Response-ph-cap-03

Ph-cap-03 Response one

The Centers for Disease Control and Prevention (CDC) define maternal mortality as any pregnancy related death of a woman while pregnant or within one year of the end of the pregnancy – regardless of the outcome or site of the pregnancy – from any cause related to or aggravated as the result of the pregnancy or its management (2018).  According to America’s Health Rankings (2018), there have been noticeable nationwide improvements in maternal mortality rates since 2016, yet in Washington State maternal mortality rates have increased from 14.7 to 14.8 per 100,000 births (America’s Health, 2018). 

It is interesting to see that decreased interactions with healthcare providers directly correlated with an increase in the maternal mortality rates (MMR) in Washington State between 2016 and 2018.  In 2016, when the maternal mortality rate was 14.7 per 100,000, 91.4% of mothers had post-partum (following birth) healthcare visits and 94.2% of women sought care prior to the third trimester (America’s Health, 2018).  In 2018, MMR increased to 14.8 per 100,000, with 90.5% or women seeking post-partum care and 93.9% having prenatal visits prior to the 3rd trimester (America’s Health, 2018).  This increase in mortality can be attributed to the decrease in care.  As research shows that 40% of pregnancy-related complications are preventable with quality medical care (America’s Health, 2018). 

Another interesting finding is that infant mortality rates in Washington decreased over the same time period while infant healthcare visit rates increased.  America’s Health Rankings reports that there were 4.9 infant deaths per 100,000 live births in 2016, which decreased to 4.7 per 100,000 in 2018 (2018).  In that same timeframe well baby check -up appointments also increased by 1.6% (America’s Health, 2018).  This is also an interesting fact because behaviorally, as the statistics would suggest that new mothers prioritized the healthcare visits of their new babies over their own healthcare visits.

With this information, it will be enlightening to further research local community resources that are available to pregnant women, such as access to low or no cost prenatal care.  In addition to access to care, it will be interesting to determine if these care providers have drop in clinical models or only offer prescheduled appointments.  Outside of an emergency room or urgent care, do pregnant women in Seattle have access to drop in or acute prenatal appointments when they have pregnancy related questions or health concerns?  What resources are available to pregnant women about health concerns and symptoms that are of concern during pregnancy?

References

America’s Health Rankings analysis of CDC, National Vital Statistics System, United Health Foundation, AmericasHealthRankings.org, access 2018. 

Centers for Disease Control and Prevention (CDC).  Pregnancy Mortality Surveillance System.  Retrieved from the CDC.gov websitehttps://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-mortality-surveillance-system.htm

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Ph-03-Response-two

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· There are thousands of people experiencing housing insecurity throughout the whole of California, and especially in San Diego County. San Diego County has the the 4th largest population of people experiencing homelessness in the country (The San Diego Foundation, 2018). There are multiple subgroups connected to this phenomenon, but the demographic that I have chosen to focus my efforts on are individuals with mental health issues.  Through my research I have found that one of the largest factors contributing to homelessness is mental health. 39-43% of individuals experiencing homelessness in San Diego self-report mental health issues (Regional Task Force on the Homeless, 2017). Societal norms about mental health are typically skewed toward negativity, which severely affects treatment acquisition. According to the organization, Mental Health Carers, people avoid seeking mental health treatment because of the stigma, embarrassment, and notion that treatment does not work,  they perceive from receiving that type of care (Mental Health Carers Arafmi NSW). These inaccuracies are birthed from lack of education, which is a major social determinant of health. Poverty is another determinant for people with mental health disorders becoming homeless. 

While there is much work being done to change the perception of mental illness and the treatment of mental illnesses in the United States, there continues to be a growing number of people experiencing homelessness that have these issues. The trends of homelessness in San Diego County show that from 2016-2017 there was a 5% increase in the total homeless population (Regional Task Force on the Homeless, 2017). This was an increase from 3% from the previous survey; and sources only predict that the percentage will grow exponentially in coming years (Regional Task Force on the Homeless, 2017). As aforementioned, one of the largest contributing factors to people becoming homeless is mental health disorders. 

The community resource that I am most interested in researching are comprehensive supportive services that provide permanent housing options, mental health treatment, and  employment training for these individuals. I believe that if we address the issues of mental illness and poverty which lead to homelessness, we will help change lives.

References

Mental Health Carers Arafmi NSW. Why many people do not seek help when they first start to experience mental health symptoms. Retrieved from http://www.mentalhealthcarersnsw.org/2017/07/advocacy-resource-library/

Regional Task Force on the Homeless (2017). 2017 We all count. Retrieved from https://www.rtfhsd.org/wp-content/uploads/2017/07/A-general-fact-sheet-final.pdf

The San Diego Foundation (2018, March 30). Rethinking homelessness in san diego. Retrieved from https://www.sdfoundation.org/news-events/sdf-news/rethinking-homelessness-in-san-diego/

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PH-Cap-03-Response three

In studying my chosen topic, I find that the number of new cases of youth and young adults infected with HIV is mind blowing. It is interesting that so many young people are participating in sexual health risk behaviors, without knowing the consequences associated with the behaviors. A great deal of youth in areas with low socioeconomic status lack the resources and knowledge to seek treatment for a sexually transmitted infection. They are smoking, doing drugs, and drinking alcohol, which impairs their judgement and pressure from peers can influence girls and boys to engage in sexual acts without protection. Many young people are unaware of how sexual diseases are transmitted because schools and parents are afraid or too busy to properly educate them. 

The resource I am most interested in researching is sex education in schools and outside sources. I remember growing up we were separated in a boys and girls class for a day in 5th grade, to attend a sex education class. During this class we learned about puberty and sexual intercourse. Although it was not in depth, it provided the basic information about STDs and the risks associated with sexual intercourse. As a former 5th grade teacher, sex education was not a part of our curriculum. A great deal of parents depend on the schools to provide that information, but the schools systems are dropping the ball which is resulting in increased cases of sexually transmitted diseases and teen pregnancy

PH-Cap-03-Response four

Carroll County, MD consists of a population of approximately 167,000. Carroll County is not a very diverse county, even though it is becoming more and more each year, with approximately 89.6% of the population being Non-Hispanic White. Some other statistics about the county are 61.9% of adults are ages 18 to 65 years old, 39.5% rural, and about an even 50/50 split of males and females. Twenty-nine percent of the adult population is considered obese, which is about 48,500 people. The interesting thing that I found was that 89% of population had adequate access to locations for physical activity, 22% adults age 20 and over reporting no leisure-time physical activity, 3% of the population are low-income and do not live close to a grocery store, and 6% of the population lack adequate access to food.

Even though it seems that the individuals in the population have access to locations for physical activity, it does not take in to factor how many of those individuals can afford to go to those locations, or those who know how to properly exercise. I was shocked to learn about how many individuals lack access to food. I have lived and worked in this county for many years and never realized this. I would like to research how to address these needs to see if improving the access to food would improve the obesity rates in the county.

Reference

County Health Rankings and Roadmaps (2018) Carroll County. Robert Wood Johnson Foundation. Retrieved October 13, 2018 from http://www.countyhealthrankings.org/app/maryland/2018/rankings/carroll/county/outcomes/overall/snapshot

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