Agenda - 02-01-1993 - III-B - Laserfiche WebLink

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attending a grade school in Southern Orange County with twenty percent of health forms reporting no physician. In other words, there appear to be many adolescents that do not have an identifiable source of primary care. Approximately ten percent of children attending the public schools in Orange County are known to have a chronic disease (ex. cystic fibrosis, diabetes, hemophilia, sickle cell disease, seizures) or significant health problem ( asthma, acne, attention deficit disorder, obesity, dysmenorrhea, injuries) causing some degree of morbidity (absenteeism, poor self image, poor school performance). This estimate is similar to national figures but is probably lower than the actual number because those reported are largely of those students who return health information forms at the beginning of the year. According to school nurse records, Northern Orange County has twelve percent of sixth graders, fifteen percent of middle school students and thirteen percent of high school students that have significant health problems. In Southern Orange County, two percent of teens have health problems requiring an emergency medical plan at school. When mental health problems are included the percentage almost doubles. There are a large number of adolescents with primary medical and psychological problems causing some degree of morbidity, such as absenteeism, poor self image and poor school performance that are unknown to a primary care provider. Pregnancy In the U.S., over one million teens aged 10 to 19 become pregnant each year with a national rate of 109 pregnancies per 1,000 females and 44 abortions per 1,000 females between the ages of 15 and 19. Although, Orange County's total pregnancy rate (71.7 per 1,000) and pregnancy rate in the fifteen to nineteen year age group (62.6 per 1,000) continue to be lower than national and state rates, there is a significant number of unwanted pregnancies as indicated by a high number of abortions and the number of pregnancies in adolescents aged ten to seventeen. Orange County has the highest total abortion rate in the state (34.0 per 1,000) and ranks in the top ten counties for abortion rates in the fifteen to nineteen year old age group (46.1 per 1,000). In the past year there have been forty three known pregnancies in adolescent females within the two school systems, with eighty six percent of the pregnancies in high school students (ages 15-17) and the remainder in middle school students (ages 13 - 14). There is a striking discrepancy between total pregnancy rates (county rates, w 59.3, nw 121.4) and total abortion rates (county rates, w 24.6, nw 69.9) for the white and nonwhite populations in the state and county. A similar finding is seen in the fifteen to nineteen year old age group ( county pregnancy rates, w 47.5, nw 113.7, county abortion rates, w 36.6, nw 76.1). This same discrepancy between white females and nonwhite females found with total rates of inadequate prenatal care, Low Birth Weight (LBW) births, fetal deaths, neonatal deaths and infants deaths, Examination of the ten to nineteen year old age groups reveals that nonwhite females have significantly higher rates of inadequate prenatal care, LBW births and fetal deaths in contrast to white females having higher rates of neonatal deaths and infant deaths in the county and statewide. In other words, there are many unwanted pregnancies in adolescent females significant racial differences in pregnance related issues which appear to impact on the final pregnancy outcome. Sexually Transmitted Diseases In 1992, over 385 adolescents were seen at the OCHD-Sexually Transmitted Disease (STD) clinic for diagnosis and treatment of an STD with the majority (98%) between the ages of fifteen and twenty one. In North Carolina, for the year of 1991-1992, there were 29 adolescents between the ages of twelve and nineteen that tested positive for HIV and twenty one known cases of AIDS in the thirteen to nineteen age group. Orange County ranks in the top ten