Important to the overall "community" of the country:

-measure of overall health of the country

-maternal mortality rate

-infant mortality rate (death in the first year of life)

-Neonatal mortality rate (death in the first 28 days of life)

-measure of the effectiveness of disease prevention and health promotion efforts

-incidence and prevalence of diseases and conditions related to or consequences of pregnancy

-incidence and prevalence of diseases and conditions of infants

-infant's health dependent on the mother's health 

-health behaviors before and during pregnancy can have long term consequences for the infant as the baby develops

-money spent on quality maternal health care can save money over course of infant's life

-ability to plan family size is one of the CDC's "Top-10 greatest public health achievements of the 20th century"

-Family planning: determining the preferred number and spacing of children and choosing the appropriate means to accomplish it

-Approximately 1/2 of pregnances in the US are unplanned

Surgical sterilization: tubal ligation or vastecomy-->99%

-By age 40, 54% have been surgically sterilized

Contraceptive implant-- >99%

Birth Control pills or vaginal ring 91 to >99% 

Diaphragm 88-94%

Condoms 82-98%

-In 2007--12.7 maternal deaths per 100,000live births

-Causes: hemorrhage (including ectopic pregnancy), pregnancy induced hypertension, and embolism

- 1990 there were between 600-900 maternal deaths/100,000 live births

-childbearing was leading killer of women of childbearing age

-common causes--post-delivery infenctions, hemorrhage, and pregnancy induced hypertension

-improvement in training in obstetrical methods for doctors and midwives

-understanding of importance of germ control during and after delivery

-antibiotic treatment for post-delivery infections

-emergency medical care for birth complications like hemorrhage

-special care for pregnant women with high risk medical complications 

Low Birth Weight (<2500 grams, 5 lbs, 8 oz)

Very Low Birth Weight (<1500 grams, 3 lb, 5 oz)

-premature birth: born before 37 weeks of gestation

-maternal diet/weight gain

-maternal smoking

-maternal drug and alcohol use

Nutrition: Breastfeeding recommended for the first year of life (but any amount of time is better than none)

-Infants environment after birth

-Home and family circumstances

-access to health care

-Infant mortality rate (birth to 2 year of age) in 2008 was 6.61 per 1000 live births

-Neonatal Mortality Rate (birth to 28 days of age) in 2007 was 4.42 per 1000 live births

1. Congenital malformations, deformations, and chromosomal abnormalities 
2. disorders related to prematuriy and low birth weight
3. sudden infant death syndrome
4. Newborn affected by maternal pregnancy complications
5. Unintentional injur

3 types

Basal Cell Carcinoma-

• most commonly developed (75% of cases)
• Found on face, neck, and hands
• highly treatable and rarely spreads

Squamous Cell Carcinoma-

• 2nd most common type
• usually develops in places exposed by the sun

Melanoma

• most dangerous and deadly
• caused by changes in cells called melanocytes, usually when skin has recieved too much of the UV rays
• appears on skin, moles, or other areas that changes appearance 

• Family history
• skin/hair/eye color
• exposure to sun
• history of bad sunburns
• certain moles
• history of indoor training

• avoid tanning outside (between 10am-4pm)
• don't use tanning beds
• try not to get burned
• wear clothing that will protect your skin
• apply sunscreen generously and often (every 2 hours)
• use broad spectrum sunscreen with 15spf or higher
• reflective surgaces like water, snow and sand increase risk of being burned
• take vitamin D supplements
• wear sunglasses
• check expiration date on sunscreen before application
• cosmetics don't count as sunscreen
• wear sunscreen even on cloudy days

A: assymetry

B: border

C: color

D:diameter

E:evolving

Biopsy

• samples are sent to pathologists
• punch biopsy
• shave biopsy
• exisional biopsy

Stage based on three factors:

• size of the growth
• depth
• spread to lymph nodes or to other parts of the body

Stage 0: The cancer involves only the top layer of skin (melanoma in situ)

Stage 1: the growth is less than two millimeters deep

Stage 2: the growth is more than two millimeters deep

Stage 3: cancer has spread below the skin to cartilage, muscle, bone, or to nerby lymph nodes--it has not spread to other places in the body

Stage 4: cancer has spread to other places in body

• UV light exposure from sunlight
• Tanning booths
• immunosuppression-impairment of the immune system, may occur as a consequence of other disease 
• exposure to high levels of x-rays
• chemical factors (arsenic)

