Category Archives: Child Development and Child Health

Juvenile Detention Centers Miss Key Health Indicators for Girls

I listened to a great NPR report this afternoon by Jenny Gold about juvenile detention centers and how they’re missing some key indicators of the health status of girls that enter into the system. As someone specializing in adolescent girls’ health, I was pretty fascinated – it detailed the personal experiences of a few girls being seen in a New Mexico facility and also tried to address ways it could be rectified. Detention centers can actually be helpful entry points for girls and young women to be connected to healthcare resources (we’re talking mental and physical health, so everything from counseling to substance abuse help to medical attention if they are victims of assault or violence or have seen physicians only irregularly).

One of the biggest issues facing these girls was confidential disclosure of their health status and any social, emotional, and physical issues they were facing. Developing rapport with a provider at a detention facility can be difficult in and of itself, but the girls reported having to answer personal questions in an open-door location, often with men and boys – staff or other teens – present; unsurprisingly, this made it difficult for many girls to feel that they could answer questions of a personal nature (sexual behavior, drug and alcohol use, history of assault, abuse or violence) honestly and openly. What we do know about these girls – 41% have vaginal injury consistent with sexual assault, 8% have positive skin tests for tuberculosis, and 30% need glasses but don’t have them – shows that getting all of this information early on is essential for appropriate and timely care.

One proposed solution to this – getting as much information as possible from these girls about their health status and the best ways to then help them, treat them, and connect them with resources – was to have them fill out a survey themselves. Currently, girls are asked 35 questions by an intake nurse when they arrive, that cover things like current medications, alcohol or drug use in the last 24 hours, and whether they have a history of self-destructive behavior. The proposed survey in the New Mexico facility is 132 questions, and according to one facility employee the time that would take is just not feasible given the traffic and business of the facility. Researchers and providers implemented a pilot study of the survey for 30 girls at the detention facility.

Of course, I can’t comment on the actual level of frantic activity in the specific facility at hand, but I can say that having a questionnaire that catches health issues which can be immediately and effectively addressed can prevent a host of issues from getting worse as time goes on without treatment – potential injuries from abuse or assault, needing STI screenings for victims of rape or girls who are sexually active without access to contraceptives or regular gynecological care, and of course mental health resources and immediate connection with social workers or therapists for those girls in need. Either having the girls fill out the survey via computer themselves or having a nurse help them would also be enormously helpful in the long run. This can also be a great way to track the care progress of these girls over the years, as many go in and out of detention centers. For girls who have experienced assault or abuse or multiple infections and injuries, this can be an easy way to follow-up with them without having to go through essentially baseline assessments of their well-being every time they enter a facility.

Some of the sobering stats about the girls from this particular New Mexico facility from this report: Of the 30 girls who participated in the piloting of implementing this survey, 12 needed immediate medical care, and 23 were coded as needing medical care within 24 hours, based on the survey’s questions. Intakes without this survey missed essential things, like burns on one girl’s torso and chest.

Check out the whole report here. I have no doubt that detention centers are in dire need of additional resources and likely way more staff than they have, for more than just this particular issue of adolescent girls’ health, but if the issue is there being one nurse for multiple intakes, having the girls fill out the survey on a computer themselves – when they’re more likely to be honest than in discussion with a nurse anyway, seems like the best solution to these kind of initial entry screenings. Especially since poor physical health is an indicator of recidivism, increasing the likelihood of girls ending up back in a facility.

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Filed under Child Development and Child Health, Health Behavior, Health Education, Mental Health, Women's Health

American Graduate, American Dropout

I don’t know how many of you educators were able to catch parts of PBS’ ‘American Graduate‘ series this year. It’s a great series that’s focused on the major issues of (mostly public) education in America, including urban versus rural education struggles, mentoring and counseling, adolescent health issues like substance use and sexual activity, ensuring that we’re serving the needs of immigrant students, social and economic class issues and how they impact opportunity and subsequently achievement (measured most commonly as high school graduation) and what’s behind some of the alarming and rising rates of dropping out across the country.

The latter three issues were behind a documentary that I was featured in and that aired in September. It was pioneered by a group of teen filmmakers at an organization based in Brooklyn called Reel Works, a group with a great mission that I encourage you to check out. If you want more background on the piece, check out the PBS brief before the video, which also includes a great interview with some of the teen filmmakers. Hope you find it interesting!

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Filed under Child Development and Child Health, Education, Health Behavior, Media

Is Media Use Slowing Kids Down Intellectually?

