Thursday, November 18, 2010

This Week: Strictly for the Grown and Sexy

In '04, Usher, Lil John, and Ludacris sang (or yelled, in John's case) about 'Lovers and Friends', and gave casual sex partners a new anthem. They probably didn't anticipate finding a common ground with the 23% of the US population who was recently reported to be taking full advantage of that 'friends with benefits' package. The National Survey for Sex and Behavior reports that 50-somethings were "highly likely to engage in these casual sex encounters." That's right, folks. Swap mid-life crisis for mid-night coitus, and we may have a serious problem on our hands. Why? The study reports that these partners are very likely to engage in casual sex unprotected.

Down here in the District, HIV and AIDS have reached well over epidemic proportions. The generally accepted benchmark for a condition to reach severe epidemic concern is 1%- D.C. is at 3%. And to put this nearing-retirement trend in context, 70% of the people infected in the District are over the age of 40. D.C. officials are making concerted efforts to lower the rates of transmission. There are needle-exchange programs in place, and plenty of interventions to make adolescents and young adults more cognizant about safe sex practices. And, the message is spreading. The study, conducted at Indiana University's Center for Sexual Health Promotion, showed that 80% of male teens (14-17) who were sexually active used a condom the last time they had sex. But, how do we spread the word to those whose Viagra just kicked in and are ro-ar-ring to go? At their age, few are looking for everlasting love, and simply want to enjoy the company of another without any strings attached. The 50+ year-olds' rate for condom use the last time they had sex- a staggering (not!) 25%.

So, health promotion people, I'm talking to you! Do we put Rap-It-Up campaign ad's in More magazine? Offer "FREE CONDOMS!" incentives for prostate exams? There are lives at risk here, and something's gotta give!

Friday, November 12, 2010

This Week: Baby Mama Drama

"There is something very wrong when a man is good enough to father your children but not good enough to marry and build a life together." -Christelyn Karazin, founder of No Wedding, No Womb

"If you can't get a husband, who am I to tell you no, you can't be a mom?" -Demetria Lucas, relationship editor for Essence magazine, Blogger, A Belle in Brooklyn

In 1991, Tupac told the story of a fictional woman named Brenda, and how her unwed pregnancy "affects the whole community." By the time Fantasia Barrino's 'Baby Mama' hit the airwaves in 2005, many women rid themselves of shame or guilt, and instead sported single motherhood as "a badge of honor."

According to an article in yesterday's Washington Post, 72% of black babies are born to unwed mothers.* Per usual, the rate of this health outcome is higher in the black community than it is in either the white or any minority population. And what's the root of the problem? WaPo offers that it could be because black men constitute the majority of the incarcerated population in the States.** Furthermore, even if a young man doesn't have a record, if he's brought up in a low socioeconomic environment, his education likely won't be enough to get him any occupation paying above the poverty line. So, essentially, we end up with a lot of men who are capable of making kids, but incapable of supporting them.

But we can't just blame the men, can we? Of course not. Not when black women are increasingly adamant on proving themselves as independent women- what do they look like waiting around for a man to start a family? This is a common mentality shared by those who are financially stable enough to support an infant-sized addition to their lives. However, U.S. Census Bureau Statistics show that more often than not, single mother households are not run by mothers with a corner office. Most single black moms have no more than a high school education, and are working class women to whom another mouth to feed is simply an added stress. What other alternative is there but to raise the child as best they can, abortion or adoption?

It's not just an issue of having help, because there are countless friends, grandmothers, or babysitters probably watching babies at this very moment, because mom has to take night classes, or works a double shift to keep food on the table, (or go out to the club, but that's a whole 'nother blog post.) No, the issue is that "...a mother cannot give all that a man can give. A truly involved father figure offers more fullness to a child's life," OB-GYN Natalie Carroll noted in the WaPo article.

As public health professionals, we are supposed to have concern for the greater community, and prevent trends and behaviors that will contribute to allostatic load. Thus, one could ague that allowing women to have babies outside of a monogamous relationship is a failure from a public health standpoint. It is allowing the continued cycle of the proven effects of poverty to endure. The more babies out of wedlock, the more mothers on welfare, the less adequate health care they are able to afford, the more youths getting into a life of crime as a means to survive...and we're right back where we started. So, as supporters of No Wedding No Womb would argue, we need to stop this "problem" at the root. Is it our place to tell a woman not to conceive until she's [happily] married?

