Health Promotion and Vulnerability in Teenage Pregnancy

Introduction

Health promotion has been considered a vital part of nursing for over 150 years. Florence Nightingale stated in 1859 that health promotion is significant to the definition of nursing. Health promotion has been confused with health education for years in nursing literature. However, health promotion as a concept requires more patient involvement than health education because it requires the patient to make a change in their lifestyle (Raingruber, 2017).

Defining Vulnerability and Health Promotion

The concept of vulnerability has been around since the 1970’s but it has changed in its meaning over the years. This concept is still pertinent to our society today because the United States still has a large amount of the population that is considered vulnerable. The concept of vulnerability is used in multiple different situations when associated with potential poor outcomes, risk or danger within a population. (Arora, Shah, Chaturvedi, & Gupta, 2015)

When vulnerability is defined by the Indian Journal of Community Medicine it is said that it is the “state or condition of being weak or poorly defended” (Arora et al., 2015, p. 193). The definition of vulnerability can differ depending on the source. Those individuals who are vulnerable populations are extremely important to health care professionals. This is due to the vulnerable populations not always having access to medical care due to lack of transportation or even insufficient funds to be able to pay for their medical bills. These populations are also important to health care providers because since they don’t always seek treatment for their medical conditions, these conditions can worsen over time and cause further issues down the road. For example, individuals who cannot afford healthcare or do not have insurance often visit the emergency room or urgent care to seek treatment and this causes a strain on the health care system.

The concept of vulnerability can be directly related to the concept of health promotion because these concepts have many similarities when it comes to vulnerable populations. According to Raingruber (2017), health promotion is defined as “lifestyle coaching designed to promote optimal health, quality of life, and well-being” (p. 6). Health promotion has many components when it comes to motivating an individual to improve their health. These components consist of the health care provider considering the individuals financial situation, social support, educational background, and any environmental factors affecting their health (Raingruber, 2017). When the health care provider considers the individuals situation, they are acting as a patient advocate. This is done by motivating the patient to improve their health and want to change their lifestyle behavior.

Biological Domain

The biological domain of the vulnerability model includes genetic predisposition, age, or race. It has been found that certain races have a higher prevalence of teenage pregnancy than others. The ages for teenage pregnancy range from 13 to 19 years old. According to the American Public Health Association, the highest adolescent birth rates in the United States occurs within Hispanic, African American, American Indian, and Alaska Native adolescents (Burrus, 2017). Therefore, studies have shown that African American and Hispanic teenagers have a higher risk for pregnancy due to their race. According to Krost and Henshaw, although the pregnancy rate of black teenagers fell 56% between 1990 and 2010, their teen pregnancy rate remains at more than twice the rate of white teenagers (2014).

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Sociocultural Domain

The sociocultural domain within the vulnerability model includes an individual’s economic status, education, social support, and health care quality and access. Studies have shown that teens with a low socioeconomic status and low education can have a higher risk of teenage pregnancy (Penman-Aguilar, Carter, Snead & Kourtis, 2013). It has also been found that teens who get pregnant while in high have a high dropout rate that could lead to a low level of education and a low economic status (Kaphagawani & Kalipeni, 2017). Lastly, it has been found that adolescents who do not have access to health care have a greater risk of getting pregnant as a teen (Bhuiya et al., 2016). It can be concluded that teens who do not have access to health care relating to reproductive health and pregnancy prevention have a higher risk of teenage pregnancy.

Environmental Domain

The environmental domain consists of an individual’s work environment, home environment, community environment, and geographical location. For pregnant teens the environmental domain mainly relates to their home environment. According to the American Public Health Association, “Rates for other vulnerable groups, such as runaway and homeless adolescents, adolescents in foster care, and adolescents living in rural areas, are higher than those of the general adolescent population (Burrus, 2017, p. 1).” An adolescent’s home life can place them at higher risk for teenage pregnancy, specifically if the teen comes from a broken home with little familial support. Studies have shown that teens who come from a household with parents who are not together or if they have witnessed domestic violence within the home are at a greater risk of teenage pregnancy (McAlister, 2016). Although an adolescent’s home life plays a large part in the environmental domain, the geographical location of the adolescent is also important. This is important because the United States has the highest teen pregnancy rates of developed countries (McAlister, 2016).

Behavioral Domain

The behavioral domain includes emotional health, sexual practices, diet and exercise, rest, alcohol, and drugs. When teenagers partake in risky behaviors it can place them at a higher chance of getting pregnant. If a teenager participates in unsafe sexual practices like not using contraception and having multiple partners, it increases their risk for an unplanned pregnancy.

Research has also shown that when teens engage in risky sexual behaviors it can correlate with an increased prevalence of engaging in other unhealthy behaviors like consuming alcohol, drugs, or tobacco (Burrus, 2017). Also, when a teenager engages in substance use it can directly correlate with them having unsafe sexual practices as well. In addition, studies have shown that if teens have lower levels of self-esteem this places them at a higher risk of becoming pregnant (McAlister, 2016).

Cultural Consideration

The teenage pregnancy population is a population that nurses should provide proficient care related to their culture and current situation. Teenagers themselves have a peculiar culture, however, pregnant teenagers have their own subculture within the teenager culture. For example, the nurse should consider the teenage culture when educating and speaking with the pregnant teenager. Many teenagers lack maturity and this could cause the teenager to use substances like alcohol or drugs while pregnant. NURSE EDUCATION

Pregnant adolescents may also struggle with the level of responsibility they will have once the baby is born.