When Teens Have Sex: Issues and Trends

Section 1: Foreword
Section 2: Overview
Section 3: National Maps
Section 4: NewsSection 5: Resources

Section 1

Foreword

This KIDS COUNT Special Report contains some hopeful news for the future of America's families. Since 1991, the percentages of American teenagers getting pregnant, giving birth, or having abortions have all fallen. Teen pregnancies have declined 14 percent since 1990, reaching the lowest annual rate in more than 20 years. Similarly, the rate of births to teens is down 12 percent from the beginning of the decade. These welcome declines occurred in every state and the District of Columbia and across all racial groups.

Of course, these improving numbers still fall far short of what is acceptable and attainable. In 1996, more than half a million American teens gave birth. Most of these adolescents were unmarried, and many were not ready for the responsibilities and demands of parenthood.

For a good share of these new mothers, premature parenting will foreshorten their schooling, narrow their personal development, and greatly increase the likelihood that they will be poor and dependent as young adults. Equally predictable is that the hardship of too-early parenting will be visited upon the next generation. The children of teenagers are far more likely than other babies to be below average in weight at birth, to be deprived of adequate learning opportunities, and to be poor. And as they grow up, these kids are more likely to drop out, get into trouble, and end up as teen parents themselves.

Perhaps the encouraging data in this Report signal that we Americans are finally coming to terms with the gravity, magnitude, and tragedy of unprepared parenthood. Over the past decade, there have been increased efforts-on the part of parents, teachers, community leaders, and service providers-to talk with and to inform young people about the challenges and hazards of adolescent sex. In many parts of the country, adolescent health services are being reconfigured to become more relevant, accessible, and helpful to the young people who need them most. And finally, there is increasing evidence that we are beginning to recognize that the most powerful pregnancy prevention strategy is to ensure that all of our children have the opportunities, skills, and confidence in their own potential to allow them to make the decisions that will safeguard their own futures. Together, these efforts to inform, serve, and inspire young people are at least part of the reason that more teens are postponing sexual initiation and that others are becoming more conscientious users of contraception.

But the progress made to date-the progress detailed in the pages that follow-is no cause for national self-congratulation. On the contrary, the data presented here pose a compelling challenge to all of us. The trends clearly affirm that things can change, that outcomes can improve, and that thoughtful interventions can make a difference. This should leave all of us with the conviction that now is the time to redouble our efforts-as parents, as policymakers, or simply as citizens-to further drive down the rates of unprepared teen pregnancy and parenting in the United States. In fact, we should hold ourselves accountable for at least a one-third reduction in the teen birth rate from current levels by the year 2005. It is an achievable goal, and striving for anything less would amount to a virtual acquiescence in compromised futures for hundreds of thousands of America's young people.

Section 2

Overview
Preventing Teen Pregnancy: Strategies That WorkMyths and Facts about Teens and Sex

Overview

The care and protection of children is, first and foremost, a family concern. But when teenagers have babies, the consequences are felt throughout society. Children born to teenage parents are more likely to be of low birth-weight and to suffer from inadequate health care, more likely to leave high school without graduating, and more likely to be poor, thus perpetuating a cycle of unrealized potential.1

Despite a 20-year low in the teen pregnancy rate and an impressive decline in the teen birth rate, the United States still has the highest teen pregnancy rate of any industrialized country. About 40 percent of American women become pregnant before the age of 20.2 The result is about 1 million pregnancies each year among women ages 15 to 19. About half of those pregnancies end in births, often to young women and men who lack the financial and emotional resources to care adequately for their children. And when parents are financially and emotionally unprepared, their children are more likely to be cared for either by other relatives, such as grandparents, or by taxpayers through public assistance.

Experts estimate that the combination of lost tax revenues and increased spending on public assistance, child health care, foster care, and the criminal justice system totals about $7 billion annually for births to teens.3 In Kids Having Kids: A Robin Hood Foundation Special Report on the Costs of Adolescent Childbearing, researchers note that during her first 13 years of parenthood, the average adolescent mother receives AFDC and food stamps valued at just over $1,400 annually.4

Hopeful Signs of Change

Recent declines in the pregnancy and birth rates are encouraging. The rate of pregnancies has dropped from a peak of 117 for every 1,000 young women ages 15 to 19 in 1990, to 101 in 1995. That 14 percent drop brought the rate to its lowest level since 1975. Similarly, the teen birth rate has dropped from 62 for every 1,000 young women ages 15 to 19 in 1991, to 54 in 1996-a 12 percent decline. During that 5-year period, the National Center for Health Statistics reports that the actual number of births to teens dropped by 5 percent, but is still close to half a million each year.

As reported in the pages that follow, every state and the District of Columbia experienced some decline in their teen birth rate between 1991 and 1996, from a 6 percent drop in Arkansas to a 29 percent drop in Alaska. In addition, the teen birth rate decreased among all races. The steepest decline-21 percent-occurred among black teenagers, whose rate of births is now the lowest in 40 years. Another hopeful sign is that nationally, the birth rate among 15- to 17-year-olds declined faster than that for 18- and 19-year-olds.

What's behind the overall drop in these rates? Some might speculate that the reduction in the teen birth rate results from an increase in the abortion rate. But the teen abortion rate (number of abortions per 1,000 females ages 15 to 19) fell from 41 in 1990 to 30 in 1995.

Rather than trying to deal with a pregnancy after the fact, more teenagers seem to be trying to prevent pregnancies. Researchers cite two main reasons for the overall drop in both pregnancy and birth rates: Fewer teens are having sex, and among those who are, more are using contraceptives. In a special analysis of the falling pregnancy and birth rates, Patricia Donovan of the Alan Guttmacher Institute (AGI) noted that researchers attribute the recent trends in teen sexual activity and contraceptive use to a variety of factors:

• greater emphasis on delaying sexual activity;

• more responsible attitudes among teenagers about casual sex and out-of-wedlock childbearing;

• increased fear of sexually transmitted diseases, especially Acquired Immune Deficiency Syndrome;

• the growing popularity of long-lasting contraceptive methods, such as the implant (Norplant) and the injectable (Depo-Provera) options, and possibly more consistent or correct use of other contraceptive methods; and

• a stronger economy, with better job prospects for young people.5

The Youth Risk Behavior Surveillance System, conducted under the auspices of the Centers for Disease Control and Prevention, confirms that fewer teens are having sex. In 1997, 48 percent of the nation's high school students reported ever having had sex, compared to 54 percent in 1990. The overall rate masks important differences among subgroups. In 1997, 44 percent of non-Hispanic whites, 52 percent of Hispanics, and 73 percent of non-Hispanic blacks reported ever having had sex (see Table 1). But only 35 percent of all respondents said that they had been sexually active in the previous 3 months.

Reported rates of sexual activity dropped more dramatically among male teens than among female teens. Between 1990 and 1997, the percent of females who reported ever having had sex remained at 48 percent, but the rate among young men dropped from 61 percent to 49 percent. The rate declined most steeply among non-Hispanic white males, dropping from 56 percent to 43 percent. Among non-Hispanic black males the rate went from 88 percent to 80 percent and among Hispanic males, from 63 percent to 58 percent.

1990

1997

54%

48%

61%

49%

48%

48%

52%

44%

72%

73%

53%

52%

40%

38%

48%

43%

57%

50%

72%

61%

As researchers from the National Center for Health Statistics and from the Urban Institute have noted, those teens who are having sex are more likely to use condoms. In 1990, 45 percent of teens who reported having had sex during the previous 3 months said that they had used a condom. By 1997, the figure was up to 57 percent. The rate among males jumped from 49 percent in 1990 to 63 percent in 1997, and the rate among females during the same period went from 40 percent to 51 percent.6

Reasons for Continued Alarm: Demographic Concerns

At best, the downward trends in teen sexual activity call for cautious optimism. No one can predict whether the rates will continue to go down or pop back up again. So, it would be a mistake to think, merely on the basis of these hopeful signs, that the problem of teen pregnancy is close to being solved.

