Kern county spans the southern end of the Central Valley of California. It has a growing diverse population and the region is a top producer of agricultural goods and petroleum and the county’s economy is tied to both industries. Slightly more than half (54%) of the Kern County population identifies as Hispanic and 45.3% of residents use a primary language other than English, most commonly being Spanish. Twenty-one percent of the population lives below the poverty line (defined as an income below $13,064 for an individual under age 65) which is 1.5 times higher than the state average.
Congenital syphilis (CS) cases have increased exponentially in Kern County since 2012. Between 2012 and 2018, 171 infants were born with congenital syphilis, including 14 fetal death or still births. Most mothers have no syphilis symptoms during pregnancy (1).
Between May 2018 and January 2019, a research team (Principal investigator: Jennifer Wagman, Ph.D. Assistant Professor, UCLA Fielding School of Public Health) conducted five focus group discussions with pregnant/postpartum women and ten semi-structured interviews with prenatal care providers in Kern County. All focus group discussions and interviews were recorded and data were transcribed, and analyzed to identify emergent themes pertaining facilitators and barriers to prenatal syphilis screening and treatment.
theme one
”For my other child, it’s really hard because she’s in foster care, and cause it’s my grand-baby, all she’s allowed to have it Medical. She’s not allowed to have Blue Cross, she’s not allowed to have Kern Family. So you have to go—it’s very strict which doctor you’re allowed to go to.”
“I think the main issue was once I found out I was pregnant, I didn’t get to actually see a doctor until 2 and a half months later. There were SO many people (waiting to see the doctor) already. I mean, so many women. They are just backed up. Unless you have a private insurance or a private doctor, you’re not getting in any time soon.”
theme two
"There are some women who are homeless and they're not doing what they're supposed to be doing (in terms of accessing prenatal care). They're afraid of being seen and they avoid going to the doctor's appointments."
theme three
"She was drinking a lot of alcohol so she didn't go to the doctor. They all thought they were going to get in trouble. They thought they would be reported. Due to that, there are 4 babies that are...going to be mentally disabled in their life cause their moms were too scared to go to the doctor because they were on drugs or they had warrants out for their arrest.”
"She had my grandson and she didn't go to the doctor the whole time because she was doing drugs. She didn't go to get any healthcare, and my grandson was born with syphilis.”
Reference.
(1) Kern County Public Health Services Department, Kern County Public Health Services Department, Congenital syphilis and the public health response in Kern county, 2019, Kern County Congenital Syphilis Elimination Summit 2019. Link to the report!
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