Hispanics, according to data from the state Department of Public Health.

Of the 22 births to teen moms ages 13 and 14, more than half – 12 girls – were to Hispanics. Nearly 15 percent of all teen births in the state were to girls who were already mothers. The rate was similar in 2008: of the 2,817 teen births, 1,364 were to Hispanic teens. Hispanics make up just 13 percent of the state’s population.

LISTEN TO FIRST PERSON: Candida Flores helps teen mothers.

To read related story on programs available to help teens click here.

In Connecticut, 84 percent of births to teen moms (ages 15 to 19) in 2009 were to low-income mothers enrolled in the publicly subsidized HUSKY or Medicaid health plans. The number of births to teens in these programs remains steady, immune to the declines statewide and nationally.

“We need to figure out what we are not doing, because what we are doing clearly isn’t working,” said Candida Flores, executive director of Family Life Education, a community-based agency in Hartford that assists pregnant and parenting teens. Flores, who had her first child at age 15, knows firsthand the challenges teen mothers face.

“Many of the girls we serve are in situations where pregnant teens are the norm,” she said. “Many are the daughters of teenage moms who are still struggling with their own issues. We end up helping both generations of mothers.”

Tony Bacewicz photo

Yanisha gives Jordan to Colon, who is there to help her care for her baby.

Advocates hope $6.4 million in federal funds targeting at-risk Hispanic and African American teens in Connecticut’s poorest cities, including New Haven, Hartford and Bridgeport, will make a difference by reaching youth at home, at school and in the community in ways that resonate with their culture and language.

But many experts say little will change until the state marshals the financial resources and political will to address the underlying issues of poverty, domestic violence, education achievement gaps, unemployment, health disparities, cultural nuances and lack of hope that impact Hispanic youth.

Complicating matters for Hispanic teens are language and cultural factors that research shows put Hispanics at greater risk of becoming parents, cited experts. These run the gamut from strictly defined gender roles and machismo, to religious beliefs that ban contraception and abortion, to the tendency for Hispanics to have older sexual partners.

“Cultural belief systems are difficult to change because they are rooted in centuries of traditions and customs,” said Dr. Raul Pino, acting director of Hartford’s Department of Health and Human Services.

Fast-growing Community, Multiple Needs

At 13 percent of the state’s population, Connecticut’s Hispanic community is growing at a dramatic rate – almost 50 percent during the past decade – while at the same time experiencing increasing social and health inequities.

Almost a third of Hispanic children ages 17 and younger live in poverty. Almost 22 percent of all Hispanics have no health insurance, leaving families with limited access to health care services.  Connecticut’s Hispanics had the third highest unemployment rate in the nation among Hispanics in 2010, according to the Economic Policy Institute, a Washington, D.C. think tank. Hispanics had a four-year high school graduation rate of 64 percent in 2010, according to state Department of Education data.

Studies show teen parents are more likely to drop out of school and live in poverty, while babies born to teen parents are at a higher risk for low birth weight and infant mortality.

“All the indicators for Latinos in Connecticut point to a community in crisis,” said Werner Oyanadel, acting executive director of the state Latino and Puerto Rican Affairs Commission.

Tony Bacewicz photo

As a public health issue, teen childbearing cost state taxpayers at least $137 million in 2008 for public health care, child welfare, incarceration and lost tax revenue due to decreased earnings and spending, reports the National Campaign to Prevent Teen and Unplanned Pregnancy.

“People who don’t believe we should focus on teenage pregnancy because it’s the right thing to do should think about their wallets because society pays a price one way or another,” said Pino.

Connecticut’s changing Hispanic community has brought new challenges to neighborhood-based organizations that at times serve as surrogate families to newcomers. Once almost exclusively Puerto Rican, the Hispanic community has grown in the past 10 years to include Latin American immigrants from Mexico (now the state’s second largest Hispanic sub-group), the Dominican Republic, Guatemala, Ecuador, Peru, Columbia and other countries.

Research shows health status and behavior vary within Hispanic subgroups and the length of time they have lived in the United States.

Although everyone speaks Spanish, each sub-group “comes with their own beliefs and traditions” about sexuality, said Flores. Undocumented immigrants are among the most vulnerable.

“Many times these families live in isolation. The children don’t have an adult figure to guide them. They’re afraid or don’t know how to access resources.” Her agency takes a holistic approach.

