Teen Pregnancy in the Panhandle

Teen Pregnancy in the Panhandle Jamie L. Moore WHNP-BC Department of State Health Services Health Service Region 1

Health Service Region 1 Teen pregnancy rate (ages 13-17) Most recent 2009 statistics Texas 24.7 HSR 1 33.0 Potter 38.6 Randall 14.9 Texas consistently ranks as one of the top three with the highest teen pregnancy rates in the nation. To surpass the rate in Texas is significant knowing only one or two other states have higher rates

Monitor/QA MCH grants Family planningpreventing teen pregnancy Tremendous cuts in funding Monitor availability of services- clinic closures Monitor and make available local statistics Prenatal- dealing with teen pregnancy

Statistics can put one to sleep

Statistics can overwhelm

Statistics can drive one crazy

Sometimes, what you find is unexpected

Warning-Comparing apples to oranges (kittens to rabbits) Teen pregnancy rate Teen birth rate Can effect rankings Ages 13-17 *DSHS statistical reports Ages 15-19 Theoretically should be close but there are differences- spontaneous loss and elective loss Look a lot alike but not the same

Texas-Rankings for teen birth 2009- ranked 3 rd Mississippi, New Mexico, Texas, Oklahoma 2008- ranked 3 rd Mississippi, New Mexico, Texas, Oklahoma 2007- ranked 1st Texas,???? Teen birth ratesages 15-19 2006- ranked 2 nd Mississippi, Texas, Arizona, Arkansas 2005- ranked 1 st Texas, New Mexico, Mississippi, Arkansas

Looking at teen birth rates

2008/2009

Looking at the United States vs. selected European Counties Pregnancy rate

Birth rates

The teen abortion rate in the U.S. is almost eight times higher than in Germany.

Percent of Total Births Births to Teens in Potter & Randall Counties 9 8 Potter Texas Randall 7 6 5 4 3 2 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Year of birth

Lets bring the statistics down to more manageable bite sizes

Lets look at the last five years comparing the teen pregnancy rate for teens ages 13-17 for Potter County to that of the state, and our region

Teen pregnancy rates-potter County 2005 Texas 25.9 HSR 1 29.3 Potter 42.6 2006 Texas 26.0 HSR 1 31.9 Potter 38.2 2007 Texas 26.3 HSR 1 32.6 Potter 41.9 2008 Texas 26.2 HSR 1 31.8 Potter 34.2 2009 Texas 24.7 HSR 1 33.0 Potter 38.6 It has consistently exceed both the sate and regional rates Had a nice dip in 2008 and back up in 2009 1998=54.1

Actual number of teens pregnant and outcomes 2004 Actual number teens pregnant: 170 births Teens giving birth:159 Teen abortions: 11 2006 Actual number teens pregnant: 163 births Teens giving birth: 153 Teen abortions: 9 Fetal deaths to teens: 1 (Potter County) 2005 Actual number teens pregnant: 180 births Teens giving birth: 162 Teen abortions: 16 Fetal deaths to teens: 2 2007 Actual number teens pregnant: 176 births Teens giving birth: 168 Teen abortions: 7 Fetal deaths to teens: 1 2008 Actual number of teens pregnant 142 Teens giving birth:135 Teen abortions: 7 2009 Actual number of teens pregnant 157 Teens giving birth: 151 Teen abortions: 6

Births to mothers 17 years of age and younger by race- Potter County 2008 Total births:135 White: 29 Black:17 Hispanic: 89 2009 Total births: 151 White: 28 Black: 25 Hispanic: 98

Percent of the total births that were to mothers 17 years of age or younger by race- Potter County 2008 Total births: 135 (6.1%) White: 29 (3.0%) Black:17 (7.8%) Hispanic: 89 (8.7%) 2009 Total births: 151 ( 6.6%) White: 28 (2.8%) Black: 25 (9.0%) Hispanic: 98 (9.7%) The denominator for percent is all births for which mother s age was reported by race and age The denominator for percent is all births for which mother s age was reported by race and age When you break it down by percent you get difference picture as well

Lets look at Potter County in comparison to some of the larger metropolitan cities in the state for the year 2009 related to teen pregnancy rates Plus a few of comparable size

Comparative data to other counties year 2009 Teen pregnancy rate (age 13-17) Potter 38.6 Dallas 29.6 Bexar (San Antonio) 28.4 Harris (Houston) 27.4 Lubbock 35.0 El Paso 31.9 Taylor (Abilene) 27.8 Travis (Austin) 24.9 Texas 24.7 Tarrant (Ft Worth) 22.2 Wichita Falls 24.4

