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TRENDS IN ABORTION ATTITUDE AMONG YOUNG ADULTS: 1977-1993.

Abstract: This study examined attitudes toward abortion among young adults, ages 18 to 25, from 1977 to 1993, and attempted to determine whether specific Supreme Court abortion rulings influenced the opinions about abortion among these age groups. Multivariate techniques were used to evaluate trends over time and pattern of change for each age category. Data for the study were taken from the General Social Survey (GSS), a national survey conducted in 1977, 1985, 1988, 1990, 1991, and 1993. Six attitude items in the GSS formed the abortion scale and measured the respondents' attitudes. Eighteen-year-olds were the most pro-choice and 21-year-olds the least. Males were pro-choice more than females. The frequency of attending religious services emerged as the strongest predictor in the regression model. Implication of these results for effectivE: health planning for health professionals, teachers, and parents of young adults are discussed.

Abortion is one of the most controversial social issues of our time. The issue has been a persistent one in history, but in the past 20 years in the United States the debate seems to have polarized. One view -- known as "pro-life" -- portrays abortion as the wanton slaughter of innocent life. The other view -- "pro-choice" -- considers abortion an option that must be available to women if they are to control their own reproductive lives. The nation appears to be split over the question of whether abortion should be available on demand or only under certain conditions (Hollis and Morris, 1992). The 1986 Washington Post-ABC News poll found that 54% of Americans believed that women should have the right to an abortion no matter what, 34% agreed only in certain circumstances, and 10% disagreed in all cases (Collins, 1987). Three years later, a survey by The New York Times -- CBS News, asking similar questions indicated that the statistics had changed only slightly. Forty-one percent of adults contacted believed abortion should be generally available, while 15% contended that abortion should be illegal under all circumstances (New York Times, 1989).

Abortion has been legal since the 1973 Supreme Court decision of Roe vs. Wade that declared that a woman has a constitutional right to privacy, which includes an abortion. There are studies, which indicate that the Court is a significant factor in shaping and changing deeply held beliefs (Franklin and Kosaki, 1989; Mondak, 1992; Cannon, 1992). The Supreme Court consistently upheld the legality of abortion in a series of cases in the early and mid-1980s, and the trend has continued in the last several years. The 1989 decision in Webster vs. Reproductive Health Services upheld the constitutionality of Missouri's more restrictive abortion statutes, which gave more power to state legislatures and courts in regulating abortion. The most significant of the more recent Supreme Court cases on abortion was Planned Parenthood of Southeastern Pennsylvania vs. Casey, decided in June 1992. The ruling reaffirmed the consitutionality of Roe vs. Wade, but it also declared that a woman's legal right to an abortion was not unduly restricted by the provisions of Pennsylvania's law. Since the Webster vs. Reproductive Health Services (1989) and Planned Parenthood of Southeastern Pennsylvania vs. Casey (1992) rulings, the debate over a woman's right to abortion has intensified.

Abortion is more common than many realize. Approximately 1.5 million abortions are performed each year in the United States. One out of four pregnancies and half of all unintended pregnancies end in abortion. Eighty percent of the women who have abortions are unmarried, and nearly 63% are between the ages of 15 and 24 (Moore and Snyder, 1996). Legalized abortion also is a major issue on college campuses. One out of ten college females has had an abortion (Leatherman, 1987). Fourteen percent of females aged 15 to 19 and 27% of females aged 20 to 24 have had abortions at some point in their lives. The majority of males and females approve of abortion regardless of circumstances, with approval rate of 96% when the woman's life is endangered by the pregnancy (Wright and Roger, 1987). Hollis and Morris (1992) found that pro-choice advocates were stronger in their beliefs if they had previous experience with abortion while a pro-life stance was stronger among those who had firmer religious affiliations as measured by church attendance.

