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Comprehensive Child Marriage Research Library

Clinic Access and Teenage Birth Rates: Racial/Ethnic and Spatial Disparities in Houston, TX


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Wisniewski, Megan M; O'Connell, Heather A

Journal Article

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Social Science & Medicine

Peer Reviewed


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Students Against Child Marriage's Object Summary:

This study explores whether clinic access alone serves to help decrease the rate of teen pregnancy in the United States because of the increased availability of contraceptive services. Based on data from the Texas Department of State Health Services for Harris County, the study found that clinic access was largely unrelated to teen birth rates in the county, even when controlling for other variables. However, decreased clinic distance may be a deterrent for teen births among non-Hispanic White people in high poverty areas. Their research suggests that clinic placement alone is not enough to make a significant difference in teen birth rates and that outreach should be tailored more specifically to the population. More research needs to be done in other cities, across time, and on other forms of outreach to determine the best ways to decrease teen pregnancy rates.

Article Abstract (If Available):

Teenage motherhood is a pressing issue in the United States, and one that is disproportionately affecting racial/ethnic minorities. In this research, we examine the relationship between the distance to the nearest reproductive health clinic and teenage birth rates across all zip codes in Houston, Texas. Our primary data come from the Texas Department of State Health Services. We use spatial regression analysis techniques to examine the link between clinic proximity and local teenage birth rates for all females aged 15 to 19, and separately by maternal race/ethnicity. We find, overall, limited support for a connection between clinic distance and local teenage birth rates. However, clinics seem to matter most for explaining non-Hispanic white teenage birth rates, particularly in high-poverty zip codes. The racial/ethnic and economic variation in the importance of clinic distance suggests tailoring clinic outreach to more effectively serve a wider range of teenage populations. We argue social accessibility should be considered in addition to geographic accessibility in order for clinics to help prevent teenage pregnancy.

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