NUR 4681 – Deliverable 5 – Global Health Agencies

NUR 4681 – Deliverable 5 – Global Health Agencies

Adolescent pregnancy rates have decreased significantly over the past 30 years, women aged 24 and under hit an all-time low in 2017. Pregnancy rates for young adults aged 24 and under have been falling steadily since the late 1980s, and this trend persists. As a whole, the birth rate for women aged 15–17 decreased to 14 in 2017 (from a peak of 75 in 1989), for women aged 18–19 to 57 (from a peak of 175 in 1991), and for women aged 20–24, to 111. (from a peak of 202 in 1990)(Maddow-Zimet & Kost, 2021). It is important to define “adolescent pregnancy” so that we may avoid misunderstandings about what it means when a girl is in her teens and pregnant. The word “adolescent pregnancy” conjures a variation of a stereotypical image of a woman suffering through life with a baby. Pregnancy outcomes that occur during adolescence, including live births, stillbirths, miscarriages, ectopic pregnancies, abortions, and fetal losses, are all included in the umbrella term “adolescent pregnancies” (OPA, 2022). There were 3,910 teen pregnancies in Kansas in 2013, but that number is expected to drop to just 1,749 by 2020. (Power To Decide, 2023). Although this is a giant leap forward, Kansas’ current ranking of #33 shows that even more progress is possible (Centers for Disease Control and Prevention [CDC], 2022). Do you need help with your assignment ? Contact us at eminencepapers.com.

Why are Kansas’s teen birthrates so low, even though the state is a part of a relatively developed nation (in terms of technology, medicine, and other resources)? Probably because there is not enough medical attention available. Availability, accessibility, affordability, acceptability, and quality are the five pillars upon which healthcare access rests. When there are enough fully operational, well-staffed, and adequately supplied healthcare facilities relative to the population, healthcare is available. These healthcare facilities are considered accessible when they are situated so that all patients, regardless of their geographical location or physical capabilities, can easily gain access to them. Affordability in service provisioning occurs when costs are less than or equal to the user’s ability to pay. Finally, it’s appropriate for healthcare to be delivered by professionals who are culturally competent and who refrain from displaying bias, judgment, and prejudice in their interactions with patients (Jacobsen, 2022).

More than 19 million women (of reproductive age) in need of publicly financed contraception live in “contraceptive deserts” – places without access to a county health facility that offers the entire spectrum of contraceptive techniques, as reported by Power To Decide, (2023). To be more exact, these areas are counties where there is a high concentration of women in need of these services and a low concentration of health centers, defined as one health facility for every 1,000 women (Power To Decide, 2023). There are 592,910 females in Kansas’ childbearing years, and approximately 181,500 of them might use access to publicly financed contraceptive services. However, there are 173,820 women who do not have access to any form of contraception and 39,170 women who do not have access to any form of contraception. There is not a single healthcare center in their area that provides the whole spectrum of contraceptives (Power To Decide, 2023).

NUR 4681 – Deliverable 5 – Global Health Agencies

How Can We Lessen Health Inequalities?

 Environments in which people are born, raised, worshiped, educated, employed, and matured are examples of social determinants of health. People’s health and happiness are impacted by the SDOH (Social Determinants of Health – Healthy People 2030, 2022). Economic security, access to and quality of education, healthcare, neighborhood and built environment, and social and community context are the five core categories of SDOH. Those with a lower SDOH might expect unfavorable health effects. Health disparities refer to large discrepancies in life expectancy between demographic groups. Improving the health of the economically and socially disadvantaged is the most effective strategy to decrease health inequalities (Jacobsen, 2022).

Teens are less likely to have sex and get pregnant if they are living with both parents and receiving positive reinforcement in their academic and social environments. Pregnancy rates among 14-year-olds are lower among those who live with both biological parents (OPA, 2022). Teens in high-risk communities, which include high rates of substance misuse, violence, and starvation, are likely to engage in promiscuous behaviors and become parents. Other teens who live in low-risk neighborhoods and have access to positive adult role models and strong community ties have less promiscuous behaviors. Females between the ages of 15 and 24 who were born to moms who had pregnancies at a young age themselves may repeat the cycle of adolescent pregnancy (OPA, 2022). People have noticed that the African American and Hispanic communities have a disproportionately high rate of teen births. This has been linked to health disparities in accessing services like family planning, differences in beliefs about contraception and teen pregnancy/childbearing, and bad experiences with healthcare in the past (OPA, 2022). There are 2,934,582 individuals in the state of Kansas, and 11.4% of them are poor (which is approximately 334,542 people). About a quarter (24.9%) of the total population of 334,542 are persons of African American heritage, while 36.5% of the population comprises young women (12-24). (People living below the poverty level, 2023).

How Can We Reduce Health Disparities?

 As was noted before, the greatest strategy to reduce health disparities is to increase the social determinants of health (SDOH) of the disadvantaged. One of the most significant ways in which adolescent mothers’ ability to continue their education is hampered is by the demands of caring for a kid. Nearly a third of teen mothers do not complete high school, only 40% go on to earn a diploma, and less than 2% earn a bachelor’s degree before turning 30 (Power To Decide, 2023). An individual’s likelihood of needing and receiving public assistance and of living on a low income in adulthood increases in proportion to their level of education (OPA, 2022). Columbia Heights Education Campus in Washington, DC, saw a high incidence of teen pregnancies, so they implemented a daycare and a pregnancy prevention program that ultimately increased their graduation rate to 95% (Harper, 2019).

While this helps close the gap between individuals, it’s crucial to remember that there are still gaps in the social, economic, and policy spheres that have an impact on people’s health.

