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Providing family planning services for young people has little impact on pregnancy rates and may have contributed to the dramatic increase in rates of sexually transmitted infections (STIs) among young people. That is the conclusion of research presented at the Royal Economic Society annual conference by Professor David Paton of the Nottingham University Business School.
The research casts further doubt on the wisdom of the Government’s Teenage Pregnancy Strategy, following on from the announcement in February 2002 that the latest figures show an increase in teenage pregnancy rates, following several years of decline.
Since the start of the Teenage Pregnancy Strategy in 1999, there has been a major expansion of family planning services in the community aimed specifically at young people. Although teenage pregnancy rates in England have decreased somewhat since 1999, diagnosis rates of sexually transmitted infections have rocketed by 24.3%.
Professor Paton’s research looks at every health authority in England to see whether those areas that have increased family planning services for young people the most have also experienced the biggest decrease in pregnancy rates.
In fact, there is almost no correlation at all, even when a range of other social and economic factors are taken into account. The research also demonstrates that controversial schemes to provide the morning after pill to teenagers free of charge at pharmacists have not reduced teenage conceptions. In contrast, areas with bigger increases in family planning services have experienced significantly bigger increases in sexually transmitted infections among teenagers.
Professor Paton comments:
‘One of the problems with research on sexually transmitted infections is that we only have data on diagnoses and not on actual infections. With some of these infections, most notably chlamydia, there are often no symptoms at all. It could be that the increase in diagnosis rates just reflects the fact more young people are aware about diseases like chlamydia and are getting themselves tested.’
‘In fact, the notable feature about my results is that I found a significantly positive correlation between increases in family planning services and increases both in rates of chlamydia and in rates of those sexually transmitted infections where the symptoms are more noticeable.’
One explanation for these results is that easier access to family planning for young people may have been partly responsible for the increase in risky sexual behaviour among young people. The increase in this risk-taking behaviour may then have outweighed any positive impact of family planning policies.
The research suggests that economic and social factors, such as improved levels of educational achievement, are the factors that are most likely to affect teenage pregnancy rates.
Professor Paton believes that policy-makers can learn important lessons from his research:
When you introduce policies that seem to be obvious, it is important to factor in the possibility that the policies may actually cause people to change how they behave.
In this case, it appears that some measures aimed at reducing teenage pregnancy rates induced changes in teenage behaviour that were large enough not only to negate the intended impact on conceptions, but to have an adverse impact on another important area of sexual health sexually transmitted infections.
Random Behaviour or Rational Choice? Family Planning, Teenage Pregnancy and STIs by David Paton will be presented at the Royal Economic Society’s 2004 Annual Conference at the University of Wales Swansea on Monday 5 April.
David Paton is Professor in Industrial Economics at Nottingham University Business School.
STI rates are diagnoses among all teenagers at GUM clinics in England per 10,000 young people aged 15-19.
The latest data for teenage pregnancy relate to 2002 and were released in Health Statistics Quarterly on 26 February 2002. The rate of conceptions to girls under 18 was 42.6 per 1,000 in 2002, compared to 42.3% in 2001.
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