Introduction
In a multicultural country such as the United States, racial and social disparities are inevitable. Specifically, black and Hispanic populations are widely perceived to be at a disadvantage in terms of economic status, education, employment, and health. When it comes to adolescent pregnancy, the U.S. has the highest number of pregnancies in young women aged 15-19 compared to other developed countries (Sedgh, Finer, Bankole, Eilers, & Singh, 2015). According to a report by Romero et al. (2016), black teens are at a higher risk of getting pregnant at a young age than white teens. In 2014, there were 34.9 births per 1,000 black females aged 15–19 years, which is over twice as high as the number of births per 1,000 white females of the same age (Romero et al., 2016). Adolescent pregnancy has many risks and consequences that can affect the health of Hispanic and black adolescent mothers and their infants. This statement aims to define and explore the problem of adolescent pregnancy in Hispanic and black females and to provide a position statement on the issue.
Significance
Teen pregnancy was first recognized as a crucial nationwide health problem in the late 20th century, which triggered national efforts to address the issue. In 2006, pregnancy rates among women aged 15-19 were 26.7 for white, 61.9 for black, and 77.4 for Hispanic women (Romero et al., 2014). By 2014, these figures lowered to 17.3, 34.9, and 38.0, respectively, with the overall decline of 41% in teen pregnancy rates (Romero et al., 2014). However, the presence of significant racial disparities threatens the health of populations that are at a high-risk, including black teens.
First of all, teen pregnancy has serious consequences for the health and well-being of both the mother and the infant. For example, Kozuki et al. (2013) studied the influence of parity and young maternal age on infant health outcomes. The research identified that young maternal age has a significant effect on infant health outcomes. Specifically, women who were both nulliparous and below 18 years of age experienced the highest risk of adverse infant health outcomes (Kozuki et al., 2013). For instance, the odds for the small-for-gestation-age outcome and preterm birth were the highest among nulliparous mothers below 18 years of age (Kozuki et al., 2013).
The lowest risk of adverse outcomes was identified in mothers aged 18-35 with parity of at least 3 (Kozuki et al., 2013). The findings thus provide evidence that adolescent pregnancy leads to impaired health outcomes in infants, thus affecting population health in general. Moreover, infants that are small for their gestation age, as well as those born preterm, require additional care and treatment, which increases healthcare costs. As estimated by Romero et al. (2016), in 2014, the average cost of adolescent pregnancy was almost 9.5 billion USD. Given that the overall cost of pregnancy and postpartum care in the U.S. was 55.6 billion USD in 2016 (Dieleman et al., 2016), adolescent pregnancy constitutes about 17% of these costs.
Adverse maternal health outcomes are also associated with young age. For instance, anemia was found to be more common in new mothers aged under 16 (Gibbs et al., 2012). Adolescent pregnancy was also widely associated with an increased weight gain during pregnancy, which can affect maternal health in the long term (Gibbs et al., 2012). Moreover, pre-eclampsia was found to be much more common in adolescent mothers than in adult mothers (Gibbs et al., 2012). Both maternal and infant health consequences can be triggered by the young age of the mother, which increases the economic and health burden of adolescent pregnancy. Furthermore, as teen pregnancy is much more common in black teens than in white teens, it creates a major population health disparity that has to be addressed.
Teen pregnancy results not only in health consequences but also in socioeconomic disadvantages, which is why the problem is significant both for the healthcare community and the general population. Mothers who give birth at a young age are rarely able to attend college or university, which limits their employment opportunities and socioeconomic status. Communities with high rates of poverty, unemployment, and low levels of education, on the other hand, are more vulnerable to the issue of adolescent pregnancy (Romero et al., 2014). According to Barr, Simons, Simons, Gibbons, and Gerrard (2013), young women raised in disadvantaged contexts are more exposed to favorable prototypes of unwed pregnant teens, which affects their contraceptive choices and increases the risk of adolescent pregnancy. For instance, if a girl’s mother gave birth at a young age and the girl views her as a favorable prototype, the daughter will be more likely to engage in risky sexual behaviors from a young age. Thus, the problem of adolescent pregnancy can persist in certain communities for generations and cannot be solved by temporary measures, such as educational interventions. It is crucial to address specific communities with long-term, viable solutions to ensure a positive outcome.
