July 13, 2005, 12:44AM
Rate is higher than other states, despite increased abstinence and contraceptive use
By MELANIE MARKLEY
Copyright 2005 Houston Chronicle
Teen pregnancies have been declining for more than a decade in Texas and Harris County, reflecting a nationwide trend that's attributed to more young people delaying sex and more using effective contraception.
Still, teens here are more likely to have babies than their peers in many other parts of the country, prompting people who work with Houston's youth to call for continued vigilance.
In one national study, only Mississippi ranks worse than Texas in teen birth rates. Other research reveals that among the 100 largest cities in the nation, only nine had higher teen birth rates than Houston in 2000. But state figures also show that the teen pregnancy rate in Texas dropped 32 percent between 1996 and 2003. And in Harris County, the decline was 37 percent.
"I do think we are, for the most part, following a national trend," said Chan McDermott, perinatal coordinator for the Texas Department of State Health Services. "We are just following a little bit behind it, and it will probably take us a little bit longer to reach the same level of achievement that has been reached in other states."
Dr. John S. Santelli, a pediatrician and professor of population and family health at Columbia University in New York City, said his research shows that delays in sexual activity account for about 50 percent of the nationwide decline, while better contraceptive use is responsible for the other 50 percent.
"We have made progress," he said, "and a lot of people should be patting themselves on the back ... But clearly, there is a lot of work to be done."
The role of race
Teen pregnancies, here and nationwide, are characterized by sharp racial differences.
In 2003, for example, black teens in Texas were more than twice as likely as their white peers to have a baby. And Hispanics were more than 3 1/2 times as likely as Anglos to give birth in their teen years.
Public health experts in Houston and elsewhere say the disparity is influenced by a wide range of issues, including social, cultural, educational, economic and religious factors. The high numbers in Texas, they say, are strongly influenced by the state's sizable population of Hispanic immigrants.
Debra Delgado, a senior associate at the social services-oriented Annie E. Casey Foundation in Baltimore, said there is a direct correlation between poverty and high rates of teen pregnancy.
"It's a worldwide phenomenon," she said. "We just see that when people live in poverty, their chances at becoming pregnant at an earlier age are much higher, and when you improve economic circumstances, you will see that the rates of early child-bearing will be reduced."
Still, even among the poor, teen pregnancies have been steadily declining virtually everywhere since 1991.
Youth advocates offer a variety of explanations.
Condom use is up, they say, in large part because of the HIV/AIDS scare. Advances in hormonal birth control now permit sexually active girls to prevent pregnancies by wearing a patch or getting a periodic shot instead of having to remember every day to take a pill.
And at a time when abstinence is the primary emphasis in school health curricula, more teens are apparently heeding the message that delaying sexual activity is the most effective method of birth control and disease prevention. Virginity, they say, is more in vogue with this generation.
"We are all talking about the importance of delaying pregnancy, and we have identified the reasons why it is better," said Dr. Ruth Buzi with the Baylor Teen Clinic. "I think we are clear about those messages, and I think we are making a bigger effort in communicating those messages to teens."
In one family-based program, East End teens in Planned Parenthood's Brighter Futures project meet after school and during the summer at St. Andrew's United Methodist Church to learn how to make better decisions in life, including preventing pregnancies.
A group of high school-age teens at a recent gathering of Brighter Futures said that the majority of their peers are having sex, although many who do are using birth control, primarily condoms.
"The last thing you want is a baby," said Hernan Mazariegos, 16. "That's a smart thing to do, and the stupidest thing is not doing it with protection."
The teens also said that oral sex is fairly common and that those who do it believe it's safe and won't affect their virginity.
How much the students are learning in their sex education classes, however, varies greatly by school. By law in Texas, the emphasis must be on abstinence. But Debbie Schultz, a parent who co-chairs the Houston school district's School Health Advisory Council, said schools can opt for an abstinency-plus curriculum that also teaches students how to protect themselves if they are sexually active.
Martha Garcia, 15, said her health class offered little information beyond the importance of abstinence and the risk of unfortunate consequences for those who don't abstain.
"Really," she said, "they just tell you not to get pregnant."
Although the nation's teen pregnancy rate is dropping, it remains substantially higher than other developed countries.
'Tools' of prevention
Meryl Cohen, vice president of education and counseling at Planned Parenthood of Houston and Southeast Texas, said she recently visited a few European countries to learn why their rates are several times lower.
Cohen said the other countries have governmental policies that provide teens with information on sexual health as well as easy-access services to prevent pregnancies.
"It's really about respecting the right of the teen to be responsible," she said. "But it's the adult's responsibility to make sure they have the tools they need. And that's just different than the way we approach it."
Chris Markham, a behavioral sciences professor at the University of Texas School of Public Health in Houston, said that despite the decline in teen pregnancies, there is still evidence that younger people are involved in risky sexual behavior.
In a study she's working on with Houston middle school students, she said, about 14 percent of seventh-graders say they have had sex and about 8 percent have had oral sex.
She said there are too few studies to show how this compares with past generations. But she said it does raise concerns about the continuing trend in teen pregnancy.
"I think we can't be complacent and assume these declines we've seen are going to keep on declining," she said.