For starters, the teen birth rate is higher than it was 10 years ago. It's also worth re-emphasizing that the U.S. rates are still the highest in the developed world (see Chart 1). The next closest nation, the United Kingdom, has a teen birth rate that is only about half that of the United States. And the high rate of childbearing among American teens is widespread. The Alan Guttmacher Institute reports that in 26 states and the District of Columbia, at least 1 out of every 10 teen females ages 15 to 19 became pregnant in 1992 (the latest year for which these figures are available). In every state, the pregnancy rate was higher than that of the United Kingdom. Equally troublesome is the fact that nationally, 22 percent of births were to teens ages 15 to 19 who already had a child.

Demographic trends confirm that the recent good news may be short-lived. As the children of the "baby boomlet" swell the ranks of American teenagers over the next few years, the absolute number of babies born to teenagers is likely to increase even if the birth rate remains constant. In fact, using the 1996 rate to project the number of births to women ages 15 to 19 in the year 2005 suggests a 14 percent increase in the number of babies born to teen mothers.

The majority of those births are likely to be out of wedlock, as were 76 percent of births to women ages 15 to 19 throughout the United States in 1996. Among the states, the percent of births that occurred to unmarried teens ranged from 58 percent in Utah to 92 percent in Rhode Island and 97 percent in the District of Columbia in 1996. According to the National Campaign to Prevent Teen Pregnancy, a private, non-partisan effort launched in 1996, the vast majority of unmarried teen mothers choose to keep their children rather than put them up for adoption.7

Today’s teen parents face very different circumstances than their counterparts of 30 years ago. During the 1960s, more than two-thirds of births to 15- to 19-year-olds occurred within marriage, even when conception occurred beforehand.8 At that time, marriage was viewed as an ultimate life goal, offering the financial and social stability that was considered essential for having and raising children. By the late 1980s, however, less than 40 percent of 15- to 19-year-olds who gave birth were married.9

Among teen mothers in 1996, AGI reports that 84 percent of 15- to 17-year-olds and 71 percent of 18- to 19-year-olds were unmarried. Even though the stigma of out-of-wedlock births has lessened, "children growing up in single-parent households typically do not have the same economic or human resources available as those growing up in two-parent families," as noted in the 1998 KIDS COUNT Data Book.10

Family structure is not the only factor that determines whether a child will succeed, but it has a definite impact, as sociologists Sara McLanahan and Gary Sandefur argue in their book, Growing Up With a Single Parent. They examined a decade's worth of data and found, "Compared with teenagers of similar background who grow up with both parents at home, adolescents who have lived apart from one of their parents during some period of childhood are twice as likely to drop out of high school, twice as likely to have a child before age twenty, and one and a half times as likely to be idle"-out of school and out of work-in their teens and early twenties."11

source: Alan Guttmacher Institute.

Reasons for Continued Alarm: The Human and Social Costs

The rates and numbers of teen pregnancies and births in the United States are cause for alarm, even with the recent dips. But it is the human and social costs of teen pregnancy and parenting that are most compelling. Premature parenthood is more than a 9-month interruption in a youth's life. Rather, it can further complicate a life that is already deficient in promise, hope, and dreams for the future.

Consequences for Young Parents

A young woman who has a child before graduating from high school is less likely to complete school than a young woman who does not have a child. About 64 percent of teen mothers graduated from high school or earned a GED within 2 years after they would have graduated, compared with about 94 percent of teenage women who did not give birth.12 The failure to go further in school can limit the mother's employment options and increase the likelihood that she and her family will be poor. And the roughly one-fifth of adolescent moms who have more than one child are even more economically vulnerable. They might further delay finishing high school, putting them at greater risk of being slotted into low-wage jobs or of facing prolonged unemployment, poverty, and welfare.

For many teens, those risks are already high, and childbirth merely propels them further along a well-traveled path. That's because teens who give birth are more likely to come from disadvantaged family situations in which their life chances are already limited. While teen pregnancy touches all levels of our society, teens who give birth are more likely to come from economically disadvantaged families and communities, to be poor academic achievers with low aspirations, and to be coping with substance abuse and behavioral problems. Teen moms are also more likely to have mothers who completed fewer years of schooling and to have mothers or older sisters who also gave birth as adolescents.13

Nearly 80 percent of teen mothers eventually go on welfare. According to Child Trends, more than 75 percent of all unmarried teen mothers went on welfare within 5 years of the birth of their first child. In fact, some 55 percent of all mothers on welfare were teenagers at the time their first child was born.14

The consequences of early parenthood for teen fathers are generally not as severe as those for teen mothers, even though teen fathers are more likely to engage in delinquent behaviors and to use alcohol routinely, deal drugs, or quit school. Among married men studied by researchers in Kids Having Kids, those who were teen fathers had the least schooling.15 Also, researchers calculated that the fathers of children born to teen mothers earned an estimated average of $3,400 less a year than the fathers of children born to mothers who were 20 or 21, over the 18 years following the birth of their first child.16

Consequences for Children

For many of the children of teen parents, the future is compromised even before they are born. Nationally, 10 percent of teens ages 15 to 19 who gave birth in 1996 received inadequate prenatal care. And, in Arizona, New Mexico, New Jersey, and the District of Columbia, more than 14 percent of teens did not receive adequate prenatal care. That undoubtedly helps to explain why babies born to teen mothers are about one-third more likely to be of low birth-weight (less than 5.5 pounds) than babies born to older women. Once born, the children of teen mothers face additional health risks. The infant mortality rate (deaths to children under age 1 per 1,000 live births) for children born to women under age 20 is about 50 percent higher than the rate for those born to women who are older than 20. The rate for children born to black or Native-American teen mothers is nearly twice that for children born to women who are older than 20. In addition, a recent study by the National Institute of Child Health and Human Development found that babies born to teen moms are at higher risk of abuse and neglect, including death.

Given the diminished economic prospects that many teen mothers experience, we should not be surprised that children born to unmarried women who are under the age of 20 and who have not completed high school are 10 times more likely to be poor than children born to married women who are 20 or older and have a high school diploma.17 In 1996, the poverty rate for all children born to teen mothers was 42 percent, twice the overall rate for children. But income is not the only problem. Studies show that teen parents are generally less able to give their children the kind of solid foundation, including proper nutrition, health care, cognitive and social stimulation, and old-fashioned nurturing-in short, the things all kids need-to get off to a good start.

Consequences for Health

Not all concerns about teenagers having sex relate to premature childbearing. Each year, more than 3 million teens contract a sexually transmitted disease (STD), accounting for about one-fourth of the 12 million Americans infected annually. Adolescents are at high risk for many of these infections because they are more likely to engage in unprotected sex and to have multiple partners over brief periods of time. And some teens are pressured into having sex without being able to protect themselves. These factors increase the likelihood that a sexually active teen will have sex with someone who is already infected with an STD. Because teens are less likely to be insured or to have a regular source of primary care, they often experience significant delays in screening, diagnosis, and treatment, leading to medical complications that would otherwise be avoidable.