“Many girls become invisible once they have their baby. People tell them to be good mothers. But what does that mean?” Flores said. “They need to understand that they are not bad mothers and that their teenage brains are still developing.”

Boys need special attention, too. The FatherWorks Program at the Village for Families & Children in Hartford helps fathers ages 15 to 24 to understand the “culture of conquest’’ that drives some males to “engage in risky sexual behavior’’ that lead to pregnancies with multiple partners, said Aldwin Allen, the program’s director. The agency has a federal grant to conduct a longitudinal study of its program.  “We need to create a safe environment for these conversations to take place with men,’’ he said.

Self Esteem, Self Worth

The Department of Social Services (DSS) spends about $2 million a year on teen-pregnancy prevention programs in 13 communities where teen birth rates exceed the state average.

Tony Bacewicz photo

“These programs help teens develop self esteem and self worth so they can make better choices and see themselves outside of their community,” said LoriBeth Young, lead planning analyst with the Bureau of Aging, Community and Social Work Services at DSS.

“Teens living in limited communities often have a difficult time seeing their lives outside the few blocks they live in unless they are shown it’s possible. They don’t see themselves with bright futures.”

Jessica Valentin, 28, is a mother of four who had three children by age 20. Today, Valentin works as a certified nursing assistant and is a former peer facilitator at the M.O.M.S. program offered by The Hospital for Central Connecticut in New Britain – the same program that guided her when she became a teen mom.

“This program helped me grow into a strong, independent woman, able to care for my children and hopefully lead them in the right way so they won’t make wrong choices,” she said. “Teens get pregnant for many reasons. My mother was the greatest. But she was a single mom raising five children, so she was always working. I was lonely and looking for love and attention when I met the father of my children. I didn’t realize the consequences of my actions.”

Valentin said parents “need to be more open and start educating their children at an early age so they can think for themselves,” even if the conversations are difficult. “Sometimes girls get pregnant because they get raped. But people don’t talk about the abuse that takes place,” she said.

Community outreach remains the most effective way to reach teens, said Dr. Leticia Marulanda, director of Programs at the Hispanic Health Council in Hartford. She points to initiatives now underway that bring evidenced-based information and intensive personalized services directly to teens at home, in school-based health clinics and at community-based organizations. These initiatives call for cross-cultural training of outreach workers, educators and others.

In Hartford, a $4.5 million federally funded grant aims to cut the city’s teen pregnancy rate by 10 percent. Another $1.9 million in federal funding for the Support Pregnant and Parenting Teens program targets boys and girls in the five Connecticut cities with the highest teen pregnancy and high school dropout rates – Bridgeport, Hartford, New Britain, New Haven and Waterbury. These cities accounted for half of all teen births in 2009.

“We’re changing the message to teens from ‘you’ve been bad and need to redeem yourself’ to a more positive and empowering approach, with supports that help teens and their children move through this critical stage in their lives,” said Grace Damio, director of Research and Service Initiatives at the Hispanic Health Council, which is providing cross-cultural training and creating an online resource for parenting teens.

The high number of Hispanic births, noted Marulanda, is partly due to cultural and religious beliefs that discourage abortion. “Latinas tend to keep their pregnancies so their delivery numbers are higher,” she said.

Jennifer Colon, a home visitor with Nurturing Families Network (NFN), said teens like Yanisha Claudio are “among the lucky ones” because they have family support. “We see homes with child abuse and neglect where the state needs to intervene,” she said.

Teens comprise half of the 2,000 mothers in NFN, a statewide system that provides home visits, education and support to first-time, at-risk parents and their children for five years.

Some schools have support programs for teen mothers that include child care.

At Wilbur Cross High School in New Haven, teens can access parenting classes and a school-based health clinic while their children attend a licensed day care facility that keeps track of developmental milestones. The day begins early at the Elizabeth Celotto Child Care Center, as teens arrive with infants and toddlers in one arm and car seats and book bags in another.

“I’m in awe of these young ladies,” said Lorraine DeLuz, the center’ director. Last year, all but one of the center’s seniors graduated, and more than half were accepted to college and post-secondary school training programs.

Maria Damiani, director of Maternal Child and Family Health and Wellness for the New Haven Health Department, views school-based health clinics as the ideal vehicle for delivering reproductive health information and services to teens.

