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APHA Scientific Session and Event Listing

Ian M. Bennett, MD, PhD¹, Kennen Gross, MPH², Scarlett Belamy Bellamy, ScD³, Elizabeth Wildsmith, PhD⁴, Vivian Gadsden, PhD⁵, and Dennis Culhane, PhD². (1) Family Medicine, University of Pennsylvania, 2nd Floor Gates Building, 3400 Spruce Street, Philadelphia, PA 19104, 215-614-0849, ian.bennett@uphs.upenn.edu, (2) CML, University of Pennsylvania, 3701 Locust Street 200 Castor, Philadelphia, PA 19146, (3) Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 6th Floor, 629 Blockley Hall, Philadelphia, PA 19104, (4) RWJ Health and Society Scholars Program, University of Pennsylvania, COLONIAL PENN CENTER, Philadelphia, PA 19104, (5) Graduate School of Education, 3440 Market Street, Philadelphia, PA 19104

Context: Low literacy is strongly associated with poor adult health outcomes but little is known about health outcomes early in the lifecourse. The contribution of poor reading skill to risk of teenage childbearing has not been well defined. Objective: To evaluate the association between pre-adolescent reading skill with incident teenage childbearing. Design Setting and Participants: Retrospective cohort study reading assessments of 12,339 girls in the 7th grade in the 1996-'97 or 1997-'98 academic years of the Philadelphia Public School System linked to birth records from the city of Philadelphia (1996-2002) and block group census data. Main Outcome Measures: Hazard ratios for teenage childbirth were compared among girls with below average (<23rd national percentile), average, and above average (>76th national percentile) reading skill. Results: A total of 2,031 live births were identified over the 6 year period of the analysis (period incidence of 165 births/1,000 girls). In the covariate adjusted survivor function less than average reading skill was associated with more than 3 times the risk of childbearing (aHR 3.49, 95% CI 2.76-4.39) and average reading skill with two times the risk (aHR 2.15, 95% CI 1.72-2.69) when compared to above average reading skill. A significant interaction was found between reading skill and race. Conclusions: Pre-existing reading skill strongly predicts risk of teenage childbearing independent of other risk factors. The effect of poor reading was stronger among Latinas and African Americans. Additional efforts should be made to assess interventions to improve reading skill among pre-adolescent students for reducing subsequent teenage childbearing.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• List the major risk factors of teenage childbearing.
• Articulate the proceedure for linking reading scores with birth certificate data.
• Articulate the association of below average reading skill and teenage childbirth.

Keywords: Teen Pregnancy, Risk Factors

Presenting author's disclosure statement:

Not Answered