Community Health Essay Example

Community Health Essay Example Community Health Essay Community Health Essay Occasionally, two or three high school seniors would be caught ranking beer purchased at a store in a nearby town. Yet these isolated incidents gave no indication of Kensington impending drug problem. Within the past year, the climate Of the town had changed considerably. Incidents of teenagers being arrested for possession of alcohol or even other drugs, such as marijuana, were being reported more regularly in the newspaper. There seemed to be more reports of burglaries, too. There had even been a robbery and two assaults reported within the last month. The population of young adults in the community seemed to be increasing, and many of these seemed to be driving impressive cars, using the hottest new digital devices, and wearing the latest clothes. All of these signs were obvious to a group of concerned citizens in Kensington and suggested the possibility of a drug problem. So the concerned citizens decided to take their concern to the city council. Questions 1-6 1. What is the real problem? No one wanting to admit that Kensington had a drug problem. 2. Who do you think the gatekeepers are in the community? The concerned citizens of Kensington. 3. What groups of people in the community might be most interested in solving the problem? The Kensington city council. 4. What groups might have a vested interest in seeing the problem remain unsolved? The people selling and buying the drugs. 5. What interventions would be useful in dealing with the problem? Jail time for those caught selling or using the drugs. 6. Unmarried Mothers compared to married counterparts, generally have -lower education -lower incomes -greater dependence on welfare assistance Prenatal Care with Teen Mothers Teen mothers are less likely to receive early prenatal care Teen Mom Stats 1/3 of Teen girls get pregnant at least once before age 20 Stats of Unintended Pregnancies 1/2 of pregnancies in U.S. are unintended How many unintended pregnancies end in abortion? 40% Unintended pregnancies associated with negative health behaviors Title X or Family Planning Act Frederal program that provides funds for family planning services for low-income people -nations major program to reduce unintended pregnancy by providing contraceptive and other reproductive health care services to low-income women. Who was Planned Parenthood started by? A labor and delivery nurse named Margaret Sanger in Brooklyn, NY in 1942 Planned Parenthood Original Name The National Birth Control League Planned Parenthood Funding Receives 1/5th of Title X funds Abortion Legalization Legalized in early stages of pregnancy (up until 12 weeks) since 1973 (Roe Vs. Wade) Amount of legal Abortions preformed in US since 1973 50 million Maternal Death death while pregnant or within 42 days of termination of pregnancy Classifications of maternal death direct, indirect, or unspecified Since 1982, the maternal death rate has remained relatively the same with black women being 4 times more likely than white women to die from pregnancy Prenantal Health Care Medical care from time of conception until birth procress Three Major Components of Prenatal Health Care 1. Risk Assessment 2. Treatment of Medical Condionts or Risk Reduction 3. Education What does prenatal care do? Lowers the likelihood of low birth weight babies What is low birth weight? 5.5 lbs or less Infant health depends on: -Mothers health behavior -Mothers level of prenatal care -Quality of delivery -Nutrition -Immunizations -Infants environment after birth (Home, family, medical services) -Access to a neonatalogist Infant Mortality (death) Death of a child younger than 1 year Neonatal Mortality death from birth to 28 days Post-neonatal mortality death from 28 days to 1 year Between the years of 1980 to 2000, infant mortality declined, but has remained stable since then Improving Infant Health:Low birth weight SINGLE most important factor in neonatal death Improving Infant Health: Cigarette Smoking leading modifiable cause of low birth weight Improving Infant Health: Alcohol and Other Drugs can cause Fetal Alcohol Syndrome Improving Infant Health: Breastfeeding Do it Improving Infant Health Education of SIDS Childhood Mortality Rates have generally declined in past few decades Unintentional injuries leading cause of death in children (What kind?) specifically, motor vehicle related deaths, especially those not wearing seat belts/restraints Childhood Morbidity Sickness Cause of Childhood Morbidity Unintentional Injuries -Significant economic, emotional and disabling impact Child Maltreatment Infectious Diseases -Importance of immunization schedule (This is complicated! Make sure to keep track of this as a parent!) Community problems -Federal Government has over 35 programs in 16 different agencies to serve needs of nations children Maternal and Child Health Bureau: Title V ONLY federal legislation dedicated to improving the health of mothers and children Maternal and Child Health Bureau (MCHB) -Established in 1990 to administer Title V funding -Accomplishes goals through 4 core public health services WIC A special supplemental food program from women, infants, and children sponsored by the USDA; est. 1974 WIC eligibility requirements residency in application state income requirements at nutrtional risk WIC: 2008 9.5 million participants: nearly half of all infants born in US, 1/4 of children ages 1-5 WIC success? VERY successful/ost effective Children without Health Assistance more likely to have care delayed or receive no care for health problems Medicaid low income individuals and families; children are slightly more than half of all Medicaid beneficiaries CHIP targest uninsured children whose families dont qualify for Medicaid FMLA-Family and Medical