US Teen Birth Rates Have Declined, but Disparities Remain

Troy Brown, RN

April 28, 2016

Birth rates among adolescents aged 15 to 19 years have declined by 61% in the United States, going from 61.8 per 1000 in 1991 to 24.2 births in 2014. The 2014 rate is the lowest teen birth rate ever recorded. Nevertheless, racial/ethnic and geographic disparities remain, according to a new report from the Centers for Disease Control and Prevention (CDC).

Lisa Romero, DrPH, from the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia, and colleagues present their findings in an article published in the April 29 issue of the Morbidity and Mortality Weekly Report.

Teenage childbearing carries enormous health, economic, and social consequences for mothers and their children, as well as costs of approximately $9.4 billion annually in the United States.

Despite the decreases in birth rates among adolescents, troubling trends remain. For example, whereas the teen birth rate decreased among Hispanics, it remained approximately twice as high for Hispanic and non-Hispanic black teenagers compared with non-Hispanic white teenagers.

That said, between 2006 and 2014, the largest declines were among Hispanics (51%), followed by non-Hispanic blacks (44%) and non-Hispanic whites (35%).

Many of the geographic and socioeconomic disparities, including low parental education and limited education and employment opportunities, that drive these differences continue in regions with higher proportions of racial and ethnic minorities.

To examine trends in births for teenagers aged 15 to 19 years by race/ethnicity and geography, the researchers analyzed National Vital Statistics System data at the national (2006 - 2014), state (2006 - 2007 and 2013 - 2014), and county (2013 - 2014) levels. They also studied data from the American Community Survey (2010 - 2014) to characterize socioeconomic indicators previously linked to adolescent births.

The overall birth rate for adolescents fell significantly in every state between 2006-2007 and 2013-2014, with declines that ranged from 13% in North Dakota to 48% in Arizona. Moreover, the birth rate ratio among black teenagers compared with white teenagers fell in 28 states, and the birth rate ratio for Hispanic teenagers also fell compared with white teenagers in 37 states.

At the county level, adolescent birth rates for 2013 to 2014 ranged from 3.1 to 119.0 per 1000 females aged 15 to 19 years. Unemployment rates were higher and education level and family income were lower in counties with higher adolescent birth rates.

Public Health Implications

Interventions at the community level must address public health practices, and those that improve social conditions that are associated with high teenage birth rates might also be effective at reducing racial/ethnic and geographic teenage birth disparities in the United States, according to the authors. Data obtained at the state and county levels can help identify those populations with the highest need, they explain.

"Despite substantial declines in teen births in the United States, disparities by race/ethnicity and geography persist, highlighting the continuing need for teen pregnancy prevention efforts. Understanding disparities in teen birth rates and the multiple causes at the local level can help target effective interventions for populations with the greatest need," the authors conclude. "Ongoing efforts to integrate social determinants of health into teen pregnancy prevention program play a critical role in addressing racial/ethnic and geographical disparities observed in teen births in the United States."

The US Department of Health and Human Services Office of Adolescent Health partnered with the CDC during 2010 to 2015 to establish community-wide programs in nine areas with high teen birth rates. Their activities and programs include "presenting community-specific teen birth data to civic leaders; encouraging health care providers to offer evening and weekend hours and low-cost services to increase access; having teen-focused, culturally appropriate materials available during health care visits; and implementing evidence-based teen pregnancy prevention programs to reach teens of both sexes both inside and outside of schools (e.g., through Job Corps, alternative schools, churches, and community colleges)," the authors add.

Morb Mortal Wkly Rep. 2016;65:409-414. Full text

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