Running Head: CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES

Examination of Teen Pregnancy Rates Among African American Adolescents Jasmine S. Hepburn Western Washington University

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES

Examination of Teen Pregnancy Rates Among African American Adolescents Introduction Battle (2002) and Winters (2012) both show that since the 1990s teen pregnancy rates have declined all across the country, and among every racial group. However, the rate of African American teen pregnancy is, and has consistently been, twice as high as the rate among white teenagers (Pazol et. al., 2011). For a developed nation, the U.S. has a staggeringly high rate of teen pregnancy yet, there is a proportionate lack of research that investigates the root causes of African American teen pregnancies. There is a problem within literature on African American teenage pregnancy, in that many studies do little more than state that African American teens have much higher rates of teen pregnancy. Literature on teen pregnancy usually deals with trends in teen pregnancy, access to healthcare and information, and preventative approaches targeted at female adolescents (Doswell et.al., 2003). There is research however, that suggests many factors influence teen pregnancy, among them social economic status (SES), education, environment, and family background. Here we will explore the myriad of environmental circumstances that affect teen pregnancy in the United States in order to identify the root causes of African American teen pregnancy. Effects of High Risk Settings Teen pregnancies for African Americans often occur within high-risk populations. A high-risk population can be defined as A group of people in the community with a higher-than-expected risk for developing a particular disease, which may be defined on a measurable parametereg, an inherited genetic defect, physical attribute, lifestyle, habit, socioeconomic and/or educational feature, as well as environment (McGraw-Hill, 2002).

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES

African American teenagers are more likely to live in high risk populations because they are more likely to be low income and have less access to resources. Poverty and low socio-economic status are two factors that place people at high-risk because they hinder access to resources (Battle, 2002). Stanley Battle (2003) describes how the racial/ethnic minorities such as African Americans carry the burden of poor health in the United States, also called the health gap. The health gap is a nationally documented phenomenon. Battle (2003) describes how high teen pregnancy rates, alcohol addiction, and drug addiction are challenges created by the health gap that affect African American youth. Winters describes how poverty negatively effects views on the future in adverse situations "When one is striving for mere survival, orientation to the future is not likely to be a focus." (Winters 2012). The health gap in high-risk populations also relates to disparities in health related information and resources (Battle, 2002). Poverty is a major barrier in which unprivileged African American teens must maneuver during adolescence. It is elements of these high-risk settings that set up many African American adolescent girls to become teen parents. Environment Social and family environments have been studied as factors of African American teen pregnancy. There have been contrasting findings on the impacts that family environment has on African American teen pregnancy. Laura Pittman and Lindsay Chase-Landsdale (1999) found that parenting style greatly impacted whether or not African American teenagers became pregnant. However, they qualify that there is no one parenting style that is guaranteed to avoid teen pregnancies. It is social circumstance, once again, that effects when and where parenting styles are effective (Pittman & Chase-

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES Landsdale, 1999). Pittman and Chase-Landsdale (2003) describe how economic status contributes to how parents perceive what is best for their children, with parents modifying their parenting styles to be more controlling in more dangerous situations. African American parents use authoritarian parenting styles more than their white counterparts, who more often used authoritative parenting styles (Pittman & ChaseLandsdale, 1999). Pittman and Chase-Landsdale found that across social-economic lines

stricter parenting is viewed by many African Americans as necessary to prepare children for realities of discrimination and racism. Winters found that during times of economic decline (times in which there are less opportunities) it is expected that racial minorities feel the effects more greatly than those from the majority group and explains "this indicates that prejudice and discrimination are more prevalent when resources are scarce. (Winters 2012). Pittman and Chase-Landsdale also found that provided within warm, supportive, conditions discipline had healthier impacts regarding sexual experience and pregnancy history. They found parental warmth and acceptance to be critical regardless of race, Pittman and Chase-Landsdales (1999) study found the following: As in European-American families, parental warmth and acceptance have been found to be associated with better academic achievement, higher levels of reported self reliance, and fewer problem behaviors in African American families in both high-and low-risk communities. Yet, parents in high-risk situations faces different obstacles than parents in low-risk situations in regards to control. In high-risk environments where for example, gang violence occurs, parents may modify their parenting to be more controlling than they

