1. The source on adolescent sexual health May 8, 2015 Teenwise Minnesota’s 24 th Annual Conference Beyond the Headlines: A Deeper Look at Adolescent Sexual Health Research and Data

2. The source on adolescent sexual health Presentation Overview Review of pregnancy, birth and STI data Key Questions regarding: – Teen birth rate increase from 2006-2007 – U.S. birth rate compared to other developed nations – Birth rates down; STI rates up – Trends in youth sexual behavior – Social determinants and their effect on adolescent sexual health – Experiences of LGBQ youth in Minnesota – Teens and social media Resources

3. The source on adolescent sexual health The Good News… Adolescent pregnancy rates in Minnesota have decreased 63% from 1990 to 2013 Adolescent birth rates in Minnesota have decreased 54% from 1990 to 2013 Although pregnancy and birth increased for the first time in 16 years in 2006 and 2007, rates declined again in 2008 and have continued through 2013

4. The source on adolescent sexual health What do I mean by “teen”? – 15-19 year olds What’s a birth rate? – Rates are calculated per 1,000 females – More accurate statistic than using numbers – Birth certificate data – includes live births What’s a pregnancy rate? – Rates are calculated per 1,000 females – More accurate statistics than using numbers – Includes births, induced abortions and fetal demise over 20 weeks gestation (for which there is a death certificate filed)

5. The source on adolescent sexual health U.S. Adolescent Pregnancy Rates 1972-2010 & Adolescent Birth Rates, 1972-2013 (pregnancies and births per 1,000 females aged 15-19) Kost, K., & Henshaw, S. (2014). U.S. Teenage Pregnancies, Births and Abortions, 2010: National and State Trends by Age, Race and Ethnicity. New York: Guttmacher Institute. Retrieved from http://www.guttmacher.org/pubs/USTPtrends10.pdf. http://www.guttmacher.org/pubs/USTPtrends10.pdf Martin, J.A., Hamilton, B.E., Osterman, M.J.K., Curtin, S.C., & Matthews, T.J. (2015). Births: Final Data for 2013. National Vital Statistics Reports, 64(1), 1-64. Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf.http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf pregnancy rate birth rate 26.6

6. The source on adolescent sexual health U.S. Birth Rates, all ages, 1990-2013 (per 1,000 population) CDC/NCHS, National Vital Statistics System, Natality.

7. The source on adolescent sexual health Adolescent Birth Rates U.S. & Minnesota, 1970-2013 (number of births per 1,000 females aged 15-19) Martin JA, Hamilton BE, Osterman JK, et al. Births: Final data for 2012. National vital statistics reports; vol 62 no 9. Hyattsville, MD: National Center for Health Statistics. 2014. Center for Health Statistics, MDH, 2015

8. The source on adolescent sexual health Key question to consider Why did the teen birth rate go up in 2006 and 2007?

9. The source on adolescent sexual health In 2013, Minnesota had the 6 th lowest Adolescent Birth Rate in the US (age 15-19 per 1,000)

10. The source on adolescent sexual health State-specific birth rate ranking, by race/ethnicity, 2012 (age 15-19 per 1,000) StateBlack Arkansas63.4 Wisconsin59 Louisiana56.7 Nebraska56.6 Oklahoma56 Ohio55.2 Mississippi54.7 Michigan54.4 Minnesota39.5 (19 th ) StateHispanic/ Latina Oklahoma67.4 South Dakota66.1 North Dakota64.4 Kansas64.3 Texas62 Nebraska60 Alabama58.7 Tennessee58.4 Minnesota51.9 (27 th ) StateWhite West Virginia45.2 Oklahoma41 Kentucky40.8 Arkansas40 Mississippi38.9 Tennessee33.4 Louisiana33.2 Alabama33.1 Minnesota12.2 (7 th )

11. The source on adolescent sexual health Minnesota Adolescent Birth Rates by Race/Ethnicity, 1996-2013 (number of births per 1,000 females aged 15-19, 3-year clusters) Black (118.8) American Indian (96) Hispanic/ Latina (130.8) Asian/ Pacific Islander (68.2) White (25.4) Center for Health Statistics, Minnesota Department of Health, 2015 47.3 60.8 38.5 27 12.7

12. The source on adolescent sexual health We’re number one…unfortunately. WHO, UNICEF, UNFPA, The World Bank, and the United Nations Population Division. Trends in Maternal Mortality: 1990 to 2013. Geneva, World Health Organization, 2014. http://wdi.worldbank.org/table/2.17http://wdi.worldbank.org/table/2.17

13. The source on adolescent sexual health Key question to consider Even though the U.S. birth rate has reached historic lows, we are still among the highest when compared to other developed countries. Why?

14. The source on adolescent sexual health Minnesota Adolescent Gonorrhea & Chlamydia Rates, 2004-2014 (age 15-19 per 100,000 population) Center for Health Statistics, Minnesota Department of Health, 2015

15. The source on adolescent sexual health Center for Health Statistics, Minnesota Department of Health, 2015

16. The source on adolescent sexual health Minnesota Adolescent Chlamydia & Gonorrhea Rates by Race and Hispanic Origin, 2014 (age 15-19 per 100,000)

17. The source on adolescent sexual health Percent that used a condom with last intercourse, 1992-2013 2013 Minnesota Student Survey

18. The source on adolescent sexual health Key question to consider Why are chlamydia and gonorrhea rates increasing while birth rates and the number of sexually active youth continue to decline?

