US Health final exam - maternal & child health Flashcards
Maternal and child
where is this on the list of priorities of PH?
what do they want to assure
what does the evidence say about the connection of conditions in utero/early life to later in life?
The health of pregnant women and children is one of the highest priorities of public health
Want to assure the best possible start to life
Evidence shows conditions in utero and during early life play an important role later in life in regards to susceptibility to chronic diseases
what is IMR
what is Infant Mortality
what number is the rate out of
factors that affect the health of the entire population also impact what
Infant Mortality Rate (IMR)
Infant mortality is considered the death of an infant before their first birthday
The rate is given per 1000 live births
Factors that affect the health of the entire population can also impact the mortality rate of infants
IMR is low in industrialized countries but high in developing places
high IMR = PH & infrastructure and life is really difficult and not conducive to having healthy children
color of skin and zip code can determine health outcome
Importance of infant and child health
what do fetal and infant stages provide
who are the most vulnerable group in society
what is IMR an indicator of
how does infant mortality in blacks compare to white and is this indicative of
Fetal and infant stages of development provide the foundations of good health throughout life
Children are the most vulnerable group in society
Infant mortality rate (IMR) is an indicator of the health status of a population
Infant mortality rate is more than double for US blacks than whites, indicative of a health disparity
Key birth statistics in USA
which state in the U.S has the highest IMR
The current infant mortality rate for the U.S. in 2023 is5.480deaths per 1000 live births, a1.21% declinefrom 2022.
States with the highest IMR:
Mississippi (poorest state): 9.39
Arkansas: 8.59
MA- 3.23 and NH 3.96
chart
when comparing different races
there is a difference between ethnicity and infant mortality
Social Factors in infant mortality
what is the #1 risk factor/cause for infant mortality
Why does low SES increase the risk? because there are:
- what kind of hazards
- is there good food
- who’s behavior imposes a risk
- what 3 things are prevalent
- what kind of factors
- who is young, is it safe, are they married
- is there prenatal care
Number one risk factor/cause is poverty
Why does low SES increase the risk? because there are:
Environmental hazards
Poor nutrition
Maternal risk behaviors
Smoking, alcohol, illegal drugs
Social factors
Young maternal age, violence, out of wedlock birth, stress, lack of social support
Lack of prenatal care
How does poverty affect women and infants
is there enough money to have a good diet for a healthy baby
is there access to fresh fruits and veggies, are they cheap
do women know how to make healthy meals
do these women often breast feed
Not enough money to have a nutritious diet to nourish fetus
Access to fresh fruits and vegetables are not readily available –or too expensive
Lack of knowledge of how to prepare nutritious meals
Breastfeeding is not commonly practiced in women of lower SES
Top reasons for infant mortality in the US
defects in what
are they full term and do they have the normal weight
do they get hurt and if so what in what way
does the mom ever have complications with pregnancy
Birth defects
Preterm birth & low birth weight
Injuries (i.e. suffocation, MV accidents)
Sudden Infant Death Syndrome (SIDS)
Maternal pregnancy complications
Prenatal Care
where does it rank in the public health-oriented kind of care
what does it give to women
poor women are linked with who
who collects prenatal care data
Prenatal care is the most public health-oriented kind of care the medical professional provides
It provides women with information
Problems are diagnosed early
Poor women are often linked with social services
State and federal governments collect prenatal care data
CDC recommends screening and treatment of all pregnant women for common infections
Outreach programs are needed for women who do not seek early prenatal care
Preventing birth defects
what kind of testing is done
what does the FDA regulate
reduction in medication for who and why
who is immunized and against what kind of disease
dietary supplements with what
Genetic and newborn testing
FDA regulation of teratogenic drugs
Warning against alcohol for pregnant women
Reduction of prescribed pain medications during pregnancy
- They may increase risk of congenital heart defects and neural tube defects in fetus
Immunization of all children against rubella
Dietary supplements with folic acid
Preventing low birth weight
are causes of low birth weight understood
what kind of disease is associated with preterm births
what could the recent increase in low brth weight be due to
what are the two preventative measures
Causes of low birth weight are not well understood
Recent evidence suggests that gum disease is associated with preterm births
Periodontal treatment may reduce risk
Recent increase in low birth weight may be due to multiple births-IVF
Preventative measures:
Prenatal care
Reduction of adolescent pregnancy
Sudden Infant Death Syndrome (SIDS)
who is SIDs common in
what campaign led to the dramatic decline in SIDS
IN 2013, SIDS fell to less than how much of what it was in 1990s
SIDS is also listed as the cause of death when what and is the term for this
SIDS is common in infants of low birth weight and in infants of smokers or drug users
“Back to Sleep” campaign led to dramatic decline in SIDS
By 2013, SIDS fell to less than one third of what it was in 1990’s
SIDS is listed as cause of death only if no other explanation is found - diagnosis of EXCLUSION
sleep diagram
don’t overheat or overdress them
Environmental Issues
where was there a mercury contamination
where is lead common in
what were pesticides known to cause and what did where does the result rank in IMR
where can organic solvents be absorbed and what can this cause
Mercury contamination - contamination of bay in Japan
Lead-common in American inner cities-lead paint and older plumbing
Pesticides-identified as causing birth defects one of the leading causes of infant mortality
Organic solvents-can be absorbed through the skin - cause of birth defects
no mercury while pregnant!
