Retinal Disorders

The retina is a layer of tissue in the back of your eye that senses light and sends images to your brain. In the center of this nerve tissue is the macula. It provides the sharp, central vision needed for reading, driving and seeing fine detail.

Retinal disorders affect this vital tissue. They can affect your vision, and some can be serious enough to cause blindness. Examples are:

• Macular degeneration - a disease that destroys your sharp, central vision
• Diabetic eye disease
• Retinal detachment - a medical emergency, when the retina is pulled away from the back of the eye
• Retinoblastoma - cancer of the retina. It is most common in young children.
• Macular pucker - scar tissue on the macula
• Macular hole - a small break in the macula that usually happens to people over 60
• Floaters - cobwebs or specks in your field of vision

NIH: National Eye Institute

Rural Health Concerns

Around 15% of people in the United States live in rural areas. There are many different reasons why you might choose to live in a rural community. You may want a lower cost of living and a slower pace of life. You may enjoy having access to big, open spaces for recreation. Rural areas are less crowded and can offer more privacy. You may choose a rural area so that you can live near your family and friends.

But there are also challenges to living in a rural area, including when it comes to taking care of your health. Compared to urban areas, rural communities tend to have:

• Higher poverty rates.
• A higher percentage of older adults, who are more likely to have chronic health problems.
• More residents without health insurance.
• Less access to health care. For example, clinics and hospitals may be far away.
• Higher rates of certain substance use, such as cigarette smoking and opioid and methamphetamine misuse.
• Higher rates of chronic health problems such as high blood pressure and obesity.
• More exposure to environmental hazards, such as chemicals used for farming.

There are solutions to deal with these problems. A few examples include:

• Clinics offering telehealth to provide care for people who live far away from specialists or can't easily get to their providers' offices.
• Local public health agencies working with their communities to promote healthy living. They can provide wellness and exercise classes and start a farmer's market.
• Local governments adding bike lanes and trails to encourage people to bike and walk.
• Rural schools can offer counseling and mental health services for their students.

Stillbirth

What is a stillbirth?

If you lose a fetus at or after the 20th week of pregnancy, it's called a stillbirth. A stillbirth can occur before or during delivery and may be considered as:

• Early. The loss of a fetus between 20 and 27 weeks of pregnancy.
• Late. The loss of a fetus between 28 and 36 weeks of pregnancy.
• Term. The loss of a fetus at 37 or more weeks of pregnancy.

Stillbirth can happen in any pregnancy. Some factors may increase the chance that one can occur. Risk factors can include if you:

• Are age 35 years or older
• Are of low socioeconomic status
• Smoke during pregnancy
• Have certain medical conditions, such as diabetes or high blood pressure
• Are a non-Hispanic Black woman
• Previously had a stillbirth
• Are pregnant with more than one baby (twins or triplets)

In many cases, the cause remains unknown. Some causes may be preventable, but most are not.

Causes for a stillbirth may include:

Before delivery, the only way to diagnose a stillbirth is to check if the fetus's heart is beating. Your health care provider may use an ultrasound to look for the fetal heartbeat.

During your pregnancy, your provider may recommend keeping track of fetal movements. However, if you don't notice movement, it doesn't always mean a stillbirth occurred. Sometimes, especially if it's your first pregnancy, it might be difficult to notice movement. If you're pregnant and something seems unusual or is worrying you, talk to your provider.

After labor and delivery, your provider will check the baby for signs of life. These can include breathing, heartbeat, voluntary movements, and pulsations in the umbilical cord. If one or more signs of life are not present, then life-saving measures are taken. If these measures are unsuccessful, a stillbirth may be diagnosed.

Care after a stillbirth depends on when it occurs. If it happens before delivery, your provider may induce (start) labor or use surgery to deliver the fetus (cesarean delivery). If it happens during labor and delivery, the placenta will still need to be removed or delivered.

No matter when it occurs, losing a pregnancy can be difficult. Counseling may help you cope with your grief. Later, if you decide to try to get pregnant again, work closely with your provider to understand any risks. Many women who have a stillbirth go on to have healthy babies.

NIH: National Institute of Child Health and Human Development

Teen Health

As a teenager, you go through many changes. Your body is on its way to becoming its adult size. You may notice that you can't fit into your old shoes or that your jeans are now 3 inches too short. Along with these changes, you are probably becoming more independent and making more of your own choices. Some of the biggest choices you face are about your health.

Healthy habits, including eating a healthy diet and being physically active, can help you feel good, look good, and do your best in school, work, or sports. They might also prevent diseases such as diabetes, high blood pressure, heart disease, osteoporosis, stroke, and some cancers when you are older.

Teenage Pregnancy

Most teenage girls don't plan to get pregnant, but many do. Teen pregnancies carry extra health risks to both the mother and the baby. Often, teens don't get prenatal care soon enough, which can lead to problems later on. They have a higher risk for pregnancy-related high blood pressure and its complications. Risks for the baby include premature birth and a low birth weight.

If you're a pregnant teen, you can help yourself and your baby by:

• Getting regular prenatal care
• Taking your prenatal vitamins for your health and to prevent some birth defects
• Avoiding smoking, alcohol, and drugs
• Using a condom, if you are having sex, to prevent sexually transmitted infections (STIs) that could hurt your baby. If you or your partner is allergic to latex, you can use polyurethane condoms.