Uptick seen in teen pregnancy rates, study finds.
In addition, teen births rose 4% and teen abortions rose 1% between 2005 and 2006, according to the report, which the institute compiled from a variety of national and state-level sources. The teen pregnancy rate hit its peak in 1990, with 117 pregnancies per 1,000 women aged 15-19 years. By 2005 it had declined 40%, to 70/1,000. But in 2006, the rate increased to 72/1,000.
"After more than a decade of progress, this reversal is deeply
troubling," Heather Boonstra, a senior public policy associate at the Guttmacher Institute, said in a prepared statement. "It coincides with an increase in rigid abstinence-only-until-marriage programs, which received major funding boosts under the Bush administration. A strong body of research shows that these programs do not work. Fortunately, the heyday of this failed experiment has come to an end with the enactment of a new teen pregnancy prevention initiative that ensures that programs will be age appropriate, medically accurate, and, most importantly, based on research demonstrating their effectiveness."
Two experts interviewed by this news organization weren't so sure that the increase in pregnancy rates could be attributed to abstinence-only sex education. "The temporal association between the increase in abstinence-only programs and the increase in the pregnancy rate definitely deserves closer attention," said Dr. Lee Savio Beers, a pediatrician who is director of the healthy generations clinic at Children's National Medical Center, Washington, D.C. "I don't know that anyone knows for sure whether it's directly related, but the two kind of came together. It's such a multifactorial issue that we may never have an answer on that."
Dr. Melissa Kottke, who is with the department of ob-gyn, at Emory University and is director of the Jane Fonda Center for Adolescent Reproductive Health, both in Atlanta, said, "I think there's going to be a lot of things contributing to [increases in teen pregnancy rates], and I don't think we're going to know what all of those are." Dr. Kottke listed some of the other possibilities: teenage sexual activity, poverty, the media, parenting, funding for care, and funding for family planning services. "All of those things are going to contribute," she said, "and I don't think we're going to be able to point our finger at one thing or the other."
About the Guttmacher Institute, Dr. Beers said, "They're a well-respected organization. Their policy views tend to be on the liberal side. But I think everyone pretty much agrees that their facts are good, and their numbers are good, and for pregnancy numbers, they're better than pretty much anyone."
Although the long decline and recent uptick in teen pregnancy rates were seen in blacks, Hispanics, and non-Hispanic whites, there were some substantial racial and ethic differences (see box). Among black teens, the pregnancy rate declined by 45%, from 224/1,000 in 1990 to 123 / 1,000 in 2005, and then increased 2.4%, to 126/1,000 in 2006. Among Hispanic teens, the pregnancy rate declined by 26%, from 170/1,000 in 1992 to 125/1,000 in 2005, and then increased 1% to 127/1,000 in 2006. And among non-Hispanic whites, the rate declined by 51%, from 87/1,000 in 1990 to 43/1,000 in 2005, and then increased 2% to 44/1,000 in 2006.
State-level data were not available for 2006, but in 2005 the highest teen pregnancy rates were in New Mexico (93 / 1,000), Nevada (90/1,000), and Arizona (89/1,000). The lowest rates were in New Hampshire (33 / 1,000), Vermont (49 / 1,000), and Maine (48/1,000).
Although there has been a long decline in the teen pregnancy rate in the United States, even at their low point in 2005, the U.S. teen pregnancy, birth, and abortion rates were still way above those for all other developed nations, Dr. Beers said.
And Dr. Kottke said that there's already evidence that the 1-year uptick is not a statistical fluke. She's seen preliminary data for 2007 indicating that the increase in teen pregnancy, birth, and abortion rates increased for a second year.
Physicians have a unique opportunity to help turn these numbers around, she said. "What we know is that young people still trust their physicians, and they look to their physicians for important education. Physicians who are serving young teens need to make sure they are an avenue for education, for care, and for confidentiality."
Major Finding: The rates of teen pregnancy, birth, and abortion increased in 2006 after declining every year since 1990.
Data Source: Data compiled from national-level and state-level sources.
Disclosures: Preparation of the report was funded by the Brush Foundation, the California Wellness Foundation, and the Annie E. Casey Foundation.
The full report is available at www. guttmacher.org/pubs/USTPtrends.pdf
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|Title Annotation:||CLINICAL ROUNDS|
|Date:||Feb 1, 2010|
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