INTRODUCTION

Health is wealth. Only a person who has a healthy mind and body can work hard and achieve whatever goals he/she has in life. Where among the various social issues, the health care issue is one of the most difficult challenges America is facing now a days. These issues basically start from the teenage pregnancy where the teenagers yet are not aware of the very challenges of life and its bitter realities. Moreover, another serious issue related to health issues is the health of children, specifically newborn babies and teenagers. In addition to the above stated issues, there are many other health issues, which are in demand for special care and services. These issues have been a problem in the west since the beginning, however, with the social, economic and political development of America, many private and governmental organizations have started providing health services to children and teenagers to help them cope with their problems and challenges.

Basic Health Issues and Health services Utilization Behavior

Health care issues are not only restricted to America. This is a problem the world over where every country has its own strategy to provide health care services. However, America being the most socially, economically and politically developed country of the world is also facing this challenge both at the state and national level. It offers many health services utilization behavior, which are designed with latest technological reforms. Despite this, there are many private and local hospitals working on the basic health care issues in the country but there is a lot of difference in the treatment and health services provided. As these private health care institutes are relatively expensive, they are not affordable by the low salaried people. This means the government provides economical services at both the state and national level. Despite spending the highest percentage per person on health care calculated all over the world, and using the most advanced technologies for this purpose, many Americans are not as healthy as people in other countries. This means that there are other factors, which play an important part in the effective utilization of health care services. The most important issue is the infant mortality rate; another issue is the teenage pregnancy where the mother and child lack basic health care facilities. Moreover, the basic health care treatment that includes vaccination of the infants is a big problem in America. (Choate, Cockrel, Parker, Forester, Garkovich, Kiesel, Maurer and Myers.1914. Part I, P.1) Initially prior to development and modernization, in fact before the world wars, the situation was the same but people used to depend on their families and tried to handle their health related problems themselves. This resulted in a high percentage of infant mortality. Apart from the basic health care problems, people also had to face severe economic problems specially the low-income category.

Health Care Issues and Health Services Utilization Behavior (19th C.)

The health risks of teenage mothers are more serious especially if they belong to a poor family. Due to poverty they have poor eating habits thus rely more on drinks, alcohol and drugs. Not only does this increase the health risks for their babies, while they are in their womb, it also puts the mother’s life at stake. During the 1980’s, 13% of teens between the ages 15-19 became pregnant. Out of these, only 50% pregnancies resulted in births while 36% were aborted and 14% were miscarriages. (Voydanoff and Donnelly, 1991,P. 163). During the 18th and 19th centuries, the percentage of teenage pregnancies increased, as the adolescents became more sexually active but lacked basic awareness and precautionary tips. At the same time there were not enough health care facilities for the poor people. Therefore, during this period due to the lack of awareness among the adolescents and concentration of the various health care organizations, not only was the rate of early pregnancies very high, but other health related problems were immensely disturbing the social development of America as well.

Health Care Issues and Health Service Utilization Behavior after the Great Depression to 1990

During the period before the great depression, the very philosophy practiced in America was that whatever events occur in life are due to religion and God. However, this view started changing gradually and with the passage of time many Americans started following a more secular and humanistic approach about the world. Therefore, the elementary growth of health care was initiated with the realization of some kind of social services as a voluntary health service utilization behavior. Starting from a community base service, it gained recognition among the whole American society and developed from a missionary health care to a more advanced shape with the formation of the Sanitation Commission and the Freeman’s Bureau, which was initiated as a volunteers organization to provide not only heath care but also a lot many social support to the people affected with the Civil War. However, presently it is now associated to Red Cross and other Public Health care organizations.

