Determinants
Teen pregnancy is a major problem in the United States that has economic, educational, and health implications all across society. The prevalence of teen pregnancy, or adolescent pregnancy can be stated using teen birth rate. This is defined as “the number of live births to women ages 13-19 per 1000 women.” (Hamilton & Ventrua, 2012, p. 5). Though teen pregnancy rates have declined throughout the 1900’s, the United States has the highest teen pregnancy rates among industrialized countries (Hamilton & Ventrua, 2012). Hoffman states for example “the United States has two to seven times greater teen pregnancy rates among industrialized nations” (Hoffman, 2006, p. 1). The highest recorded teen birthrate 96.3 per 1000 women was in 1957. Although teen birthrates have decreased since then, there has been a recent increase in birthrates in 1991 (Azar, 2012; Russle & Lee, 2004). The teen birthrate for all races in 1991 was 61.8 per 1000 women (Hamilton & Ventrua, 2012). If this rate were to stay constant, then there would be approximately 3.4 million births to teenage mothers throughout 2010 (Hamilton & Ventrua, 2012). The rate of teenage births varies across the nation depending on the race and ethnicity of the teen mother (Waddell, Orr, Sackoff, & Santelli, 2010). According to a study conducted by Christine Dehlendorf published in the Journal of Maternal and Child Health, Hispanics have the highest prevalence of teen births among all races and ethnicities in the U.S. (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). The Center for Disease Control and Prevention defines Hispanic or Latino as “ a person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race (CDC, 2012 para. 1). The U.S. Census Bureau states that the Hispanic population is the largest and fastest growing minority population in the country (CDC, 2012). It is estimated that there are 52 million Hispanics as of 2011, which make up 16.7% of the U.S. population. The CDC estimates that by 2050, the Hispanic population will reach 132.8 million and make up 30% of the U.S. population (CDC, 2012). The population of Hispanic teens is projected to increase 50% by the 2025, and make up 25% of the entire U.S. teen population (Ryan, Franzetta, & Manlove, 2005). One fourth of the Hispanic teens in the U.S. will give birth before age 20 (Ryan, Franzetta, & Manlove, 2005). In 2009 the teenage birthrate for Hispanics was 81 per 1000 women, while the teen birthrate was 26 per 1000 women for whites (Ryan, Franzetta, & Manlove, 2005). Although overall teen pregnancy rates have been dropping for all ethnicities, the Hispanic teen pregnancy rates have been decreasing at a much slower rate (Ryan, Franzetta, & Manlove, 2005). From 1991 to 2005, Dehlendorf states that teen birthrates in whites and African Americans decreased by 50% and 48% respectively, but only 22% among Hispanics (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). Abortion among Hispanic teen is less common then among teens from other races, which leads to a higher rate of Hispanic teen pregnancy (Ryan, Franzetta, & Manlove, 2005). Ryan states that in the year 2000, “22% of Hispanic teen pregnancies ended in abortion compared with 30% of pregnancies among all other teens (Ryan, Franzetta, & Manlove, 2005, p. 3).”
There are many issues that lead to the problem of teen pregnancy in the Hispanic population. The majority of the problems can be categorized as individual or social determinants of health. The World Health Organization defines social determinants of health as “the conditions in which people are born, grow, live, work, and age including the health system. These circumstances are shaped by the distribution of money, power and resources at the global, national, and local levels (WHO, 2012, p. para 1).” Individual determinants of health can be defined as a “person’s individual characteristics or behaviors that lead to a health outcome (WHO, 2012, p. para 1).” One of the major individual determinants of teen pregnancy in the Hispanic population is individual teen behavior and attitude regarding contraception use to prevent pregnancy (Russle & Lee, 2004). Another individual determinant is mate selection and how the teen attitudes reflect happiness with their partner (Griffin, Lesser, Uman, & Nyamathi, 2003). Social determinants that affect teen pregnancy in Hispanics include ideals of Hispanic culture, socioeconomics, education, and acculturation into the U.S. (Zsembik & Fennell, 2005). There are some cultural determinants that act as protective factors, which help reduce the risk of teen pregnancy.
