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CDC Winnable Battles

                     Teen Pregnancy




U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Teen pregnancy costs taxpayers more than $9
 billion/year and perpetuates the cycle of poverty
    Each year, about 750,000 girls age 15–19 become
     pregnant in the U.S. – 2/3 unintended
    Public cost to U.S. taxpayers/year:
     >$9 billion
    Estimated national costs saved by
     taxpayers in 2004 due to 1/3
     decline in teen birth rate between
     1991 and 2004: $6.7 billion
          Highest savings: >$1 billion in California
    Perpetuating inequality

Source: The National Campaign to Prevent Teen Pregnancy
Teen pregnancy has heavy social, economic, and
               personal costs
   Teen mothers are
       Less likely to complete high school
       More likely to have low-paying jobs
       More likely to be financially dependent on family/society
   Children of teen mothers are more likely to
       Be born prematurely and die in infancy
       Have low school achievement
       Drop out of high school
       Have health problems
       Be incarcerated or give birth as teens
       Face unemployment as young adults
U.S. teen birth rate one of highest among
            industrialized countries
     Bulgaria                                                                                43
           U.S.                                                                         39
    Romania                                                                             39
           U.K.                                                                  27
       Ireland                                                 17
         Israel                                           14
      Canada                                              14
    Germany                                          10
        France                                       10
      Norway                                     9
          Italy                              7
     Sweden                              6
    Denmark                              6
    Netherla…                        5
  Switzerland                    4

Teen birth rates internationally, per 1,000 girls aged 15-19 years, 2008 and 2009
SOURCE: UN Demographic Yearbook (all data for 2008, except US 2009 preliminary data).
Rates are far lower and are decreasing much
                faster in other countries
80
                                               1970       2006
70
         39%
60

50
                  80%
40
                            68%                                  82%
30                                    81%

20
                                                   80%
10

 0
       U.S.    Norway   France    Denmark   Switzerland   Sweden
Birth rates, girls ages 15-19
     AK
                                 2009, by state
                              WA
                                                                                                       Lowest: 16
                                               MT           ND                                                                    ME
                         OR                                            MN                                               VT
                                     ID                                                                                      NH
                                                            SD                    WI                               NY        MA
                                                 WY                                          MI
                                                                                                                                   RI
                                                                        IA                                    PA                   CT
                               NV                           NE
                                                                                                  OH                               NJ
                                          UT                                       IL   IN                                         DE
                    CA                               CO
                                                                                                       WV                          MD
                                                                 KS         MO                                VA                   DC
                                                                                             KY
          HI
                                                                                                              NC
                                                                                        TN
                                     AZ                           OK
                                                    NM                       AR                          SC
                                                                                   MS   AL         GA
                                                                                                                        Highest: 64
                                                            TX               LA

                                                                                                         FL


  Birth rate per 1,000 girls 15-19                                           10 highest rates (51-64)
  • U.S. rate: 39                                                            Significantly higher than US rate (42-50)
                                                                             Not significantly different from US rate (38- 41)
  • Europe: 4 (lowest)-24 (highest)                                          Significantly lower than US rate (29-37)
                                                                             10 lowest rates (16-28)
Source: National Center for Health Statistics, CDC, 2009.
U.S. teen birth rates are down in all groups, but
                 wide disparities persist
                                                   140
                                                                                                                Hispanic
                                                                                                                Black
                                                   120    118
                                                                                                                American Indian/Alaska Native
     Rate per 1,000 girls in specified age group




                                                                                                                White
                                                          105
                                                                                                                Asian/Pacific Islander
                                                   100

                                                          84
                                                    80
                                                                                                                                                 70
                                                    60                                                                                           59
                                                                                                                                                 56
                                                          43
                                                    40
                                                          27
                                                                                                                                                  26
                                                    20
                                                                                                                                                 15

                                                     0
                                                     1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

