Teen pregnancy in Ohio has seen a dramatic decline since 2006, as well as a drop in the abortion rate. Ridiculously, Ohio Medical Board member (and anti-abortion activist) Mike Gonidakis is crediting the War on Women for the decline in abortion even though the abortion rate fell faster under Strickland than under Kasich’s first year… which is the most recent data we have.

image 1

Gonidakis was probably thinking of the drop in teen pregnancy, though we yet don’t have any Kasich-era statistics for that. What we see is huge decreases in 2000 and 2001, then a plateau followed by huge decreases in 2009 and 2010.

What explains this?

I think we can rule out behavioral factors. We see year-over-year declines that are very similar across age groups, but we don’t see those declines within cohorts. Remember, Ohio’s 18-19 year-olds for 2010 were Ohio’s 16-17 year olds for 2008.

18-19 15-17 15-19 10-14
2010 9.4% 11% 9.8% 8.3%
2009 4.6% 15.8% 7.1% 7.7%
2008 2% 2.3% 1.2% 7.1%
2007 -2% 0.3% -1.2% 12.5%
2006 -3.8% -0.3% -1.4% -6.7%
2005 -0.7% -0.3% 0% 0%
2004 0% 2.9% 0.9% 0%
2003 1.4% 0% 0.8% 6.3%
2002 6.2% 4.7% 6% 5.9%

 

The same colors are the same kids1. 2005’s 10-14 cohort was no less likely than the year prior to become pregnant, but when they were 5 years older they were 10% less likely to get pregnant.

If a behavioral intervention (namely, sex education at a particular age) were responsible for the decline, then a given cohort would be equally less likely to get pregnant early as they are later.

We don’t see that:

image 2

This scatter chart compares the relative drop in pregnancy rate versus the prior cohort. If behavioral factors were strong determinants of teen pregnancy, there would be a clearer pattern when comparing cohorts.

Since teen pregnancy drops fairly consistently across all age groups simultaneously, environmental factors (rather than behavioral factors) will be correlated with the drop. The two main possibilities here are 1) expansion of birth control access and 2) delay in sexual activity.

Here’s a graph of growth in CHIP enrollment against decline in teen pregnancy:

image 3

Growth in CHIP enrollment since 2007 is predictive of the relative decline in pregnancy among 15-17 year olds, and slightly less so among 18-19 year olds (who aren’t eligible for CHIP).

Prior to 2007, we don’t get that correlation:

image 4

Starting in 2007, CHIP covers birth control at no cost, including Long Acting Reversible Contraceptives (LARCs) like IUDs and Nexplanon. Here’s a 2007-vintage Heritage article bemoaning the prospect of teens getting their hands on contraception like they do in Massachusetts and California2.

image 5

What we see is that states that maintained contraceptive coverage for minors had an earlier and more constant drop than the national as a whole, which saw a 2003-2007 increase followed by a more recent drop.

Bringing in CDC data about self-reported sexual behavior, we can compare birth control usage to teen pregnancy in both 2005 and 20103:

image 6

image 7

In both years, states where more teens used birth control had lower teen pregnancy rates; states with fewer teens using birth control had higher teen pregnancy rates. After the addition of LARC coverage to CHIP, the correlation was slightly stronger.

But what if the Crisis Pregnancy Centers are right, and delaying sexual activity deserves credit for the drop in teen pregnancy? Well, since teen sexual activity only dropped 0.2% between 2005 and 2011, that pretty much rules it out.

It also, FWIW, basically discredits Abstinence Only in its entirely.

2011 2009 2007 2005 2003 2001 1999 1997 1995
33.7% 34.2% 35% 33.9% 34.3% 33.4% 36.3% 34.8% 37.9%

Here’s a graph of sexual activity vs. teen pregnancy.

image 8

image 9

Since the expansion of CHIP, teen sexual activity is less predictive and has a weaker effect on teen pregnancy.

