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Teenage Pregnancy. Social Policy Choices Carole Hanks. School of Nursing. Agenda. Burton’s article and her approach to research on a social problem 20 min

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teenage pregnancy

Teenage Pregnancy

Social Policy Choices

Carole Hanks

School of Nursing

agenda
Agenda
  • Burton’s article and her approach to research on a social problem 20 min
    • Discuss Burton’s article and it’s thesis -- teenage pregnancy is an alternative life course strategy created in response to socio-environmental constraints.
  • Background of facts and attitudes about teenage pregnancy
    • Teenage pregnancy rates
    • Neonatal mortality rates
    • How did teen age pregnancy = cause of poverty
what are burton s conclusions
What are Burton’s conclusions?
  • within low-income black families there is an different timetable for assume various life roles than in higher-income families
  • a separation of reproduction and marriage
  • age-condensed family structure (matrilineal)
  • grand-parental child-rearing along with reciprocal care of grandparents by young adult grandchildren
  • marginalization of males
value of this research
Value of this research?
  • Her research was with 20 families; she just “talked to them.” Is this generalizable? valid?
  • Think of Ghana -- when are causes and solutions to poverty the same?
  • What other kinds of research would clarify these issues?
social policy
Social Policy
  • TA Pregnancy -- example of a “social problem”
  • Related to what we have studied this semester: identifying and defining social issues; measuring beliefs, dispositions, and behaviors related to those issues (specification); developing and evaluating social policy
  • Is teenage pregnancy a “problem” or a strategy to deal with poverty and the poor health and deprivation linked to poverty
  • The wrong public policy could do more harm than good.
myths about teenage births
Myths about teenage births:
  • higher infant mortality (not biologically prepared to have children)
  • causes dropping out of school
  • prevents completing education and entering workforce
  • irresponsible act (Is teenage childbearing an individual or a social act?)
personal responsibility work opportunity reconciliation act
Personal Responsibility & Work Opportunity Reconciliation Act
  • Values & behaviors of the poor---> poverty
  • Teen age childbearing in particular --> poverty
  • So, incentives to decrease TA childbearing
    • deny benefits
    • moral renaissance
teenage births
Teenage Births
  • 1920 rate per thousand women aged 15 to 19 62.6
  • 1930 56.7
  • 1940 53.5
  • 1950 79.5
  • 1960 91.0
  • 1970 73.3
  • 1980 53.0
  • 1985 51.0
  • 1990 59.9
  • 1991 62.1
  • 1993 59.6
  • 1994 58.9
  • 1998 ~50
  • U.S. BR was 15.2 in 1994
neonatal mortality
Neonatal Mortality
  • Cross-sectional research conclusions
    • NNMR of teens is higher than women in 20’s
    • But what does maternal age measure?
  • Non random distribution of maternal age at first birth
    • socio-economic status is a confounder
    • control statistically, sister studies, miscarriage studies
when are poor women healthiest
When are poor women healthiest?
  • Prevalence of smoking, drug use, and drinking increases as poor women age
  • Cumulative risk of infection of reproductive organs --->low fertility
  • Hypertension, diabetes prevalence increase
  • shortened lifespan overall
nnmr by age and race
15 18.5

16 16.8

17 14.3

18 14.3

19 13.3

20-23 12.7

24-26 26.5

27-29 15

30-34 15.3

>34 14.3

15 12 (1.54)

16 13.8 (1.22)

17 9.9 (1.44)

18 8.7 (1.67)

19 7.4 (1.79)

20-23 7.3 (1.74)

24-26 6.1 (2.68)

27-29 6.8 (2.19)

30-34 8.1 (1.88)

>34 7.2 (1.97)

NNMR by Age and Race
summary
Summary
  • teenage pregnancy and birth is not a very useful construct, that is, it is too general -- covering a wide age span and drastically different cultural contexts
  • what is normative in one culture may not be in another
  • social policy must recognize the rationale for deciding to give birth as a teen
  • social policy should address “proximate determinants” of neonatal births such as poor nutrition, STD’s, access to medical services, and poor health status. Other social science issues in the decision to give birth and the sucess or failure for the mother and child include rural isolation, unemployment, low wages, lack of day care.
  • postponed childbearing among the poor could lead to increased rates of infant mortality, childhood morbidity, welfare dependency, and more years spent in poverty for children.,
  • What do you think
where to get more information
Where to get more information
  • Family Planning Perspectives , and other journals. Arlene Geronimus has written numerous articles about this issue.
  • Kristin Luker, Dubious conceptions: The Politics of Teenage Pregnancy
  • Linda Burton also studies the grandparent generation & the contribution of neighborhood context to children’s health and development