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The Status of Reproductive and Sexual Health in Southern USA: Policy Recommendations for Improving Health Outcomes

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Abstract

A review of public health data for the 50 states shows that southern states including Alabama, Arkansas, Louisiana, Oklahoma, and Texas consistently have the highest teen pregnancy, teen birth, and sexually transmitted disease (STD) rates in the USA. Furthermore, these states also lack mandates regarding sexuality education; and when sexuality education is provided, abstinence must be stressed while medically accurate information is not a specific requirement. This article synthesizes findings from recent health data collected by the Centers for Disease Control and Prevention (CDC), Guttmacher Institute, the National Campaign to Prevent Teen and Unplanned Pregnancy, and the National Assembly on School-Based Health Care with research and professional recommendations from the scientific literature. Based on the summary of these findings, the goal of this article is to provide recommendations aimed at addressing sexual health in these states, as well as other states with abstinence-only policies, to help improve the health of young people through preventing unintended pregnancy and STD transmission.

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Notes

  1. Authors have utilized terminology to describe race/ethnicity according to the language utilized by the Centers for Disease Control and Prevention.

References

  • American Academy of Pediatrics [AAP]. (2012). Council on school health. school-based health centers and pediatric practice. Pediatrics, 129, 387.

    Article  Google Scholar 

  • American Medical Association [AMA] (2007). Sexuality education, abstinence, and distribution of condoms in schools. Policy Statement, H-170.968. http://www.ama-assn.org/resources/doc/PolicyFinder/policyfiles/HnE/H-170.968.HTM.

  • American Public Health Association (2006). Abstinence and U.S. abstinence-only education policies: ethical and human rights concerns. Policy Number 200610. http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1334.

  • Arkansas Code § 6-18-703, The Arkansas Department of Education rules governing standards for accreditation of Arkansas public schools and school districts, the K–8 physical education and health curriculum framework, and the health and safety curriculum framework for grades nine through 12.

  • Arai, L. (2009). What a difference a decade makes: Rethinking teenage pregnancy as a problem. Social Policy and Society, 8(2), 171–183.

  • Centers for Disease Control and Prevention [CDC]. (2013a). Chlamydia-CDC fact sheet. http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm.

  • Centers for Disease Control and Prevention [CDC]. (2012a). Youth risk behavior surveillance—United States, 2011. MMWR 2012;61(SS-4).

  • Centers for Disease Control and Prevention [CDC]. (2012b). Infertility prevention activities. http://www.cdc.gov/std/infertility/ipa.htm. Last reviewed Nov 20, 2012.

  • Centers for Disease Control and Prevention [CDC]. (2012c). http://gis.cdc.gov/GRASP/NCHHSTPAtlas/main.html.

  • Centers for Disease Control and Prevention [CDC]. (2011a). http://gis.cdc.gov/GRASP/NCHHSTPAtlas/main.html.

  • Centers for Disease Control and Prevention [CDC] (2011b). African Americans and sexually transmitted diseases—CDC fact sheet. http://www.cdc.gov/nchhstp/newsroom/docs/AAs-and-STD-Fact-Sheet-042011.pdf.

  • Centers for Disease Control and Prevention [CDC] (2009). Prevalence of sexually transmitted infections and bacterial vaginosis among female adolescents in the United States: data from the National Health and Nutritional Examination Survey (NHANES) 2003–2004; Oral Session, Thursday, March 13, 8:30 am Central [Oral Abstract D4a – Embargo: Tuesday, March 11, 11:30 am Central (12:30 pm ET)] http://www.cdc.gov/stdconference/2008/press/release-11march2008.htm.

  • Committee on Adolescence (2013). Condom use by adolescents. Pediatrics,132, 973; originally published online October 28, 2013; DOI: 10.1542/peds.2013-2821. Available at: http://pediatrics.aappublications.org/content/132/5/973.full.pdf.

  • Constantine, N. A., Jerman, P., & Huang, A. X. (2007). California parents’ preferences and beliefs regarding school-based sex education policy. Perspectives on Sexual and Reproductive Health, 39(3), 167–175.

    Article  PubMed  Google Scholar 

  • Chesson, H. W., Blandford, J. M., Gift, T. L., Tao, G., & Irwin, K. L. (2004). The estimate direct medical cost of sexually transmitted diseases among American youth, 2000. Perspectives in Sexual and Reproductive Health, 36(1), 11–19.

