By Iliana White, MPH, CHES, CPH
Senior Program Manager, Adolescent Health; AMCHP
Our efforts are clearly paying off: May’s opening of National Teen Pregnancy Prevention Month coincided with some encouraging news from the U.S. Centers for Disease Control. According to the CDC, the U.S. is yielding its lowest teen pregnancy rate of all time, a mere 25 years from its peak in 1991. The teen birth rate has fallen 40 percent over the past decade alone. In addition, the birth rates among black and Hispanic teens dropped by almost half between 2006 and 2014.
Although much is to be celebrated in regards to our successes with this public health and social issue, MCH advocates cannot become complacent. It is important to note that the reduction was not proportional among all populations within this age group, and there is more to be done to lower the disparity.
Teen pregnancy can certainly impact familial, educational and economic outcomes that extend well into adulthood and can become cyclical for their children as well. For adolescents themselves, early and unplanned parenthood can generate a number of health and social challenges. Teen mothers and fathers graduate from high school at lower rates than peers who do not give birth, and teen mothers are even less likely to go on to complete either a two- or four-year degree program. Given the fact that educational attainment is a strong indicator of financial viability, teen parents are more likely to experience poverty and dependence on public assistance than their peers. Through the lens of the life course, we understand that children of adolescent parents also face significant challenges – including poorer educational, behavioral and health outcomes – that can extend well into their adult years.
For MCH advocates, improving the health equity of children and families has increasingly become a point of emphasis in supporting the needs of underserved populations, which include racial or ethnic minorities, those experiencing poverty and those who reside in urban and rural communities. Adolescents within these underserved populations are at an additional risk of becoming teenage parents. For instance, poverty is both a contributor to and outcome of teen pregnancy; black and Hispanic youth in particular are more likely to experience poverty than their white peers. Similarly, there are geographic patterns of states and characteristics of counties with the highest levels of teen birth rates. Data show that across the southern U.S. from New Mexico to Mississippi (the Sun Belt), the rates exceed 50 births per 1,000 teen girls. Factors such as limited or no access to family-planning services and to evidence-based sexual and reproductive health education enable rates in some communities to remain higher than in other parts of the country.
While often referred to as a "winnable battle" by the CDC, preventing teen pregnancy among at-risk adolescents is a complex challenge that can be solved only through multi-faceted approaches; there is simply no one strategy that will solve the problem. Title V agencies and partners can, and should, be strategic in collaborating across several efforts to combat much of the underlying causes of this inequality.
Contributing risk factors include substance abuse, mental health conditions and experiencing or being exposed to violence and trauma. It is imperative that prevention efforts across the state, counties and local communities are both practical and sensitive to these factors. In addition, engaging youth to be part of these strategic efforts – not just as a participant of the interventions — is key to ensuring the programming is culturally relevant for adolescents. Prevention has proven to help curb teen birth rates thus far; however, intentional initiatives focused on those who continue to be disproportionately at risk can also help narrow the disparity of these rates.
To learn more about programming efforts focused on teen pregnancy, visit the Office of Adolescent Health’s webpage.