o time for complacecy what who how why whe key fidigs key recommedatios A C T S H E E T No Time for Complacecy: Tee Births i Califoria is the first report of its kid to aalyze tee birth rates by legislative districts, offerig isight ito taxpayer ad societal costs by state seate district The study was coducted by the Public Health Istitute s (PHI) Ceter for Research o Adolescet Health ad Developmet. The authors were Dr. Norm Costatie, PHI seior scietist ad the Ceter s director, ad Dr. Carme R. Nevarez, PHI medical director ad vice presidet of exteral relatios. The study was fuded i part by a grat from The Califoria Welless Foudatio. The Public Health Istitute obtaied birth data from the Califoria Departmet of Health Services. Tee populatio by zip code data were obtaied from the US Cesus Bureau, ad mappig of zip codes to legislative districts was doe by Capitol Equiry. All data are from year 2000. Dr. Norm Costatie coducted data maagemet ad aalysis. Tee birth rates for the year 2000 were aalyzed by each of Califoria s 40 seate districts. This report ivites policymakers ad their costituets to uderstad how the issue of tee pregacy impacts their districts commuities ad what they ca do to positively affect the situatio. This report is based o birth data from year 2000. The data were aalyzed ad released i March 2003. Califoria has led the atio i reductio of tee birth rates over the last decade. Total societal costs for tee births i Califoria for 2000 were $3.3 billio. The Califoria tee birth rate was higher tha those of every other developed coutry i the world. Withi five years, the aual umber of tee births i Califoria is projected to exceed 66,000 a pheomeal 23 percet icrease. Every oe of Califoria s 40 state seate districts had higher tee birth rates tha Japa, the Netherlads, Italy, Frace, Germay ad Irelad. I Califoria, the Latia tee birth rate was more tha three times higher tha the white o- Hispaic rate ad Asia/Pacific Islader rates. At a miimum, all program fudig aimed at reducig tee pregacies ad births must be maitaied. Califoria cotiue to declie participatio i ad cotributio of matchig fuds for the federal abstiece-oly-util-marriage educatio program. Califoria cotiue to fud effective school- ad commuity-based programs that provide educatio, outreach ad services to support tees i delayig childbearig. Elected officials step up to the plate ad iitiate commuity dialogues by brigig together parets, adolescets ad other school ad commuity stakeholders to address the issue of high tee birth rates ad to determie what additioal steps ca be take. Califoria provide for eforcemet of existig educatio stadards that require medically accurate iformatio be taught i school-based sexuality educatio programs.
o time for complacecy S P O K E S P E R S O N S report authors Norm Costatie, Ph.D. Seior Scietist ad Program Director Ceter for Research o Adolescet Health ad Developmet, Public Health Istitute (925) 284-8118 bay area Shelly Masur, MPH (Redwood City) Associate Director Tee Pregacy Coalitio of Sa Mateo Couty (650) 814-0349 Bryce Skolfield (Sa Fracisco) Director of Programs Youth Leadership Istitute (415) 812-2404 Mara Larse-Flemig (Oaklad) TechiCliic Supervisor Oaklad Techical High School La Clíica de La Raza (510) 388-9653 Yvette Leug, M.P.H., R.D. (Sa Leadro) Coordiator School-Based Health Ceter Coalitio Alameda Couty Health Care Services Agecy (510) 667-7991 cetral valley Yami Gutierrez (Freso) Marketig Cosultat Ecourage Tomorrow (559) 453-2289 ilad empire Biaca L. Guzma, Ph.D. (La Puete) Director of Research Choices (909) 896-5183 Carme R. Nevarez, M.D., M.P.H. Medical Director ad Vice Presidet of Exteral Relatios Public Health Istitute (510) 644-8200 los ageles Agela Acosta Hispaas Orgaized for Political Equality (HOPE) Program ad Policy Director (213) 622-0606 Hele Torres Executive Director Hispaas Orgaized for Political Equality (HOPE) (213) 622-0606 orth coast Beth Chato (Eureka) Presidet Califoria Alliace Cocered with School-Aged Parets ad Pregacy Prevetio Office: (707) 445-7179 Cell: (707) 845-2428 sacrameto Katherie Keer Presidet & Chief Executive Officer Plaed Parethood Affiliates of Califoria (916) 446-5247 sa diego Roby Prime Director of Health Promotios Multicultural Health Promotio Ceter Lida Vista Health Care Ceter (858) 279-9675 Nora Vargas (Sata Aa) Public Affairs Director Plaed Parethood, Sa Berardio/Orage Couty Affiliate (714) 922-4115