“School-based health clinics provide holistic care from nurse practitioners who know the kids,” she said. “It’s a safe and welcoming environment where students can talk honestly about what is going on in their lives.”

Hope Through Early Intervention

RoseAnne Bilodeau, executive director of Pathways/Senderos Center in New Britain, finds hope in the “army of feminists” among Hispanics in the teen-pregnancy prevention program.

“It’s outstanding to see what happens when girls who come from tough backgrounds believe they can do something with their lives and start channeling that energy,” said Bilodeau.

Among those finding her voice is Alondra Vasquez, a New Britain eighth-grader in the Pathways program.

“To be honest, I was thinking of having a baby when I was 14 or 15 because it’s the thing to do,” said Vasquez. “There’s a lot of pressure from girls and boys to have sex, but mostly boys who say they will beat you or leave you unless you have sex.” Learning about the realities of becoming sexually active at a young age changed her mind.

“Now I think I’ll wait until I have a good job and can take care of my baby,” she said.

EN PRIMERA PERSONA: Candida Flores ayuda a madres adolescentes.

To listen to WNPR’s report on this project click here.

Magaly Olivero wrote this story and helped produce the podcasts for C-HIT while participating in The California Endowment Health Journalism Fellowship, a program of the University of Southern California’s Annenberg School for Communication and Journalism.

Colleen Shaddox produced the podcasts for C-HIT.

The report—“Army 2020: Generating Health & Discipline in the Force”—shows the suicide rate among active-duty soldiers reaching a new high in 2011 of about 24.1 per 100,000—up from 9.6 per 100,000 in 2004. In terms of stressors, military work stress was the leading factor in suicides in 2010, replacing relationship problems, which had been considered the prime factor in suicides from 2003-09.

In the report, Army officials acknowledge that some of the suicides were preceded by warnings that went unheeded by leaders.

“To be sure, the Army has investigated numerous suicide cases that, in hindsight, seemed to present a clear trail of behavioral indicators that may have afforded leaders or others in the social circle an opportunity to respond,” the report said. “However, post?mortem suicide investigations can never truly capture the subtlety of pre? suicide indictors, nor truly judge the appropriateness of the response within the pre?suicide context.”

The Army has improved mental-health services and taken myriad other steps to stem suicides since 2005, as pressure on soldiers increased with long, repeated deployments. The new report shows that the percentage of suicides committed by soldiers who had deployed multiple times increased steadily from 2009 through 2011.

Army officials said that while the increase in suicides over the last six years has been “dramatic,” self-inflicted deaths among active-duty troops appear to be “stabilizing at approximately 160 deaths (per year)” in the last several years.

Among other findings in the report:

• Research indicates that Iraq and Afghanistan veterans in general are at higher risk for suicide immediately following the transition from active duty, with risk decreasing over time.  Following separation from active duty, veteran suicide rates were 23.1 per 100,000 in the first two years, 18.1 in years two through four, and 12.9 in years four through six.

• Approximately 950 veterans under VA care attempted suicide each month between October 2008 and December 2010.

• The Army reported an increase in sex crimes by active-duty troops—28 percent overall from 2006 to 2011. The increase was especially steep for violent sex crimes: from 665 in 2006, to 1,313 in 2011, (more than 90 percent).

• Domestic violence crimes increased 85 percent, to 2,699 incidents, from 2001 to 2011. Child abuse rose 44 percent, to 2,201 incidents, in the same period.

• Prescription drug use among soldiers has climbed, including psychotropic and controlled substances, which were used by 358,203 active-duty troops in fiscal year 2011—up from 337,932 service members in 2010. The report says, however, that research ” counters the assertion that the Army is overmedicating the Force ” compared to the civilian population.

• The Army provided outpatient behavioral health services to 280,413 soldiers in the 2011 fiscal year—up from 253,773 the year before. Incidence rates of mental-health diagnosis doubled from 2000 to 2009. Forty-four percent of soldiers who committed suicide in 2010 had received outpatient behavioral healthcare, with about 37 percent of suicide victims having been seen at a
military treatment facility within 30 days of the event.

• Reported depression among soldiers can be attributed at least in part to deployments, with about one-third of soldiers reporting depression symptoms three to six months after returning home.  Research by the Institute of Medicine found that 27 percent of those who deployed three to four times received diagnoses of depression, anxiety or acute stress, compared to 12 percent of those who deployed just once.