A couple interesting studies recently came out that I thought were clearly linked with implications for the development of our younger generations. I recently wrote a post for The 2×2 Project that discusses the impact of media use on the mental health of teens, so I thought this was fairly pertinent.

The first study showed how much the U.S. economy loses to social media use every year. Take a guess at what that amount is.

10 billion bucks? Nope.

100 billion? Not even close.

500 billion? Still no.

According to Mashable’s summary via LearnStuff, social media costs the U.S. economy $650 billion. Check out the infographic they put together:

I’m someone who is generally really torn about social media. I have a blog and am active on Twitter, though along with my Facebook profile I use these all primarily for semi-professional purposes. ‘Semi’ in the sense that they aren’t part of my job, but I use them to promote interesting finds or essays related to my field of public health; I’ve found the sites to be remarkably helpful in communicating important points and connecting with wider audiences compared to different – usually more traditional – media channels. I use social media heavily to promote work being done in my fellowship – my own and other fellows’ – and it unquestionably has helped us reach researchers and organizations it would have been otherwise very difficult to do.

That being said, I am also fairly hesitant about social media given that I don’t particularly like my personal life broadcast across channels, so I have to be pretty meticulous about what and how I use the mediums. I think it can be enormously helpful for children who have difficulty communicating and making connections; I also find that it can feel almost more isolating than no communication at all since it emphasizes and underscores that real interpersonal interaction isn’t exactly happening. So, I’m clearly torn.

The second study, by the great group Common Sense Media, addresses the concerns of teachers and educators that the various kinds and amount of time kids are using media at home is impacting the quality of their classroom work and engagement. 71% of teachers said that they think media use is hurting kids’ attention spans in school, 59% said that it’s impacting the students’ ability to communicate face to face, and 58% have said that the media use is impacting kids’ writing skills – and not in a good way.

Given that the LearnStuff infographic shows that 97% of college students are daily Facebook users, it seems that these symptoms have the potential to get worse at increasingly younger ages, and that by the time kids who grew up in this media-rich environment are in college…well, who knows. And 60% of people visit social media sites at work (something I found most interesting? that more people are on LinkedIn than Twitter), which are obviously impacting work in the sense that they are taking away from productivity or activities related to the job – unless the job is one that incorporates social media, as many jobs increasingly are. Not to be a doomsday reporter, but I do think the implications for these studies are very real.

Thoughts? Come chat on Twitter.

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Filed under Child Development and Child Health, Education, Media, Pop Culture, Technology

Lots of Rest Can Prevent STD Transmission! At Least, That’s What Fresno is Telling Kids

In case you wanted to read something today that will make make you fume, check out ThinkProgress’ report about an abstinence-only education program in Fresno (for shame, California). It is massively, massively irresponsible.

Did you know that getting a lot of rest can prevent you from getting STDs? And that HIV can be spread by kissing? Let that marinate for a bit, because that’s what kids in Clovis, CA, are going to come out of school thinking.

Condoms? Not addressed. Contraception? Not covered.

This curriculum is actually against California law, which requires medically accurate sexual health education to be delivered to students. The ACLU is suing.

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Filed under Child Development and Child Health, Education, Health Education, Public Health, Reproductive and Sexual Health

Maternal Health and the Status of Women

Both globally and domestically, maternal health and the standing of women are inextricably linked. If women do not have the means and access to give birth safely, with trained and educated midwives, physicians and nurses, with appropriate prenatal education and care, it is often indicative of the standing of women in their communities and countries overall. Women’s inequality is also linked to the soaring population growth in developing countries, which will pose a range of new challenges for the next few generations.

Some may point to the United States as an anomaly, citing women’s increasing economic and financial independence, education, and leadership roles in America, while in terms of maternal health rankings, we remain pathetically far down the line for our resources (49 other countries are safer places to give birth than the U.S. – despite us spending more money on healthcare than anywhere else). Of course, the recent and incessant attacks on allowing women to access credible, accurate, up-to-date and comprehensive sexual and reproductive health education and services makes this statistic not entirely…surprising, shall we say.

