CDC Winnable Battles Teen Pregnancy Note: This presentation outlines the burden on teen pregnancy, as well as recommended efforts to address this public health challenge. CDC recommends that you localize the data as much as possible for your state or community. U.S. Department of Health and Human Services Centers for Disease Control and Prevention

Teen pregnancy costs taxpayers more than $9 billion/year and perpetuates the cycle of poverty Each year, about 750,000 girls age 15–19 become pregnant in the U.S. – 2/3 unintended Public cost to U.S. taxpayers/year: >$9 billion Estimated national costs saved by taxpayers in 2004 due to 1/3 decline in teen birth rate between 1991 and 2004: $6.7 billion Highest savings: >$1 billion in California Perpetuating inequality Source: The National Campaign to Prevent Teen Pregnancy

Teen pregnancy has heavy social, economic, and personal costs Teen mothers are Less likely to complete high school More likely to have low-paying jobs More likely to be financially dependent on family/society Children of teen mothers are more likely to Be born prematurely and die in infancy Have low school achievement Drop out of high school Have health problems Be incarcerated or give birth as teens Face unemployment as young adults

U.S. teen birth rate one of highest among industrialized countries The United States has one of the highest rates of teen births than all other industrialized countries. Teen birth rates internationally, per 1,000 girls aged 15-19 years, 2008 and 2009 SOURCE: UN Demographic Yearbook (all data for 2008, except US 2009 preliminary data).

Rates are far lower and are decreasing much faster in other countries 39% 80% 68% 82% 81% 80%

Birth rates, girls ages 15-19 2009, by state AK HI CA IA MN NE MT ND SD MI VT ME IN KY ID NV UT AZ NM TX OK WY IL PA WV SC TN AR MS AL VA NC GA FL NY NH MA RI CT NJ DE MD DC MO KS LA WI WA OR CO OH Highest: 64 Lowest: 16 This map highlights the states with the highest rates of teen births: The states with the red, mostly found in the Southeast and Southwest, have the highest rates. And historically in those regions the greatest burden is found among African American and Latina adolescents in particular. Birth rate per 1,000 girls 15-19 U.S. rate: 39 Europe: 4 (lowest)-24 (highest) 10 highest rates (51-64) Significantly higher than US rate (42-50) Not significantly different from US rate (38- 41) Significantly lower than US rate (29-37) 10 lowest rates (16-28) Source: National Center for Health Statistics, CDC, 2009.

U.S. birth trends by race/ethnicity, girls ages 15-19, 1991-2009 U.S. teen birth rates are down in all groups, but wide disparities persist Hispanic Black American Indian/Alaska Native White Asian/Pacific Islander 118 105 84 70 59 56 43 27 26 15 U.S. birth trends by race/ethnicity, girls ages 15-19, 1991-2009 Source: National Center for Health Statistics

What we can do to prevent teen pregnancy Support evidence-based prevention programs and policies that address needs of teens who are abstinent as well as teens who are sexually active Increase access to youth-friendly family planning services Increase access to and use of the most effective contraceptives by sexually active teens

Evidence-based prevention programs and policies should support all teens – those who are abstinent and those who are sexually active Target implementation of evidence-based programs at the community level Promote coordinated programs that leverage service and prevention systems Enhance community partnerships Educate stakeholders about teen pregnancy prevention issues and strategies Improve access to education and youth-friendly services Target efforts to reach those at greatest risk, including African American and Latina youth

Efforts should focus on increasing access to family planning services Medicaid family planning expansions are proven to increase access to contraceptive services, prevent unintended pregnancies and save money for state and federal government Contraceptive services provided to low and no-income women Medicaid provides states with an enhanced matching rate (90%) for family planning services A good investment: For every public dollar spent on family planning services, nearly $4 in public expenditures is saved 28 states have implemented a Medicaid family planning expansion Affordable Care Act includes streamlined option for states to expand Medicaid family planning programs

Efforts should focus on better access to the most effective contraceptive methods Improve access to and use of the most effective contraceptives by teens Address barriers to use of Long Acting Reversible Contraceptives (LARC) Educate providers: Ensure wide dissemination of the 2010 Medical Eligibility Criteria Recommendation that young women and women who have not given birth may be eligible to use all LARC methods Increase interest and acceptance among young women through education and social marketing Address cost barriers to ensure that publicly funded services include LARC 

– Thomas R. Frieden, MD, MPH “Teen pregnancy and childbirth continue existing cycles of social, economic and educational disadvantages in our nation’s communities. This is why CDC has identified Teen Pregnancy Prevention as a Winnable Battle for public health programs. Together with our partners, we can reduce teen pregnancy and childbirth rates in this country.” – Thomas R. Frieden, MD, MPH Director, Centers for Disease Control and Prevention Administrator, Agency for Toxic Substances and Disease Registry

www.cdc.gov/winnablebattles U.S. Department of Health and Human Services Centers for Disease Control and Prevention