• people with fair skin, especially skin types that freckle and sunburn easily
• people with light hair, blue or green eyes
• those with genetic disorders: albinism, xeroderma pigmentosum
• people with unique, unusual moles
• medical history of skin cancer
• people had at least 1 severe sunburn early in life

• Skin cancer is most common form of cancer in U.S.
• 59,695 people in US were diagnosed with cancers of the skin, including 38,484 men and 25,211 women
• 8,623 people in US died from skin melanoma, including 5,672 men and 2,951 women
• 1999-2008 skin cancer has increased 2.3% among men, 2.1% white men
• women skin cancer increased 2.5% 
• mortality rate increased 1% in white men

Varies depending on size, type, depth and location

• freeze small skin lesions
• excisional strategy
• laser therapy
• mohs surgery
• curettege and electrodesiccation
• radiation therapy
• chemotherapy
• photodynamic therapy
• biological therapy

• Melanoma Monday (first Monday in May) Sun Safe Smart Skin bracelets are sold
• start white then turn blue when exposed to ultraviolet light 
• 4 for $10 and 100% of the Profits are donated to the Melanoma Research Foundation, Camp Discovery or CCMAC 
• Relay for Life--12 hour event that lasts throughout the night--goes toward Hope Lodge, Road to Recovery, Look Good..Feel Better 

Cigarette smoking: #1 most preventable cause of death in the US

• smoking doubles the risk of suffering a stroke and developing heart disease 
• decreases the amount of oxygen in your blood 
• extra effort of the heart can make blood clots form more easily
• smoking adds build-up in the arteries, decreasing blood flow to the brain

• "Brain Attack"
• occurs when there is a blood clot in an artery or a breakage in a blood vessel
• when the blood source to the brain is cut off, brain cells begin to die, can lead to permanent damage

• Smoking causes muscles and arteries to harden--when muscles harden, body doesn't function the way it should (heart, blood, and vascular)
• Blood clots often occur because smoking causes blood to thicken--when reaches the brain=stroke
• High blood pressure--poor blood circulation worstened by smoking
• high cholesterol--carbon monoxide found in cigarettes

• sudden numbness in face arm or leg especially on only one side of the body
• sudden vision changes
• trouble speaking 
• confusion 
• trouble walking and with balance
• sudden severe headach
• irregular heartbeat
• damaged heart valve
• recent heart attack are all factors that increase risk of stroke

• Coronary Artery Disease-narrowing of blood vessels
• Cardiomyopathy-disease within the heart muscle
• Myocarditis-inflammation of the heart muscle
• Tricuspid Stenosis-tricuspid valve is narrowed
• Atherosclerosis-hardeinging of the arteries

• Main cause is smoking--artery wall thickens as result of fatty materials
• smoking traps oxygen from White Blood Cells--causes artery to become inflamed
• muscle cells enlarge and form hard cover over artery

• Chest pain or chest discomfort
• pain in one or both arms, shoulder, neck, jaw or back
• abnormal heartbeats
• shortness of breath
• dizziness
• naseau 
• rapid heart beats
• feeling very tired

• Cardiovascular Disease is used to describe over 60 conditions that affect the heart and blood vessels
• Change lifestyle

- stop smoking

-increase exercise

-have a healthy diet

• become more educated on family history
• special procedure, surgery, medication 

Recommendations from CDC:

• increase unit prices of tobacco products
• mass media compaign 
• school/community based prevention programs 

Ohio Law:

• public places and businesses must prohibit smoking in any public place 

• Mayo Clinic defines diabetes as "a group of diseases that affect how your body uses blood glucose, commonly called blood sugar"
• Glucose=main source of energy for cells that make muscles and other tissues 

• Diabetes patient's immune system attacks or destroys insulin producing cells
• Excess of glucose in the blood--change in diet, physical activity and additional health percautions can help

• common among young 
• can transpire at any point in ones lifetime
• beta cells don't work
• autoimmune disease
• genetic

• blurry vision
• excessive thirst
• fatigue
• hunger
• weight loss
• increased urination
• vomiting
• weight loss
• developed over short period of time--diagnosed in emergency situation

• Life long to keep blood sugar levels at normal range
• monitor multiple times on a daily basis
• use insulin injections or insulin pump
• exercise, healthy life choices
• medical check ups to check for complications