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would in safer settings (Pittman & Chase-Landsdale, 1999). It was found by Pittman and Chase-Landsdale that firm control among working class and disadvantaged teens lowered problem behavior, while across the board restrictive control lead to more problem behavior. Loretta I. and Paul C. Winters (2012) agreed that the family is an important environmental factor in teen development, because it is within the family that children learn how to be productive members of society. But contrary to Pittman and ChaseLansdales findings, Loretta I. and Paul C. Winters found that single parent and femaleheaded households were not factors of teen pregnancy, and instead attributed race and social-economic status as more accurate predictors of teenage pregnancy (Winters 2012). They found that race was a factor that could only predict teenage pregnancy is specific situations "Being Black is found to have a statistically significant effect on teenage pregnancy only in poor economies" (Winters, 2012). Winters found that during times of economic decline (times in which there are less opportunities) it is expected that racial minorities will feel the effects more greatly than those from the majority group and explains "This indicates that prejudice and discrimination are more prevalent when resources are scarce (Winters 2012). They go on to say that, When presented with other options pregnancy was not the first choice for African American teens, "In good economies when there are greater job opportunities, Black teens may choose education, work, or career over motherhood" (Winters 2012). Family Structure Family size and structure are two other factors that can buffer rates of teen pregnancy. Hogan and Kitigawa (1985) note that matrifocal families are common among low-income African American populations. Hogan and Kitigawa (1985) explain that the

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES matrifocal family structure seen with single mothers may be attributed to instability of employment among low-income African American men as it makes maintaining a husband-and-wife family more difficult. They pose the idea that there are three avenues

to adulthood for teens: the traditional route of early marriage and parenthood, completing school and beginning a career, or becoming a parent prior to marriage or a career (starting a matrifocal family). In their research, Hogan and Kitagawa (1985) found that African American teens whose sisters had chosen the matrifocal family approach to adulthood were more likely to choose that same path. Family size also plays a role in outcomes for teens in high-risk, single-parent households. Having the luxury of time to sit down and open a dialogue between mothers and daughters about sex was found to be very effective in postponing first sexual encounters (Doswell et. al., 2003). Hogan and Kitigawa (1985) found large families to be associated with over-crowding, socio-economic disadvantage, less intensive communication and interaction. Some of this simply has to do with the fact that parental time and supervision has to be more widely distributed (Hogan & Kitagawa, 1985). Paths into Adulthood The path a teenager chooses into adulthood will profoundly affect the rest of their life. Hogan and Kitigawa (1985) noted that African American teens who had grown up in socioeconomically disadvantaged circumstances and who had witnessed lack of employment opportunities for African American males saw early marriage as less economically advantageous. Hogan and Kitigawa (1985) said that poor prospects for career achievement and economic uncertainty in low-income neighborhoods discourage young women from choosing educational and career achievements over parenthood to

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES

transition into adulthood. Winters (2012) however focused on the role environment plays in choosing a path into adulthood, and noted that pregnancy is often chosen in times where there are not options for education, work, or careers. Familial Support and Education Crosby (2003) describes how perceived family support can impact a teens sexual history. In a study done on pregnant African American teens, teens with lower perceived family support were found to have higher histories of STD infections and were more likely to experience pregnancy (Crosby et.al, 2003). In their study, Crosby et. al, (2003) determined that histories of pregnancy and STD infections stems from a lack of perceived support and/or lack of communication about sex and STD prevention. Perceived family support is related to family size, and parenting style as both can affect how teens view their relationships with their parents. Within the family, Doswell et. al., (2003) found that among fathers, mothers, and peers, mother were found to have the most influence on their young daughters abstaining. Mother daughter communication can be a critical way for girls to ask questions about sex and prevention, especially in environments where other educational resources are scarce. Mothers who can provide accurate, honest information and resources to their daughters can foster perceived support and education with their daughters (Doswell et. al., 2003). That same study also found that education can delay the age at which a teen becomes sexually active, and that age of first sexual experience affects likelihood of teen pregnancy because the earlier a teen becomes sexually active the longer the period of exposure to risk (Doswell et. al., 2003). Perceived family support, exposure to young teen mothers, and parent control and supervision may positively or negatively affect a teens decision to become sexually active.

