Teenage Pregnancy in Columbus, Georgia - Research Paper Example

Teenage Pregnancy in Columbus, Georgia Community: Columbus is a in Muscogee County, Georgia. In Columbus was d one of the largest metropolitan areas in the state with a population of 198,413. Columbus covers a geographical area of approximately 220 square miles. The female population within Columbus is slightly higher as compared to that of men; by approximately 2.7%. The total number of males is 90375; equating to approximately 48.65% of the entire population. By means of comparison, the total female population is approximately 95406; which equates to 51.35%. The major population comprises individuals between the ages of 25 to 54 years. These individuals contribute to 41.9% of the entire population. Within the city itself, the smallest population percentage is comprised of people over 85 years of age; these individuals make up only 1.28% of the population. This statistic is followed by those between the ages of 65 to 74 who make up only 3.38% population. However, children under the age of twelve years make 15.01% of the total population. Children above the age of 12 but below the age of 20 make 15.52%, while those between 20 and 24 years represent 8.26% of the total population (Atkins & Wilkins, 2013). Georgia itself is comprised of 159 counties; with an overall population that exceeds nine million people; as the population of Georgia has grown increasingly diverse over the past several years, so too has the population of Columbus. Overall, Columbus, GA has seen a population increase of around 15% over the past 10 years. As the overall population within Georgia and within Columbus has grown, so too have the levels of diversity that are exhibited within the state; and within the city in question. Prominent racial composition, as indicated by a recent census, indicated that the largest minority groups included: Black/African American, Native American/American Indian, Hispanic/Latino (all races), Native Hawaiian or Pacific Islander, Asian, and Multi-racial, (Thorpe & Williams-York, 2008). The total population that is represented within the town currently stands at 198,413. The physical and social environments of this particular city are heavily impacted upon by the presence of a very large military base; one that comprises over ¼ of the land mass of the entire county. Further, as with so many other cities and towns throughout the deep south, the predominant religious affiliation is Southern Baptist; with other religions comprising a large percentage of religious adherence within the region. The impact of these two factors is something that will be covered at some depth later in the analysis; as the author is of the strong belief that these factors help to define some of the causal reasons for why the teenage pregnancy ratios are so highly skewed in Columbus as compared to other similar places throughout the State of Georgia. Health Concern: The ultimate health concern that can be indicated from this study is with regards to the many types of negative impacts that can be felt within the overall health of the mother as well as the overall potential health concerns that exist for the child that is born from a teenage mother. Due to the dangers that teenage pregnancies engender, as compared to pregnancy in later adulthood, combined with the economic hardships and life realities that impact upon individuals at this particular stage of life, scholars agree that teenage pregnancy creates unnecessary hardship not only upon society but also upon the mother and the child. Healthy People 2020 denotes several core issues that are linked to teenage pregnancy. For instance, teenage mothers are less likely to breastfeed their infants; resulting in weaker immune systems for these children and a higher potential for disease and hardship throughout adolescence. Secondly, delays in initiating prenatal care is also discussed by Healthy People 2020 as a core concern that specifically affects teenage mothers. Due to the hardships that pregnancy can inflict upon these unprepared mothers, the resource also denotes that teenage mothers have a much higher rate of depression as compared to more mature counterparts. However, perhaps the most important level of discussion that Healthy People 2020 is able to provide is with regards to the actual nature of teenage pregnancies. For instance, the resource denotes that 82% of all teenage pregnancies are unintended. This statistic is particularly harrowing when it is then compared to the negative health outcomes and the potential for abuse, intended or non-intended, that can face children that are ultimately unwanted. Finally, from a socio-economic standpoint, Healthy People 2020 references the fact that teenage mothers are far less likely to graduate high school or receive a GED as compared to those teenagers that do not become pregnant. As a direct result of this their earning potential, and by extension theiry ability to care for the material needs of their offspring is drastically reduced. As such, seeking to counter these issues has come to be a primary focus that medical professionals and societal stakeholders have come to champion over the past several years. Moreover, an identification of unique inequalities those individuals that represent the majority of teenage pregnancies is an effective means of seeking to affect levels of positive change on this reality. Population: The population of inquiry with regards to