o time for complacecy K E Y I N D I N G S I 2001, more tha 53,000 tees aged 15-19, early oe out of twety, gave birth i Califoria. Califoria tee birth rates are higher tha those of every developed coutry i the world. Califoria tee birth rates are betwee 4 ad 12 times higher tha rates for Frace, Spai, Italy, the Netherlads ad Japa. The Latia tee birth rate was more tha three times higher tha the white o-hispaic ad Asia/ Pacific Islader rates. The Africa-America rate was more tha two times higher. I some Califoria legislative districts, tee birth rates are as much as twice the overall statewide rate, with 1 i 10 tee girls givig birth. Every oe of Califoria s 40 state seate districts had higher tee birth rates tha Japa (3.6), the Netherlads (5.8), Italy (6.9), Frace (10.0), Germay (13.2) ad Irelad (15.0). The curret aual cost to taxpayers for tee births i Califoria is estimated to be $1.5 billio, ad the total aual cost to society is estimated to be $3.3 billio. Aual societal costs of tee births were calculated to rage from a low of $27 millio i Seator Ross Johso s 35th district, to a high of $192 millio i Seator Dea Florez s 16th district. Califoria s uprecedeted ivestmet i tee pregacy prevetio has cotributed to the largest declie, ad secod largest percetage reductio (after Alaska), i tee birth rates of all 50 states over the last decade. The uparalleled 40 percet reductio i Califoria s aual tee birth rate over the last decade represets 35,000 fewer tee births i 2001 tha the 89,000 that would have occurred had the tee birth rate remaied at its 1991 level. Traslated ito aual costs averted, this reductio represets a aual savigs to taxpayers of $968 millio ad a total aual savigs to society of $2.2 billio. Due to chagig demographics ad growth of the tee populatio, the Califoria Departmet of Fiace predicts that the recet declie i Califoria s tee birth rate will begi to reverse withi the ext three years. Due to risig poverty levels, Califoria s tee birth rate declie may have already begu to reverse i 2002.
o time for complacecy programs R E C O M M E N D A T I O N S At a miimum, all program fudig aimed at reducig tee pregacies ad births must be maitaied. Califoria cotiue to declie participatio i ad cotributio of matchig fuds for the federal abstiece-oly-util-marriage educatio program. Califoria cotiue to fud effective school- ad commuity-based programs that provide educatio, outreach, ad services to support tees i delayig childbearig. leadership Elected officials step up to the plate ad iitiate commuity dialogues by brigig together parets, adolescets, ad other school ad commuity stakeholders to address the issue of high tee birth rates ad to determie what additioal steps ca be take. educatioal policy Califoria provide for eforcemet of existig educatio stadards that require medically accurate iformatio be taught i school-based sexuality educatio programs. Califoria revise ad stregthe Califoria Educatio Code to clarify ad cosolidate the miimal stadards for comprehesive sexuality educatio istructio. Califoria begi discussio ad developmet of a legislative madate for Califoria public middle schools, high schools, ad alterative schools to teach research-based comprehesive sexuality educatio. Califoria support reliable ad complete school-based survey research that will elicit scietific uderstadig of tee health risk behaviors, icludig sexual risk behaviors. school & commuities Schools ad commuities provide multi-level comprehesive sexuality educatio ad youth developmet programs, with school, paret, youth, ad commuity compoets workig i syergy. Schools ad commuities review ad moitor school polices ad curricula to assess compliace with Califoria Educatio Code, ad to brig these policies ad curricula ito compliace as ecessary.
