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MBI 131: FINAL
Maternal, Infant, and Child Health
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Maternal, infant, and child health (MIC) encompasses health of women of childbearing age from pre-pregnancy through pregnancy, labor and delivery, and the postpartum period, & the health of the child prior to birth through adolescence
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Family Planning
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Determining the preferred number and spacing of children and choosing the appropriate means to accomplish it
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maternal mortality rate
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Maternal mortality and morbidity rates
Causes include poverty and limited education
death during pregnancy
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prenatal care
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Medical care from time of conception until birth process.
Three major components
Risk assessment
Treatment of medical conditions, or risk reduction
Education
Early and continuous prenatal care leads to better pregnancy outcomes
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infant mortality rate
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Measure of a nation’s health
Decline in infant mortality due to
Improved disease surveillance
Advanced clinical care
Improved access to health care
Better nutrition
Increased education
Leading causes of infant death: congenital abnormalities, preterm/low birth weight, SI
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reproductive health
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being healthy so you can make babies // be fertile
# of children you are able to have
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factors effecting maternal health
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Effect of pregnancy and childbirth on women important indicator of health
Pregnancy and delivery can lead to serious health problems
Maternal death
Maternal mortality and morbidity rates
Causes include poverty and limited education
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teen pregnancies
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Teens who become pregnant and have a child are more likely to
Drop out of school
Not get married or to have a marriage end in divorce
Rely on public assistance
Live in poverty
Substantial economic consequences for society
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unintended pregnancies
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~½ of pregnancies in U.S. are unintended
40% of those end in abortion
Unintended pregnancy
Mistimed or unwanted
Unintended pregnancy associated with negative health behaviors
Delayed prenatal care, inadequate weight gain, smoking, alcohol and other drug use
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title X
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Federal program that provides funds for family planning services for low-income people
Nation’s major program to reduce unintended pregnancy by providing contraceptive and other reproductive health care services to low- income women
Supports 61% of the 4,000+ family planning clinics in U.S.
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infant risk factors
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Premature births
Low birth weight
Cigarette smoking
Alcohol and other drugs
Breastfeeding
SIDS
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abortion |
Legal in early stages of pregnancy since 1973 (Roe V. Wade)
Majority of abortions
Unmarried women (83.5%)
55% white
52% under age 25
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child morbidity
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Unintentional injuries
Significant economic, emotional, and disabling impact
Child maltreatment
Strong community response needed
Infectious diseases
Importance of immunization schedule
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WIC
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A special supplemental food program for women, infants, and children sponsored by the USDA; established in 1974
Eligibility requirements
Residency in application state, income requirements, at “nutritional risk”
2008: 9.5 million participants; nearly half of all infants born in U.S., ¼ of children ages 1-5
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CHIP
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CHIP – targets uninsured children whose families don’t qualify for Medicaid
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adolescants/young adults
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high school, college, adults. Peaked in 1979 at 21% of population; now ~14%
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employment status young adults
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Employment status
Participation in labor force has remained fairly constant in recent decades
Disparities by race
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mortality of young adults
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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
Most threats stem from behavior rather than disease
Unintentional injuries (46.5%), homicide (16%), suicide (12%)
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morbidity of young adults
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Communicable diseases
Measles immunizations important
Sexually transmitted diseases
This age group acquires nearly half of all new STDs in the U.S.
Some effects can last a lifetime
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young adults health behavior
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Unintentional injuries
Violence, Tobacco use, Alcohol and other drugs
Sexual behaviors – unintended pregnancies and STDs, Physical activity
Overweight and weight control
Main factors affecting community health with age group are social and cultural factors and community organizing
Alcohol use a main problem
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sexual health
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Sexual behaviors – unintended pregnancies and STDs
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adults activity
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Risk factors for chronic disease
Most significant for adults – smoking, lack of exercise, BMI, alcohol
weight control
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chronic diseases
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Many associated with unhealthy behaviors and poor lifestyle choices
Lifestyle improvements and public health advances have led to decline in death rate for adults
Most significant for adults – smoking, lack of exercise, BMI, alcohol
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hypertension
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a disorder in which a person's blood pressure is consistently higher than normal
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Hypercholesterolemia
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High blood cholesterol condition
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cancer |
#1 cause of death for adult age group in recent decades
Males – prostate, lung, and colorectal
Females – breast, lung, and colorectal
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improve adult health
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Emphasis on individual responsibility for health
Primary, secondary, and tertiary prevention efforts for adults
Primary – exercise and nutrition programs
Secondary – self and clinical screenings to identify and control disease processes
Tertiary – medication compliance
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aging population
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Majority of elders today are active and well
Many still working
Many strongly engaged in community, volunteer, and advocacy programs
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old
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Young old – 65-74
Middle old – 75-84
Old old – 85+
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aged
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look up terms.