this specific case can be described as children above the age of 12 but below the age of 20; comprising all the “teen years”. As briefly referenced in the introduction, this particular demographic accounts for 15.52% of the total population of Columbus, GA. Although this percentage might not seem as particularly large, demographic analysis of other major metropolitan areas throughout the United States reveals individuals within this 7 year window typically only account for between 8-12% of population totals. As such, the reader can aptly note that Columbus, GA exhibits a unique situation with respect to the size of this particular demographic; creating a compounding situation with respect to the impact that teenage pregnancy can and does have upon the population in question. Furthermore, with reference to the primary health concerns that were engaged within the research; these were concentric upon issues relating to the complications that arise from teenage pregnancy and the prevalence/existence of pre-existing health issues for pregnant teen mothers. Health Inequality: In 2007, Georgia ranked 40th in the general health status that was carried out by United Health Foundation. The people who are facing the utmost threat and who undergo the worst health outcome should be given the first priority in order to significantly improve the health status of the state as a whole. The Hispanics and African Americans in Georgia are more economically disadvantaged as compared to whites of Georgia. In every five Hispanics and African Americans, more than one person has family earnings lower than the poverty level compared to whites. Furthermore, the lack of education and resources that exist for the poorer members of society oftentimes results in serious cases of malnutrition as well (Clear & Crosby, 2012). These levels of malnutrition are greatly impactful; as they create a situation through which the needed nutrients and vitamins that an individual with a balanced diet would receive are not being ingested by these stakeholders. This creates a situation in which health inequalities are present within the most disadvantaged members of society. Naturally, WIC and other programs, specifically focused upon acting on the nutritional inequalities for new and expectant mothers and/or infants, is a useful tool in helping to alleviate this reality (Georgia WIC Program, 2013). The power and core mission of WIC and other programs will be discussed at some depth later in this discussion. Data: The Georgians in rural areas face higher poverty level compared to those in the urban areas. 23.4% of babies born out of wedlock belonged to whites, 46.9% to Hispanics, and 29.7% to African-American. In the case of education, whites were better educated with a percentage of 77.5 completed high school. This statistic is compared to 65.5% of Hispanics and 60.3% of the African American population within Columbus, GA (Thorpe, 2008). In Georgia, the Hispanics have the highest rate of teenage pregnancies. The teen pregnancy rates in other races gradually decrease, but for the Hispanic teenagers this number continues to increase with every year (Taub, 2006). In 2007, the African-American rate of teen pregnancy was at 85.3 percent and that of the white teenagers was at 46.9% (University of Georgia County Statistics, 2013). These rates have continued to decrease significantly over the years and now the percentage for both the whites and the African-American are minimal in comparison with the Hispanics rate that has continued to grow with time. The Hispanic children are healthier than both the African-American and the whites. This is due to the high numbers of obese children from the other two races. These percentages range from 17 for African-Americans to 11 for whites (Grace et al., 2013). Resources and Partners: Agencies and entities as broad ranging as the CDC, DHHS, and a litany of others have recognized the impact that teenage pregnancy has upon the overall health of regions such as Columbus, GA. As a function of this, there have been efforts by many of these organizations/branches of the government, as well as private community partnerships, to take definitive strides towards reducing teenage pregnancy. Some of the most effective efforts have been the use of community health centers, sponsored by local/state/and federal government. These health centers provide teenagers counseling on abstinence, health education, pregnancy testing, sexually transmitted diseases evaluation, birth control, HIV testing, and how to live a healthy lifestyle (Mayfield, 2014). Accordingly, rather than merely having a primary focus upon healthful living, issues related to birth control, STDs and pregnancy are also provided. Naturally, due to the shifting nature of state/federal/and local budgets, the level of emphasis that each of these areas receives is contingent upon the healthcare risk that exists within a specific region. However, the recent months and years have noted a situation in which stakeholders within Columbus, GA have highlighted the need for more resources and action to be taken in helping to reduce teenage pregnancy. In this way, these health centers serve teenagers by providing them with the necessary knowledge to cope with the realities that face them. It was built to serve the teenage residents of Georgia with attestation of residence and some type of identification. The centers also provide services and counsel related to STD Screening, Family