2012 Summer Institute on Adolescent Health: Equal Access, Equal Say: Achieving Health Equity for all Young People

The Center for Leadership Education in Maternal and Child Public Health, in partnership with the Center for Adolescent Nursing, the Minnesota Department of Education, the Healthy Youth Development-Prevention Research Center, the Minnesota Department of Health, and Teenwise Minnesota, is pleased to announce the 2012 Summer Institute on Adolescent Health.

When: July 30- August 2, 2012

Where: Minnesota Department of Health, Snelling Office Park, Minnesota Department of Health Snelling Office Park, 1645 Energy Park Drive, St. Paul, Minnesota 55108

Cost: $250

Register at:
http://www.nursing.umn.edu/Adolescent_Nursing/Continuing_Education/home.html
.

Change – the one word that best epitomizes adolescence – changing bodies, changing schools, changing friends. While change is essential for healthy transitions to adulthood, it can also increase vulnerability. For young people today, inequitable social conditions in families, schools, and communities can lead to dramatically differing pathways to adulthood, some healthier than others. Inequities in social determinants of health abound – socio-economic status, housing, physical environment, food security, neighborhood safety, social support, health care services, transportation, and working conditions, to name a few.

What helps all young people achieve their highest level of health? Assuring optimal health for all requires equalizing the conditions for health – life-skills, access to quality services, educational attainment, readiness for gainful employment, and opportunities to contribute to their communities in positive ways. This means that we must pay attention to creating services and programs that are accessible, acceptable, appropriate, and effective.

During the 2012 Summer Institute in Adolescent Health, consider the myriad of social, political, educational, environmental, and economic conditions that underlie disparities in health. Visit settings that are successfully addressing avoidable inequalities that impact adolescents. Talk with young people and their program leaders along with health providers and educators who have walked the talk of health equity in just, creative, and empowering ways. Learn strategies for assuring supportive environments, sustaining authentic relationships, and providing services that are responsive to the uniqueness of each young person. Gain new skills to effectively advocate for health equity among all young people.

Who should attend?

All who work with young people – teachers, coaches, and administrators; nurses, physicians, nutritionists, psychologists, social workers, counselors, and youth workers; religious leaders and policy makers.

Contact hours and two graduate credits are available (graduate students only).

Strong Foundations: Minnesota’s Birth to Three Institute for Healthy Development

The Center for Leadership Education in Maternal and Child Public Health, the Center for Early Education and Development, the Minnesota Department of Health, the Minnesota Department of Human Services and the Minnesota Department of Education are excited to sponsor Strong Foundations: Minnesota’s Birth to Three Institute for Healthy Development.

The purpose of this institute is to strengthen the knowledge, skills, strategies, and alliances of those who work with expectant families, infants, toddlers, parents and communities to build a strong foundation for healthy development.

When: May 30-31, 2012

Where: Earle Brown Heritage Center, 6155 Earle Brown Drive, Minneapolis, MN

Cost: $195; $165/students. Limited scholarships are available.

Register at:
http://www.cehd.umn.edu/CEED/conferences/strongfoundations/default.html

Keynote Speakers include:

• Sondra Samuels, Northside Achievement Zone (NAZ) President and Chief Executive Officer

Cradle to College is the cornerstone of the work of the Northside Achievement Zone (NAZ). Focusing on the importance of community leadership and family engagement, as well as starting early (prenatally), Sondra asserts that taking a life course perspective will positively impact the achievement of all children.

• Sasha Silveanu, Washington State Family Policy Council, Policy Analyst and Story Tracker

A Powerful Framework will share examples of how communities in Washington State have applied a science-based framework to fuel practice and policy changes. Sasha and her colleagues’ work include strengthening foundations for positive early childhood development; responding to ACEs with innovation and informed care; making accommodations for people, including parents and their children, with high ACEs; and improving response to ACEs focused on resilience and positive adaptation. She will share examples from–but not limited to–the education, social work, child care, mental health, home-visiting, and public health sectors.

Contact hours and graduate credits are available (graduate students only).

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?

Is there a Plan b for Plan B?