As the debate over abortion continues, it is worthwhile to examine whether approval of legalized abortion has remained stable, declined, or increased among young adults (18 to 25 years) over the past sixteen years, especially after the Webster and Casey decisions. One might expect to find support for legalized abortion to be higher due to these Supreme Court rulings. Numerous studies have examined the trend in attitudes of Americans toward abortion in the last three decades. Approval of legalized abortion increased between 1965 and 1975 with the largest shift occurring between 1965 and 1970 (Beniger, 1984; Granberg and Granberg, 1985). Lesser changes were found between 1975 and 1980 (Ebaugh and Haney, 1980; Granberg and Granberg, 1980), and there was a significant though small drop in approval from 1980 to 1985 (Gillespie, Ten Vergert, and Kingma, 1988). Not since 1985 has a study based on a national sample been conducted which examined the attitudes of young adults toward abortion. The present research adds to our knowledge by examining young adults' (18-25 years) change in attitudes toward abortion between 1977 and 1993. By using the National Opinion Research Center's (NORC) General Social Survey (GSS) data a more comparable assessment over the seventeen-year period will be possible. The NORC, which was founded in 1941 and supported by grants from the National Science Foundation, conducts the GSS. The GSS's contain a wide range of demographics covering respondent and parental characteristics;behavioral items such as group membership and voting; personal, psychological evaluations of happiness, misanthropy, life satisfactions, and other aspects; and attitudinal questions on such public issues as abortions, crime and punishment, race relations, sex roles, and spending priorities. Many GSS questions are replicated according to a fixed rotation pattern. Other items appear on a single survey as part of their topical or International Social Survey Program modules or as methodological experiments. The NORC GSS, since its inception in 1972, has assessed public opinions on legal abortion. Consequently, this data has appeared in a large number of studies on abortion attitudes (Ebaugh and Haney, 1980; Granberg and Granberg, 1980).

In previous studies, demographic variables such as religion, race, and education have been found to be consistently related to pro-life attitudes (Jelen, 1988). Regular church attendance was associated with stronger pro-life attitudes (Bryan and Freed, 1993; Scott and Schuman, 1988). Minorities, especially Blacks and Hispanics, were more pro-life than Caucasians (Hall and Ferree, 1986; Scott and Schuman, 1988), and increased education was positively related to pro-choice attitudes (Szafran and Clagett, 1987). Other demographic variables such as gender, age, and marital status, have been less consistently related to attitudes toward abortion. Males and young, single women were more pro-choice than females and older, married women respectively (Wright and Rogers, 1987). Demographic variables, however, account for only a small percent of variance in abortion attitudes (Granberg and Granberg, 1980; Torres and Forrest, 1988). Psychological variables, such as attitudes toward sex and religion, explain a greater amount of the variance.

The purpose of this study is to examine: (1) the change in attitudes toward abortion over a seventeen-year period from 1977 (after the Roe vs. Wade ruling) to 1993; and (2) use multiple regression analysis in order to control for the effect of various demographic, socioeconomic, and religious variables in approval of legalized abortion. The research questions addressed in this study are: (1) What is the trend in attitude toward abortion of young adult males and females from the 1970s to the 1990s?; (2) Do the Supreme Court's rulings influence attitudes toward abortion among young adults?; (3) Do attitudes toward abortion vary by age and gender? and (4) What factors predict attitudes toward abortion?

