Associations between social determinants of health and adolescent pregnancy: An analysis of data from the National Longitudinal Study of Adolescent to Adult Health

Although rates of adolescent pregnancy are at an all time low in the U.S., major disparities persist. Examining relationships between social determinants of health (SDoH) and adolescent pregnancy can provide support for funding/public policy directions and interventions to reduce disparities. This study utilized data from the National Longitudinal Study of Adolescent Health to analyze empirical relationships between SDoH and adolescent pregnancy, and assessed the following research questions: 1) Is there a bivariate association between adolescent pregnancy and each element of the Social Determinants of Health? If an association exists, then a) what is the strength and direction of the association and b) does the association remain after controlling for additional factors?  The Healthy People 2020 SDoH Framework was utilized for this study. Chi square, t-tests and logistic regression were employed to examine the relationship between each SDoH and adolescent pregnancy. Data were analyzed using SAS Version 9.2. Of the 9204 male and female participants, 403 (4.4%) reported a pregnancy within a relationship before age 18. Results indicated a relationship between 6 (of 17) measures of SDoH and adolescent pregnancy. Measures related to lower odds of pregnancy included 1) feeling close to others at school, 2) receipt of high school diploma, 3) enrollment in higher education, 4) participation in volunteering, and 5) two-parent home. Reporting litter as a neighborhood problem was significant in an unexpected direction, indicating lower odds of pregnancy. Results of this study can inform future research and interventions based on SDoH that show an association with adolescent pregnancy.