19. The source on adolescent sexual health Nationally, 2/3 of adolescents have had sex while they are still in high school Percent of High School Students Who Have Had Sex At Least Once Centers for Disease Control and Prevention. YRBS, 2011. MMWR 2012;61, p. 24

20. The source on adolescent sexual health 2013 Minnesota Student Survey Percentage of sexually active adolescents in Minnesota, 2013

21. The source on adolescent sexual health Top 5 reasons why Minnesota teens report that they are not having sex: 1.Fear of pregnancy 2.Fear of sexually transmitted diseases 3.I don’t think it’s right for a person my age to have sex 4.My parent(s) would object 5a. I have not had a chance to have sex (males) 5b. I don’t want to have sex (females) 2013 Minnesota Student Survey

22. The source on adolescent sexual health Percentage of sexually active adolescents in Minnesota, 1992-2013 2013 Minnesota Student Survey

23. The source on adolescent sexual health Key question to consider Why has the percentage of sexually active youth declined so much in the last 20 years? Why is Minnesota so much lower than the national average?

24. The source on adolescent sexual health State Adolescent Birth Rates, 2012 (births per 1,000 females aged 15-19) Martin, J. A., Hamilton, B. E., Ventura, S. J., & Osterman, M. J. K. (2013). Births: Final data for 2011. Hyattsville, MD: National Center for Health Statistics.

25. The source on adolescent sexual health Kost K and Henshaw S, U.S. Teenage Pregnancies, Births and Abortions, 2010: National and State Trends by Age, Race and Ethnicity, 2014, New York: Guttmacher Institute, http://www.guttmacher.org/pubs/USTPtrends10.pdfhttp://www.guttmacher.org/pubs/USTPtrends10.pdf State Adolescent Pregnancy Rates, 2010 (pregnancies per 1,000 females aged 15-19)

26. The source on adolescent sexual health

33. Key question to consider Birth rates have declined nationwide – regardless of state policies, demographic characteristics, etc. Why?

34. The source on adolescent sexual health LGBTQ Data Collection in MN LGBTQ largely absent from publicly health data collected in Minnesota Current sources of data around LGBTQ County Level data (2010 Hennepin County SHAPE data) Institutional data gathering (Boynton Survey) Community Based Organizations (Rainbow Health Initiatives) A few health care providers (Family Tree Clinic) 2013 Minnesota Student Survey one of the first statewide government-funded attempts to include sexual orientation in data collection

35. The source on adolescent sexual health 9th-11th combined MaleFemaleMaleFemale Heterosexual (straight)37,04435,75495%92% Bisexual50717161%4% Gay or lesbian3882671% Not sure (questioning)1,0161,0663% 38,95538,803100% 9 th and 11 th grades combined

36. The source on adolescent sexual health Have had sexual intercourse

37. The source on adolescent sexual health Alcohol or drug use before last sex

38. The source on adolescent sexual health Talked to all partners about STI/HIV protection

39. The source on adolescent sexual health Used a condom at last sex

40. The source on adolescent sexual health Been pregnant or gotten someone pregnant

41. The source on adolescent sexual health Key question to consider What are the implications of this data? What does this mean for our work with youth?

42. The source on adolescent sexual health Teens and Social Media 92% of teens are online daily 88% have a phone, 73% of these are smartphones 85% of black youth; 71% of white and Latino youth Desktop/laptop computer, smartphone, basic phone, tablet and game console 70% of teens have three or four of those items; about 1% of teens own no devices and just 4% say they only have one Girls text, use Instagram, Snapchat, Tumblr and Vine, while boys are more likely to play video games Pew Research Center’s Teens Relationship Survey, 2015

43. The source on adolescent sexual health Key question to consider The rise of social media has coincided with the decline in teen birth and pregnancy rates. Could social media be a protective factor?

44. The source on adolescent sexual health Resources CDC Vital Signs – www.cdc.gov/vitalsignswww.cdc.gov/vitalsigns CDC Vital Signs offers recent data and calls to action for important public health issues CDC Youth Risk Behavior Survey - www.cdc.gov/healthyyouth/yrbs/ www.cdc.gov/healthyyouth/yrbs/ The Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, including sexual behaviors. Guttmacher Institute – www.guttmacher.orgwww.guttmacher.org Research, policy analysis and public education on abortion, law/public policy, pregnancy, birth, prevention and contraception, HIV/STIs Minnesota Department of Health Center for Health Statistics (birth & pregnancy data) - www.health.state.mn.us/divs/chs/www.health.state.mn.us/divs/chs/ Minnesota Student Survey - www.health.state.mn.us/divs/chs/mss/www.health.state.mn.us/divs/chs/mss/ STD Division – www.health.state.mn.us/divs/idepc/dtopics/stds/stdstatistics.htmlwww.health.state.mn.us/divs/idepc/dtopics/stds/stdstatistics.html HIV Division - www.health.state.mn.us/divs/idepc/diseases/hiv/hivstatistics.htmlwww.health.state.mn.us/divs/idepc/diseases/hiv/hivstatistics.html National Campaign – www.thenc.orgwww.thenc.org Their mission is to promote values, behavior, and policies that reduce both teen pregnancy and unplanned pregnancy among young adults

45. The source on adolescent sexual health Thank you! Jill Farris, MPH Director of Training and Education jill@teenwisemn.org 651-289-1381 Teenwise Minnesota 1619 Dayton Avenue, Suite 111 Saint Paul, MN 55104 tel. 651-644-1447 fax. 651-644-1417