The teen birth rate in Kansas remains higher than the national average but has still reached an historic low.

Since 1991, the national teen birth rate has decreased 37 percent, according to a recent report from the Centers for Disease Control and Prevention.

It’s now as low as it’s been in nearly 70 years - 39 births per 1,000 teens, ages 15 through 19.

“The fact that the teen pregnancy rate is down nearly 40 percent and that the teen birth rate in this country is down by about a third, might be one of the best kept secrets in America," said Bill Albert, chief program officer with the National Campaign to Prevent Teen and Unplanned Pregnancy.

"We have seen progress in all 50 states and in all racial and ethnic groups. Progress hasn’t been even in all 50 states and it's not been even in all racial and ethnic groups, but they’ve all declined significantly. It’s really been remarkable progress.

“I’d be hard-pressed to think of another social issue in which the nation has made such progress, whether it’s been smoking, drinking and driving or obesity," Albert said.

In Kansas, the teen birth rate in 2009 – the latest year for which data was available – was almost 44 births per 1,000 teens. That's considerably lower than it was in 1991, when it was 55 births per 1,000 teens.

Despite the progress, the U.S. still has by wide margin the highest teen birth rate in the industrialized world. For example, the rate in the Netherlands is 3.8 births per 1,000 teens. In Japan, it is 5.1 and in Italy, 7.

And Kansas still ranks relatively poorly among the states. New Hampshire, the state with the lowest rate, has 20 births per 1,000 teens. Mississippi has the highest rate, 66 births per 1,000 teens.

How the U.S. Compares

Greater risk
Studies show that children born to teen mothers are often at a disadvantage physically and socially.

Those born to young, unwed, low-income mothers are at a much greater risk for inadequate prenatal care, infant death or poor development. They are more likely to be abused or neglected, score lower in standardized testing and are more likely to go to prison than a child born to an older mother, according to the National Campaign to Prevent Teen and Unplanned Pregnancy.

Poverty also is common for children born to teen moms. According to the CDC, nearly half of the nation’s teen mothers do not graduate from high school by the time they’re 22. Less education generally means less income.

According to the National Campaign to Prevent Teen and Unplanned Pregnancy, a child born to a teen mother who was unwed when she gave birth and had no high school degree has a 64 percent chance of growing up in poverty. The likelihood of poverty for a child born to a married mother older than 19 with a high school diploma is 7 percent.

Public Costs of Teen Childbearing

In Kansas, 40 percent of all children are in low-income homes with annual earnings below 200 percent of federal poverty guidelines. And 49 percent of the children in low-income households live with a single parent.

In Missouri, 43 percent of all children are in low-income homes, and 54 percent of those children live in a single parent home, according to the National Center for Children and Poverty.

Other costs
Teen births also take a toll on state and federal treasuries and taxpayers.

According to "By the Numbers," a 2006 study, teen births cost federal, state and local taxpayers $9.1 billion in 2004.

The costs to Kansas alone between 1991 and 2004 were estimated at $1.5 billion.

The figures include the costs of additional public health programs, food stamps and other welfare benefits.

The costs to Missouri in the same period were $3.3 billion.

Why a decline?
The CDC report did not explain the reasons for the overall decline in the teen birth rate but noted that sex education and easy access to contraceptives were known to be effective.

Improved contraception has played a major role in the decrease according to at least one study, results of which were published in the American Journal of Public Health.

That report concluded that contraceptive use by teen accounted for 86 percent of the reduction between 1995 and 2002, a period during which the national rate dropped 24 percent. Fourteen percent of the decrease was attributed to teens who were in the 15-through-17 age group abstaining from or postponing sexual activity until they were older.

Albert attributed the decline to a variety of factors.

“As Americans, we tend to be very practical people. We look for magic-bullet solutions to our social problems. We think ‘If we just did this, we’d fix that,’” he said. “But the success in bringing down the teen pregnancy rate lies with there not being a single intervention that works. It’s a combination of things. It’s parents talking to kids, it’s the adoption of programs in and outside of schools that have evidence of success, it’s the availability of more methods of contraception, it’s a media effort to get people to understand the risk of unprotected sex and that it’s OK not to have sex.

“Teen pregnancy is a complex issue. It resists the magic-bullet solution," he said. "All these things are very important.”

Sex education
Others say two factors are key:
“We know that the most effective way to reduce the teen pregnancy rate is through providing medically accurate, age appropriate, comprehensive sex education,” said Sarah Gillooly, public affairs manager for Planned Parenthood of Kansas and Mid-Missouri. “The other way is by providing affordable birth control although, for teens, sex education is far more important than providing affordable birth control."