Leave Act -Grants 12 weeks unpaid job protected leave to men or women after birth of child, adoption or illness in immediate family Child Care Stats 13 million children younger than 6 in child care every day -Family Support Act -At Risk Childcare Program Childrens Defense Fund Never accepted federal money, relies entirely on donations United Nations Childrens Fund (UNICEF) only organization of the UNs assigned exclusively for children Infant and Maternal Health health of women of child-bearing age from pre-pregnancy through pregnancy, labor and delivery, and the post partum period and the health of the child prior to birth through adolescence Family marriage or having two parents, important family characteristics to a childs well-being Teen mothers are more likely to: -smoke during pregnancy -have preterm births -have low birth weight babies -have pregnancy complications Unintended Pregnancy mistimed or unwanted Negative health behaviors associated with UNINTENDED PREGNANCIES -delayed prenatal care -inadequate weight gain -smoking, alcohol and other drug use State with Highest teen pregnancy rate Mississippi State with lowest teen pregnancy rate: New Hampshire Title X or Family Planning Act -supports 61% of the 4000+ family planning clinics in the U.S. -over 5 million women received care at clinics founded by Title X Heartbeat Bill -must have ultrasound 24 hours before abortion -must hear heartbeat before abortion Roe Vs. Wade -Dallas, Texas -Norma McCorvy (9 months pregnant) wanted an abortion because of rape. -Won Gag Rule -1981-Reagan docs/nurses cannot counsel women about abortion in federally funded clinics Doe V. Bolton along with Roe Vs. Wade in Georgia-same ruling Leading Cause of Infant Death -congenital abnormalities -preterm/low birthweight, SIDS Premature Birth less than 38 weeks Cost of Premature Birth $51,000 Federal Government Community Problems -only available to people who fit into a specific group -many people fall through the cracks Title V Infastructure building, population-based, enabling and direct health care services What is the only industrialized nation that was NOT enacted a paid infant-care leave program or law? United States What are the ages of adolescents and young adults? (15-24) Adolescent is regarded as puberty to maturity Young Adult is considered one of the most difficult time periods Adults are ages 25-64 Decade of Decision 18-28 What percent of the population are adolescents and young adults? 14% Youths are increasingly being raised in what kind of families? single-parent families Young adults complete. physical growth and experience significant life changes Adolescent/ Youth Adult Mortality -significant decline in death rates over past several decades: mostly due to advances in medicine and injury and disease prevention -male mortality rate higher than female -lowest mortality rate: Asian Americans/Pacific Islanders -Most threats stem from behavior rather than disease Adolescent/Youth Adult Mortality: Unintentional injuries 46.5% Adolescent/Youth Adult Mortality: Homicide 16% Adolescent/Youth Adult Mortality: Suicide 12% Top three causes of adolescent/youth adult mortality 1. Car Accidents (46.5%) 2. Homicide (16%) 3. Suicide (12%) Adolescent/Youth Adult Mortality: Homicide and Suicide Rates up 200-300% over last 50 years Violence in Teens 1/6 of high school students carry a weapon at school Tobacco Use in Teens Decreases but 1/5 of students are smokers: White students are more likely to smoke than black or hispanic Sexual behaviors of Teens unintended pregnancies and STDs Aged 65+ Aging continuation of older and old and older Gerontology covers broad process of aging Geriatrics branch of medicine Geriatician physician or clinician specifically targeting elderly population Young Old 65-74 Middle Old 75-84 Old old 85+ Elders represent what percent of the population? 12.8% 1 in every 8 Americans age 65+ Ageism prejudice and discrimination against the aged Common myths not accurate representation of elders -majority of elders today are active and well -many still working -many strongly engaged in community, volunteer, and advocacy programs Normal Blood Pressure 120/80 Size and growth of elder population Americas population has drastically shifted ; other countries have shifted as well ; ; Population Pyramid describe aging of populations gastest growing segment of older population 85+ Baby Boomers Birth Years 1946-1964 How many babies born during Baby Boom? 70 million + Elder mortality rates life expectancy has continued to increase-especially in the 20th century Migration movement of people from one country to another can affect population size Immigration people coming in Emigration people going out Net Migration total population gain or loss from immigration and emigration 3 Factors affecting population size and age 1. Fertility Rates ; 2. Mortality Rates ; 3. Migration Dependency Ratio (Age matters) ; economically unproductive to economically productive ; -traditionally definied by age (19-64 was productive) ; -can be used for social policy decision making Labor Force Ratio (age DOESNT matter) number of people actually working and those who are not Future Dependency and Labor Force Ratios ratio of workers to dependents will be lower in the future than today Demographic variables impacting elders -marital status -living arrangements -racial and ethnic composition -geographic distribution -economic status Marital Status of Elders -3/4 of elder men are married -just over 1/2 of elder women are married Elder women 3x more likely to be widowed -men have shorter life expectancies -men tend to marry women younger than selves -men more likely to remarry after loss of spouse Number of divorced elders continues to rise -new concerns: lack of retirement benefits, insurance, lower net worth assets living arrangements -closely linked to income, health status and availability of caregivers -2/3 of non-institutionalized elders live with someone else -women are more likely to live alone How many elders live in nursing homes? 