Over the past decade, teenage birth rates have decreased in the United States. However, teenage motherhood remains a pressing issue in the U.S., one that disproportionately impacts ethnically and economically marginalized communities.
Previous research has indicated that federally funded health clinics that offer family planning and contraceptive services may help reduce teenage birth rates. A 2018 study published in Social Science & Medicine sought to further understand this relationship, specifically in terms of geographical distance.
Looking at Texas
The study, conducted by researchers from Rice University and Louisiana State University, evaluated the relationship between distance to the nearest reproductive health clinic and teenage birth rates of local areas in Houston, Texas, specifically Harris County.
Texas has the fourth-highest birth rate in America and does not require sexual education in public schools. Houston is also the most racially/ethnically diverse major metropolitan area in America. According to the researchers, this provided an ideal context for studying the relationship between clinic distance and teenage birth rates, along with compounding factors like race.
Health Clinics Examined
While there are a variety of clinics that offer family planning and contraceptive services, this study focused on two types of health clinics: Federally Qualified Health Centers (FQHCs) and Title X clinics. FQHCs and Title X clinics receive funding from public resources, which the researchers say makes them ideal for research that aims to inform public policy.
Both of these clinic types are also more economically accessible as they are committed to serving patients regardless of insurance status and offer services that are charged based on income. Title X clinics are also the only health providers in Texas that do not require parental consent for minors seeking family planning and contraceptive services.
Researchers concluded that there was limited support for a connection between low teen birth rates and clinic distance in Harris County. In other words, the geographical accessibility of reproductive health clinics alone was not correlated with low teenage birth rates in Harris County. This pattern was consistent across each racial/ethnic group analyzed.
The analysis provided some evidence of a correlation between clinic distance and low teen birth rates, but only for non-Hispanic white teen birth rates in high-poverty areas. According to the study, this suggests that “clinic distance is similarly related to local teen birth rates regardless of the level of concentrated poverty.”
These findings challenge a strictly geographic approach to understanding accessibility. Researchers explain that reproductive health clinics need to do more than simply be present to reduce rates of teenage births.
“We need to consider factors that affect the social accessibility – and not just the geographic accessibility – of clinics when designing programs and services,” the researchers write. These social factors include providing a safe space and age-appropriate sex education to teenage patients, reducing social stigma around contraceptive use, and tailoring outreach to the needs of specific populations.
Connection to Child Marriage
Texas not only has high rates of teenage motherhood, but also child marriage. From 2000 to 2014, 40,000 children were married in Texas, giving it the second-highest rate of underage marriage in the country. Current Texas law bans marriage for those under 16; however, it allows
emancipated minors to marry.
Teen pregnancy can open the door for these underage marriages, often because of familial or societal pressure. Helping to reduce teen pregnancy rates through tailored health clinic outreach, strengthened sexual education, and a departure from social stigma may help reduce child marriage rates and safeguard the health of young girls.