Child and Adolescent Health

Read chapter 16 of the class textbook and review the attached PowerPoint presentation.  Once done, answer the following questions.

1.  Identify and discuss the major indicators of child and adolescent health status.

2.  Describe and discuss the social determinants of child and adolescent health.

3.  Mention and discuss at least 2 public programs and prevention strategies targeted to children’s health.

4.  Mention and discuss the individual and societal costs of poor child health status.

INSTRUCTIONS:

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled “Week 12 discussion questions” and the SafeAssign exercise in the assignment tab of the blackboard.   It is mandatory to post your assignment in the SafeAssign exercise.  If the assignment is not posted there, I will grade the assignment as 0.  A minimum of 2 evidence-based references besides the class textbook no older than 5 years must be used and quoted.  You must post two replies to any of your peers sustained with the proper references no older than 5 years in two different days to verify attendance and as well make sure the references are properly quoted and mention to whom you are replying to.  The reply is a comment to your peer not an extension of your assignment.  What I mean is that you can’t post in your replies the same that you posted in your assignment.   A minimum of 800 words is required.  Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.  I will also pay close attention to spelling and/or grammar.  Please review the rubric attached to the lecture.  You must present the assignment according to how it is posted, answering the questions by number, essay-style assignments will not be accepted unless otherwise specified.  I’ve been grading a lot of assignments with quite a few spelling/grammar errors.  As a BSN student, you should be able to present an assignment according to APA and without errors.  This reflects our University.

Chapter 16

Child and Adolescent Health

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

The Health of a Child Has
Long-Term Implications
Health habits adopted by children and youth profoundly influence their potential to lead healthy, productive lives.
The physical and emotional health of a child plays a pivotal role in the overall development and well-being of the entire family.
Children who are healthy, well-nourished, well cared for at home, and safe and secure in their world achieve a higher potential.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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U.S. Children by Race/Ethnicity
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Figure 16-1 From Federal Interagency Forum on Child and Family Statistics: America’s children in brief: key national indicators of well-being, 2012. www.childstats.gov/americaschildren/demo.asp. Accessed March 8, 2013.

Impact of Pregnancy on a Child’s Health
The health of the mother before, during, and after pregnancy has a direct impact on the health and well-being of her children.
A comprehensive approach is needed to…
Identify and treat potential risks
Overcome barriers to good health before, between, and beyond pregnancy
Protect and promote the health of women and children
Ensure the health of future generations
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Risk Factors
Risks to mother  Risks to baby
Not in optimal health  Poor pregnancy outcome
Uncontrolled medical conditions  Low birth weight with serious medical conditions
Exposure to drug, alcohol, tobacco, poor nutrition  Chronic conditions that affect health and well-being
Unsafe environment (secondhand smoke, lead-based paint)  Chronic conditions throughout childhood and maybe adolescence/adulthood
Risks to Children
No preventive health care and immunizations  preventable diseases or chronic conditions in life
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Infant Mortality
Infant mortality reflects the health and welfare of an entire community and is used as a broad indicator of health care and health status.
Infant mortality is related to several factors:
Maternal health
Medical care quality and access
Socioeconomic conditions
Public health practices
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Infant Mortality (Cont.)
Leading causes of infant death in the United States (almost 60% of all infant deaths)
Congenital defects
Disorders relating to short gestation and low birth weight
Sudden infant death syndrome (SIDS)
Maternal complications of pregnancy
Accidents such as suffocation
United States ranks 27th in infant mortality among industrialized nations
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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U.S. Infant Mortality
Has dropped every year since 1940 (not 2002)
Attributable to public health measures and improved standard of living
Improved sanitation
Clean milk supply
Immunizations
Nutritious food
Enhances access to maternal health care
Technological advances also contributed
e.g., synthetic lung surfactant
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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International Comparisons of
Infant Mortality Rates* (2011)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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*Infant mortality rate represents infant deaths per 1000 live births.
World Rank Country 1960 2011
1 Iceland 13.0 0.9
2 Sweden 16.6 2.1
3 Japan 30.7 2.3
4 Finland 21.0 2.4
4 Norway 16.0 2.4
6 Czech Republic 20.0 2.7
7 Republic of Korea — 3.0
8 Portugal 77.5 3.1
9 Spain 43.7 3.2
10 Belgium 31.4 3.3

