I asked Josh Libresco, Executive Vice President of The OSR Group, a public opinion and marketing research firm based in San Rafael, California, to weigh in on the recent CDC study showing that states emphasizing abstinence-only education in schools also have the highest teen pregnancy rates. Did the media infer too much causation?
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Does Abstinence Make the Heart Grow Fonder?
Quinn Fabray, the fictional cheerleading captain on the Fox series, Glee, spent most of last season pregnant and feeling that the pregnancy had turned her world upside down. Ironically, Quinn was also the President of the Celibacy Club, at least until her condition was revealed and she quickly became the ex-President.
A new study released by the Centers for Disease Control and Prevention suggests that irony is not confined to the Fox Network. According to the CDC study, some U.S. states have dramatically higher teenage pregnancy rates than others, and the states with the highest teen pregnancy rates happen to be states that emphasize abstinence-only education.
In Connecticut, Massachusetts, New Hampshire, and Vermont, for example, 2008 birth rates were less than 25 per 1,000 teens aged 15 to 19. By contrast, in Mississippi, Arkansas, New Mexico, Oklahoma, and Texas, the birth rate was higher than 60 per 1,000 teens in the same age group.
There is no doubt that teen pregnancies can lead to poor health outcomes for both the mother and the child, and the CDC data have been used to advocate for more aggressive efforts at sex education.
But is it really fair to connect abstinence-only education with teen pregnancy? Or, to put it more precisely, is it fair to say that there is a causal link between abstinence-only education and higher teen pregnancy rates? The two items may be correlated, but is it fair to say that the first causes the second?
Other state-by-state data provide some clues. In the New England states, for example, the average age of mothers at first birth is more than 27, among the highest in the nation. (This is from a National Center for Health Statistics Study conducted in 2002.) At the other extreme are Mississippi, Arkansas, Louisiana, New Mexico, Oklahoma, and Wyoming - many of the same states highlighted above. In these states, the average age of mothers at first birth is around 23. Is the average lower because of teen births, or are there other factors that lead people to start their families earlier in these states?
A 2007 AAUW (American Association for University Women) study revealed that the same set of states also tends to be lowest in educational attainment for women. Arkansas ranks next to last among the states in the proportion of women who have achieved a four-year college degree. Mississippi ranks 45th; Oklahoma ranks 42nd, Texas is 35th, and New Mexico ranks 25th. Are these educational levels lower because of teen pregnancy, or are there other reasons that women in these states might choose to forgo college and begin their families earlier?
A 2010 study by the Guttmacher Institute provides another important piece of the puzzle. While teen birthrates are highest in the five states listed above, the abortion rates in these states tend to be among the lowest. Arkansas ranks 45th in the percentage of teens 15-19 who choose to end their pregnancies with abortions, and Mississippi, Oklahoma, and Texas are also in the bottom half of the states with respect to abortion percentage. Teens in the New England states are much more willing to consider abortions - for example, Connecticut ranks 5th on this measure, and Massachusetts ranks 11th. So some of the explanation for high teen birth rates in the abstinence-only states is that teens in those states are more likely to carry their babies to term.
And now we get to the key, unspoken factor in the equation - religion. In some states, strong Fundamentalist religious beliefs discourage sex education, and also discourage both birth control and abortion. Young women in Fundamentalist families may also be less interested in pursuing higher education and more interested in starting families early.
How does this relate to the five high-profile, abstinence-only states? According to statistics from the Southern Baptist Convention, in 1990, Mississippi had the highest percentage of Southern Baptists in the nation - almost 34%. Oklahoma was third, at 31%, and Arkansas, at 25%, was in 7th place. Texas stood 10th in Southern Baptist percentage (19%), and even New Mexico - not exactly a Southern state - had 10% Southern Baptists, good for 14th place nationwide.
So yes, it may be true that abstinence-only education is related to higher teen pregnancy, but it is also related to a number of other factors - including average age of the mother at birth, educational attainment of women, willingness to have an abortion, and even religious affiliation. Yet correlation is not the same as causation. The CDC study does not prove that abstinence-only education has somehow caused an increase in teen pregnancy, and the study does not separate the influence of abstinence-only education from the influences of many other, related factors.
After all, abstinence-only states should not be the only targets in the battle against teen pregnancy. In 2010, Ohio abandoned abstinence-only, and began a sex education program in schools for the first time in 10 years. Glee's Quinn Fabray lives in Lima, Ohio.
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Josh Libresco is Executive Vice President of The OSR Group, a public opinion and marketing research firm based in San Rafael, California. His firm conducts research projects using online interviews, telephone surveys, focus groups, and other methods for corporations, foundations, and government agencies throughout the United States and in more than 60 countries around the world.
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