METHODOLOGY

Sample: The sample used in this analysis is based on seven national samples of the U.S. population, conducted by the NORC as a part of its GSS. The NORC maintains a national probability sample. GSS has several modules (e.g., social networks, welfare, sociopolitical participation, culture, etc.) that are batteries of questions asked or organized around a single theme. These data on social trends are gathered in order to monitor changes over time. To describe the instrument is beyond the scope of this paper as there are more than 1,924 variables in the survey. The data collection is done by personal interviews. The GSS employ standard field procedures, including interviewer hiring and training by area supervisors in interviewing locations when necessary. Interviewer specifications are communicated by means of an annotated interview schedule and memoranda on specific interviewing problems, thus increasing the internal validity of the data collected. The data collected are made up of three components: Classification, Core and Focus. The Classification content consists of variables that provide means of delineating population groups such as age, sex, education, and income, and is used in the analysis of Core and Focus content. The GSS asks respondents whether they would approve or disapprove of abortion, which appears under the Focus content, under these six different conditions: (1) a woman requests an abortion when there is a strong chance of serious defect in the baby (DEFECT), (2) a woman is married and does not want any more children (NO MORE), (3) the woman's own health is seriously endangered by the pregnancy (HEALTH), (4) the woman became pregnant as a result of rape (RAPE), (5) the woman is not married and does not want to marry the man (SINGLE), and (6) the family has a very low income and cannot afford any more children (POOR). Each item had two attributes, "approve" and "disapprove." Each "approve" response was assigned a score of 1; each "disapprove" response was assigned a score of 2. The Focus content is not repeated on a periodic basis. The six abortion items were repeated in 1977, 1985, 1988, 1989, 1990, 1991, and 1993 and the analysis was restricted to those years. Full probability sampling from the National Opinion Research Center national probability sample was used for the survey years utilized in this study. The sample sizes for the surveys 1977, 1985,1988,1989,1990, 1991, and 1993 were 1,530, 1,534, 1,481, 1,537, 1,372, 1,517, and 1,606 participants respectively. The total sample size of 2,930 was reduced to 2,429, due to the elimination of any cases that had missing values on two or more of the six abortion items ("don't know" and "no response" codes were treated as missing values).

INDEX CONSTRUCTION/ISSUE OF UNIDIMENSIONALITY

In order to assess individuals' attitudes towards abortion, the six items were examined for issues of unidimensionality. Previous studies on abortion attitudes have not resolved the issue of unidimensionality of the items. Some studies treated the items as measuring a single dimension (Hall and Ferree, 1986; Combs and Welch, 1982; Finlay, 1985) and others, as measuring two-dimensional scales (Granberg and Granberg, 1980; Barnett and Harris, 1982). These studies used the DEFECT, HEALTH, and RAPE items as a measure of attitude toward abortion for "medical" reasons, and the NO MORE, POOR, and SINGLE items as a measure of attitudes for "social" reasons. Gillespie, Vergert, and Kingma, using the Mokken method of scale analysis, a stochastic extension of Gutman scaling, concluded that the six items were unidimensional and, therefore, created a single scale to measure the changes in abortion attitudes across the three periods they studied (1975, 1980, and 1985) (Gillespie, Vergert, and Kingma, 1988). For the purpose of this study all the items were considered as unidimensional. The dependent was Attitude Towards Abortion -- constructed by summing the six items. The scores therefore could range from 6-12 with lower scores representing pro-choice and higher representing pro-life. Cronbach alpha of the scale was 0.88, indicating moderately high internal consistency (Nunnally, 1978).

The NORC GSS data set contains dozens of potential predictor variables. The, selection of those used herein proceeded primarily from a list of variables considered in the previously published studies The predictor variables used in this study were: age, gender (male = 0, female = 1); religion in which raised (Protestant = 0, Catholic = 1); satisfaction with financial situation (satisfied = 0, not at all/more or less = 1); number of people in the family, education, marital status (currently married = 0, not currently married i.e., widowed, separated, divorced or never married = 1), race (White = 0, Black/other = 1); work status (full-time = 0, not full-time = 1); respondent's view of self as liberal/conservative, family income, attendance at religious services (ranges from never = 0, to more than once per week = 8); whether born in this country (yes = 0, no = 1); size of the place lived (population in thousands); views of life (exciting = 0, routine/dull = 1); and type of place lived when the respondent was 16 years old (ranges from country, nonfarm = 1, to city greater than 250,000 = 6).

