Assignment 2: Health Promotion Project Paper
Introduction
Over the years, health disparity has a been a significant challenge in the public health sector in the United States. Both federal and states health departments have conducted numerous health studies to determine the impact of health disparities on the health of the people. The key determinants of health including economic factor, access to health services, gender, and individual people behavior among others are responsible to the changes in the infant mortality rates. The infant mortality rates at the national and state levels is different due to the racial and ethnic composition differences. For example, Florida state has a lower infant mortality rate than the U.S national rate (de Andrade, et al., 2015). Cultural consideration including the cultural values, prejudice, and religious beliefs could also impact on the ability of the society to control infant mortality rates. Theory of reason action is a health promotion perspective that provides relevant guidelines to improve the reduction of infant mortality rates at both the state and federal levels. Therefore, the analysis seeks to evaluate the adoption and implementation of theory of reason action as a health promotion model to deal with the rate of infant mortality disparity.
Health Disparity
Health disparity can be defined as the preventable differences in the disease burns, violence, potential injuries, or opportunities to get optimal health. It also refers to the health status differences among various groups of people or individuals. For example, the concept explains that a certain area might suffer from one health condition compared to another area. A specific example of health disparity in my area is infant mortality. Infant mortality describes the death of an infant before he or she is 1 year old (Selix, et al., 2017). Areas with strong maternal and child health programs have helped to lower the rate of infant mortality while other areas with inefficient maternal and child health programs have high infant mortality rate (Renfrew, et al., 2014). To overcome the health disparity in infant mortality, the federal and state government needs to work together in reducing infant mortality.
Determinants of Health
The nine determinants of health include income and social status, education, individual characteristics and behaviors, economic environment, physical environment, social support networks, genetics, health services, and gender (World Health Organization, 2015). Income and social status are a critical influence on the level of infant mortality in the society. Higher income level and social position reduces the risk of infant mortality. A wider gap between the rich and poor people leads to increased disparity in infant mortality. Education shapes the health of people in the society. Low education levels are associate with adverse health, increased stress, and lower level of self-confidence. Low education levels could trigger higher level of infant mortality.
Physical environment includes the access to safe water, quality breathing air, and safe working environment and communities. Poor working environment and unsafe communities are related to the increased level of infant mortality. While, access to safe water and security in the communities lowers the disparity in the infant mortality rates. Social support networks are important in managing the infant mortality rates (World Health Organization, 2015). An increased support from the family members and communities helps in improving health. Culture including traditions and customs also influences the access to health. Positive customs and improved support networks help in reducing the infant mortality disparity.
Moreover, genetics that refers to the inheritance of genes has a significant impact on the health span of an infant and the risk of developing certain health conditions. Infant mortality disparity has been associated with genetics at times. Individual behavior and coping experiences also influence rate of infant mortality. When the pregnant mother is engages in unhealthy behavior, her actions and coping skills could contribute to the infant mortality rates. It shows that individual behavior and coping abilities of people could also contribute to the infant mortality disparity in the society.
Individuals should always make healthy decisions such as eating balanced diets and exercising regularly. Access to health services is another important factor influencing the nature of infant mortality disparity. The ability to access and use the health services helps in preventing and treating health conditions influencing the nature of health. When it is difficult to get access to health services, the rate of infant mortality is high compared to when health services are easily accessible. The government should work with the private sector to improve the access to quality health services.
Economic environment is also critical in shaping access to quality health. Economic environment includes interest rates, inflation rates, and employment rates among others. An adverse inflation and unemployment rates could lead to wider infant mortality disparity as it creates an unhealthy environment (de Andrade, et al., 2015). Finally, gender factor is a significant element of influencing the rate of infant mortality disparity. Male and females suffers from different diseases in the various life stages. Similarly, infants would face health disparity based on their gender. Heath promotion interventions should base gender-based to help in re-shaping access to infant and maternal care.
Epidemiology Associated with Infant Mortality Rate and Incidence Rates
Infant mortality rate occurs when infants do not get quality child care and proper maternal health to the mothers. The public health officials rely on infant mortality rates as a maternal and child health metrics as they are available and reliable. The infant mortality rate differs from county to another in Florida. The variation in the infant mortality is because of the differences in the demographic composition in the varied county populations. The demographic composition includes the maternal race, educational achievement, and marital status. These variables have significant relationship with the risk of infant mortality and offers a good way for making comprehensive comparisons.
