Deaths from cancer and heart disease are higher in parts of CT. How a health system is fighting that

Hartford Courant – Thursday, May 28, 2026
By Helen I. Bennett 

For one Connecticut doctor, now is the best time to make sure you have a doctor who is helping you take care of your health.

That doctor is Greg Haller, and what he means is that anyone who is thinking “I really should have a doctor,” should realize that “now is always a good time to start getting involved with your health, now is always the best time to start making changes.”

Haller, who works at the Winsted Health Center, knows that taking action is sometimes easier said than done. He recognizes, he said, that life can get in the way, and people often have myriad reasons for not making, or keeping, health care appointments.

Haller works at the health center as part of the Hartford HealthCare Rural Residency Program, done in conjunction with Quinnipiac University’s Frank Netter School of Medicine. He is one of four residents in the program, which is growing and will have eight such residents next year.

Haller wants his patients, now and in the future, to know the care he provides is always intended to help people be healthy and happy. He is in the first group of the residents assigned to the program and has been working there for about a year. It followed a year of residency at St. Vincent’s Medical Center in Bridgeport.

During the past year, and as of the end of April, Haller said they have added 391 new patients at the health facility, which sits along the main road through Winsted, conveniently close to the Route 8 exit that brings traffic into the city. In an example of the difference the resident doctors make, Haller noted the residents working under primary care doctors can take over some of the patient load there, seeing up to 16 patients a day.

Why rural residency
Definitions of what constitutes a rural town in Connecticut can vary, but Data Haven notes that the Connecticut Office of Rural Health “uses a definition based on population and population density” and per that office, “a town in Connecticut is considered rural if it has a population of up to 10,000 and a population density of no more than 500 people per square mile.” That definition includes 68 towns statewide, according to Data Haven, an organization that by collects and shares data on well-being, equity, and quality of life in Connecticut.

A 2025 report on rural health done by the state notes that rural hospitals “continue to operate under financial strain: according to Medicare cost reports filed by the state’s hospitals, uncompensated care costs totaled more than $271 million in 2024.”

Further, the report states, the state’s “aging population, transportation barriers, and limited behavioral health capacity compound the crisis” in a small state “where 9% of residents live in rural area” and that “without targeted investment, rural health systems will continue to erode, threatening not only access to services for residents in rural areas but also the economic and social stability of rural communities.”

This is a circumstance Hartford Healthcare officials said they are working to change.

By adding residents such as Haller to the rural health program, who all work with doctors at the clinic, their presence also has has decreased wait time to see a new patient from nine weeks to seven days and the goal is to “do better than that,” said Paul Scalise, a Hartford HealthCare senior vice president and president of the system’s northwest region.

Scalise said while Hartford HealthCare’s goal is to bring health care to where people are, the factors that face patients in the state’s rural area can differ from those in more suburban and urban areas of the state.

Health care in non-metropolitan areas of the state can be marked by isolation, including long travel distance, lack of available care in the area, economic issues, lack of transportation and lack of health insurance, Scalise said.

“These are things we need to address,” Scalise said. “Getting insurance is hard and travelling is hard … superimpose a lack of providers and it’s a perfect storm for poor health care outcomes.”

The state report notes that household income makes “a significant impact on rural residents’ health, as the cost of traveling long distances for healthcare and the cost of services and insurance can lead people to avoid treatment.”

Further, low-income significantly affects health outcomes in Connecticut’s rural communities, driving greater need and higher costs. Across all rural tracts, 26% of households earn under $50,000 and 44% of rural employees earn less than $75,000 per year,” the report states.

Among Connecticut’s rural residents, “4% do not have any health coverage, contributing to the 10.2% of adults statewide reporting medical debt. Higher costs are also a function of treating complex chronic conditions rather than root causes of health and prevention,” the report states.

The rural health care report prepared by the state also notes that, in Connecticut between 2015 and 2024, rural adults aged 65 and older faced significant access gaps, and 16% delayed medical care, 8% skipped care entirely, and 6% lacked a designated primary care provider.

Scalise said the lack of access in rural areas can result in a much higher percent of chronic disease, late stage cancer discoveries, and untreated substance abuse and behavioral health issues.

“We are committed to figuring out how to increase our availability,” Scalise said.

Scalise said the residents in the rural health program are trained specifically in rural medicine. He cited as an example animal bite exposures, which you do not typically “see in downtown Hartford.”

“Training at a rural hospital gives you the exposures to these diseases,” he said. “It is very important for us to build this pipeline … Not just once or twice but that we build care.”

Preventative care
Haller, who grew up in Nova Scotia, came with knowledge of rural areas and awareness of the growing health care needs in these areas. He said that while in medical school he rotated through urban and rural settings, so became familiar with a wide array of patient populations. Northwest Connecticut is a rural area and the vast majority of patients are living in rural settings, he said.

Speaking in general terms about what he sees at the Winsted center, in order to protect patient privacy, Haller said in the new patients visits they see issues that “range widely,” from no chronic concerns to patients who have not seen a seen a doctor in nearly 20 years. Given travel distance, the setting also is one where specialists can be few and far between, he said.