                                                         U.S. birth trends by race/ethnicity, girls ages 15-19, 1991-2009
Source: National Center for Health Statistics
What we can do to prevent
             teen pregnancy
 Support evidence-based prevention programs
  and policies that address needs of teens who are
  abstinent as well as teens who are sexually active
 Increase access to youth-friendly family
  planning services
 Increase access to and use of the most effective
  contraceptives by sexually active teens
Evidence-based prevention programs and
    policies should support all teens –
   those who are abstinent and those who are
                sexually active
 Target implementation of evidence-based
  programs at the community level
 Promote coordinated programs that leverage
  service and prevention systems
  • Enhance community partnerships
  • Educate stakeholders about teen pregnancy prevention
      issues and strategies
  •   Improve access to education and youth-friendly services
  •   Target efforts to reach those at greatest risk, including
      African American and Latina youth
Efforts should focus on increasing access to
          family planning services
 Medicaid family planning expansions are proven to
  increase access to contraceptive services, prevent
  unintended pregnancies and save money for state and
  federal government
   •   Contraceptive services provided to low and no-income women
   •   Medicaid provides states with an enhanced matching rate
       (90%) for family planning services
   •   A good investment: For every public dollar spent on family
       planning services, nearly $4 in public expenditures is saved
 28 states have implemented a Medicaid family planning
  expansion
 Affordable Care Act includes streamlined option for states
  to expand Medicaid family planning programs
Efforts should focus on better access to the
     most effective contraceptive methods
 Improve access to and use of the most effective
  contraceptives by teens
 Address barriers to use of Long Acting Reversible
  Contraceptives (LARC)
   • Educate providers: Ensure wide dissemination of the
       2010 Medical Eligibility Criteria
           Recommendation that young women and women who have
            not given birth may be eligible to use all LARC methods
   • Increase interest and acceptance among young women
       through education and social marketing
   •   Address cost barriers to ensure that publicly funded
       services include LARC
“Teen pregnancy and childbirth continue
existing cycles of social, economic and
educational disadvantages in our nation’s
communities. This is why CDC has identified
Teen Pregnancy Prevention as a Winnable
Battle for public health programs. Together
with our partners, we can reduce teen
pregnancy and childbirth rates in this country.”

         – Thomas R. Frieden, MD, MPH
         Director, Centers for Disease Control and Prevention
         Administrator, Agency for Toxic Substances and Disease Registry
www.cdc.gov/winnablebattles




For more information please contact Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: cdcinfo@cdc.gov     Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.




         U.S. Department of Health and Human Services
         Centers for Disease Control and Prevention

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Teen Pregnancy Winnable Battle Presentation