• most common type of diabetes
• body isn't making enough insulin and not responding to insulin--high levels of glucose in the blood
• developed disease
• often onset in adulthood

• Frequent infections
• blurred vision
• cuts/bruises heal slowly
• tingling/numbness in the hands/feet
• recurring skin, gum, or bladder infections
• any type 1 diabetes symptoms--frequent urination, unusual thirst, etc

• occurs due to body becoming resistant to effects of insulin
• cause: drastic change in diet from paleolithic/natural diet--high in sugar/fat
• prevention: return back to diet of natural foods--low fat/saturated fat but HIGH in protein, fiber, and complex carbs
• consistent significant bodily exercise at least 3 times a week

• occurs in women during pregnancy
• hormonal changes during pregnancy cause one to be less responsive to insulin

-if they can't adapt to insulin, blood sugar levels rise, cuasing gestational diabetes

• many women don't have it after pregnancy because blood sugar levels return to normal
• increased risk for future diabetes

Those more likely to develop:

-obese

-over 35

-exessive weight gain during pregnancy

-high blood pressure

-have had a previous stillborn child, child with a defect or a large child

-australian, african-american, south and north asian, pacific islander, hispanic more suseptable

• some have had it and not known about it 
• increased thirst
• increased urination
• increased hunger 
• blurred vision
• only way to find out for sure is to get tested because symptoms also common with pregnancy

• maintain blood glucose levels equal to pregnant women wtihout gestational diabetes
• special meal plans
• scheduled physical activity
• blood glucose level testing (daily)
• insulin injections

• 70,000 people diet of diabetes every year
• 13.7% of men over 30 have diabetes
• 11.9% women over 30
• more men have disease than women
• Colorado, Minnesota, Montana and Vermont have lowest rates
• Southeastern states have highest rates (mississippi 27.7%)

• Uncontrolled growth in the breast cells
• breast cancer in both men and women 
• invasive or noninvasive
• invasive--spread from milk ducts to other tissue in breast
• noninvasive--not yet spread into other areas of the breast

• Ductal Carcinoma: originates in lining of tubes, known as ducts, moves the milk from breast to nipple (most common)
• Lobular Carcinoma: originates in the part of breast that is called the lobules which produce the milk

• Women: 100 times more likely in women than men
• Age: older--higher chances, 2/3 of women who have invasive breast cancer are over the age 55
• women with BRAC1 and BRAC2 genes 80% more likely to get breast cancer
• higher chances with genetic family history
• having children later in life increases risk
• being overweight or obese (fat around waist)
• lack of exercise--10 hrs a week risk decreases by 18%
• 2-5 drinks daily are 1 1/2 times more likely to get breast cancer

• Stage 0-4 determined by:
• size of tumor 
• cancer is found in lymph nodes
• invasive vs. noninvaive
• cancer spread beyond breast
• local,regional,distant--words commonly used to describe
• local: cancer cells confined in breast
• regional: cancer in lymph nodes
• distant: cancer involved other areas of body

Stage 0:

-non-invasive

-no cancer cells present

-no non cancerous, cells in healthy tissue

Stage 1:

-invasive cells invading healthy tissue

-tumor up to 2cm and has not spread

Stage 2:

-cancer in lymph nodes, no tumor (2a)

-tumor larger than 2cm, not in lymph nodes (2b)

-tumor is 2-5 cm, has spread to lymph nodes

-tumor exceeds 5 cm, has not spread

Stage 3: 

-any size, cancer cells spread, clumped in lymph nodes

-any size spread to bone or chest

-cells have spread to lymph nodes, skin

Stage 4

-invasive, cancerous cells

-spread to other organs, lymph nodes

-referred to as "advanced" or "metastatic"

• Men can't get breast cancer--2190 diagnosed each year, 410 die on average--higher mortality rate because unaware of its existance 
• Finding a lump means breast cancer--80% of lumps are benign or cysts
• Only women with family history are at risk--majority of women dont have family history
• Negative mammogram means no cancer--10-20% fail to detect--clinical exams and self exams important

Lumpectomy

• breast-conserving surgery
• removal of only tumor and small amount of surrounding tissue
• perserve appearance of breast

Mastectomy

• removal of all breast tissue
• more refined and less instrusive than it used to be
• muscles under the breast are no longer removed
• doesn't require radiotherapy after surgery

Naturopathic Medicine

• support whole body wellness, immune system, digestion, sleep, energy levels, diet, exercise and spirituality
• normal metabolism during treatment
• decrease side effects
• boost immune system

