Cameron Quist
3/25/13
I am from the Cleveland area of Ohio,
and so I chose to learn about Cuyahoga County. I found that the most
interesting issues in that area have to do with infant, child and adolescent
health. I was able to contact Chris Kippes, Director of Epidemiology, Surveillance, and Informatics
of the Cuyahoga County Board of Health. He told me that the major issues facing
the health of infants, children and adolescents are high infant mortality rate,
blood lead poisoning in children, childhood obesity, and STDs for teens. Using
the additional resources that he sent me, I also identified racial disparity of
infant mortality as a significant issue for the health of infants.
High Infant Mortality
Infant mortality rate is defined as
the death of a child before reaching one year in age. The national average is
approximately 6.81 deaths per 1000 births, but Cuyahoga County has a rate of
approximately 9.8. This has increased slightly over the last five years, though
it is lower than it was 10 years ago. 90% of the infant mortality rate can be
traced to three causes: prematurity, sleep related deaths and birth defects.
These trends are especially prevalent in the municipalities that are poorer.
Blood Lead Poisoning
Lead poisoning symptoms include insomnia, delirium, cognitive
deficits, tremor, hallucinations, and convulsions. They usually begin at
about 60 μg/dL. Cuyahoga County and especially the cities of Cleveland and East
Cleveland have very high rates of children with high levels of lead in their
blood (<= 5 μg/dL). While the number cases of lead poisoning have continued
to decrease over the past decade, it is still extremely high-with 17.6% of
Cleveland children and 27% of East Cleveland children exposed to higher levels of lead than
is acceptable. The reason that so many children are at risk in these areas is
that the housing in these cities is often older and may have lead based paint.
Childhood Obesity
The CDC defines childhood obesity as a
BMI above the 95th percentile. Over the past 5 years, Cuyahoga
County has increased its childhood obesity rate by 3.7%. On a basic level, this
means that children do not use as many calories in a day as they consume. This
problem is especially prevalent among the lower class, which is a significant
portion of Cuyahoga County’s population. For children, this problem can turn
into not just a health issue, but a psychological one if their peers mock them.
STDs
Cuyahoga County has a serious issue
with STDs. Chlamydia cases alone have increased by 4.3% over the past three years. 41.8% of
these cases were among teens aged 15-19.
Additionally, 73% of the reported cases were for females. The areas with high
rates are also some of the poorest–with Cleveland and East Cleveland again
making an appearance in my report, as well as North Randall. The rate is also
highest among African-Americans.
Racial Disparity
As I looked through the sources that
Mr. Krippes sent me, I found that racial disparity was a strong theme no matter
what the health issue was. The racial disparity was also often higher than that
of the state average, which makes me wonder if it is more of an economic issue
than a race issue. I could not find any data that compared rates among suburban
communities and city communities. The overall rates of any health issue was
lower over the county than over the communities that would be described as
urban, so it can be assumed that the data would show a better level of health
in the suburbs. It would be interesting to see if the racial disparity is still
significant when controlling for environment.
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