Teenage Pregnancy: Barriers to an Integrated Model for Policy Research
Nash, Roy, Social Policy Journal of New Zealand
New Zealand has one of the highest teenage pregnancy rates in the developed world. In the UK, where the rate is lower than New Zealand's but twice the European average, a Cabinet-led programme has been launched to bring the problem under control. This paper argues the case for New Zealand research into teenage pregnancy -- and the sexual activity of young people in general -- in its full social and cultural context. Three conceptual barriers to this project are identified and discussed: (i) "at risk" positivism; (ii) "true effect" reductionism; and (iii) the concept of culture. It is suggested that a realist structure-disposition-practice model with a "numbers and narratives" methodology may be able to overcome these barriers, and thus widen the focus of an area of research currently dominated by a medical paradigm.
New Zealand has one of the highest teenage pregnancy rates in the OECD. In 1997 the age-specific pregnancy rate for women 15-19 years of age was 33/1,000 for non-Maori and 94/1,000 for Maori (Dickson et al. 2000). Among developed countries, only the United States records a higher statistic.
The specific incidence of teenage pregnancy is not necessarily influenced by changes in the sexual activity of young people, but there is an obvious relationship between sexual activity and pregnancy, and there is much to be said for an integrated approach in this field. Reliable studies indicate that the age of first sexual intercourse in New Zealand is decreasing and that the proportion of sexually active young people at school is increasing (Silva and Stanton 1996, Dickson et al. 1998). It is safe to conclude that at least a third of New Zealand teenagers are sexually experienced before they are 16, the minimum school-leaving age, and that well over half are engaged in sexual activity while at school (Fenwicke and Purdie 2000).
It is appropriate that medical research should focus on matters of social and individual health. Studies within this paradigm emphasise the need for sex education aimed at the prevention of unwanted pregnancy and the control of sexually transmitted diseases. Specific health concerns, however, do not exhaust the reasons for taking a legitimate interest in the sexual activity of young people and its consequences in pregnancy (Cunningham 1984, Simms and Simms 1986). The long-term costs of teenage pregnancy to the state, in terms of sole-parent family benefits expenditure is substantial (Goodger 1998). These are acknowledged as the principal reasons for the recent determination to tackle teenage pregnancy in the United Kingdom, where the Cabinet has launched a multi-pronged campaign to address what is perceived there to be a serious problem (Social Exclusion Unit 1999:4).
This paper outlines an agenda on teenage pregnancy in New Zealand that would provide what policy makers need to know in order to carry out their tasks. This will include assessing the actual state of affairs and whether there is a problem to address, identifying the sectors of the population involved, developing policy options, and evaluating the results of intervention programmes. The challenge for sociologists with a responsibility to assist in these state tasks is to construct a realist framework within which the complex processes that generate social inequalities of various kinds can be modelled. An approach able to transcend the dichotomies that plague social research -- qualitative versus quantitative, positivist versus hermeneutic, and theoretical versus applied -- can be achieved. The realist framework developed here has been influenced by Archer (1995), Bhaskar (1993), Bunge (1998) and, despite the different ontological foundations of his work, Bourdieu (1993, 1998, 2000).
In a word, social structures generate socialised dispositions, socialised dispositions generate collective practices, and practices are adopted by individuals. Social practices should not be confused with the level of behaviour; they are socially recognised ways of doing things that are taken up, perhaps as "discourses", by people in a certain frame of mind. …