It is estimated that one-fourth of all new human immunodeficiency virus (HIV) cases each year occur in people ages 13 to 21, that half are among people under the age of 25, and that the majority of these infections are transmitted sexually. Other sexually transmitted viral infections that are prevalent among adolescents include the human papillomavirus, associated with the vast majority of cases of cervical dysplasia (a pre-cancerous condition of the cervix that affects over 2.5 million American women), and hepatitis B virus, which increases the risk of cirrhosis and cancer of the liver.

Adolescent women are also highly vulnerable to chlamydia and gonorrhea. While the target gonorrhea rate established by the U.S. Department of Health and Human Services is 225 per 100,000 people, the national rate for females ages 15 to 19 in 1996 was 699.18 And in some urban areas, the rate among adolescent females has ranged as high as 6,000 for more than a decade. In 1996, the national rate of chlamydia per 100,000 females ages 15 to 19 was 1,942. Chlamydia is probably the most common sexually transmitted disease in the United States. Together with gonorrhea, chlamydia is a leading cause of pelvic inflammatory disease and a common cause of infertility, ectopic pregnancy, and fetal complications, including premature birth.

Consequences for Society

Taken as a whole, society has to view the dangerous consequences of teenage sexual activity as an ongoing challenge. We should want to protect our teenagers from the risk of premature parenthood and from disease, and we should want to protect the children they would struggle to raise. If we are serious about breaking the cycles of poverty and underachievement that, too often, result from kids having kids, then we must not be satisfied with the recent downward trends, and we must expand our efforts to help those teens who are at greatest risk. Rather than becoming complacent because of the recent downturn, we must be more aggressive in implementing the positive lessons that contributed to it and redouble our efforts to cut the teen birth rate even more significantly. The National Campaign to Prevent Teen Pregnancy suggests a sensible goal of reducing the teen pregnancy rate by one-third between 1995 and the year 2005.

Preventing Teen Pregnancy: Strategies That Work

To accomplish this ambitious, but feasible, goal will require an unwavering commitment and aggressive action by both communities and families. It must be recognized that there is no magic solution to reducing teen pregnancy, childbearing, and STD rates, nor will a single intervention work for all teens. Because the decline from 1990 to 1996 is attributable to many factors, it is essential to continue and expand a range of programs that embrace many strategies. Experts agree that holistic, comprehensive, and exible approaches are needed.

The Importance of Information

Communities and families need to provide accurate and consistent information about how to reduce risk-taking behaviors, such as unprotected sexual activity.

At a minimum, teens should be given basic information-about abstinence; about contraceptives, condoms, and other options for protection; and about their reproductive health. We need to talk to them more openly about the consequences of having a child and, certainly, about the consequences of having more than one child, before the age of 20. We need to more actively present to disadvantaged teens, in particular, a broader vision of their life possibilities. And we need to provide them with more targeted academic and job opportunities. An estimated 85 percent of teen pregnancies are unintentional.19 But, too many teenagers become parents either because they cannot envision another positive future direction to their lives, or because they lack concrete educational or employment goals and opportunities that would convince them to delay parenthood.

Teens also need access to specific information about how their bodies work and how to keep their bodies safe and healthy. Adults should recognize that young people need accurate, age-appropriate information about sexual behavior and its consequences. Whether or not they choose to have sex, teens need to develop skills in communication and sexual decision making so that sex does not just "happen."

Much relevant information about sexual behavior and its consequences can be conveyed through sex education classes, and a Harris Poll in 1988 found that 85 percent of adults support required sex education programs in schools.20 Yet a 50-state survey a decade later by Child Trends found that 19 states have an official policy requiring or encouraging pregnancy prevention programs in the public schools. In contrast, states have been much more aggressive in educating students about STDs. All but 8 states have an official policy regarding HIV/AIDS education in their public schools.21 Despite that emphasis by states, many teens continue to take risks. Less than half of sexually experienced teen boys and only 38 percent of teen girls say they have used birth control every time they have had intercourse.22

Presenting Clear Messages

Communities and families need to encourage more frequent and less ambiguous communication from adults, especially parents, on the issue of teenage sexual activity.

Today's adolescents are bombarded with a constant barrage of sexual images in popular culture, from advertisements to movies to song lyrics. Sex sells. But the sales pitch is often one-dimensional, ignoring the importance of values, emotional involvement, or the possibility of unintended consequences like pregnancy or disease.

Given these mixed messages about sex, and the fact that a large proportion of teens learn about sex from their friends, it is especially important for adults, particularly parents, to get past their own discomfort and have frank and open discussions with teens. In addition to basic information about sex, open communication can lead teenagers to seek the health counseling and services that they need.

Programs like the Casey Foundation's Plain Talk Initiative recognize the importance of reproductive health information and supports for teens-and the important role that adults play in providing them. Plain Talk has operated in five cities-San Diego, Hartford, Atlanta, New Orleans, and Seattle. It focuses on adults in the community, including parents and other relatives, teachers, neighbors, clinic service providers, ministers, and others, who interact with teens who may already be sexually active. The program seeks to create a community-wide consensus among parents and other adults to protect these youths from unintended pregnancies and disease. It also helps adults communicate more effectively with teens about responsible sexual decision making and behavior. And it helps mobilize adults to ensure that teens have access to good-quality, age-appropriate, and conveniently available reproductive health care, including contraceptives.

Community Reinforcements

Communities and families need to develop comprehensive, community-wide plans of action for adolescent pregnancy prevention, including adolescent reproductive health services, sexuality education, and programs to encourage young people to delay childbearing.

Adolescent reproductive health is not just about young women. Nor is it just about birth control pills. It encompasses an array of services, including comprehensive sex education; health promotion; and prevention of pregnancy, STDs, and HIV/AIDS. The challenge is to make clinical services available to teens in ways that increase their motivation and capacity to protect themselves.

Research, experience, and common sense confirm that, ideally, adolescent reproductive health services should include a site that is convenient to teens, such as a school or a mall; services for males as well as females; services that are provided during non-school hours, such as late afternoons, evenings, and weekends; non-medical services, such as peer education and mental health counseling; staff specifically selected and trained to work with adolescents; appropriate involvement of family members and significant others; confidentiality of patient information; and low-cost or free services.

Screening is one essential service that should be provided as part of any comprehensive strategy to reduce STD rates among teens. Screening programs are especially important for chlamydia because many infected persons have no symptoms. Studies indicate that screening for chlamydia can reduce the incidence of pelvic inammatory disease by as much as 60 percent. Family planning clinics with screening programs in Alaska, Idaho, Oregon, and Washington registered a drop of 67 percent in chlamydia infection rates between 1988 and 1997. During that same period, the national reported rate of chlamydia infection more than doubled.23

We must also recognize that contraception works for sexually active adolescents and that the recent drop in teen pregnancies and births is due, in part, to more consistent use of contraceptives by sexually active teens. Family planning is an important component of adolescent reproductive health. The Alan Guttmacher Institute estimates that as a result of publicly funded family planning programs, including clinics and family planning services, about 386,000 unintended pregnancies among females ages 15 to 19 are prevented each year. Beyond access to quality reproductive health services, all young people need comprehensive sexuality education to prepare them for healthy adult relationships. Effective programs give information about abstinence, healthy relationships, and contraception. They also help young people explore attitudes, feelings, and values about human development, dating, gender roles, sexual behavior, and healthy sexual decision making. They are most effective when they are culturally specific and focus on building skills, including the ability to say "no."

One model is Girls, Incorporated's Preventing Adolescent Pregnancy program. Girls, Inc. is a national youth organization, and their program provides females, ages 9 to 18, with the information, skills, and motivation-building activities they need to avoid early pregnancy and to plan full, satisfying lives. The program has four components targeting specific age groups. Starting with the youngest participants, the program focuses on building positive parent/daughter communication about sexuality and values (ages 9 to 11), emphasizing how to recognize and resist pressure to become sexually active (ages 12 to 14), setting life goals that include using abstinence or contraception to avoid pregnancy (ages 15 to 18), and linking participants with community-based health services, including access to contraception (ages 12 to 18).