Plan B One-Step is a single-dose emergency contraceptive pill that contains higher levels of levonorgestrel, a hormone found in some birth control pills, and has been available in the U.S. since 2009. Its effectiveness is linked with timeliness of use: the drug should be taken within 72 hours of intercourse. The Food and Drug Administration (FDA), after reviewing the scientific evidence on its safety and effectiveness, recommended that it be available–without prescription–to females of any age.

On December 7, 2011, Secretary of Health and Human Services (HHS) Kathleen Sebelius overruled this FDA recommendation. While the Secretary of HHS has the authority to override the FDA, The New York Times reported that this issue was the first time a HHS secretary has publicly overruled the FDA. Secretary Sebelius’ action limits an attempt by the FDA to improve the accessibility of Plan B One-Step among young girls, but it does not affect the legality of the drug. Plan B One-Step remains available, without a prescription, to women who are 17-years old and older; and it is still approved for use, with a prescription, for females who are younger than 17.

Sebelius argued that there should be no change in the current law requiring females younger than 17 to obtain a prescription for Plan B One-Step because they require health-care provider guidance to use the pill properly and safely (to see Sebelius’ counterstatement to the FDA’s recommendation, click:
http://www.hhs.gov/news/press/2011pres/12/20111207a.html
). However, as FDA Commissioner Dr. Margaret Hamburg stated, “Based on the information submitted to the agency, [the FDA’s] CDER [the Center for Drug Evaluation and Research] determined that the product was safe and effective in adolescent females, that adolescent females understood the product was not for routine use, and that the product would not protect them against sexually transmitted diseases. Additionally, the data supported a finding that adolescent females could use Plan B One-Step properly without the intervention of a healthcare provider.” Further, young girls are able purchase a variety of over-the-counter medications and personal products that could be harmful in large doses, such as Tylenol, with no ill effects. President Barack Obama had the opportunity to overrule Sebelius’ decision, but instead agreed with her, noting that he felt uncomfortable, as a father, with the FDA’s decision.

What’s at play here?  What’s going on in this dance between science and good health policy? Did upcoming presidential race play a role here? Are there additional moral or ethical considerations about the proper age for emergency contraception? What’s going on?

How much should, or do,  data really matter in creating health policy? How we talk about – frame – this and other politically charged health issues matters. Consider the language used in various news sources covering the issue. The emotionally charged responses to this specific drug from both evidence-based and ethical-based sides merge to create a unique and complicated discussion. As we launch into an election year, how can we expand the conversation on the topic with our peers and colleagues to further consider the multiple dimensions influencing the availability and accessibility of Plan B for women of all ages across the U.S.?

December 13, 2011 Coverage Update:  14 U.S. Senators, including Minnesota’s Al Franken, have called for further explanation of Sebelius’ decision made on December 7, 2011. The letter–defending the importance of using science to create policy—asks Sebelius for “specific rationale and scientific data” behind limiting Plan B’s accessibility. To see the letter and co-signers, visit:
http://murray.senate.gov/public/index.cfm/newsreleases?ContentRecord_id=77e3d54b-bb6b-4c7c-9f05-bfe8c8d3b304
. Sebelius has not yet released a response.

Health Disparities and Children in Rural Areas

The Health Resources and Services Administration (HRSA) has released a report on U.S. rural children and their health, called The Health and Well-Being of Children in Rural Areas: A Portrait of the Nation 2007. Compared to urban areas, children living in rural locations are more likely to face adverse health outcomes.

The study uses parental responses from the 2007 National Survey of Children’s Health (NSCH) (2011 NSCH data collection is expected to be complete in March 2012). Health indicators include children’s body mass index (BMI), behaviors, skills, chronic disease status, access to health care, socioeconomic status, family structure, parental wellbeing, and community protective and risk factors. Statistically significant comparisons are at the 0.05 level.

The disparities seen in this population may be related to the fact that that children in rural areas are more likely to be poor than those in urban districts. About 23% of children living rurally are part of households with income below the federal poverty line compared to 17% of children in urban areas.  Socioeconomic status is related to poor access to care and thus health problems. Although there are other differences in this population compared to children in other areas, it will be necessary to focus efforts at these correlations.

To see the report, methodology and results, visit the Maternal and Child Health Bureau’s (MCHB) site:
http://mchb.hrsa.gov/nsch/07rural/
.