International Comparisons of Infant Mortality Rates* (2011) (Cont.)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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*Infant mortality rate represents infant deaths per 1000 live births.
World Rank Country 1960 2011
11 Italy 43.9 3.4
11 Greece 40.1 3.4
13 France 27.7 3.5
13 Israel — 3.5
13 Ireland 29.3 3.5
16 Germany 35.0 3.6
16 Austria 37.5 3.6
16 Denmark 21.5 3.6
16 Netherlands 16.5 3.6
20 Switzerland 21.1 3.8

International Comparisons of Infant Mortality Rates* (2011) (Cont.)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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*Infant mortality rate represents infant deaths per 1000 live births.
World Rank Country 1960 2011
20 Australia 20.2 3.8
22 United Kingdom 22.5 4.3
23 Poland 54.8 4.7
24 Slovakia 28.6 4.9
24 Hungary 47.6 4.9
26 New Zealand 22.6 5.5
27 United States 26.0 6.1
28 Chile 120.3 7.4
29 Turkey 189.5 7.7
30 Mexico 92.3 13.6

Infant Mortality Rates
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Figure 16-2 From Murphy SL, Xu J, Kochanek KD: Deaths: Final Data for 2010, National Vital Statistics Report, Vol 61, No.4, May 8, 2013. http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04 . Accessed September 3, 2013.

Preterm Birth and Low Birth Weight
Preterm: Birth before 37 weeks of gestation
LBW: Infant born less than 5.5 pounds
Important predictors of infant health
Greater risk of death than full term
Greater risk of mental and physical disabilities
Cerebral palsy
Visual problems (e.g., retinopathy of prematurity)
Feeding problems
Hearing loss
Developmental delays
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Preterm Birth and Low Birth Weight (Cont.)
Factors associated with preterm and LBW
Minority status
Chronic stress
Maternal age of <17 years and >35 years
Chronic health problems of mother
Lack of prenatal care
Multiple births
Certain problems with the uterus or cervix
Low socioeconomic status
Unhealthy maternal habits
Induced labor and elective C-section births
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Preconception Health
Half of all pregnancies are unintended.
Impact on developing fetal organ systems by:
Healthy maternal weight and good nutrition
Tending to chronic maternal diseases
Being up-to-date on vaccinations
Avoiding environmental toxins
Decreasing stress and eliminating abusive relationships
Avoiding illicit drugs, tobacco, and alcohol
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Preconception Health (Cont.)
Preconception counseling as a prevention strategy:
Effective contraception to avoid unintended pregnancies and pregnancy spacing
Recommend intake of folic acid daily
Encourage healthy lifestyle modifications
Prenatal care
Prenatal substance use
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Prenatal Care
Early and regular prenatal care enhances chance of a healthy, full-term baby.
Health education and counseling
Risk identification
Monitoring and treatment of symptoms
Referral to health, nutrition, social services
Medicaid, WIC, food stamps, smoking cessation services, housing, child care, job training, substance abuse treatment, domestic violence screening and counseling
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Prenatal Substance Use
The use of tobacco, alcohol, or illicit drugs in any combination is dangerous to a woman’s health and worsens infant health and development outcomes.
Smoking is one of the most preventable causes of infant morbidity and mortality
Alcohol can lead to FAS
Drugs can cause permanent harm to an unborn baby
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Breastfeeding
“Breastfeeding is a natural and beneficial source of nutrition and provides the healthiest start for an infant. In addition to the nutritional benefits, breastfeeding promotes a unique and emotional connection between mother and baby.”
– American Academy of Pediatrics, 2012
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Breastfeeding (Cont.)
AAP recommends
Exclusive breastfeeding for first 6 months
Breastfeeding in combination with introduction of complementary foods until at least 12 months
Continuation of breastfeeding for as long as mutually desired by mother and baby
2011Surgeon General’s Call to Action to Support Breastfeeding
Actions aimed at increasing society support
Nurses, other professionals, and support groups
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Breastfeeding Advantages
Mother
Lower risk of breast and ovarian cancer
Lower risk of postpartum depression
Lower risk of type 2 diabetes
Saves money on formula
Baby
Cells, hormones, and antibodies in breast milk
Lower risk of asthma
Lower risk of obesity
Lower risk of diabetes
Lower risk of SIDS
Fewer illnesses
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Sudden Unexplained Infant Death
Definition of SUID
Less than 1 year of age
Occurs suddenly and unexpectedly
Cause of death not immediately obvious before investigation
Half of SUID are SIDS
Definition of SIDS
Death cannot be explained after a thorough investigation, including autopsy, examining death scene, and review of clinical history
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Sudden Unexplained Infant Death (Cont.)
Back to Sleep campaign (1994)
Heighten awareness of the safety of positioning infants on their backs for sleep
SIDS death declined by >50%
Safe to Sleep campaign (2010)
Included other actions to reduce risks of other sleep-related causes of death (e.g., suffocation)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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http://www.nichd.nih.gov/sts

