Monday, March 25, 2013

Cameron Quist Community Trends Assignment


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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