RESULTS

The gender distribution of respondents was 45.4% male and 54.6% female participants. The majority of the respondents were Caucasian (81.2%), born in the US (94%), raised as Protestants (60%), and belonged to the working/middle class. Median family income was $20,000-22,499. Mean years of education were high school level (12.55 years). Forty two percent of the participants reported that they attend church at least 2-3 times a month, 15.1% indicated that they never go to church, and 32.4% had strong religious affiliation. Twenty-one percent of the respondents indicated that they resided in a country/farm when they were 16 years old, 32.5% in a town less than 50,000 population, and 46.2% in big cities. Forty-nine percent of the respondents indicated that they feel life to be exciting, 46% as routine, and only 4.7% indicated it to be dull.

AGE AND ATTITUDES TOWARD ABOLITION

The first examination of this study is a comparison of the mean scale scores from 1977 to 1993 for each of the eight age categories (18 to 25 years), in general, and by gender. Abortion attitudes of single year birth cohorts over the seventeen-year period indicated no discernible trend (Figure 1). Change in mean score was greater among the 18, 20, and 22 year-olds having a greater change (approximately 1.5 points) over two or more consecutive survey years than the other categories. Eighteen-year-olds showed greatest approval in their attitudes towards abortion in 1977, and became slightly disapproving until 1989. After the Webster decision the pro-choice sentiment declined in this age group. Twenty-one year-old males and females were the most conservative in their abortion attitudes in 1977. This was true as well in 1985 and 1988 but with the Webster decision their pro-life sentiment escalated. Older respondents (21, 24, and 25 year-olds) exhibited the greater approval in their pro-choice attitudes after the Webster decision than younger individuals.

Next we examined the extent and direction of attitude change for both males and females as we followed single year birth cohorts over time (Table 1). For example, a respondent who is 18 years old in 1977 will be 26 years old in 1985 and 34 years in 1993. A "plus" sign indicates the change in pro-choice direction in subsequent survey years and a "minus" sign in the table indicates pro-life direction. The abortion attitude fluctuated both in the pro-life and pro-choice direction in all ages and both genders. Males were considerably more pro-choice than females in all age groups. The mean scale scores for the seven periods for males and females which measures the amount of change in abortion attitudes is indicated at the bottom of the table. Mean scale scores show that females had lesser change than males.

[TABULAR DATA 1 NOT REPRODUCIBLE IN ASCII]

Mean scores in abortion attitudes are presented by gender, year and age category (Table 2). This table, for example, allows a comparison of the abortion attitudes of all 18-year-olds over the seven survey years. Difference between the two genders in Table I also is apparent. Males were more prochoice than females in all the age groups and years except in 1988 and 1990. Hence, after the Webster decision pro-life sentiment was slightly higher among males than females. Women demonstrated a slight decrease in the pro-life attitudes between 1977 and 1993 as compared to men. The net change was the difference in the mean attitude score between 1977 to 1993. The smallest increase was 0.12 which occurred among the 24-year-old females ar/d the largest increase was 1.60 among the 19-year-old males. Thus, as of 1993, there was a slight increase in pro-choice attitudes among both young boys and girls; the decrease being slightly higher among males than females.

[TABULAR DATA 2 NOT REPRODUCIBLE IN ASCII]

The overall attitude score aggregated for the seven survey years by age category indicated 18-year-olds had greatest approval in their attitudes towards abortion and the 21-year-olds were the most conservative in general. The highest mean in abortion attitude (8.37) occurred among 21-year-olds, and the lowest mean (6.66) occurred with the 18-year-olds. In general, the pro-life attitudes increased from 18-year-olds to 21-year-olds and then showed a pro-choice shift until age 25. The same analysis for males and females separately indicates Et similar trend for males. However, there was no discernable trend for females. Although. the 18-year-old females still had the most favorable attitude (mean = 6.50), the most conservative attitude was among the 24year-olds. Unlike the males, as the females grew older, their abortion attitudes did not show a bigger fluctuation.

