- The Washington Times - Tuesday, August 21, 2001

Fewer teen-age girls have given birth in every state between 1991 and 1999, bringing the national teen-age birthrate to its lowest level in 14 years, but the United States has the highest teen birthrate of 12 developed countries, a new review of teen childbearing shows.
These findings demonstrate how complicated the issue of teen childbearing is, said Kristin A. Moore, president of Child Trends Inc., which has released its annual "Facts at a Glance" report on teen births in the states and 150 major cities.
"It really has been a long haul," said Mrs. Moore. The United States has had a couple of decades of rising and falling birthrates, and "we've only now gotten back to dipping under where we were in 1986."
The data reveal a wide range of results, some of which are disheartening:
Some states cut their teen birthrates by a third while other states reduced their rates by 11 percent.
The overall rate of repeat births to teens hasn't budged for several years.
A survey of state sex-education policies doesn't offer a conclusive link between the kind of sex education a state uses in its public schools and the size of the decline in its teen birthrate.
The new Child Trends report shows that, based on 1995 data, the United States with 57 births per 1,000 females ages 15 to 19 has the highest teen birthrate of 12 developed countries. England, Canada, Australia, Germany, France, Spain, Italy, and Japan all have rates below 30 births per 1,000 teens.
These data provide yet another reason the United States should "keep the focus on the topic of teen childbearing," said Mrs. Moore.
The Child Trends report also shows that between 1991 and 1999, the national teen birthrate fell 19 percent, from 62 births per 1,000 teens to 50 births per 1,000 teens. Of these births, 21 percent were to married teens.
Alaska, Vermont, Maine, California and Michigan saw the largest declines, cutting their teen birthrates by 31 percent or more.
A total of 22 states, including Maryland and Virginia, saw birthrate declines of 20 percent or more.
The District also saw a considerable decline: In 1991, it had 114.4 births per 1,000 teens. In 1999, the rate was 83.5 births per 1,000 teens, a 27 percent drop, according to Child Trends.
In an effort to track the impact of sex education on birthrates, the Child Trends report includes a state-by-state survey of sex-education policies. But this survey gave only clues about what might work in reducing teen birthrates.
For instance, 42 states used HIV/AIDS education programs, making them the most popular kind of sex education, the Child Trends report said.
HIV programs were used in 19 of the 22 states with birthrate declines of at least 20 percent.
This could indicate a connection between HIV/AIDS education and lower birthrates, said Mrs. Moore, a trustee of the National Campaign to Prevent Teen Pregnancy.
In May, she noted, the campaign released a report on pregnancy-prevention programs. That report, written by Douglas Kirby, found that five HIV education programs were associated with teens postponing sexual intercourse, having less sex and fewer partners and using contraceptives more often.
If HIV programs had any magic, it didn't seem to work in every state, as 11 of the 14 states with the smallest teen birthrate declines used HIV education programs, too, according to the data.
The same murky story could be seen with other approaches:
Of the 22 states with 20 percent or higher birthrate declines, 14 had a statewide "coordinated pregnancy prevention policy" in their public schools. So did half of the 14 lowest-performing states.
Six of the 22 top-performing states used four approaches a coordinated state pregnancy policy, HIV education, contraceptive education and abstinence education. So did four of the 14 lowest-performing states.
Alaska, which had a whopping 35 percent decline in its teen birthrate according to Child Trends, allowed its schools to choose their sex-education programs. A similar "hands free" approach also was used in Nebraska, which netted a 12 percent decline.
"Certainly, the state-by-state variation continues to be huge … and there does seem to be something at a cultural or normative level that might be going on," said Mrs. Moore. But as for why birthrates are falling, "my guess is that it's not any one thing," she said.
In Alaska, health officials say their 1991 to 1999 birthrate decline is lower than Child Trends' estimate 32.6 percent instead of 35 percent because of different population estimates.
They link their falling teen birthrates to a growth in the number of 15- to 17-year-olds. This helps lower the teen birthrate because younger teens have much lower birthrates than the 18- and 19-year-olds that Child Trends included in its survey, said Phillip Mitchell, an official with the Alaska Bureau of Vital Statistics.
Alaska also has been proactive about teen-pregnancy prevention, said Becky Judd, the adolescent health coordinator with Alaska's public health department.
"We believe that teens are going to make healthy decisions when they have more positive things going on in their lives," said Ms. Judd. Based on this belief, she said, Alaska has distributed more than 75,000 copies of a "homegrown" book for families, schools and communities, called "Helping Kids Succeed Alaskan Style."
The new Child Trends data also show that the national rate of repeat births to teens has been 22 percent in five of the last six years.
"Having two children before age 20 is a huge impediment to education and employment," said Mrs. Moore.
The District has seen the largest decline in repeat births, falling from 32 percent in 1994 to 24 percent in 1999.
An official with the D.C. Campaign to Prevent Teen Pregnancy said the Generations Program at the Children's National Medical Center may be one reason for the decline.
The Generations Program which has worked with 450 teen parents and children since 1995 encourages teens to delay having second children, improve their parenting skills and become self-sufficient, said program director Dr. Tina L. Cheng.

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