Therefore, the concept of charity and health services was changed due to the economic shortcomings in America. Not only the minorities, the poor were in need for health care as well as social services, but the whites as well were in strong need for social health care services. Poverty was on its rise; at the same time the ratio of pregnancies without marriage either teenage or adult was at an increased rate. Nonetheless the minorities, specifically the African-American, were suffering far more than other Americans. For instance, the blacks had the highest birth mortality rates among the other ethnic groups as a result of teenage pregnancies i.e. 16.8 deaths per 100,000 births. Teenage pregnancy was not the only cause for the high mortality birth rate but also poverty and malnutrition, which resulted in a low birth weight and short gestation. (Fred 1996)

Moreover, during the period of the World War I passing from the phase of Great Depression and then World War II, the need for health care services was not realized. However, during the 80’s the health care bill was increased up to 110% while the business was increased up to 221% as the cost for the health care services. At the same time the biggest share in regard to the national health care expenses was around 40%, which was spent via general taxes by families. While 50% of the health services were deducted as tax from salaries of the employees. (Choate, Cockrel, Parker, Forester, Garkovich, Kiesel, Maurer and Myers.1914. Part I, P.2-3) Therefore, it comes to our understanding that the health service utilization behavior existed even before World War I but it was not recognized as an international or national issue. Health care services were initially provided independently then slowly transformed to community base organizations. After World War I, during the Great Depression to the end of World War II, more organizations were formed to undertake the volunteer the health care services. However, many religious and private organizations were working as social organizations that not only focused on the teenage pregnancy and child health but also tried to work in other areas related to health issue for both men and women. Nonetheless, with the formation of UNO, health care services were shaped to a modernized form where the international community has started working in collaboration for the same cause. Though the demand of health services of teenage pregnancies and health services to unmarried adolescents and their infants are the most serious challenge America is facing these days but the role of private organizations and hospitals have helped a lot along the federal and national health care institutions.

MODIFYING HEALTH SERVICES UTILIZATION BEHAVIOR TEENAGE PREGNANCY

Though America has started focusing more on health services utilization behavior after the formation of UNO as it is now working not only for the health issues related to America, but also has engaged the international community towards health services utilization behavior. Therefore, the government provides free health services to families and people belonging to low income, as they are poor and needy. Moreover, America is the best health care service provider in the world but at the same time it has the highest rare of birth mortalities. (UNICEF, July 7, 1998.) Nonetheless, the ratio of teenage pregnancy and parenting without marriage has increased to a dangerous limit. This increase has given rise to other serious social issues like education and unemployment as the mothers and infants are dependent on food, shelter and clothing, which is becoming a burden on the American economy. These pregnancies are the result of sexual harassment and older men, who do not take interest in using pills or condoms, dating teenage girls who are not aware of the precautionary steps before sexual intercourse. However, statistics show that girls dating men of the same age follow the precautionary tools for controlling birth or pregnancy. (De Vita, Vol. 50, no.41. 1996). Apart from pregnancy these women are exposed to sexually transmitted diseases of which the rate is increasing day by day.

Furthermore, according to a national study conducted in America, more then 70% of the low-income women face tremendous problems related to parental care and delivering the baby, which includes both out of marriage and teenage unmarried mothers. (A report to the Congress of the United States. HRD-87-137. 1987.) However, the poor and rural areas are in more demand of health care utilization services, as a result America has started taking this into consideration to improve the health care utilization behavior. Therefore, the most concerning issue related to health care behavior for America these days is to cope with the challenge of limiting the burden on its economy that is resulting due to the physical pleasure of the poor and uneducated families of the American nation. America has to spend more on the new born babies, their health and their food as well as their mothers during delivery and other medication. In such a situation, sexual awareness should be made more common among the teens as an essential subject of their course and at the same time, precautionary education must be provided door to door, school to school as well as other public places so teens who are sexually active at a very young age should adopt a precautionary method as killing the natural desire is not possible. Moreover, the various health services utilization behavior should be expanded with new policies where basic education and awareness should be the main agenda apart from health care services, medication and expenses baring policy. Apart from this, the private and the governmental health care organizations should coordinate to each other and share technical and medical information and discuss ideas whereby a pragmatic solution can result for the increasing trends of teenage pregnancies and the health services behavior.