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Health People 2010 – Chlamydia incidence far off the mark February 23, 2009

Posted by Katy Roberson in Prevention.
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Healthy People 2010, launched in January 2000 by the Department of Health and Human Services, is a national agenda for the health promotion and disease prevention. The objectives are meant to serve as a framework for improving the health of Americans over ten years. During the first decade of the 21st century, the National Center for Health Statistics (NCHS) has and continues to be responsible for monitoring the progress toward the 2010 targets for each of the 467 objectives. This data is made available by the NCHS in DATA2010, the Healthy People 2010 database.

Taking a look at the database I noticed an alarming lack of change. Cases of chlamydia among women 15-24 years old have increased since baseline measurements in 1998 until the most recent measurements in 2004. What makes this increase more alarming are concurrent increases in responsible adolescent sexual behavior and increased use of condoms. Responsible sexual behavior includes students (grades 9-12) who never had sexual intercourse and students who had sexual intercourse but not in the past 3 months. Increases in condom use were shown among 18 to 24 year old women reporting partner condom use. It goes without saying that we are far from the 2010 target for cases of chlamydia. If behaviors identified as indicators for improving health outcomes are not affecting outcomes, what behaviors should we be targeting?

In a recent New York Times Well blog post, The Myth of Rampant Teenage Promiscuity, Tara Parker-Post revealed that despite increases in teenage pregnancy (or in the case of the data, sexually transmitted diseases), the vast majority of teenagers are not engaging in risky sexual behavior. The post went as far to say “The reality is that in many ways, today’s teenagers are more conservative about sex than pervious generations.” These leads me to believe that there are specific sub-populations of teenagers that are allowing teenage pregnancy and sexually transmitted diseases to continue to spread. If this is the case, we must do a better job of targeting those that are engaging in risky sexual behavior. Dr. Maria Kefalas, an associate professor of sociology at St. Joseph’s University, told Tara Parker-Pope that

What’s really important for us to pay attention to, as researchers and parents, are the characteristics of the kids who become pregnant and those who get sexually transmitted diseases.

The blog post brings light to society’s lack of understanding when it comes to teenagers and their sexual behavior. Moving forward from Health People 2010, Health People 2020 should target the populations where these sexually transmitted diseases persist and continue to spread. This may involve adjusting the target reductions and creating objectives for more segmented groups. As Dr. Kefalas said, this should involve developing a better understanding of the characteristics of this population in order to target behaviors that ultimately affect the incidence of sexually transmitted diseases, specifically chlamydia.

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