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HEALTH GUIDE
October 2013
Pregnancy on the Hi-Line: Sexually transmitted disease also high ■ Continued from page 11 “We really try in everything that we do, we do it in a very clinical, factual method, and we coach our folks, and our folks do a wonderful job on this of not bringing in opinion,” he said about the teachers and school nurse who present information in the classrooms. “We try to be very honest with the kids but do it from a very clinical and factual way.” One of the important components of the schools sex ed curriculum is to have teachers and staff meet with parents before the first sex ed class to tell them about what the kids will be taught that year, and how, and to suggest ways that these conversations can be furthered at home. “We get a very small amount of time that we can provide students with factual information,” he said, especially compared to the amount of time they can get information elsewhere. “We have really tried to focus on bridging that gap between here’s the factual information they’re getting in school and saying, OK, mom, dad, we’re going to give you a conversation starter. We’re hoping that this talk continues at home,” he said. “There are homes … where these conversations are not occurring,” he added, “and we would hope that we can provide maybe a little bit of a window to make that happen.” Wanda Meredith, Hill County Family Planning coordinator, said that today the subject of teen pregnancy and sexual activity is much more transparent than in was in generations past when pregnant girls were “just sent to Aunt Tilly’s house.” Still, she said, when the conversation turns to teens, sex and sexually transmitted infections, it can quickly turn into a moral issue because people are uncomfortable with the topic as if “we can’t talk about it because then people will do it.” When families feel that these conversations are best kept in the home, she doesn’t disagree, but she has seen in the community a wide variety of family situations that don’t fit that ideal of the parents taking on that responsibility. “I don’t argue that a bit,” she said. “But, you know, some kids don’t necessarily have a place to sleep or parents who will do this. ... Then you can have the other side of it — the so-oppressive type of a parent that it’s not a safe place for them to have that discussion either.” That’s where education from outside, neutral sources, like the school classroom, the confidential office of Family Planning, or some other safe place, is so important,
There are homes where these conversations are not occurring. Andy Carlson Havre Public Schools Superintendent
she said.
Why curbing teen pregnancy is important Teen pregnancy was identified as a key area of concern for the Community Health Improvement Plan through the 2013 Hill County Needs Assessment and the 2012 community assessment by the Early Childhood Investment Team, an independent group which began as a committee of the community health consortium. “It is such a larger creature in the fact th at w h e n p e o p l e h ave c h i l d re n younger, they don’t finish school, they don’t go to college, they end up being on more of the welfare system, at the lower s o c i o - e c o n o m i c e n d, a n d we h ave s o many kids that are being raised in poverty — and we keep repeating that cycle,” said Meredith, a member of the planning group. The U.S. Department of Health and Human Resources website cites reports that the economic and social costs of teenagers giving birth is that the mothers tend not to finish school or go on to college, the children are most likely to be raised in poverty in single-parent households, to have poorer health than the average child and to have a high likelihood of ending up in the justice system. Multiplying the problem, all these factors are listed as contributing to a child’s likelihood of growing up to be a teenager who gets pregnant or fathers a child. “Teen pregnancies are your highest risk because they’re young, they don’t have income and … statistically it shows that once they’ve had one pregnancy they’re likely to have a second one within a year to two years after that first teen pregnancy, so then that’s a huge impact on our society as well,” said Danielle Golie, Hill County Public Health Director. The nonprofit group National Campaign to Prevent Teen and Unplanned Pregnancy compiled statistics from 2008 and found that the cost of teen pregnancies to Montana taxpayers was $29 million — of that $12 was
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October 2013
Bullhook Community Health Center Executive Director Cindy Smith, then county health director, spearheaded an effort to create the Hill County Consortium. The consortium, which included health and social service providers, faith-based representatives, educational consultants and representatives of the Hutterite community, did its own health assessment of the county to determine the top priorities it should address then. The top need identified by the consortium was to increase health care access in the county, which led to the creation in 2005 of the Bullhook Community Health Center, which now is erecting a new facility across from City Hall on 4th Street and 5th Ave. in which to house its services, including in medical, dental and mental health. The consortium continued its work, including in 2011 released a health assessment and health improvement plan that focused on reducing obesity and increasing physical activity for Hill County residents; increasing awareness of health care resources available in the county, and increasing awareness of the dangers of unsafe sex. Another assessment looking at issues in maternity and in families with young children was adopted by the Hill County Early Childhood Investment Team in 2012.
Another health assessment conducted The latest health assessment of the county, released this year, had its origins in the national health care reform, the Affordable Care Act. That act requires certain organizations, including community health centers and nonprofit hospitals, as well as accredited health departments, to conduct periodic health assessments in their region. Benefis Healthcare began preparing a health assessment for its region, including Hill County, and the Havre hospital, community health center and county health department partnered with the Great Falls hospital in developing the health assessment for Hill County. The health assessment used data both from a survey sent out to residents as well as statistics from a variety of sources to provide a snapshot of health issues in the county. More of the respondents felt that the overall health of the county was not good, with 30 percent responding that they believed the county was healthy and 42 responding that they did not. Another 22 percent did not respond to that question. The most serious concern for the Hill County residents who participated was alcohol abuse, followed by cancer, illegal drug abuse, weight and obesity, and dental care. Binge drinking and tobacco use both were listed in the report at a higher rate
HEALTH GUIDE
A look at three three major health problems in Hill County
The Community Needs Assessment conducted for Hill County selected three major areas that should be the focus of activities for area health care professionals. The three problems involved alcohol abuse, mental disorders and teen pregnancy. The Havre Daily News in this special section will look at each of these areas in depth. Staff writers Pam Burke, Tim Leeds and John Paul Schmidt have talked to professionals in the area and, defining what services are available in these areas and what can be done to help people with these problems.
than for the state overall. The Early Childhood assessment noted that Hill County has a much higher rate of teen pregnancy than the state, and also that 26 percent of families with children younger than 18 live on incomes below the federal poverty level.
Developing a plan At a meeting Aug. 29, about 30 people representing a variety of health care and governmental organizations spent five or so hours reviewing the 2012 and 2013 assessments, then narrowing down local concerns and issues to items on which the group could set goals with measurable results. The final vote brought dealing with alcohol abuse, teen pregnancy and mental health issues to the top of the list, followed by nutrition. The group agreed to forward the nutrition issue to the OPEN GYM group that developed as a result of the 2011 health improvement plan to address obesity, exercise and nutrition, allowing the new Health Improvement Plan to focus specifically on the top three. The people at the meeting then split into three groups to start developing specific objectives regarding those three priorities, and set strategies — and measurements — for meeting those goals. A common thread in the three groups was to try to hook up with other groups already working on those issues in the community, and to find — locally and nationally — proven strategies already in use. Part of the next step is to develop focus groups to continue developing, and implementing, the strategies to address the issues selected.
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