Transcript Document

What’s the Data Telling Us?
A Deeper Look at Adolescent Sexual Health Stats
May 2, 2014
Teenwise Minnesota’s 23rd Annual Conference
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
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
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)
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U.S. Adolescent Pregnancy Rates 1972-2008
& Adolescent Birth Rates, 1972-2012
(pregnancies and births per 1,000 females aged 15-19)
120
100
95.1
pregnancy rate
80
60
68
61.7
birth rate
40
29.4
20
0
1972
1976
1980
1984
1988
1992
1996
2000
2004
2008
2012
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.
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.
The source on adolescent sexual health
Adolescent Birth Rates
U.S. & Minnesota, 1970-2012
(number of births per 1,000 females aged 15-19)
70
66
60
50
40
30
60
53
56
51
48
42
41
35
31
36
33
30
42 42.5 41.5
26 28
29
20
39
34
27
24 22.4
31.3 29.4
United States
Minnesota
19.3 18.6
10
0
1970 1980 1985 1990 1995 2000 2005 2006 2007 2008 2009 2010 2011 2012
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
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In 2010, Minnesota had the 9th lowest
Adolescent Birth Rate in the US
(age 15-19 per 1,000)
New
Hampshire
16
Massachusetts
17
Vermont
18
Connecticut
19
New Jersey
20
Maine
21
Rhode Island
22
New York
23
Minnesota
23
Wisconsin
26
0
5
10
The source on adolescent sexual health
15
20
25
30
So, everything’s fine, right?
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
The source on adolescent sexual health
Adolescent Birth Rates
U.S. vs. Minnesota, 2012
(births per 1,000 females aged 15-19)
70
60
60.4
51.9
50
40
39
34.9
43.9
46.3
27
30
20.5
20
10
0
12.8
9.7
American Indian
Asian/Pacific Islander
Black
Hispanic/Latina
Center for Health Statistics, Minnesota Department of Health, 2014; National Center for Health Statistics, 2013
The source on adolescent sexual health
White
MN
US
Minnesota Adolescent Birth Rates
2011 vs. 2012
(births per 1,000 females aged 15-19)
80
60
71.6
60.4
48.6
51.9
40.3 39.0
40
29.6
2012
27.0
20
0
2011
13.3 12.8
American Indian
Asian/Pacific Islander
Black
Hispanic/Latina
Center for Health Statistics, Minnesota Department of Health, 2014
The source on adolescent sexual health
White
Minnesota Adolescent Birth Rates by
Race/Ethnicity, 1995-2012
(number of births per 1,000 females aged 15-19, 3-year clusters)
150
125
Hispanic/
Latina
Black
100
75
50
American
Indian
66.2
Asian/
Pacific Islander
54.3
43.1
25
29.6
13.6
White
0
1995-97
1998-2000
2001-03
2004-06
Center for Health Statistics, Minnesota Department of Health, 2014
The source on adolescent sexual health
2007-09
2010-2012
Number of Adolescent Births in Minnesota
age 15-19, 2012
2000
1909
1500
1000
581
574
500
212
0
American Indian
325
277
Asian/Pacific
Islander
Black
Hispanic/Latina
Center for Health Statistics, Minnesota Department of Health, 2014
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White
Other/Unknown
We’re number one…unfortunately.
Netherlands
Switzerland
Japan
Denmark
Sweden
Italy (2006)
Norway
Finland
Germany
France
Greece
Spain
Canada
Australia
Portugal
United Kingdom (2006)
United States
0.0
3.8
4.3
4.9
5.6
6.0
6.9
Adolescent Birth Rate, 2007
9.1
9.2
10.0
10.5
11.2
13.3
14.1
16.0
17.0
26.7
5.0
10.0
15.0
20.0
25.0
41.3
30.0
35.0
40.0
45.0
United Nations Statistics Division. (2010). Millennium Development Goals Indicators. Retrieved from: http://unstats.un.org/unsd/mdg/SeriesDetail.aspx?srid=761
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Another perspective…
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.
The source on adolescent sexual health
State Adolescent Pregnancy Rates, 2008
(pregnancies per 1,000 females aged 15-19)
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
The source on adolescent sexual health
The source on adolescent sexual health
The source on adolescent sexual health
The source on adolescent sexual health
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.
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State-specific birth rate ranking,
by race/ethnicity, 2008
(age 15-19 per 1,000)
State
Black
Arkansas
83
Nebraska
83
Wisconsin
82
Iowa
78
Mississippi
77
Ohio
75
Kansas
74
Tennessee
74
Minnesota
64
State
Hispanic/
Latina
Alabama
123
Tennessee
115
Georgia
108
Wash. D.C.
