216050 Moving policies upstream to disrupt the links between social injustice and early childbearing

Wednesday, November 10, 2010 : 8:50 AM - 9:10 AM

Lee SmithBattle, RN, DNSc , School of Nursing, Saint Louis University, St. Louis, MO
Background and Issues: Social injustice is deeply implicated in early childbearing. Prior to 2005, the U.S. birth rate for teens 15-19 years of age was already 2 to 4 times higher than comparable countries; since 2005, the rate has increased an additional 5%. Reasons for this dismal record include policies favoring abstinence, barriers to contraception, and high levels of social disadvantage. U.S. policies also frame early childbearing as costly for mothers, children, and taxpayers, while overlooking the background risk factors that predispose disadvantaged youth to “drift” into young parenting. Description: Because politicians and policy makers have exploited the costs of early childbearing to promote a conservative agenda, these costs are reviewed with findings from state of the art studies. Key federal policies are then described and critiqued in light of the evidence that teen mothers and their children are disadvantaged slightly, if at all, by a teen birth. Lessons Learned: Federal policies have been driven more by political ideology and “dubious assumptions” than by empirical evidence. In embracing downstream approaches, policies reinforce stereotypes of teen mothers and deflect attention away from the grim social worlds and structural inequalities which prefigure teen births and poor maternal-child outcomes, regardless of maternal age. Recommendations: As staunch advocates for social justice, public health nurses are well positioned to advocate for upstream policies that address the social determinants of early childbearing. Recommended policies are consistent with social justice, public health, and pro-family rhetoric.

Learning Areas:
Advocacy for health and health education
Diversity and culture
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
1. Describe how social injustice is deeply implicated in early childbearing in the U.S. 2. Examine the quality of the scientific evidence of the costs and outcomes of early childbearing. 3. Compare and contrast downstream and upstream U.S. policies in addressing the social determinants of early childbearing.

Keywords: Teen Pregnancy, Social Inequalities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have studied teen pregnancy, and part of my professional practice includes teen pregnancy in relation to social justice.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.