  • Curtin, S.C., Abma, J.C., Ventura, S.J., & Henshaw, S.K. (2013). Pregnancy rates for U.S. women continue to drop. NCHS data brief, no 136. Hyattsville, MD: National Center for Health Statistics. http://www.cdc.gov/nchs/data/databriefs/db136.pdf.

  • Demissie, Z., Brener, N.D., McManus, T., Shanklin, S.L., Hawkins. J., & Kann, L. (2013). School Health Profiles 2012: characteristics of health programs among secondary schools Atlanta: Centers for Disease Control and Prevention.

  • Eisenberg, M. F., Bernat, D. H., Bearginger, L. H., & Resnick, M. (2009). Condom provision and education in Minnesota public schools: a telephone survey of parents. Journal of School Health, 79, 416–424.

    Article  PubMed  Google Scholar 

  • Ethier, K. (2011). School based health centers access, reproductive health care, and contraceptive use among sexually experienced high school students. Journal of Adolescent Health, 48(2011), 562–565.

    Article  PubMed  Google Scholar 

  • Finer, L. B., & Zolna, M. R. (2011). Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception, 84(5), 478–485.

    Article  PubMed  PubMed Central  Google Scholar 

  • Geronimus, A. T. (1997). Teenage childbearing and personal responsibility: An alternative view. Political Science Quarterly, 112, 405–430.

  • Geronimus, A. T. (2003). Damned if you do: culture, identity, privilede, and teenage childbearing in the United States. Social Science & Medicine, 57, 881–893.

  • Hamilton, B. E., Martin, J. A., & Ventura, S. J. (2012). Births: preliminary data for 2011. National Vital Statistics Reports, 61(5), 1–18.

    Google Scholar 

  • Hamilton, B. E., Martin, J. A., & Ventura, S. J. (2010). Births: preliminary data for 2009. National Vital Statistics Reports, 59(3), 1–19.

    Google Scholar 

  • Hoffman, S. D. (2008). Kids having kids: economic costs and social consequences of teen pregnancy. Washington, DC: The Urban Institute Press.

    Google Scholar 

  • Kempner, M. (2014). Louisiana legislature continues to restrict sex education. Retrieved July 13, 2015, from http://rhrealitycheck.org/article/2014/05/21/louisiana-legislature-continues-restrict-sex-education/ .

    Google Scholar 

  • Kirby, D. (2007). Emerging answers 2007: research findings on programs to reduce teen pregnancy and sexually transmitted diseases. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy. http://www.thenationalcampaign.org/EA2007/EA2007_full.pdf .

    Google Scholar 

  • Kirby, D. (2008). The impact of abstinence and comprehensive sex and STD/HIV education programs on adolescent sexual behavior. Sexuality Research & Social Policy, 5(3), 18–27. www.cfw.org/Document.Doc?id=283 .

    Article  Google Scholar 

  • Klein, J., et al. (2005). Adolescent pregnancy: current trends and issues. Pediatrics, 2005, 281–286.

    Article  Google Scholar 

  • Kost, K., & Henshaw, S. (2013). U.S. teenage pregnancies, births and abortions, 2008: state trends by age, race and ethnicity: http://www.guttmacher.org/pubs/USTPtrendsState08.pdf.

  • Lofink, H., et al. (2013). 2010–2011 School-based health alliance census report. Washington, D.C.: School-Based Health Alliance.

    Google Scholar 

  • Martin, J. A., Osterman, M. J. K., & Sutton, P. D. (2010). Are preterm births on the decline in the United States? Recent data from the National Vital Statistics System. NCHS Data Brief, 39, 1–8.

  • Martin, J.A., Hamilton, B.E., Ventura, S.J., Osterman, M.J.K., & Matthews, T.J. (2013). Births: Final Data for 2011. National Vital Statistics Reports, 62(1). Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_01.pdf.

  • Martin, J. A., Hamilton, B. E., Osterman, M. J. K., Curtin, S. C., & Mathews, T. J. (2015). Births: Final Data for 2013. National Vital Statistics Reports, 64(1), 1–65.

  • Martinez, G., Copen, C. E., & Abma, J. C. (2011). Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006–2010. National Survey of Family Growth. National Center for Health Statistics. National Vital Health Statistics, 23(31), 1–35.

    Google Scholar 

  • Mathews, T.J., & MacDorman, M.F. (2010). Infant mortality statistics from the 2006 period linked birth/infant death data set. National Vital Statistics Reports, 58(17). Hyattsville, MD: National Center for Health Statistics.