Safe to Sleep Campaign Recommendations
Always place baby on back to sleep for naps and night
Place baby on firm surface with fitted sheet
Not in adult bed, couch, or chair alone or with adults
Keep soft objects, toys, and loose bedding out of sleep area
Do not smoke during pregnancy
Do not allow smoking around baby
Do not let baby get too hot during sleep
Follow vaccine and health check-up recommendations
Avoid advertised SIDS products
Get regular health care during pregnancy
– National Institute of Child Health & Human Development: Safe sleep for your Baby, 2013
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Childhood Health Issues
Accidental injury is the leading cause of death in children ages 1 to 14.
Childhood obesity is a health crisis; it can lead to numerous health problems.
Childhood immunization is a benchmark of child health.
Environmental concerns can be found in air, water, and from toxic exposure to chemicals.
Child maltreatment is an indicator of children’s physical and emotional health status.
Children with special health care needs frequently need multiple health care services.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Adolescent Health Issues
Adolescent sexual activity is often unprotected and can result in pregnancy and STIs.
Teen childbearing and parenting often have long-term negative consequences for both child and mother.
Violence among youth is a multifaceted problem.
The use of tobacco, alcohol, and drugs has serious and long-lasting consequences for adolescents and society.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Factors Affecting Child and Adolescent Health
Significant factors in overall well-being:
Parents’ or caregivers’ income, education, and stability
Security and safety of the home
Nutritional and environmental issues
Health care access and use
Specific issues:
Poverty
Racial and ethnic disparities
Health care use
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Children Lacking Health Insurance
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Figure 16-5 Data from DeNavas-Walt C, Proctor D, and Smith J: Income, poverty, and health insurance coverage in the United States: 2011. U.S. Census Bureau Current Population Reports, September 2012. http://www.census.gov/prod/2012pubs/p60-243 . Accessed March 8, 2013.

Strategies to Improve Child and Adolescent Health
Collect/analyze data tracking well-being of children and adolescents.
Establish goals and set measurable objectives using Healthy People 2020.
Implement health promotion and disease prevention strategies.
More significant and cost-effective for children than other age groups.
Utilize public health programs targeted to children and adolescents.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Public Health Programs Targeted to Children and Adolescents
Health Care Coverage Programs
Affordable Care Act
Medicaid and CHIP
EPSDT (Early and Periodic Screening, Diagnosis, and Treatment)
Direct Health Care delivery programs
Maternal and Child Health Block Grant (Title V)
Community & Migrant Health Centers program
School-Based Health Centers
WIC
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Sharing Responsibility for Improving Child and Adolescent Health
Parents’ role
Community’s role
Employer’s role
Government’s role
Community health nurse’s role
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Community Health Nurse’s Role
An advocate for improved individual and community responses to children’s needs.
A researcher for effective strategies to serve women and children.
A participant in publicly funded programs.
A promoter of social interventions that enhance the living situations of high-risk families.
A partner with other professionals to improve service collaboration and coordination.
Understand the legal and ethical implications of decision making.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Monitoring the Health and Well-Being of Children
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Resource Website address
Centers for Disease Control and Prevention (CDC) http://www.cdc.gov
Federal Interagency Forum on Child and Family Statistics http://www.childstats.gov
National Center for Education Statistics (NCES) http://nces.ed.gov

National Center for Health Statistics (NCHS) http://www.cdc.gov/nchs
US Bureau of Justice http://www.ojp.usdoj.gov/bjs
US Bureau of Labor Statistics http://www.bls.gov
US Census Bureau http://www.census.gov
USDHHS Healthy People 2020 http://www.healthypeople.gov

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1940 1970 1980 1990
Neonatal
Postneonatal
Figure 7. Infant, neonatal, and postneonatal mortality rates: United States, 1940-2010
1950 1960 2000
Infant
NOTE: Rates are infant (under 1 year), neonatal (under 28 days), and postneonatal (28 days-11 months) deaths per 1,000 live births in
specified group.
SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.
2010
National Vital Statistics Report, Vol. 61, No. 4, May 8, 2013 68