Transcript Slide 1

The Power of Prevention:
What Doesn’t
Happen to
Improve Teen
Health?
What are the important health problem facing teens in
Texas?
6 Critical Types of Behaviors
Physical inactivity
 Poor eating habits
 Tobacco use
 Intentional and
unintentional
injuries
 Alcohol/drug use
 Sexual risk behaviors
Costs to the U.S.
$435 billion per year.
Physical inactivity
 Poor eating habits
 Tobacco use
 Intentional and
unintentional
injuries
 Alcohol/drug use
 Sexual risk behaviors
How is Texas doing in preventing youth risk behaviors?
12%
34%
21%
45%
26%
16%
14%
Sexual Behavior
Students begin having sex at early ages
About 1 in 10
6th grade
students have
had sex
Source: Shanklin, S.L., Brener, N., McManus, T., Kinchen, S., Kann, L. (2007). 2005 Middle School Youth Risk Behavior Survey. Atlanta, G.A.: Centers for Disease Control and Prevention.
Sexual Behavior
by 12th grade…
7 in 10 students have had sex
7 in 10 students have had sex
Source: Centers for Disease Control and Prevention. (2007). YRBSS: Youth Online Comprehensive Results. Retrieved August 13,2008 from http://apps.nccd.cdc.gov/yrbss/
Trends in Sexual Behavior in Texas
Middle School
71
Percent
100
90
80
70
60
50
40
30
20
10
0
High School
10
6th
7th
8th
9th
Source: It’s Your Game…Keep It Real. University of Texas, Center for Health Promotion and Prevention Research.
10th
11th
12th
Sexual Behavior
Therefore… in Texas with over 2 million students in 6-12 grade, the
estimated total number of students having sex in any given year
Grade
Percent Having Sex
Number of Students
Having Sex
6th
11.2%
37,460
7th
14.7%
48,732
8th
18.1%
61,239
38.0%
150,582
51.0%
166,430
11th
60.9%
176,586
12th
70.6%
185,610
9th
10th
Total
826,644
826,644
Source: Shanklin, S.L., Brener, N., McManus, T., Kinchen, S., Kann, L. (2007). 2005 Middle School Youth Risk Behavior Survey. Atlanta, G.A.: Centers for Disease Control and
Prevention. YRBS Results YRBSS: Youth Online Comprehensive Results. Retrieved June 4,2008 from http://apps.nccd.cdc.gov/yrbss/
Source for TX student numbers: Enrollment in TX Public Schools, 2007-2008. Available at: http://ritter.tea.state.tx.us/research/pdfs/enrollment_2007-08.pdf
Why We Need to
Do More
Why we need to do more
Sexual behavior
Outcomes
Prevention
Sexually transmitted infections & HIV
In the U.S. nearly
half of all new STI
and HIV cases
occur among those
aged 15-24 years.
Source: Weinstock, H, Berman, S, Cates, W, Jr. Sexually Transmitted Diseases among American Youth: Incidence and Prevalence
Estimates, 2000. Perspect Sex Reprod Health, 2004:36(1):6-10.
Few cases of HIV and STIs are detected
Detected
Undetected
Source: Weinstock, H, Berman, S, Cates, W, Jr. Sexually Transmitted Diseases among American Youth: Incidence and Prevalence Estimates, 2000. Perspect Sex Reprod Health, 2004:36(1):6-10.
Birth Rates in Developed Countries, Teens 15-19 years
(per 1,000 teen girls)
Netherlands
Japan
France
Germany
Canada
5
6
8
11
15
United Kingdom
United States
Source: United Nations Statistics Division. (2004). Demographic Yearbook 2004. New York: United Nations; Advocates for Youth
27
41
Birth Rates in Developed Countries, Teens 15-19 years
(per 1,000 teen girls)
Netherlands
Japan
France
Germany
Canada
United Kingdom
5
6
8
11
15
27
United States
Texas
Source: United Nations Statistics Division. (2004). Demographic Yearbook 2004. New York: United Nations; Advocates for Youth
41
63
Birth Rates by Selected States, Teens 15-19 years (per 1,000
teen girls)
New Hampshire
New York
Wisconsin
California
19
26
31
38
South Carolina
Texas
Source: United Nations Statistics Division. (2004). Demographic Yearbook 2004. New York: United Nations; Advocates for Youth
53
63
Birth Rates by Selected States, Teens 15-19 years (per 1,000
teen girls)
California
38
Texas
Source: United Nations Statistics Division. (2004). Demographic Yearbook 2004. New York: United Nations; Advocates for Youth
63
But wait!
This isn’t about ……
• Pregnancy……
• Sexually transmitted diseases……
• Adolescent sexual behavior….