5% 3/4 of nursing home residents are male or female? Female More than half of nursing home residents are what age? 85+ 2010 Elders: Whites 80% 2010 Elders: Blacks 9% 2010 Elders: Hispanic 7% 2010 Elders:Asian 3% 2050 Projection of Elders: White 58% 2050 Projection of Elders: Blacks 11% 2050 Projection of Elders: Hispanic 15% 2050 Projection of Elders: Asian 8% Greatest number of elders lives in California Greatest proportion of elders live in Florida Geographical Distribution of Elders 2/5 live in southern states -more than half live in 10 states: CA, FL, IL, MI, NJ, NY, NC, OH, PA, TX in 1970, how many elders lived in poverty? 25% In 2006 how many elders lived in poverty? less than 9% Income: Average elder $ made up of. 37% social security 15% asset income 18% pension income 28% earnings Top causes of death for elders (responsible for 2/3 of deaths) 1. Heart Disease 2. Cancer 3. Stroke 4. CLRD (Chronic Lower Respiratory Disease 5. Alzheimers Disease Health Behaviors in Elders generally more favorable than younger poeple ; -less likely to consume large amounts of alcohol, smoke cigarettes, or be overweight Chronic condition of elders impact quality of life Chronic disease are not impacted by former income level and occupational exposure Impairments impacted by former income level and occupational exposure Elder Areas of Improvement physical activity, immunizations (influenza and pneumonia Are male or female elders neglected more often? femals Who are elders more often neglected by? spouse or children Adult Protective Services (APS) states have set up reporting systems for elder neglect or abuse Special problems for elders -may be frail ; -unable to defend themselves ; -vulnerable to telemarketing ; -most common victims of theft or stolen benefit checks Instrumental Needs of Elders: Income Medical costs go up, taxes go down Instrumental Needs of Elders:Housing Continuting-Care Retirement Communities (CCRCS) ; green houses, eden alternatives sprouting up Instrumental Needs of Elders: Personal Care -instrumental tasks, expressive (emotional) tasks, cognitive (mental) tasks, or daily living Medicare Part D Medicare prescription plan Instrumental Needs of Elders: Transportation on average, elders live 10 years after they stop driving Older Americans Act of 1965 (OAA) increased services and protect rights of elders ; -national nutrition programs for elders ; -state and area agencies on aging Binge Drinking for women 4 drinks in an hour Binge Drinking for Men 5 drinks an hour Suicide men are more successful ; women are more likely to attempt Lung Cancer Highest killing cancer Breast Cancer #1 Cancer killer for women Prostate Cancer #1 Cancer killer in men Majority of America White- non hispanic (66%) Racial or Ethnic Minorities in America 34% Minority Below 50% Majority Above 50% disparity not similar/ equal parity equality Secretarys Task Force Report on Black and Minority Health (1985) Landmark report! First case to focus on health disparities Initiative to Eliminate Racial and Ethnic Disparities in Health (Race and Health Initiative) Goal: to eliminate racial/ethnic disparities Classifications use to operationalize race and ethnicity -in 1977, classifications standards changed -split apart Asian or Pacific Islander category -add Hispanic vs. Non-Hispanic question Categories of race are more.. social than biological self reported data can be.. unreliable Bias Analysis not all ethnic determinations are the exact same ethnicity and race on every questionaire Acculturation becoming more like one culture/starting to identify with one culture Hispanic origin is an ethnicity, not a race! Hispanic Origin` people of Mexican, Puerto Rican, Cuban, Central American, or South American decent, or some other Spanish origin Hispanic Origin: Educational Attainment less likely than any other group -least likely to graduate high school Hispanic Income lower than national average Curarderismo Mexican-American folk medicine Marianismo to be more like Virgin Mary Black Americans People having origin in any of the black racial groups form Africa Blacks: Location more than 1/2 live in southern regions of the U.S. Blacks and Health care many still find it really hard to find access to health care due to descrimination Black Educational Attainment less likely to graduate high school Black Income lower than national average Asian and Pacific Islands two seperate racial groups -bipolar distribution of income and educational attainments -generally concentrated in western states Asian Americans Two large subgroups: Chinese and Filipino Asian Incomes and Education higher income and education attained Chi balance is key to good health (asian) Pacific Islanders large subgroup: Hawaiian. Pacific Islanders Health Care topography of Hawaii makes health care hard to access Pacific Islanders: Income and Education lower American Indians and Alaska Natives Original Inhabitants of America (now only 1.5% of population -economically and socially disadvantaged -relatively poor health and many living in poverty American Indians and Alaska Natives Education and Income low Alaska Natives and American Indians Health beliefs HIGHEST RATES OF DIABETES THAN ANY OTHER GROUP -various tribal groups have distinct customs, languages and beliefs -traditional Indian healing (enphasizing wholeness, balanace and energy) can be counter to Western medicine Native Americans and Health Care Many tribes have their own hospitals and schools (sovereign nations) Indian Health Services (IHS) is within Health and Human Services -responsible for federal health services to Natice Americas and Alaska Natives