Planning Services, and immunizations for HPV or hepatitis. The health standards of the community should be increased by providing better health care facilities and counseling people on how to protect themselves from health hazards. With Ft. Benning occupying 25% of the land, this section of the population significantly influences several areas in the community. It houses a ranger basic training program and receives a large volume of young males into the program. These men go through a rigorous training and only have a small amount of time that they are allowed off the base for recreational activities. Their home is usually not from the nearby area and unfortunately, they are here for months with nobody to lean on for emotional support. It is not uncommon for them to be attracted to young women in the community when they have the opportunity to leave the military base. The combination of high stress from the training, loneliness, and participation in nightlife activities often results in increased sexual activity with the local females. Diagnosis: Even though there has been substantial development with regards to the impacts that these stakeholders can leverage to prevent against pregnancy and gain further health information, the issue that continues to present itself is one in which Columbus continues to suffer from abnormally high rates of teenage pregnancy. However, even though there are community based centers that can provide basic levels of education and/or services to the most disadvantaged members of the community, this comes far from solving the problem. Some realistic aspects that these centers are unable to impact upon include issues relating to culture and integrating the necessary education that these stakeholders require prior to teenage pregnancy ever being a reality. In such a manner, the most effective means of accomplishing this would be a two step process that seeks to engage stakeholders from a cultural perspective as well as from a primary/secondary education standpoint. Naturally, in order to do this and to maximize the impact upon public health, it will be necessary for the educational system and the community members, as well as the healthcare professionals to come to gather in order to craft a path forward. Outcomes and Goals: The core outcome that is desired is a situation in which the overall rate of teenage pregnancy will be reduced; at least to the point that it mirrors the average that is exhibited elsewhere throughout the United States. A further objective, tangentially related to the first, would be to reduce the obesity rates and associated disease issues that this demographic is specifically known to struggle with. Psychological studies into the realm of teenage sexuality reveal that those individuals with a particular low self esteem or understanding of their own personal worth are the most likely to engage in premature and otherwise unprotected sexual relations (Hill et al., 2013). As such, seeking to alter the rates of diabetes, obesity, and other health impacts that are exhibited within this community must be a secondary goal of the healthcare professional. Nursing Actions: In order to affect these previously mentioned goals and objectives, it is necessary for stakeholders within the medical community to be deeply involved in helping to create positive change with regards to the situation elaborated upon above. Nurses, as well as other healthcare professionals, are the ones that are most oftentimes at the point of direct patient and/or community interaction. Accordingly, outreach programs, volunteer organizations, educational interaction, and cultural integration will be required in order for the field of nursing to hope to have a positive impact with respect to the issue of teenage pregnancy. Naturally, these situations will not come about on their own; they are something that must be fostered by the entire community and medical community. One functional change that can be effected is for nurses, regardless of their function, to seek to continually promote the need for physical and psychological health. Rather than merely treating the patient, nurses that work within the field of education, or within the previously specified clinics, will need to take an active role in promoting health as a means of helping to shift the culture that is evidenced within Columbus, GA. Work to Improve Health Concerns: In order for this objective to take place, the community itself must be engaged. Whether this takes place by leveraging the use of existing partnerships or whether new ones will have to be created in order to improve these is ultimately a question of reach, resources, and scope. However, with that being stated, it should also be understood that the complexity of this issue reaches far beyond merely the issue of teenage pregnancy and touches upon issues of psychological identity formation, body image, culture, and overall interpretations regarding wellness and health. A core issue that must sadly be addressed is the overall lack of resources that exist to fund the many different grants and programs that attempt to interact with the stakeholders in question. The recent economic hardships that have been faced by the entire nation has created a situation in which government entities are seeking to cut costs in any way possible. As such, the degree of impact that these programs and interventions can have are greatly reduced over the past several years. It must also be noted