Public Health Case Study

1. Describe the population/community in terms of their demographics (age, gender, ethnicity, etc.) and their current health status (mortality, illnesses, etc.). How do you gather this data? Infant mortality is a huge issue affecting public health in the United States. For the past three years the maternal mortality rate in Miami-Dade County has been increasing, due to racial disparities. The percentage of preterm birth and births of low birth weight and very low birth weight babies are higher in Miami-Dade County than in city in Florida.
Currently in Miami-Dade County black infants are more than twice as likely as white infants to die before their first birthday. According to Florida Vital Statistics Miami-Dade (2014), “black infants die at
rate of 8.8 per 1,000 births in 2013, 10.1 in 2012, 9.3 in 2011 and 8.3 in 2010”. While white infant death switched off between 3.1 and 3.0 from 2010 to 2013.according to Florida Vital Statistics Miami-Dade (2014) “the peak of infant deaths occur in the late 20’s for white mothers and early 20’s for black mothers”. Currently women health care status is horrible due to lack of jobs, health care access and educational opportunities in the community. Due to these statistics WIC programs in Miami-Dade offer women health care access, for themselves and their child, educational program and other services to meet a women’s needs. 2. With what population do you specifically work in the community? Are they a vulnerable population and why? Maria Gonzalez states: “She has worked for the WIC organization in Miami for over ten years as a WIC counselor”. She also states “Miami is a beautiful cultural diverse city that has beautiful beaches great food, and shopping centers, but lack affordable safe places for women to raise their family”. Due to lack of affordable housing the majority of the population WIC centers treat are Hispanic and African American women that live in low-income communities like little Haiti, Liberty city, little Havana, and Overtown”. Maria also states “over 25 % of the women that join the WIC program are vulnerable do to the fact they lack education, do not speak English, experience domestic abuse, homelessness, and substance abuse”. They also do not receive prenatal care, adequate and nutritional food, and health care access for themselves and their unborn child, which can cause a women to be depressed and lead to infant, low weight and possibly infant death.

3. What services and programs are provided for this population? Which of the services are primary, secondary, or tertiary prevention? Maria states “WIC programs are federally funded Supplemental Nutritional Program that provides nutrition education, nutritional foods, breastfeeding support, and health care access to low-income women, pregnant women, infants and children”. WIC provides women postpartum counseling, and provide health care referrals to low-income women who are eligible for the WIC program.
Maria sates “the Primary services WIC offer is supplemental food, infant formula secondary is access to health insurance and social services and tertiary prevention program that support nutrition and breastfeeding education and postpartum counseling”. Supplement food is given as a form of food checks or an EBT card that is issued to participants in the program. With the checks or EBT card participants can buy milk, cereal, eggs vegetables, and fruit. For infant formula participants receive vouchers to receive a certain amount of formula for each month. Women that are pregnant are also given health care access to Medicaid in order to receive child immunization and checkups.

4. What health promotion and/or health education is provided for this population? Maria states “WIC offers health promotion like breastfeeding. Maria believes that breastfeeding is the best food for a baby’s first year of life. Breastfeeding provides nutrition to a child and provides an emotional bond between a mother and a baby. Maria states “WIC main goal is to improve nutritional status of infants”.
WIC encourages mother to breastfeed and educate women on the certain foods to eat to remain healthy.
Once a women decides she will breastfeed the Breastfeeding program will offer materials from a certified lactation educator which will provide certain breastfeeding techniques, receive follow up through a peer counselor, receive enhanced food package, breast pump, breast shells and nursing supplements to help support the continuation of breastfeeding.

5. What are the major challenges in your work in public health? Maria states “WIC faces a lot of challenges that hinder services that are delivered to the women in the Miami-Dade area such as lack of funding, lack of employees, and misunderstanding commination among participants in the WIC program”. These issues has caused barriers for WIC agencies which unfortunately affects our participants who need care.
Maria states “WIC agencies play a huge role in helping women and their families, they help prevent nutrition related health problems and help women eat healthier and provide child services for families in needs”. The lack of funding have made our agencies unable to reach other women in need of different prenatal help, like women that are overweight women that have diabetes and young women that are afraid to receive help during their
pregnancy.
Maria states “It takes a lot of patients and skilled staffing to work with WIC participants”. Employees hired in the WIC agency are individuals that really love their job and enjoy helping people, but since WIC is government funded the organization does not offer great salaries or benefits which causes a shortage of staff. Since we lack staff it is hard to communicate with certain participants that don’t speak English, which challenges WIC employees when trying to provide appropriate services to participants.

6. What are the major satisfiers in your work in public health? Maria states “she really enjoys helping women and their families receive appropriate affordable care”. She loves the fact that women she help still call her for advice and enjoys watching the children she help from birth become bright healthy kids. That alone satisfies her and makes her appreciate her life more because she was once a participant in the program.
Maria states “A few years back she was a high school dropout pregnant at the age of 18 living in a shelter”.
In the shelter she met a lovely women name Julie who coordinated the shelter. Maria said “Julie took the time to get to know her and provided her with information about WIC”. That day she went to the center, filled out an application, from their talk to a counselor. Within months she had insurance for herself and her son, child care with early head start, received help for affordable housing. WIC gave her the opportunity to go back to school and receive a college degree.
7. What is needed to strengthen the public health system in our community? Be specific. Maria states “she believes the Affordable Care Act is a step in strengthening public health in the United States and cities like Miami- Dade experiencing poverty, affordable and lack of educational services, financial burden, lack of housing and lack of access to affordable health insurance”. The Affordable Care Act will provide health insurance to families, and individuals that cannot afford health insurance by expanding Medicaid, and providing preventable
services
Maria states “All government such as Federal, local, state and tribal need to work with communities and strategically plan to develop better educational programs that promote healthy eating in schools, and workplace”. They need to provide affordable tuitions for young adults so they can become future advocates in teaching and promoting healthy lifestyles. Open up primary care clinics in areas in need to tackle on diseases that affect the areas that have higher rates of HIV/AIDS diabetes, cancer and other diseases, if we try to work together as a whole we will be able to strengthen the public health care system.

8. Does WIC offer services to men? Maria states “men do not receive a food prescription for themselves but they do receive other benefits”. Because WIC programs was developed to meet the needs of a pregnant woman, infants, and children, who need nutritional foods, infant formula, and education on breastfeeding and access to health care. These programs are only offered to pregnant women and their children who need these services. A Men that has a participants in his family can benefit from the supplies of nutritional foods, and receive educational programs offered to participant such as nutritional education and participate in the breastfeeding class so support the participant. Maria states “men are encouraged to participate and support the women in the WIC program since they are a family oriented agency that offers services to benefit families”.

9. Does WIC offer baby food since they provide food checks? Maria states “WIC only provides formula to infants not baby food, but provides baby cereal”. Maria also states “WIC has contracts with manufactures that provide them with affordable discount products for their participants that are eligible for WIC formula and baby cereal”. If an infant is allergic to the formula WIC will need a physician or pediatrician to write up a prescription so WIC can accommodate that child’s need and change formula voucher.
Maria also states “the food packages WIC offer are approved for usage in Miami and designed to help meet infant needs and pediatric feeding recommendations, to complement the eating patterns of preschool children and provide special supplement food programs that help pregnant women who are breastfeeding”.