Comparative data to other counties 2008 Potter County Teen pregnancy rate (age 13-17) Texas 26.1 Potter 34.2 *Odessa (Ector) 49.5 El Paso 32.2 Dallas 32.0 Bexar (San Antonio) 30.6 *Lubbock 37.6 Midland 33.1 Travis (Austin) 26.7 Taylor (Abilene) 27.8 Wichita Falls 26.4 Harris (Houston) 27.8 Smith (Tyler) 21.0 Tarrant (Ft Worth) 23.6 Galveston 21.0 * at least a few other counties had a bigger problem in 2008

Comparative data to other counties - 2007 Ector (Odessa) 46.7 Potter 41.9 Lubbock 37.0 Dallas 33.0 Midland 31.2 El Paso 31.2 Bexar (San Antonio) 30.0 Wichita (Wichita Falls) 29.0 Travis ( Austin) 28.5 Harris (Houston) 27.7 Texas 26.3 Taylor (Abilene) 24.7 Tarrant (Ft Worth) 23.9 Smith (Tyler) 23.0 Galveston 20.4 Teen pregnancy rate (age 13-17)

Lets identify the top 15 counties intexas with highest teen pregnancy rates for the year 2009 Note: 2009- Potter ranked 47 th of 254 counties

Teen pregnancy rates by county for teens age 13-17, 2009 6 of 15 top counties in 2009 were in our public health region., Swisher- Tulia; Dickens- Dickens; Crosby-Crosbyton; Deaf Smith- Hereford; Roberts-Miami; Castro-Dimmitt live births female population Kenedy 200.0 (1) (5) Swisher 84.3 (21) (249) Dickens 69.0 (4) (58) Crocket 63.4 (9) (142) Crosby 63.0 (16) (254) Zavala 60.8 (32) (526) Knox 60.2 (8) (133) Gonzales 59.5 (37) (622) Brooks 59.2 (17) (287) Reeves 58.0 (24) (414) Deaf Smith 56.4 (43) (762) Roberts 55.5 (1) (18) Uvalde 52.8 (55) (1,042) Castro 52.8 (15) (284) McMullen 52.6 (1) (19)

Teen pregnancy rates by county for teens age 13-17, 2009- next 15 live births Briscoe- Silverton Sherman- Stratford Hale-Plainview King- Matador female population Crane 51.9 (8) (154) Briscoe 51.7 (3) (58) Kleberg 51.1 (43) (842) Terrell 50.0 (2) (40) Sherman 49.2 (6) (122) Ector 49.0 (216) (4,876) Ward 49.0 (17) (347) Martin 48.8 (10) (206) Pecos 48.1 (26) (540) Hale 47.9 (64) (1,337) Hardeman 47.2 (6) (127) King 45.5 (1) (22) Jim Hogg 44.8 (9) (201) Zapata 44.7 (28) (627) Karnes 44.5 (20) (449) Potter was 47th Potter 38.6 ( 157) (4,071)

Top 30-for the most part decent size communities live births female population Kenedy 200.0 (1) (5) Swisher 84.3 (21) (249) Dickens 69.0 (4) (58) Crocket 63.4 (9) (142) Crosby 63.0 (16) (254) Zavala 60.8 (32) (526) Knox 60.2 (8) (133) Gonzales 59.5 (37) (622) Brooks 59.2 (17) (287) Reeves 58.0 (24) (414) Deaf Smith 56.4 (43) (762) Roberts 55.5 (1) (18) Uvalde 52.8 (55) (1,042) Castro 52.8 (15) (284) McMullen 52.6 (1) (19) live births female population Crane 51.9 (8) (154) Briscoe 51.7 (3) (58) Kleberg 51.1 (43) (842) Terrell 50.0 (2) (40) Sherman 49.2 (6) (122) Ector 49.0 (216) (4,876) Ward 49.0 (17) (347) Martin 48.8 (10) (206) Pecos 48.1 (26) (540) Hale 47.9 (64) (1,337) Hardeman 47.2 (6) (127) King 45.5 (1) (22) Jim Hogg 44.8 (9) (201) Zapata 44.7 (28) (627) Karnes 44.5 (20) (449)

Teen pregnancy rankings- first through six 1st 2nd 3rd Kenedy Swisher Dickens Crockett 4th 5th 6th Crosby Zavala

7th 8th 9th Knox Gonzales Brooks 10th 11th 12th Reeves Deaf Smith Roberts

13th Uvalde 14th Castro 15th McMullen

Of the top highest counties in the state of Texas for teen pregnancy rates,10 of the top 30 were in our region But have to be cautious of numbers in small communities