that programs to alleviate hardships within these communities must also be leveraged to a new and renewed degree. Firstly, WIC (a federal program sponsored as a means of promoting health and development for both the newborn and the mother) goes a long way in helping to provide the necessary resources for new and expectant mothers that might otherwise struggle to provide these specific resources on their own (Roberts, 2014). However, the fact remains that not all stakeholders are aware of the way in which this program can be utilized and do not have a great deal of understanding with regards to the process through which they can sign up. As such, ensuring that healthcare professionals, specifically nurses, can serve as effective gate keepers of these programs is essential. Furthermore, partnership with the CDC allows for programs such as Safe Kids/Safe Homes to engage individuals within underserved communities and provide an understanding of relevant dangers; up to and including issues relating to health and pregnancy (Safe Kids, 2013). Naturally, such a program is not able to focus the majority of its resources towards dealing with issues pertaining to health or pregnancy; however, tangentially discussing them and seeking to raise awareness where possible would most certainly be useful and allow the healthcare professional to reference this resource whenever possible. Partnerships: From an analysis of the culture in and around Columbus, GA, it is clear and apparent that religion plays a pivotal role with regards to the way in which people identify with one another and a broader interpretation of morality. As such, any nursing intervention that will hope to affect a degree of positive change must leverage this reality and seek out partnerships with these entities (American Academy of Pediatrics, 2014). Yet, engagement with religious organizations and institutions will not be enough to integrate with the needs of the specific demographic in question. Further education must be provided in terms of the way in which individual health can be maximized and the way in which sexual development and health can be addressed (Davidson, 2013). Naturally, a change in federal school curriculum is not possible; however, a partnership between healthcare professionals and the regional schools would be highly beneficial with regards to addressing the unique realities that exist within this specific geographic region and presenting solutions and actionable approaches to the stakeholders within the affected demographics. Further, seeking out ways to leverage grant monies, both from a federal and state standpoint, will be highly beneficial in providing the much needed advertising that can help raise awareness in the community (Georgia Academy of Family Physicians, 2014). Objective: The clear objective is to reduce the rate of teen pregnancy and address the many health concerns that have definitively been linked to encouraging complications in pregnancy or increasing the risk of pregnancy. Naturally, this objective is broad and cannot be accomplished by a simple one or two step process. Firstly, the existing programs must be engaged. This of course sounds simplistic; however, the stakeholder within society is, at any one time, only aware of a small percentage of the existing resources that they can leverage to promote their own health and issues related to pregnancy. Secondly, promoting a further level of renewed integration between the healthcare professionals and those that they regularly interact with is needed. Thirdly, nurses and healthcare professionals should seek to integrate with partners as a means of reaching the greatest numbers of stakeholders throughout the community. Timeline: The timeline for accomplishing these tasks vary. For broadening understanding and access to existing programs and resources for these individuals, there will not be a set time limit for integration or declared “success” as this mission will be ongoing for months and years. However, providing metrics that the healthcare professional can meet, such as number of patients provided information concerning such resources, is a way in which a maximal level of understanding can be promoted. However, the integration with partners is a process that can have much stricter metrics for success. For instance, most of the expansion within the healthcare profession can take place with these partners within only a few months’ time. As such, engaging stakeholders in terms of broadening the scope of existing programs should take place in no less than 1 year’s time. Changing curriculum and seeking to measure the data that can be gathered, as well as incorporating the “best practices” that might be understood to have a positive impact with regards to the unique case of Columbus, GA should not be engaged prematurely. As such, it is the recommendation of this author that such a process should be slated for at least a 2 year implementation schedule. However, even though these represent the “long term” goals and timelines, a more immediate timeline can be affected with regards to delineating an approach that healthcare professionals can provide to the communities that they serve. Such a consolidated message will go a long way in seeking to integrate with the extant needs of the populace and immediately begin shifting the dynamics of the healthcare situation that is faced on a day to day basis. As such, such a goal can and should be accomplished in no more than 