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES Lack of Resources

Lack of access to health services is an important argument present in many claims regarding high teen pregnancy rates among African Americans. While lack of education and access to resources such as contraceptives certainly plays a large part to teen pregnancy, family was found to also influence teens seeking out resources (Crosby et. al., 2003). Indeed infrequent mother daughter communication about sex and prevention of STDs reported higher histories of pregnancy and STD infections (Doswell et. al., 2003). Access to resources is a significant barrier that should be alleviated in order to lower rates of African American teen pregnancy. Brubaker (2007) found that marginalization before pregnancy, where African American teenage girls are denied access to formal health care leaves them particularly vulnerable to unplanned pregnancies. Regularity of contraceptive use is a critical factor in prevention of teen pregnancy that can be hindered by lack of resources, and can have extremely adverse effects on the African American teenage population (Crosby et. al., 2003). Conclusion African American teen pregnancy rates are an extremely complex problem where environmental, familial, socio-economic, and educational adversities intersect. Teens of marginalized identities living in high-risk, environments in crowded single-parent homes with low perceived warmth and family support were found to be the most at risk for teen pregnancy and parenthood. Socio-economic status, education, and access to resources were found to play large roles in predicting pregnancies among marginalized, lowincome, high-risk populations. Racism and lack of employment and education opportunities are some of the reasons that proportionately, a higher number of African

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American teenagers will become pregnant. Due to these social and environmental factors, Winters states, "it can be concluded that Black teenagers (themselves) should no longer be seen as the model for the problem of teen pregnancy"(Winters 2012).

Research Proposal The disproportionately high rates of African American teenage pregnancy is concerning and must be addressed. I propose a nationwide study in which African American teens between the ages of 13-18 be part of a longitudinal study to explore environmental factors of socio-economic status on African American teen pregnancy. Participants from high, middle, and low-income environments will be sought out in order to compare and contrast environmental causes on African American teen pregnancy. There will be an in-person interview process with the study participants, and an initial survey followed by follow up surveys via email every six months until participants reach their twentieth birthdays. Method Sample The population will be African American teenage girls living in high, middle, and low-income communities. Because not all subjects will be attending high school (due to graduation, dropping out, etc.) high schools will not be the only sampling frame, although high school registrars will be a large source of the sampling frame. The sampling frame will also be derived from community centers, churches, and health clinics in an effort to get a more diverse population. The sample will consist of African American females between the ages of 13-18. The intent will be to have girls who are pregnant, are teen

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES parents, along with girls who have not experienced teen pregnancy at the start of the study.

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Because of the variation in age at the start of the study, we will have less data on some participants than on others. However, in order to expand the sample size it is important to include a range of ages. A range in ages may also provide insight into what percent of cohorts based on birth year experience teen pregnancy. For older teens we will counterbalance the number of surveys with thorough interviews focusing on their earlier teenage years to supplement the lack of data. Design A longitudinal study will span at most seven years, to accommodate those aged 13 at the start of the study. Questionnaires, in person individual interviews, and electronic surveys will also be used to collect data. By using a longitudinal study with our sample we will obtain a more complete picture of how environmental factors affect African American girls throughout their teenage years and into early adulthood. We will also be able to investigate if year of birth is correlated with likelihood of experiencing teenage pregnancy. The independent variable in the study will be socio-economic status (SES) and the dependent variable will be rates of teen pregnancy among female African American teenagers in the U.S.. The operationalization of SES will be measured by: education, family income, and parents occupation. The data will be collected directly from participants. Procedure Data will be collected through an initial questionnaire given to participants which will ask questions related to SES (level of education, where they live, their parents

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES occupations) and pregnancy history. Due to the nature of the study and its focus on

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minors, parents and guardians consent will be obtained before the study and will address all aspects of the study including the research question. After the initial questionnaire, an hour long interview will be conducted to further explore how the participants view environmental factors and their relationship to teen pregnancy, as well as questions about their own knowledge/experience with teen pregnancy. After the initial meeting in which the questionnaire will be given and individual interviews, participants will receive an electronic survey every six months which they will be asked to complete. Electronic surveys will be given every six months until the participants reach 20 years of age at which point the study will conclude. An initial questionnaire in conjunction with individual interviews will assist in obtaining an in-depth analysis of environmental factors and how they affect individuals of different socio-economic statuses. Follow up surveys will be provided every six months to observe the affect of environmental factors of socio-economic status over time and the effects on African American female teenagers, and to report changes in environment, pregnancy history, etc. The most prominent weakness of interviews and surveys is threat of lack of participation, or failure to respond to surveys as well as the time and money that will be required by the research team. However interviews are crucial in order to understand how environmental factors related to SES are being internalized by African American teens. Interviews will provide the opportunity to expand the research questions in response to the answers provided by participants. Examples of questions at the time of the intial interview are as follow: Are you sexually active?*

