Writing on the wall: The effects of neighborhoods on teen reproductive health

Over the past fifteen years, neighborhood characteristics have increasingly come into focus as a factor in health outcomes and an opportunity for health interventions. Previous research has demonstrated that neighborhood context influences an adolescent's risk of sexual initiation, unprotected sex and teenage pregnancy, but the relationship between neighborhood-level factors and these health outcomes is not well understood. Through an extensive analysis of existing literature (23 studies), it is apparent that definitions and measurement of neighborhoods as geographic units and neighborhood-level variables vary significantly. In spite of differing measurement approaches, however, the most common finding was that increasing neighborhood poverty was associated with increased likelihood of all three outcomes for teenage girls. Studies examining neighborhood poverty found mixed results regarding neighborhood poverty and the three outcomes for boys. For both genders, neighborhoods with higher perceived levels of ambient hazards were associated with increased risk of sexual initiation. Studies examining neighborhood composition found mixed results regarding the concentration of a given racial or ethnic group, and the risk of teen birth, sexual initiation or unprotected sex, indicating that the impact of neighborhood composition on health outcomes may differ by racial and ethnic group. Most studies found that peer influence in the form of youth idleness, peer deviance or peers' pro-childbearing attitudes contributed to risk of sexual initiation, unprotected sex and teen pregnancy. Further research is needed to understand how neighborhood factors impact specific populations of at-risk youth to better tailor sexual health interventions and policies.