By Chelsea Vuong

Background and Motivation:

Adolescents engaged in risky sexual behaviors, such as having multiple sex partners or partaking in sexual intercourse without birth control, have an increased risk of negative reproductive health outcomes. These outcomes can range from acquiring a sexually transmitted disease (STD) to an unintended pregnancy. Moreover, the physical, mental, and intellectual abilities compromised through high-risk pregnancies deeply impact a teen’s adulthood productivity. Therefore, by mitigating the factors that contribute to risky teen sexual behaviors, adult outcomes can be greatly improved. This paper studies reproductive health education and contraceptive usage among teens, as these are two effective factors that help mitigate risky sexual behaviors.

 

Data and Methodology:

State level data within the United States is used for this analysis.  Reproductive health education and publicly funded clinics are the two independent variables of interest, and no condom or any birth control use among teens are the two dependent variables of interest. Data on condom or birth control use, the primary outcomes of interest, comes from the Center for Disease Control and Prevention’s (CDC) High School Youth Risk Behavior Survey (YRBS). The state level data on publicly funded clinics, one of two independent variables of interest, comes the Health Resources & Services Administration (HRSA) for the total number of federally qualified health centers (FQHCs). The state level data on reproductive health curriculum, the second independent variable of interest, comes from the Sexuality Information and Education Council of the United States (SIECUS).

The first part of the study measures the correlation of FQHCs and reproductive health education on risky teen sexual behaviors using an Ordinary Least Squares (OLS) regression model. Then, an instrumental variable (IV) design is used to address the endogeneity issue with the OLS regression model. The two risky teen sexual behaviors analyzed in this paper are teens not using a condom or any method of birth control during their last sexual intercourse.

 

Key Findings and Implications:

The IV regression results for FQHCs indicate that there is no statistically significant effect of the number of health centers per 1000 teens on risky teen sexual behaviors. These results may hold strength in the overall context of publicly funded clinics, as publicly funded clinics comprise of FQHCs, Title X-funded clinics, and Planned Parenthood clinics. Since this study only analyzed FQHCs, it merely captured the effects of a portion of publicly funded clinics. To better estimate the impact of funding cuts on publicly funded clinics, data on Title X-funded and Planned Parenthood clinics should also be analyzed.

 

The IV results for reproductive health education show that mandated sex education, marriage education, and abstinence education were significant at reducing no condom use. For the simulated instrument regression, contraceptive education and education that prohibits abortion instruction were significant towards improving no condom and birth control use. While the findings are mixed, it is likely that continuing any type or mixture of education has potential in improving risky teen sexual behaviors.

 

Overall, my thesis provides a preliminary look at the multifarious dimensions of risky teen sexual behavior factors. Additional research that builds upon the findings of this study is necessary to develop informed school and state policies that better address teen reproductive health.