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Health Outcomes

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Submitted By class2014
Words 1598
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Introduction: Health outcomes refer to the changes in the health status of individuals or the population. The outcomes are attributed to multiple or planned interventions, whether or not the intention of the intervention was to alter the health status. These interventions include health services and programs including health promotion programs, government policies, laws and regulations, and consequent programs. Intervention may also include unintended or intended health outcomes of government policies in areas besides health. Health outcomes are evaluated by health indicators (World Health Organization, 1998). Health indicators are a single measure, represented quantitatively, that encapsulates an important aspect of health, such as the amount people suffering from a chronic disease. It also captures a variety of health determinants such as income, or the important aspects of the health care system, such as the proportion of patients who revisit the hospital for additional care following previous treatment (World Health Organization, 1998). These indicators can be used to describe a public health concern at a specific point in time. It can indicate periodic changes over time at the population or individual health level, describe differences in the population health, and examine the extent at which program objectives are being met. These indicators can possibly encompass illness or disease measurements which are commonly used in measuring health outcomes, such as health expectancy, life skills, and quality of life, and behaviors or actions taken by individuals related to health (Rigby &ump; Kohler, 2002). Child health outcomes tend to be influenced by the parents, the home environment, intact families, maternal and non-maternal quality of care, and religious involvement. The social and behavioral development of children is directly related to the quality of care provided by their mothers and non-maternal care for those in child care. Studies have suggested that the emotional health of pre-adolescents is related to their parent’s religious practices (The Heritage Foundation, 2011). Children are born into a complex environment which can have negative and positive effects on their health (Rigby &ump; Kohler, 2002). Many services such as the Center for Adolescent Services, the Ounce of Prevention, Care Source and Women, Infants, and Children (WIC) are available to promote, protect, and address specific child health population problems. Measuring the health of children is important because the youth are citizens that are unable to act as self-advocates at the population level and their health determines the health of the population in the future. Child health measurement indicators are central in identifying priorities, progress, problems, newly emergent issues, and changes over time (Rigby &ump; Kohler, 2002). Youth violence, childhood obesity, childhood asthma, and pre-term births are a few childhood indicators that will be presented in the succeeding sections. The indicators and data presented pertain to the state of Ohio, specifically Montgomery and Summit County, and the Wellness Matters areas. Youth violence: Youth violence, both interpersonal and self-directed, can result in serious physical and emotional consequences for both the victims and perpetrators of the violent offenses. One needs to look no further than the most recent school shootings, or scan the local newspapers for examples of troubled youth tragically taking their own lives in order to understand the toll of youth violence. In 2007 the National Survey on Drug Use and Health Report found that 18 percent of adolescents reported carrying a knife or gun to school, 35.5 percent had been in a physical fight in the past year and 4.2 percent had been in a serious fight requiring medical attention in the past year (Ferguson, 2010).While these numbers are disputed by data from the Youth Risk Behavior Surveillance System (YRBSS) presented below (See Appendix Table.1-2), both sets of data indicate the continued prevalence of youth violence. Evidence is accumulating that concludes those perpetrators of violent offenses have mental health issues at greater rates than the non-offending population. Therefore, the juvenile justice system is a logical point of intervention for these mental health issues (Ferguson, 2010). Early recognition of those mental health issues that predispose youth to violence could be a method of preventing future violence. Additional, evidence supports this early recognition by stating that certain difficulties in childhood can predispose children to violence as they become young adults (Mallett, 2009). Lastly, the juvenile justice system fails to appropriately diagnose and manage the mental health issues of young offenders. Thus understanding this failure could lead to the development of evidence-based practices for diagnosing and managing mental health disorders in these young-offenders with the idea of rehabilitating and preventing future offenses (Townsend, 2010). Healthy People 2020: Youth Violence: The use of illicit drugs has been associated with aggressive behavior in adolescents (Ferguson, 2010). Several Healthy People 2020 objectives are relevant to youth violence, such as adolescent health (AH) objective 7, reducing the percentage of adolescents who have been offered, sold, or given an illegal drug on school property. In 2009 22.7 percent of students in grades 9–12 were offered, sold, or given an illegal drug on school property. The target for this indicator is 20.4 percent based on a 10 percent improvement. Furthermore, several adolescent health objectives are directly related to the problem of youth violence such as AH-10 reducing the proportion of public schools with a serious violent incident. In 2008 17.2 percent of public schools reported a serious violent incident. The target for this indicator is 15.5 percent, again based on a 10 percent improvement. AH 11.1 states decrease the rate of minor and young adult perpetration of violent crimes. In 2008 444 per 100,000 adolescents and young adults age 10 to 24 were arrested for perpetration of crimes included in the violent crimes index. Based on a 10 percent improvement the goal for this objective is 399.6 arrests per 100,000. The mental health and mental disorders (MHMD) objectives from Healthy People 2020 are directly related to the association of mental health issues with youth violence such as MHMD-2, reducing suicide attempts by adolescents (Mallett, 2009). According to the baseline in 2009 there were 1.9 suicide attempts per 100 youths. The target is to reduce this number by 10 percent to achieve a target of 1.7 suicide attempts per 100. MHMD 4.1 goal is to reduce the proportion of persons, aged 12 to 17, who experience a major depressive episode because depressive symptoms are associated with youth violence (Ferguson, 2010). In 2008 8.3 percent of adolescents experienced a major depressive episode. The target is to reduce the number by 10 percent achieve a target of 7.4 percent. Lastly, MHMD-7 is also relevant, because evidence is accumulating that youth offenders do not get the help they need for mental health issues (Townsend, 2010). It states that in 2006 58 percent of juvenile residential facilities screened admissions for mental health disorders. The goal of this objective is a 10 percent improvement and a target of 64 percent of residential facilities screenings for mental health disorders. Youth Violence Statistics: The Centers for Disease Control (CDC) monitors health risk behavior in youth via the Youth Risk Behavior Surveillance System (YRBSS). Appendix Table 2 shows the 2007 data for Ohio, which is the most recent year available. From the data it can be concluded that the youth participates in risky, violent, and aggressive behaviors and are victimized at alarmingly high rates. When analyzing the 1999, 2005, and 2007 survey much improvement was made in many questions, this suggests that interventions during that time period were successful and potentially contributed to these improvements. Resources Related to Teen Violence Available in Montgomery County: Adolescents in Montgomery County who have been adjudicated delinquent have access to the Center for Adolescent Services which provides residential treatment for up to 34 boys and 10 girls. This facility aims to allow adolescents to reach personalized behavioral and academic goals. The Intervention Center provides services for youth regardless of how they arrive to the facility. This means that the youth do not need to be adjudicated delinquent nor have official charges brought against them to receive care. The Intervention Center provides access to mental health services, drug and alcohol counseling, group and family therapy and medication. Montgomery County Youth Services (MYCS) offers several programs that are related to the diagnosis and treatment of mental disorders in children. They offer 24-hour 7-day per week crisis counseling in the event that a troubled youth needs to talk to someone. This program focuses on suicide prevention and cites daunting statistics. They state that, “According to the CDC, in the past 60 years, the suicide rate for males, ages 15-24 has quadrupled, while it has doubled for females of the same age group.” Clearly this organization recognizes the significance of self-directed youth violence and aims at preventing it. In addition to the programs aimed at crisis intervention and suicide prevention, the MYCS offers transitional living arrangements for children and families in times of crisis. In addition they have facilities to assist with food and basic hygiene products in times of need. The Montgomery County Juvenile Court runs the Nicholas Residential Treatment Facility. This facility is a non-secure 24-bed unit which houses males, who have been adjudicated delinquent, and aims to rehabilitate these young men to become productive, responsible citizens. This mission is pursued with comprehensive treatment strategies, including family therapy and social-skill building. While staying at the Nicholas Residential Treatment Facility, youths will participate in educational, work, and recreational programs aimed at ensuring their swift and successful reintroduction to society.…...

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