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Teen pregnancies and births reach historic lows in Minnesota, but disparities persist

University of Minnesota

Pregnancies and births among Minnesota’s teens reached a historic low in 2014, and the overall gonorrhea rate among the state’s youth is continuing to decline, according to a new report from the University of Minnesota.

Researchers say the pregnancy rate dropped 8.2 percent from 2013 to 2014, to 20.4 pregnancies per 1,000 Minnesota youth aged 15 to 19, and the birthrate dropped an almost identical 8.1 percent, to 15.5 per 1,000. Those rates are down a stunning 66 percent for pregnancies and 58 percent for births since the early 1990s.

Gonorrhea rates among 15- to 19-year-olds fell 17 percent in 2015, to 174 cases per 100,000 Minnesotans in that age group. That marks a continuation of a steady three-year decline.

But, as the report also makes clear, disparities in pregnancies, births and sexually transmitted infections (STIs) persist among Minnesota’s teens.

And all the rates remain far too high.

“We’re really happy that teenagers are making good choices and healthy decisions, but there’s still a lot more work to do,” said Jill Farris, director of adolescent sexual health training and education at the U’s Healthy Youth Development–Prevention Research Center, in a phone interview with MinnPost.

Other key findings

Here are some other key findings from the report: 

  • The 10 counties with the highest teen birthrates are all in Greater Minnesota, with Watonwan, Mahnomen, Cass, Nobles and Kandiyohi leading the list. In Watonwan, for example, the teen birthrate is almost four times higher (58.2 per 1,000 15- to 19-year-olds) than the overall state rate (15.5).

“We have to make sure we have [health-care] facilities in place in rural Minnesota that are accessible and comfortable for young people,” said Farris.

Confidentiality, which can appear more elusive in smaller communities, is particularly important to adolescents seeking sexual-health services, she stressed.

University of Minnesota

“Young people need confidential services in order to access them,” she said. “That’s one of the most important things. If it’s not confidential, they will not seek those services, and they will continue to have sex." 

  • Although birthrates decreased in 2014 among Minnesota’s adolescents in every racial group, the rates remain higher for American Indian (40.9 per 1,000), Hispanic (38.8) black (34.2) and Asian (19.5) youth than for white (11.0) youth.

To eliminate these racial and ethnic disparities, the state needs to address disparities in the social determinants of health, such as poverty, racism and unequal access to health care and education, said Farris.

The state also needs to ensure that health-care facilities are “culturally competent” — able to meet the social, cultural and language needs of everyone, she added.

  • Adolescent women in Minnesota who are bisexual are five times more likely to become pregnant than their straight peers. In addition, questioning and gay young men are four times more likely than their straight peers to report getting someone pregnant.

One reason for the higher pregnancy rates in these populations is that “a lot of young people this age are questioning and trying to figure out their identity,” said Farris. “They may not understand their risk for pregnancy because they may not have gotten the same message as their straight counterparts.”

Sex education aimed at teens tends to focus on heterosexual health, she explained.

University of Minnesota

“We need to broaden the messages we give about pregnancy,” Farris added. “We need to be saying, ‘You’re at risk for pregnancy if you’re having the kind of sex that can lead to pregnancy. It doesn’t matter what your orientation is. It matters what body parts are involved in the equation.’” 

  • STIs are widespread throughout the state. Although 45 percent of chlamydia cases among Minnesotans aged 15 to 19 in 2015 were reported in Hennepin and Ramsey Counties, another 33 percent were reported in rural counties. Of the gonorrhea cases reported among Minnesota’s youth in 2015, 26 percent were in rural counties.

Youth STI rates are disproportionately high among populations of color. The gonorrhea rate, for example, is 33 times higher for black youth and 11 times higher for American-Indian youth when compared with white youth.

Jill Harris
Jill Farris

Reducing these STI disparities will require addressing the same social determinants of health, such as poverty, education and access to health care, that affect pregnancy rates among Minnesota’s youth, said Farris.

Better access to sexual-health services is particularly important, she stressed. 

“Teenagers 15 to 19 years old are only about 7 percent of the [state] population, but they are they are a quarter of the chlamydia cases and 16 percent of the gonorrhea cases,” Farris pointed out.

“Part of that is access to health care, access to being able to go get tested and treated for an STI,” she added. “But also, are those services friendly? Are they confidential? Are they affordable? Those things all play into whether a teenager is going to get tested for an STI.”

FMI: You can read the “2016 Minnesota Adolescent Sexual Health Report” in full on the Healthy Youth Development–Prevention Research Center’s website. You will also find detailed county-by-county reports at the site.

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