Potter County rankings over time- Teen pregnancy rates 2001-17 of 254 counties 2002-15 of 254 counties 2003-33 of 243 counties 254 counties in Texas. These numbers reflect where Potter falls among those 254 counties. This is where you want a big number not a small one 2004-30 of 254 counties 2005-18 of 254 counties 2006-37 of 254 counties 2007-31 of 254 counties 2008-64 of 254 counties 2009-47 of 254 counties

Potter County Includes the communities of Amarillo 2010 Population: 122,019 (Anglo 48.6%, Black 9.9%, Hispanic 37.2%) Teen Pregnancy (age 13-17) Year Teen Pregnancy Rate (TPR) State Rank out of 254 counties Texas TPR Pregnant Teens (actual number) 2009 38.6 47 24.7 157 2008 34.2 64 26.1 142 2007 41.9 33 26.3 176 2006 38.2 37 26.0 163 2005 42.6 18 25.9 180 Teen Births (age 13-17) Year Total Live Births Teen Births (actual number) Percent Births to Teens Texas Teen Births 2009 2,300 151 6.6% 4.7% 2008 2,207 135 6.1% 4.9% 2007 2,206 168 7.6% 4.9% 2006 2,251 153 6.8% 4.9% 2005 2,332 162 6.9% 4.9% Teen Births % Race/Ethnicity Year Total Teen Births White Black Hispanic 2009 151 18.5% 16.6% 64.9% 2008 135 22% 12% 66% 2007 168 25% 13% 62% 2006 153 26% 17% 57% 2005 162 25% 15% 60% Infant Mortality and Low Birth Weight (all maternal ages) Year Infant Mortality Rate (per 1,000) Texas (IMR) (per 1,000) Percent Low Birth Weight Texas Low Birth Weight 2009 10.9 6.0 10.1% 8.5% 2008 10.9 6.1 9.8% 8.4% 2007 11.8 6.2 8.8% 8.4% 2006 6.2 6.2 10.9% 8.5% 2005 10.7 6.5 10.3% 8.3% Source: DSHS Center for Health Statistics http://www.dshs.state.tx.us/chs Page 1 only

Analogy A new national record for the fastest time in the 100 yard dash is published But it you are the last or next to the last to finish the race every year, even if your times are getting faster, there is much to be done to feel good about your race or Qualify for the state tournament, but 207 of the 254 runners cross the line ahead of you- got to change you strategy to win

Lets take a look at Randall County

Randall County Rankings for teen pregnancy (254 counties) Teen pregnancy rate= (births +fetal deaths+ abortions/female population of age group*1000 2004 224 of 254 2005 215 of 254 2006 199 of 254 2007 219 of 254 2008 220 of 254 2009 198 of 254

Actual number of teens pregnant and outcomes ( Randall County) 2005 Actual number teens pregnant: 50 births Teens giving birth: 44 Tees abortion: 6 2006 Actual number teens pregnant: 67 births Teens giving birth: 56 Teen abortion: 11 2007 Actual number teens pregnant: 48 births Teens giving birth: 40 Teen abortion: 8 2008 Actual number of teens pregnant 53 Teens giving birth: 46 Teen abortions: 7 2009 Actual number of teens pregnant 59 Teens giving birth: 52 Teen abortions: 7

Randall County break down teen births by race 2005 44 teens gave birth 22 Caucasian 1 Black 21 Hispanic

2005 44 teens gave birth 22 Caucasian 1 Black 21 Hispanic 2006 56 teens gave birth 32 Caucasian 2 Black 22 Hispanic 2007 40 teens gave birth 19 Caucasian 2 Black 19 Hispanic 2008 46 teens gave birth 25 Caucasian 3 Black 18 Hispanic 2009 52 teens gave birth 30 Caucasian 2 Black 20 Hispanic Randall County

Percent of the total births that were to mothers 17 years of age or younger by race- Randall County 2008 Total births: 46 (2.9%) White: 25 (2.1%) Black:3 (6.4%) Hispanic: 18 (5.8%) 2009 Total births: 52 ( 3.3%) White: 30 (2.5%) Black: 2 (3.8%) Hispanic: 20 ( 5.7%) The denominator for percent is all births for which mother s age was reported by race and age The denominator for percent is all births for which mother s age was reported by race and age