  • 1. CDC Winnable Battles Teen Pregnancy U.S. Department of Health and Human Services Centers for Disease Control and Prevention
  • 2. Teen pregnancy costs taxpayers more than $9 billion/year and perpetuates the cycle of poverty  Each year, about 750,000 girls age 15–19 become pregnant in the U.S. – 2/3 unintended  Public cost to U.S. taxpayers/year: >$9 billion  Estimated national costs saved by taxpayers in 2004 due to 1/3 decline in teen birth rate between 1991 and 2004: $6.7 billion  Highest savings: >$1 billion in California  Perpetuating inequality Source: The National Campaign to Prevent Teen Pregnancy
  • 3. Teen pregnancy has heavy social, economic, and personal costs  Teen mothers are  Less likely to complete high school  More likely to have low-paying jobs  More likely to be financially dependent on family/society  Children of teen mothers are more likely to  Be born prematurely and die in infancy  Have low school achievement  Drop out of high school  Have health problems  Be incarcerated or give birth as teens  Face unemployment as young adults
  • 4. U.S. teen birth rate one of highest among industrialized countries Bulgaria 43 U.S. 39 Romania 39 U.K. 27 Ireland 17 Israel 14 Canada 14 Germany 10 France 10 Norway 9 Italy 7 Sweden 6 Denmark 6 Netherla… 5 Switzerland 4 Teen birth rates internationally, per 1,000 girls aged 15-19 years, 2008 and 2009 SOURCE: UN Demographic Yearbook (all data for 2008, except US 2009 preliminary data).
  • 5. Rates are far lower and are decreasing much faster in other countries 80 1970 2006 70 39% 60 50 80% 40 68% 82% 30 81% 20 80% 10 0 U.S. Norway France Denmark Switzerland Sweden
  • 6. Birth rates, girls ages 15-19 AK 2009, by state WA Lowest: 16 MT ND ME OR MN VT ID NH SD WI NY MA WY MI RI IA PA CT NV NE OH NJ UT IL IN DE CA CO WV MD KS MO VA DC KY HI NC TN AZ OK NM AR SC MS AL GA Highest: 64 TX LA FL Birth rate per 1,000 girls 15-19 10 highest rates (51-64) • U.S. rate: 39 Significantly higher than US rate (42-50) Not significantly different from US rate (38- 41) • Europe: 4 (lowest)-24 (highest) Significantly lower than US rate (29-37) 10 lowest rates (16-28) Source: National Center for Health Statistics, CDC, 2009.
  • 7. U.S. teen birth rates are down in all groups, but wide disparities persist 140 Hispanic Black 120 118 American Indian/Alaska Native Rate per 1,000 girls in specified age group White 105 Asian/Pacific Islander 100 84 80 70 60 59 56 43 40 27 26 20 15 0 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 U.S. birth trends by race/ethnicity, girls ages 15-19, 1991-2009 Source: National Center for Health Statistics
  • 8. What we can do to prevent teen pregnancy  Support evidence-based prevention programs and policies that address needs of teens who are abstinent as well as teens who are sexually active  Increase access to youth-friendly family planning services  Increase access to and use of the most effective contraceptives by sexually active teens
  • 9. Evidence-based prevention programs and policies should support all teens – those who are abstinent and those who are sexually active  Target implementation of evidence-based programs at the community level  Promote coordinated programs that leverage service and prevention systems • Enhance community partnerships • Educate stakeholders about teen pregnancy prevention issues and strategies • Improve access to education and youth-friendly services • Target efforts to reach those at greatest risk, including African American and Latina youth
  • 10. Efforts should focus on increasing access to family planning services  Medicaid family planning expansions are proven to increase access to contraceptive services, prevent unintended pregnancies and save money for state and federal government • Contraceptive services provided to low and no-income women • Medicaid provides states with an enhanced matching rate (90%) for family planning services • A good investment: For every public dollar spent on family planning services, nearly $4 in public expenditures is saved  28 states have implemented a Medicaid family planning expansion  Affordable Care Act includes streamlined option for states to expand Medicaid family planning programs
  • 11. Efforts should focus on better access to the most effective contraceptive methods  Improve access to and use of the most effective contraceptives by teens  Address barriers to use of Long Acting Reversible Contraceptives (LARC) • Educate providers: Ensure wide dissemination of the 2010 Medical Eligibility Criteria  Recommendation that young women and women who have not given birth may be eligible to use all LARC methods • Increase interest and acceptance among young women through education and social marketing • Address cost barriers to ensure that publicly funded services include LARC
  • 12. “Teen pregnancy and childbirth continue existing cycles of social, economic and educational disadvantages in our nation’s communities. This is why CDC has identified Teen Pregnancy Prevention as a Winnable Battle for public health programs. Together with our partners, we can reduce teen pregnancy and childbirth rates in this country.” – Thomas R. Frieden, MD, MPH Director, Centers for Disease Control and Prevention Administrator, Agency for Toxic Substances and Disease Registry
  • 13. www.cdc.gov/winnablebattles For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. U.S. Department of Health and Human Services Centers for Disease Control and Prevention

Notas do Editor

  1. Note: This presentation outlines the burden on teen pregnancy, as well as recommended efforts to address this public health challenge. CDC recommends that you localize the data as much as possible for your state or community.
  2. The United States has one of the highest rates of teen births than all other industrialized countries.
  3. This map highlights the states with the highest rates of teen births: The states with the red, mostly found in the Southeast and Southwest, have the highest rates. And historically in those regions the greatest burden is found among African American and Latina adolescents in particular.