Health Rankings: Teen Pregnancy Rates Decline, But Disparities Persist

Second in a series of blogs by the Colorado Health Institute reporting on the 2018 County Health Rankings.

On average, 45 of each 1,000 Hispanic teen girls in Colorado gave birth annually over a seven-year period ending in 2016, a rate three times higher than the yearly average of 14 births per 1,000 among the state’s white teen girls during that time.

This data point from the 2018 County Health Rankings, released this week by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, highlights a notable racial/ethnic disparity on an important health indicator: births to girls between ages 15 and 19.

Teen pregnancy, one of 35 health-related indicators in the rankings, has a well-documented impact on young women and their futures. Teen moms are more likely to drop out of school, making it tougher to get good jobs and earn livable wages. And their children are more likely to become teen parents themselves, with lower educational attainment and worse behavioral health, a concerning generational cycle.

A Dropping Teen Birth Rate

Before examining the disparity in Colorado’s teen pregnancy rates in more detail, we want to start with the big picture on teen birth rates, which contains good news.

Colorado’s teen birth rate plummeted by 47 percent between the 2011 and 2018 County Health Rankings reports. It dropped to an annual rate of 24 births per 1,000 teens in the 2018 report (which used data from 2010 through 2016) from an annual rate of 45 births per 1,000 teens in the 2011 report (which used data from 2001 through 2007). Many other states are seeing a similar downward trend.

(Note: The year of each County Health Rankings report corresponds to an earlier seven-year period for teen births data, which we show in parentheses. Data from 40 counties was used to calculate the state teen birth rate for Hispanic and white teens.)

Nationally, the teen birth rate hit an all-time low of 20.3 births per 1,000 in 2016, the most recent data available from the National Vital Statistics System. 

Colorado counties with the highest teen birth rates in the 2018 report: Crowley (55), Baca (50), Prowers (47), Otero (46), and Montezuma (45). Counties with the lowest teen birth rates: Pitkin (4), Douglas (5), Park (9), Elbert (9) and Boulder and Gunnison (both 10).

That’s a 51-point difference between the lowest rate in Pitkin County and the highest rate in Crowley County. 

Pitkin County’s teen birth rate saw the state’s biggest decline, dropping by 67 percent from an annual rate of 12 births per 1000 in the 2011 report (which uses data from 2001-2007) to an annual rate of four births per 1000 in the 2018 report (which uses data from 2010-2016).

Rural teens have an average teen birth rate of 27 births per 1000 in Colorado, which is higher than the average birth rate of their urban peers, which is 19 births per 1000.

But despite progress overall, racial and ethnic disparities persist. And wide variations exist within counties. For example, in Kit Carson County, the Hispanic teen birth rate is 91 per 1,000, 66 points higher than the birth rate for white teens of 25 per 1,000. In Larimer County, the birth rate for black teens of eight per 1,000 compared with a rate of 10 per 1,000 for whites and 38 per 1,000 for Hispanics.

Policy in Action

The Hispanic teen birth rate — while high — has been decreasing more rapidly than the white teen birth rate nationally from 2006 to 2014, according to the National Vital Statistics System data.

This is evidence that teen pregnancy prevention programs designed to address the cultural and socioeconomic complexity are promising approaches.

Yet a list of 41 evidence-based teen pregnancy prevention programs issued by the federal Office of Adolescent Health includes only three that target Hispanics, indicating a need for more targeted prevention programs. 

Colorado has demonstrated successful policy changes through the Colorado Family Planning Initiative (CFPI). This initiative supported Title X clinics to purchase and provide long acting reversible contraceptives to low-income women. CFPI was funded by a private donor between 2009 and 2015, and has been funded by the Colorado Legislature since 2016. Colorado’s teen birth rate dropped dramatically over those years.

Other states have taken advantage of available to data to implement policy changes. Mississippi, for example, passed a bill directing colleges to create plans to combat teen pregnancy. The County Health Rankings show that Mississippi’s teen birth rate has dropped 33 percent since 2012.

Read the first blog in this series by Sara Schmitt, and be looking for other posts in the blog series coming next week

Find Jalyn Ingalls on Twitter: @CHI_JIngalls

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