Births to Mothers 17 years and younger - By Race and Ethnic Group: Randall Total White+Other Black Hispanic Year Number Percent Number Percent Number Percent Number Percent 1992 47 3.8 40 3.8 1 4 6 4.4 1993 67 5.2 47 4.3 2 8.7 18 11.1 1994 55 4.5 40 3.8 1 * 14 9.1 1995 56 4.2 48 4.2 1 4.8 7 4.2 1996 55 4.3 46 4.2 2 8.3 7 4.2 1997 59 4.4 39 3.4 2 * 18 9.7 1998 65 4.9 42 3.7 1 * 22 12.3 1999 59 4.8 45 4.3 0 0 14 7.7 2000 52 4.3 38 3.8 5 0 9 4.7 2001 43 3.3 28 2.6 2 * 13 7.4 2002 47 3.4 36 3.1 1 4.2 10 4.8 2003 45 3.2 29 2.5 1 4 15 6.1 2004 44 3.2 28 2.6 1 3 15 6.1 2005 44 3.1 22 1.9 1 3.8 21 8.3 2006 56 3.7 32 2.7 2 4.9 22 7.3 2007 40 2.5 19 1.5 2 5.3 19 6.0 2008 46 2.9 25 2.1 3 6.4 18 5.8 2009 52 3.3 30 2.5 2 3.8 20 5.7 Again, % versus numbers one gets a different picture than just looking at numbers. We see a shift in higher % for Hispanic

Randall County Includes the communities of Canyon, Umbarger, Bushland, part of Amarillo 2010 Population: 120,725 (Anglo 78.2%, Black 2.4%, Hispanic 16.4%) Teen Pregnancy (age 13-17) Year Teen Pregnancy Rate (TPR) State Rank out of 254 counties Texas TPR Pregnant Teens (actual number) 2009 14.9 198 24.7 59 2008 13.5 220 26.1 53 2007 12.1 219 26.3 48 2006 17.4 199 26.0 67 2005 13.0 215 25.9 50 Teen Births (age 13-17) Year Total Live Births Teen Births (actual number) Percent Births to Teens Texas Teen Births 2009 1,589 52 3.3% 4.7% 2008 1,571 46 2.9% 4.9% 2007 1,590 40 2.5% 4.9% 2006 1,512 56 3.7% 4.9% 2005 1,420 44 3.1% 4.9% 2004 1,365 44 3.2% 5.0% Teen Births % Race/Ethnicity Year Total Teen Births White Black Hispanic 2009 52 57.7% 3.8% 38.5% 2008 46 54% 7% 39% 2007 40 48% 5% 47% 2006 56 57% 3% 40% 2005 44 50% 2% 48% Infant Mortality and Low Birth Weight (all maternal ages) Year Infant Mortality Rate (per 1,000) Texas (IMR) (per 1,000) Percent Low Birth Weight Texas Low Birth Weight 2009 6.9 6.0 9.2% 8.5% 2008 6.4 6.1 7.6% 8.4% 2007 9.4 6.2 8.7% 8.4% 2006 6.6 6.2 8.8% 8.5% 2005 4.9 6.5 6.9% 8.3% Page 1 only Source: DSHS Center for Health Statistics http://www.dshs.state.tx.us/chs

Rate per 1,000 Randall County Teen Pregnancy (ages 13-17) 35 Randall County 30 25 29.5 28.5 27.6 26.6 25.9 26 26.3 26.1 Texas 24.7 20 17.4 15 13 14.4 14.1 12.7 13 12.1 13.5 14.9 10 5 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 Year

Take a look a little deeper in the drawer

Potter county for 14 years 2009 total births- 2,452 TPR- 38.6 TP-157 TB-151 AB-6 2008 total births- 2,353 TPR- 34.2 TP-142 TB-135 AB-7 2007 total births- 2,206 TPR- 41.9 TP-176 TB-168 AB-7 FD-1 2006 total births- 2,251 TPR- 38.2 TP-163 TB-153 AB-9 FD-1 2005 total births -2,332 TPR- 42.6 TP-180 TB-162 AB-16 FD-2 2004 total births- 2,406 TPR- 41.0 TP-170 TB-159 AB-11 2003 total births- 2,200 TPR- 41.5 TP-172 TB-164 AB- 8 2002 total births- 2,129 TPR- 46.7 TP-191 TB-176 AB-13 FD-2 2001 total births- 2,182 TPR- 48.2 TP-195 TB-184 2000 total births -2,245 TPR- 48.5 TP-197 TB-178 1999 total births- 2,167 TPR- 48.3 TP-196 TB-179 1998 total births- 2,053 TPR- 54.1 TP-217 TB-185 1997 total births- 2,025 TPR- 50.1 TP-202 TB-177 1996 total births- 2,144 TPR- teen pregnancy rate, TP- teens pregnant TB- teens giving birth AB- teen abortions, FD- fetal deaths