This is very strong evidence that increased access to birth control is responsible for the decrease in Ohio’s teen pregnancy rate. The same logic predicts that expanded access to birth control (through no co-pay coverage and Medicaid expansion) will reduce the unintended pregnancy rate for 20-29 year-olds, and greatly reduce the abortion rate in Ohio.

That is, it would greatly reduce the abortion rate if the GOP were expanding Medicaid and not restricting access to birth control. Which kind of shows you where their priorities lie.

 ——

 Not quite. ODH breaks it into 18-19 and 15-17, so the cohorts overlap somewhat.

2 Irritatingly, I can only find teen birth rates for California, not teen pregnancy. Those are here:

3 This is extrapolated from teen births. We don’t have national teen pregnancy data from 2010 because reportage of non-births varies widely from state to state. I assumed a constant abortion ratio in 2010 compared to 2005.

That probably isn’t the case, but abortion ratios are so strongly determined by the unemployment rate that I would imagine the fluctuations were similar enough across the board, particularly among 15-19 year olds.

Using birth rates rather than pregnancy rates lowers the r2 value to 0.24 (in 2005) and 0.17 (in 2010), which is still a stronger correlation than sexual activity.

 
  • SlapFat

    It remains true: access to contraception decreases the number of abortions and unplanned pregnancies.

  • Ming Ho

    I don’t follow many of the graphs. For the first graph (Ohio abortion and teen pregnancy rates), there are no units for the numbers on the right and left sides.

    For first scatterplot (Pregnancy decline in 15-17 vs 18-19), maybe if you pick a point on the scatterplot and explain the numbers with units and how the relative changes are calculated, that would be helpful.

    As another example, in the time series graph of births to teen mothers, in 1988, the number for the US is about 52, but 52 what? Were there just 52 births to teen mothers in the entire country back in 1988? Or was it a rate like 52 births for every 10,000 teenage females? Was the claim that
    “states that maintained contraceptive coverage for minors had an earlier and more constant drop than the national as a whole, which saw a 2003-2007 increase followed by a more recent drop”
    backed by statistical analysis to confidently reject the possibility that such appearance in the data result from random variation?

    There’s more, but you get my drift.

    While I DO believe in what this article claims, I cannot yet repeat the data analysis in this article as support.

  • dmoore2222

    Why let facts stand in the way of your decisions when you have to suck up to the religious right for votes?

  • Luke Brockmeier

    Sorry, the transposition from Numbers to Pages to WordPress seems to have eaten the unit labels. Your labeling suggestions are dead-on, but I wasn’t able to include them legibly. It seems easiest to explain them, because adding them isn’t working out well.

    I’m adding a link to the Induced Abortions in Ohio report, where most of the Ohio statistics originate.

    The measurement labeled (x) is the x-axis.

    Teen Pregnancy Rate is pregnancies to 15-19 year-olds per 1000 15-19 year old women (rates of 20-90 per 1000)
    Abortion Rate is abortions per 1000 women aged 15-44 (rates of 11.1 to 14.3 per 1000)
    Teen Sexual Activity is the % of high school students who report sexual activity within the prior 3 months (rates of 25%-40%)
    “No Hormonal Birth Control” is the % of sexually active high school students who report not using hormonal birth control (rates of 50%-80%)

    As for the last point (from Massachusetts’ graph), I unfortunately couldn’t find a graph of teen birth/pregnancy rates in states that continuously subsidized birth control for teens vs the nation as a whole. NY, CA, and MA all saw continuous drops (as shown in the graph) since the early-90s peak, whereas the nation as a whole saw an increase from 2004-2007.

    There is (strangely) no published collection of teen pregnancy rates per year by state, nor is there collected historical data about state-level contraceptive policy.

    I hope that clarifies! I can also add the spreadsheet I used, though it’ll probably be very hard to read.

  • anastasjoy

    What a HUGE surprise. I can’t follow these charts, but the facts make sense. And a legislature that shows no interest in expanding access to contraception should just shut up about abortion. As should a Congress that wants to cut off the born children’s food.

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