Effective interventions to reduce SDOH disparities must alter the framework of social and environmental policies that contribute to and sustain these inequities. In order to combat the complex character of SDOH, interventions must be diverse and extend beyond the level of the person to affect systemic change (Brown et al., 2019). Additionally, the following interventions have been shown to reduce health disparities:

Raising public, political, and policy-level understanding of these inequalities

Promoting and facilitating the delivery of culturally competent care grounded in best practices gleaned from the scientific literature

The best way to help your patients get the care they need and find the best possible treatment is to implement patient education.

A cultural competence training program should be incorporated into the education of existing and future medical professionals (AMA, 2023).

How Do We Improve Access to Care?

Typical sexuality education for today’s youth typically focuses on the negative outcomes of sexual engagement (pregnancy, STIs, etc.) and how abstinence is the best way to avoid them. Although there is some instruction on the various forms of birth control, students learn relatively little about where they might get their hands on accessible, low-cost options today. Teens typically lack both the knowledge of where and when to find affordable contraceptives and the resources to pay for them. To improve patients’ ability to receive medical attention, removing these roadblocks through intervention may show to be a fruitful strategy. Adolescents’ needs and preferences were better met when policies were removed or adjusted (within existing services) to protect confidentiality and privacy. When services were made available at no cost or at a reduced cost more teenagers started using birth control (Chandra-Mouli & Akwara, 2020).

Mobile health clinics have been a valuable resource with long-term effects. There is evidence that mobile outreach clinics increased access to care and met high unmet needs for family planning and limited access to modern contraceptives, especially in areas where geographical, economic, or social barriers made it hard to get to these healthcare needs. Mobile outreach got around these problems by bringing information, supplies, and services to patients in rural areas for little or no cost (High Impact Practices [HIP], 2023).

NUR 4681 – Deliverable 5 – Global Health Agencies

One potential strategy for doing so would be to boost Title X funding. Family planning and related preventative treatments are the main focus of Title X funding, a government grant program. Title X’s current objectives include improving health equality and increasing coverage of healthcare services without compromising on quality. Those who have been negatively impacted by long-term poverty and inequality, such as those from low-income households, minorities, underserved communities, and many others, should be given special attention in the quest to advance equity (Title X Program, OPA, 2022).

References

AMA. (2023). Reducing disparities in health care. American Medical Association. https://www.ama-assn.org/delivering-care/patient-support-advocacy/reducing-disparities- health-care

Brown, A. F., Ma, G. X., Miranda, J., Eng, E., Castille, D., Brockie, T., Jones, P., Airhihenbuwa, O., Farhat, T., Zhu, L., & Trinh-Shevrin, C. (2019). Structural interventions to reduce and eliminate health disparities. American Journal of Public Health, 109(S1), S72–S78. https://doi.org/10.2105/ajph.2018.304844

Centers for Disease Control and Prevention. (2022, February 25). Stats of the state – teen birth rates. https://www.cdc.gov/nchs/pressroom/sosmap/teen-births/teenbirths.htm

Chandra-Mouli, V., & Akwara, E. (2020). Improving access to and use of contraception by adolescents: What progress has been made, what lessons have been learned, and what are the implications for action? Best Practice & Research Clinical Obstetrics & Gynaecology, 66, 107–118. https://doi.org/10.1016/j.bpobgyn.2020.04.003

Harper, A. (2019, March 20). On-site school day care centers keep teen moms on track. https://www.k12dive.com/news/on-site-school-day-care-centers-keep-teen-moms-on- track/550785/

High Impact Practices. (2023). Mobile outreach services for reproductive health needs – hips.

Hips. https://www.fphighimpactpractices.org/briefs/mobile-outreach-services/ Jacobsen, K. H. (2022). Introduction to Global Health (4th ed.). Jones & Bartlett Learning. https://ambassadored.vitalsource.com/books/9781284282078

Maddow-Zimet, I., & Kost, K. (2021, February 17). Pregnancies, births and abortions in the United States, 1973–2017: National and state trends by age. Guttmacher Institute. https://www.guttmacher.org/report/pregnancies-births-abortions-in-united-states-1973- 2017

OASH. (2020). Trends in teen pregnancy and childbearing. HHS Office of Population Affairs. https://opa.hhs.gov/adolescent-health/reproductive-health-and-teen-pregnancy/trends- teen-pregnancy-and-childbearing

OPA. (2022). Title x program expectations. Office of Population Affairs. Retrieved 2022, from https://opa.hhs.gov/grant-programs/title-x-service-grants/about-title-x-service-grants/title- x-program-expectations

OPS. (2022). Trends in teen pregnancy and childbearing. HHS Office of Population Affairs. https://opa.hhs.gov/adolescent-health/reproductive-health-and-teen-pregnancy/trends- teen-pregnancy-and-childbearing

People living below the poverty level. (2023). KansasHealthMatters. https://www.kansashealthmatters.org/?module=indicators&controller=index&action=vie w&comparisonId=&indicatorId=347&localeId=19&localeChartIdxs=1%7C2%7C3%7C 4

Power To Decide. (2023). Kansas data. https://powertodecide.org/what-we- do/information/national-state-data/Kansas

Social determinants of health – healthy people 2030. (2022). https://health.gov/healthypeople/priority-areas/social-determinants-health

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Based on a current global health problem, develop a case study scenario and two open-ended questions related to the scenario. Provide answers with rationales to the case study questions.

The case study scenario should address variables affecting access to healthcare in a global population (at least five)

The first question, answer, and rationale should address approaches to reduce health disparities in a global population.

The second question, answer, and rationale should address interventions to improve access to healthcare for a global population.

Use APA format for citations and reference lists. Information should be supported by evidence from professional sources, published within the past five years.