The use of contraception is an integral part in preventing teen pregnancy (Goodyear & Newcomb, 2002 ). Examples of contraception include condoms, oral birth control, as well as birth control injections (Russle & Lee, 2004). Teens who are Hispanic use less contraception compared to teens from other races (Ryan, Franzetta, & Manlove, 2005). According to Ryan, “ between 1991 and 2003, 43% of Hispanic teens did not use a condom during their most recent sexual experience (Ryan, Franzetta, & Manlove, 2005, p. 4).” In a study published in the Journal of Nursing Research and Health, Deborah Griffin states that contraception use is directly related to a teen’s attitudes regarding contraception (Griffin, Lesser, Uman, & Nyamathi, 2003). A positive attitude towards contraception and the perceived risk of pregnancy allows teens to openly communicate with their partners about contraception (Griffin, Lesser, Uman, & Nyamathi, 2003). The majorities of Hispanic teens do not have positive attitudes regarding contraception, and do not openly communicate with their partners (Griffin, Lesser, Uman, & Nyamathi, 2003). One of the reasons that potentially explain the lack of communication between Hispanic teen partners is that girls choose partners that are on average three years older (Goodyear & Newcomb, 2002 ). This age difference creates a communication barrier because the girls do not want to jeopardize the trust of their partners by asking to use contraception (Goodyear & Newcomb, 2002 ). Additionally, the girls have a fear of abuse or retaliation from their partner if trust is jeopardized (Griffin, Lesser, Uman, & Nyamathi, 2003). The girls also want to build a closer relationship and have a sense of belonging related to their partners (Griffin, Lesser, Uman, & Nyamathi, 2003). Furthermore, older partners are more likely to initiate sex at an earlier age, especially when the younger girls are not emotionally ready to deal with issues of contraception and pregnancy (Griffin, Lesser, Uman, & Nyamathi, 2003).
Choosing sexual partners who are supportive of the overall well being of teenage Hispanic girls also relates to teen pregnancy within the population (Goodyear & Newcomb, 2002 ). Girls who are depressed and have a low self-esteem are likely to choose partners who reinforce those negative feelings (Goodyear & Newcomb, 2002 ). Consequently, these girls expect to marry their partners within the first year of their relationship, but actually do not (Ryan, Franzetta, & Manlove, 2005). Likewise, these partners may be more coercive towards initiating sex without the use of contraception (Goodyear & Newcomb, 2002 ). Girls who have a higher self esteem and are more socially competent, are likely to choose partners that are more supportive and share similar views about sex, pregnancy, and contraception use. (Goodyear & Newcomb, 2002 ).
Several determinants exist that are imbedded as a part of Hispanic culture, and beyond an individual teen’s control when it comes to dealing with pregnancy. Contrast to the U.S. culture that views delaying pregnancy until people are financially able to support children, the Hispanic culture encourages women to marry and have children at a younger age, which many lead to an increased risk of teen pregnancy (Russle & Lee, 2004). The culture does not see getting pregnant as a problem for teens, but as symbol of womanhood (Russle & Lee, 2004). Likewise, the culture does not emphasize the importance of advancing education for women (Russle & Lee, 2004). These cultural norms force Hispanic teenage girls to have lower expectations about education, and settle to get pregnant at an earlier age (Griffin, Lesser, Uman, & Nyamathi, 2003). A study conducted by Suzanne Ryan shows that in 2002, 25% of Hispanic teens would not be upset if they got pregnant (Ryan, Franzetta, & Manlove, 2005). Family is very important within the Hispanic culture. The culture places a greater value on maintaining family ties versus getting an education (Russle & Lee, 2004). Hispanic families have more extended family members such as grandparents, aunts, cousins who may all be living in the same household (Russle & Lee, 2004). Teens feel that if they get pregnant there are many relatives living at home who are there to take care of the child (Russle & Lee, 2004). This reiterates the idea of getting pregnant early and starting a family versus getting an education. Hispanic culture views sexual activity very different in men compared to women (Ryan, Franzetta, & Manlove, 2005). While men are encouraged to have sex to show masculinity, women are not (Russle & Lee, 2004). For this reason, many Hispanic teens feel that they cannot seek the resources to prevent pregnancy (Russle & Lee, 2004). Though woman are encouraged to get married and have children at an early age, the topic of sex is not openly discussed in Hispanic households (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). This creates a lack of communication between parents and teens regarding sex and contraception (Russle & Lee, 2004).
