Analysis, Pages 7 (1609 words)
Reducing Hillsborough County’s Teen Pregnancy Rate
A few major concerns of the maternal, infant, and young children population exist. Difficulties affecting the population have lasting effects on the future generations. The main issue of focus in this population is teen pregnancy and birth, and the repetition of this cycle. Although there has been a drastic decline in teenage births in the United States, teen pregnancy is still a significant social, health and economic problem. Teen pregnancy and birth has both long-term and short-term effects on the teen, their parents and the entire community (CDC, 2017).
Initially, having a child as a teen is the leading cause of school dropout and delayed employment, among teenage females. When a young girl drops out of school, parents, relatives, or even friends are forced to meet her daily financial needs, including transport and pre-natal health expenses (Philliber, 2015). Consequently, there is a high possibility that the teen parents will meet more challenges having access to health care, adequate housing, a stable job, and other basics that affect overall well-being.
According to the Center for Disease and Control (CDC) (2017), there are estimated 1700 teenage births every week in the United States. While the number of teenage births has reduced countrywide, there are evident racial, socioeconomic, geographic, and ethnic disparities. CDC notes that the Hispanic and Non-Hispanic African-American teen birth levels are still very high compared to those of Native American and non-Hispanic white teens (Penman-Aguila et al., 2013). In fact, the rates of teen births among Latina and black teens remain almost twice that of their non-Hispanic white counterparts.
Combined, Hispanic and black accounts for at least 57 percent of the overall teen birth in the United States (Penman-Aguila et al., 2013).
Several factors have been associated with teenage pregnancy and births including social-cultural norms, access to birth control, contraceptive type and sexual behaviors and partnership traits. Social, economic gaps and poverty at the neighborhood, household, and individual level constantly have been linked with sexual decision making and teen pregnancy. The existing theory that associates negative health outcomes to continued exposure to political and socioeconomic inequalities provides a good theoretical explanation, which may cause the associations (Penman-Aguila et al., 2013). Also, acculturation or the process of adapting children of immigrants to different social and cultural norms in their community and home environment may be a particularly strong factor for Hispanic or Latino teens. Additionally, socioeconomic opportunities regarding academic and career goals and expectations together with poverty, have been found to influence sexual or reproductive behaviors among teenagers (Minnis et al., 2012). Convincingly, teenage girls with low or no career goals are more likely to engage in careless sexual behaviors and get pregnant than those with high educational and career expectations.
More so, teenager parents, especially mothers are likely to drop out of school, register lower academic achievement, get involved in crime, face unemployment, and have constant health problems. The problem of teen pregnancy and birth affect the entire community (Penman-Aguila et al., 2013). In the United States, teen birth accounts to over 9 billion dollars of overall government expenditure per year (Lopez et al., 2014). In Florida alone taxpayers spent 443 million dollars to support teen childbearing (Counting It Up: The Public Costs of Teen Childbearing, 2014). Hence, teen pregnancy is a high priority public health area that affects the well-being of people at all levels of the society.
Hillsborough County Teen Births
In Florida, there were more than 11,000 teen births in 2016, which represents a decline of at least 6.4 percent of teen birth between ages of 13 and 19. Hillsborough county teen pregnancy rate is ranked at 41 out of Florida’s 67 counties. Hillsborough recorded at least 800 births in 2016, which accounts for approximately 7.5 percent of the overall teen births in Florida. Although Hillsborough has shown a significant decline in some teen pregnancy and births since 2009, the numbers are still significant. In order to reduce the rate of teen pregnancy, focus on increased access to long-acting but reversible birth control in low-income and/or free clinics is a necessity. Implementing a program in low-income community clinics would greatly improve the number of teenagers likely to fall pregnant at a young age. The overall goal as consistent with the Health People 2020 goals are to reduce pregnancy among adolescent females and to increase the percentage of sexually active persons aged 15 to 19 years who use hormonal or intrauterine contraception methods (Family Planning, 2017).
Long-acting Reversible Contraceptives
Long-acting reversible contraceptives (LARCs) refer to birth control methods that can prevent pregnancy for several years and can be withdrawn when the person is ready for pregnancy. Some of the most common LACRs include implants and intrauterine devices (IUDs), which can last for up to 10 years. According to CDC (2017), LACRs have a tested effectiveness of more than 99 percent, which is significantly higher than other contraceptive options. Long-acting reversible contraceptives can be safely implanted into a women or girl’s body regardless of their previous birth status. Increased access to and use of LARC will assist with the decline of unplanned teen pregnancies. Therefore, LARC and associated education and counseling will provide teenagers with the necessary knowledge and space to have cautionary sex.