Immunotherapy

• biological therapy
• uses bodies immune system to fight cancer, reduce side effects
• halts precess of cancer growth 
• helps immune system identify cancer cells
• promotes natural ability to repair

Acupuncture

• thin needles on part of body to increase energy flow 
• control pain and relieve symptoms 
• not believed to cure
• decreases negative side effects and relieves stress

Mind-body

• assumes that tending to your psychological and spiritual health help healing faster
• reduces nasea, vomiting, muscle tension, sleep issues/side effects

• maintain healthy lifestyle and diet
• plenty of physical activity
• limit alcohol
• breastfeed
• those with high risk (genetic disorder)--prophylactic mastectomy (removal of both breasts)--prophylactic oophorectomy (removal of ovaries)

-excessive intake of alcohol where judgement is impaired and a person loses self control

-binge drinking--intake enough alcohol for BAC to reach .08 within 1-2 hours--can cause death or alcohol poisening

-moderate drinking

- Men: 4 drinks in one day or 14 in a week

-Women: no more than 3 drinks in a day, 8 in a week

Depressant--restricts function of central nervous system 

-low to moderate amounts of alcohol--blood alcohol conent begins to rise (under .06) as alcohol moves from stomach to blood

-begin to experience stimulating effects

-increases arousal, energy, confidence cause by sugar 

-after consuming over .06 BAC--experience down fall--depressant effects

-fatigue, lack of coordination, suppressant of pain, judgement, thoughts and memory

-prolong consumption--restricts brain from receiving oxygen--"black outs"

• one person in an intimate relationship tries to dominate or control other person through physical force
• excessive alcogol consumption leads to unintentional and intentional cases of domestic violence
• alcohol loosens inhibitions--more physical
• adverse health effects--broken bones, bruises, sexual injuries, emotional anxiety 

• Most drivers that have had some drinks have a low BAC.

  -Not very many people who drive after drinking have a BAC above .15.

  - For drivers involved in single-vehicle crashes, the relative risk of death is 385 times more than a driver with a BAC of zero.

  - Drivers with high BAC’s are usually men, ranging from 25 to 35 years old, with a background of DUI history, and abuse of drugs.

  - For men, the risk is 707 times more than that of a sober driver.

  
  

  Car Accidents

  - Someone dies in a car accident involving alcohol once every 22 minutes.

  -Drunk driving is the top freeway safety issue today.

Chronic Disease

1. Cirrhosis (liver failure, body can't filter blood anymore)
2. diabetes
3. high blood pressure
4. artherosclerosis
5. cornoary heart disease

Psychological Issues

• Lack of sleep, increased agression, coping, mood disorders
• affects family life--feelings of inadequacy

More common in men than women 

• Men--alcohol decreased levels of tesosterone
• inability to perform sexually udring middle age
• alcoholism for women extremely dangerous, increases risk of liver cancer, breast cancer, kidney cancer

• Risk factors for becoming dependent on alcoholism

-men: >15 drinks per week

-women: >12 drinks per week

-anyone: >5 drinks per occasion at least 1 time per week

Other factors:

-family history

-young-adult peer pressure

-depressiong and other mental health problems

-easy access to alcohol

-low self-esteem

-relationship issues

-stress

-social and cultural factors

• 1400 deaths among college students linked to alcohol
• 1/3 of all drownings
• fatal alcohol snydrome 10% of healthcare costs
• 4/5 high school students claim to have tried alcohol before gradution
• most used date rape drug

Ohio Laws

• can't consume alcohol under 21
• BAC less than .08%
• can't sell to underage
• have open container in public
• fake ID
• persons under 21 drinking on your property

Prevelence: proportion of a population found to have a condition

-drinking alcohol> smoke tobacco/marijuana

18-20 year old drinkers

-showed largest increase (56%) in binge-drinking episodes among American adults

-second-highest rate of binge drinking

-most widespread health problem on college and university campuses in US is high risk alcohol

-National surveys, local populations, special populations provide information

• underage drinking results in either a 

- 1st offense: 2 hours of substances abuse education

-2nd offense: comprehensive substance abuse assessment

-3rd offense: suspension from the university

• Police officers patrol uptown bars--resident assistants 

No-use programs/abstinence-only

-Based on 3 myths

• alcohol use is the same as alcohol abuse
• alcogol consumption is a gateway to other drug use
• exaggerating dangers of alcohol consumption who scare young people into abstinence

