1. The source on adolescent sexual health May 2, 2014 Teenwise Minnesota’s 23 rd Annual Conference What’s the Data Telling Us? A Deeper Look at Adolescent Sexual Health Stats

2. The source on adolescent sexual health Presentation Overview Pregnancy, birth and STI statistics and trends – Minnesota county rankings – U.S. vs. Minnesota comparison – Regional and national rankings – International comparisons Health disparities Adolescent sexual behavior trends Social determinants of adolescent sexual health Key questions Resources

3. The source on adolescent sexual health The Good News… Adolescent pregnancy rates in Minnesota have decreased 58% from 1990 to 2012 Adolescent birth rates in Minnesota have decreased 49% from 1990 to 2012 Although pregnancy and birth increased for the first time in 16 years in 2006 and 2007, rates declined again in 2008 and have continued through 2012

4. The source on adolescent sexual health What do I mean by “teen”? – 15-19 year olds What’s a birth rate? – Rates are calculated per 1,000 females – More accurate statistic than using numbers – Birth certificate data – includes live births What’s a pregnancy rate? – Rates are calculated per 1,000 females – More accurate statistics than using numbers – Includes births, induced abortions and fetal demise over 20 weeks gestation (for which there is a death certificate filed)

5. The source on adolescent sexual health U.S. Adolescent Pregnancy Rates 1972-2008 & Adolescent Birth Rates, 1972-2012 (pregnancies and births per 1,000 females aged 15-19) Kost, K., & Henshaw, S. (2012). U.S. Teenage Pregnancies, Births and Abortions, 2008: National Trends by Age, Race and Ethnicity. Retrieved February 2012, fromhttp://www.guttmacher.org/pubs/ustptrends08.pdf.http://www.guttmacher.org/pubs/ustptrends08.pdf Martin JA, Hamilton BE, Osterman JK, et al. Births: Final data for 2012. National vital statistics reports; vol 62 no 9. Hyattsville, MD: National Center for Health Statistics. 2013. pregnancy rate birth rate

6. The source on adolescent sexual health Adolescent Birth Rates U.S. & Minnesota, 1970-2012 (number of births per 1,000 females aged 15-19) Martin JA, Hamilton BE, Osterman JK, et al. Births: Final data for 2012. National vital statistics reports; vol 62 no 9. Hyattsville, MD: National Center for Health Statistics. 2013. Center for Health Statistics, MDH, 2014

7. The source on adolescent sexual health In 2010, Minnesota had the 9 th lowest Adolescent Birth Rate in the US (age 15-19 per 1,000)

8. The source on adolescent sexual health So, everything’s fine, right?

9. The source on adolescent sexual health The not so good… Every day in Minnesota about 12 adolescents become pregnant; about 4,500 every year There are significant disparities in adolescent pregnancy, birth, and STI rates Chlamydia rates continue to increase dramatically (check GC) Fewer young people report using condoms during their last sexual encounter Societal costs of not investing in youth… – Adolescent mothers are more likely to drop out of school, receive late or no prenatal care, rely on public assistance, become single parents and live in poverty – Children born to adolescents have higher rates of health, learning, and social challenges

10. The source on adolescent sexual health Adolescent Birth Rates U.S. vs. Minnesota, 2012 (births per 1,000 females aged 15-19) Center for Health Statistics, Minnesota Department of Health, 2014; National Center for Health Statistics, 2013

11. The source on adolescent sexual health Minnesota Adolescent Birth Rates 2011 vs. 2012 (births per 1,000 females aged 15-19) Center for Health Statistics, Minnesota Department of Health, 2014

12. The source on adolescent sexual health Minnesota Adolescent Birth Rates by Race/Ethnicity, 1995-2012 (number of births per 1,000 females aged 15-19, 3-year clusters) Black American Indian Hispanic/ Latina Asian/ Pacific Islander White Center for Health Statistics, Minnesota Department of Health, 2014 54.3 66.2 43.1 29.6 13.6

13. The source on adolescent sexual health Number of Adolescent Births in Minnesota age 15-19, 2012 Center for Health Statistics, Minnesota Department of Health, 2014

14. The source on adolescent sexual health We’re number one…unfortunately. United Nations Statistics Division. (2010). Millennium Development Goals Indicators. Retrieved from: http://unstats.un.org/unsd/mdg/SeriesDetail.aspx?srid=761http://unstats.un.org/unsd/mdg/SeriesDetail.aspx?srid=761

15. The source on adolescent sexual health Another perspective…

16. The source on adolescent sexual health State Adolescent Birth Rates, 2011 (births per 1,000 females aged 15-19) Martin, J. A., Hamilton, B. E., Ventura, S. J., & Osterman, M. J. K. (2013). Births: Final data for 2011. Hyattsville, MD: National Center for Health Statistics.