Environmental exposures include and what does each cause
Tobacco smoke—increase
Viruses- rubella—
Heavy metals –
brain development
Drugs: legal drugs
The FDA has identified certain teratogen drugs (phenytoin, thalidomide, Accutane. etc…)- these tend to be Category X drugs
Environmental exposures include:
Tobacco smoke—increase risk of cleft palate/lip
Viruses- rubella—deafness, mental retardation
Heavy metals – increase risk of miscarriage, brain development
Drugs: legal drugs
The FDA has identified certain teratogen drugs (phenytoin, thalidomide, Accutane. etc…)- these tend to be Category X drugs
Environmental exposures:Maternal behaviors
what do drugs lead to
- what do infants suffer from
- what is permanently impaired
what is alcohol considered to be
- what kind of syndrome can it cause in fetuses
all of these behaviors are not limited in what
Drugs: illegal drugs:
-“crack babies”
-Infants suffer from withdrawal
-Permanent neurological impairments
Alcohol:
-A teratogen
-Fetal alcohol syndrome
All of these behaviors are not limited by SES
face of crack baby
Social Factors
In poorer neighborhoods:
- are the mothers young or old
- are they educated
- are they married when they give birth
- is their environment safe
- lack of what care has been linked with high risk of mortality in who
In poorer neighborhoods:
Young maternal age
Low maternal education
Out-of-wedlock births - really hard for single moms
Violence
Lack of prenatal care has been linked with a high risk of infant mortality
Barriers to seeking prenatal care
- do they have info about services
- are the hours convenient
- how long do they have to wait in the clinic
- do they have transportation
- can they find child care
- in some states, are they allowed prenatal care
Lack of information about available services
Inconvenient hours of service
Long waits at clinic
Inadequate transportation
Lack of child care for older children
Denial of prenatal care for immigrants in some states
Congenital Malformations
- what is it a factor in
- how much % of infant deaths
- through what method can genetic screening be done and for what diseases
A factor in infant mortality
20% of infant deaths
Genetic screening may be done via amniocentesis for:
Tay-Sachs disease
Hemophilia
Down Syndrome
Congenital malformations
- what is there a deficiency in and what may it result in
- where can folic acid be found
- what is the minimum amount of women
- during pregnancy, what is the recommended amount
Deficiency in folic acid, a B vitamin may result in neural tube defects
Folic acid can be found in green leafy veggies, beans, liver, orange juice and grapefruit juice
The minimum recommended amount of folic acid for women in child bearing years is 400 mcg
During pregnancy typically recommend 800 mcg-1 mg
800mcg is OTC
1mg is Rx
Prevention
what is the most desirable strategy
how to European countries establish this
when level of prevention is the current U.S. strategies for improving outcomes for preterm infants
what level of prevention is strategies aimed at identifying women at risk
Primary prevention of preterm births is the most desirable strategy
European countries establish this by providing social and financial assistance
Finland baby boxes
Current U.S. strategies for improving outcomes for preterm infants is considered tertiary prevention
Strategies aimed at identifying women at risk is considered secondary prevention
Family Planning
Consequences of teen pregnancy:
- how does it effect education
- how does it effect career
- how does it effect $
- how does it effect family unit formation
- how does it effect health of baby
Consequences of teen pregnancy:
Interferes with education
Interferes with career prospects
Economic hardship
Interferes with formation of a strong family unit
Increase in health risks to the child
Nutrition of Women and Children
what is a key component of maternal and child health
Nutrition is a key component of maternal and child health
Breastfeeding offers the healthiest start in life for infants
Reduces the risk of:
Infectious diseases
Ear infections/Respiratory infections
Obesity
Chronic diseases such as asthma and allergies
Nutrition of Women and Children
what do medical experts recommend for the first 6 months of infancy
what 3 resources are available to mothers
Medical and public health experts recommend exclusive breastfeeding of infants for first 6 months of life
Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
School Meals Programs- older children
Supplemental Nutrition Assistance Program (SNAP)
WIC Program
what 3 things does the program provide for federal grants to states?