So, I found the incredibly detailed and visually impressive infographic by the National Post, pulled from spectacular data and research done by Save the Children to be particularly fascinating. What they did was combine information on the health, economic, and education status of women to create overall rankings of the best and worst countries for women, splitting the countries into categories of more developed, less developed, and least developed, and the countries were ranked in relation to the other countries in their category (the divisions were based on the 2008 United Nations Population Division’s World Population Prospects, which most recently no longer classified based on development standing). While these divisions and the rankings can certainly be contentious and may incite some disagreement (nothing unusual there, these kind of rankings usually are), I thought the results were interesting. Some highlights – Norway is first, Somalia is last. The United States was 19th, and Canada was 17th (Estonia fell in between us and the Great White North) in the most developed. Israel is first in the less developed category, and Bhutan is first in the least developed category. The full report with data from Save the Children is also available, if you want to learn more about the information combined to make this image. Take a look:

A Woman’s Place – Courtesy of the National Post

One thing that I thought was particularly great was that the researchers combined women’s health and children’s heath data to create rankings specific to being a mother, when that category is sometimes only assessed based on access to reproductive care.The specific rankings of maternal health highlights largely mimics the overall standing of women, as seen here – Norway is number one, again, and Niger falls into last place:

Mother’s Index, Courtesy of Save the Children

I think these images and graphs are particularly moving given one of the top health stories coming out of the New York Times today, which showed that a recent Johns Hopkins study indicated meeting the contraception needs of women in developing countries could reduce maternal mortality (and thereby increase the standing of women in many of the nations doing poorly in the above ranking) globally by a third. When looking at the countries in the infographic that have low rates of using modern contraception and the correlation between that and their ranking in terms of status of women, it’s not surprising what the JH researchers found. Many of the countries farther down in the rankings have rates below 50%, and for those countries filling the bottom 25 slots, none of them even reach a rate that is a third of the population in terms of contraceptive use – which of course in most cases has to do with availability, not choice. Wonderfully, the Gates Foundation yesterday announced that they would be donating $1 billion to increase the access to contraceptives in developing countries.

Also of note, and in relation to maternal and newborn health, is a new study recently published by Mailman researchers that showed PEPFAR funded programs in sub-Saharan Africa increased access to healthcare facilities for women (particularly important for this region, as 50% of maternal deaths occur there), thereby increasing the number of births occurring in these facilities – reducing the avoidable (and sometimes inevitable) complications from labor and delivery, decreasing the chance of infection and increasing treatment if contracted. This has clear implications for children as well (and why I think this study relates to the National Post infographic and the NY Times article), since newborns are also able to be assessed by trained healthcare workers and potentially life-threatening conditions averted – including HIV, if the newborns have HIV+ mothers and need early anti-retroviral treatment and a relationship with a healthcare worker and system. And it goes without saying that if a new mother is struggling with post-delivery healthcare issues, including abscesses and fistulas, or was dealing with a high-risk pre-labor condition like preeclampsia, the child will have an increasingly difficult early life, perhaps even a motherless one.

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Filed under Child Development and Child Health, Health Education, International, Politics, Public Health, Reproductive and Sexual Health, Women's Health

Social Media Continues to Make People Feel Bad About Themselves

A study out of the UK has found (as have others more than once), that use of social media sometimes doesn’t make you feel like…really socializing. Instead, it can make you feel anxious and depressed, which are more likely to make you feel withdrawn than anything else.

The study found that participants noted a drop in their own self-esteem after viewing the accomplishments of their Facebook friends. Combine this with the fact that 25% of them claimed to have had relationship issues due to online ‘confrontations’ (which could, of course, mean many things), that more than half were rendered uncomfortable when they couldn’t easily access their social media accounts, that other studies have claimed more socially aggressive (subtly termed ‘hateful’) folks use Facebook more often, that people often deliberately post bad pictures of their friends to make themselves look better and subsequently compare their weight, body size, and physical appearance to these friends, and that Facebook is cited in divorce proceedings as being problematic for couples, and you may be liable to think that this phenomenon offer little in the way of improving our lives.

A good thing to remember here, aside from the pretty remarkable things being done with social media in terms of education, research, medicine, and public health (this USC study is great news, and touches upon the influence of social networks in ways I’ve been exploring as it relates to substance use, sexual behavior, and disordered eating behaviors, and that other studies have shown the exact opposite in terms of emotional response, is that social media does allow users to tailor the perception and identity they project. Another recent study (I’ll try to find the URL for it!) showed, unsurprisingly, that what users often admire about their friends’ virtual lives is the positive sliver that their friends elect to promote about themselves.

