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Rural teen birthrates higher than in metro areas

Lack of contraception, comprehensive sex ed can lead to disparities

(MGN)
(MGN)

Teenagers in rural areas are more likely to have sex and less likely to use contraception than teens living in more metropolitan areas, leading to higher teen birthrates.

That's according to a May report from the National Campaign to Prevent Teen and Unplanned Pregnancy, a Washington, D.C.-based not-for-profit that wants to reduce unplanned pregnancies among women under the age of 30.

“Teens in rural communities engage in risky behaviors at higher rates because, a lot of times, there aren't things to do in small-town Iowa — they have more downtime,” said Kristin Fairholm, executive director of Eyes Open Iowa, a Des Moines-based group that advocates for teen sexual education.

The report, which looked at public health data and national health surveys, found that 55 percent of rural teens reported that they had engaged in sex, and 41 percent had sex in the past three months. This is compared with 40 percent of metropolitan teens who've ever had sex and 29 percent who had sex in the past three months.

In addition, a significantly smaller percentage of rural teen girls used contraception the first time they had sex, according to the report — 81 percent of teen girls in metropolitan areas used contraception the first time they engaged in sex compared with 71 percent of rural teenage girls.

This equates to a significantly higher birthrate among girls 15 to 19 years old in rural areas. The report found that the teen birthrate was 45.3 per 1,000 teen girls in areas where the population is below 10,000 people. This is compared with a birthrate of 35.3 per 1,000 teen girls in the country's largest areas with populations more than 1 million people.

Top third

A Gazette Analysis of Eyes Open Iowa data, taken from the Iowa Department of Public Health statistics, showing teen birthrates by county between 2008 to 2012 found that 20 of Iowa's 66 counties with populations of fewer than 20,000 had teen birthrates that ranked in the top third over all, and 39 of those counties had teen birthrates higher than the state average.

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Additionally, out of the 15 counties with the highest birthrates, seven had populations of fewer than 20,000.

Clarke County — with a population of 9,325 in south-central Iowa — had the highest teen birthrate in the state — with a rate of 54.3 per 1,000 girls aged 15 to 19 years old.

Fairholm said there are many reasons as to why rural teens use contraception less often than those in more urban areas, including lack of transportation, fear of visiting the local doctor because the office is staffed by someone the teen knows and lack of access.

“Casey's (General Store) doesn't carry condoms and Planned Parenthood can be far away,” she said, adding that in many small towns, Casey's is one of the only nearby retail establishments. “We're working to make headway with Casey's — I mean, what a difference that would make.”

Comprehensive, evidence-based sexual education is just as important as access to contraception, Fairholm said, but again, that is not always available.

“Some schools are afraid of the controversy,” she said. “But nine times out of 10, parents already think it's being taught.”

Iowa has a Human Growth and Development Mandate, which tells school districts to provide age-appropriate and research-based instruction regarding human sexuality. But the mandate isn't funded and it doesn't specify how much time schools should devote to sexual education, and experts say schools may interpret the mandate differently.

As school is out for summer, phone calls to some districts were not returned.

But Aluralee O'Grady, a family consumer-science and health teacher at Leon Junior and Senior High School in Leon said all 10th-graders are required to take health class, which runs the entire year.

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The 1,977-person town, in Decatur County, had a teen birthrate of 27.3 per 1,000 girls aged 15 to 19 years old from 2008-2012 — higher than the state rate of 24.

O'Grady believes the course is comprehensive, saying it covers all health issues — mental, physical, and social. She said students cover everything from sexuality to sexual relationships, but added the class is the only program students receive.

Andrea Nielsen, a health teacher at OA-BCIG High School in Ida Grove, said she teaches a comprehensive 14-day class to 10th-graders that covers sexually transmitted diseases, birth control methods, sexual pressures, harassment and sexual assault, among other topics.

The town of 2,153 had a teen birthrate of 27.4 per 1,000 girls aged 15 to 19 years old from 2008-2012 — also higher than the state average.

“The last thing we work on is setting sexual limits,” Nielsen said. “I have them think about where they will draw the line. Recognizing that even if they are choosing abstinence, there are still decisions to be made in the behaviors that lead up to sex.”

By the numbers

• 45.3 — births per 1,000 teen girls, aged 15-19 in areas with fewer than 10,000 people

• 35.3 — births per 1,000 teen girls, aged 15-19 in areas with more than 1 million people

• 54.3 — births per 1,000 teen girls, aged 15-19 in Clarke County, population 9,300 and highest in the state

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• 39 Iowa counties with population fewer than 20,000 people have teen birthrates higher than the state average, which is 24

• 7 of the 15 counties with the highest birthrates in the state have populations of fewer than 20,000

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