Looking beyond structural processes: Neighborhood effects in communities with elevated and declining teen birth rates

Teenage pregnancy has been associated with neighborhood-level poverty, mobility, crime, peer pro-childbearing attitudes and low levels of educational attainment among adults. Research has examined the influence of neighborhoods on adolescent development through structural processes, such as poverty and education, however findings from social processes as they relate to adolescent behavior and teenage pregnancy are not conclusive. Our study examined youth and adult community stakeholder perspectives on neighborhood setting, resources, teenage pregnancy and access to reproductive health services. Twenty-two same sex focus groups were conducted with 186 male and female youth in four California counties with elevated or declining teen birth rates. Additionally, 94 interviews were held with adult stakeholders including school personnel, religious leaders, health educators, clinicians, politicians, law enforcement personnel. Results indicate that youth in all communities face a barrage of barriers and enablers to achieving desired pregnancy status, including adult relationships, violence, gang affiliation, apathy, and generational cycles of teen parenting. Interestingly, some factors served as both barriers and enablers, including violence and generational cycles of teen pregnancy. Acceptance of teen childbearing varied by community, though it was generally viewed as more acceptable than in the past, exemplified by baby showers for teen mothers and on-site day care at schools. Stakeholders noted that parents often lacked the necessary knowledge to educate their youth. Youth and adults agreed that parents rarely discuss sexuality, pregnancy, or parenting in depth. Results demonstrate the need for teen pregnancy prevention efforts to incorporate community norms, resources, and parents to better support youth.