1. 1 Local Public Health Efforts to Address Teen Pregnancy/STD Prevention CityMatCH/NACCHO Emerging Issues in Maternal and Child Health Kristen Tertzakian October 21, 2004

2. 2 About the Campaign National Teen Pregnancy and Birth Trends Teen Pregnancy Prevention’s Link to Other Critical Social Issues Teen and Adult Opinions Overview of Remarks

3. 3 About The Campaign

4. 4 Our goal is to reduce the rate of teen pregnancy in the United States by one-third between 1996 and 2005. The Campaign’s mission is to improve the well- being of children, youth, and families by preventing teen pregnancy. 2 The National Campaign to Prevent Teen Pregnancy

5. 5 Our Strategy… Influence cultural values and messages Strengthen state & local programs Tolerance & Bipartisanship Teen Voices Research NCPTP Unusual Partners 3

6. 6 Teen Pregnancy and Births in the United States

7. 7 Henshaw, S. (2003). U.S. teenage pregnancy statistics with comparative statistics for women aged 20-24. New York: The Alan Guttmacher Institute. Teen Pregnancy Rates, 1972-2000 (number of pregnancies per 1,000 girls aged 15- 19) After increasing 23% between 1972 and 1990 (including 10% between 1987 and 1990), the teen pregnancy rate for girls aged 15-19 decreased 28% between 1990 and 2000 to a record low.

8. 8 Henshaw, S. (2003). U.S. teenage pregnancy statistics with comparative statistics for women aged 20-24. New York: The Alan Guttmacher Institute. Teen Birth Rates, 1940-2002 (number of births per 1,000 girls aged 15-19) From 1940 to 1957, the teen birth rate increased 78% to a record high. The birth rate dropped fairly steadily from the end of the 1950s through the mid-1980s, but then increased 23% between 1986 and 1991. Between 1991 and 2002, the teen birth rate decreased 30% to a record low of 43.0 in 2002.

9. 9 More Good News… Teen pregnancy, birth, and abortion rates are down. If teen birth rates had not declined since 1991, nearly 1.2 million more babies would have been born to teens. Between 1991 and 2003: Percentage of teens who ever had sex declined from 54% to 47%. Percentage of teens with four or more partners declined from 19% to 14%. Percentage of teens that used condoms increased from 46% to 63%.

10. 10 What is Behind the Good News? Between 1991 and 2000, there was a 33 percent decline in the pregnancy rate among teens. The decline was attributed nearly equal to: Santelli JS, Abma J, Ventura S, et.al. Can Changes in Sexual Behaviors Among High School Students Explain the Decline in Teen Pregnancy Rates in the 1990s? Journal of Adolescent Health 2004; 35 (2): 80-90. Improved contraception use 47% Decreased Sexual Experience 53%

11. 11 Teen Birth Rates by Race and Ethnicity (number of births per 1,000 girls aged 15-19) Teen birth rates, and rates of decline, vary substantially among the largest racial/ethnic subgroups. Between 1991 and 2002, teen birth rates declined 42% for African- Americans, 36%, for Native Americans, 34% for non-Hispanic Whites, 33% for Asian/Pacific Islanders, and 20% for Hispanics. The decline for all teens was 30%.

12. 12 Teen birth rates vary among Latina subgroups

13. 13 Why does this matter? Hispanics are the largest minority group and the fastest-growing racial or ethnic group in the U.S. Hispanic teens make up 14% of the total U.S. teen population; by 2020, 1 in 5 teens will be Latino. The total teen population will grow by 8% over the next two decades, Latino teens will grow by 60%. Any effort to reduce teen pregnancy nationwide must pay special attention and offer support to groups with high rates of teen pregnancy and birth.

14. 14 Some Bad News… The U.S. still has the highest rate of teen pregnancy in the industrialized world. 35% of teen girls become pregnant at least once before age 20. Recent data show an increase in the percent of high school girls who have had sex (2001 – 2003).

15. 15 Approximately 1 in 5 teens has had sexual intercourse before his or her 15 th birthday 29% of 12-year olds used contraception the first time they had sex; compared to 61% of 14-year olds. Bigger age gap = more risk: 13% of same-age relationships among those aged 12-14 include sex, compared with 26% if the partner is two years older, and 33% if the partner is three or more years older. More Cause for Concern

16. 16 What About Contraception? Forty percent of teens never talked about contraception with their partner before having sex for the first time. Information gap: 77% of surveyed teens were familiar with birth control pills, yet 43% believed they protect against STDs. Science Says: Characteristics of Teens’ First Sexual Partner and Kaiser Family Foundation and Seventeen Magazine, July 2004.

17. 17 Boys aged 12-19 are slightly more likely than girls the same age to report feeling pressured to have sex (82% vs. 79%). About half (51%) of boys agree with the statement, “I have never really thought about what my life would be like if I got someone pregnant as a teen.” Science Says: The Sexual Attitudes and Behaviors of Male Teens What About Boys?

18. 18 This Translates Into: Approximately 850,000 pregnancies to teens per year in the United States. 100 teen girls getting pregnant each hour. At least $7 billion a year in costs to taxpayers related to teen childbearing.

