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

Trends in Teen Childbearing: Patterns & Explanationssites.nationalacademies.org/cs/groups/dbassesite/... · Teen Pregnancy Outcomes, 2010 59% . 15% . 26% . Live Births. Miscarriages

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Page 1: Trends in Teen Childbearing: Patterns & Explanationssites.nationalacademies.org/cs/groups/dbassesite/... · Teen Pregnancy Outcomes, 2010 59% . 15% . 26% . Live Births. Miscarriages

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

Page 2: Trends in Teen Childbearing: Patterns & Explanationssites.nationalacademies.org/cs/groups/dbassesite/... · Teen Pregnancy Outcomes, 2010 59% . 15% . 26% . Live Births. Miscarriages

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.

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

0

10

20

30

40

50

60

70

80

90

NH White NH Black Hispanic NativeAmerican

AsianAmerican

Birt

h Ra

te p

er 1

,000

15-1915-1718-19

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

0

10

20

30

40

50

60

70

80

90

100

Birt

h Ra

te p

er 1

,000

15-1915-1718-19

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

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

0

20

40

60

80

100

120Birth RateNumber of Births

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

0

20

40

60

80

100

120

140

NH White NH Black Hispanic NativeAmerican

AsianAmerican

Birt

h Ra

te p

er 1

,000

199120052012

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WHAT IS DRIVING DECLINES IN TEEN CHILDBEARING?

Proximate Determinants

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Proximate Determinants • Initiation or frequency of sexual activity?

• Utilization or type of birth control?

• Availability or access to abortion?

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Contraceptive Utilization • Increasing usage at first sex

• Increasing consistency of utilization

• Increasing efficacy of method used (dual method

& LARCs)

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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.

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WHAT IS DRIVING DECLINES IN TEEN CHILDBEARING?

Distal Determinants

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Distal Determinants • Restricted economic opportunities

• Neighborhood Disadvantage

• Expectations regarding health & mortality

• Policy initiatives, peer influences & cultural messages

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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

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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)

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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

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National Campaign to Prevent Teen Pregnancy

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Virginity Pledges

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Virginity Pledges

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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

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Thank You!