Parents play a very important role in the Hispanic culture (Zsembik & Fennell, 2005). Teens claim that parents are their primary source of information when it comes to dealing with sex and pregnancy (Ryan, Franzetta, & Manlove, 2005). Though the Hispanic culture places a taboo on the topic of sex, parents who have a higher level of education tend to discuss sex more openly with their teenage children compared to parents who have less education (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). This allows parents the opportunity to communicate the risks of teen pregnancy and the use of contraception in its prevention. Many parents of Hispanic teens work multiple jobs and do not have the time to talk about sex and pregnancy prevention (Zsembik & Fennell, 2005).
In addition to communication with parents, the time a teen spends in the United States also plays an important role in pregnancy risk. The term acculturation can be used to describe the “exposure and adaptation to the U.S. culture such as birthplace, number or years in the U.S. and the use of the English language spoken at home (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009, p. 195).” Dhelendorf states that teens, who have entered the U.S. at an earlier age and have resided longer, tend to have increased levels of sexual activity compared to teens that come at a later age (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). This may be due to the exposure of the high frequency of sex being portrayed in U.S. media and culture (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). In addition to time spent in the U.S., language spoken at home affects the risk of teen pregnancy for Hispanics (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). Those who spoke only Spanish at home were more likely to engage in early sexual activity compared to those who spoke English at home (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). Teens who spoke a combination of English and Spanish at home had the lowest levels of sexual activity (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). The ability to speak English acts as a protective determinant on teen pregnancy, and may open up more opportunities to obtain education about the topic (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). For example, by being able to speak English, Hispanic teens are able to communicate with healthcare professionals who design teen pregnancy prevention programs (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). This would allow teens to have resources such as contraception along with the education to use them (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009).
In addition to speaking English, having a strong religious affiliation also acts as a protective determinant towards reduced levels of sexual activity and pregnancy among Hispanic teens (Russle & Lee, 2004). A study conducted by Stephen Russell, found that Hispanic teens that attend church are more likely to practice abstinence compared to those who do not (Russle & Lee, 2004). These teens claim that it is against their religion to engage in premarital sexual activity along with the fear of disappointing their parents (Russle & Lee, 2004).
Along with intrinsic cultural determinants that lead to high levels of teen pregnancy among Hispanics, are many societal determinants. Many of the Hispanic teens within the U.S. live in poor urban areas of the country where they may lack access to proper healthcare resources (Zsembik & Fennell, 2005). This would make getting contraception difficult (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). Additionally, Hispanic teens that have parents with lower incomes, may not be able to afford contraception, which would lead to increased risk of pregnancy (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). Furthermore, many Hispanic teens use alcohol and other drugs, which impair judgment when dealing with pregnancy (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). Lastly, a large portion of the U.S. Hispanic teen population is undocumented (Zsembik & Fennell, 2005). In 2010, the U.S. Department of Homeland Security Estimated that there were 10.8 million undocumented Hispanics in the United States and 10% were under the age of 18 (Hoefner, Rytina, & Bryan). These teens would not trust professionals who administer teen pregnancy prevention programs due to a fear of deportation (Russle & Lee, 2004).
There are many individual, social, and cultural determinants that affect teen pregnancy in the rapidly growing U.S. Hispanic population. Some of these determinants such as personal attitudes towards the use of contraception, and choosing a good partner are under a teen’s control. Hispanic teens that have high self-esteems along with positive attitudes towards the use to contraception have lower risks of pregnancy. The partners of Hispanic teens who support the use of contraception and openly communicate about sex within the relationships also reduce the risk of pregnancy. Other determinants such as culture, and socioeconomics are not under individual control. (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009) (Goodyear & Newcomb, 2002 ). Aspects of Hispanic culture such as getting married early and starting a family without progressing education, lead to higher risk of pregnancy (Russle & Lee, 2004). Having parents who are educated and communicate with teens about the use of contraception and the risk of pregnancy, helps to combat some of the cultural expectations (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). Conversely to cultural determinants that increase the risk of pregnancy are those that serve as protective determinants and reduce the risk. Having strong religious values and being able to speak English reduces the risk of pregnancy (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). Teens who grow up in poor communities that lack access to healthcare and education have an increased risk of pregnancy (Waddell, Orr, Sackoff, & Santelli, 2010).