How much of an independent impact does age and gender exert on attitudes toward abortion? A multivariate analysis helps answer this question by controlling for the combined effects of other variables that influence abortion attitudes. The results of the regression analysis are summarized in Table 3. Dummy variables were created: place of residence, views of life, race, marital status, class, and work status. Controlling for the effects of the independent variables, no gender difference in attitudes toward legalized abortion were found. Frequency of attendance at religious services had the greatest impact on the predictive value of attitude ([R.sup.2]=0.140). This alone explained approximately 14 percent of the variance. Political views of the respondent, the next variable to enter the model, increased the [R.sup.2] value to 0.182. The next variables to be added in hierarchical order were the number of children present at home, class, strength of religious affiliation, views of life, place of residence, number of persons in the household, and size of the home community. The overall model was significant (F = 47.9, p [is less than] 0.0001). Pro-life individuals in this study were more likely to attend church, have conservative political views, more children, strong religious affiliation, view life as dull, and reside in urban areas and larger communities than individuals who were pro-choice. A coefficient of determination of 0.231 indicated that 23 percent of the variance in attitude was explained by the variables used ill the model. Given the low [R.sup.2], it is clear that other types of intervening variables need to be examined in order to completely understand attitudes toward abortion.

DISCUSSION

The major purpose of this study was to assess the possible extent and direction of a change in abortion attitudes among males and females in young adults from 1977 to 1993. Overall, respondents were generally found to be in favor of allowing a woman to have an abortion no matter what the circumstance. The highest mean of 9.54 is approximately the median score of the scale, indicating that respondents in the present study responded "agree" to at least three of the six abortion items. Surveys in the past have shown that significant difference in conditions for abortions exists (Kondracke, 1989). Young adults tend to agree to abortion if the "woman became pregnant as a result of rape," and is a "mother of three" (Hollis and Morris, 1992). This is attributed to the fact that for many young people the "legal right" to abortion is separate from the moral choice that must be made for each individual case.

Males were slightly more pro-choice than females at all ages (Tables 1 and 2). Mean change in abortion attitude among birth cohorts over time was higher for females than males. Perhaps this greater support by males reflects the socialization process in which males are brought up to feel more in control of their lives than females. The greater support for abortion by males also could indicate that they do not identify themselves as being responsible for a child. Controlling for other independent variables led to no significant gender difference in the regression model. Ages of the respondents also were not significant. It should be noted however, that the largest increase in approval of abortion was among 18-year-olds and the least was among 21-year-olds males and females. When comparing the attitudinal trends across the seven survey years, the net change was highest among the 24-year-old males followed by 19-year-old males and 21-year-old females. In these three age groups change was toward becoming more pro-life. A pro-life trend was observed among the 20, 21, and 22-year-males and 18 and 22-year-old females. After the Webster decision in 1989 and the Casey decision in 1992, the mean scale score declined among the 19, 21, 24, and 25-year-olds and increased among the 18, 20, and 22-year-olds (the greatest increase was among the 22-year-olds). Interestingly, the abortion attitudes among the 23-year-olds remained almost the same after both the Supreme Court rulings. Further, females became more pro-abortion after 1989 in general, whereas males became slightly more pro-life. Numerous factors may be contributing to these changes such as large increases in delayed marriage, divorce and cohabitation, and in non-marital childbearing, but our results indicate that pro-choice sentiment parallel the Webster decision and is on the rise among the majority of young adults in this sample.

Although racial differences among adults have been reported in the literature, a lack of significance in the regression equation indicated that racial differences among young adults in abortion attitudes are explained by the demographic and religious control variables used in the model. It should be noted that racial divergence may well exist in this sample, but when mediated by another measured characteristic, like church attendance, it was not significant. Interestingly, the interaction of gender and race also was not significant. It might be expected that young Blacks who became pregnant before marriage were more likely than Whites to have a pro-life stand as they (Blacks) tended to resolve the pregnancy through abortion (Zelnik and Kantner, 1975). Mean scores that have been aggregated over all survey years show males have a consistently positive relationship between age and mean scores until 21 when this trend reverses. Females, on the other hand, had a higher fluctuation of mean scores with age indicating women are more ambivalent in their opinion than males.