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES *If yes, at which age did you become sexually active? Are you on birth control? Have you ever been pregnant? Did you receive sex education? Where did you receive sex education? (Parents, school, church, peers) At what age did you receive sex education? What type of sex education did you receive? (Abstinence only, Comprehensive, or other)

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These questions will compare the sexual activity level, pregnancy rate, and sex education of African American teens with different socio-economic statuses. Follow up surveys will help to recognize patterns present over a period of time among African American teens. Results I believe that a regression table will help correlate the relationship between the dependent variable of teenage pregnancy and the independent environmental variables related to socio-economic status. Due to the number of independent variables, a regression table will help view correlations between the independent variables on the dependent variable. I hypothesize that there will be a correlation between socioeconomic status and African American teenage pregnancy, and that as socio-economic status goes down, pregnancy rates will increase. The correlation between sex-education, age of first sexual activity, SES, and pregnancy will all be very closely examined. Frequency of teen pregnancy between high, middle, and low-income socio-economic classes will be also be closely examined and tested for correlations. Frequency will

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provide a clearer picture of where rates of African American teenage pregnancy cases are happening most, between high, middle, or low income African Americans. Significance This study will provide much needed information on the environmental factors affecting African American teenage pregnancy in the United States and may help to explain the severely inflated rate of teenage pregnancy between African American and White teens. Public policy should be influenced by the results of this study leading to social and educational interventions in order to lower rates of African American teen pregnancy to those equal to or lower than their White peers.

CAUSES OF AFRICAN AMERICAN TEENAGE PREGNANCIES References

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Battle, S. F. (2002). Health Concerns for African American Youth. Journal of Health & Social Policy, 15(2), pp. 35-44.

Brubaker, S. J. (2007). Denied, Embracing, and Resisting Medicalization: African American Teen Mothers Perception of Formal Pregnancy and Childbirth Care. Gender and Society, 21(4), pp. 528-552

Crosby, R. A., DiClemente, R. J., Wingood, G. M., Rose, E. & Lang, D. (2003). Correlates of Continued Risky Sex among Pregnant African American Teens. Sexually Transmitted Diseases, 30(1), pp. 57.

Doswell, W. M., Kim, Y., Braxter, B., Taylor, J., Kitutu, J., Hsu, Y. A. (2003). A Theoretical Model of Early Teen Sexual Behavior: What Research Tells Us about Mother's Influence on the Sexual Behavior of Early Adolescent Girls. Journal of Theory Construction & Testing, 7(2), pp. 56-60.

Guttmacher, I. (1987). Social Background, Not Race, Conditions Black Premarital Childbearing. Family Planning Perspectives , 19(5) , pp. 219-220

High-risk populations. (n.d.). In McGraw-Hill Dictionary of Scientific and Technical Terms online. Retrieved from http://medicaldictionary.thefreedictionary.com/high-risk+group

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Hogan, D.P., Kitagawa, E. M. (1985). The Impact of Social Status, Family Structure, and Neighborhood on the Fertility of Black Adolescents. The American Journal of Sociology, 90(4) , pp. 825-855.

Pazol, K., Warner, L., Gavin, L., Callaghan, W. M., Spitz, A. M., Anderson, J. E., Barfield, W. D., & Kann, L. (2011). Vital Signs: Teen Pregnancy United States, 1991-2009. MMWR: Morbidity & Mortality Weekly Report, 60(13), pp. 414-420.

Pittman, L., Chase-Landsdale P.L. (1999). African American Adolescent Girls In Impoverished Communities: Quality of Parenting and Adolescent Outcomes. Family Planning Perspectives , 31(6) , pp. 112-140.

Shi, Leiyu, Stevens, Gregory D., Wulu, John T. Politzer, Robert M., & Xu, Jiahong. (2004). Americas Health Centers: Reducing Racial and Ethnic Disparities In Perinatal Health Care and Birth Outcomes. Health Services Research, 39(6).

Winters, L. I., & Winters, P. C. (2012). Black Teenage Pregnancy: A Dynamic Social

Problem. SAGE Open, (2), pp.1-14. Doi: 10.1177/2158244012436563