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.

MAMA: Motherhood Around the Globe

An online exhibition of global art, voices, and ideas, MAMA: Motherhood around the Globe is an inspiring community for anyone who is a mother, knows one, or works with one (that’s all of you!). Housed through the International Museum of Women, the website includes videos, facts, and figures promoting healthy moms and its significance with delivering healthy babies. Graphic designs describe the status of Millennium Development Goals in related to gender equity, reproductive health and maternal mortality.

Visit the art gallery for paintings, photographs, drawings and sculptures of the beauties and perils of pregnancy, childbirth and motherhood.  Read stories of motherhood from women around the world. Explore global MCH heroes and their novel ideas in preventing maternal mortality and supporting the health of women everywhere.

Do you have an experience (either domestically or globally) working with mothers you would like to share? As a mother, do you have stories you would like to tell others? What did you find most inspiring about the website? Let us know below or send us your anecdotes!

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.

Perceptions of HIV in Hard Hit Areas

The Henry J. Kaiser Family Foundation (KFF) has released a new and enlightening report from a 12-city project initiated by the Department of Health and Human Services (HHS). The Department created the plan to enhance HIV prevention, care and treatment in cities with high HIV/AIDS burden. These metropolitan cities represent 44% of the U.S.’s AIDS cases and include New York, San Francisco, Dallas, Washington D.C., as well as others. Because the concentration of HIV/AIDS in these areas is so high, KFF analyzed perceptions and public opinions of HIV/AIDS in these cities compared to adults living elsewhere.

Results: Overall, Black and Latino respondents were more likely than white adults to perceive HIV as a major problem in their community. These aspects include a higher percentage of knowing someone with HIV, being concerned with themselves or knowing someone becoming infected, talking with others about HIV, and naming HIV/AIDS as the most urgent health problem. However, a larger percentage of Black and Latino respondents noted that they have been tested for HIV compared to their white counterparts.

Furthermore, HIV/AIDS visibility was found higher in these hard hit areas compared to respondents elsewhere (the categories listed above define visbility perception). People in hard hit areas are twice as likely to perceive HIV/AIDS as the most urgent health problem for the United States than respondents in other regions (10% versus 5% respectively).

These results may show us that because people in hard hit areas are more exposed to HIV/AIDS, they view the problem as greater than other districts. This is seen in one question that asks about media exposure: Blacks and Latinos compared to whites, and adults in these metro cities compared to other areas, say they have seen or read a lot about the AIDS problem in the past year. Future implications include looking at opinions on these exposures and how public health professionals can use these to intervene differently depending on geographic location and population.

You can check out the report here: http://www.kff.org/kaiserpolls/8255.cfm. Feel free to start a discussion on findings and implications!

Public health in Alaska: some thoughts

Greetings, MCH readers!

Laura Andersen here, a master’s student at the University of Minnesota’s Maternal and Child Health program. I’m writing you from Alaska, where I am currently about halfway through one of the most interesting internships I’ve ever held – at the State of Alaska’s Section of Women’s, Children’s, and Family Health.

Alaska is incredibly beautiful and diverse, both in terms of its people and its geography. Folks in Juneau will tell you that Anchorage is “30 miles from Alaska,” but coming from the Midwest, it feels wild and remote. The Cook Inlet runs along the city’s eastern side, and to the west, the Chugach Mountains loom. Locals fish for salmon downtown, and moose and bears are routinely seen in neighborhood alleys.

At the same time, the city is the largest in Alaska, boasting more than 40% of the state’s total population. Health disparities are more sharply defined by the state’s challenging geography: public health practitioners here struggle to provide equal access to health care programs across the state’s 591,004 square miles and within the 75% of Alaskan communities still unconnected by roads.

Alaska, furthermore, has substantial health issues (both environmental and social) to contend with.  One of the more pressing environmental health issues right now is the debate over Pebble Mine, a proposed exploratory mine along Bristol Bay in southwest Alaska — its opponents argue that the  mine will radically harm the area’s water, wildlife, and health of surrounding communities.  Rates of preventable illness, such as diabetes and hypertension, continue to rise in both urban and rural areas, while complex social ills—intimate partner violence, suicide, and substance abuse, are regularly cited as “epidemic” in proportion.

Last week I sat in on a meeting of the Legislative Health Caucus downtown. They are currently putting together their 2010 Well-Being report, which includes a substantial list of health concerns and requests for state and federal funding. Health advocates here must work closely in order to coordinate services, and with a gubernatorial race just around the corner, many agencies are busy pushing hard for their programs. With two ongoing field projects, I’m pushing hard, too — and looking forward to a little more travel before I head back to the lower 48.

To learn more about Alaska health, visit the Department of Health and Human Services online, at http://hss.state.ak.us

To learn more about Alaska culture, I highly recommend the Pulitzer Prize-winning Anchorage Daily News, at www.adn.com

To learn about about internships with HRSA’s Maternal and Child Health Bureau, click here: http://mchb.hrsa.gov/mchirc/gsip