By: Lauren Caton
While the U.S. and California have made substantial progress in reducing rates of adolescent birth over the past twenty years, significant disparities in family planning access and reproductive health knowledge persist for youth in rural areas. In fact, these youth are more likely to give birth during adolescence and less likely to use contraception at first sex than their urban counterparts. These statistics have dramatic implications for young people with racial and ethnic disparities in the region as well (Table 1).
Source: California Department of Public Health, Center for Family Health, Maternal Adolescent and Child Health, Adolescent Birth rate report by Medical Service Area, California 2010 – 2012.
A recent study completed by UCSF may shed light on the underlying reasons for these disparities in adolescent birth rates. Researchers at ASHWG partners Phillip R. Lee institute for Health Policy and Bixby Center for Global Reproductive Health, found that rural participants in the California Personal Responsibility Education Program (CA-PREP) were less aware of locations to access family planning services than their urban counterparts. Accordingly, young women in the program from rural settings were less likely to report using family planning services. These gaps in knowledge and use of service place adolescents in rural areas at greater risk for unintended pregnancy and STIs.
Source: California Personal Responsibility Education Program 2014
As the results of this study showed, there are promising results for youth enrolled in alternative schools, foster care, shelters, or transitional living programs who were more likely to have knowledge of family planning programs than youth in mainstream school settings. However, students should not have to be high-risk in order to receive information they require – and have a right to access – to make healthy decisions about their future. The passage of California’s Healthy Youth Act for comprehensive sex education is a step in right direction. Special attention should be paid to rural schools to ensure fidelity and the development of clinical partnerships these programs require to prove success.
A new state law in California allows patients to receive hormonal contraception directly from a pharmacist’s prescription, allowing medically-underserved rural areas to have greater access to preventative care. However, rural youth report greater factors, such as embarrassment and increased likelihood of encountering individuals in their social network, that influence disposition to seek care in these settings. Schools and family planning providers in rural areas should work together to build youth-friendly and confidential resources for linking students to family planning services and more research should reveal innovations to address these additional barriers rural adolescents face. Through collaborative partnerships, we can help youth reach their full potential in sexual and reproductive health.