Also encouragingly, those children and adolescents who will have known no life without social media, recently were surveyed about their use of technology and reported that they still preferred face-to-face communication. I put limits on myself in terms of use (though I’m sure to some of you it may not seem like it!) since I feel as though I miss a lot in terms of nuance when communication online, but it remains true that both my research and personal communication projects require a fairly consistent social media presence – I admit that I’m torn. As with most everything, balance is key, but how can we monitor our behavior in ways that allow us to strike that balance without teetering into territory that destroys our positive sense of self?

Thoughts? How about you ironically follow me on Twitter to discuss?

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Filed under Advertising, Child Development and Child Health, Education, Health Education, Media, Technology

Child Mortality – What Are the True Biggest Causes?

A great image from Population Services International‘s most recent issue of their magazine, Impact, from the cover article written by Desmond Chavasse, Ph.D, Vice President, Malaria Control & Child Survival, PSI, about causes of child mortality globally.

Causes of Child Mortality – Image courtesy of Population Services International

One of the purposes of the image, of course, is to show the stark contrast between directed funding for treatment and eradication of certain diseases and the number of children afflicted with these illnesses. How does this impact our understanding of global health and of the marketing around certain hot topic health issues and ways in which donors feel as though they are contributing to a decline in preventable deaths?

When I worked in development for HIV/AIDS organizations, it was fascinating to speak with donors about their reasons for giving and their understanding of the prevalence and incidence (and the general audience grasp of the word incidence, which is the measure of risk of contracting a certain illness or disease within a specified time frame) of HIV. Contrast this with the understanding of malaria, TB, diarrhea, deaths due to childbirth complications (for the mother and the infant), and the gap between perception and reality was startling. In no way do I want to deny the importance of consistent development support for all diseases on a global scale, but I do think there is something lacking in terms of the education around these issues for donors and even some advocates.

Solutions? Come chat with me on Twitter.

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Filed under Child Development and Child Health, Health Education, International, Public Health

Juveniles no Longer Sentenced to Mandatory Life Without Parole

It’s about time, don’t you think? Amidst the flurry of SCOTUS activity today (striking down three components of the Arizona immigration law, but retaining the ability for law enforcement officials to require anyone they stop to show their papers, confirming that Citizens United does indeed apply to states in the case study of Montana), I was moved by their (late) decision to rule that ordering life without parole for juveniles is unconstitutional and was considered cruel and unusual punishment. Now courts will not be able to automatically hand a juvenile a life-without-parole sentence for some crimes. This doesn’t mean that sentence will no longer happen – it just means that for crimes like murder, that sentence is not automatic.

One of the most important things to remember about childhood and adolescence is that actions taken during that time are so often misunderstood in terms of their impact and their consequences, juveniles so often lack the ability to grasp the implications and depth of their choices, and they always lack real-world context. This is long overdue. It’s true that these sentences are often brought down upon juveniles who have committed atrocious acts, or were accessories in brutal crimes, but isolating the incident from the developmental stage is risky and unfair. Putting someone away without the affirmation that we also believe they can grow and develop and change is also a psychological judgment that would likely result in the juvenile’s agreeing self-assessment that they are unable to be rehabilitated.

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Filed under Child Development and Child Health, Politics

Body Judgments Begin…Pretty Close to Birth

I know it’s been a while since I’ve written – I took six weeks off to finish my dissertation and prepare for its defense (I passed!), and to take a bit of a breather after all that required writing! But what better way to start a new month than with a new post?

One of the many reasons I went to graduate school to study adolescent female and women’s health was because I wanted to gain a better understanding of why women and girls develop disordered eating behaviors, what makes them worse, and most importantly, how to prevent them. And more and more studies are telling us what many researchers, clinicians, and patients themselves have been telling us for years.

A few recent studies in particular that have been published in the past few weeks highlight these issues well. One new study out of UCLA has again proven that strong self-perception is key to the prevention of risky behaviors in teen girls. The results of this study showed that overweight girls who had high body satisfaction and who were happy with their size and shape were less likely to engage in a range of unhealthy and disordered eating behaviors like fasting, skipping meals, and self-induced vomiting. And more importantly, the study also showed that these girls had lower rates of anxiety and depression, which are so disturbingly common among girls with burgeoning eating disorders.

And the best thing about the study’s results was the discussion that these public health experts, dieticians, and professors had, in which they emphasized that for effective, healthy weight-loss interventions for teens who may need to lose weight for real medical reasons (preventing the onset of diabetes or hypertension and increasing cardiovascular health, for example), these programs need to be rooted in positive self-esteem and the enhancement of self-image. When you feel better about yourself, you want to keep taking care of yourself. You are also more likely to want to share yourself with others, and creating positive social networks increases the likelihood that people will have supporters pushing them to stay healthy as well as a community that makes them feel worthwhile, appreciated, and worth the kind of self-care that diet and exercise changes require.

