A new study by the Federal Inter-agency Forum on Child and Family Statistics reports that the teen birth rate is at an all time low. The current birth rate for teens between 15-17 in the US according to the study is 21 per 1000.* (That’s down from a high of 39 per 1000 in 1991). The same report gives a teen pregnancy rate of 44 per 1000 in 2002, the most recent year for which they give a rate, and some of the drop is attributable to an increase in condom use. You can see a PDF version of the report here.
Any drop in the teen pregnancy rate, the teen birth rate, and any increase in the rate of condom use is certainly very good news. But the good news is hardly unqualified. There is a fair bit of bad news that surrounds those important bits of good news.
One bit of bad news is that the teen pregnancy rate in the US is still much higher than it is in other western postindustrial societies. In the Netherlands and in Switzerland there were only 5 births per 1000 women between 15 and 19 in 2002 according to UN data. (There were 53 per 1000 young women in the US that same year according to the UN figures). The UN data I found did not report pregnancies, only births. Data from the Guttmacher Institute indicate that the pregnancy rate in the Netherlands was 12 per 1000 in 2001.
Another bit of bad news is that in the US there are significant differences in birth rates for girls of different racial and ethnic groups. The lowest teen birth rate is found among Asians (including Pacific Islanders). That group has 8 births for every 1000 girls between 15 and 19. For non-Hispanic White teens, the rate is 12 per 1000, for Native Americans (classified as American Indian/Alaska Native) the rate is 31 per 1000, for non-Hispanic Blacks it is 35, for Hispanics it 48 per 1000.
These differences must reflect, at least in part, access to health care, contraception, accurate sex education, and abortion services. The differences are not likely to be primarily related to differences in sexual activity between groups. A study published by the National Center for Health Statistics reporting on National Survey of Family Growth data from 2002 finds that Hispanic girls between 15-17 are less likely than their non-Hispanic black or white counterparts to have had sex. The same is true for 18-19 year olds. In the first age group 30% of non-Hispanic white girls, 41% of non-Hispanic black girls, and 25% of Hispanic girls report having had sexual intercourse with a male. In the second age group 68% of non-Hispanic white girls, 77% of non-Hispanic black girls, and 59% of Hispanic girls report having done so (p. 24). And, of those girls who had had sex in the previous four weeks, 19% of non-Hispanic white girls had had sex 4 or more times in that period compared with 13% for both black girls and Hispanic girls.
Why do white girls have lower pregnancy and birth rates if they’re having sex more frequently? This same study found inequality in use of contraception (which may provide some support both for the observation of unequal access and also of the observation of cultural barriers to use). White girls were more likely than either other group to be on the pill at the time of their first intercourse (18% compared to 13% of black girls and 10% of Hispanic girls), and were also more likely to use both pills and condoms together during their first time (15% compared to 9 % for black girls and Hispanic girls). This may speak at least in part to their access to multiple methods of contraception and to their ability to gain access to birth control pills before becoming sexually active.
In fact, when asked whether they had ever used specific methods of contraception, the study found that only 37% of Hispanic girls had ever used birth control pills (compared to 68% of white girls and 55% of black girls). Given an intersection between ethnicity and religion, and the prohibitions against contraception by the Catholic church, some of this difference might be explained by religion and culture. But given that Catholics around the world use birth control pretty regularly, I think that inequality of access to health care and prescriptions is a big part of the story.
There is no teen sex crisis in the United States, but there is a sex education and sexual health care crisis in the United States. If we want to bring our levels of teen pregnancy and teen births down to rates that are in line with those of countries like the Netherlands, we need to start addressing teens sexual health as a serious matter, treating teens with respect, and giving them the tools they need to make smart decisions and creating an environment in which those decisions are respected.
We need to do this while paying attention to race, class and ethnic inequality. Teen parenthood is associated with long term disadvantage for parents and for their children. Girls who become parents in high school are less likely to finish high school, and less likely to go to college. Children who start their lives in poverty are less likely to make it into the middle class. They’ve got all kinds of structural factors working against them.
The answer is definitely not to continue promoting abstinence-only sex education. The answer is complicated, but it certainly requires promoting sound, accurate sex education where the values of abstinence are taught in conjunction with the importance of contraception, relationships skills, and emotional well-being. It involves providing support for teen parents so that they are not so disadvantaged. It involves making sure that access to emergency contraception is secured for everyone, and that abortion remains a legal option for young women. It involves providing equal access to health care. And it involves the acknowledgment that we can’t talk about inequality without talking also about sex.
*The original version of this post incorrectly labeled that rate as the “teen birth rate” which would have been the rate for girls between 15-19. The error was brought to my attention by a very careful reader, Carole Joffe, of UC Davis, who continued:
“…the overall figures from 15-19 (birthrate) was 40/thousand–in fact, nearly identical to the year before. This fact aside, I think your analysis of the Report is right on. I look forward to reading more of your postings. Best wishes from a fellow sociologist, Carole.”