1. Insert name of presentation on Master Slide Making the case for sexual health: teenage pregnancy and the wider determinants of health Sarah Andrews

3. Sexuality is much more than sex What being a man or woman means and how we express our gender How we feel about our own bodies, physical pleasure and looking our best Who we are attracted to and what we choose to do about it If we have intimate relationships, how we behave with each other

5. What is sexual health promotion? Helping prevent: Sexually transmitted infections Unwanted or young pregnancies Sexual harm or exploitation (of children or adults) Promoting the health benefits of: Comfort in your own sexual identity Supportive relationships A happy sex life

6. Main issues in sexual health Sexually transmitted infections Unplanned and teenage pregnancy –One in 3 pregnancies unplanned –One in 5 pregnancies ends in abortion (one in 3 for teenagers, one in 2 under 16) –One in 4 women has an abortion –Young pregnancies lead to health problems for mother and child

7. Other important issues Sexual/gender identity and discrimination –Macho behaviour & vulnerable girls –Family, social, employment acceptance Relationships –Partnership and sexual problems Harm and exploitation –Rape and assault –Sexual harassment at work

8. Ingredients for a happy healthy sexuality Love, affection, respect, acceptance –Strong sense of identity and self-esteem Security and safety –Protection from abuse and the chance to experiment and take risks Relationship role-models Good sex education, formal and informal A source of wise advice Accessible health services

9. Perceived problems of sex “Promiscuity” Teenage pregnancy Sexually transmitted infection Social exclusion Child health problems Disease Infertility Cervical cancer

10. Benefits of sex Good sexual relationships Good mental health Strong partnerships Emotional resilience Better physical health Secure families Social inclusion Better child health

11. From Dahlgren and Whitehead

12. Funding of services Sexual health services have been shown to save money, but are hard to fund. What priority do sexual health services have compared with other services? Are the connections fully understood? Need to demonstrate how sexual health is a key part of how the wider determinants of health impact on most if not all health and inequality outcomes

13. What’s the connection? Sexual Health and... Injuries? Children at home Road traffic Youth violence Sarah Andrews 16.2.11

14. What’s the connection? Sexual Health and... Cancer? Sarah Andrews 16.2.11

15. What’s the connection? Sexual Health and... Cardiovascular disease? Sarah Andrews 16.2.11

16. What’s the connection? Sexual Health and... Tooth decay? Sarah Andrews 16.2.11

17. What’s the connection? Sexual Health and... Alcohol misuse? Sarah Andrews 16.2.11

18. What’s the connection? Sexual Health and... Homelessness? Sarah Andrews 16.2.11

19. What’s the connection? Sexual Health and... obesity? Sarah Andrews 16.2.11

20. What’s the connection? Sexual Health and... Infant mortality? Sarah Andrews 16.2.11

21. What’s the connection? Sexual Health and... Mental ill-health? Sarah Andrews 16.2.11

22. Some barriers to sexual health promotion Taboos on discussing sex “I couldn’t talk about that.” Moral confusion or uncertainty “It’s wrong.” “It would be like I was condoning it.” Lack of training “I don’t know where to start.” Perceived legal obstacles “We’re not allowed to.”

24. Sex is good for us!