It is important to address individual, cultural, and social determinants when looking at Hispanic teen pregnancy. Teens are getting mixed messages from cultural determinants, which affect individual determinants. Coupled with mixed messages are societal barriers placed by social determinants. Hispanic culture is telling teens to get married and have children while U.S. culture is placing an emphasis on education and delaying pregnancy. Russell states that Hispanic teens in the U.S. face the problem of “ a shift in thinking about what it means to be Hispanic. A shift from interdependent and family based identity to one based on economic and individual independence from both family and intimate partners (Russle & Lee, 2004, p. 148).” Addressing individual, cultural, and social determinants will help to reduce teen pregnancy in the United States Hispanic population.
Works Cited
Azar, B. (2012, August 16). Adolescent Pregnancy Prevention: Highlights From a
Citywide Effort. American Journal of Public Health , 1-5.
CDC. (2012). Hispanic or Latino Populations. Retrieved October 9, 2012, from Center
for Disease Control: http://www.cdc.gov/minorityhealth/populations/REMP/hispanic.html
Dehlendorf, C., Marchi, K., Vittinghoff, E., & Braveman, P. (2009). Sociocultural
determinants of Teenage Childbearing Among Latinas in California. Journal of Maternal and Child Health (14), 194-201.
Goodyear, R., & Newcomb, M. (2002 ). Pregnant Latina Teenagers: Psychosocial and
Developmental Determinants of How They Selected and Perceive the Men Who Father Their Children. Journal of Counseling Psychology , 49 (2), 187-201.
Griffin, D., Lesser, J., Uman, G., & Nyamathi, A. (2003). Teen Pregnancy, Motherhood,
and Unprotected Sexual Activity. Research in Nursing and Health (26), 4-19.
Hamilton, B., & Ventrua, S. (2012, April). Birth Rates for U.S. Teenagers Reach
Historic Lows for All Age and Ethnic Groups. National Center for Health Statistics (89).
Hoefner, M., Rytina, N., & Bryan, B. Estimates of the Unauthorized Immigrant
Population Residing in the United States: January 2010. Department of Homeland Security , Office of Immigration Statistics.
Hoffman, S. (2006). By the numers: The Public Costs of Teen Chidbearing. The
National Campaign to Prevent Teen Pregnancy , pp. 1-50.
Madan, A., Palaniappan, L., Urizar, G. W., Fortmann, S., & Gould, F. (2006, March ).
Sociaocultural Factors that Affect Pregnancy Outcomes in Two Dissimilar Immigrant Groups in the United States. Journal of Pediatrics , 341-346.
Russle, S., & Lee, F. (2004). Practitioners; Perspectives on Effective Practices for
Hispanic Teenage Pregnancy Prevention. Perspectives on Sexual and Reproductive Health , 4 (36), 142-149.
Ryan, S., Franzetta, K., & Manlove, J. (2005, February). Hispanic Teen Pregnancy and
Birth Rates: Looking Behind the Numbers. Child Trends , 1-8.
WHO. (2012). Social Determinants of Health. Retrieved October 9, 2012, from World
Health Orgnaization: http://www.who.int/social_determinants/en/
Waddell, E., Orr, M., Sackoff, J., & Santelli, J. (2010). Pregnancy Risk among, Black,
White, and Hispanic Teen Girls in New York City Public Schools. Journal of Urban Health , 87 (3), 426-439.
Zsembik, B., & Fennell, D. (2005). Ethnic Variation in Health and the determinants of
health among Latinos. Journal of Social Science and Medicine (61), 53-63.
There are many issues that lead to the problem of teen pregnancy in the Hispanic population. The majority of the problems can be categorized as individual or social determinants of health. The World Health Organization defines social determinants of health as “the conditions in which people are born, grow, live, work, and age including the health system. These circumstances are shaped by the distribution of money, power and resources at the global, national, and local levels (WHO, 2012, p. para 1).” Individual determinants of health can be defined as a “person’s individual characteristics or behaviors that lead to a health outcome (WHO, 2012, p. para 1).” One of the major individual determinants of teen pregnancy in the Hispanic population is individual teen behavior and attitude regarding contraception use to prevent pregnancy (Russle & Lee, 2004). Another individual determinant is mate selection and how the teen attitudes reflect happiness with their partner (Griffin, Lesser, Uman, & Nyamathi, 2003). Social determinants that affect teen pregnancy in Hispanics include ideals of Hispanic culture, socioeconomics, education, and acculturation into the U.S. (Zsembik & Fennell, 2005). There are some cultural determinants that act as protective factors, which help reduce the risk of teen pregnancy.