Another program that is widely used in communities across the country was developed for seventh and eighth graders by the Emory University School of Medicine and the Grady Memorial Hospital Teen Services Program in Atlanta, Georgia. One component of the program, called Postponing Sexual Involvement, employs older teens to teach younger people how to resist social and peer pressure to become sexually active. A second component, Respecting Your Future, enlists nurses and counselors to provide basic information about teen sexuality, including methods of protection against pregnancy and STDs. Overall, the program promotes more open dialogue about reproductive health between parents and their children, from the preteen years through adolescence.

Motivational Opportunities and Related Services

Communities and families need to give young people a real vision of a positive future by investing time and resources to help them acquire good decision-making, communication, and work skills that prepare them for the adult world.

It is essential to help those teens at highest risk of pregnancy learn about educational and economic opportunities and about how to cope with the many social and psychological factors associated with risky sexual behavior. A number of approaches are needed to reach these teens, including counseling for and treating sexual abuse, drug and alcohol use, and/or family distress; mentoring by an adult with whom a close relationship can be developed; providing educational opportunities, including tutoring and access to higher education; offering recreational activities, such as sports, drama, and social clubs; developing vocational and job skills and helping with job placement; and providing community service opportunities.

Many of these approaches are encompassed in the Pregnancy Prevention Program of the Children's Aid Society in New York. This is a long-term, holistic, multidimensional adolescent sexuality and pregnancy prevention program for youths, parents, and adults. Its many components include job clubs and career awareness; family life and sex education; medical and dental services; mental health services; education and tutoring; guaranteed college admission upon completion of high school in some locations; lifetime individual sports; and self-expression through the arts. A 1995 study of the program found that it had positive effects on participants-delaying initiation of sex, increasing use of condoms among those who were having sex, and decreasing pregnancy rates.
Similarly, the Teen Outreach Program (TOP), currently managed by the Cornerstone Consulting Group, is being implemented in about 125 sites around the country in school-based and out-of-school youth programs aimed at 12- to 17-year-olds. TOP combines life skills and adolescent reproductive health education with youth involvement in community service. An educational component occurs in small groups with a facilitator who also serves as a mentor. Studies have shown that the program helps reduce pregnancy rates.

While evaluations lag behind promising practices, communities can find what works and then integrate the research and lessons learned from effective programs into local strategies and plans of action.

Improving Media Images

Communities and families should support advocacy campaigns to encourage responsible portrayals of sexuality in television, movies, and other mass media.

Campaigns that address teen sexuality can be direct or indirect. Plain Talk is one example of how caring adults take a direct approach in presenting clear, strong, and positive messages to teens. The Kaiser Family Foundation has successfully taken an indirect approach by persuading some television shows to include more realistic story lines that deal with adolescent reproductive health. Increased efforts to work with screenwriters, musicians, producers, advertisers, and other opinion molders to put different media images and messages before teenaged audiences should be pursued.

Parents can also use television and other mediums of popular culture, even controversial news events, to talk more, and more openly, with their children about sex and its consequences. In Families Matter, a publication issued by the National Campaign to Prevent Teen Pregnancy, Brent C. Miller found, "While parents cannot determine whether their children have sex, use contraception, or become pregnant, the quality of their relationships with their children can make a real difference."24

Next Steps: Practicing What We Know

The unacceptably high rates of teen childbearing can be reduced, as evidenced by the promising dip in recent years. However, much work remains to be done to ensure that the downward trend continues. Fortunately, more information is becoming available to help identify young male and female teens who are at risk for early parenthood. We also have better information to help us curb the spread of sexually transmitted diseases that threaten growing numbers of young Americans. And we know more about effective practices that have promising evaluation results for community-based programs that can be replicated throughout the nation.

Taking the measures that we have outlined-and reaping the benefits they can bring-is contingent upon recognizing that the physical development of teens is often out of sync with their emotional and cognitive development. More important, they are often exposed to inconsistent and confusing messages about sex and sexuality from parents, schools, communities, and the media. These realities are not going to disappear. But growing public recognition of the negative consequences of unprotected sex and the role of parents and communities in helping young people to acquire the skills to protect themselves gives us an opportunity to reinforce the hopeful trend that is reducing the incidence of children having children. We cannot fail to capitalize on this opportunity.

Myths and Facts About Teens and Sex

Opinion and myth abound regarding the cause and extent of teen pregnancy and births. The issues, fueled by media coverage and by personal experience and observation-and the emotional nature of the topic-are often clouded by erroneous assumptions. Over the past decade, however, careful studies have been able to examine and to measure more objectively adolescent sexuality in the United States. By asking teenagers more directly about their own views on sex, pregnancy, and childbearing-and by reassessing the male role in teen pregnancy prevention-many popular beliefs on the subject have been found to be unsupported by facts. Drawing on recent research, here are some common misperceptions and the facts that help correct them.

Sex education and access to contraception tend to increase sexual activity.
In programs that provide information about both contraception and abstinence, evaluators have found no increase in sexual activity. Indeed, some programs that include information on contraception were found to delay initiation of sexual activity. A review of 47 diverse programs found that sex education not only tended to delay the onset of sexual activity, but it also appeared to reduce the number of sexual partners, the number of unplanned pregnancies, and the rates of sexually transmitted diseases.

The high incidence of teen births is a new development in America.
The rate of teen births in the United States has been high for a long time. In the 1950s, the rate was as high as 90 births per 1,000 young women ages 15 to 19. By 1986, the rate had declined to 50, but by 1991, it had risen again to 62. What has changed is the proportion of births to unmarried teens. In 1960, only 15 percent of teen births were to unmarried teens, but in 1996, the figure was 76 percent.

Most Americans don't believe that teens should have access to birth control measures.
An overwhelming majority of Americans-73 percent-agree that if teens are sexually active, then they should have access to contraceptives. Among adult Americans, however, 95 percent say that it is important for teens to receive a strong message from society that they should abstain from sex at least until they are out of high school, including 78 percent who say that this is "very important."

Teenagers don't care about what parents think or say.
Young people rank parents as the preferred source of information about sex and health. They also rank parents as the most trusted source, and 1 out of 2 teenagers say that they trust their parents most for reliable and complete information about birth control. Only 1 in 10 say that they trust a friend most. When asked about the reasons why teenage girls have babies, about 3 out of 4 teenagers cited a lack of communication between a girl and her parents.

The recent decline in the Teen Birth Rate is due to an increase in abortions.
Along with pregnancy and birth rates, abortion rates also have declined. The teen abortion rate (number of abortions per 1,000 females ages 15 to 19) fell from 41 in 1990 to 30 in 1995. Of course, preventing pregnancies will reduce reliance on abortion to avoid unwanted births.

Teen pregnancy is only a problem of minority populations.
Every year, 1 million young females in the United States get pregnant. Just over half of those pregnancies result in births; one-third result in abortions; and about one-sixth result in miscarriages. Consequently, the United States has the highest teen pregnancy, teen birth, and teen abortion rates of any industrialized nation. In 1997, about 45 percent of mothers ages 15 to 19 were white, 27 percent were black, 25 percent were Hispanic, and 3 percent were from other racial or ethnic groups. From 1991 to 1996, the Teen Birth Rate for blacks fell more sharply than for whites or Hispanics and is currently the lowest ever recorded.

