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ArleneHealthyPeople2020Maternal
- 1. Healthy People 2020 Maternal, Infant, and Child Care Arlene Quiñones HBSS 4100
- 2. Background • Improving the health and well being of expectant mothers and infants determine the health for future generations. • Pregnancy can help identify pre-existing health conditions such as hypertension, heart disease, diabetes, depression, genetic diseases, STDs and inadequate nutrition. • Factors that affect pregnancy and childbirth: Preconception health status Age Access to appropriate and quality preconception and interconception health care Poverty • Goal of Healthy People 2020: “Improve the health and wellbeing of women, infants, children and families.”
- 3. Healthy People 2020 Objectives 1. Reduce the rate of fetal and infant mortality. 2. Increase the proportion of women who receive early and adequate prenatal care. 3. Increase the use of daily multivitamin/folic acid in the month prior to conception. 4. Increase the abstinence of alcohol, cigarettes and illicit drug use among pregnant women. 5. Increase the proportion of infants that are breastfed.
- 4. MICH-10: Increase the proportion of women who receive adequate prenatal care by race/ethnicity
- 5. MICH-11: Increase the proportion of pregnant women abstaining from alcohol, cigarettes and illicit drugs
- 6. Social Determinants of Maternal, Infant, and Child Health 1. Access to quality health care prenatal, delivery, and post-delivery 2. Racial and ethnic disparities 3. Family income 4. Educational attainment 5. Health insurance coverage 6. Chronic stress
- 7. Achieving the Behavioral and Social Program Core Competency The process of changing an individual or group’s behavior is one that brings many challenges. I believe that by using evidence based research and theory to target specific communities may prove helpful in influencing change. It takes the combination of community based and individual based approaches to tackle behavioral change, such as implementation of health policy, community and individual support, and a diverse team of health educators. It is not a simple task of rewiring ingrained behaviors which is why it takes analytical, tactful and knowledgeable educators to influence change across all spectrums.
- 8. Achieving the Professional Identity of Core Competency Healthy People 2020 made me realize the importance of collaborating, implementing and evaluating health programs specific to maternal, infant and child care. The importance of providing the best care and education for expectant mothers will create lasting benefits for generations. I am most passionate about strategizing and implementing programs that will improve the health of infants and children. It is essential that as I build a career in health education, I keep abreast on the latest research, continue to network within various organizations, and maintain my passion for social equality within the health sector. This will allow me to become the well-rounded professional that will provoke change in underprivileged communities.
- 9. Achieving the Health Equity Program Core Competency The implementation of quality health education programs can only go so far if the necessary resources are scarce. This proves to be the biggest hurdle in effectively changing the behavior and environment of impoverished communities, which numerous studies show the direct correlation between socioeconomic status and health. Ultimately, we can achieve equity by working to integrate and/or fund resources to disadvantaged communities. This will take various government and private organizations, schools, health facilities, and health educators working together to collaborate ideas, research, and strategies to work towards equity.
- 10. Recommendations Electronic screenings and brief interventions Implement Quitline programs Health insurance coverage for women with low income
- 11. References 1. Healthy People. 2020 Topics & Objectives: Maternal, Infant and Child Care www.healthypeople.gov. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child- health 2. Williams DR, Collins C. US Socioeconomic and racial differences in health: Patterns and explanations. Ann Rev Soc. 1995;21:349-86 3. Larson K, Russ SA, Crall JJ, et al. Influence of multiple social risks on children’s health. Pediatrics. 2008 Feb 1;121(2):337-44. 4. Preventing Excessive Alcohol Consumption: Electronic Screening and Brief Interventions (e-SBI). (Community Guide Recommendation) Retrieved from https://www.thecommunityguide.org/findings/alcohol-excessive-consumption-electronic-screening-and- brief-interventions-e-sbi 5. Reducing Tobacco Use and Secondhand Smoke Exposure: Quitline Interventions (Community Guide Recommendation) Retrieved from https://www.thecommunityguide.org/findings/tobacco-use-and- secondhand-smoke-exposure-quitline-interventions 6. CDC. Recommendations to Improve Preconception Health and Health Care --- United States: A Report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5506a1.htm 7. CDC. Health Insurance Coverage — United States, 2008 and 2010.Supplements. November 22, 2013 / 62(03);61-64. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/su6203a10.htm?s_cid=su6203a10_w
Notes de l'éditeur
- The one common experience many women face in our society is creating a family. According to the CDC, in 2000 an estimated 62 million women in the United States were of childbearing age. Approximately half of all women have experienced at least one birth by age 25, and approximately 85% of all women in the United States have given birth by age 44. In 2003, the fertility rate was 66 live births per 1,000 women aged 15 to 44 years, with highest rates among women aged 25 to 29 years and lowest rates among women aged older than 44 years. A similar age pattern has been observed within racial and ethnic populations, although women aged younger than 25 years who are non-Hispanic black and Native American had higher fertility rates than non-Hispanic whites and Asian/Pacific Islanders. Hispanic women have the highest fertility rates overall and within each age group. Improving the physical and mental health of expectant mothers sets the stage for a healthier generation. Pregnancy can also serve as a barometer of health for the mother, as health professionals are able to identify pre-existing conditions such as hypertension, heart disease, diabetes, depression, genetic diseases, STDs and inadequate nutrition. It is essential for women to have adequate access to quality health care across all socioeconomic levels. In order to diminish factors that affect pregnancy and childbirth, such as preconception health status, age, access to quality health care, and poverty, we must understand the complicated interwoven socioeconomic determinants of health.
