Priority Area: Healthy Mothers, Healthy Babies, Healthy Children - Adolescent Pregnancy Prevention

Young people between the ages of 10 and 19 years establish patterns of behavior and make lifestyle choices that have long-standing benefits or consequences. Adolescent pregnancy is a significant public health problem, with 58 out of every 1000 females ages 15-19 years becoming pregnant in 2008. This often results in lost social, educational and vocational opportunities, perpetual poverty and dependence on public income maintenance and health programs for both parents and children. Teen mothers in NYS are more than twice as likely as older moms to receive late or no prenatal care (11.6% vs. 3% for women over age 19), compromising the health of mothers and newborns. Infants born to teen mothers are at higher risk for low birthweight, infant morbidity and mortality, and are at greater risk for child abuse and child safety issues. Young fathers are less likely to marry the mothers of their children and more likely to have lower educational attainment and earnings, which hurts their children's chances of success.

Since the peak in 1993, adolescent pregnancy rates have declined 39%. However, NYS continues to have striking regional, racial and ethnic disparities in adolescent pregnancy rates. The rates in New York City are at least double that of the rest of the state and almost three times higher for black and Hispanic teens than for white teens. Unhealthy adolescent sexual behaviors often continue into later adult life, contributing to unintended pregnancies and transmission of HIV and STDs.

Teen childbearing in the United States costs taxpayers (federal, state, and local) at least $9.1 billion, according to a 2006 report published by the National Campaign to Prevent Teen Pregnancy. In NYS alone, the total cost (federal, state, and local) was $421 million in 2004. Most of the costs of teen childbearing are associated with negative consequences for the children of teen mothers, including increased costs for health care, foster care, and incarceration.

Objectives

  • By the year 2013, reduce New York's adolescent pregnancy rate (births, fetal deaths, and induced abortions) to no more than 28 per 1,000 females aged 15-17. (Baseline: 36.5/1,000 females 15-17 yrs., Vital Statistics, 2005)

Indicators for Tracking Public Health Priority Areas

Data and Statistics

NYS Population tables
Tables, available from the Vital Statistics of New York, are organized by gender, age, region, population density and life expectancies.
NYS Adolescent Pregnancy rate
Tables 26 to 30, available from the Vital Statistics of New York, are organized by the number of pregnancies and pregnancy rates by age, race, gender, and county.
NYS Adolescent birth rate
Tables for adolescent birth rates are available under "Live Births" from the Vital Statistics of New York.
NYS Community Health Data Set
Statistics related to adolescent pregnancy prevention are available under Family Planning and Maternal and Infant Health.
NYS County Health Assessment Indicators
Among the 14 health topic areas in the NYS County Health Assessment Indicator (CHAI) Reports, indicators for adolescent pregnancy can be found in family planning/natality, and maternal and infant health areas. The indicators are organized by county.
NYSDOH Bureau of Sexually Transmitted Diseases (STD) Control Data and Statistics
The STD Statistical Abstracts has tables on gonorrhea, syphilis and chlamydia by age.
Youth Online
The Youth Risk Behavior Surveillance System (YRBSS) is a national school-based survey conducted by the Centers for Disease Control and Prevention. It utilizes surveys conducted by state, territorial, and local education and health agencies and tribal governments. The Youth Online has comprehensive, searchable results for behaviors related to sexual activity, unintentional injury and violence, tobacco use, alcohol and other drug use, dietary behaviors, and physical activity, among others, at the national, state and larger metropolitan area levels.

New York State Department of Health Programs

The NYSDOH supports comprehensive community-based programs that provide age-appropriate sexuality education, access to reproductive health services, and supportive services that promote positive personal and social development. Although several programs provide services to adolescents, such as the Comprehensive Family Planning and Reproductive Health Care Services Program, two health initiatives are specifically designed to reduce adolescent pregnancies, promote positive youth development, and reduce racial and ethnic disparities by targeting areas with high adolescent pregnancy rates. These programs also encourage enrollment in the state-sponsored The Community Based Adolescent Pregnancy Prevention Program.

Comprehensive Adolescent Pregnancy Prevention (CAPP).
The purpose of the Comprehensive Adolescent Pregnancy Prevention initiative is to develop and expand primary prevention programs aimed at decreasing the incidence of adolescent pregnancy through the establishment of a comprehensive and coordinated approach to reduce the risk of initial and repeat pregnancies, STDs and HIV/AIDS rates among New York State adolescents. The initiative will more effectively address issues associated with adolescent parenting and the racial, ethnic, and geographic disparities that are related to adolescent sexual health outcomes. The specific goals of the CAPP community-based initiative and local CAPP projects are to:
  • Promote healthy sexual behaviors and reduce the practice of risky sexual behaviors among adolescents;
  • Ensure access to comprehensive reproductive healthcare and family planning services for adolescents;
  • Expand opportunities and provide support and alternatives to sexual activity for adolescents, including pregnant and parenting teens, in order to promote an optimal transition through adolescent developmental milestones into a healthy young adulthood;
  • Advance a comprehensive and sustainable local community effort to improve the community environment for adolescents through the development of a coordinated community plan
Family Planning Benefit Program
This is a program for New Yorkers who need family planning services, but may not be able to afford them. It is intended to increase access to family planning services and to enable individuals of childbearing age to prevent or reduce the incidence of unintentional pregnancies. The NYSDOH funds 52 agencies in approximately 207 sites to provide accessible reproductive health care services to women and men, especially low-income individuals and those without health insurance. These programs provide: contraceptive (birth control) education, counseling and methods to reduce unintended pregnancies and to improve birth spacing and outcomes; counseling and testing for HIV and treatment for sexually transmitted infections; routine screening for breast and cervical cancer; and health education in community settings to promote reproductive health and prevent unintended pregnancy. More than 330,000 women and men receive services through the family planning program annually, of whom approximately 100,000 are teenagers.