The use of contraception is an integral part in preventing teen pregnancy (Goodyear & Newcomb, 2002 ). Examples of contraception include condoms, oral birth control, as well as birth control injections (Russle & Lee, 2004). Teens who are Hispanic use less contraception compared to teens from other races (Ryan, Franzetta, & Manlove, 2005). According to Ryan, “ between 1991 and 2003, 43% of Hispanic teens did not use a condom during their most recent sexual experience (Ryan, Franzetta, & Manlove, 2005, p. 4).” In a study published in the Journal of Nursing Research and Health, Deborah Griffin states that contraception use is directly related to a teen’s attitudes regarding contraception (Griffin, Lesser, Uman, & Nyamathi, 2003). A positive attitude towards contraception and the perceived risk of pregnancy allows teens to openly communicate with their partners about contraception (Griffin, Lesser, Uman, & Nyamathi, 2003). The majorities of Hispanic teens do not have positive attitudes regarding contraception, and do not openly communicate with their partners (Griffin, Lesser, Uman, & Nyamathi, 2003). One of the reasons that potentially explain the lack of communication between Hispanic teen partners is that girls choose partners that are on average three years older (Goodyear & Newcomb, 2002 ). This age difference creates a communication barrier because the girls do not want to jeopardize the trust of their partners by asking to use contraception (Goodyear & Newcomb, 2002 ). Additionally, the girls have a fear of abuse or retaliation from their partner if trust is jeopardized (Griffin, Lesser, Uman, & Nyamathi, 2003). The girls also want to build a closer relationship and have a sense of belonging related to their partners (Griffin, Lesser, Uman, & Nyamathi, 2003). Furthermore, older partners are more likely to initiate sex at an earlier age, especially when the younger girls are not emotionally ready to deal with issues of contraception and pregnancy (Griffin, Lesser, Uman, & Nyamathi, 2003).
Choosing sexual partners who are supportive of the overall well being of teenage Hispanic girls also relates to teen pregnancy within the population (Goodyear & Newcomb, 2002 ). Girls who are depressed and have a low self-esteem are likely to choose partners who reinforce those negative feelings (Goodyear & Newcomb, 2002 ). Consequently, these girls expect to marry their partners within the first year of their relationship, but actually do not (Ryan, Franzetta, & Manlove, 2005). Likewise, these partners may be more coercive towards initiating sex without the use of contraception (Goodyear & Newcomb, 2002 ). Girls who have a higher self esteem and are more socially competent, are likely to choose partners that are more supportive and share similar views about sex, pregnancy, and contraception use. (Goodyear & Newcomb, 2002 ).
Several determinants exist that are imbedded as a part of Hispanic culture, and beyond an individual teen’s control when it comes to dealing with pregnancy. Contrast to the U.S. culture that views delaying pregnancy until people are financially able to support children, the Hispanic culture encourages women to marry and have children at a younger age, which many lead to an increased risk of teen pregnancy (Russle & Lee, 2004). The culture does not see getting pregnant as a problem for teens, but as symbol of womanhood (Russle & Lee, 2004). Likewise, the culture does not emphasize the importance of advancing education for women (Russle & Lee, 2004). These cultural norms force Hispanic teenage girls to have lower expectations about education, and settle to get pregnant at an earlier age (Griffin, Lesser, Uman, & Nyamathi, 2003). A study conducted by Suzanne Ryan shows that in 2002, 25% of Hispanic teens would not be upset if they got pregnant (Ryan, Franzetta, & Manlove, 2005). Family is very important within the Hispanic culture. The culture places a greater value on maintaining family ties versus getting an education (Russle & Lee, 2004). Hispanic families have more extended family members such as grandparents, aunts, cousins who may all be living in the same household (Russle & Lee, 2004). Teens feel that if they get pregnant there are many relatives living at home who are there to take care of the child (Russle & Lee, 2004). This reiterates the idea of getting pregnant early and starting a family versus getting an education. Hispanic culture views sexual activity very different in men compared to women (Ryan, Franzetta, & Manlove, 2005). While men are encouraged to have sex to show masculinity, women are not (Russle & Lee, 2004). For this reason, many Hispanic teens feel that they cannot seek the resources to prevent pregnancy (Russle & Lee, 2004). Though woman are encouraged to get married and have children at an early age, the topic of sex is not openly discussed in Hispanic households (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). This creates a lack of communication between parents and teens regarding sex and contraception (Russle & Lee, 2004).