- Healthy People 2020 has 33 objectives to improve the health of expectant mothers, infants and children. I’ve included a sample of 5 objectives: 1. Reduce the rate of fetal and infant mortality within perinatal period to 1 year. 2. Increase the proportion of women who receive early and adequate prenatal care. 3. Increase the use of daily multivitamin/folic acid in the month prior to conception. Increase the abstinence of alcohol, cigarettes and illicit drug use among pregnant women. Increase the proportion of infants that are breastfed. For this Healthy People 2020 presentation I will focus on number 2 and 4.
- The graph illustrates the percentage of pregnant women who received adequate prenatal care based on race/ethnicity. In 2007, only 70.8% of females delivering a live birth received prenatal care beginning in the first trimester. The Healthy People 2020 goal is reaching the target of 77.9% which is a 10% improvement. Asian/Pacific Islander and White women are the highest proportion of individuals receiving adequate prenatal care with a percentage above 72%. Racial disparities are apparent within specific racial/ethnic groups. Only 64.7% of Hispanics or Latinos, 59.0% of Black or African American, and 55.7% American Indian or Alaska Native received adequate prenatal care beginning in the first trimester. These are the largest groups of individuals living in poverty in which health care coverage and educational resources are lacking.
- This graph illustrates the increase of the proportion of pregnant women abstaining from alcohol, cigarettes and illicit drugs. There was a significant increase in the proportion of pregnant women abstaining from alcohol, cigarettes and illicit drugs from 2009 to 2015. In 2009 the proportion of pregnant women abstaining from alcohol was 89.4%, cigarettes 89%, and illicit drugs 95.6%. Healthy People 2020 goal for pregnant women abstaining from alcohol is 98.3%, cigarettes 98.6% and illicit drugs 100%. Some effects on the fetus while consuming these harmful substances include low birth weight, miscarriage, premature ruptures of membranes, mental retardation, birth defects and death.
- The social determinants of maternal, infant and child health include: 1. Access to quality health care prenatal, delivery and post-delivery 2. Racial and ethnic disparities 3. Family income 4. Educational attainment 5. Health insurance coverage 6. Chronic stress
- My recommendations to improve maternal and infant health include electronic screenings and brief interventions, quitline programs and health insurance coverage for women with low income. Electronic screenings and brief interventions: Strong evidence have indicated that the prevention of excessive alcohol consumption starts with electronic screening and brief intervention (e-SBI). This entails screening individuals for excessive drinking habits by using electronic devices such as computers, telephones and mobile devices, and then delivering a brief intervention where the individual is informed about the risks and consequences by a trained counselor. The counselor schedules monthly follow-ups to offer support during this behavioral change. This method can be delivered in various settings such as health care facilities, universities, and communities. This is especially essential for the health of the fetus as the use of alcohol and other harmful substances are known to cause birth defects or mortality. Implement Quitline programs: Proactive Quitline programs have been determined successful in the cession of tobacco use. Individuals are connected through the use of telephones to receive evidence based counseling by specialized professionals who follow standardized protocols over a duration of several months. This can provide the support and knowledge pregnant women require for the cession of smoking. Health insurance coverage for women with low income: Lack of adequate coverage makes it difficult for pregnant women to get the health care they need and, when they do get care, burdens them with expensive medical bills. It is essential that we support policy makers who focus on the provision of insurance coverage as the principal means of ensuring access to health care among the general population.