Exploring the Predictors that may Influence the Variations in Teen Birth Rates byState

Deepthi Moparthi, MBBS, MPH, M. Elizabeth Fore, Ph.D., Monica Mispireta, MD, MHS, Ph.D. (C)., Neill F. Piland, Dr.P.HIdaho State University, Master of Public Health Program

This study found that, when keeping all other factors constant •Teen birth rate was directly associated with number of uninsured adults (p < 0.001) •Teen birth rate was directly associated with level of religiosity (p < 0.001) •Teen birth rate was inversely associated with average freshman graduation rate (p = 0.054)•Teen birth rate was inversely associated with the supply of abortion providers in the state (p = 0.011).

•No statically significant relationship between policies on sex education and parental consent for abortion with the teen birth rates by state.

Source: CDC/NCHA. National Vital Statistics System, 2010

Bivariate Analysis of Variables

  Bivariate Analysis  

Factors

β-coefficient*

95%Confidence Interval

p-value**

State Policy   

Abstinence only sex education 2.727 -1.761 7.216 0.228Comprehensive sex education 1.909 -2.743 6.561 0.413

Required Parent Consent for Abortion 2.844 -0.818 6.507 0.125

 Economy  

Gini Coefficient 0.898 0.113 1.682 0.026

 Education

Average Freshman Graduation Rate -0.355 -0.551 -0.160 0.001

 Social Factors

Religiosity 0.424 0.298 0.549 0.000

Political Preferences - Democratic statePolitical Preference – Republican State -6.578 -9.468 -3.689 0.000

 Health Services

Percentage of uninsured 0.784 0.438 1.131 0.000

Percentage of counties without a known abortion provider 0.088 0.029 0.146 0.004

Number of abortion providers per state -0.014 -0.350 0.008 0.210

Multivariate Analysis of Variables with Significant Outcome

 

Multivariate Analysis  

   

Factors Predicting Teen Birth Ratesβ-coefficient*

95%Confidence Interval

p-value**

Education

 Average Freshman Graduation Rate -0.131 -0.264 -0.021 0.054

Social Factors

  Religiosity 0.379 0.141 0.325 0.000

Health Services

  Percentage of uninsured 0.309 0.233 0.666 0.000

  Number of abortion providers -.0143 -0.025 -0.003 0.011

Birth rate for women aged 15 – 19. By state for 2010

*β-coefficient shows the strength of association**P<0.05 is said to be significant

Introduction

The U.S. teen birth rate declined in 2010, reaching a historic low at 34.3 births per 1000 women aged 15-19. Despite the steady decline in birth rates, the United Nations reports that the teenage pregnancy rate in the United States continues to be nearly nine times higher than the majority of other developed nations (Hamilton, Martin, Ventura, 2011). Numerous factors were said to contribute to high rate of teenage births in the U.S. Various individual-level factors that are attributed to the disparities in teen birth rate include, race and ethnicity, family structure, single parent household, and behavioral factors such as early sexual activity

Despite a significant decline of 44% in the U. S. teen birth rate from 1999-2010, the continuing wide range of state specific rates from 15.7 per 1000 teens in New Hampshire to 55.0 births per 1000 teens in Mississippi in 2010 has raised concern about identifying factors influencing state level variation. Teen birth rates were higher in South and Southwest and lower in the Northeast and Upper Midwest. No data is available on possible disparities in teen birth rates of states with various economies, education, social, health care services, and policies of states with regards to sex education programs and abortion policies requiring parental consent.

The aim of this study was to examine the relationship between sex education, abortion policies, socio-demographic factors including education, poverty, conservatism and religiosity, and access to health services and state-level teen birth rates. The findings will impact future policy and funding decisions.

Results

Discussion

Teen birth rates of states with high teen birth rates have lower high school graduation rates, are more religious, and have more uninsured patients and fewer abortion providers. These factors might have played a significant role in the differences in teen birth rates of states. Sex education policies and policies on parental consent for abortion did not have a significant relationship with the teen birth rates by state.

The wide variation in teen birth rates across states and in state specific factors makes implementation of health policies difficult thereby reducing the applicability and effectiveness of adopted policies.

Strengths and Limitations

This study explored the impact that these significant factors could cause in the implementation of various preventive measures and policies to reduce teen birth rates indicating the need for states to address the concerns and perceptions of their conservative populations when planning and implementing prevention programs. As the data obtained for this study included all the population of the U.S., the results of this study can be generalized to all of the U.S. population. The study was limited to the data and information provided by the primary sources. Furthermore this was an ecological study. Individual factors which are beyond the scope of this ecological study could not be assessed.