Previous studies indicate that religious affiliation played an important role in shaping attitudes toward abortion. In this analysis three religious variables were used: attending church, religious affiliation, and religion in which raised. Religion in which the respondent was raised was not significant. Frequency of attending religious services was the strongest predictor of abortion attitudes in the regression model. The relatively conservative outlook of those who attend religious services frequently and have strong religious affiliation seems to be consistent with a sociopolitical model of attitude determination. This result confirms previous studies that report that support for antiabortion increases with orthodoxy of religious beliefs (Hollis and Morris, 1992; Bryan and Freed, 1993; Arney and Trescher, 1976; Cook, Jelen and Wilcox, 1993). Education of the respondents was not significantly associated with the prediction of attitude. Studies have indicated that as the number of years of education increases, respondents become more pro-life (Szafran and Clagett, 1987; Secret, 1987). The reason for the failure of education to be a significant factor in this study may be due to the limited variability (SD = 2.35) in this variable.

Urban residence at 16 years of age also was a significant predictor of abortion attitudes. Respondents who resided in urban areas and larger communities (defined by the population of the place in thousands) were more pro-choice compared to those in rural and smaller communities. Although region of residence did not reach significance, North-South differences might be apparent if a separate analysis were done for both regions as indicated by one study (Secret, 1987). A significant association of the variable year to the attitude scale, after statistical controls are introduced indicated that even after taking into account the social and demographic composition of the population between 1977 and 1993, the change in abortion attitude was towards pro-choice among the respondents (negative Beta indicates that as years increased attitudes became pro-choice). This demonstrates that attitude changes in the seventeen year period involved a changed outlook among the young adults.

CONCLUSION

This study, using a national database, examined attitudes toward abortion among young adults (18 to 25 years) 1977-1993. Data were analyzed by age and gender. A "pro-choice trend" in abortion attitudes occurred among both young males and females in the United States from the 1970s to 1990s. While males werE; found to be slightly more pro-choice than females at all ages, these observed differences were not significant. It has been suggested that attitudes toward abortion are influenced by Supreme Court Rulings (Franklin and Kosaki, 1989). This study found that prochoice sentiment following the Webster decision rose more significantly among older respondents (21, 24, and 25 year-olds) than among younger ones. In all cohorts except two (18 and 19 year-olds), pro-choice seems to be more acceptable. Females were more pro-choice after 1989 in general, whereas males became slightly pro-life. Psychosocial variables that correlate with abortion attitudes are attitudes towards sex and religion. The pro-life respondents describe themselves as having more religiosity (attending church regularly and strong religious affiliation) than pro-choice respondents. Previous studies have likewise found males to support abortion more than females. Males' support for abortion, like females', was more for social reasons than medical reasons.

IMPLICATIONS FOR HEALTH EDUCATION

The findings (age and gender differences) found in this article provide important implications for health professionals, teachers, and parents of young adults. A pro-choice trend in abortion attitudes was observed among 18-year-old males and females in the United States. While males were found to be slightly more pro-choice than females, for all ages, these observed differences were not significant. Pro-choice 18-year-olds may see abortion as a means of birth control. This same group is not likely to be cognizant of the physical and mental health risks involved with abortion. Our concern extends beyond 18-year-olds, since with a large number of adolescents 17 years of age and younger engaging in sexual intercourse today, there are increased number of unintended out-of-wedlock conceptions among this group (Moore and Snyder, 1996). This may impact the frequency of abortions to terminate these unwanted pregnancies well before the age of 18. Decreasing sexual activity to avoid unwanted pregnancy is ideal but difficult to achieve among adolescents and young adults. These findings suggest health professionals and parents should focus on pregnancy prevention programs.

