CPH SOCIAL FACTORS:

1. Young maternal age

MATERNAL AND CHILD HEALTH AS A SOCIAL PROBLEM 2. Low maternal education
- 19th century the children’s health first become a public health 3. Out of wedlock birth
concern. 4. Violence

FACTORS; “stress is a state that occurs after persons perceive that

1. Heat demands exceeds their ability to cope”
2. Poor sanitation
3. Lack of refrigeration FACTORS THAT LINKED POVERTY TO IMR:
1. Poor women
1893- New York’s established milk sanitation 2. Poor housing
1912- Establishment of the children’s bureau 3. Mother’s ability to cope
1921- Health services for Mother and Child 4. Young and single mother
RESULT: Cal-Adaptive Behavior
MATERNAL AND INFANT MORTALITY:
 Infant Mortality Rate (IMR) DISADVANTAGE OF THE TECHNOLOGICAL APPROACH:
- number of infant deaths within the first year of life 1. Disrupts normal bonding between parents and infant
- indicators of the health status of a population as a whole 2. Leave a significant number of survivors with the long-term
development disabilities
DISRTURBING FEATURE OF TRENDS: RACE 3. Severe handicap
- IMR for black Americans is more than double that for the 4. Very expensive
white Americans
PREVENTING INFANT MORTALITY:
REASONS FOR THE DECLINE OF IMR: 1. Focus of Public Health
1. Improved socio-economic status a) Pregnant women in general:
2. Housing and nutrition  Highly motivated to bear a child
3. Immunization  Receptive to information on how to avoid risk
4. Clean water and pasteurization of milk b) High risk women:
5. Antibiotics  Poor
6. Better Pre-natal care and delivery  Young
7. Availability of family planning service  Minority
8. Legalization of abortion (US)  Unmarried women

INFANT MORTALITY: HEALTH PROBLEM OR SOCIAL PROBLEM? 2. Pre-natal Care

“Infant mortality is not health problem. It is a social problem - it provides women with information on how to have a healthy
with health consequences pregnancy and a bear healthy child
- Most public health-oriented kind of care the medical
EPIDEMIC BIRTH DEFECTS: profession provides
1. Minimata, Japan - provide the opportunity to diagnose problems that needs
-mercury contamination of the bay medical intervention
2. US - important for women with the lowest status
-lead contamination
3. Pesticides CDC = recommends that all pregnant women should be
4. Organic Solvent screened for common infection and treated if infected.

 Poverty BARRIERS THAT DISCOURAGE WOMEN AT HIGHEST RISK FROM

 Lack of knowledge, time or energy SEEKING PRENATAL CARE:
 Ignorance or lack of financial resources 1. Lack of information available service
 Breastfeeding 2. Inconvenient hours of service
3. Rudeness and along wait at the clinic
MATERNAL BEHAVIOR: 4. Inadequate transportation
1. Smoking (SIDS) = Sudden Infant Death Syndrome
2. Drinking alcohol (teratogen)
3. Use of illegal drugs (crack babies)

BIANCA JANE V. ASUNCION

“REVIEWER”
 for bearing a child with a broad large of birth defects
CONGENITAL MALFORMATION: - smoking during pregnancy increase the risk of premature
leading specific causes of Infant mortality: birth (cleft-lip palate)
1. Congenital malformation -drinking alcohol during pregnancy may cause fetal alcohol
2. Discover disorder related to short gestation and low birth syndrome.
weight
3. Sudden Infant Death Syndrome (SIDS) NUTRITIONAL FACTORS:
1. Anencephaly:
 Congenital Malformation: - a lethal condition in which all or most of an infant’s brain
 Disorders is missing
1. Tay-Sachs Disease: 2. Spina Biflida (scoliosis)
a) Inherited - protrusion of a spinal cord form the spinal column
b) Mode of action: disrupts the function of brain and accompanied by paralysis of lower body caused by
spinal cord deficiency in folic acid (vitamin B)
c) Experience seizure
d) Vision and hearing can be affected PRETERM BIRTH:
2. Hemophilia: 1. Prematurity:
a) Abnormal bleeding - disorder of Short gestation and low birth weight
b) Most of the boys developed this kind of disorder - 2006, preterm birth is responsible for many more infant
3. Down Syndrome: death that are indicated in the death certificate
a) Trisomy 21 - 6 to 11 leading cause of death
b) Have 3 chromosome
PREVENTIVE MEASURE:
 Newborn Screening Programs: 1. Tertiary prevention:
- designated to identify infants hormone defects in body - give antibiotics
chemistry that can be remedied by equally diagnosis treatment - focus how to keep baby healthy
2. Secondary prevention
DISORDER EFFECTS IF NOT EFFECTS IF - identify woman at in risk
SCREENED SCREENED SCREENED - if she smoked, drink alcohol, and prenatal care
- provide education
Congenital Severe mental Normal 3. Primary Prevention
hypothyroidism retardation - provide education, financial support risk
Congenital Death Alive or normal
adrenal
 SUDDEN INFANTS DEATH SUNDROME (SIDS)
hyperplasia
-3rd leading cause of infant
Galactosemia Death or cataract Alive or normal
- any unexplained death
- Commons in infants of low birth weight and in infant of
Phenylketonuria Severe mental Normal smokers or drugs users mother
retardation - occurred more frequently in infants that are sleeping on
their stomach
G6PD Severe anemia anomaly - “back of sleep” campaign
-other factor: soft bedding, being over heated, bed
sharing
PUBLIC HEALTH INTERVENTION
FDA regulation of teratogenic drugs such as
1. Thalidomide
2. Accutane - drugs for acne
3. Dilantin - drugs to those who have epilepsy