Purpose of no-use programs

• prevent any and all consumption of alcohol among those under 21--scare tactics
• to provide strategies to help refuse alcoholic beverages
• nothing provided to hose who choose to drink

This tactics not effective

Mission-strengthen scientific foundation for preventing excessive alcohol consumption

Goals:

• to improve public investigation of the excessive use of alcohol (binge drinking and underage drinking)--health realted outcomes
• Increase research on alcohol related health issues 
• build state public health capacity in epidemiology
• provide national public health leadership to prevent excessive drinking

• Public health surveillance--monitor trends in bine and unerage consumption
• Alcohol Epidemiology Studies--research in relationship between excessive drinking and other health and social oucomes
• State Public Health Capacity--draws attention to excessive drinking as related to health risk behavior
• National Leadership Parnership--participates along with other committees to prevent underage drinking and works with state and local public health agencies

History:

-1733 George Cheyne introduced idea of mental health in relation to emotions and feelings

Ex: nervousness

-1808 Johann Christian Reil first psychiatrist

-1941 congress passed National Mental Health Act

-1956 substance abuse recognized as disease

-syndrome that causes progressive memore loss

-affects memory, speech, language and orientation

-irreversible and slow

-liklihood increases with age

-may contrivute to cognitive impairement: depression, effects of drugs and alcohol, delirium, Vitamin B12 deficiency

• most common form of Dementia
• account for 60% of the cases

• Maintain mental health:
• early diagnosis
• provide treatments that may help slow cognitive deterioration
• make plans
• breain healthy diet
• brain games for prevention
• sudoku

Mental Health Parity and Addiction Equity Act 

• companies with 50+ employees must offer coverage for mental illness and substance use disorders
• eliminates the practice of unequal health treatment
• improves access to treatment 
• 44 million American do not have health insurance plans
• 1/5 Americans have experienced mental illness over the past year alone--overlap
• Mental Health Parity and Addiction Equity Act--working Americans can get mental and substance abuse coverage

Entire body illness that causes the patient to have trouble functioning in everyday life activities: eating, socializing, oversleeping, thoughts of suicide

• 17.5 million Americans who are affected by some form of depression, 9.2 million have major or clinical depression
• most people don't seek the proper treatment
• 2020, WHO estimates depression will be number 2 cause of "lost years of healthy life worldwide"
• more common in women than men

-anti-depressants

-therapy sessions

-institutionalization

-other clinical treatments

• Preventable, yet still 10th leading cause of death in US in 2007
• Gender rates vary
• Methods of dying also vary by gender
• Inbalance of serotonin in brain

Protective Factors 

• primary care doctors and medical care
• support from family, friends, religious affiliations

Treatment

• cognitive therapy
• medication

Immediate Situation

• Doctor help, emergency room, hospital or 911
• remove objects that someone could use to harm themselves
• don't leave the individual alone

• Youths with MI and/or SA have highest offense rates
• alcohol-prevalent drug involved offenses
• high correlation between crime, SA and MI doesn't establish causality---underlying family, individual and situational issues 
• MI and SA treatment can lead to decrease in crime rates---change in policy regarding access to treatment and higher alcohol prices

Four types of program aiming to reduce SA and crime rates

• methadone maintenance program
• therapeutic communities
• outpatient drug free (least successful)
• civil commitment programs
• use of SA and MI treatment to delay or prevent youth detention for any offense
• Stricter alcohol laws may be highly effective

• 1/8 of 95 million visits to hospital ER mdae by adults are due to mental health or substance abuse
• mood disorder (42.7%), anxiety (26.1%), alcohol-related (22.9%), drug disorders (17.6%)
• 20% of Americans with anxiety/mood disorder suffer from substance abuse
• posttraumatic stress disorder and panic disorder--associated with substance abuse problems
• alcohol abuse common among people suffering social anxiety
• disorders treated with substance abuse issue--decrease relapse
• cognitive-behavior therapy--ofen used in treatment for both issues when occuring at same time--more effective

Psychiatric diagnosis for a modd disorder in which people experience disruptive mood swings that encompass a frenzied state known as mania (or hypomania), usually symptoms of depression