6 moth’s time; with a quarterly review process that helps to ensure that the range, scope, and level of engagement is still relevant. Evaluation: The overall effectiveness of each of these metrics can only be based upon the overall level of success or failure that they denote. However, before success or failure can be measured, a clear set of metrics must first be set forward. For instance, tracking the amount of information presented to stakeholders within the community, keeping track of partnerships and overall reach, and measuring the manner through which change is effected must all be tracked carefully. Although success can of course be noted in the long term, with respect to a decreased rate of teenage pregnancies, a more immediate level of analysis with regards to whether or not the approach can be evaluated as successful or not is with respect to measuring stakeholder involvement, integration, and increased levels of education; both with regards to healthcare professionals and with respect to stakeholders within the community. Statistics regarding societal knowledge can be drawn using test groups that are polled prior to the engagement taking place and then successive analysis of similar groups, in terms of age, demographics, relationship status etc, as the program goes along. By referencing these statistics and analyzing them, the levels of education that can be provided, and tangentially the level of awareness with respect to the issue of teen pregnancy and its ramifications, can serve as a helpful metric in determining whether or not the program can be counted as moving in the right direction or not. Conclusion: From the information that has thus far been related, it is clear and apparent that definitive actions can be taken as a means of reducing the high rate of teenage pregnancies that are currently exhibited within Columbus, GA. Whereas it was my own personal view that the issue of teenage pregnancy within Columbus, GA, and throughout the United States for that matter, was one of societal importance, the range and extent to which the factors surrounding this problem impacts upon all stakeholders within society was not fully realized prior to engaging with this research. As such, the socio-economic realities of teenage pregnancy, the reduced potential earnings for the mother, the proclivity for depression, the hardships that it denotes, and the lack of healthcare knowledge that is oftentimes found in this population have all been underscored and highlighted in terms of issues that seek definitive and immediate action to correct. Although such intervention and engagement usually requires a massive amount of resources, from the information that has been presented, it is obvious that a great many of these resources are already represented throughout the community. As such, a true improvement in the situation can only be affected by leveraging these existing resources and engaging stakeholders to a more effective level and degree. Genogram: Figure 1.0 helps to illustrate Muscogee County, GA (and by extension the major metropolitan area of Columbus that is within this county). Figure 1.0 As can clearly be noted, this particular county is on the westernmost edge of the state; relatively far removed from other major metropolitan areas; such as Atlanta, Augusta, or Statesboro. As noted in the introduction, the population is comprised of 198,413 individuals; of whom 46.3% are white, 45.5% are African American, 2.2% are Asian, 0.2% Native American, 0.14% Pacific Islander, and 1.90% from other races. As might be expected, the overall economic situation within Columbus, GA is worse than many other parts of the nation. For instance, whereas the median household income as of 2010 was $50,233, the statistic from Columbus, GA represents a much more economically challenged area; with a median household income of just $32,040. Furthermore, as the largest demographic group within Columbus is young adults, the “median” numbers or averages that have thus far been denoted are necessarily high. Target population health: One of the most serious issues that presents itself to individual living within Columbus, GA is the issue of extraordinarily high rates of obesity as compared to the remainder of the country (or even to the remainder of the state). Current estimates indicate that Columbus, GA has an obesity rate of 25.8% (Muscogee County Press Release, 2011). This has a level of overall importance for a number of reasons; firstly, the high rates of obesity within an otherwise young population creates a drastically increased likelihood that serious health issues will arise at some point within these individual’s lives. These include but are not limited to: hypertension, heart disease, and an increased risk for a great many other life threatening illnesses. Health issue of interest: Teenage pregnancy is a common issue in the United States of America with over a million teenage girls getting pregnant every year. This particular health issue of interest is of specific impact with regards to Columbus, GA; due to the fact that this particular city has one of the highest rates of teenage pregnancy within a state that already has a higher than average rate of teenage pregnancy. This is a hazard because young girls face more difficulties, complications, and economic hardship during pregnancy compared to older women who face fewer problems. Their babies tend to be have a much higher likelihood for being born with fatal