19. 19 Not Just Another Single Issue Teen Pregnancy Prevention’s Link to Other Critical Social Issues

20. 20 Making the Connection Welfare Dependency and Poverty Child Well-Being Out-of-Wedlock Birth and Marriage Responsible Fatherhood Workforce Development Preventing teen pregnancy should not be viewed only as a reproductive health issue. It’s also linked to: 10 For more information see National Campaign, Not Just Another Single Issue

21. 21 Welfare Dependence and Poverty 52% of all mothers on welfare had their first child as a teenager. Two-thirds of families begun by a young unmarried mother are poor. If teen birth rates had not declined 1991-2002, 460,000 more children would have lived in poverty. The decrease in teen birth rate accounts for 26% of the reduction in the number of young children in poverty (1995 – 2002).

22. 22 Child Well-Being The children of teen mothers bear the greatest burden of teen pregnancy and childbearing. They are at significantly increased risk for a number of economic, social, and health problems. Children of teen parents suffer higher rates of abuse and neglect.

23. 23 Education and Workforce Development Teen pregnancy and early childbearing often preclude the education and training crucial to a productive labor market. 6 of 10 teen mothers who begin their families before age 18 never graduate from high school. Half of teen mothers drop out of school before becoming pregnant. Nearly one-fourth of teenage mothers have a second child before turning 20 — making it harder to finish school or keep a job.

24. 24 Out-of-Wedlock Births and Marriage Nearly 80 % of teen births are now to unmarried teens, up from 15% in 1960. Only 30 % of teen mothers who marry after their child is born remain in those marriages. Children in single-parent families are more likely to get pregnant as teenagers. If teen birth rates had not declined 1991-2002, close to 700,000 more children would have lived in single mother households.

25. 25 Responsible Fatherhood 8 of 10 teen fathers do not marry the mothers of their children. Children born to teen parents are often denied a close connection with their fathers. Children without involved fathers are more likely to drop out of school, abuse alcohol or drugs, and end up in prison. Boys and girls who live apart from their fathers are 5 times more likely to be poor than children with both parents at home.

26. 26 So What’s the Point? Framing the issue broadly helps: Find new friends and allies Find more money Steer around the culture wars 18

27. 27. What Do Teens and Adults Think?.

28. 28 Parents Underestimate Their Influence Teens: Who Most Influences Your Decisions About Sex? Parents: Who Most Influences Teens’ Decisions About Sex? With One Voice 2003 Parents FriendsTeens’ Friends

29. 29 Teen Sexual Attitudes 67% of sexually experienced teens say they wish they had waited longer before having sexual intercourse. 85% of teens say sex should only occur in a long term committed relationship. Only 26% of teens say it is embarrassing for teens to admit they are virgins. Teens’ own morals, values, and/or religious beliefs (34%) – as well as concerns for the future (34%) – influence their decisions about sex far more than concerns about pregnancy (17%) or STDs (15%). Science Says: American Opinion on Teen Pregnancy and Related Issues 2003

30. 30 Teen Sexual Attitudes 68% of those in grades 9-12 surveyed believe that “most teens my age have had sex.” However, The Center for Disease Control’s 2003 Youth Risk Behavior Survey reports that only 47% of those in grades 9-12 have had sex. Science Says: American Opinion on Teen Pregnancy and Related Issues 2003

31. 31 94% of adults and 92% of teens believe that it is important for teens to be given a strong message from society that they should not have sex until they are at least out of high school. 71% of adults and 59% of teens believe that teens should not be sexually active, but teens who are should have access to birth control. 75% of adults and 60% of teens wish that teens were getting more information about abstinence and contraception, rather than just one or the other. Source: Science Says: The Case for the Cautious Generation and American Opinion on Teen Pregnancy and Related Issues Teen and Adult Attitudes

32. 32 60% of teens believe that teen boys often receive the message that sex and pregnancy are not a big deal. 45% of teens and 58% of parents of teens say the media has sparked a recent conversation about the consequences of sex. 87% of adults and 88% of teens wish the media showed more or talked more about the consequences of sex. Source: Science Says: The Case for the Cautious Generation and American Opinion on Teen Pregnancy and Related Issues More Attitudes…

33. 33 What Now?

34. 34 Really listen to what parents and teens have to say. Support parents in their critical role. Don’t forget about the media. Develop persuasive cost/benefit equations Connect to larger issues such as workforce preparation, fatherhood, child poverty, empowerment of young women, family stability/marriage… Broaden the number of active players and partners. Tolerate and respect differences –Unity of goals –Diversity of means –Engage and highlight teens How can we make progress?

35. 35 What Can We Do to Help You? Full-Service, Interactive Website www.teenpregnancy.org Publications and Postcards Get Organized Across America Putting What Works to Work Sign up for our bi-weekly egram at www.teenpregnancy.org/informed/notificationnet.asp

36. 36 Thank You! www.teenpregnancy.org Kristen Tertzakian 202-478-8556 ktertzakian@teenpregnancy.org