o time for complacecy A U T H O R S B I O S NORM CONSTANTINE, Ph.D. Seior Scietist ad Program Director, Ceter for Research o Adolescet Health ad Developmet, Public Health Istitute. As seior scietist ad director of PHI s Ceter for Research o Adolescet Health ad Developmet, Dr. Costatie s primary areas of specializatio iclude research ad evaluatio o adolescet health promotio ad paret educatio programs, ad policy use of evaluatio results ad health statistics. Dr. Costatie has taught research methodology classes at several uiversities ad has published i leadig jourals, icludig the Joural of Pediatrics, the Joural of the America Medical Associatio, ad Child Developmet. He is co-editor of a forthcomig book o effective uses of evaluatio by philathropic foudatios to be published by Jossey-Bass. Dr. Costatie is curretly fuded by the Robert Wood Johso Foudatio to study smokig ces- CARMEN RITA NEVAREZ, M.D., M.P.H. Medical Director ad Vice Presidet of Exteral Relatios, Public Health Istitute With more tha 23 years of experiece as a physicia ad 19 years as a public health practitioer, Dr. Carme Rita Nevarez is uiquely qualified to serve as a advocate for issues impactig the public s health. Dr. Nevarez curretly serves as the medical director ad vice presidet for exteral relatios at the Public Health Istitute (PHI), oe of the largest ad most comprehesive public health orgaizatios i the atio. Prior to joiig PHI, Dr. Nevarez served as a health officer ad departmet director with the Departmet of Health ad Huma Services at the city of Berkeley. There she directed a $19 millio agecy that provided itegrated public health services ad a wide rage of commuity programs. As a physicia, Dr. Nevarez has helped to provide medical services to multi-cultural, satio amog pregat ad paretig tees, ad by the Califoria Welless Foudatio to study ad promote effective tee pregacy prevetio policies i Califoria. He serves as seior methodologist for the statewide evaluatio of the Califoria Childre ad Families Commissio s Kit for New Parets, ad pricipal evaluator for the Sacrameto Couty AIDS Prevetio Program Evaluatio ad the Califoria Youth Coectio Foster Youth Advocates Evaluatio. He previously has served as lecturer i Pediatrics at the Staford Uiversity School of Medicie, co-director of the Califoria Healthy Kids Survey, director of data aalysis systems for a atioal evaluatio of the Ifat Health ad Developmet Program, director of the Califoria Iteragecy Data Collaboratio, ad as a couselor workig with early adolescets i residetial treatmet settigs. multi-ethic commuities i a diverse array of settigs icludig: servig as medical director at La Cliica de la Raza, Oaklad, ad the Beach Area Commuity Cliic i Sa Diego. Dr. Nevarez also serves i a advisory capacity to umerous public health ad commuity health orgaizatios. Dr. Nevarez received her M.D. from the Uiversity of Miesota ad her M.P.H. from the Uiversity of Califoria at Berkeley. She completed a Geeral Prevetive Medicie Residecy with Califoria Departmet of Health Services. She curretly serves as executive board member for the America Public Health Associatio. She is also past presidet of the Califoria Public Health Associatio North, ad former chair of the board of the Califoria Ceter for Public Health Advocacy.
o time for complacecy ORGANIZATIONAL BACKGROUNDS public health istitute The Public Health Istitute (PHI) is a idepedet, oprofit orgaizatio dedicated to promotig health, well-beig ad quality of life for people throughout Califoria, across the atio ad aroud the world. As oe of the largest ad most comprehesive public health orgaizatios i the atio, the Public Health Istitute focuses its efforts i two distict but complemetary ways. PHI promotes ad sustais idepedet ad iovative research, traiig ad demostratio programs may i collaboratio with the private health care system ad commuitybased orgaizatios. PHI also serves as a parter with govermet to support its role i assessmet, policy developmet ad assurace. The quality programs ad projects of PHI improve the health of people ad commuities ad iform the developmet of public policy. At the forefrot of curret issues, the Public Health Istitute is a icubator for iovative commuityorieted solutios to emergig public health issues ad a vital coector for traditioal ad otraditioal public health parterships. PHI acts as The Califoria Welless Foudatio (TCWF) was fouded upo a visio to promote the health of the people of Califoria by makig grats for prevetio. The foudatio believes that, rather tha focusig oly o medical treatmet, it is importat also to work to prevet health problems. Guided by this missio, TCWF pursues the followig goals through gratmakig: to address the particular health eeds of traditioally uderserved populatios, icludig low-icome idividuals, people of color, youth ad residets of rural areas; a coveer for public health dialogue, discussio ad leadership developmet opportuities. The Istitute is a resource for researchers ad professioals who view the social, evirometal, ecoomic ad demographic chages i our commuities i terms of the impact o health ad well-beig. These experts work to deepe uderstadig of icidece ad causatio, create appropriate strategies ad systems, ad support the buildig of capacity withi commuities ad istitutios to develop the most effective solutios. A vital, growig, fiacially-stable orgaizatio with a log history of excellece i admiisterig govermet ad foudatio grats ad cotracts, PHI provides a variety of professioal project support services ad maitais various cotractual relatioships with its parters. The Public Health Istitute urtures ew programs ad iitiatives, ofte i partership with foudatios ad other fuders. It provides a home for several large atioal ad iteratioal ceters ad istitutes based i Califoria. PHI also acts as a fiscal sposor for idepedet or soo-to-be idepedet orgaizatios. the califoria welless foudatio to support ad stregthe oprofit orgaizatios that seek to improve the health of uderserved populatios; to recogize ad ecourage leaders who are workig to icrease health ad welless withi their commuities; ad to iform the developmet of public policies that promote welless ad ehace access to prevetive health care. Sice its first year of operatio TCWF has awarded 2,900 grats totalig more tha $378 millio. It is oe of the state s largest private foudatios, makig a average of $40 millio i grats each year i pursuit of its missio.