Section 3

• Teen birth rate (births per 1,000 females ages 15-19)

• Percent change in teen birth rate (births per 1,000 females ages 15-19)

• Birth rate for younger teens (births per 1,000 females ages 15-17)

• Percent of teen births that are repeat births

• Teen births as percent of all births

• Percent of births to teens receiving inadequate prenatal care

• Gonorrhea rate (cases per 100,000 females ages 15-19)

Teen birth rate
(births per 1,000 females ages 15-19)

Scroll down for individual state ranks. 

Percent change in teen birth rate
(births per 1,000 females ages 15-19)

Scroll down for individual state ranks.  

Birth rate for younger teens
(births per 1,000 females ages 15-17)

Scroll down for individual state ranks. 

Percent of teen births that are repeat births

Scroll down for individual state ranks.

Teen births as percent of all births

Scroll down for individual state ranks.

Percent of births to teens receiving inadequate prenatal care

Scroll down for individual state ranks.

Gonorrhea rate (cases per 100,000 females ages 15-19)

Scroll down for individual state ranks.

Section 4

Press ReleaseFact Sheet

News - Press Release

Hold for Release: CONTACT: Ryan McDay 202-667-0901
January 20, 1999 (10:00am) Diane Camper 410-223-2948

Special KIDS COUNT Report Provides Recommendations on Reducing Teen Births & Represents Most Comprehensive State-by-State Analysis of Data on Teen Sexual Activity

WASHINGTON, D.C.: With four out of 10 U.S. teen women becoming pregnant before age 20, the nation must redouble its efforts to continue reducing teen births, according to a report released today by the Annie E. Casey Foundation.

With demographic projections suggesting that the downward trend in the number of teen births could reverse itself early in the next decade, the report warns against complacency in the movement to reduce teen pregnancies.

The publication, When Teens Have Sex: Issues and Trends, a KIDS COUNT Special Report, describes the impact teen pregnancy has on the nation and outlines a series of recommendations designed to help communities and families reduce teen pregnancy. In addition, the report offers the most recent data on teen pregnancy, childbearing and STD rates, and provides detailed state by state data on teen sexual activity.

"While recent declines in the pregnancy and birth rates are encouraging, it would be a mistake to think that the U.S. no longer needs to be concerned about teen pregnancy," said Annie E. Casey Foundation, President Douglas W. Nelson. "The information in this report must be nothing less than a wake-up call, giving us an opportunity to reinforce a hopeful trend in reducing the incidence of children having children."

The report also renews a call by advocacy groups for a national goal of an additional one-third reduction in the teen birth rate by the year 2005.

Rates Too High, Consequences Severe

According to When Teens Have Sex, roughly 40 percent of American girls in their teen years become pregnant before age 20. Moreover, the one million pregnancies that occur each year among women ages 15 to 19 result in nearly 500,000 teen births - a serious economic and social challenge for the United States.

"The U.S. has the highest teen birth rate among developed nations," said KIDS COUNT Program Coordinator William O'Hare.

"The next closest, the United Kingdom, has a teen birth rate that is only about half that of America. The problem of teen births is evident in every state. In fact, every U.S. state has a birth rate that is higher than that of the United Kingdom."

The report notes that despite recent downward trends, the teen birth rate in 1996 is still higher than it was a decade earlier, and that demographic trends suggest that the number of births to teens is likely to increase by as much as 14 percent by the year 2005.

"As the children of the "baby boomlet" swell the ranks of American teenagers over the next few years, the absolute number of babies born to teenagers is likely to increase even if the birth rate remains constant," said O'Hare.

The report states that more than 75 percent of all unmarried teen mothers went on welfare within five years of the birth of their first child. In addition, the report notes that in 1996, the poverty rate for children born to teens was 42 percent, twice the overall rate for children.

"We cannot afford to take the issue of teen pregnancy lightly. Children born to teenage parents are more likely to be of low birth rate, to suffer with inadequate health care, to leave high school without graduating and are more likely to be poor, thus perpetuating a cycle of unrealized potential," said Annie E. Casey Plain Talk Program Director Debra Delgado.

Recommendations for Communities and Families

When Teens Have Sex charges that the nation's high rates of teen pregnancy and childbearing can be reduced through unwavering commitment and aggressive action by parents and community leaders. The report outlines a series of recommendations for communities and families, including:

• Communities and families need to provide accurate, clear, and consistent information about how to reduce risk-taking behaviors, such as unprotected sexual activity;

• Communities need to encourage more clear communication from adults, especially parents, on the issue of teenage sexual activity;

• Communities and families need to develop comprehensive, community-wide plans of action for adolescent pregnancy prevention, including adolescent reproductive health services, sex education, and programs to encourage young people to delay childbearing;

• Communities and families need to give young people a real vision of a positive future by investing time and resources to help them acquire good decision-making, communication, and work skills that prepare them for the adult world; and

• Communities and families should support media advocacy campaigns to encourage responsible portrayals of sexuality in television, movies and other mass media.

"Society as a whole must recognize that there is no magic solution for reducing childbearing and STD rates, nor will a single intervention work for all teens," said Delgado. "The human and social costs of children having children is something our nation cannot afford. Therefore, it is essential to continue and expand a range of programs that embrace many strategies."

Programs That Work

When Teens Have Sex notes that much work remains to be done to ensure that the downward trend continues, and highlights a range of community-based programs that embrace many effective strategies which can be replicated nationwide.

"The nation's unacceptably high rates of teen childbearing can be reduced, as evidenced by the promising dip in recent years. But to accomplish this, we need to better support programs that are addressing these issues," said Nelson.

The report highlights several programs across the country which are having a positive impact within the communities they serve. Among these programs is the Annie E. Casey Foundation's Plain Talk initiative, which was implemented in urban neighborhoods in Atlanta, San Diego, Seattle, New Orleans and Hartford.

According to the report, Plain Talk helps young people obtain accurate and straightforward facts about teen pregnancy, sexuality, HIV and AIDS, sexually transmitted diseases, and other matters having consequences which can change young lives forever. Through Plain Talk, adults learn skills to open lines of communication between the generations.

"Today, we know more about effective practices that have shown promising results in community-based programs, and all of us a the Annie E. Casey Foundation believe this information should be shared with parents, educators, policy makers, and community leaders across the country," Nelson said.

The Annie E. Casey Foundation is a private, charitable organization dedicated to helping build better futures for disadvantaged children in the United States. Its primary mission is to foster public policies and community support to meet the needs of vulnerable children and families. Working with neighborhoods and state and local governments, the Foundation provides support for long-term efforts to strengthen services, social networks and other vital aspects of American communities.

For more information, please contact Ryan McDay at 202-667-0901 or Diane Camper at 410-223-2948.

News - Fact Sheet

Teen pregnancy rates are dramatically higher in the United States than in any other country in the industrialized world. The next closest nation, Great Britain, has a teen pregnancy rate that is only half that of the U.S. About 40 percent of American women become pregnant before the age of 20. Contrary to popular belief, most of these pregnancies are unintended.

Since 1990, the teen pregnancy rate in the U.S. has been dropping, from a peak of 117 for every 1,000 young women aged 15 to 19, to 101 in 1995. This 14 percent drop brings the rate to its lowest level since 1975.

Since 1991, the teen birth rate has dropped by 12 percent. The actual number of births to teens dropped by 5 percent--from about 519,000 to less than half a million.

Despite these trends, the United States continues to face significant problems. According to recent estimates, teen pregnancy costs American taxpayers nearly $7 billion per year.

Each family that begins with a birth to a teenager is expected to cost the public an average of about $17,000 a year in some form of support over the next 20 years.