Official Position
Although the American Nurses Association (ANA) has not issued a separate position statement on adolescent pregnancy, it addressed adolescent health in general. For instance, ANA supports nursing education and research that would equip nurses with knowledge and skills crucial to help adolescents (ANA, 2000). Moreover, ANA (2000) supports initiatives designed to improve adolescents’ access to care such as school health services, Title X Children’s Health Insurance Program (CHIP), and more. Overall, ANA’s position is not specific to a single health issue or community; instead, it promotes a comprehensive approach to researching and treating health issues that are common in adolescents in general.
Personal Position
My personal position on the issue of high rates of teen pregnancy in black and Hispanic communities would help to target specific populations to provide interventions that would lower adolescent pregnancy rates in the long term. I would support:
- educating nurses on the specific factors that influence sexual behaviors and family planning in black and Hispanic adolescents;
- developing and testing interventions specific to the target populations, including the provision of contraception, education, and more;
- providing guidance and health services to black and Hispanic teens free of charge;
- researching the influence of individual and community factors on adolescent pregnancy rates and developing interventions to moderate the effect;
- promoting services and programs community-wide, ensuring higher awareness and increased use;
- developing creative ways of delivering services to large communities (for instance, mobile clinics providing OB/GYN services to local residents);
- legislation and policies targeting health issues in specific communities that take into account demographic, socioeconomic, and behavioral factors characteristic of the target communities.
Conclusion
Overall, I believe that adolescent pregnancy is a serious health problem that must be targeted by appropriate policies and interventions. Successful action against the problem of adolescent pregnancy requires addressing communities that are especially vulnerable to the problem, including low-income neighborhoods with high shares of Hispanic and black youths. Interventions directed at the disadvantaged populations would help to reduce the rate of adolescent pregnancy in general, thus improving overall community health and decreasing the health and economic burden of teen pregnancy.
References
American Nurses Association (ANA). (2000). Adolescent health ANA position statement. Web.
Barr, A. B., Simons, R. L., Simons, L. G., Gibbons, F. X., & Gerrard, M. (2013). Teen motherhood and pregnancy prototypes: The role of social context in changing young African American mothers’ risk images and contraceptive expectations. Journal of Youth and Adolescence, 42(12), 1884-1897.
Dieleman, J. L., Baral, R., Birger, M., Bui, A. L., Bulchis, A., Chapin, A.,… Lavado, R. (2016). US spending on personal health care and public health, 1996-2013. Journal of the American Medical Association, 316(24), 2627-2646.
Gibbs, C. M., Wendt, A., Peters, S., & Hogue, C. J. (2012). The impact of early age at first childbirth on maternal and infant health. Paediatric and Perinatal Epidemiology, 26(1), 259-284.
Kozuki, N., Lee, A. C., Silveira, M. F., Sania, A., Vogel, J. P., Adair, L.,… Humphrey, J. (2013). The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis. BMC Public Health, 13(3), 1-10.
Romero, L., Pazol, K., Warner, L., Cox, S., Kroelinger, C., Besera, G.,… Barfield, W. (2016). Reduced disparities in birth rates among teens aged 15–19 years — United States, 2006–2007 and 2013–2014. MMWR: Morbidity and Mortality Weekly Report, 65(16), 409-414.
Sedgh, G., Finer, L. B., Bankole, A., Eilers, M. A., & Singh, S. (2015). Adolescent pregnancy, birth, and abortion rates across countries: Levels and recent trends. Journal of Adolescent Health, 56(2), 223-230.