STIs at a Peak in Minnesota

Sexually transmitted infections (STIs) are on a rise in Minnesota. From 2010 to 2011, there was an 8% increase in bacterial-related cases.  Chlamydia, for example, has more than doubled from its dip seen in 1996. This data—from Minnesota Department of Health’s (MDH) 2011 Sexually Transmitted Disease Surveillance Statistics Report—includes information on Minnesota’s most commonly reported communicable infections: Chlamydia, gonorrhea, syphilis and chancroid.

This newly released data shows disparities between race and sex; for example, Chlamydia rates increased 20% in one year for the American Indian population. Differences in geographic regions (metro areas versus rural MN) also exist: the City of Minneapolis has the highest rates of Chlamydia in the state. There has also been resurgence in syphilis since its last stable point in 2002; men who have sex with men are the most impacted.

Physicians and laboratories are mandated to report these infections to MDH, and the Partner Services Program helps collect the information. The Partner Services Program ensures sexual partners of untreated cases also get service, and that data on positive cases is sent for surveillance reporting. The State does not require MDH to gather data on other communicable STIs (e.g. HPV).

An improved Minnesotan surveillance program or increased screening and reporting requirements may have influenced these rates. In addition, this year MDH used 2010 Census data as reference points for population incidence rates; this may explain the differences seen between the beginning of the decade—which used 2000 as a reference—and 2011. Even so, Minnesota has consistently been a gold standard for passing pro-public health policies. These statistics are alarming; why are we seeing an increase in preventative diseases? In fact, underreporting is an issue because asymptomatic and treated cases are not reported to MDH, and this surveillance report does not include people from federal and private prisons.

With these statistics, where should  we target interventions and prioritize our resources?

To access the information, visit: http://goo.gl/CaqqH. MDH’s STI website includes some great graphs, charts, and an archived webinar with detailed slides.

2012 SPH Research Day

On April 2, 2012, students from the University of Minnesota (UMN) were given the chance to present research they have been working on, bridging their training with producing and presenting original work. School of Public Health Student Research Day includes Master’s thesis and other projects students may have worked on throughout their career. Research Day also gives students the opportunity to develop and present a formal poster. Check-out some of the amazing work our Maternal and Child Health students are involved with! To see more UMN MCH Master’s Projects, visit our website: http://www.epi.umn.edu/mch/index.php/Page/View/Masters-Projects-Links

Findings show high rate of dental sealants but low rate of treatment care among Minnesota’s low SES 3^rd graders MaiSee Moua

Healthy Teen Initiative: A Teen Pregnancy Prevention Project in Ramsey County, MN Charla Jones

Complementary and Alternative Medicine Use Among Youth with Juvenile Arthritis: Are Youth Using CAM, But Not Talking about It? Elisabeth Seburg

Assessment of Prenatal Care Knowledge and Utilization by Resettled African Refugee Women in Utah Jessica Lowe

The influence of adolescent feelings of hopelessness and lack of self-worth on trying for pregnancy and future pregnancy feelings Annie Fedorowicz

Healthy Babies are Worth the Wait

The March of Dimes has initiated a new project called Healthy Babies are Worth the Wait (HBWW). This public health campaign strives to prevent factors related to preterm birth, including social, medical and biological influences. Children born prematurely are more likely to have vision and hearing problems, lasting physical and mental disabilities, and learning delays later in life. [i] Aiming for pregnancies that are at least 39 weeks in length decreases the likelihood of children developing health problems There has been a rise of in the number of U.S. births before week 39 over the past two decades, with 12.8% of live births in 2006 classified as a preterm birth. [ii]

The Kentucky Department for Public Health in collaboration with the March of Dimes and Johnson & Johnson Pediatric Institute helped create HBWW: a community-based, preterm birth prevention initiative. An innovative key to the campaign is engaging the community among local- and state-level clinical and public health partners. It includes targeted resources for both the public (info sheet: http://www.marchofdimes.com/pregnancy/getready_atleast39weeks.html) and professionals (toolkit: http://www.marchofdimes.com/professionals/medicalresources_39weeks.html).

How can we use these strategies in our work throughout MCH? This collaborative theory and process influences much of our work, but more can be done across sectors, fields and levels of work. Check out a webinar March 29, 2012 11:00pm CST sponsored by Healthy People 2020 Leading Health Indicators: http://goo.gl/iFJbQ. Participants will learn about how collaboration and partnerships, provider initiatives, patient support, public engagement, and progress measures helped inform HBWW’s conceptualization.

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[i] March of Dimes. (2010, April). Your premature baby. Retrieved from March of Dimes: http://www.marchofdimes.com/baby/premature_indepth.html

[ii] March of Dimes (2011). Medical Resources. Retrieved from March of Dimes: http://www.marchofdimes.com/professionals/medicalresources_hbww.html.