Despite ongoing efforts at prevention, the United States continues to have high rates of teenage pregnancies and births, highest among developed countries (U.S. Public Health Service, 1995; Vital Statistics, 1994). This indicates the need for human sexuality education in schools, the community, and home. Research has repeatedly demonstrated that sexuality education in the schools does not lead to increases in sexual activity in adolescents (Feigenbaum, Weinstein, & Rosen, 1995). Sexual interest and sexual activity does not begin in high school, rather at much earlier ages. Indeed, attitudes towards sex and abortion appear to be critical elements in understanding the social context within which premarital sex occurs. It is important for schools and colleges to take a hard look at the issue and what it implies for them. In addition to increasing pressure for high completion rates and a rethinking of curriculum, it is important for schools and colleges to note that the role of women, men, and families in relation to school is of necessity changing (Burdell, 1998).

This article also examined the extent to which the Supreme Court rulings induced attitude change among young adults. Results indicated that the Court indeed influenced attitudes especially among the older respondents, a finding consistent with previous research (Franklin and Kosaki, 1989; Cannon, 1992; Mondak, 1992). Pro-choice sentiment rose more significantly among older respondents than younger ones implying legal policies does not necessarily impact younger individuals as the older ones. Besides policies, abortion attitudes can also be impacted by other societal events: economic resources, labor-market opportunities, and access to reproductive health services (Matthews, Ribar, and Wilhelm, 1997). Prior to the Supreme Court decisions after Roe vs Wade many states imposed some restriction on minors seeking abortions, usually requiring parental notification or consent, a mandatory waiting period, and opposed public funding for abortions (Schaeffer, 1998). Such state-imposed restrictions have been upheld by the two Supreme Court decisions subsequent to Roe v Wade: Webster vs Reproductive Health Services in 1989 and Planned Parenthood vs Casey in 1992. Kausen (1994) believes sexual activity and pregnancy has increased as a result of government involvement in the abortion issue. Parental involvement and resistance training are important measures for controlling teen pregnancies and probable subsequent abortions. O'Brian (1995) has prepared an educational source for addressing bioethical issues such as abortion in a curriculum context. He believed issues of bioethical subject matter are now inherent in the United States and require educating students with a conceptual focus. Teachers should also be aware of the common risk factors for teenage pregnancy: poverty; previous victimization; women from chaotic homes where having sex, getting pregnant, and having an abortion is considered normal (Bryan and Freed, 1993).

Abortion is not an act without a set of predetermining factors and should not be thought of as an isolated health concern. The early educational implications lean toward the schools because of the readily available target audience, but this should not be at the exclusion of the community (religious leaders, physicians, nurses, health educators, etc.) and home (parents and guardians). Research indicates that parents do support the public school's role in sexuality education (Johnson and Immerwahr, 1994). However, parents remain sharply divided and often choose to exclude controversial topics such as abortion (King, 1994). Health educators must be aware that there are many contributing factors to abortion and that abortion (the topic itself) may not need separate inclusion to provide adequate knowledge. The Sex Information and Education Council of the United States (1993) has prepared guidelines for developmentally appropriate sexuality education curriculum. It is not likely that any one program will prevent all sexual activity (with subsequent abortion concerns) among this age group, but with knowledge, skill development, support, and resources, young Americans will have the tools to make more intelligent decisions regarding their sexual health.

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Ranjita Misra, Ph.D., CHES, Assistant Professor, School of Health Sciences, College of Health and Human Services, 307.4, The Tower, Athens OH 45701-2979, (740) 593-0528, Fax: (740) 5930555, Email: misra@ohio.edu. Steven Hohman, Ph.D., CHES, RN, Assistant Professor, School of Health Sciences, College of Health and Human Services, The Tower, Athens OH 45701-2979, (740) 593-0434 (w), Fax: (740) 593-0555, Email: Hohman@ohiou.edu. Correspondence to: Ranjita Misra, Ph.D., CHES, Assistant Professor, School of Health Sciences, College of Health and Human Services, 307,4, The Tower, Athens OH45701-2979, (740) 593-0528, Fax: (740) 593-0555, Email: misra@ohio.edu.
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Publication:American Journal of Health Studies
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Date:Mar 22, 2000
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