  • National Campaign to Prevent Teen and Unplanned Pregnancy. (2011). Counting it up: the public costs of teen childbearing.

    Google Scholar 

  • New York Times. (2012). President—Live election results—NYTimes.com. Retrieved July 13, 2015, from http://elections.nytimes.com/2012/results/president.

  • Owusu-Edusei, K., Chesson, H. W., Gift, T. L., Tao, G., Mahajan, R., Octemia, M. C., & Kent, C. K. (2013). The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008. Sexually Transmitted Diseases, 40(3), 197–201.

    Article  PubMed  Google Scholar 

  • Perper, K., Peterson, K., & Manlove, J. (2010). Diploma attainment among teen mothers. child trends, fact sheet publication #2010-01. Washington, DC: Child Trends.

    Google Scholar 

  • Sonfield, A., & Kost, K. (2013). Public costs from unintended pregnancies and the role of public insurance programs in paying for pregnancy and infant care: estimates for 2008. New York: Guttmacher Institute. Retrieved from http://www.guttmacher.org/pubs/public-costs-of-UP.pdf .

    Google Scholar 

  • Smith, E. (2010). An hour with Rick Perry. Retrieved July 13, 2015, from http://www.texastribune.org/2010/10/18/an-interview-with-gov-rick-perry/ .

    Google Scholar 

  • Trenholm, C., for Mathematica Policy Research Inc, et al. (2007). Impacts of Four Title V, Section 510 Abstinence education programs—final report. Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. http://www.mathematicampr.com/welfare/abstinence.asp .

    Google Scholar 

  • Trussell, J. (2007). The cost of unintended pregnancy in the United States. Contraception, 75(3), 168–170.

    Article  PubMed  Google Scholar 

  • Underhill, K., et al. (2007). Sexual abstinence only programmes to prevent HIV infection in high income countries: systematic review. British Medical Journal, 335(7613), 248. downloaded from http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17656503 .

    Article  PubMed  PubMed Central  Google Scholar 

  • US Department of Health and Human Services (2014). Regional offices. Retrieved July 13, 2015, from http://www.hhs.gov/iea/regional/index.html.

  • U.S. Department of Health and Human Services, Office of Adolescent Health (2013). Teen pregnancy prevention. Retrieved from http://www.hhs.gov/ash/oah/oah-initiatives/tpp.

  • Ventura, S.J., Mathews, T.J., & Hamilton, B.E. (2001). Births to teenagers in the United States, 1940—2000. National Vital Statistics Report, 49(10), 1–23. Available at http://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_10.pdf.

  • Ventura, S.J., Hamilton, B.E., & Mathews, T.J. (2014). National and State Patterns of Teen Births in the United States, 1940-2013. National Vital Statistics Reports, 63(4), 1–34

  • Voter turnout data for United States (Parliamentary, Presidential) | Voter Turnout | International IDEA (2014). Retrieved July 7, 2015, from http://www.idea.int/vt/countryview.cfm?CountryCode=US.

  • Waxman, H. (2004). The content of federally funded abstinence-only education programs. Washington, DC: U.S. House of Representatives Committee on Government Reform — Minority Staff Special Investigations Division. http://oversight.house.gov/documents/20041201102153-50247.pdf .

    Google Scholar 

  • Weinstock, H., Berman, S., & Cates, W. (2004). Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health, 36(1), 6–10.

    Article  PubMed  Google Scholar 

  • Yardley, E. (2008). Teenage mothers' experience of stigma. Journal of Youth Studies, 11(6), 671–684.

  • Zief, S., Shapiro, R., & Strong, D. (2013). The Personal Responsibility Education Program (PREP): launching a nationwide adolescent pregnancy prevention effort, OPRE Report # 2013–37. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

    Google Scholar 

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Acknowledgments

The authors would like to acknowledge Ms. Nicole Cushman and Ms. Jessica Silk for their assistance in reviewing the article.

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Correspondence to Kristen N. Jozkowski.

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Jozkowski, K.N., Crawford, B.L. The Status of Reproductive and Sexual Health in Southern USA: Policy Recommendations for Improving Health Outcomes. Sex Res Soc Policy 13, 252–262 (2016). https://doi.org/10.1007/s13178-015-0208-7

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  • DOI: https://doi.org/10.1007/s13178-015-0208-7

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