Randall county for 13 years Yr 2009 total births-1,586 TPR- 14.9 TP-59 TB-52 AB-7 Yr 2008 total births-1,695 TPR- 13.5 TP-53 TB-46 AB-7 Yr 2007 total births-1,590 TPR- 12.1 TP-48 TB- 40 AB-8 Yr 2006 total births-1,512 TPR- 17.4 TP-67 TB-56 AB-11 Yr 2005 total births-1,420 TPR- 13.0 TP-50 TB-44 AB-6 Yr 2004 total births-1,365 TPR- 12.7 TP-49 TB-44 AB-5 Yr 2003 total births-1,413 TPR- 14.1 TP-56 TB-45 AB-11 Yr 2002 total births-1,383 TPR- 14.4 TP-58 TB-47 AB-11 Yr 2001 total births-1,284 TPR- 12.9 TP-52 TB-43 Yr 2000 total births-1,200 TPR- 15.5 TP-62 TB-52 Yr 1999 total births-1,229 TPR- 20.2 TP-75 TB-59 Yr 1998 total births-1,336 TPR- 22.3 TP-87 TB-65 Yr 1997 total births-1,344 TPR- 18.3 TP-73 TB-59 Yr 1996 total births 1,280 TPR- teen pregnancy Rate, TP- teens pregnant TB- teens giving birth, AB- teen abortions

Too many statistics!

Caution on stats Never just look at a single year or two Watch the numbers, percents, and rates The more years you have the better Differentiate between teen pregnancy and teen birth information

Available: The teen pregnancy rates by county for the top 26 counties of the Texas Panhandle and their rankings Next few slides

Perspective: Lets look at some counties with some observable items that stand out Let s look at some counties that have shown a change, but have enough numbers to look at. Lets look at counties that have the greater numbers of teen pregnant

Rank Texas Region County Deaf Smith- 762 female Population age13-17 11 24.7 33.0 56.4 (43) 59 26.1 31.8 35.4 (28) 61 26.8 32.6 34.4 (28) 34 26.0 31.9 36.9 (31) 33 25.9 29.3 37.8 (32) 2009 2008 2007 2006 2005

761 female population ( ages13-17) Rank Texas Region County 36 24.7 33.0 42.0 (32) Hutchinson 89 26.8 31.9 29.4 (23) 205 26.0 31.9 16.1 (13) 141 25.9 29.3 22.3 (18) 2009 2007 2006 2005 88 26.6 31.1 29.9 (25) 156 27.6 32.9 21.7 (19) 2004 2003

861 female population ages 13-17-2009 Rank Texas Region County 79 24.7 33.0 30.2 (26) Moore 19 26.8 31.9 48.3 (41) 36 26.0 31.9 38.3 (33) 103 25.9 29.3 26.1 (22) 54 26.6 31.1 34.5 (29) 83 27.6 32.9 30.4 (26) 2009 2007 2006 2005 2004 2003

Rank Texas Region County Population 13-17 Crosby County 5 24.1 33.0 63.0 (16) 254 2009 182 26.1 31.8 19.2 (5) 261 2008 1 26.3 31.9 70.1 (18) 271 2007 3 26.0 31.9 72.5 (20) 276 2006 24 25.9 29.3 40.4 (11) 272 2005 10 26.6 31.1 50.9 (14) 275 2004 5 27.6 32.9 62.7 (18) 287 2003

Swisher 249 female teen population ages 13-17 Rank Texas Region County 2 24.7 33.0 84.3 (21) 30 26.1 31.8 46.9 (12) 179 26.8 32.6 18.5 (5) 34 26.0 31.9 38.3 (11) 53 25.9 29.3 33.2 (10) 2009 2008 2007 2006 2005

Rank Texas Region County Randall 198 24.7 33.0 14.9 (59) 219 26.8 31.9 12.3 (48) 199 26.0 31.9 17.4 (67) 215 25.9 29.3 23.0 (50) 224 26.6 31.1 12.7 (49) 2009 2007 2006 2005 2004 252 27.6 32.9 0 2003

Myth: pregnancies are counted in the county they deliver They are reported by county of residence.

May have raised more questions than we answered today Jamie Moore WHNP-BC Texas Department of State Health Services, Health Service Region 1 Jamie.moore@dshs.state.tx.us 655-7151

Where do we go from here?xxxxxxxxxx

Jamie Moore WHNP-BC Texas Department of State Health Services, Health Service Region 1 jamie.moore@dshs.state.tx.us 655-7151