So why do companies, organizations, media outlets, and other vocal critics keep harping on the idea that shame, insults, and bullying will help people lose weight? To me, the root of this problem lies in the misguided thought that anyone else’s weight is anyone else’s business. It isn’t.

Another recent study has unfortunately shown something I find really upsetting. Preschoolers - remember, that’s ages 2-5 – show negative perceptions of overweight children. The way this study was conducted involved an adult reading four different stories to a group of children, in which one character was ‘nice’ and the other was ‘mean.’ They then showed the children pictures of one overweight figure and one normal weight figure, and asked them to select which one was the ‘nice’ character from the story and which was the ‘mean’ character. Nearly half of all students said that in all four stories, the overweight figure was selected as the ‘mean’ one. Mind you, these figures had no faces. No physical expressions. One was just bigger than the other. And because of that, the children thought they were meaner.

I mean…whoa. Ages 2-5 are in the early developmental stages, when children are absorbing and processing and incredible amount of information - verbally, visually, and physically – and learning how to reason. We do not need judgments about others’ weight getting ingrained at this age, creating perceptions that are very difficult to change. Of course, this one study bears repeating, and should incorporate additional measures of exploring these outcomes; nonetheless, these results are troubling.

Of course, this study begs the revisiting of one of my most pressing points on this blog. Weight, just like food, is not a characteristic that is inherent in measures of good versus evil. That’s very dangerous territory to traverse – once one allows weight to dictate the assessment of whether or not someone is not only of value and worth (societally speaking, this already happens, when overweight people are ignored, more easily dismissed, not taken as seriously), but whether or not they are actually truly ‘bad’ or ‘mean’ or capable of certain sins because they are overweight, one’s morality becomes game for critics. I also always remain shocked at some critics’ short-sightedness in this relam – if you yourself gain weight in the future – something which may happen for a variety of reasons – are you readily willing to take on the label of weakness, ‘meanness’, gluttony? The impassioned rhetoric around the blaming and shaming of overweight people is so starkly in need of an infusion of compassion.

What this shows is that children are inundated with messages, both direct and indirect, from so many different sources at such a young age, that the idea of being overweight is coded as bad in so many ways, that it seems nearly inescapable. To me, this means we have to keep making intense efforts to combat these messages, because we are climbing one steep hill.

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Filed under Child Development and Child Health, Disordered Eating, Health Education, Mental Health

Reader Roundup (It’s Been a While…)

I am currently very guilty of completely falling behind on my (totally self-prescribed) schedule of at least weekly, hopefully twice weekly, original writings. I’m in a major data analysis crunch in my dissertation, and the stats interpretation is taking up a healthy number of my hours everyday. That being said, I’ve tried to keep up with my reading schedule, and with that in mind, I’ve done a little round up of some great articles I’ve read in the past couple weeks that I think some of my readers might enjoy. Without further ado:

For those of you interested in adolescent development, the Wall Street Journal had a great article about how the teen brain works, and how it’s changed: What’s Wrong With the Teenage Mind?

ESPN had a section on their website specifically devoted to viewers being able to comment on how much they hated female commentators. So, there’s that: ESPN Allowed People to Complain About ‘Female Commentators.’

Great details from the Huffington Post about what is at stake in an election year for women’s health, and how women’s health is used as fodder for politicos: What Does an Election Year Mean for Women’s Health and Rights?

Gail Collins, who I am a huge fan of, takes this to task as well, questioning how the allowance for employers who oppose birth control to deny coverage for female employees can be seen as a risky precedent: Tales From the Kitchen Table

Mother Jones, with excellent reporting as always, details The Republican War on Contraception – it’s even more frightening when all the facts are compressed into one terrifying testimony.

The International Center for Research on Women has a new series: HIV and AIDS: Are We Turning the Tide for Women and Girls? The chronicle case studies of women driven efforts to prevent HIV infection, projects that adapt to the need of the communities they work in (I’m always amazed that this essential element of global development remains sometimes misunderstood and underestimated), and innovative new endeavors is some great coverage on current global health initiatives aimed at reducing HIV infections and AIDS progression.

What interesting pieces have you read lately?

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Filed under Child Development and Child Health, Education, Feminism, Health Education, International, Politics, Public Health, Sexism