Nearly 80 percent of teen mothers go on welfare. Some 55 percent of all mothers on welfare were teenagers at the time their first child was born.

• Children born to teenage mothers are more likely to suffer severe health problems, and are less likely to receive adequate health care.

• Children born to teen mothers are more likely to drop out of high school. They have lower grade point averages, poor school attendance, and are less likely to go to college. The sons of teen mothers are more likely to end up in jail.

Teens and Sexual Activity

About half of all high school students have had sex at least once.

Between 1990 and 1997, the proportion of high schoolers who were sexually experienced declined from 54% to 48%. Among males the percent sexually experienced declined from 61% to 49%, while the percent of females remained constant at 48%. Among males, the percent of sexually experienced fell from 56% to 43% for whites, from 88% to 80% for blacks and from 63% to 58% for Hispanics.

The decrease in teen births during the 1990's can be attributed to two factors: 1) fewer teens are having sex, and 2) among those having sex, a higher percentage are using contraceptives.

• Recent trends in teen sexual activity and contraceptive use can be attributed to a variety of factors:

• Greater emphasis on delaying sexual activity;

• More conservative attitudes among teenagers about casual sex and out-of-wedlock childbearing;

• Increased fear of sexually transmitted diseases, especially AIDS;

• New popularity of long-lasting contraceptive methods, such as the implant (Norplant) and injectable (Depo-Provera);

• More consistent and correct use of other contraceptive methods; and

• A stronger economy, with better job prospects for young people.

Each year, more than three million teens contract a sexually transmitted disease, accounting for about one-fourth of the 12 million Americans infected annually.

• One-fourth of all new HIV cases each year occur in people aged 13 to 21. Half are among people under 25. A majority of these infections are transmitted sexually.

• In 1996, the national gonorrhea rate per 100,000 females aged 15-19 was 699. In some urban areas, the rate among adolescent females has ranged as high as 6,000 for more than a decade.

• In 1996, the national rate of chlamydia per 100,000 females aged 15-19 was 1,942.

• Gonorrhea and chlamydia are the leading causes of pelvic inflammatory disease (PID), and a common cause of infertility, ectopic pregnancy, and fetal complications including premature births.

When asked why they got pregnant, 78 percent of white and 70 percent of African-American teenage girls reported that lack of communication between them and their parents was the principle factor.

Although 82 percent of adults support required sex education programs in school, only 19 states and the District of Columbia direct their schools to provide such programs. Half of these states mandate the inclusion of abstinence education, but not contraception. 16 states do not require schools to provide information about STDs and HIV/AIDS. Some sex education programs have been shown to delay initiation of sexual activity.

Section 5

Appendix 1Appendix 2Definition and Data StructuresContacts
 

Appendix 1: Teen Abortion Rate by State

This table provides figures for the state-level Teen Abortion Rate from 1992 to 1995 that were used to create the graphs that appear on the state pages. The rates reflect the number of abortions occurring to females ages 15 to 19 per 1,000 females in this age group. Please see the Definitions and Data Sources section for more information on this data series.

Appendix 2: Teen Birth Rate by State

This table provides figures for the state-level Teen Birth Rate from 1980 to 1996 that were used to create the graphs that appear on the state pages. The Teen Birth Rate reflects the number of births to females ages 15 to 19 per 1,000 females in this age group. Please see the Definitions and Data Sources section for more information on this data series.

Definitions and Data Sources

Among Those Who Have Ever Had Sexual Intercourse, Percent Who Have Had No Sexual Intercourse During the Last 3 Months: 1997 is the percentage of males and females who reported having had no sexual intercourse during the 3 months preceding the survey and who were enrolled in high school (9th-12th grades) at the time of the survey. This question was asked only of students who reported ever having had sexual intercourse. This information is available only for 20 states and the District of Columbia.

SOURCE: Kann, L., Kinchen, S.A., Williams, B.I., Ross, J.G., Lowry, R., Hill, C.V., Grunbaum, J., Blumson, P.S., Collins, J.L., and Kolbe, L.J., "Youth Risk Behavior Surveillance-United States, 1997." Morbidity and Mortality Weekly Report, 47(SS-3). Atlanta, GA: Centers for Disease Control and Prevention, 1998.

Birth Rate for Younger Teens: 1996 (births per 1,000 females ages 15-17) is the number of births to teenagers between ages 15 and 17 per 1,000 females in this age group. Data reflect the mother’s place of residence rather than the place where the birth occurred. This measure of teenage childbearing focuses on the fertility of all females ages 15-17, regardless of marital status.

SOURCE: Ventura, S.J., Mathews, T.J., and Curtin, S.C., "Teenage Births in the United States: State Trends, 1991-1996, An Update," Monthly Vital Statistics Report, Vol. 46, No. 11, Supplement 2. Hyattsville, MD: National Center for Health Statistics, 1998, Table 1.

Birth Rate to Females Ages 15-19 by Race/Ethnicity: 1991 and 1996 displays in the first two columns the number of births to teenagers between ages 15 and 19 per 1,000 females in this age group for both 1991 and 1996, total and separately for non-Hispanic whites, blacks, and Hispanics. Rates for blacks include a small number of Hispanic blacks. Persons of Hispanic origin can be of any race. Birth rates are not available for a racial or ethnic group if fewer than 20 births were reported for that group or if the estimate of the number of women in that racial or ethnic group was fewer than 1,000 women. Displayed in the third column is the percent change in each birth rate between 1991 and 1996. Percent change is calculated by subtracting the 1991 birth rate from the 1996 birth rate and dividing the difference by the 1991 birth rate. The results are multiplied by 100 for readability. Data reflect the mother’s place of residence rather than the place where the birth occurred.

SOURCE: Ventura, S.J., Mathews, T.J., and Curtin, S.C., "Declines in Teenage Birth Rates, 1991-97: National and State Patterns," National Vital Statistics Reports, Vol. 47. Hyattsville, MD: National Center for Health Statistics, 1998.

Gonorrhea Rate: 1996 (cases per 100,000 females ages 15-19) is the number of cases of gonorrhea per 100,000 females ages 15-19 reported to the Division of STD (sexually transmitted disease) Prevention, Centers for Disease Control and Prevention, by the STD control programs and health departments in the 50 states and the District of Columbia. Because there are differences across states in case definitions as well as in the policies and systems for collecting data, comparisons of rates between areas should be interpreted with caution. For example, in many states, reporting from public sources (e.g., STD clinics) is more complete than reporting from private sources.

SOURCE: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, "Total Gonorrhea Cases and Rate per 100,000 by State and Age, 1996." Special tabulation by Division of STD Prevention, 1998.

Number of Births to Females Ages 15-19: 1996 and 2005 (Assuming Teen Birth Rate Remains Constant) is the number of births occurring to mothers who were ages 15-19 at the time of the birth. Births for 1996 are reported by the mother’s place of residence rather than the place where the birth occurred. Projection of births for 2005 was calculated by multiplying the 1996 birth rate for females ages 15-19 for each state by the U.S. Bureau of the Census "Series A" projection of the number of females ages 15-19 for each state for 2005. The population projections are consistent with the Census Bureau’s "Middle Series" projection of the national population and are based on state-specific data on births, deaths, international migration, and domestic migration. This projection of teen births is provided to illustrate the effect of changes in the population of teen females on teen births. This projection should be viewed with caution and not interpreted as a forecast. In recent decades, the Teen Birth Rate has been volatile and may change substantially during the 1996-2005 period.

SOURCES: 1996 birth data: National Center for Health Statistics, "Teen Births by Age and Race of Mother, United States and Each State, 1996." Special tabulation by Division of Vital Statistics, 1998. 2005 female population projection: Child Trends tabulations of state projection data from the U.S. Bureau of the Census (online) available at http://www.census.gov/population/www/projections/stproj.html.