what demographic does this program cover
what foods does it cover
The program provides Federal grants to States for:
supplemental foods
health care referrals
and nutrition education
qualificatons- For low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.
Covers: formula, milk, cereals, whole wheat bread, eggs, fruit juice
School Meal Programs
what age groups is it intended for
what do schools offer
what must they meet?
how much is the cost of the program (2 options)
Intended for older children
Schools offer lunch and breakfast programs
Must meet income eligibility requirements
Programs are either free or at reduced fees
School Meal Programs
who is it administered by
what is the purpose of it?
who does the state reimburse
Administered by State agencies,
The purpose is to help fight hunger and obesity
The state reimburses organizations such as schools, child care centers, and after-school programs to provide healthy meals to children.
Supplemental Nutrition Assistance Program (SNAP)
the largest program in the US to address what
what was it formally called
what do recipients hold to have access to this
what must they meet
SNAP is the largest program in the US to address domestic hunger
Formally the Food Stamp Program
Currently, recipients have an electronic benefits transfer card (EBT)
Must meet income eligibly requirements
Supplemental programs
which families does it aid?
what are the 4 things that children are at risk for
- stunting of what
- do they have good cognitive stimulation
- how is their iodine
- how is their iron and what does it cause
These program are to aid families in need
Children that do not have adequate nutrition are at risk for:
Stunting of growth
Inadequate cognitive stimulation
Iodine deficiency
Iron deficiency anemia
Child Health and Safety
what kind of programs for kids
what has it reduced for infectious diseases?
how does the federal government help with this
Childhood immunization programs
Have reduced the number of deaths caused by infectious diseases dramatically
The federal government has a program to cover immunizations for children uninsured or if their insurance does not cover vaccines
Child Health and Safety
what are the 5 vaccines
Children’s Vaccines:
Haemophilus influenza type b
Varicella
Pneumococcal disease
Hepatitis A & B
Human papilloma virus (HPV)- boys and girls
Child Health and Safety
Well-baby visits:
are all kids up to date on vaccines
how frequent are they when they are young
what do these visits screen for
Well-baby visits:
Not all infants/children are up to date on well-baby checks
Are scheduled more frequently when a child is younger- will coincide with the immunization schedule
These visits also include screening for scoliosis, vision, hearing, and TB (if at risk)
Child Health and Safety
kids from where is it common it
what may contribute to the increase in numbers
Fluoridation of water
how does it affect tooth decay
Asthma
Common with inner city low income children
Environmental exposures may contribute to increase in numbers
Fluoridation of water:
Proven to recue tooth decay
One of top 10 public health achievements
Does Worcester has fluoride in water? - no
Does Manchester have fluoride in the water? - yes
Child Health and Safety
what daycare is provided
where are more kids taken care of
Issues of daycare
what can spread and what is an example of this
what training does it require
what kind of staff is needed
what must Daycare centers follow
Safe and affordable daycare
More children are being taken care of by daycare centers
Issues
Spread of infectious diseases such as Norovirus
Requires training in proper hygiene practices
Adequate and trained staff
Daycare centers licensed must follow basic health and safety standards
Developmental disabilities-
Infant mortality rate-
Death of an infant before their first birthday
Low birth weight-
Being under weight at birth
Maternal death-
Death of a women during her pregnancy
Maternal mortality rate-.
