Having children is an event that many in Americans choose to embark upon and has been built into the "typical" model of the American dream. While there are many factors that contribute to the decision to have a child, early child care costs from infancy to the start of grade school may be a large deterrent. According to Census Bureau, the cost of child care has almost doubled in the last 25 years. This burden falls heavily on working mothers as they are more likely to leave their jobs to take care of children if they make less than their partner. And once children reach grade school, these women find it difficult to get back into, and become a competitive force in the workplace again.
Regardless of income, many feel the strain of childcare. However some of the hardest hit are those right above the income bracket to receive government assistance and those living in poverty. While the average percent of household income spent on childcare is about 7%, It can be much higher for low income families (about 30%!). This can impact the families ability to pay for other things such as housing, utilities and food; Which can effect the health and wellness of every family member.
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| Alex Harrington, Class of 2016 at the Assembly Hall of Palais Des Nations at the United Nations office in Geneva ~ |
So what are the numbers? Khurshid R. Ghani, MD, and his colleagues from the Henry Ford Health System in Detroit analyzed the changes from 2006-2009. They conducted a national survey using charges for patients with upper urinary tract stones from ER visits. Per 100,000 patients, incidence for upper urinary tract stones increased from 289 to 306. In Total, over 3.6 million were treated. For women, treatment rose an estimated 2.85% per year and they were also more likely to be hospitalized. Over the course of the study, that would be a 3 year increase of about 8.5 percent, and if those numbers have stayed the same, there would have been about an almost 20 percent increase from 2006 to today!
With rising incidence rates, kidney stones are another issue that may need to be discussed with certain patients; especially women who are obese or borderline obese. Trying to lower rates of obesity and encouraging patients to take proper care measures if they are able to pass a stone are important. In addition, the future of medical technology may benefit financially by finding an alternative diagnostic method for kidney stones. If obesity trends continue, we are likely to keep seeing these rates of kidney stone hospitalizations, with similar or higher costs to the healthcare system. 
For those of you who are interested in learning more, upcoming we will be holding a Women's Health Scholars info session (still TBA). We will be sending an email out with details to all first and second year students. The info session will describe the requirements in greater detail and give a general timeline so you can begin to assess if this is something you would like to do. If so, you will work further with WHEP to craft your own personal plan of action.  |
| Examining the nuchal translucency of a fetus |
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| The left displays a normal level of thickness. Notice the small arrow on the right picture indicating the access fluid around a fetus' neck. |
It is also apparent that this is an issue we are seeing more in young girls. Girls are more likely to both be cyberbullied and cyberbully someone else. And while many student suicide cases are not based solely on cyber bullying, we have been seeing an increase of (girls especially) suicide in which cyberbullying is involved. In some of the worst cases, students are sexually assaulted only to have it posted on the internet where they are further humiliated and sometimes blamed for what happened. Examples like this have come to light recently with cases such as the Stubenville, Ohio rape case.
What could this mean for physicians? In the future young patients may benefit from screening questions that target cyberbullying. In addition to asking if kids feel safe at home or school, perhaps physicians should ask if they feel safe using a phone or the internet (first asking about access), Or ask additionally about technomedia experiences if young patients seem despondent. And while children and teens are effected most frequently, adults can also experience cyberbullying, and it should be considered in patient assessment at every stage of the life cycle.
