Trends in Teen Childbearing: Patterns &...

Trends in Teen Childbearing: Patterns & Explanations Dr. Cynthia G. Colen

Teen Pregnancy Outcomes, 2010

59%

15%

26%

Live BirthsMiscarriagesAbortions

Kost K and Henshaw S, U.S. Teenage Pregnancies, Births and Abortions, 2010: National and State Trends and Trends by Age, Race and Ethnicity, 2014, <http://www.guttmacher.org/pubs/USTPtrends10.pdf>, accessed May 1, 2014.

U.S. Teen Birth Rate in 2012, by Race

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NH White NH Black Hispanic NativeAmerican

AsianAmerican

Birt

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Trends in U.S. Teen Births, 1988-2013

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Trends in U.S. Teen Births, 1940-2013

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Recent Decline in U.S. Teen Birth Rate, by Race

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NH White NH Black Hispanic NativeAmerican

AsianAmerican

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199120052012

WHAT IS DRIVING DECLINES IN TEEN CHILDBEARING?

Proximate Determinants

Proximate Determinants • Initiation or frequency of sexual activity?

• Utilization or type of birth control?

• Availability or access to abortion?

Contraceptive Utilization • Increasing usage at first sex

• Increasing consistency of utilization

• Increasing efficacy of method used (dual method

& LARCs)

Martinez G et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006–2010 National Survey of Family Growth, Vital and Health Statistics, 2011, Series 23, No. 31.

WHAT IS DRIVING DECLINES IN TEEN CHILDBEARING?

Distal Determinants

Distal Determinants • Restricted economic opportunities

• Neighborhood Disadvantage

• Expectations regarding health & mortality

• Policy initiatives, peer influences & cultural messages

Economic Opportunity • Procyclical fertility: When economy improves and labor

market tightens, birth rates increase.

• Countercyclical fertility: When economy improves and labor market tightens, birth rates decrease (Butz & Ward 1979).

• Some evidence that countercyclical fertility emerged during economic boom of the 1990s but not before (Colen et al. 2006)

• Declines in unemployment rate (1992-1999) explained 20% and 85% of decrease in first birth rates among African American 15-17 and 18-19 year olds

Neighborhood Disadvantage • Neighborhood disadvantage strongly associated with

increased risk of teen childbearing

• Concentrated poverty as opposed to racial concentration (Browning et al. 2004). Affluence more than disadvantage (South & Baumer 2000). Violence and social disorganization (Browning et al. 2005; Harding 2009)

• Neighborhood disadvantage shown to exert stronger effect on risk of teen childbearing among Whites compared to Blacks (Harding 2003; South & Crowder 1998)

• Neighborhood disadvantage might be driving decision to terminate pregnancy rather than avoiding getting pregnant (South & Baumer 2001)

Health & Mortality • Essential connection between fertility & mortality – drives

demographic transition

• Weathering hypothesis suggests that African Americans experience accelerated aging due to social, economic, political exclusion

• If African American women, especially from high poverty communities, can expect to have multiple chronic diseases by their 30s, teen childbearing “makes sense”

• Thus…during periods where health disparities are decreasing, we would expect less teen childbearing

National Campaign to Prevent Teen Pregnancy

Virginity Pledges

Virginity Pledges

Conclusions • Decline in teen CB began much earlier than 1990s

• Increase in contraceptive use, especially at first intercourse.

Teens still heavily reliant on methods with high failure rates.

• Increasing economic opportunities in conjunction with countercyclical fertility – especially increasing college enrollment among (minority) women

• Declines in racial disparities in health and mortality, especially among women

Thank You!