Asked why Kansas’ teen birth rate is above the national average, Gillooly said she didn’t know.

“I’ve not seen any studies on that,” she said, “but we do know that Kansas does not have any kind of statewide implementation or standards for comprehensive sex education.”

In Kansas, public school curriculums are required to include courses on health and human sexuality. The content of these courses, however, is left up to local school boards.

Some school districts offer semester-long courses on health and sex education; others blend the topics in once-a-year assemblies.

“There is no regulation as to how much or what they have to cover,” said Darrel Lang, HIV/AIDS and human sexuality consultant at the Kansas Department of Education. “We make available resources and curriculum that’s medically accurate and research-based. Whether they’re used or how they’re used – those decisions are made locally.”

The Internet
Lang said it is unclear the effect that near-instant access to sex-education materials on the Internet has had on teen birth rates.

“There is more information available, that’s true; whether it’s information that's valid or reliable is another thing,” he said. “You can type in a question having to do with human sexuality and anything having to do with sex will show up, everything from porn to abstinence-till-marriage. A lot of it, I’m afraid, is not good, medically accurate information,”

According to Kansas Department of Health and Environment’s latest “Adolescent and Teenage Pregnancy Report,” which was issued in January, 4,980 teens between ages 15 and 19 were known to be pregnant in 2009; 4,239 gave birth.

Fifteen percent of the state’s pregnant teenagers had abortions. Fewer than 15 miscarried.

The number of abortions performed in Kansas also has declined in recent years.

According to KDHE, there were 8,338 abortions reported in 2010. That was 1,136, or 12 percent, fewer than in 2009 and 3,989, or 32.4 percent, fewer than in 2000.

Increased awareness
Sandy Pickert, executive director at Pure and Simple Health Education, a Wichita-based program that stresses abstinence from high-risk activities, attributed the declines in teen birth and pregnancy rates to increased awareness.

“I’ve worked with kids for 30 years and I can honestly say that today’s generation is a generation of truth seekers,” Pickert said. “They’ve really started to figure out that high-risk behaviors come with a cost.

“This isn’t just about sex. It’s about sex, it’s about alcohol and drugs and tobacco-use,” she said. “It’s about high-risk behavior, understanding the consequences of those behaviors, and making a conscious decision ahead of time that you’re not going to engage in them.”

Pickert said the Pure and Simple curriculum reaches about 7,000 students a year. Most of them are in middle school.

Teen pregnancy
Some Kansas counties report teen pregnancy rates that are more than double the state average.

Between 2005 and 2009, the state’s average pregnancy rate for teens, ages 15 through 19, was almost 53 per 1,000 female teens.

The five counties with the highest five-year averages were:
• Seward County (Liberal) – 106.3 pregnancies per 1,000 teens.
• Geary County (Junction City) – 105.8 pregnancies per 1,000 teens.
• Wyandotte County (Kansas City) – 104.5 pregnancies per 1,000 teens.
• Stanton County (Johnson City) – 99.3 pregnancies per 1,000 teens..
• Hamilton County (Syracuse) – 90.5 pregnancies per 1,000 teens.

"It is what it is"

“We don’t dispute the data. It is what it is,” said Patricia Hunter, administrator at the Junction City-Geary County Health Department. “But we have several factors going on.”

Hunter said the Geary County numbers were skewed by “…so many young people being stationed at Fort Riley and starting families.”

The health department, she said, runs a family planning clinic and a clinic geared toward young people.

“We try to focus our efforts on those below the age of 18 because they should be in school,” Hunter said. “They need to graduate.”
But, she said, “…we have such a mobile community here. It is hard to have an impact, there are so many people moving in and moving out all the time.”

In the state’s rural counties, teen pregnancy rates tend to be driven by access to contraceptives, said Steve Fawcett, director of the Work Group for Community Health and Development at the University of Kansas.

“If you’re a teenager in a small town, there's a pretty good chance that the person on the other side of the counter at the local pharmacy is not the person you want to be purchasing contraceptives from,” Fawcett said.

Studies have shown that sex education and access to contraceptives are about equal in their effect on teen pregnancies, he said.

“It’s not one or the other, they both matter,” Fawcett said. “Abstinence is the best approach – if you’re abstinent in your behaviors, it’s pretty hard to get pregnant. But for those who aren’t abstinent, there needs to be access to contraceptives.”