SRFP101: The Impact of State Policies on Sexual Education on Teenage Birth Rates

Destiny Phillips, BA; Jonathan Shaw, MD, MS; Kate Shaw

Abstract

Context: Although teenage birth rates are declining in the United States, they remain higher than those of most developed countries. Within each state, these rates are declining at different rates. It is possible that state policies on sex education are associated with teen birth rates, especially policies that mandate stressing abstinence or comprehensive sexual education. This work is important for primary care as it provides information on preventing teenage birth.
Objective: We sought to determine the effect of state sex education policies on teen birth rates.
Study Design: We performed a retrospective observational cross-sectional study of 50 states and the District of Columbia. Birth rate data were obtained from the National Vital Statistics Reports and state policy information from the Guttmacher Institute. Descriptive statistics and regression analyses were performed to understand the effect of various policies. We used difference in differences estimation to determine if specific state sexual education policy changes impacted rates relative to other states that did not implement similar educational policy changes.
Main Outcome Measures: Teen birth rates
Results: In 2017, while states that stressed abstinence-only education had higher birth rates than states that did not (19.18/1000 versus 15.72/1000 respectively, p=0.05), the difference was no longer significant after controlling for confounding variables in the multivariate regression model. However, difference in difference models demonstrated that New Mexico’s comprehensive sexual education policy change in 2009 had larger decreases in teenage birth rates than similar states without changes in policy.
Conclusion: Although state policies do not predict teenage birth rates, implementation of a mandate for comprehensive sexual education program may result in a greater decline in teenage birth rates, further supporting comprehensive sexual education as a way to prevent unintended teenage birth.
Leave a Comment
Jack Westfall
jwestfall@aafp.org 11/21/2021

This is a very important topic and research study. Nice work. Thanks

Lauren Oshman
laoshman@med.umich.edu 11/22/2021

Thank you for this interesting study. I'm curious, thinking about the impact of the new mandates and the populations at greatest risk for teen pregnancy, if a targeted strategy is more important than a universal mandate for sex ed.

Diane Harper
harperdi@med.umich.edu 11/22/2021

THIS IS SO IMPORTANT In addition to state policies, what are the local community religion and cultural knowledge? rural vs. inner city vs. suburban? Present your results in Phoenix next year! Thank you for sharing your work with NAPCRG!

William R. Phillips
wphllps@uw.edu 11/23/2021

Great. I appreciate seeing this kind of policy analysis at NAPCRG. Thanks for addressing this very important issue in patient care and public health. Your poster is too dense to read easily. What did you discover that might inform more effective policies or implementation of those policies? What more can we make of these mostly negative findings to address the questions that will no doubt come from skeptics? Thanks for sharing your work here at NAPCRG. - Bill Phillips

Alison Huffstetler
alison.huffstetler@vcuhealth.org 11/23/2021

Thanks for bringing up this topic for NAPCRG. I'm a bit surprised by the results, which as Bill states, makes it a bit more challenging to convince policy makers to make changes when equivical or negative results are found. However, it does seem that there might but other markers, such as STD rates, that could also be affected by sexual education. Also, silly question, but why do we use unintended teen birth for these populations? It seems like most pregnancies for school aged adolescents are unintended in the US. I suspect that there are some communities that still have a cultural component of late adolescent pregnancy, but it seems to me we should address the way we look at "unintended" pregnancies in this population overall!

Andy Pasternak
avpiv711@sbcglobal.net 11/28/2021

Great topic and very important. Would be nice if our policy makers could take this data into account.

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