17. The source on adolescent sexual health Kost K and Henshaw S, U.S. Teenage Pregnancies, Births and Abortions, 2008: State Trends by Age, Race and Ethnicity, New York: Guttmacher Institute, 2013, http://www.guttmacher.org/pubs/USTPtrends13.pdf http://www.guttmacher.org/pubs/USTPtrends13.pdf State Adolescent Pregnancy Rates, 2008 (pregnancies per 1,000 females aged 15-19)

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21. Three in ten females get pregnant at least once before age 20. Source: National Campaign to Prevent Teen Pregnancy. (April 2010). Briefly:…Teen Pregnancy and Childbearing in the United States: Ten Headlines. Retrieved from http://www.thenationalcampaign.org/resources/pdf/Briefly_Teen-Pregnancy-and-Childbearing-Ten-Headlines.pdf. http://www.thenationalcampaign.org/resources/pdf/Briefly_Teen-Pregnancy-and-Childbearing-Ten-Headlines.pdf

22. The source on adolescent sexual health State-specific birth rate ranking, by race/ethnicity, 2008 (age 15-19 per 1,000) StateBlack Arkansas83 Nebraska83 Wisconsin82 Iowa78 Mississippi77 Ohio75 Kansas74 Tennessee74 Minnesota64 StateHispanic/ Latina Alabama123 Tennessee115 Georgia108 Wash. D.C.106 Nebraska104 N. Carolina104 S. Carolina103 Mississippi102 Minnesota80 StateWhite Arkansas52 Mississippi50 Kentucky50 Oklahoma48 West Virginia47 Tennessee43 Wyoming42 Louisiana40 Minnesota18

23. The source on adolescent sexual health Top 10 MN Counties Ranked by Adolescent Birth Rate 2012 Birth Rate 15-19 State of Minnesota 18.6 Mahnomen 74.3 Big Stone 69 Cass 57.4 Nobles 57.3 Renville 50.8 Watonwan 45.2 Beltrami 45.1 Cottonwood 44.1 Chippewa 40.3 Lake 40.1

24. The source on adolescent sexual health Minnesota Adolescent Gonorrhea & Chlamydia Rates, 2003-2013 (age 15-19 per 100,000 population) Center for Health Statistics, Minnesota Department of Health, 2012

25. The source on adolescent sexual health Center for Health Statistics, Minnesota Department of Health, 2013

26. The source on adolescent sexual health Minnesota Adolescent Chlamydia and Gonorrhea Rates by Race and Hispanic Origin, 2012 (age 15-19 per 100,000)

27. The source on adolescent sexual health Top 10 MN Counties Ranked by Chlamydia Rate 2013 Chlamydia Rate (per 100,000) 15-19 State of Minnesota 1,394 Red Lake 4,237 Freeborn 2,251 Ramsey 2,177 Hennepin 2,017 Lake of the Woods 2,016 Mahnomen 1,902 Beltrami 1,741 Becker 1,705 Olmsted 1,654 Cass 1,567

28. The source on adolescent sexual health Top 10 MN Counties Ranked by Gonorrhea Rate 2013 Gonorrhea Rate (per 100,000) 15-19 State of Minnesota 267 Hennepin 684 Ramsey 540 Cass 348 Mower 300 Polk 296 Clay 220 Beltrami 214 St. Louis 204 Anoka 198 Olmsted 113

29. The source on adolescent sexual health Other Trends in the Field…

30. The source on adolescent sexual health Minnesota Student Survey changes The 2013 Minnesota Student Survey was administered to public school students in Grades 5, 8, 9, and 11 statewide Past student surveys were administered to students in Grades 6, 9 and 12. As a result, trend data is limited to 9th grade only Approximately 69% of 9 th graders and 62% of 11 th graders participated in the 2013 Minnesota Student Survey

31. The source on adolescent sexual health Nationally, 2/3 of adolescents have had sex while they are still in high school Percent of High School Students Who Have Had Sex At Least Once Centers for Disease Control and Prevention. YRBS, 2011. MMWR 2012;61, p. 24