• DSM-IC states hypomanic episode is distinguished from manic episode where hypomania isn't as sever as mania--doesn't require hospitalization or impairment in social or occupational functioning
• self esteem significantly elevated above the usual
• decreased need for sleep
• hyperactivity
• talking too much--or feeling need to talk
• racing thoughts
• increases distractibility 
• intense drive to attain some goal (sexual, social or career in nature)

• Substance abuse--increase symptoms of mental illness or trigger new symptoms
• most abused substance is alcohol--followed by marijuana and cocain
• National Institute of Mental Health--1 in 5 adults in US sufers from diagnosable mental disorder
• 50% mentally ill population has substance abuse problem

• Major depressive disorder
• bipolar disorder
• schizophrenia
• panic disorder
• generalized anxiety disorder
• social phobia 
• Alzheimer's disease

Mania

• feelings of euphoria or extreme irritability
• unrealistic, grandiose beliefs
• decreased need for sleep
• increased energy
• rapid speech and racing thoughts
• impaired judgement and impulsivitiy
• hyperactivity
• anger or rage

Anxiety

• excessive tension and worry
• feeling resless or jumpy
• irritability or feeling "on edge"
• racing heart or shortness of breath
• nausea, trembling or dizziness
• muscle tension, headaches
• trouble concentrating
• insomnia

• most common on college campuses
• binge drinking--the intention to get drunk
• BAC
• physical, social, and psychosocial effects

• condition that disrupts a person's thinking, feeling, mood, ability to relate to others and daily functioning
• hard to pinpoint one reason for development of a mental illness

• no cure--recovery and relief possible through inidividual treatment
• treatment plans vary based on severity, symptoms and options
• medications, psychosocial treatments, electroconvulsive treatments, transcranial magnetic stimulation
• PROCESS

Statistics

• 46% of teenage girls and 22% of teenage boys who engage in first sexual experience before 15 involved in pregnancy
• risk declines to 25% at age 15 and older
• US teenage birth rate is highest among most developed countries in the world 
• per 1,000 women ages 15-19---34.3 live births
• 2005 in Ohio--girls 15-19 had 24,790 births/712,610 national average
• teenage girls more likely to become pregnant with older partners
• US higher than any other country because abortion, contraceptives, social acceptance and unbiased public health media campaigns and government support for teens

Loss of Trust

• finding out child is sexually active can cause parents to lose trust in their child

Financial Stress

• having to provide for another family member--financial risk and stress
• counseling is offered about planning ahead for a child
• college offer financial aid for mothers

Family Decision

• family often makes decisions together whether or not to keep the child, have an abortion, put child up for adoption

• trouble finishing their education--less opportunity for jobs
• National Coalition--40% of pregnant teens never finish high school
• HS drop outs--more likely to live in state of poverty and live on welfare
• twice as likely to feel depressed
• mortality rates 4X higher for pregnant teenager from 15-19
• frustration, depression, fear and other emotional problems

Emotionally

• emotional impact of having a child, in childs life or not
• hard balance of school, jobs, child

Goals

• teens goals change because now responsible for child

Financially

• fathers are required to pay child support
• majority of teen fathers have lower salaries

Education

• more likely to drop out of high school
• more likely to not attend college

Behavior/Crime

• teen fathers more likely to be involved in criminal behavior
• drug/alcohol abuse, drug dealing
• charges of statuory rape

-Premature
-Low Birth Weight

• doubles the childs chances of hyperactivity, dyslexia

-blindness
-infant death
-deafness
-respiratory problems

• 50% repeat grade
• lower standardized test scores
• higher chance of not completing high school
• boys have a 13% chance of ending up in prison
• girls have 22% chance of becoming teen moms
• neglect of child common

-Significant decline since 1991--US still highest rates among other industrialized countries

-Identification of problems--lack of education

-Implementing solutions 

• raising awareness in schools
• programs to help teen mothers improve parenting skills and continue education
• encouraging mothers to live "outside the system"

-US tax payers paid at least 10.9 billion to account for teenage childbearing

-closely linked to poverty, welfare dependence and other publickly funded social services

-costs associated with negative consequences on teen mother and child

• health care
• foster care
• lost tax revenue

• Teen pregnancy increases chances of absentee father
• children with strong relationship with their father are less likely to be having sex by age 16
• increase inability to form healthy relationships with men

• President's teen pregnancy prevention initiative (TPPI)
• CDC partnering with OASH to reduce teen pregnancy 
• aiming to demonstrate effectiveness of teen pregnancy prevention programs
• accomodate to specific area for different strategies

