Effect of State-Based Policies on Teen Birth and Teen Abortion Rates in the United States [261

Abstract

INTRODUCTION: The United States has one of the highest teen birth rates among developed countries. Interstate birth rates and abortion rates vary widely as do policies on abortion and sex education. The objective of our study is to assess whether the U.S. state-level policies regarding abortion and sexual education have an effect on teen birth and teen abortion rates. METHODS: We carried out a state-level (n=51) retrospective observational cross-sectional study using data imported from the National Vital Statistics System. State policies were obtained from the Guttmacher Institute. We used descriptive statistics and regression analysis to evaluate the effect of state policies on teen birth and teen abortion rates. RESULTS: The state-level mean birth rates when stratifying between restrictive or permissive policies were not statistically different. For sex education policies, 39.8 per 1,000 compared with 45.1 per 1,000 (P<.219); for parents' consent to abortion, 45 per 1,000 compared with 38 per 1,000 when the minor could consent (P<.073); for deterrents to abortion 45.4 per 1,000 compared with 37.4 per 1,000 (P<.045). Political affiliation (35.1/1,000 compared with 49.6/1,000, P<.001) and ethnic distribution of the population were the only variables associated with a difference between mean teen births. Lower teen abortion rates were however associated with restrictive abortion policies, specifically lower in states with financial barriers, deterrents to abortion, and requirement for parental consent. CONCLUSION: Although teen birth rates do not appear to be influenced by state-level policies, state-level policies restrictive to abortion appear to be associated with a lower state teen abortion rate.