complications that require further resources to attend to; resources that are obviously not oftentimes within the reach of these individuals. All these obligations come with the need for standard financial support. The teenage mothers are forced to drop out of school to go and try to make ends meet so their babies have a comfortable life. The time that these teenagers used to spend with their friends is now for trying the best they can to support the baby. Whereas the rates of pregnant teenagers have fallen slightly over the past five years in Columbus, further decreases must be engaged if stakeholders within the community, and across the state, wish to increase public health. What has been noted, through a review of the available literature is that part of the reason for why teenage pregnancies have decreased slightly over the past several years in Columbus has to do with the fact that advertisements done on the billboards, commercials, magazines, social media, and in schools about the consequences of teen pregnancies have helped reduce the cases of teenage pregnancies to levels not seen in several years. The health department has also contributed to this decrease by providing a health center for teens to go for counseling on HIV and other issues on how to live a healthy life, (Teen pregnancies down in the Columbus area, 2014). Assessment findings: Whereas early life is typically a time in which an individual suffers from few health issues, the data that was studied as a means of drawing inference upon this issue of teenage pregnancy in Columbus, GA revealed the fact that a large number of these teenagers suffered from health issues in addition to becoming pregnant at a young age. Although correlation does not equate to causation, an identification of these has been included so that the analyst can read and interpret the data (Suleiman et al., 2013). Firstly, diabetes was noticed in fully 24.7% of teenage pregnancies that were tracked. Secondly, BMIs that could be determined as above average were noted in fully 32.1% of teenage pregnancies. These findings help to point the reader to the fact that complicating health factors are present and prevalent to a higher extent within the those teenage pregnancies statistics as compared to the general population/demographic within the same age representation. Community Factors/Diagnosis: Naturally, as has briefly been discussed, the health realities and community diagnoses are heavily impacted upon by socio-economic factors. A clear and salient point that comes to be presented time and time again throughout the research is the fact that those individuals who are below the average in terms of socio-economics are the most likely to become pregnant in their teenage years. Whether this is the result of culture, money, or education is a point that continues to be contested by researchers; however, the reality that this particular sub-group of the demographic in question is at the most risk is definitively clear. References Atkins, D. N., & Wilkins, V. M. (2013). Going Beyond Reading, Writing, and Arithmetic: The Effects of Teacher Representation on Teen Pregnancy Rates. Journal Of Public Administration Research & Theory, 23(4), 771-790. Clear, E., Williams, C., & Crosby, R. (2012). Female Perceptions of Male Versus Female Intendedness at the Time of Teenage Pregnancy. Maternal & Child Health Journal, 16(9), 1862-1869. doi:10.1007/s10995-011-0934-2 Davidson, H. (2013, November 22nd). Personal Interview. Georgia Academy of Family Physicians (2013, May 13). GAFP. Retrieved February 9, 2014, from http://www.gafp.org Georgia Chapter of American Academy of Pediatrics (2014, July 15). Statistics of Teenage Pregnancy. Retrieved September 29, 2013, from http://www.gaaap.org/ Georgia Department of Health (2014, January 14). Health Care Provider Information | Georgia Department of Public Health. Retrieved February 9, 2014, from http://dph.georgia.gov/health-care-provider-information-1 Georgia WIC Program (2013, April 22). WIC Program. Retrieved February 9, 2014, from health.state.ga.us/programs/wic Grace, A., Ihuoma, I., & Temitope, N. (2013). Attitude and Perception of Adolescents towards Teenage Pregnancy. Gender & Behaviour, 11(1), 5272-5277. Hill, S., Young, D., Briley, A., Carter, J., & Lang, R. (2013). Infant Health. New England Journal of Medicine, 21(7), 485-491. Mayfield, Sheila. (2014, January 17th). Personal Interview. Muscogee County Press Release (2011, November 6). Press Release. Retrieved February 8, 2014, from https://www.muscogee.k12.ga.us/News/Press/PressReleases/110607_TAPCentertoClose_News%20Release.pdf Roberts, Constance. (2014, January 14th). Personal Interview Safe Kids (2013, October 19). Safe Kids Worldwide. Retrieved February 8, 2014, from http://www.safekids.org Sulaiman, S. S., Othman, S. S., Razali, N. N., & Hassan, J. J. (2013). Obstetric and perinatal outcome in teenage pregnancies. American Journal Of Obstetrics & Gynaecology, 19(3), 77-80. doi:10.7196/SAJOG.679 Taub, A., Birch, D. A., Auld, M., & Cottrell, R. R. (2006). Task Force on Health Profession’s Education. Journal Of School Health, 81(3), 123-127. doi:10.1111/j.1746-1561.2010.00570.x Thorpe, Q., & Williams-York, B. (2008). Georgia Health Disparities Report. Journal Of Health Education, 5(2), 810-819. University of Georgia County Statistics (2013, June 4). University of Georgia Statistic Overview. Retrieved February 9, 2014, from http://georgiastats.uga.edu/counties/215.pdf Read More