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Abstract

While both California and Texas have experienced declines in teen birth rates over the past three decades, declines in California have been larger, particularly among Hispanic teens. Differences in state policies may have shaped this disparity, as suggested by Tortolero and her colleagues in their article “A Tale of Two States: What We Learn from California and Texas”. Fundamental differences exist between Texas and California in their approaches to sex education, access to family planning services for teens, and public-private partnerships. However, methodological challenges are present when drawing state comparisons, including the limitations of available public health data and the difficulty of disaggregating state characteristics from state policies. Based on their comparison of state data and policies, Tortolero and her colleagues issue sensible recommendations for reducing the teen birth rate in Texas. History suggests that state policies are most effective when political commitment is linked to scientifically effective approaches. Based on our understanding of the scientific literature, the most effective strategies for reducing rates of teen childbearing in Texas would be providing comprehensive school sexuality education and improving teen access to contraceptive services.

Author Biography

Ronna Popkin is a Ph.D. candidate in the department of Sociomedical Sciences at Columbia University. She is a Fellow in the NIH pre-doctoral training program in Gender, Sexuality, and Health. Her research interests include adolescent and young adult sexual and reproductive health, sexuality education, and women’s health in the United States. Prior to coming to Columbia, Ms. Popkin worked as a Community Sexuality Educator for Planned Parenthood of Wisconsin and lectured courses at the University of Wisconsin-Madison on sexuality education, women’s health, and the politics of fertility control. Ms. Popkin earned her Master of Science in Health Education and Bachelor of Science with Honors in Women’s Studies from the University of Wisconsin-Madison.

John Santelli, MD, MPH is the Harriet and Robert H Heilbrunn Professor and Chair of the Heilbrunn Department of Population and Family Health at the Mailman School of Public Health at Columbia University and a Senior Fellow at The Guttmacher Institute. John is a medical epidemiologist and adolescent medicine specialist. Between 1991 and 2004, he worked in a variety of Divisions at CDC on research related to adolescent health. This research has included studies on HIV/STD risk behaviors, programs to prevent STD/HIV/unintended pregnancy, school-based health care, and research ethics. John received his MD from the Buffalo School of Medicine and his MPH degree from Johns Hopkins University. He has served on the editorial boards of the Journal of Adolescent Health, Perspectives on Sexual and Reproductive Health, American Journal of Sexuality Education, and AIDS Education and Prevention. He has been a national leader in insuring that adolescents are appropriately included in health research and have access to medically accurate, comprehensive sexuality education. John is president-elect for the Society for Adolescent Health and Medicine.

Douglas Kirby, Ph.D., is a Senior Research Scientist at ETR Associates. For more than 30 years, he has directed state-wide or nation-wide studies of adolescent sexual behavior, abstinence-only programs, sex and STD/HIV education programs, school-based clinics, school condom-availability programs and youth development programs. He has summarized the effects of programs throughout the world that were designed to reduce adolescent sexual risk and published these results in many articles and volumes. In the last few years he has worked with the UN family – WHO, UNESCO, UNFPA, UNICEF and UNAIDS – to help develop and implement effective HIV education programs in developing countries.

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A Response To:

A Tale of Two States: What We Learn from California and Texas by Susan R. Tortolero, Paula M. Cuccaro, Nancy M. Tucker, I. Sonali Weerasinghe, Dennis H. Li, Melissa F. Peskin, Ross Shegog, and Christine Markham.