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Alison HadleyTeenage Pregnancy Unit 2000-2012
Teenage Pregnancy and Young People’s Sexual Health
Maintaining progress in the new system
Building on progress
Using the evidence base
Maintaining priority in the new system
Involving young people
Building on progress
25% reduction in under 18 conception rate
35% reduction in conceptions leading to birth
Lowest rate since 1969 – over 40 years
Continuing decline in first three quarters of 2011
Concerted and sustained effort makes a difference but...
But progress needs maintaining and some LAs lag behind
-50%
-40%
-30%
-20%
-10%
0%
10%
20%
30%
40%
50%
Top-tier LAs
Per
cent
age
chan
ge in
rat
e 19
98-0
0 to
200
8-00
Tower Hamlets
Hackney
Oldham
Swindon
Milton Keynes
Remembering the evidence base
Vast majority of teenage pregnancies are unplanned
Provision of high quality SRE (Kirby 2007) and improved use of contraception (Santelli 2008) are areas where strongest empirical evidence exists on impact on teenage pregnancy rates
No evidence that alternative approaches (e.g abstinence-only/benefit conditionality) are effective
..and how to translate evidence into practiceA whole system approach: clear actions for different agencies
Why teenage pregnancy still matters
11% of all young people who are not in education, employment or training (NEET) are teenage mothers or pregnant teenagers
20% more likely to have no qualifications at age 30
22% more likely to be living in poverty at 30, and much less likely to be employed or living with a partner
3 times the rate of post-natal depression
higher risk of poor mental health for
3 years after the birth
Children of teenage mothers have a 63% increased risk of child poverty and are more likely to have childhood accidents and behavioural problems
The infant mortality rate for babies born to teenage mothers is 60% higher
3 times more likely to smoke throughout their pregnancy, and 50% less likely to breastfeed, with negative health consequences for the child
The majority of teen pregnancies are unplanned and over half end in abortion
Maintaining the priority in the new systemPublic Health Outcomes Framework
▪ Under 18 conception rate▪ Chlamydia diagnosis (15-24)▪ Sexual violence
Related indicators ▪ Children in poverty▪ Child development at 2-2.5 years▪ Rates of adolescents not in education, employment or training (NEET)▪ Proportion of people in long term unemployment
▪ Infant mortality rate▪ Incidence of low birth weight of term babies▪ Maternal smoking prevalence (including during pregnancy)▪ Breastfeeding initiation and prevalence at 6-8 weeks▪ Hospital admissions caused by unintentional and deliberate injuries to under 5s
▪ Child Poverty Act: under 18 conception rate a national and local measure of progress
Joint Strategic Needs Assessment: getting it right
Know your local data:
▪ Trends in the LA under 18 and under 16 rate over the last ten years
▪ Most recent picture from 2011 Q1, Q2 and Q3 data▪ Comparison with national and regional rate – and statistical
neighbours▪ Proportion of conceptions ending in abortion or maternity▪ Repeat abortions▪ High rate wards: low-average rates at LA level can hide high rate
wards e.g. Essex has a LA rate of 29.2 v national rate of 35.4 but has
15 wards with rates >58.
Making the JSNA real: walking in the footsteps of young people and mapping data against schools and services young people use (Illustrative slide from Leeds)
Barw ick and Kippax
Halton
Cookridge
BramleyPudsey North
Weetw ood
Kirkstall
Pudsey South
Wortley
City &Holbeck Richmond
Hill
Moortow n
Garforth &Sw illington
Morley South
Morley North
Bingley Rural
Thornton
Wyke
Brighouse
Rastrick
Tow n
Cleckheaton
Deighton
Heckmondw ike
Mirf ield
Spen
Thornhill
Aireborough
Armley
Beeston
Burmantofts
Chapel Allerton
HarehillsHeadingley
Horsforth
Hunslet
Middleton
NorthOtley and Wharfedale
Rothw ell
Roundhay
Seacroft
University
Wetherby
Whinmoor
Pannal
Caw ood w ith Wistow
Whitley
Bradford
Calderdale
Kirklees
Wakefield
Harrogate
Selby
Ward under-18 conception ratesper1000, 2002-04
Over 6050 to 6040 to 5030 to 40Under 30
Under-18 conception rates (02-04) & secondary schools in Leeds
Involving young people
Key messages from young people in Positive for Youth
▪ make seeking health advice normal, not a last resort ▪ tackle the stigma about asking for sexual health advice▪ integrate information and advice into wider youth services▪ make services friendly and welcoming▪ publicise services widely
Use existing youth fora and Local HealthWatch to involve young people in JSNA
…and finally, making every contact count
▪ Making the system work to full capacity
▪ Joining up the dots for all relevant services and frontline practitioners so young people are supported by the whole system
▪ ‘Engagement days’ for all practitioners to make teenage pregnancy and young people’s sexual health everyone’s business
Links to data and further information
Reviewing progress on conception data (including trends on maternity and abortion) http://www.education.gov.uk/childrenandyoungpeople/healthandwellbeing/teenagepregnancy/a0064898/under-18-and-under-16-conception-statistics
Connecting to other relevant data
Chimat Teenage Pregnancy Snapshot Reports: including other relevant LA data e.g. on NEET, secondary school exclusions, alcohol related hospital admissions, infant mortality.http://atlas.chimat.org.uk/IAS/profiles/servicereportsNew Child Health Profiles: www.chimat.org.uk/profiles:
Links to relevant guidance: http://www.education.gov.uk/childrenandyoungpeople/healthandwellbeing/
teenagepregnancy