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misconceptions against elders
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Ageism – prejudice and discrimination against the aged
Common myths not accurate representation of elders
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age pyramind
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book
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fertility and mortaility rates of elders
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Fertility rates
Baby boomers – 1946-1964
Mortality rates
Life expectancy has continued to increase; significant increase in 20th century
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elders living arrangements
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Closely linked to income, health status, and availability of caregivers
2/3 of noninstitutionalized elders live with someone else
Women more likely to live alone
Only 5% of elders live in nursing homes
¾ of nursing home residents are women
More than half of nursing home residents are 85+
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race/ethnic background of elders
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U.S. older population growing more diverse
2010 elders:
80% white, 9% black, 7% of Hispanic origin, 3% Asian
2050 projection of elders:
White 58%, Hispanic origin 15%, black 11%, Asian 8%
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economic status of elders
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1970 – 25% of elders lived in poverty
2006 – less than 9% lived in poverty
Income
37% of elder income from Social Security
15% asset income
18% pension income
28% earnings
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where are elders located?
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2/5 live in southern states
More than half live in 10 states: CA, FL, IL, MI, NJ, NY, NC, OH, PA, TX
California greatest number; Florida greatest proportion
Reasons some states “age”
Inward migration (FL), young people leave (farm belt states)
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health behaviors of elders
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Generally have more favorable health behaviors than younger counterparts
Less likely to consume large amounts of alcohol, smoke cigarettes, or be overweight
Areas for improvement
Physical activity, immunizations
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abuse and neglect of elders
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Reports have increased greatly in recent years
All states have set up reporting systems
Special problem for elders
May be frail
Unable to defend themselves
Vulnerable to telemarketing and mail scams
Most common victims of theft of benefit checks
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6 needs of elders
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Six instrumental needs that determine lifestyle for people of all ages; aging process can alter needs in unpredictable ways
Income
Housing
Personal care
Health care
Transportation
Community facilities and services
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health care for elders
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Elders heaviest users of health care services
Use of health care services increases with age
Most money spent on health care is in last years of life
Medicare primary source of payment for health care services of elders
Will see major changes in future years
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diversity
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(n) - of different kind, form, or character; variety. Strength of America lies in diversity of people
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racial and ethnic categories in gov
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Classifications used to operationalize race and ethnicity
Challenges with classifications representing diversity of population
Categories of race are more social than biological
Self-reported data can be unreliable
Many nonfederal systems do not collect racial and ethnic data
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limitations of racial categories
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Challenges in complete and accurate collection of racial and ethnic data
Bias analysis
HHS has long-term strategy for improving collection and use of racial and ethnic data
Important to understand health beliefs of various groups
Heterogeneity within groups
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immigration and refugees
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Refugees
Immigrants
Aliens
Illegal aliens
Can be classified into existing racial/ethnic groups; as a single group, present special concerns
Education, health problems, injuries, employment, etc.
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health issues in ethnic groups
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Black infant death rate more than two times that of white. Lack of prenatal care and low-birth-weight babies. Incidence and death rates highest among black for various types of cancer. Many disparities attributed to lifestyle factors, late diagnosis, access to health care. Black have higher rates from CHD and stroke.Black tend to develop hypertension earlier in life than whites; unknown reason /Proportional distribution of AIDS cases has increased in black and Hispanics and decreased in white.
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health care
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Health care delivery in U.S. is unlike other developed countries
Is delivered by an array of providers in a variety of settings
Is paid for in a variety of ways.
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how is health care structured?
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Spectrum of health care delivery
Various types of care
Types of health care providers
Health care facilities and their accreditation
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population based health care
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Interventions aimed at disease prevention and health promotion
Health education
Empowerment and motivation
Much takes place in governmental health agencies
Also occurs in a variety of other settings
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medical practice health care
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Primary medical care
Clinical preventive services; first-contact treatment; ongoing care for common conditions
Secondary medical care
Specialize attention and ongoing management
Tertiary medical care
Highly specialized and technologically sophisticated medical and surgical care
For unusual and complex conditions
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end of life
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Services provided shortly before death
Hospice care
Terminal diagnosis
Variety of settings
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allopathic vs oteopathic providers
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Allopathic providers
Produce effects different from those of diseases
Doctors of Medicine (MDs)
Osteopathic providers
Relationship between body structure & function
Doctors of Osteopathic Medicine (DOs)
Similar education and training
Most DOs work in primary care
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CAM
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Complementary and Alternative medicine (CAM)
Used together with conventional medicine, therapy is considered “complementary”; in place of considered “alternative”
Chiropractors, acupuncturists, naturopaths, etc.
Natural products, mind-body medicine, manipulation, etc.
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Medically Indigent
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People whose incomes are above what would qualify them for Medicaid but whose medical expenses are high enough to bring their adjusted income to the poverty level.
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patient bill of rights
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- written in 1972
-list of rights that a pt. can expect that the hospital may not violate during their stay
- not a legal document. still no national one.
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deductible
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terms in book
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deductible
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terms in book
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affordable care act
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obamacare.
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