Toward a health equity approach in adolescent reproductive health: Addressing social determinants in teen pregnancy prevention

While sexual behavior and unintended pregnancy in adolescents is a result of individual behavior, health related decisions and behaviors are also nested in a complexity of social and environmental contexts differing from community to community. Addressing social determinants of health is a primary approach to achieving adolescent sexual and reproductive health equity. In order to achieve adolescent health equity, teen pregnancy prevention initiatives need to identify social factors at the local level and work to address these factors or “root causes” while providing education and access to clinical services. A root cause analysis (RCA) process brings community stakeholders together to identify contributing factors and underlying causes of a health issue with the goal of reducing its impact. Applied to teen pregnancy prevention, an RCA followed by a community wide action planning process can be used to forge a shared understanding of teen pregnancy and its influences within a particular community, spurring innovative ideas and strategies for addressing the underlying causes that impact teen pregnancy. JSI is the training and technical assistance provider of the “Working with Diverse Communities” component, in CDC/OAH's 5 year community wide demonstration project to reduce teen birth rates in 10 US communities. This project has created a unique opportunity domestically to complement traditional teen pregnancy prevention individual-level interventions with new strategies that address social determinants of health. The presentation will provide case examples of how social determinants were identified in some communities and challenges/lessons learned in the process.