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One of the major indicators of population health is _______
Maternal Health
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Maternal health is measured by:
MMR (maternal mortality rate)
(calculated by dividing the # of maternal deaths by the # of live births per 100,000)
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Another valid indicator of population health other than maternal health
Infant mortality
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National overview of women, infant and adolescent status:
- PRECONCEPTION CARE is huge!!!
- Slight declining in teenage mother until 2005
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Risk factors for Pregnant Women and Infants
Substance abuse and use leading to adverse consequences (alcohol, tobacco, illegal substances)
Socioeconomic Status
Adolescent Pregnancy
Maternal Developmental Disability
Intimate Partner Violence (pregnancy is a very vulnerable time for women in abusive relationships: unintended preg, increase stress, jealousy)
STIs (Chlamydia most common, gonorrhea, HSV2, HIV/AIDS)
Poor nutrition/weight gain
Oral health
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True or False: Bacterial vaginosis is an STI
FALSE
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Specific complications during pregnancy:
Hypertension, Preeclampsia, Eclampsia
Gestational Diabetes
Preterm Labor
Postpartum Depression
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Goal of healthy people 20:20 for maternal, infant and child health
Improve health and wellbeing of women, infants, children and families
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Global Hx of Children's Health Care:
Only recently the view of children as valuble
Female infants and those with congenital anomalies not valued in some countries
Inequitable care for boys and girls
Sex-selective abortions and infanticide
Cultural practices/rituals possibly harsh and hazardous
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Risks to infants, toddlers, and preschoolers:
- Accidents and Injuries:
- -suffocation
- -falls, burns, accidental poisoning
- -drowning (1-3 years)
- -motor vehicle accidents
- Communicable Diseases:
- -respiratory infections
- -conjunctivitis
- -vaccine-preventable diseases
- Chronic Diseases:
- -asthma, autism, sickle cell, food allergies, muscular dystrophy, cystic fibrosis
- Child Abuse and Neglect:
- (typically 4 areas)
- -Parent of caregiver behaviors (depression)
- -Family characteristics (step-parent)
- -Child Factors (increases stress on caregiver)
- -Environment (poverty, isolation, crime)
- Poor Nutrition and Dental Hygiene:
- -breast feeding encouraged
- -infant overfeeding
- -child and adolescent obesity
- -fluoride supplements/water
- -tooth decay (proper nutrition/dental hygiene)
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Leading cause of infant deaths:
Suffocation
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Drowning is highest in what ages:
1-3 years
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2 major initiatives to finance immunizations for infants and children
- Vaccines for Children program
- Child health insurance program
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Primary Prevention for Protection from Child Maltreatment
- Public Service Announcements
- Parent preparation/education
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Secondary prevention for Protection from Child Maltreatment:
- (focused on high risk families)
- -Respite Care
- -Home visits
- -Targeted education (pregnant teens)
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Tertiary care for protection from Child Maltreatment:
Intervention and treatment programs to assist families abuse and neglect have already occured
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Preventive Health Programs for Infants, Toddlers, and Preschoolers
- Immunization programs
- Parent training programs
- Day care and preschool programs
- (Head Start- ages 3-5)
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Health Protection Programs for infants, toddlers, and preschoolers
Safety and Injury programs (car seat and lead poisoning)
Protection from child abuse and neglect
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Health Promotion Programs for infants, toddlers and preschoolers
Infant brain development research (parent-child interaction)
Developmental Screening
Programs for children w/ special needs
Nutritional programs (Special Supplemental Food program for women, infants and children)
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Children and adolescents spend most of their time in:
SCHOOL (child's work)
Their academic success can predict future education, employment, and income
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___ has been linked to school success
Child Health
-healthy children found to be more motivated and prepared to learn
-coordinated school health programs are linked to academic achievement
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Chronic Disease of School Age children and adolescents
- Asthma
- Autism
- Diabetes
- Juvenile Rheumatoid Arthritis
- Seizure Disorders
- (Childhood Cancers)
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Behavioral and Learning issues for school age children/adolescents:
- Learning disabilities
- ADHD
- Behavioral and Emotional problems
- Disabled Children
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Problems that can be associated with economic status:
- Lead poisoning
- Iron deficiency anemia
- Increased susceptibility to illness
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Death or permanent disability from injuries (67% for 5-19 years; 80% for adolescents)
- MVA
- Other Injuries
- Homicides
- Suicides
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A large study looking at risk factors for passenger deaths in MVAs found that more than 21% of cases involved:
Alcohol
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____ use while driving has been estimated to lead to a 4x greater risk of an accident
Cell phone
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3rd Leading cause of death in teens:
Emotional problems/ Teenage suicide
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Adolescent health status/needs
- Emotional problems/suicide
- Violence
- Substance abuse
- Teen sexuality/pregnancy
- STDs
- Acne
- Poor nutrition and eating disorders
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School Age and adolescent health status/needs
- Communicable Diseases
- Head lice
- Under-nutrition
- Poor Dental Health
- Obesity
- Inactivity
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Prevention programs for school age/ adolescents
- Immunizations
- TB testing
- Education and Social services
- -basic services
- -parental support services
- -family planning/STI services
- -risk reduction services
- -peer education
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Health protection for School Age/Adolescents
- Safety/Injury prevention
- Infectious diseases
- Child protective services
- Oral hygiene and dental care
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Health promotion programs for school age/adolescents
- Nutritional programs
- Weight control programs
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Main goals of Healthy People 2020 for adolescents:
- AH-1
- Increase the proportion of adolescents who have had a wellness checkup in the
- past 12 months
- AH-2
- Increase the proportion of adolescents who participate in extracurricular
- and/or out-of-school activities
- AH-3
- Increase the proportion of adolescents who are connected to a parent or other
- positive adult caregiver
- AH-4 Increase
- the proportion of adolescents who transition to self-sufficiency from foster
- care
- AH-5 Increase
- educational achievement of adolescents and young adults
- AH-7 Reduce
- the proportion of adolescents who have been offered, sold, or given an illegal
- drug on school property
- AH-8
- Increase the proportion of adolescents whose parents consider them to be safe
- at school
- AH-9
- Increase the proportion of middle and high schools that prohibit harassment
- based on a student’s sexual orientation or gender identity
- AH-10
- Reduce the proportion of public schools with a serious violent incident
- AH-11
- Reduce adolescent and young adult perpetration of, and victimization by, crimes
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Barriers to goals for adolescents:
Risk taking behaviors (accidents, drinking, drug use)
Mental Health Issues
Limited Contact with Health Care System
Sexual Activity
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Role of the Community Health Nurse in Women/Children
Assessing each population's current health problems
Determining available and needed services
Focusing on health promotion and early intervention
Educating about family planning, nutrition and exercise, safety precautions, or child care skills
Conducting voluntary immunization programs, encouraging smoking cessation during pregnancy, preventing communicable diseases, encouraging use of child safety devices
Ensuring compliance with laws for immunizations, reporting of child abuse, violations of environmental health standards
Advocating and acting as resource for families and young children
Protecting and preserving the rights of children and families
Securing needed services in the community
Ensuring adequate resources for a safe and healthy environment for children
Lobbying for law changes, initiating efforts to establish needed services
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