Teenage Pregnancy in Nova Scotia Communities: Associations with Contextual Factors
Langille, Donald B., Flowerdew, Gordon, Andreou, Pantelis, The Canadian Journal of Human Sexuality
ABSTRACT: This study used data from the Nova Scotia Department of Health (1995-20a communities was estimated. The cumulative probability of pregnancy (CPP) among 15- to 19-year-olds was calculated for each of one hundred and one separate communities. Enumeration area centroids were overlain on community boundaries and linked to community level data from the 1996 Canadian Census. CPP ranged from 0.01 to 0.39, indicating that some communities do well with respect to this health outcome, while others do not. Factors negatively associated with CPP were increasing level of education in communities, and proportions of those indicating a religious faith. Positive associations were seen with increased proportions of single parent families, proportion of population native or black, and the rate of female participation in the work place. Seventy-three per cent of the variance in CPP was explained by these factors. Socio-economic factors, and the social support, community norms and influence of parental control, which religious affiliation and family structure may represent, are important areas to pursue further to understand why these community differences occur.
Key words: Adolescent pregnancy Community context Ecological
ADOLESCENT PREGNANCY IN CANADA AND OTHER COUNTRIES
In 2000, the pregnancy rate for Canadian women aged 15-19 was 38.2/1000 (Statistics Canada, March 2004). This rate includes live births, spontaneous abortions presenting to hospital, therapeutic abortions performed in hospitals and government clinics (but not private abortion clinics), and stillbirths. In 1997, 21233 Canadian women aged 15 to 19 had abortions, for the first time surpassing the number of live births (Dryburgh, 2000). A significant proportion (about 75%) of teenage pregnancies is unintended (Henshaw, 1998), and one review has estimated that 35,000 unintended teenage pregnancies occur annually in Canada (McKay & Bissell, 2000).
Over the past three decades there has been a decline in teenage pregnancies in developed countries. In 1970, twenty-nine industrialized countries had annual rates of births to teenagers of 35/1000 or more; there were only twelve such countries by 1995 (Singh & Darroch, 2000). With respect to Canada, McKay and Bissell (2000) determined that while Canada's decline in rates of births to teenagers was 43% from 1970 to 1995, greater declines were observed in Australia (62%), France (75%) and Sweden (77%). Of the five developed countries with which Canada was compared, only the U.S. had less decline, while that of England was identical to Canada's (McKay & Bissell, 2000). Despite these encouraging trends, teenage pregnancy remains a significant concern. Adolescent pregnancy can lead to low birth weight, preterm delivery, and higher infant mortality, and social consequences for teenage mothers may include decreased educational and employment opportunities (The Social Exclusion Unit, 1999). The latter associations remain incompletely understood, however, in that it may be the case that since socially disadvantaged young women more often have such outcomes, the impact of early pregnancy on their life trajectories may not be as profound as might be intuitively expected (Geronimus, 2003; Spencer, 2001; Stevens-Simon & Lowy, 1995).
ADOLESCENT PREGNANCY IN NOVA SCOTIA
Nova Scotia is a small province on the east coast of Canada. It has a population of approximately 900,000, of whom the vast majority are of western European descent. The largest municipal area, Halifax Regional Municipality (population 360,000), is home to most government services and three of the province's five universities. There are eighteen counties, each with a county seat of from five to thirty thousand. Unemployment is high by Canadian standards, and though the economy is diverse, there is strong reliance on resource-based industry. Many Nova Scotian adolescents have had sexual intercourse (Beazley, King, & Warren, 1988; Langille, Beazley, Shoveller, & Johnston, 1994; Poulin, 1998), and are similar in this respect to their counterparts in the rest of the country (Boyce, Doherty, Fortin, & MacKinnon, 2003). …