32. The source on adolescent sexual health 2013 Minnesota Student Survey Percentage of sexually active adolescents in Minnesota, 2013

33. The source on adolescent sexual health Top 5 reasons why Minnesota teens report that they are not having sex: 1.Fear of pregnancy 2.Fear of sexually transmitted diseases 3.I don’t think it’s right for a person my age to have sex 4.My parent(s) would object 5a. I have not had a chance to have sex (males) 5b. I don’t want to have sex (females) 2013 Minnesota Student Survey

34. The source on adolescent sexual health 2013 Minnesota Student Survey Percentage of sexually active adolescents in Minnesota, 1992-2013

35. The source on adolescent sexual health How many times have you been pregnant or gotten someone pregnant? 9 th grade Male9 th grade Female 11 th grade Male 11 th grade Female 0 times98%99%97%98% 1 or more times2%1%2% Not sure1%0%1%0% 2013 Minnesota Student Survey

36. The source on adolescent sexual health Which of the following best describes you? 9 th grade Male9 th grade Female11 th grade Male11 th grade Female Heterosexual (straight) 95%91%95%93% Bisexual1%5%1%4% Gay or lesbian1% Not sure (questioning) 3% 2% 2013 Minnesota Student Survey

37. The source on adolescent sexual health The LAST time you had sexual intercourse, what ONE method did you or your partner use to prevent pregnancy? 9 th grade Male 9 th grade Female 11 th grade Male 11 th grade Female No method was used to prevent pregnancy 14%16%8% Birth control pills9%10%18%24% Condoms53%49%55%46% Shot, ring, implant or any IUD 2%5%3%9% Withdrawal (pull-out)13%14%11% Some other method1% Not sure8%4% 1% 2013 Minnesota Student Survey

38. The source on adolescent sexual health 2013 Minnesota Student Survey Percent that used a condom with last intercourse, 1992-2013

39. The source on adolescent sexual health Percentage of Minnesota teens that talked to their partners about preventing: 2013 Minnesota Student Survey

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41. Trends in Ages at Key Reproductive Transitions in the United States, 1951–2010,” by Lawrence B. Finer and Jesse M. Philbin

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45. Key questions to consider Why has the percentage of sexually active youth declined so much in the last 20 years? Birth rates have declined nationwide – regardless of state policies, demographic characteristics, etc. Why? Why are chlamydia and gonorrhea rates increasing while birth rates and the number of sexually active youth continue to decline? Even though the U.S. birth rate has reached historic lows, we are still among the highest among developed countries. Why?

46. The source on adolescent sexual health Some questions to ponder… Anything you learned that you didn’t know before today? What information might you like to know more about? How will you use this information in your work? What would the young people in your world (personally or professionally) think of this information? How might we change public perception of adolescent sexual health, in light of the information that was presented?

47. The source on adolescent sexual health Resources CDC Vital Signs – www.cdc.gov/vitalsignswww.cdc.gov/vitalsigns CDC Vital Signs offers recent data and calls to action for important public health issues CDC Youth Risk Behavior Survey - www.cdc.gov/healthyyouth/yrbs/ www.cdc.gov/healthyyouth/yrbs/ The Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, including sexual behaviors. Guttmacher Institute – www.guttmacher.orgwww.guttmacher.org Research, policy analysis and public education on abortion, law/public policy, pregnancy, birth, prevention and contraception, HIV/STIs Minnesota Department of Health Center for Health Statistics - http://www.health.state.mn.us/divs/chs/ (birth & pregnancy data)http://www.health.state.mn.us/divs/chs/ STD Division – www.health.state.mn.us/divs/idepc/dtopics/stds/stdstatistics.htmlwww.health.state.mn.us/divs/idepc/dtopics/stds/stdstatistics.html HIV Division - www.health.state.mn.us/divs/idepc/diseases/hiv/hivstatistics.htmlwww.health.state.mn.us/divs/idepc/diseases/hiv/hivstatistics.html National Campaign – www.teenpregnancy.orgwww.teenpregnancy.org Their mission is to promote values, behavior, and policies that reduce both teen pregnancy and unplanned pregnancy among young adults

48. The source on adolescent sexual health Thank you! Jill Farris, MPH Director of Training and Education jill@teenwisemn.org 651-289-1381 Teenwise Minnesota 1619 Dayton Avenue, Suite 111 Saint Paul, MN 55104 tel. 651-644-1447 fax. 651-644-1417