Teen pregnancy prevention as a state priority: Assessment of continuity with contextual state data

Background: The US teen pregnancy rate decreased 9% between 2009 and 2010, reaching an all-time low of 34.3 births per 1,000 women aged 15-19. There is currently no framework for using relevant state-level contextual information to understand the relationship of state systems with state teen pregnancy prevention (TPP) activities.

Methods: An assessment was conducted to understand the relationship between states identifying TPP as a Title V priority and state: teen population counts; teen pregnancy rates; fertility rates; Medicaid expansion waivers/state plan amendments; abstinence-only education program funding; developed performance measures; and Title V assessed TPP activities.

Results: Among the 50 states and DC, 31% identified TPP as a Title V priority; 41% of states with teen birth rates above the national average identified TPP as a Title V priority. Of the states that identified TPP as a priority, 56% did not have a state-developed measure for teen pregnancy and 13% did not identify any activities related to TPP. Among all states with teen birth rates above the national average, only 32% had some form of Medicaid family planning expansion waiver or State Planning Amendment covering teens ages 15-17.

Discussion: A diversity of publicly available data that can provide state-level contextual information related to TPP is available; however, teen pregnancy rates do not co-align as might be expected with TPP being named a Title V priority. Reasons for this discontinuity between data and priority remain unknown, but methods that better incorporate relevant state policy information may be necessary to understand this occurrence.