Teenage Pregnancies: A Major Health Concern

Teenage Pregnancies: a Major Health Concern

'Responsible Sexual Behavior' is one of the Healthy People 2020 leading health indicators, and teen pregnancy has become a significant public concern (Healthy People, 2020). Adolescents often believe themselves to be invincible, and place themselves at risk for unwanted pregnancy by abusing drugs and alcohol, and engaging is risky sexual behavior (Matteucci & Schub, 2010). Many sexual encounters among teenagers are unplanned, and they often happen without the use of a condom and birth control measures (Wasik & Kachlic, 2009).

Teenage mothers are considered a high risk group for pregnancy complications like pre-term births, low birth weight, and increased infant mortality (Langille, 2007). Pregnant teens are often socially isolated and do not have the emotional maturity to deal with the consequences of the pregnancy (Langille, 2007). Other possible negative results of teen pregnancy include poor child health outcomes, dropping out of school, and poverty associated with low income jobs and lack of education (Schaffer, Jost, Pederson, & Lair, 2008). Teenage pregnancy has a negative impact on communities whose dwindling resources are affecting the level of support available to help this vulnerable population (Stanhope & Lancaster, 2008).

Epidemiology Related to Teen Pregnancy

Epidemiology is the study of health and disease in communities (Stanhope & Lancaster, 2008). Epidemiology is used to investigate patterns of health events by gathering statistics and using the information to determine how best to control the identified health problem (Stanhope & Lancaster, 2008). Several national surveys conducted by different agencies have highlighted problems associated with adolescent health and risky behavior, including smoking, drug and alcohol abuse, suicide, accidents, and prevalence of sexually transmitted disease (Stanhope & Lancaster, 2008). Multiple studies conducted on teen pregnancy reflect that there has been a decline in the rate of teen pregnancy in the United States (Centers for Disease Control and Prevention (CDC), 2011). In 2009, 46% of high school students had engaged in sexual intercourse, 14% of which had more than four partners, and 34% did not use a condom during their last sexual encounter (CDC, 2011). Identifying the causes of risky sexual behavior among teenagers, and determining the extent of teen pregnancy problems requires a methodical approach to help epidemiologists understand which populations are more at risk.

Steps and Methods of Epidemiology Related to Teen Pregnancy.

Once a health concern is identified epidemiologists use a variety of tools to assist in the retrieval of information (Stanhope & Lancaster, 2008). An important focus on epidemiology is to determine rates, proportions, and risks of the health concern related to the population of concern (Stanhope & Lancaster, 2008). The first step in planning effective teen pregnancy prevention is to conduct surveillance (Stanhope & Lancaster, 2008). Surveillance incorporates data collection, data interpretation, and sharing results so that public health action can be implemented to improve health outcomes (Stanhope & Lancaster, 2008).

Examples of Teen Pregnancy Surveillance

A variety of studies related to teen pregnancy must be conducted to understand the extent and cause of the problem. Research is conducted to determine the number of live births by recording birth certificates, the number of stillbirths, the number of abortions, and the number of spontaneous miscarriages (NCHS, 2011). According to the Centers of Disease Control and Prevention (CDC), each year in the United States, 800,000--900,000 adolescents aged less than19 years become pregnant (CDC, 2011). In 2007 a survey conducted by the National Center for Health Statistics (NCHS) revealed that teenage birth rates for women between the ages of 15-19 averaged at 41.5 out of every 1000 in the United States (US), (National Center for Health Statistics (NCHS), 2011). A new large-scale survey conducted by the CDC's National Survey of Family Growth (NSFG) identified that there has been no improvement in the number of teens using effective birth control methods (Melby, 2010).

Monitoring trends in the target population, and the effects of outcomes and interventions is an important step in epidemiology (Stanhope & Lancaster, 2008). Information gathered from surveys and research on contributing factors like teenagers sexual activity versus condom use, and studies to examine teen pregnancy prevention programs in relation to statistical data all contribute to decisions made by public health departments on how to prevent teen pregnancy (Melby, 2010).

Epidemiology Triangle Related to Teen Pregnancy

When referring to epidemiology and prevention of infection, injury, or any other health concern, epidemiologists often refer to a model called the epidemiology triangle to identify the major risk factor categories for that health concern (Stanhope & Lancaster, 2008). The model is to use it as a tool to identify the risk factors and show the relationship between the three factors that influence the occurrence and prevention of disease and injury. These factors are:

a) HOST, or the person or population with health concern

b) AGENT, or the disease causing organism/

c) ENVIRONMENT, or place in which the host and agent interact (Stanhope & Lancaster, 2008).

The teenage woman (host) may willingly participate in risky sexual behavior by making poor choices not to use adequate contraception (agent) or may be the victim of sexual abuse (agent) (Langille, 2007). The environment is an important factor in teen pregnancy, and there are many environmental influences that can determine the risks for a teenager becoming pregnant (Langille, 2007). On individual level the teen's knowledge, attitudes and beliefs, future expectations, and influences like substance abuse can place the teenager at risk (Langille, 2007). Other environmental influences include family structure, parent and child communication, and socioeconomic status; peer influences, and sexual health education at school also play an important role (Langille, 2007). Another important factor involves the community; where norms and values concerning teenage pregnancy can assist in determining outcomes related to teen pregnancy (Langille, 2007).

Risks for becoming pregnant or for allowing someone else to get pregnant is a higher risk for some teenagers (Saewyc, Magee, & Pettingell, 2004). One group at high risk is the teenager who is sexually