Number of Females Ages 15-19 by Race/Ethnicity: 1996 is the estimated number of females (by race and Hispanic origin) living in each of the 50 states and the District of Columbia who were between the ages of 15 and 19 as of July 1, 1996. Persons of Hispanic origin may be of any race. Estimates were rounded to the nearest 100.

SOURCE: U.S. Bureau of the Census (online) available at http://www.census.gov/population/estimates/state/sarh/sasrh96.txt.

Percent Change in Teen Birth Rate: 1991-1996 (births per 1,000 females ages 15-19) is the percent change in the Teen Birth Rate from 1991 to 1996. To calculate percent change, the birth rate for 1991 (births per 1,000 females ages 15-19) was subtracted from the birth rate for 1996, and that difference was divided by the birth rate for 1991. The results were multiplied by 100 for readability.

SOURCE: Ventura, S.J., Mathews, T.J., and Curtin, S.C., "Teenage Births in the United States: State Trends, 1991-1996, An Update," Monthly Vital Statistics Report, Vol. 46, No. 11, Supplement 2. Hyattsville, MD: National Center for Health Statistics, 1998, Table 1.

Percent of Births to Teens Receiving Inadequate Prenatal Care: 1996 is the percentage of births that occurred to mothers who received inadequate prenatal care according to the Kessner Index. The Kessner Index is a multidimensional measure that examines when prenatal care began in terms of the total number of prenatal visits made by the mother as well as the gestational age of the infant. Care is classified as "adequate," "intermediate," or "inadequate." Adequate care is care that was begun in the first trimester with an appropriate number of prenatal care visits consistent with the length of gestation. Women classified as having inadequate care include all women who began care in the third trimester plus women whose care began earlier but who had four or fewer visits depending on the length of the pregnancy. Intermediate care is the classification for all other combinations of care, visits, and length of gestation. For more information on the Kessner Index, see Kessner, D.M., Singer J., Kalk C.E., Schesinger, E.R. (1973), "Infant Death: An Analysis by Maternal Risk and Health Care," in Contrasts in Health Status, Volume 1. Washington, D.C.: U.S. Government Printing Office.

SOURCE: National Center for Health Statistics, "Births to Mothers Aged 15 to 19 by Adequacy of Care and Race of Mother, United States and Each State, 1996." Special tabulation by Division of Vital Statistics, 1998.

Percent of High School Students Who Have Ever Had Sexual Intercourse: 1997 is the percentage of males and females who reported ever having had sexual intercourse in their lifetime and who were enrolled in high school (9th-12th grades) at the time of the survey. This information is available only for 20 states and the District of Columbia.

SOURCE: Kann, L., Kinchen, S.A., Williams, B.I., Ross, J.G., Lowry, R., Hill, C.V., Grunbaum, J., Blumson, P.S., Collins, J.L., and Kolbe, L.J., "Youth Risk Behavior Surveillance-United States, 1997." Morbidity and Mortality Weekly Report, 47(SS-3). Atlanta, GA: Centers for Disease Control and Prevention, 1998.

Percent of High School Students Who Have Had Four Or More Sexual Partners During Their Lifetime: 1997 is the percentage of males and females who reported having had four or more sexual partners during their lifetime and who were enrolled in high school (9th-12th grades) at the time of the survey. Information is available only for 20 states and the District of Columbia.

SOURCE: Kann, L., Kinchen, S.A., Williams, B.I., Ross, J.G., Lowry, R., Hill, C.V., Grunbaum, J., Blumson, P.S., Collins, J.L., and Kolbe, L.J., "Youth Risk Behavior Surveillance-United States, 1997." Morbidity and Mortality Weekly Report, 47(SS-3). Atlanta, GA: Centers for Disease Control and Prevention, 1998.

Percent of High School Students Who Used a Condom During Last Sexual Intercourse: 1997 is the percentage of males and females who reported using a condom during last sexual intercourse and who were enrolled in high school (9th-12th grades) at the time of the survey. This question was asked only of students who reported being currently sexual active (meaning they had engaged in sexual intercourse during the 3 months preceding the survey). This information is available only for 20 states and the District of Columbia.

SOURCE: Kann, L., Kinchen, S.A., Williams, B.I., Ross, J.G., Lowry, R., Hill, C.V., Grunbaum, J., Blumson, P.S., Collins, J.L., and Kolbe, L.J., "Youth Risk Behavior Surveillance-United States, 1997." Morbidity and Mortality Weekly Report, 47(SS-3). Atlanta, GA: Centers for Disease Control and Prevention, 1998.

Percent of Teen Births That Are Repeat Births: 1996 is the percentage of births that were second or higher order births to mothers who were between the ages of 15 and 19 at the time of the birth. The data are reported by the mother’s place of residence rather than the place where the birth occurred. Percentages are based on those birth certificates on which birth order is reported. Data for Connecticut should be viewed with caution because birth order was not stated on more than 13 percent of certificates of births to teen mothers.

SOURCE: National Center for Health Statistics, "Births to Mothers Aged 15 to 19 by Birth Order and Race of Mother, United States and Each State, 1996." Special tabulation by Division of Vital Statistics, 1998.

Percent of Teen Births That Occurred to Unmarried Teens: 1996 is the percentage of all teen births occurring to unmarried females between the ages of 15 and 19 at the time of the birth. Marital status is obtained from a question on the birth certificate in 45 states. The mother’s marital status is inferred for California, Connecticut, Michigan, Nevada, and New York from other birth certificate information. Births are reported by the mother’s place of residence rather than the place where the birth occurred.

SOURCE: National Center for Health Statistics, "Births to Mothers Aged 15 to 19 by Marital Status and Race of Mother, United States and Each State, 1996." Special tabulation by Division of Vital Statistics, 1998.

Smoking Among Teenage Mothers: 1990/91 and 1995/96 is the percentage of teen mothers ages 15-19 who smoked during pregnancy. The percentages shown are the averages for 1990 and 1991 data and for 1995 and 1996 data, respectively. Two-year averages were used to provide more reliable state estimates. Also shown is the percent change between the two time periods. The percent change was calculated by subtracting the unrounded 1990/91 rate from the unrounded 1995/96 rate and dividing the difference by the 1990/91 rate. Data for smoking in 1990/91 are not available for California, Indiana, New York, Oklahoma, and South Dakota. Data for smoking in 1995/96 are not available for California, Indiana, New York, and South Dakota.

SOURCE: Mathews, T.J., "Smoking During Pregnancy, 1990-96," National Vital Statistics Reports, Volume 47, No. 10. Hyattsville, MD: National Center for Health Statistics, 1998.

Teen Abortion Rate: 1992-1995 (number of abortions per 1,000 females ages 15-19) is the number of abortions occurring to teenagers ages 15 to 19 per 1,000 females in this age group. Abortions are reported by the state in which the abortion occurred (state of occurrence), not the state in which the female resided (state of residence). These rates should be viewed with caution because in many states a substantial percentage of abortions are performed on persons who actually reside in another state. Rates are not available for states not reporting age of female receiving the abortion. Rates were calculated by Child Trends, using data on the number of abortions from the Centers for Disease Control and Prevention and population estimates from the U.S. Bureau of the Census. To calculate the Teen Abortion Rate, the number of reported abortions was divided by the population of females ages 15-19 in each state and then multiplied by 1,000.