According to Selix, et al. (2017), the infant mortality rate has reduced from 5.4 to 4.5 per cent in the last 10 years that is lower than the U.S average of 6.0 in 2014. In the last three years, Florida has recorded a gradual decrease in the infant mortality rates among the Hispanic and black minorities. However, the infant mortality rates among the Hispanics and black minorities is higher compared to the whites’ infant mortality rates. As 2014, Florida also recorded that the infant morality rate among male infants was 5.6 higher than 4.3 among female infants from 2005 to 2014 (Renfrew, et al., 2014). It shows that male infants were likely to die in Florida compared to the female infants. According to Renfrew et al. (2014), around 65% of infant deaths were reported to occur during the neonatal period. However, the rate is varied based on the ethnicity and race of the mothers.
Both at state and national levels, preterm birth is critical concern in public health that has been claimed to trigger infant mortality. In terms of the U.S national figures, CDC reported by in 2014, close to 23,000 infants were reported death in the country (Renfrew, et al., 2014). The U.S infant mortality rate is 6.0 per 1000 live births as of 2014, which is higher than the state infant mortality rate. The differences in the demographics, race, and ethnicity also impacts on the level of infant mortality among the various states.
Cultural Considerations
Compared to the U.S, developing countries have recorded high infant mortality rates due to cultural norms and values. For example, in Brazil, people value male infants over the females due to their cultural norms. This often increases infant mortality rates among the female infants (Ickovics, et al., 2016). Another cultural consideration in the U.S is the prejudice against mothers and the newborn babies. Women might face certain restrictions such as being confined to the house that hurts their health and that of the infants. Cultural influences in minority communities in the U.S such as among Puerto Ricans has been seen to increase infant mortality rates. Teenage pregnancy and smoking often causes premature births that often leads to the death of the infants.
Health care Literacy Challenges
Among pregnant mothers, there are various health care literacy challenges that often leads to increased rates of infant mortality. Lowly-educated mothers have poor communication and understanding of their health conditions. This often creates literacy challenges that hurts the provision of quality maternal health. Family members and friends providing support might not have clinical knowledge and understanding of the patient’s status (Ickovics, et al., 2016). Mismatched communication also limits health care literacy due to proper understanding of medical information and data. Pregnant mothers are also vulnerable to manipulation as they are unable to get in research and reviewing the maternal processes.
Health Promotion Theory
Theory of reason action is a critical model that would help in shaping the intervention to deal with infant mortality rates in the society. The theory argues that an individual’s health behavior is influenced by their attitude towards the specific health behavior and subjective norms and values (Selix, et al., 2017). The subjective norms describe the external social and environmental factors that controls the health behavior of a persons. The treatment plan for infant mortality will include two phases. First, improving maternal care and child care services that is a critical aspect of influencing the social and environmental aspects. Second, pushing for positive individual attitude and external norms would assist in reducing infant mortality as the mothers would take more care of their infants due to the additional support offered from the external care services. The theory has been used to developed health promotion initiatives that helps to reduce prevalence of infant mortality in the United States.
Conclusion
In summary, health disparity concerns are a huge public health issue in the United States and other countries across the world. In Florida, infant mortality disparity has been a severe health disparity that questions the ability of the state agencies to improve equal health care services. There are factors that influences health including economic environment, physical environment, genetics, gender, individual behavior, income and social status, and health services among others. The national US infant mortality rate is higher than the Florida State infant mortality rate indicating the efforts of the state to reduce infant deaths. The health literacy challenges could impact on the health interventions. Theory of reason action is an effective health promotion model in help to design a treatment plan to tackle infant mortality.
References
de Andrade, L. O. M., Pellegrini Filho, A., Solar, O., Rígoli, F., de Salazar, L. M., Serrate, P. C. F., … & Atun, R. (2015). Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries. The Lancet, 385(9975), 1343-1351.
Ickovics, J. R., Earnshaw, V., Lewis, J. B., Kershaw, T. S., Magriples, U., Stasko, E., … & Tobin, J. N. (2016). Cluster randomized controlled trial of group prenatal care: perinatal outcomes among adolescents in New York City health centers. American journal of public health, 106(2), 359-365.
Renfrew, M. J., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N. F., … & McCormick, F. (2014). Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. The Lancet, 384(9948), 1129-1145.
Selix, N., Henshaw, E., Barrera, A., Botcheva, L., Huie, E., & Kaufman, G. (2017). Interdisciplinary Collaboration in Maternal Mental Health. MCN: The American Journal of Maternal/Child Nursing, 42(4), 226-231.
World Health Organization. (2015). WHO recommendations on health promotion interventions for maternal and newborn health 2015. Washington, DC: World Health Organization.
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