Parents play a very important role in the Hispanic culture (Zsembik & Fennell, 2005). Teens claim that parents are their primary source of information when it comes to dealing with sex and pregnancy (Ryan, Franzetta, & Manlove, 2005). Though the Hispanic culture places a taboo on the topic of sex, parents who have a higher level of education tend to discuss sex more openly with their teenage children compared to parents who have less education (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). This allows parents the opportunity to communicate the risks of teen pregnancy and the use of contraception in its prevention. Many parents of Hispanic teens work multiple jobs and do not have the time to talk about sex and pregnancy prevention (Zsembik & Fennell, 2005).
In addition to communication with parents, the time a teen spends in the United States also plays an important role in pregnancy risk. The term acculturation can be used to describe the “exposure and adaptation to the U.S. culture such as birthplace, number or years in the U.S. and the use of the English language spoken at home (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009, p. 195).” Dhelendorf states that teens, who have entered the U.S. at an earlier age and have resided longer, tend to have increased levels of sexual activity compared to teens that come at a later age (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). This may be due to the exposure of the high frequency of sex being portrayed in U.S. media and culture (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). In addition to time spent in the U.S., language spoken at home affects the risk of teen pregnancy for Hispanics (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). Those who spoke only Spanish at home were more likely to engage in early sexual activity compared to those who spoke English at home (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). Teens who spoke a combination of English and Spanish at home had the lowest levels of sexual activity (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). The ability to speak English acts as a protective determinant on teen pregnancy, and may open up more opportunities to obtain education about the topic (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). For example, by being able to speak English, Hispanic teens are able to communicate with healthcare professionals who design teen pregnancy prevention programs (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). This would allow teens to have resources such as contraception along with the education to use them (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009).
In addition to speaking English, having a strong religious affiliation also acts as a protective determinant towards reduced levels of sexual activity and pregnancy among Hispanic teens (Russle & Lee, 2004). A study conducted by Stephen Russell, found that Hispanic teens that attend church are more likely to practice abstinence compared to those who do not (Russle & Lee, 2004). These teens claim that it is against their religion to engage in premarital sexual activity along with the fear of disappointing their parents (Russle & Lee, 2004).
Along with intrinsic cultural determinants that lead to high levels of teen pregnancy among Hispanics, are many societal determinants. Many of the Hispanic teens within the U.S. live in poor urban areas of the country where they may lack access to proper healthcare resources (Zsembik & Fennell, 2005). This would make getting contraception difficult (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). Additionally, Hispanic teens that have parents with lower incomes, may not be able to afford contraception, which would lead to increased risk of pregnancy (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). Furthermore, many Hispanic teens use alcohol and other drugs, which impair judgment when dealing with pregnancy (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). Lastly, a large portion of the U.S. Hispanic teen population is undocumented (Zsembik & Fennell, 2005). In 2010, the U.S. Department of Homeland Security Estimated that there were 10.8 million undocumented Hispanics in the United States and 10% were under the age of 18 (Hoefner, Rytina, & Bryan). These teens would not trust professionals who administer teen pregnancy prevention programs due to a fear of deportation (Russle & Lee, 2004).