The report cites several new programs designed to improve mental-health care, including pre- and post-deployment screenings and embedding behavioral health providers in combat units and in primary-care clinics. The Army pledged to continue seeking ways to improve soldier healthcare, including better detection and treatment of mental health issues and improvements to its transition services, to provide a “warm hand-off” of troops to VA healthcare programs.

“Leaders at all levels must recognize that while our Army has completed operations in Iraq and will eventually do the same in Afghanistan, this does not equate to less responsibility or fewer demands on them in coming days,” the report says. “To the contrary, arguably more will be asked of them during upcoming periods of reintegration and reset…The challenges facing our Army’s leaders in the days ahead are incredibly complex and consequential.”

Trina Parker of West Haven, said many women like her, who were in the military in peace time think that VA services are just for veterans of war, and they often don’t even see themselves as soldiers.

Another woman veteran, Juliet Taylor, who served in Iraq, said many female vets don’t take advantage of health services at the VA in West Haven because they connect it with “old men” who are Vietnam War veterans. They envision the women’s health center there as a “dungeon” since it’s in a basement.  As a result, many don’t get any health care.  “While the services are great at the VA, it’s not a place where we go.  There’s a stigma attached to the VA.  I didn’t care what they had there.  I didn’t want to go,” she said.

The two women spoke at the VA Connecticut Homeless Veteran Summit attended by service providers and veterans.  The conference, at the VA’s Errera Community Care Center in West Haven, focused on services for female veterans.

Out of more than 15,000 women veterans in the state, 2,752 go to the VA for health care, said Jane Sarja, women’s program manager for VA Connecticut.  In an interview, she admitted that it’s a challenge to attract more women vets partly because of misconceptions that “the VA doesn’t know how to take care of women.”  She said a separate women’s health center opened at the West Haven VA in 1996 in a basement to give women privacy.  The center will move to an upper floor next year, and will still be separated from men’s services, she said.  “It will provide the same privacy and good care,” she said.

“We’ve made great strides, but we have a long way to go,” she said.  VA health services are provided at the main health facilities in West Haven and Newington and in outpatient clinics in New London, Danbury, Stamford, Waterbury, Windham and Winsted.

Parker, the Marine Corps vet, served from 1982 to 1986.  Afterward, she suffered from anxiety, alcoholism and PTSD, which she attributed to “unwanted sexual advances” while in the service.  She couldn’t hold a job and was homeless at times, living with friends. In 2003, she applied for welfare and was sent to the state Dept. of Labor for employment assistance.

The staff member happened to be a female veteran who referred her to Errera, where she received mental health care.  “If I had the opportunity of mental health treatment 17 years before, it would have saved me 17 years of aging with alcohol,” she said. “I didn’t know about the VA.  Nobody was out there letting you know,” she added.

Parker has worked at Errera as a peer specialist for five years, the longest she’s held a job. She has been sober for eight years. In an interview, she said she is starting a new job in late November in Bedford, MA, helping women veterans.  She’s passionate about reaching out to women from her peacetime era who, she said, are “falling through the cracks.”

But, Taylor, the Iraq War veteran, said many women veterans, regardless of their era, aren’t getting health care because they refuse to go to the VA.  She said she finally went for dental care five and a half years after she left the Army.  She had been rejected by two clinics for insurance reasons, then referred to a facility that only treated male veterans.

She said she received such good care at the VA, she has since brought other women vets there for help.  One hadn’t had her prescription eyeglasses checked for 15 years.

She urged VA officials to “get out into the community” to reach out to women veterans.  She suggested community colleges because many women veterans, herself included, attend the schools because it’s paid for under the federal GI Bill, and there’s often money left to pay for housing.

Others at the conference said they had never thought of community colleges as resources for reaching veterans and now plan to tap them.  They also suggested contacting domestic violence centers which may serve female veterans, using personal contact instead of relying on events to spread the word, and changing language in publicity so it refers to people who served in the military, so there is no confusion about wartime vs peacetime service and the definition of the word “veteran.”

Sarja, the VA women’s program manager, said the VA is “committed to working very hard” to convince women to take advantage of its services.  She said that although West Haven is the only VA facility in the state with a separate space for treating women, there are doctors in each VA location that are “specially trained in women’s health.”

“We know that tens of thousands of women will be coming back from Iraq and Afghanistan. They are not going away.  The numbers of women vets are rising,” she said.