Changing Behavior Risk for Teen Pregnancy in the United States, 1991-2007

John Santelli, Columbia University
Mark G. Orr, Columbia University
Laura Lindberg, Guttmacher Institute
Daniela C. Diaz, Columbia University

After declining dramatically from 1991-2005, teen birth rates rose in 2006. Using sexual behavior and contraceptive use data from the Youth Risk Behavior Survey (N~125,000), we calculated changes in pregnancy risk over time. Our index of pregnancy risk declined between 1991 and 2003, closely following declines in teen birth rates. Improvements in contraceptive use between 1991 and 2003 were responsible for 70% of declining pregnancy risk. Between 2003 and 2007, sexual activity was unchanged and pregnancy risk based on contraceptive use increased (p=.06). Although pregnancy risk was higher among blacks and Hispanics compared to whites, differences in sexual activity between blacks and other groups declined over time. After improvement in the 1990s and early 2000s, sexual behavioral change related to teen pregnancy appears to have stalled or reversed after 2003. These behavioral trends portend stagnant or even rising teen birth and pregnancy rates through 2008.