The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #59615

Luisa Franzini, PhD¹, Polly Cromwell¹, Christine M. Markham, PhD², Elena Marks¹, Sheryl McCurdy, PhD¹, Nicole McKirahan¹, Jan Risser, PhD³, Pauline Vaillancourt Rosenau, PhD⁴, BJ Selwyn, ScD⁵, and Carrie Shapiro³. (1) University of Texas School of Public Health, 1200 Herman Pressler, Houston, TX 77030, 713 500 9487, lfranzini@sph.uth.tmc.edu, (2) Center for Health Promotion and Prevention Research, University of Texas-Houston, 7000 Fannin, Ste 2610C, Houston, TX 77030, (3) Epidemiology, University of Texas School of Public Health, 1200 Herman Pressler, RAS E 703, Houston, TX 77030, (4) Department of Management and Policy Sciences, School of Public Health - University of Texas - Health Science Center, 1200 Herman Pressler, P.O. Box 20186, Houston, TX 77225, (5) Epidemiology, The University of Texas Health Science Center Houston, School of Public Health, 1200 Hermann Pressler, RAS E619, Houston, TX 77030

Background: Historically, health care providers have relied on their professional expertise to determine whether a patient is a victim of abuse, and they have reported cases of abuse to the appropriate governmental agencies. Recently, it has been suggested by some in Texas that health care providers should report to the police the identity of all patients under 17 whom they have reason to believe are sexually active. Aim: This paper estimates the increase in teen pregnancies, births, abortions, and untreated STDs resulting from enforcing the reporting requirements in Texas. Economic costs are also computed. Methods: A model is constructed based on data on the consequences of parental notification on teen use of reproductive health services, on the effectiveness of reproductive health services in averting pregnancies and in treating STDs, and on the number of Texas teens affected. Sensitivity analysis is used to vary the values of the estimates. Results: Reporting requirements are estimated to result in an additional 15,851 pregnancies, 10,521 births, and 2,935 abortions among the 140,350 teens currently receiving reproductive health services in Texas. The cost of the additional births and abortions is estimated at $79,085,811. Untreated cases of chlamydia and gonorrhea will increase by 5,475 and 3,826 respectively. Discussion: The effect of reporting requirements on teen health is significant. They are estimated to increase pregnancies and births by 20% and abortions by 18% and cause significant increases in untreated STDs. The estimated costs underestimate the true costs as they include solely abortion costs and Medicaid costs of births.

Learning Objectives:

At the conclusion of the session, the participant will be able to:
• construct a model to estimate the health and economic costs associated with reporting sexually active teens
• assess the health and economic costs associated with reporting sexually active teens
• discuss the public health implications of reporting requirements

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.