106
Nebraska
104
N. Carolina
104
S. Carolina
103
Mississippi
102
Minnesota
80
The source on adolescent sexual health
State
White
Arkansas
52
Mississippi
50
Kentucky
50
Oklahoma
48
West Virginia
47
Tennessee
43
Wyoming
42
Louisiana
40
Minnesota
18
Top 10 MN Counties Ranked by
Adolescent Birth Rate
Birth Rate
2012
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
The source on adolescent sexual health
Minnesota Adolescent Gonorrhea &
Chlamydia Rates, 2003-2013
(age 15-19 per 100,000 population)
1600
1384
1200
927
968
989
1032 1071
1164 1196
1458
1394
1273
Chlamydia
Gonorrhea
800
400
209
198
213
216
229
214
163
164
158
213
267
0
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Center for Health Statistics, Minnesota Department of Health, 2012
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Racial Composition of Minnesota Youth
Aged 15-19, 2010
2%
6% 5%
American Indian
7%
Asian/Pacific
Islander
Black
White
80%
Chlamydia Cases Among Minnesota Youth
Aged 15-19, 2013
Other/Unknown
Gonorrhea Cases Among Minnesota Youth
Aged 15-19, 2013
3% 3%
4% 1%
American Indian
29%
30%
American Indian
22%
Asian/Pacific Islander
Asian/Pacific Islander
Black
White
Other/Unknown
36%
Center for Health Statistics, Minnesota Department of Health, 2013
The source on adolescent sexual health
16%
Black
57%
White
Other/Unknown
Minnesota Adolescent Chlamydia and
Gonorrhea Rates by Race and Hispanic
Origin, 2012 (age 15-19 per 100,000)
Hispanic/Latino
*
71
Asian/Pacific
Islander
50
1,180
Chlamydia
Gonorrhea
619
527
American Indian
3,076
1,772
Black
6,396
42
White
634
0
1,000
2,000
3,000
The source on adolescent sexual health
4,000
5,000
6,000
7,000
Top 10 MN Counties Ranked by
Chlamydia Rate
Chlamydia Rate
2013
(per 100,000)
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
15-19
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Top 10 MN Counties Ranked by
Gonorrhea Rate
Gonorrhea Rate
2013
(per 100,000)
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
15-19
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Other Trends in the Field…
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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 9th graders and 62% of 11th
graders participated in the 2013 Minnesota Student
Survey
The source on adolescent sexual health
Nationally, 2/3 of adolescents have had
sex while they are still in high school
100
Percent of High School Students Who Have Had Sex At Least Once
75
50
64
63
38
45
55
43
52
28
25
0
Males
9th grade
Females
10th grade
11th grade
Centers for Disease Control and Prevention. YRBS, 2011. MMWR 2012;61, p. 24
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12th grade
Percentage of sexually active adolescents
in Minnesota, 2013
38
40
37
30
20
Female
Male
17
13
10
0
9th grade
11th grade
2013 Minnesota Student Survey
The source on adolescent sexual health
Top 5 reasons why Minnesota teens report
that they are not having sex:
1.
2.
3.
4.
5a.
5b.
Fear of pregnancy
Fear of sexually transmitted diseases
I don’t think it’s right for a person my age to have sex
My parent(s) would object
I have not had a chance to have sex (males)
I don’t want to have sex (females)
2013 Minnesota Student Survey
The source on adolescent sexual health
Percentage of sexually active adolescents
in Minnesota, 1992-2013
70
61.2
55.1
50
50
30
47.9
45.9
48.4
50.5
37
29.7
27.6
9th graders
23.3
19
19.7
18.9
2001
2004
2007
11th grade
20
15.0
10
1992
1995
1998
12th graders
-10
2013 Minnesota Student Survey
The source on adolescent sexual health
2010
2013
How many times have you been pregnant or
gotten someone pregnant?
9th grade Male
9th grade
Female
11th grade
Male
11th grade
Female
0 times
98%
99%
97%
98%
1 or more times
2%
1%
2%
2%
Not sure
1%
0%
1%
0%
2013 Minnesota Student Survey
The source on adolescent sexual health
Which of the following best describes you?
9th grade Male
9th grade Female
Heterosexual
(straight)
95%
91%
95%
93%
Bisexual
1%
5%
1%
4%
Gay or lesbian
1%
1%
1%
1%
Not sure
(questioning)
3%
3%
2%
2%
2013 Minnesota Student Survey
The source on adolescent sexual health
11th grade Male 11th grade Female
The LAST time you had sexual intercourse,
what ONE method did you or your partner
use to prevent pregnancy?
9th grade
Male
9th grade
Female
11th grade
Male
11th grade
Female
No method was used to
prevent pregnancy
14%
16%
8%
8%
Birth control pills
9%
10%
18%
24%
Condoms
53%
49%
55%
46%
Shot, ring, implant or any
IUD
2%
5%
3%
9%
Withdrawal (pull-out)
13%
14%
11%
11%
Some other method
1%
1%
1%
1%
Not sure
8%
4%
4%
1%
2013 Minnesota Student Survey
The source on adolescent sexual health
Percent that used a condom with
last intercourse, 1992-2013
80
69.8
68.2
70
63.4
63.1
61.5
60.2
60
69.8
70.3
62.9
68.5
61
65
64.0
12th grade
56.5
54
51.1
11th grade
50
40
1992
1995
1998
9th grade
2001
2004
2013 Minnesota Student Survey
The source on adolescent sexual health
2007
2010
2013
Percentage of Minnesota teens that talked to
their partners about preventing:
75
70
62
59
53
50
48
57
52
46
9th grade Females
9th grade Males
11th grade Females
11th grade Males
25
0
STI/HIV
2013 Minnesota Student Survey
Pregnancy
The source on adolescent sexual health
The source on adolescent sexual health
Trends in Ages at Key Reproductive Transitions in the United States, 1951–2010,” by Lawrence B. Finer and Jesse M. Philbin
The source on adolescent sexual health
The source on adolescent sexual health
The source on adolescent sexual health
The source on adolescent sexual health
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?
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?
The source on adolescent sexual health
Resources
•
CDC Vital Signs – www.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/
• 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.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)
• STD Division – www.health.state.mn.us/divs/idepc/dtopics/stds/stdstatistics.html
• HIV Division - www.health.state.mn.us/divs/idepc/diseases/hiv/hivstatistics.html
National Campaign – www.teenpregnancy.org
• Their mission is to promote values, behavior, and policies that reduce both teen pregnancy and
unplanned pregnancy among young adults
The source on adolescent sexual health
Thank you!
Jill Farris, MPH
Director of Training and Education
[email protected]
651-289-1381
Teenwise Minnesota
1619 Dayton Avenue, Suite 111
Saint Paul, MN 55104
tel. 651-644-1447
fax. 651-644-1417
The source on adolescent sexual health