MCH Student Annie Fedorowicz on her first Professional Presentation

A hundred different thoughts were racing through my head as I waited to give my first professional presentation at the 2^nd annual Making Lifelong Connections meeting… Will I remember to take a breath and slow down? How do I connect with the audience? I have to remember not to read the slides and just tell my story. Do I really have something to contribute to this field?

Luckily, all my worries were quelled as I told a room full of Maternal and Child Health Bureau (MCHB) current and former trainees about my field-experience as data collector on the Mobile Youth Survey (MYS), and discussed how my interactions with participants and their families shaped my secondary data analysis. My analysis examines the influence of hopelessness and self-worth on pregnancy feelings and intention among sexually-active adolescents in Mobile, Alabama. I witnessed how environmental stresses of poverty, poor housing, and neighborhood violence influences adolescents’ decisions to engage in high-risk behaviors and how these factors affect their feelings of self, community connections, and peer and parental relationships. I told the audience about conversations I had with adolescents and their care-givers (mostly mothers and grandmothers), reflecting on how those conversations led me to my research question and provided me with a context for interpreting my research findings. I emphasized the importance of examining adolescent health holistically, through understanding the intersectionality of the social influences and feelings of self. This holistic approach informs research that examines the etiology of risk-taking behaviors, such as adolescent feelings about being involved in a pregnancy as a distinct outcome, which ultimately informs future sexual decision-making that could lead to a pregnancy.

After my presentation, I had wonderful conversations with MCH professionals that work with adolescents. We discussed how more health research needs to focus on the process of decision-making or lack of decision-making as a distinct outcome. Many of them had worked on adolescent pregnancy prevention initiatives that solely focused on access and behavioral modification through providing sexual health information. They see a gap in this type of programming that fails to address the complexities of adolescent feelings towards pregnancy, which is shaped by psychosocial factors. Through these conversations, I became more confident that my research would contribute valuable information about adolescent pregnancy feelings and intention. I was also able to connect with professionals working at the University of Alabama who had grown-up in the state. They reflected on their experiences as adolescents and validated some of the field observations that I shared in my presentation.

Professional connections were also spurred through my presentation, as I provided adolescent health professionals with information on other MYS published studies and they provided me with helpful job search advice. Several Leadership Education in Adolescent Health (LEAH) fellows provided me with tips on how to communicate my data collection and research experience in job interviews. LEAH fellows receive extensive training on public health policy and programmatic communication. They also have extensive knowledge on adolescent health theories and current practice, such as utilizing a healthy youth development framework in designing programs that promote protective factors that negate sexual risk-taking behaviors among adolescents. It was helpful to see how my analysis fit into the larger discourse of adolescent health.

Overall, my first presentation experience exceeded my expectations. I was able to use my MCH training and skills to execute a secondary data-analysis and more importantly, translate my research findings into an engaging presentation to share with leading MCH professionals. The goals of the MCHB annual meeting were to provide leadership development and networking opportunities. I met both goals through presenting and attending this meeting. I now feel ready to join this skilled cohort of MCH leaders in the field.

Annie Fedorowicz is an MPH student at the University of Minnesota School of Public Health. She is currently writing her Master’s paper for her Maternal and Child Health degree on hopelessness and self-worth on pregnancy feelings and intention among sexually-active adolescents in Mobile, Alabama.

Local Highlight: Reported Kids Concussions on the Rise

Concussions are a form of Mild Traumatic Brain Injury, and are on the rise in Minnesotan children. Symptoms can range from mild (e.g. headaches) to severe (e.g. mood changes, blurry vision, slowness in acting) and may not appear until days or weeks after an injury.

The Star Tribune reports that from 2000 to 2008, the number of children treated for concussions in Minnesota hospitals had increased by 75%. Although most of the injuries were in adolescent boys (ages 15-19), the number of concussions in younger children has sharply increased. Football, hockey, and soccer are the top 3 sports most treated for concussions. These research results come from Minnesota Department of Health Injury and Violence Department epidemiologist, Dr. Leslie Seymour.

An issue to consider with rate changes is whether the actual number of concussions has risen, or the number of children getting treatment has risen. A law (MN Chapter 90) enacted at the start of the school year aims to improve awareness among coaches, parents, and players. Information will reflect the National Centers for Disease Control and Prevention’s (CDC) guidelines and ‘Heads Up’ training.

Dr. Seymour recently received a federal grant to explore the effect of Minnesota’s and various states’ concussion laws. Other possible explanations may be an increase in organized sports involvement or more violent, stronger competition. What are your thoughts on this rise in concussions? Are there any other explanations? What about kids’ participation in extreme sports? Are there disparities between populations?