It is about ……
• Poverty……
• Education……
• Economic well-being of all of
Texas….
It’s about the teen mother
living in poverty…….
• 60% of teen moms are living
in poverty at the time of the
birth
• > 40% of teen moms report
living in poverty by age 27.
• 40% will remain dependent
on the welfare system for 5
years or longer
Source: Kirby, D. (2007). Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Disease. Washington, D.C.: National Campaign to
Prevent Teen and Unplanned Pregnancy, (Alan Guttmacher Institute 1994)., (Moore 1995)
It’s about the child of a teen mother
living in poverty…….
Source: Kirby, D. (2007). Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Disease. Washington, D.C.: National Campaign to
Prevent Teen and Unplanned Pregnancy, (Alan Guttmacher Institute 1994)., (Moore 1995)
It’s about an approach
to address poverty…..
The 30 % decline in the teen birth rate between 1991
and 2002 = 25% of the decline in the number of young
children living in poverty.
Without this decline, some 460,000 more children would
have been living in poverty in 2002 alone.
Source: Kirby, D. (2007). Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Disease. Washington, D.C.: National Campaign to
Prevent Teen and Unplanned Pregnancy, (Alan Guttmacher Institute 1994)., (Moore 1995)
Correlation between teen births and poverty
It’s about the sons of teen moms……
& disrupting the cradle to prison
pipeline before if begins
Sons of a teen mom :
2 times more likely to end up in prison
than sons of mother’s aged 20-21
14 % have been in prison by their late 30s,
compared with 6 % of the sons of
mothers age 20–21.
Spend 2.5 times longer than the average
prison time of sons of women who had a
first birth at age 20–21.
It’s about education…
or the lost opportunities….
for both the teen mom,
the father, & their child
• The major cause of dropout
• Less likely to complete high
school
• Less likely to attend college
• Have decreased economic
stability, income, and
occupational attainment
Source: Kirby, D. (2007). Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Disease. Washington, D.C.: National Campaign to
Prevent Teen and Unplanned Pregnancy
It’s about preventing neglect & abuse……….
& reducing the foster care population
The children of teen parents are 2 times
more likely to suffer from abuse and
neglect
Almost 1 in 10 children of young teen
mothers were reported for abuse or
neglect, compared with 1 in 20 for
children of mothers age 20 to 21.
Why We Need to
Do More
Why we need to do more
Sexual behavior
Outcomes
Prevention
Pause
http://www.etr.org/recapp/documents/theories/Matrix200712.pdf
What works….
Dialogue
Evidence-based programs
Access to contraception
Parent factors
What works….
Dialogue
How is Texas doing in having a public dialogue about
teen pregnancy?
Important health outcomes to Texas in 2009
Important health outcomes to Texas in 2009
Important health outcomes to Texas in 2009
Important health outcomes to Texas in 2009
What works….
Evidence-based programs
How is Texas doing implementing evidence-based
sex education programs?
Prevention
Most Texas schools implement programs that are NOT
evidence-based
Abstinence +
4%
Nothing
2%
Abstinence onlyno evidence
94%
Wiley, Wilson, Valentine,
2008
How is Texas doing implementing evidence-based
sex education programs?
• More abstinence until marriage
money
• Refused money to implement
evidence-based programs
• http://www.power2wait.com/
http://apps.sph.uth.tmc.edu/itsyourgame/
Never taught in school about AIDS or HIV
Percent
50
45
40
35
28
30
25
20
15
17
15
11
10
5
TX
US
US
TX
0
Total
Hispanic
Myths and Misconceptions
2 million
students
th
6 -12th grade
1,173,356
826,644
inexperienced
experienced
What works….
Access to contraception
Urgency
A sexually active teen who does not
use contraceptives has a 90% chance
of becoming pregnant within a year
SourSources: Harlap S, Kost K and Forrest JD, Preventing Pregnancy, Protecting Health: A New Look at Birth Control Choices in the United States, AGI, New York, 1991; and Abma JC et
al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, 23(24).
ce: Texas Department of State Health Services. (2005). Teen Pregnancy Prevention. Retrieved April 28, 2008 from http://www.dshs.state.tx.us/famplan/tpp.shtm
What works….
Parent factors
The Parent Factor: what works?
Connection
Communication
Coaching
Checking
Faulty connections
40% of parents think
they regularly discuss
sex at home
7% of teens thought
this
What does NOT works?
Control
Shame
Negative
Emotion
Threats
Fear
Birth rate change per 1000 teens for Texas and
California
75
71
63
Source: United Nations Statistics Division. (2004). Demographic Yearbook 2004. New York: United Nations; Advocates for Youth
Ca.
California
1990
38
2008
If we implemented programs similar to California,
we would have 21,151 fewer births per year
$412,409,000 in total costs saved