The problem with that, he said, is that means there was no blood work, so no identification of diabetes or pre-diabetes, no colonoscopy despite a family history of colon cancer.

He said the clinic adds space for urgent care, and “we can get you in sometimes on the same day” and that saves a trip to the much more expensive emergency room so “they can get the care they need on the spot.”

An important element, Haller said, is catching issues early, such as testing for blood sugar now, so “we can intervene, have close follow up, that saves them 10 to 15 years down the line” and “we might have much better outcomes for people.”

The state report outlines the stark nature of the concerns: “mortality rates for cancer are statistically higher in rural regions of Connecticut, reinforcing the need for enhanced rural screening and early detection access.”

“In 2019, the cancer death rate in rural areas was 15% higher,” or 164.1 per 100,000, than in urban areas, or 142.8 per 100,000), and cardiovascular heart disease mortality from heart disease is “higher across all rural regions of the state when compared to the statewide average, reflecting broader national trends where heart disease death rates are greater in rural areas,” the report says.

Haller said a patient survey they did on reaction to care at the center showed “across the board it was widely positive.”

“No one wants to be unhealthy,” he said. “There can be situations where people just don’t know” [of possible impending health issues.]

Donna Handley, also a Hartford HealthCare senior vice president and president of the system’s east region, said that, in terms of rural health care in Connecticut, “each community is just a little bit different, one size doesn’t necessarily fit all.”

Handley said that, for example, in one senior center, they assigned nurses who are there to check blood pressure, ensure medication is dispensed correctly and do other checks. She said the program is so popular with the seniors that she has received thank you notes for it.

Handley said the strategy, with 68 Connecticut towns considered rural, is to look at access to care and affordability. “We want members of our community to stay healthy, so we bring care to our communities,” she said. “We want to provide that access closer to home.”

Asked about reactions patients have to being considered in a “rural” grouping, Handley said, “we meet people where they are,” and there is absolutely nothing “judgemental” as “we meet people, we get them the care they need.”

“We look at needs of each community … it is really knowing our communities and what they need,” she said.

Jeffrey A. Flaks, president and CEO of Hartford HealthCare, said the devotion to rural health care comes amid a belief that, “every person, regardless of geography, deserves access to world-class, affordable, safe care close to home.”

Flaks has often noted that access is a goal of the system, such as last year launching a new concierge provision of health care, through what was dubbed “HHC 24/7,” an app made available to both existing and new Hartford HealthCare patients. It offers service 24 hours a day, seven days a week. The system also is amid a $1 billion-plus investment in Hartford Hospital over the next decade that is bringing in a building boom not seen in the hospital’s 172-year history.

“This is a defining moment for rural health in Connecticut,” he said. “At Hartford HealthCare, we remain deeply committed to all of the communities we serve, and we have doubled down on that commitment in rural Connecticut, where access to high-quality care can shape the future of entire communities.”

Flaks said that while Hartford HealthCare is “proud to be the leader in rural health care in our state,” it also recognizes “both the challenges and the extraordinary opportunities ahead.

“That is why we continue to invest in innovation, expand access points across the state, strengthen partnerships, and reimagine how care is delivered, all in service of building healthier communities and a stronger future for Connecticut,” he said.

Hartford HealthCare has more than 500 locations in the state and also now has eight acute care hospitals that provide cancer, heart and vascular services, neuroscience, orthopedics, urology, digestive health and other services: Backus Hospital, Hartford Hospital, The Hospital of Central Connecticut, Manchester Memorial Hospital, Manchester Memorial Hospital Rockville Campus, MidState Medical Center, Windham Hospital, Charlotte Hungerford Hospital, St. Vincent’s Medical Center.

The system
The need for investing in rural health is no surprise to state officials. The state applied for federal funding to participate in the new Rural Health Transformation Program, which officials said, “represents a significant opportunity to bolster our state’s rural health systems.” The state was awarded $154.2 million and there is an estimated funding of $771 million over the full five-year grant period, records show.

A spokesman for Gov. Ned Lamont said the proposal passed, and was incorporated into a separate, omnibus bill that contained several provisions related to public health, which Lamont signed into law.

Scalise said Hartford HealthCare would seek funding from the grant, but decisions have not yet been made by the state.

The Connecticut Department of Social Services says it is Connecticut’s lead agency for the Rural Health Transformation Program, “partnering with other state agencies to implement 30 projects. The projects are organized across four initiatives, including population health outcomes, workforce, data and technology, and care transformation and stability.”

The state report submitted as part of obtaining funding notes that “a recent Consumer Affairs report ranked Connecticut as the fifth most unaffordable state for healthcare costs, based on factors including average annual health insurance premiums and deductibles, percent of residents forgoing care due to cost, and percent of children whose families struggle with paying medical bills.”

Scalise said the skepticism some people might feel about rural settings is alleviated when they see the intent is to have the health care there for good. “They recognize were not in it for the short run.

“We want to be viewed as the leader in health in these communities,” Scalise said. “It is not just here for today, it is here for the future.”

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