Teen Birth Rates in the U.S. from 1990 to 2008: The Role of State Policy, Women’s Opportunity and Contextual Factors

Abstract

Objective: Teen birth rates in the U.S. have declined significantly, with the most recent decline spanning two decades; but patterns of teen childbearing differ substantially across states. Although many policy and expenditure decisions are made at the state level, few studies have examined the relationship between state policies intended to reduce teen births or enhance opportunity and the teen birth rate. Methods: Data from 1989 to 2008 for all 50 states were used in analyses combining time-varying effects models and multilevel modeling, allowing the identification of associations between teen birth rates and state policies that affect women’s health and their educational and employment opportunities, as well as other state characteristics that vary over time, while accounting for between-state differences in the teen birth rate. Results: We find that, at the state level, greater family planning expenditures, higher public assistance benefits, and the proportion of children who are uninsured, are associated with lower teen birth rates and that this relationship has remained constant over the past 18 years. Higher rates of female labor force participation, a lower poverty rate, a higher freshman graduation rate, higher levels of education funding, and a higher proportion of the population with a Bachelor’s degree are also associated with lower teen birth rates rates. Further research on how public assistance policies affect teen childbearing is needed. Conclusion: This study suggests that state-level efforts to provide reproductive health care and to improve educational and employment prospects for state residents are associated with lower teen birth rates.