SOURCES: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. 1995 abortion data: Koonin, L.M., Smith, J.C., Ramick, M., and Strauss, L.T., "Abortion Surveillance-United States, 1995," Morbidity and Mortality Weekly Report, 47(SS-2). Atlanta, GA: Centers for Disease Control and Prevention, 1998. 1993 and 1994 abortion data: Koonin, L.M., Smith, J.C., Ramick, M., Strauss, L.T., and Hopkins, F.W., "Abortion Surveillance-United States, 1993 and 1994," Morbidity and Mortality Weekly Report, 46(SS-4). Atlanta, GA: Centers for Disease Control and Prevention, 1997. 1992 abortion data: Koonin, L.M., Smith, J.C., Ramick, M., and Green, C.A. "Abortion Surveillance-United States, 1992," Morbidity and Mortality Weekly Report, 45(SS-3). Atlanta, GA: Centers for Disease Control and Prevention, 1996. 1992-1995 population data: U.S. Bureau of the Census (online) available at
http://www.census.gov/population/www/estimates/st_sasrh.html.

Teen Birth Rate: 1996 (births per 1,000 females ages 15-19) is the number of births to teenagers ages 15 to 19 per 1,000 females in this age group. Data reflect the mother’s place of residence rather than the place where the birth occurred. This measure of teenage childbearing focuses on the fertility of all females ages 15-19, regardless of marital status. We did not include births to females under age 15 in this analysis, since less than 3 percent of teen births occurred to females who were less than 15 years old.

SOURCE: Ventura, S.J., Mathews, T.J., and Curtin, S.C., "Teenage Births in the United States: State Trends, 1991-1996, An Update," Monthly Vital Statistics Report, Vol. 46, No. 11, Supplement 2. Hyattsville, MD: National Center for Health Statistics, 1998, Table 1.

Teen Births as Percent of All Births: 1996 was calculated by dividing the number of births to females ages 15-19 by the total number of births to women of all ages. Births are reported by state of residence of the mother, not by state of occurrence of the birth.

SOURCE: Ventura, S.J., Martin, J.A., Curtin, S.C., and Mathews, T.J., "Report of Final Natality Statistics, 1996," Monthly Vital Statistics Report, Vol. 46, No. 11, Supplement. Hyattsville, MD: National Center for Health Statistics, 1998, Table 10.

Youths Ages 12-19 Lacking Health Insurance: 1995 is the percentage of females and males ages 12-19 who were not covered by private or public health insurance. Figures shown here represent an average of yearly data reflecting experience from 1993 through 1997.

SOURCE: Urban Studies Institute, University of Louisville, special tabulations of the 1994-1998 March Current Population Surveys.

Contacts

References:

©1999 The Annie E. Casey Foundation

The Annie E. Casey Foundation

701 St. Paul St. Baltimore, MD 21202

ph: 410-547-6600 fax: 410-547-6624 e-mail: webmail@aecf.org

Resources

For more information about the Plain Talk Initiative and the programs cited in this Special Report, contact the individuals listed here.

Plain Talk

Atlanta

Cheryl Boykins The Center for Black

Women’s Wellness

477 Windsor Street, SW

Room 309

Atlanta, GA 30312

(404) 688-9202

(404) 880-9435 (fax)

Plain Talk/ Hablando Claro

Hartford

Flora Parisky Hartford Action Plan

on Infant Health

30 Arbor Street

Hartford, CT 06106

(860) 236-4872

(860) 232-8321 (fax)

Plain Talk

New Orleans

Tammi Flemming St. Thomas/Irish Channel Consortium

812-814 St. Andrew Street

New Orleans, LA 70130

(504) 524-1700

(504) 595-5064 (fax)

Hablando Claro

San Diego

Marta Flores Logan Heights Family Health Center

1809 National Avenue

San Diego, CA 92113

(619) 234-8171

(619) 237-1856 (fax)

Plain Talk

Seattle

Howard Martin Neighborhood House

905 Spruce Street

Jesse Epstein Building

Seattle, WA 98104

(206) 461-8379

(206) 461-3857 (fax)

Pregnancy Prevention Programs

Dr. Michael A. Carrera

Director Children's Aid Society

350 E 88 Street

New York, NY 10128

(212) 876-9716

casntc@IBM.net

Preventing Adolescent Pregnancy

Linda Lazier

Director Girls, Incorporated

441 W Michigan Street

Indianapolis, IN 46202

(317) 634-7546, ext. 34

llazier@girls-inc.org

Teen Outreach Program

Lynda M. Bell

National Coordinator The Cornerstone Consulting Group, Inc.

1 Greenway Plaza

Suite 550

Houston, TX 77063

(713) 627-2322

hn7602@handsnet.org

Teen Services Program

Marion Howard, PhD

Clinical Director Grady Health System

80 Butler Street, SE

PO Box 26158

Atlanta, GA 30335-3801

(404) 616-3513

Endnotes

1. The National Campaign to Prevent Teen Pregnancy, Whatever Happened to Childhood? The Problem of Teen Pregnancy in the United States, May, 1997; Maynard, Rebecca A. (Ed.), Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy, The Urban Institute Press, 1997.

2. Whatever Happened to Childhood? p.3.

3. Ibid. p. 11; Kids Having Kids (Urban Institute), p. 288.

4. Maynard, Rebecca A. (Ed.), Kids Having Kids: A Robin Hood Foundation Special Report on the Costs of Adolescent Childbearing, 1996, p. 52

5. The Alan Guttmacher Institute, press release 10/15/98; The Guttmacher Report on Public Policy, October, 1998, pp. 6-8.

6. Youth Risk Behavior Surveillance--United States, 1997, published, 8/14/98; Chronic Disease and Health Promotion Reprints from the MMWR, 1990-1991 Youth Risk Behavior Surveillance System.

7. Whatever Happened to Childhood? p. 4.

8. Kids Having Kids (Urban Institute), pp. 44-45.

9. Ibid.

10. Annie E. Casey Foundation, 1998 KIDS COUNT Data Book, p. 23.

11. McLanahan, Sara and Sandefur, Gary, Growing Up With a Single Parent, Harvard University Press, 1994, pp. 1-2.

12. U.S. General Accounting Office, June 1998, Teen Mothers: Selected Socio-Demographic Characteristics and Risk Factors, p. 14.

13. Kahn, Joan R. and Anderson, Kay E., Intergenerational Patterns of Teenage Fertility; Demography, Vol.29, No. 1, 1992, pp. 39-58;

14. Wertheimer, Richard and Moore, Kristin, Childbearing by Teens: Links to Welfare Reform, No. A-24 in Series, "New Federalism: Issues and Options for States," The Urban Institute, 1998.

15. Kids Having Kids (Urban Institute), p. 107.

16. Ibid. p. 303.

17. Annie E. Casey Foundation, 1993 KIDS COUNT Data Book, p.13.

18. U.S. Department of Health and Human Services, Healthy People 2000, National Health Promotion and Disease Prevention Objectives, p. 496.

19. Whatever Happened to Childhood? p.4.

20. Kirby, Douglas, Sex Education in the Schools, Sexuality and American Social Policy: A Seminar Series, published by the Henry J. Kaiser Family Foundation, 1994, p. 11.

21. Childbearing by Teens: Links to Welfare Reform, p. 5.

22. National Survey of Teens: Teens Talk About Dating, Intimacy, and Their Sexual Experiences, Henry J. Kaiser Family Foundation, 1998, p. 13.

23. Sexually Transmitted Disease Surveillance, 1997, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Sept. 1998, p. 6.

24. Miller, Brent C., Families Matter: A Research Synthesis of Family Influences on Adolescent Pregnancy, released by The National Campaign to Prevent Teen Pregnancy, April, 1998, p. 1.