Prevention of German Measles by immunization

- CDC coordinated with the ongoing National Birth Defects
Prevention Study

FINDINGS:
- uncontrolled diabetes or who are obese are at increase risk
BIANCA JANE V. ASUNCION
“REVIEWER”
 - Iodine deficiency
- Iron deficiency anemia
FAMILY PLANNING AND PREVENTION OF ADOLESCENT - overweight and obesity
PREGNANCY: CHILDRENS’ HEALTH AND SAFETY:
 WELL BABY CARE:
1. Teenage Pregnancy harmful Consequences - children are vaccinated against;
 Interference with the young mother’s education and 1. Diphtheria
career prospect 2. Tetanus
 Economic hardship 3. Pertrussis (whooping cough)
 Interference with the information of a strong family 4. Polio
 Increase health risk to the child 5. Measles
 Less likely to seek prenatal are 6. Rubella (german measle)
 More likely to smoke 7. Mumps
 Less likely to gain adequate weight 8. Hepa.B

UNINTENDED PREGNANCY IN OLDER WOMEN: 1993; - free vaccination coverage among children ages
- Only half of the pregnancies among American women are 19-25months
planned
- Consequences of unintended pregnancy is in abortion ADDITIONAL VACCINE:
- 1 abortion for every 4 live birth 1. Haemophilus Influenza type B (Spinal meningitis)
2. Varicella (chicken pox)
2. Contraception 3. Pneumococcal disease
 Female sterilization and vasectomy for men 4. Hepa.A
 Intrauterine device (IUD)
 Hormonal implant 2008;- FDA approved the HUMAN PAPILLOMA VIRUS VACCINE
 Pills - prevent cervical cancer and genital warts
 Depo-provera
 Condom and cervical cap 2009;- immunization rates are tracked by CDC
 “morning after pill” or PLAN B
- can be used after 72 hours of unprotected sex CHILDREN WHO DO NOT GET REGULAR WELL-BABY CARE:
1. Tuberculosis
PUBLIC HEALTH PROGRAMS: 2. Problems with vision and hearing
1. Comprehensive sex education in school 3. Scoliosis - curvature of the spine
2. Abstinence only advocate
3. Promote value of responsible and protective behavior
4. Family planning

NUTRITION OF WOMEN AND CHILDREN:

-to emphasize was on breastfeeding and safety of milk
reducing risk of:
1. Infectious disease
2. Respiratory infection
3. Obesity
4. Chronic disease (asthma and allergies)

INFANTS MUST BE EXCLUSIVE BREASTFEED FOR THE FIRST 6

MONTHS:

 During the great depression (1938)

- established several food assistance program (milk, fruit
juice, cereals for pregnant women, lactating mothers,
infants and children up to 5 years old)
- nutrition education
- school lunches
- electronic benefits transfer card
 Poor nutrition increase children risk of;
- inadequate cognitive stimulation
BIANCA JANE V. ASUNCION
“REVIEWER”
MENTAL HEALTH: PUBLIC HEALTH INCLUDES HEALTHY MINDS
 Cognitive deficits
COMMON MENTAL ILLNESS DISTURBANCES OF COGNITION
1. Anxiety - Lose the ability to organize, process, and recall
2. Psychosis information as well as execute complex sequences of
3. Mood Disturbances tasks.
4. Cognitive Deficits
EXAMPLE:
 Anxiety  Alzheimer’s Disease
- Response to dangerous situations that prepares one to  Dementia
evade or confront a threat in the environment
CAUSES
EXAMPLES  - Biological factors (Schizophrenia, Bipolar Disorder,
 Phobia Autism, ADHD)
 Panic Attacks  -Psychological factors (PTSD)
 Generalized Anxiety  -Sociocultural factors
 Obsessive-compulsive Disorder
 Post-traumatic Stress Disorder (PTSD) PREVENTION
 Individual Factors
 Psychosis  Family Factors
- Disorders of perception and thought process  Community Factors
Characteristically associated with schizophrenia