The rate of maternal deaths
Premature (preterm) birth-
Born before 37 weeks
Too early
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) –
Food assistance program for low income pregnant women, postpartum women and children under 5
Sudden Infant Death Syndrome (SIDS) –
Sudden death of infant
Supplemental Nutrition Assistance Program (SNAP) –
Food assistance program
Recipient get electronic benefits transfer card
List environmental and social issues affecting infant mortality
Environmental exposures include:
Tobacco smoke—increase risk of cleft palate/lip
Viruses- rubella—deafness, mental retardation
Heavy metals – increase risk of miscarriage, brain development
Drugs: legal drugs
The FDA has identified certain teratogen drugs (phenytoin, thalidomide, Accutane. etc…)- these tend to be Category X drugs
Mercury contamination-contamination of bay in Japan
Lead-common in American inner cities-lead paint and older plumbing
Pesticides-identified as causing birth defects one of the leading causes of infant mortality
Organic solvents-can be absorbed through the skin-cause of birth defects
Identify benefits of prenatal care & risks associated with lack of prenatal care
benefit
- Preventing birth defects
- Problems are diagnosed early
- prevent low birth weight
risk
Discuss congenital birth defects & environmental effects on growth and development
A factor in infant mortality
20% of infant deaths
Genetic screening may be done via amniocentesis for:
Tay-Sachs disease
Hemophilia
Down Syndrome
Deficiency in folic acid, a B vitamin may result in neural tube defects
Folic acid can be found in green leafy veggies, beans, liver, orange juice and grapefruit juice
The minimum recommended amount of folic acid for women in child bearing years is 400 mcg
During pregnancy typically recommend 800 mcg-1 mg
Drugs: illegal drugs
“crack babies”
Infants suffer from withdrawal
Permanent neurological impairments
Alcohol
A teratogen
Fetal alcohol syndrome
All of these behaviors are not limited by SES
Identify nutrition programs available in the U.S.
WIC Program
Program provides Federal grants to States for:
supplemental foods
health care referrals
and nutrition education
Program provides Federal grants to States for:
supplemental foods
health care referrals
and nutrition education
School Meal Programs
Intended for older children
Schools offer lunch and breakfast programs
Must meet income eligibility requirements
Programs are either free or at reduced fees
Administered by State agencies,
Purpose is to help fight hunger and obesity
State reimburses organizations such as schools, child care centers, and after-school programs to provide healthy meals to children.
Supplemental Nutrition Assistance Program (SNAP)
SNAP is the largest program in the US to address domestic hunger
Formally the Food Stamp Program
Currently recipients have an electronic benefits transfer card (EBT)
Must meet income eligibly requirement
Supplemental programs
These program are to aid families in need
Children that do not have adequate nutrition are at risk for:
Stunting of growth
Inadequate cognitive stimulation
Iodine deficiency
Iron deficiency anemia
Identify issues addressing children’s health and safety
Safe and affordable daycare
- More children are being taken care of by day care centers
Issues:
- Spread of infectious diseases such as Norovirus
- Requires training of proper hygiene practices
- Adequate and trained staff
- Day care centers licensed must follow basic and health and safety standards
Asthma
- Common with inner city low income children
- Environmental exposures may contribute to increase in the numbers
- Fluoridation of water
- Proven to reduce tooth decay
- One of top 10 public health achievements
Does Worcester have fluoride in water?
Does Manchester have fluoride in the water?
Well-baby visits
- Not all infants/children are up to date on well baby checks
- Are scheduled more frequently when child is younger- will coincide with the immunization schedule
- These visits also include screening for scoliosis, vision, hearing and TB (if at risk)
Children’s Vaccines
- Haemophilus influenza type b
- Varicella
- Pneumococcal disease
- Hepatitis A & B
- Human papillomavirus (HPV)- boys and girls
Childhood immunization programs
- Have reduced the number of deaths caused by infectious diseases dramatically
- The federal government has a program to cover immunizations for children uninsured or if their insurance does not cover vaccines
The minimum strength of folic acid for a pregnant woman is 400 mcg.
A
True
B
False
B
False
it is 800mcg
Infant mortality is defined as death in the _____ year of life?
A
First
B
Second
C
Third
D
Fourth
E
Fifth
A. first
Which supplemental program is for low-income pregnant women and children up to the age of 5?
A
WIC
B
SNAP
C
School meal program
A
WIC