Strategies –The Evidence Base for Effective Interventions

Adolescent Pregnancy Prevention Strategies for Effective Interventions
The Association of State and Territorial Health Officials (ASTHO) hosted a webinar on June 30, 2010 entitled, Evidence-Based Public Health: Strategies from New York that featured presentations by NYSDOH staff about strategies and approaches to implement evidence-based public health concepts in prevention programs and policies. The presentation highlighted strategies to improve adolescent sexual health outcomes in communities with the highest burden of adverse outcomes. Communities are funded to utilize evidence-based programming to establish a comprehensive and coordinated approach to reduce the risk of initial and repeat pregnancies, STDs and HIV/AIDS rates among New York State adolescents. Programs address the issues associated with adolescent parenting and the racial, ethnic, and geographic disparities. The webinar archive and Powerpoint slides are available on ASTHO's Evidence-Based Public Health website.
Emerging Answers 2007, Dr. Douglas Kirby, the National Campaign to Prevent Teen and Unplanned Pregnancy
This report identifies 15 programs with strong evidence of positive impact on sexual behavior or pregnancy or sexually transmitted diseases (STD) rates. These programs include curriculum-based sex and STD/HIV education programs; mother-adolescent programs, clinic protocols and one-on-one programs; and service learning and multi-component programs with intensive sexuality and youth development components.
What Works, 2009
The 24-page report includes a listing of 30 effective programs evauated using experimental and quasi-experimental designs. These programs use one or more of the following five approaches: curriculum-based education that encourages both abstinence and contraceptive use; service learning programs whose primary focus is keeping young people constructively engaged in their communities and schools; youth development that takes a very broad approach; parent programs that involve both parents and adolescents; and community-wide programs such as educational activities and public service announcements.
Science and Success, Second Edition: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV and Sexually Transmitted Infections, Advocates for Youth.
This 2008 publication highlights 26 U.S.-based programs that have been proven effective at delaying sexual initiation or reducing sexual risk taking among teens. Fourteen of the 26 programs demonstrated a statistically significant delay in the onset of sexual activity. Fourteen programs helped sexually active youth to increase condom use and nine programs demonstrated success at increasing use of other contraception. Thirteen programs showed reductions in the number of sex partners and/or increased monogamy. Seven programs assisted sexually active youth to reduce the frequency of sexual intercourse and ten programs helped sexually active youth to reduce the incidence of unprotected sex.

Reports and Resources

Weaving Science and Practice: Frequently Asked Questions about Science-based Approaches, Healthy Teen Network and ETR Associates, 2008.
Describes the Promoting Science-Based Approaches Using Getting to Outcomes (PSBA-GTO) planning framework. The PSBA-GTO model provides a ten-step framework for four phases of program planning outcomes including: 1) setting goals; 2) designing programs; 3) evaluating programs; and 4) sustaining good outcomes, using seven science-based approaches.
Guiding Principles for Adolescent Sexual Health Education – New York State Department of Health Adolescent Sexual Health Workgroup, 2008
Describes 10 guiding principles supported by the NYSDOH.

Return on Investment

By the Numbers: Cost of Teen Childbearing
This report documents the public costs of teen childbearing at both the national and state level. Teen childbearing in the United States costs taxpayers (federal, state, and local) at least $9.1 billion, according to this 2006 report by Saul Hoffman, Ph.D. and published by the National Campaign to Prevent Teen Pregnancy. Most of the costs of teen childbearing are associated with negative consequences for the children of teen mothers, including increased costs for health care, foster care, and incarceration.
Teen and Non-Marital Childbearing. Kearney MS. National Bureau of Economic Research Reporter, Number 1, 2009
This report describes research on policy determinants to teen and non-marital pregnancy, socioecomic differences in rates of teen childbearing and parental time investment in children.

Partners

More Information

Bureau of Maternal and Child Health
Adolescent Health Unit
Corning Tower, Room 1805
Empire State Plaza
Albany, NY 12237
Voice: (518) 474-0535
Fax: (518) 474-7054
Email: bwh@health.state.ny.us