Health Resource Capacity Assessment for Putnam, Connecticut, May 2001

Health Needs/Barriers to Care: Parental Stress

The most common recurring theme across populations in Putnam was the high level of stress faced by young families. The word "struggle" was used over ten times during the parent focus group. Health care providers, school representatives, social service providers, children and town residents also voiced this concern. Seniors in their focus group had to search to identify their own unmet health care needs, but were quick to identify the challenges facing young families.

Parental stresses included both parents working long hours, often at more than one job, sometimes on different shifts. Parents felt growing economic pressures; that they are working harder for less and less money. Parents recognized the increasing challenges facing their children but felt powerless to address them. In a survey of 5th through 12th graders, Putnam students reported a lower level of parental bonding than students statewide. ²² Putnam families face transportation challenges that exacerbate social isolation and difficulty in meeting family needs (see Transportation section).

Time constraints were particularly pressing. Parents felt that they don't have enough time to spend with children talking, preparing meals, helping with homework. Parents are always rushing and always tired. When middle school students were asked if they thought that kids have enough time with their parents, one responded, "It's never a good time to talk." As one childcare provider stated, "Finding time to read a story at bedtime is just not realistic for these families." ²³

Lack of insurance is a significant problem for many working parents. One woman in town quit her job so she and her husband could qualify for HUSKY, Connecticut's public health insurance program. Another mother hurt her hand twice at work, but her son said she was very happy because her employer paid for the treatment. Many families are not aware that HUSKY is available for low-income working parents, but for many Putnam parents the income limits are too low. Even for families with insurance, high copays and deductibles are often barriers to accessing care. While families are criticized for inappropriately using the emergency department, it is often the most rational choice in a complex and inaccessible system. ²⁴

Making arrangements for preventive health care is often not a top priority for stressed families. Several providers stated that some parents only get check ups for their children when it is required for school registration. Parents noted that it can take up to six months to schedule an appointment. When that appointment is missed, due to changing work schedules or unreliable transportation among other reasons, it can take six months again to schedule another. ²⁵ Several stakeholders emphasized the need for a walk-in clinic in Putnam. For some parents there is a lack of understanding about the importance of preventive health care.

Some parents are reluctant to access help through public programs. There is a strong stigma attached to some programs, and parents may choose to manage on their own rather than "take a handout." Some parents reported rude treatment by providers and social service agencies. ²⁶

A critical shortage of childcare slots, particularly for infants and after school programs, was noted by many in the community. Childcare providers reported long waiting lists and many calls for applications. Needs for parenting classes and offering childcare at town programs, activities, and classes were emphasized by parents. Many providers were frustrated by the challenge of engaging busy parents in any programs designed for them. Many felt that the neediest parents do not advocate for themselves within government and social agencies because of time constraints and a sense of powerlessness. ²⁷

In some families, pressures on parents build up until they become overwhelming. This can lead to depression and alcohol or substance abuse. As one parent described, "Once one problem isn't solved, it leads to more problems, and that leads to more problems. It snowballs."

Many stakeholders stated the need for a central resource for information and services and assistance in applying for programs. The need for case management services and assistance in navigating the maze of programs available for families was also noted (see Availability of Health Care section). ²⁸

Footnotes

22. Connecticut Substance Abuse Prevention Student Survey, Putnam Public Schools, Health Services Research Unit, Dept. of Community Medicine & Health Care, UConn Health Center, 4/30/99.
23. Interview
24. Focus groups
25. Focus group
26. Focus group
27. Focus group
28. Focus groups, interviews