There are many individual, social, and cultural determinants that affect teen pregnancy in the rapidly growing U.S. Hispanic population. Some of these determinants such as personal attitudes towards the use of contraception, and choosing a good partner are under a teen’s control. Hispanic teens that have high self-esteems along with positive attitudes towards the use to contraception have lower risks of pregnancy. The partners of Hispanic teens who support the use of contraception and openly communicate about sex within the relationships also reduce the risk of pregnancy. Other determinants such as culture, and socioeconomics are not under individual control. (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009) (Goodyear & Newcomb, 2002 ). Aspects of Hispanic culture such as getting married early and starting a family without progressing education, lead to higher risk of pregnancy (Russle & Lee, 2004). Having parents who are educated and communicate with teens about the use of contraception and the risk of pregnancy, helps to combat some of the cultural expectations (Madan, Palaniappan, Urizar, Fortmann, & Gould, 2006). Conversely to cultural determinants that increase the risk of pregnancy are those that serve as protective determinants and reduce the risk. Having strong religious values and being able to speak English reduces the risk of pregnancy (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). Teens who grow up in poor communities that lack access to healthcare and education have an increased risk of pregnancy (Waddell, Orr, Sackoff, & Santelli, 2010).
It is important to address individual, cultural, and social determinants when looking at Hispanic teen pregnancy. Teens are getting mixed messages from cultural determinants, which affect individual determinants. Coupled with mixed messages are societal barriers placed by social determinants. Hispanic culture is telling teens to get married and have children while U.S. culture is placing an emphasis on education and delaying pregnancy. Russell states that Hispanic teens in the U.S. face the problem of “ a shift in thinking about what it means to be Hispanic. A shift from interdependent and family based identity to one based on economic and individual independence from both family and intimate partners (Russle & Lee, 2004, p. 148).” Addressing individual, cultural, and social determinants will help to reduce teen pregnancy in the United States Hispanic population.
Works Cited
Azar, B. (2012, August 16). Adolescent Pregnancy Prevention: Highlights From a
Citywide Effort. American Journal of Public Health , 1-5.
CDC. (2012). Hispanic or Latino Populations. Retrieved October 9, 2012, from Center
for Disease Control: http://www.cdc.gov/minorityhealth/populations/REMP/hispanic.html
Dehlendorf, C., Marchi, K., Vittinghoff, E., & Braveman, P. (2009). Sociocultural
determinants of Teenage Childbearing Among Latinas in California. Journal of Maternal and Child Health (14), 194-201.
Goodyear, R., & Newcomb, M. (2002 ). Pregnant Latina Teenagers: Psychosocial and
Developmental Determinants of How They Selected and Perceive the Men Who Father Their Children. Journal of Counseling Psychology , 49 (2), 187-201.
Griffin, D., Lesser, J., Uman, G., & Nyamathi, A. (2003). Teen Pregnancy, Motherhood,
and Unprotected Sexual Activity. Research in Nursing and Health (26), 4-19.
Hamilton, B., & Ventrua, S. (2012, April). Birth Rates for U.S. Teenagers Reach
Historic Lows for All Age and Ethnic Groups. National Center for Health Statistics (89).
Hoefner, M., Rytina, N., & Bryan, B. Estimates of the Unauthorized Immigrant
Population Residing in the United States: January 2010. Department of Homeland Security , Office of Immigration Statistics.
Hoffman, S. (2006). By the numers: The Public Costs of Teen Chidbearing. The
National Campaign to Prevent Teen Pregnancy , pp. 1-50.
Madan, A., Palaniappan, L., Urizar, G. W., Fortmann, S., & Gould, F. (2006, March ).
Sociaocultural Factors that Affect Pregnancy Outcomes in Two Dissimilar Immigrant Groups in the United States. Journal of Pediatrics , 341-346.
Russle, S., & Lee, F. (2004). Practitioners; Perspectives on Effective Practices for
Hispanic Teenage Pregnancy Prevention. Perspectives on Sexual and Reproductive Health , 4 (36), 142-149.
Ryan, S., Franzetta, K., & Manlove, J. (2005, February). Hispanic Teen Pregnancy and
Birth Rates: Looking Behind the Numbers. Child Trends , 1-8.
WHO. (2012). Social Determinants of Health. Retrieved October 9, 2012, from World
Health Orgnaization: http://www.who.int/social_determinants/en/
Waddell, E., Orr, M., Sackoff, J., & Santelli, J. (2010). Pregnancy Risk among, Black,
White, and Hispanic Teen Girls in New York City Public Schools. Journal of Urban Health , 87 (3), 426-439.
Zsembik, B., & Fennell, D. (2005). Ethnic Variation in Health and the determinants of
health among Latinos. Journal of Social Science and Medicine (61), 53-63.