Root Cause Analysis
Vieira, (2016) found cost and inadequate information among providers and patients as a significant hindrance to the utilization of LARCs. Inadequate training among the care providers and financial commitments associated with LARC tools may be a huge challenge for local health centers located in remote areas, are small, and have inadequate government funding (Rocca et al., 2016). Due to the limited health funds, most health centers tend to prioritize other public health areas such as chronic illness and disease. Teenagers also face other unique barriers including limited pocket money, unequal insurance coverage, lack of experience and pre-natal knowledge, and parental consent requirements issues, among others (Lopez et al., 2014). Majority of teenage mothers in Hillsborough County originate from low-income neighborhoods and families. Parents of the teenagers are also likely to be academically illiterate, often having little government support in areas of health and food. Usually, teens from such backgrounds lack adequate parental supervision, which contributes to sexual tendencies. Current political policies have limited availability of contraceptives to teenage girls. Looking at the numbers of teenage pregnancy in Hillsborough and likelihood of teenagers to stop schooling, these girls face numerous forms of problems that otherwise adults would never experience.
The primary objective of this intervention is to reduce the rates of unplanned/repeated pregnancy and childbirth. To achieve the objective, it is essential to execute a need assessment, conduct a study in minimizing unplanned pregnancies, create a strategic plan for a set of health education subjects, and partner with local leaders to create materials to send the information to the community. It encompasses developing ways to ensure long-term programming by launching a strong workforce and marinating funding. An approach to examine the effectiveness of the program will also need to be established. Another issue is teenagers are still developing physically and psychologically, meaning pregnancy is likely to build conflict within the family due to the parental control. Considering these factors, it is crucial to define the psychosocial factors involved to ensure effective implementation of the LARC program.
The development of effective and safe contraceptives for both teenagers and adults has evolved over the years. Several studies have shown that increasing the availability and use of long-acting contraceptives (LARCs) help to reduce unplanned and overall teen pregnancies. The positive outcome is reinforced by cost reduction overall and effective contraceptive counseling (Broecker, Jurich, & Fuchs, 2016). Unplanned and repeat teenage pregnancy as well as childbirth not only affects the individual and family, but the overall society as well. Teenage pregnancy affects the education and working period of the mother and costs the government billions of dollars every year through labor loss. Nevertheless, reducing teen pregnancy requires the collaboration of teens, parents, community leaders, and health care professionals. Teenage pregnancy reduction interventions are crucial, especially to those from low-income households who are at high risk due to socioeconomic, geographic, and ethnic disparities.
- Broecker, J., Jurich, J., & Fuchs, R. (2016). The relationship between long-acting reversible contraception and insurance coverage: a retrospective analysis. Contraception, 93(3), 266-272. doi:10.1016/j.contraception.2015.11.006
- CDC. (2017). Contraception | Reproductive Health | CDC. Retrieved from https://www.cdc.gov/reproductivehealth/contraception/index.htm
- Counting It Up: The Public Costs of Teen Childbearing. (2014). Retrieved from The National Campaign to Prevent Teen and Unplanned Pregnancy: https://thenationalcampaign.org/why-it-matters/public-cost
- Family Planning (2017). Retrieved from Healthy People 2020: https://www.healthypeople.gov/2020/topics-objectives/topic/family-planning/objectives
- Lopez, C., Ramirez, D. C., Valenzuela, J. I., Arguello, A., Saenz, J. P., Trujillo, S., … Dominguez, C. (2014). Sexual and Reproductive Health for Young Adults in Colombia: Teleconsultation Using Mobile Devices. JMIR mHealth and uHealth, 2(3), e38. doi:10.2196/mhealth.2904
- Minnis, A. M., Marchi, K., Ralph, L., Biggs, M. A., Combellick, S., Arons, A., … Braveman, P. (2012). Limited Socioeconomic Opportunities and Latina Teen Childbearing: A Qualitative Study of Family and Structural Factors Affecting Future Expectations. Journal of Immigrant and Minority Health, 15(2), 334-340. doi:10.1007/s10903-012-9653-z
- Penman-Aguilar, A., Carter, M., Snead, M. C., & Kourtis, A. P. (2013). Socioeconomic Disadvantage as a Social Determinant of Teen Childbearing in the U.S. Public Health Reports, 128(2_suppl1), 5-22. doi:10.1177/00333549131282s102
- Philliber, S. (2015). Evaluating Teen Pregnancy Prevention Programs: Decades of Evolving Strategies and Practices. Societies, 5(3), 631-645. doi:10.3390/soc5030631
- Rocca, C. H., Thompson, K. M., Goodman, S., Westhoff, C. L., & Harper, C. C. (2016). Funding policies and postabortion long-acting reversible contraception: results from a cluster randomized trial. American Journal of Obstetrics and Gynecology, 214(6), 716.e1-716.e8. doi:10.1016/j.ajog.2015.12.009
- Vieira, C. (2016). Long-Acting Reversible Contraceptives: An Important Approach to Reduce Unintended Pregnancies. Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 38(05), 207-209. doi:10.1055/s-0036-1583761