You tell me.

*CNN reported this data; their source was the National Center for Health Statistics, who completed the study in 2007
**3,161/100,000 black men were incarcerated in 2008, compared 1,200/100,000 Hispanics, and 487/100,000 whites.

Saturday, November 6, 2010

This Week: Mind Your Business

BPHSN family and followers, it is my pleasure to introduce this week's guest blogger, Jana Baldwin. Jana is the author of, an alum of George Washington's School of Public Health and Health Services, and most importantly, a founder of the BPHSN blog! I'll let her do the rest of the talking...

I have been told by many that I am “over-the-top,” “too pushy,” “crazy,” among many other things when I discuss the topic of mental health and illness.  I have personally experienced mental health issues in my own life since a young girl and it has been painful to watch my brother go through serious but different mental health issues as well.  I am grateful that my mother took me to see a psychologist since I was about 7 years old.  I felt like everyone in my class knew that I was different and I knew that I wasn’t “crazy.”  My mother always reassured me that I was going to the psychologist to discuss health issues and that was one way of breaking down the stigma.  At some point in my life I was diagnosed with ADD, Obsessive Compulsive Disorder, and Bi-polar to name a few.  At the end of the day I am sure I am all of the above and I am grateful for educating myself around how I can make better choices to treat my chronic illnesses- which happen to be in my brain.  I still find myself at 28 years old running into road blocks and getting into situations that I knew I should have avoided, but every time the situation is a little bit easier and a little bit better.  Frankly, the best psychiatrist I have ever had told me “fake it till you make it.”  I have been doing that very thing ever since.  I give a little background about myself before I make statements about anything involving the mental health so you know where I am coming from.

Living in DC for a few years, I have spent many a days, hours, jobs, internships, volunteering, or random conversations talking about mental health and the black community.  It is a topic that is near to my heart as I watch people close to me, and people I don’t know struggle to a point that I don’t think is necessary.  One could say (and people do) “Who is this white girl and why does she care about me or think she knows anything about me?”  Well, I don’t know too much in life but I will say that DC has one of the most comprehensive mental health services in the country.  When I was without insurance I was able to go to the local mental health community center and receive services including a case manager, a psychiatrist, Rx coverage etc.  In Utah, where I am from this is unheard of.  There are no wrap-around services for the poor (yes I just say poor instead of underprivileged).  So, I wonder how we as a community reduce the stigma in the black community to encourage people to seek treatment, to know that treatment is available, but mostly to understand the benefits of mental health in general.  I wonder how many young men would not meet law enforcement or get locked up,  how many more kids would graduate high school,  if there had been some kind of intervention.  Everyone can benefit from learning how to communicate more effectively, working through anger, etc.  Access in the District is available.  Sometimes even having an “intervention” doesn’t solve anything. I am not saying that only reducing stigma around mental health issues in the black community will change everything but, frankly, I think it’s a start.

The Substance Abuse Mental Health Service Administration recently launched a new campaign called “Stories that Heal” geared towards black young adults. Check out the link and tell me what you think!

For all you public health folks that are into stats:
  • Poverty level affects mental health status. African Americans living below the poverty level, as compared to those over twice the poverty level, are 4 times more likely to report psychological distress.
  • African Americans are 30% more likely to report having serious psychological distress than Non-Hispanic Whites.
  • Non-Hispanic Whites are more than twice as likely to receive antidepressant prescription treatments as are Non-Hispanic Blacks.
  • The death rate from suicide for African American men was five times that for African American women, in 2005.

“Ultimately, happiness rests on how you establish a solid sense of self or being. Happiness does not lie in outward appearances nor in vanity. It is a matter of what you feel inside; it is a deep resonance in your life. To be filled each day with a rewarding sense of exhilaration and purpose, a sense of tasks accomplished and deep fulfillment- people who feel this way are happy. Those who have this sense of satisfaction even if they are extremely busy are much happier than those who have time on their hands but feel empty inside.” – Daisku Ikeda