• Planned parenthood
• Live Strong Campaign
• HUD
• Religious organizations
• Elizabeth New Life Center--Southwestern Ohio--abstinence education--post abortion support

• exposure has increased in last 10 years---42% decrease in pregnancy rate
• ABC family, TLc and MTv all shows that have grossed great success of Teen Pregnancy

3000 B.C.E-0

• condom was invented in Egypt
• Pessaries and concoctions were earliest device for women
• not very effective
• amenorrhea (no periods for two months after given birth) and prolong lactation

Middle East 800-900

• all methods were documented in a medical encyclopedia by Persian Polymath called "The Canon of Medicine"
• over 20 different 
• coitus interruptus the "pull-out" method effort to avoid insemination
• vaginal suppositories to block cervix (elephant dung, cabbages and pitch)

India 1100s

• concoction comprised of powdered palm leaf and red chalk in addition to vaginal suppositories containing honey, ghee, rock salt or palasa tree seeds 

Europe 1300s

• massive plagues wiped out thousands
• use of birth control diminished

Italy/Europe 1400s

• church implemented a policy that supported "which hunts"--those who conducted abortions were found and killed
• Pope Innocent V111 "Witch Bull of 1484" on December 5, he recognized witches as real and gave approval to the Inquisition to continue the pursuit of so called "witches"

Syphilis epidemic across Europe-1500s--spread widely by unprotected sex

Gabrial Fallopius

• anatomist for which fallopian tubes are named
• created linen condoms to prevent spread of disease
• condoms worked best when soaked in an unknown chemical acting as a spermicide 

1700s

• condoms manufactured from animal intestines (sheep bladders)
• super expensive
• condoms often reused--increased the spread of disease

Vulcanization of Rubber (1839-1844)

• Charles Goodyear
• Latex+lead Oxide+Sulfure=Rubber
• greater elasticity, strength 

1751-1850

• first latex condoms produced
• developmen of modern day condoms

Comstock Act- 1873

• Anthoney Comstock--U.S. Postal inspector and politician
• criminalized contraceptives and all material related to possession, publication and distribution of any "obscene literature" 
• responsible for 4,000 arrests, 15 ons of books and 4 million pictures 
• Penalties--jail time and hard labor
• 1957--Roth V. United States

Julius Schmid-1880s

• Germany immigrant arrested under Comstock act, Vice squad
• condoms made of animal intenstines
• "Safe vulcanized rubber condom" Fourex, Ramses and Sheik
• Built condom empire, Julias Schmid Inc.

Margaret Sanger-1990s

• 1914-wrote The Woman Rebel
• 1916-opened U.S.'s first birth control clinic
• 1921-Founded American Birth Control League (Planned Parent Hood)

Lysol

• most popular contraceptive
• contained high levels of cresol
• Lehn and Fink ignored recommendation of important health boards
• study showed it was not even effective as a contraceptive

Envoid

• first oral contraceptive
• received FDA approval in 1960
• 100% effective
• just as dangerous as Lysol
• Dosage was 10 times more than needed

• urge to "find oneself"--activism of 1960s--ques for autonomy were characerized by changes towards sexual attitudes
• "the pill" provided many women a more affordable way o avoid pregnancy
• 1965--birth control illegal in some staes

• Supreme Court ruled Constitution proected a right of privacy
• case involved Connecticut law that prohibited use of contraceptives
• vote of 7-2, Supreme Court invalidated the law on grounds that it "violated the right to marital privacy"

• brought dangers of combined oral contraceptive pill use to the attention of Senator Nelson--Doctors Case Against the Pill
• Senate hearings in January 1970 to investigate the problems Seaman's book addressed

• Supreme Court case established the right of unmarried people to possess contraception on same basis as married couples 
• Struck down a Massachusetts law prohibiting distribution of contraceptives to unmarried people---ruling that it violated Equal Protection Clause of the Constitution 

High-dose birth control pills removed from market

• could cause deadly health risks
• less severe side effects included nausea, headache, and weight gain

Two types of low-dose birth control pills introduced

• 1982-biphasic
• 1984-triphasic

1992- first hormone shot approved by FDA

• referred to as "the shot"
• injeced into the butocks or arm muscle every three months

Emerency contraception is approved by the FDA 

• Preven was approved in 1998
• Plan B was approved in 1999

"Morning after pill"--effective up to 72 hours after unprotected sex