A new article in the Journal of Economic Perspectives entitled Why is the Teen Birth Rate in the United States so High and Why Does it Matter? by Melissa Kearney and Phillip Levine has caused the media to raise a lot of questions - and make a lot of guesses - about how we address teen pregnancy in the United States.
One of the most widely circulated articles by Slate's Matt Yglesias goes so far as to say that we may as well hang in the towel on teen pregnancy as long as some girls are poor and (I'm paraphrasing Yglesias' dumb conclusion) "have nothing better to do than make a bunch of babies." Laura Sessions Stepp has a smartly written rebuttal to the Yglesias article. But, we're more interested in what the research means for North Carolina's prevention practitioners.
The Chicken and The Egg
The original journal article is the strongest on the old chicken and egg question on teen births: Are girls poor because they have babies too young? Or, are there so many teen births because there are so many girls living in poverty? The journal article says it's the latter.
Basically, the article makes a pretty sound and clear case that girls living in poverty are more likely to have babies, and that having a baby is likely to keep those girls in poverty. (Insert your own joke about this being published in the Journal of No-Duh here.) Here is the interesting part: A teen birth has fewer economic consequences for girls not in poverty. In other words, if you're not in poverty already, having a teen pregnancy won't necessarily make you poor.
Many times, we prevention practitioners are quick to describe teen birth as a one-way ticket to poverty. This article debunks that idea.
Changing Solutions? Not So Fast!
Yglesias' Slate article plays off of some pretty stupid myths about teen births, mainly that teens have babies because their lives are terrible and they think a baby will make it awesomely better. Actual data from The National Campaign to Prevent Teen and Unplanned Pregnancy shows that more than 90% of teens do not want to get pregnant or cause a pregnancy. Unfortunately, there are far too many teens living in poverty. If they really wanted to get pregnant, that polling data would be far different. To his credit, Yglesias is just making easy distillation of the academic paper's assertion that older, low-income teens are ambivalent about pregnancy - when we know teens have many, many mental barriers to contraceptive use (lack of info, misinformation, unclear understanding of risk or contraceptive effectiveness...)
We know the two behaviors that prevent teen pregnancy: delaying sex and using contraceptives. We know what works to help young people delay sex and use contraceptives: effective, comprehensive sex education and access to comprehensive, affordable, teen-friendly clinical services. Poverty certainly doesn't change those things. Poverty may, however, change how a young person can access and experience those things.
As a practitioner, it's important to recognize the additional barriers young people in poverty face in acting on effective sex education or accessing clinical care. Could they get to a clinic if they wanted to and needed to? Can they afford clinical care? Are they more exposed to interpersonal violence or unhealthy messages about sexuality in their homes and neighborhoods? Think about how your clients' or students' economic situation might alter their pathway to safe, healthy, and responsible actions.
We know that there are more than 400 risk and protective factors related to teen pregnancy. Some are close (access to clinical care) and some are distant (local ratios of men to women). This new research should make us think twice about writing off poverty - and, by extension, policies that address poverty - as "not our issue".
Those of you who attended last week's 2012 Annual APPCNC Conference got to hear a great keynote by Jodie Levin-Epstien of CLASP, a national organization that works on policy solutions to lift people out of poverty. She suggested five areas where North Carolina's teen pregnancy prevention practitioners can make a difference:
- Ensure North Carolinians actually have access to public services when they qualify. Whether it's medical care, child care, nutrition programs, or other supports, there are too many cases where people qualify to get the help they need but can't actually access that help because of waiting lists, lack of information, misinformation, or other barriers.
- Partner with organizations that raise awareness about poverty and promote anti-poverty solutions. She gave particular credit to North Carolina groups like Together NC and the NC Justice Center.
- Protect North Carolina's gains in early education and child care. Teen parents cannot finish high school, go to college, or work without access to subsidies for high quality child care.
- Really examine the needs of today's teen parents. Levin-Epstein made the interesting point that today's teen parents have different educational needs, job prospects, and aspirations than teen parents did 10, 20, or 30 years ago.
- Stop blaming individuals for institutional problems. While individual responsibility is important, we cannot hold individual teens fully responsible when failures in our economic, educational, and health care systems place those individuals at higher risk. Making teen pregnancy solely a "failure of the individual" unfairly and irresponsibly passes the buck.
So, should we think about how closely poverty relates to our work? Yes! Do sex education and access to clinical care still matter? Absolutely!
Are you interested in learning more about the linkages between poverty and teen pregnancy? Register for our June 5 workshop Social Determinants That Affect Teen Pregnancy.