SYMPTOMS:
CHILDREN
 Hallucinations- sensory impressions that have no basis in BIOLOGICAL RISK FACTORS
reality  Intrauterine exposure to alcohol or cigarettes
 Delusion false beliefs held despite evidence to the  Environmental exposure to lead
contrary  Malnutrition of pregnancy
 Birth trauma
 Mood disturbance  Specific chromosomal syndromes
DISTURBANCE OF MOOD  Quality relationship between infants and their primary
- Sustained feeling of sadness caregiver
or sustained elevation or fluctuation of mood  Maternal depression
 Child abuse and neglect
SYMPTOMS:
Disturbances in..  AUTISM
 Appetite -severe, chronic developmental disorder by severely
 Sleep Patterns compromised ability to engage in social interaction.
 Energy Level -1 in every 110 children (2009 CDC survey)
 Concentration -boys is about 4-5 times higher in girls
 Memory
 Thoughts of Suicide  MOOD DISORDERS (Bipolar Disorder)
- Major depression and suicide are a matter of serious concern
for anyone
- Mortality from suicide increases steadily through the teen
years, and suicide is the 3rd leading cause of death at the age.
- Suicide is rare for preteens and young adolescents, but much
higher in 15-19 y.o. and even higher in ages 20-24 y.o.

 ADHD (Attention Deficit/Hyperactivity Disorder)

-Most commonly diagnosed behavior disorder of childhood.
-Pharmaceutical treatment is more effective when
accompanied by behavioral therapy
-Oppositional defiant disorder and conduct disorder

BIANCA JANE V. ASUNCION

“REVIEWER”
Other Mental Illnesses TYPES OF PSYCHOTHERAPY
1. Separation anxiety
2. Social phobia 1. Prolonged Exposure Therapy (PE)
3. Eating disorders -involves helping people confront their fear and feelings about
4. Obsessive-compulsive disorder the trauma they experience
Ex. Mental imagery and Writing
Project Head Start
- Best known prevention program 2. Cognitive Processing Therapy (CPT)
- Include better peer relations, less truancy, and less -patient is asked to recount his or her traumatic experience and
antisocial behavior a therapist helps the patient redirect inaccurate or destructive
- Include prenatal education component thoughts about the experience.

MENTAL HEALTH IN ADULTHOOD MOOD DISORDERS

- Confidence in one’s own disabilities to cope with diversity is a  Includes major depression and bipolar disorder
major contributor to mental health in adulthood.  More prevalent in women than in men.
 SUICIDE- most dreaded consequence of this disorder
MOST COMMON PSYCHOLOGICAL AND SOCIAL STRESSOR  Men complete suicide 4x as often as women; women
attempt suicide 4x as often as men.
1. Breakup of intimate romantic relationships  Substance use disorders are also common individuals with
2. Death of a family member or friend mood disorder
3. Economic hardships  Genetic factors are strongly implicated in bipolar disorder
4. Racism and discrimination
5. Poor physical health TREATMENT
6. Accidental and intentional assaults on physical safety  Antidepressant drugs
 Mood stabilizer (LITHIUM)
EFFECTIVE TREATMENTS  Psychotherapy- often added to pharmaceutical treatment
- Variety of psychotherapy approaches  Electroconvulsant Shock Therapy –severe mood disorder
(From Freudian psychoanalysis to Cognitive-behavioral
therapy)  SCHIZOPHRENIA
- Drugs for treatment of Depression, Anxiety and Schizophrenia - Profound disruption in cognition and emotion, affecting
language, thought, perception, affect, and sense of self.
ANXIETY DISORDERS Affects about 1% of the population
- Most prevalent mental disorders in adults
Include: SYMPTOMS:
 Panic disorders - Hallucinations and Delusions
 Agrophobia Onset generally occurs during young adulthood
 Generalized anxiety disorder Role of genetics
 Specific phobia
 Social phobia TREATMENT:
 Absessive-compulsive disorder - Antipsychotic Medication combined with Psychotherapy
 Acute stress disorder and Family Intervention Programs
 PTSD

ANXIETY DISORDER
- 1 year prevalence of anxiety disorders among adults is
about 18%
- Females have a higher rate than males
- Treated with COUNSELING or PSYCHOTHERAPY or DRUG
- Many veterans of IRAQ and AFGHANISTAN wars suffer
from PTSD
-August 2012, Obama signed an Executive Order

MENTAL HEALTH IN OLDER ADULTS

BIANCA JANE V. ASUNCION
“REVIEWER”
 Alzheimer’s Disease
 Alcohol and Drug Misuse and Abuse
 Anxiety
 Late-life Schizophrenia

RISK FACTORS
 General medical conditions
 Admission to a nursing home
 High number of medications taken by many older
individual
 Psychosocial stressors (Bereavement or Isolation)
 Depression after loss of a spouse

SYMPTOMS
- Not specific to any identified syndrome are prevalent in
older adults
Schizophrenia- similar symptoms to those in younger patients

TREATMENT
- Similar to that for younger patients
HOWEVER: -increase the risk of side effects of drug
treatment
-interactions with medications used for other
disorders of aging also complicate effective
treatment for mental illness

TREATMENT:
- Most people with mental disorders do not seek treatment.

PAST: hospitalization was the norm for serious mental

illness (ASYLUM)
:Patients became excessively dependent and lost
connection to the community.

PRESENT: Inpatient units are used for crisis care,

focusing on the reducing risk of danger to self or others
and rapid return of patients to community.

BIANCA JANE V. ASUNCION

“REVIEWER”