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