Teen pregnancy in Colorado

Because it’s garnering a significant amount of nationwide attention, I figured I’d come out of my quasi-retirement of late from blogging (really, I’ve just been bouncing around the country/world and super busy trying to get life started in a new place or three) to talk about the State of Colorado’s announcement that its teen contraception program led to a 40% drop in the teen pregnancy rate. Put another way, the teen birth rate dropped from 37 live births per 1,000 people in 2009, to 22 live births per 1,000 in 2012. This is a drop from significantly above the national average to significantly below, which is a huge accomplishment.

With those numbers, the teen pregnancy rate did indeed drop by 40%, the question is whether all of that is attributable to the program. Importantly, the press release notes:

Fertility rates among low-income women aged 15–24 were compared with expected trends. Abortion rates and births among high-risk women were tracked, and the numbers of infants receiving services through the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were examined.

However, a true comparison with expected trends would require subtracting out the expected drop in teen pregnancy rates by identifying a comparison group (this is called a difference-in-difference strategy or a randomized control trial if the program was rolled out randomly, which is probably was not). 

The Denver Post article, probably in the interest of journalistic integrity, interviewed some people about the findings, but in my opinion, not anyone with the ability to really evaluate the claim. Teen pregnancy rates have been falling in the US, as have overall birth rates, and likely would have fallen in Colorado regardless of whether these individuals received the program or not. From 2011 to 2012, the US teen birth rate fell by 6% alone. The question is whether they fell by more than they otherwise would have if the program had not been put in place. Or would they have increased?

While it seems that the state did some analysis to net out this effect from their press release, the 40% figure probably overstates the true effect of the program. It could also understate the true effect. If teenage sexual activity was also increasing among those groups targeted by the program, the expected pregnancy rate would have been higher, resulting in a larger difference. In all likelihood, the program did likely reduce the teen pregnancy rate, but I don’t think we know exactly by how much.

In related news, I’ve got a great new research idea; I just need some data on a teen contraceptive program in Colorado. Governor Hickenlooper, I’m looking at you.

Advertisements

Jobs, poverty and teen child-bearing

Several weeks ago, I printed out an NBER working paper on teen childbearing by Melissa Schettini Kearney and Phillip B. Levine. I had every intention of reading it then, but it just wasn’t going to happen at the end of this totally crazy semester. Since then, a few things forced my hand. I finished the semester (yay for surviving my first year of professoring!), the paper has been accepted for publication in the Journal of Economic Perspectives, Matt Yglesias put together a nice little review of the article in Slate, and a friend emailed me rather incensed by Yglesias’ review. From a quick scan of the JEP version, it doesn’t appear too much different from the NBER version, but my comments refer to the NBER version.

Yglesias’ review presents Kearney and Levine’s research as novel and surprising, but I think that misses the point. While the authors do a good job of aggregating statistics from several data sources and findings from different papers, the primary contribution of this paper is not novel, but rather confirming what we already know: that teen pregnancy is higher in the US than other places and; that poverty likely causes teen pregnancy more than teen pregnancy causes poverty. Past studies, cited in the paper, have shown that teen pregnancy has little to no effect on outcomes when you control for poverty, or within-family characteristics, and in some cases, may even result in better outcomes than if the teen hadn’t become pregnant. This is a significant theme in Edin and Kefalas’ ethnographic study, Promises I Can Keep, which I discussed here, and other research in fields such as sociology and demography.

Ultimately, the economics community thought it was an important paper as it went to a very prominent journal, but I really just see it as a good synthesis of what we know.

In related, and I think more exciting research, the link between poverty and teen child-bearing may be even tighter than suggested Kearney and Levine’s paper, though not in the way that the Kearney and Levine paper posit. A working paper by three Duke Sanford professors, Elizabeth Oltmans Ananat, Christina Gibson-Davis, and Anna Gassman-Pines examines the link between job losses and teen pregnancy.

I’m so predictable. I love this paper because even the anticipation of poverty, or joblessness, more specifically, predicts teen pregnancy rates. The authors show that when mass layoffs are announced in a North Carolina (before the layoffs actually occur), that county sees a subsequent corresponding reduction of births to teenagers in that county, but only for Black teenagers. The mechanism appear through both reduced pregnancy rates and reduced birth rates, which suggests that teens are both practicing safer sex and having more abortions when job prospects in their counties suddenly become dimmer.

There were a few places I thought the paper could improve, and the first one is my primary concern. Even though the authors find a statistically significant effect, I’m curious about the mechanism for how this affects teenagers. What evidence is there to show that teenagers would be affected by these job losses? Why aren’t they just in school and ignoring them? Initial information about their education level, school attendance, when they enter the workforce, etc, would be useful, to sell the story. I think the age and education of teens would be a big factor here. Wouldn’t you see a bigger effect for teens closer to graduation? Or a smaller effect in counties where teens are more likely to go to college (say wealthy Orange county, where Chapel Hill is located)?

The ability of inhabitants to migrate and commute is also problematic and suggests a (you guessed it!) spatial auto-correlation issue that I imagine is present. The authors claim they are underestimating the effects of job losses by ignoring migration and spillovers, but I wonder whether there are spillover effects that could be estimated through job loss in surrounding counties, rather than just say it’s a lower bound. Also, if spatial auto-correlation is present, that’s going to affect the standard errors, not just bias the estimates.
A minor, but I think incredibly important interesting, result is that the job losses also resulted in fewer black mothers reporting a father’s name on the birth certificate. The magnitude of the effect is approximately half of the effect of that on the pregnancy rate itself, which is pretty large. I think this result actually goes a long way towards answering my first question: Why do we think teenagers would be affected by this? If the story is that teens are being more careful about sex or having more abortions when their job prospects are low, is it really their own unemployment they fear, or also their partner’s? Teenage parents are less likely to be married than their older counterparts, so who is supporting them through their pregnancy? Paying for prenatal visits? Do teens feel they’re going to be working and raising their children? My own work shows that black mothers at any age are more likely to receive a promise of financial support and Edin & Kefalas suggest that the promise is key to the marginal have a baby (or at least stop trying not to have one) for mothers of low socio-economic status. I think this relationship could be teased out a little more.
All in all, it’s a good read, and presents an interesting counterpoint to the Levine and Kearney paper. L&K say poverty causes teen pregnancy, but the Duke paper says that teens are responsive to future job prospects, and respond by delaying (or at least trying to avoid) childbearing.
At first glance, the papers might seem incongruous, but it’s really a stock versus flows kind of issue. Other things equal, teenagers in poverty are more likely to become pregnant early due to a host of factors, but they still plan and have an idea about how they will care for the child. When that plan is disrupted, it appears it can affect some teens’ decision to bear children, on the margin.