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Select and discuss 3 Health People 2020 objectives for Family Health 1. Reduce the proportion of females

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experiencing pregnancy despite use of a reversible contraceptive method: From 1995-2002 Healthy People 2020 aimed to reduce the number of females becoming pregnant due to failed method of contraceptive use. As of 2002 the number has declined by 12 percent and Healthy People 2020 goals are to have a decline by 25 percent. The 2002 survey asked women, ages 15-44, to check off which contraceptive use they were using on a monthly basis. The contraceptive list included; birth control pills, condoms, partner’s vasectomy, diaphragm, foam, jelly or cream, cervical cap, suppository insert, today sponge, female condom, vaginal pouch, IUD, coil, loop, norplant, depo-provera, injections, morning after pill, rhythm or safe period by calendar, safe period by temperature, cervical mucus test, natural family planning, withdrawal, pulling out, respondent sterile, partner sterile ,other method. 2. Increase the proportion of publicly funded family planning clinics that offer emergency contraception onsite: Healthy People 2020 aims to increase the proportion of publicly funded family planning clinics that offer onsite emergency contraception, by 10 percent. Their goal is to increase the number of family planning clinics to offer emergency contraception onsite. The emergency contraception includes; Plan B, Preven, or a concentrated dose of oral contraceptives for emergency contraception to client’s onsite. 3. Reduce pregnancies among adolescent females aged 15 to 17 years: Adolescent pregnancies include; resident live births, induced abortions, and fetal losses to females aged 15 to 17 years. There are two separate age categories for adolescent females. One category consists of ages 15-17 and the second includes ages 18-19. The objective has been amended to focusing more on reducing the rate of adolescent pregnancy, rather than the actual number of adolescent pregnancies. Access to Health Services Healthy People 2020 set forth the goal of improving access to comprehensive, quality health care services and its importance in maintaining, preventing and managing health. Access to health services relies significantly on three main components; health insurance, available health services and timeliness of care. Programs such as the Patient Protection and Affordable Care Act of 2010 were put into place to help families obtain adequate health insurance. Proper insurance coverage helps alleviate the high cost of providing for a family, which is the main barrier to accessing services. Introducing more healthcare facilities and primary care providers within communities provides structure and ongoing sources of care. Timeliness of care is vital to recognize and treat health needs within the family. This component is achieved by providing availability to schedule appointments and by limiting time spent waiting for health services. Collectively used, the three components will provide a seamless route to better health improvement of families which in turn improved the health of the community. Substance Abuse According to Healthy People 20/20, “Although progress has been made in substantially lowering rates of substance abuse in the United States, the use of mind- and behavior-altering substances continues to take a major toll on the health of individuals, families, and communities nationwide.”. Substance abuse has a huge impact on family health because it can cause stress on the family trying to stop the individual from using drugs and alcohol. It can cause legal issues, financial problems, and domestic violence. The individuals can lose their jobs or if they are younger it can lead them to dropping out of school because of their substance abuse issue. This causes an additional stress on the families. Healthy People 20/20 notes that substantial progress has been made among youths in regards to substance abuse. According to data from the National Institute of Drug Abuse (NIDA) Monitoring the Future (MTF) survey, a drop in the past-year use of methamphetamine use was reported for all grades, and lifetime use dropped significantly among 8th graders, from 2.3 to 1.6 percent. The success in preventing and lowering the rates of substance abuse is due in part to educating the younger generation and talking to them regarding the issues they may face. Sports, after school activities, and friends can all be utilized to help keep kids and teens occupied and away from drugs. One of the objectives was too reduce the rate of drug induced deaths, there was a ten percent improvement in this area. Although some improvements were seen, this country still has a huge opioid problem. This issue is something that’ll have to be addressed over a long period of time. More treatment centers need to be opened and readily available, laws need to be strictly enforced, and doctors need to stop overprescribing narcotics. A syringe exchange program was a step in the right direction because although people will still be using, it lessens the bigger health risks that come with sharing needles. Nutrition, Physical Activity, and Obesity According to Healthy People 2020, nutrition, physical activity, and obesity are very important for a person’s overall health and well-being. It can help lower the risk of developing serious health conditions, such as hypertension, diabetes, heart disease, and cancer. The indicators affect family’s health in many ways. Lack of appropriate nutrition and exercise can result in unhealthy family members, who can become obese over time and develop diabetes, heart problems and other complications. A number of factors play an important role in success or failure of this objective. Socioeconomic factors, education, and family’s access to facilities where family members can engage in physical activities have critical impact on behaviors that influence health. Unfortunately, not all communities have a place to buy fresh fruit and vegetables, or an appealing place to play or be active. Recommendations for success will be education regarding nutrition, and healthy diet on a budget. In addition, education regarding the importance of physical activities, such as walking, running and going to the park, and their incorporation into daily life. Additional resources, such as a social worker or using the internet may help families obtain information regarding free or affordable programs.(Healthy People 2020) Clinical Preventive Services According to Healthy People 2020, clinical preventive services includes routine screening and scheduled immunizations. This indicator has an important impact on family health because “prevention and early detection reduces the risk of illness, disability, early death and medical care costs.” (U.S. Dept. of HHS, 2018) Through data collection and monitoring, Healthy People 2020 has aimed to improve the overall use of four key preventive services which includes: (1) colorectal cancer screening, (2) blood pressure screening and control in adults with hypertension, (3) lowering A1C levels in patients with diabetes, and (4) increasing the amount of children ages 19-35 months who receive the recommended doses of age appropriate vaccinations. According to the most recent data available, the only preventive service that has not shown a statistically significant change towards improvement is the percentage of adults with diabetes having an A1C level < 9 %. Many sociocultural and physical barriers may contribute to this lack of improvement including but not limited to: lack of education and understanding of their disease process, adherence to life style changes, and having access to medications or glucose monitoring equipment. Recommendations to improve the A1C levels and the overall health of adults with diabetes could include utilizing community health nurses who can provide counseling and support when needed. Improving patient education, diabetes testing/monitoring, medication adherence, life style changes and weight management are all necessary steps to achieve this goal. The use of new technology such mobile phone apps and telehealth can also provide an additional source of support for self-care management. Injuries and Violence In American injuries whether intentional or not are listed as one of the 15 leading causes of death in America. The leading cause of death for Americans ages 1 to 44 are injures. It has been shown that every year around 29 million emergency department visits are a result of injures. The indicators for injuries and violence are injury deaths and homicides. Violence related injuries or unintentional injuries can happen anywhere and have a number of causes which include assault and motor vehicle crashes. Injuries and violence not only affect the victim it has a long standing effect on the family. Injuries leads to poor mental health, premature death, high medical cost, years of lost life potential, disability and loss of productivity. The Healthy People 2020’s goal for Injury Deaths is to go from the baseline of 59.7 to the target of 53.7. The most recent study in 2010 showed a decrease of 43.4%. The goal for Homicides is go from the baseline of 6.1 to a target of 5.3. In 2010 it was shown that this goal has been met and the progress towards the target was 133.3%. A barrier to meeting these goals are a lack of educating the public on ways to prevent accidents and violence at a young violence. Ways that these goals can be met is using a community health nurse to get involved at teaching preventive strategies. Educating youth about bullying and violence can help prevent it from occurring in the future. Educating the community about the importance of safe driving and wearing your seat built can prevent injury from car accidents. Having self defense classes and teaching people what to do in an emergency can also be effective in preventing injury.
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