BACKGROUND: In 2014, the birth rate among teenage women (15-19 years old) in Hawaii was 23.1 per 1,000 women. Not all teen pregnancies are unintended, but unplanned teen births can have enormous personal and public costs. In 2010, Hawaii spent 32 million dollars on teen childbearing costs. Teenage births put mothers at higher risk for lower economic and educational attainment and infants at higher risk of poor health outcomes. Disparities in teen births exist in Hawaii. Some races and geographic areas experience disproportionate rates of teen births. Our objective is to identify factors associated with higher rates of teen births to ensure all teen women have access to educational resources and clinical services.
METHODS: We analyzed 188,708 birth records from 2006 to 2015 Hawaii Vital Statistics. Births were categorized as either teen births (mothers aged 15-19 years) or non-teen births (mothers aged 20 years and older). For our multivariate logistic regression, we analyzed the most recent data (2014 and 2015) to identify associations between teen births and maternal race and county.
RESULTS: Approximately 6.7% (n=12,694) of total births from 2006 to 2015 were among teen mothers. The rate of teen births dropped by 50.4% from 2006 (8.5%) to 2015 (4.3%). Adjusting for county, Native Hawaiians experienced 4.4 times the odds of teen births (95% CI=3.7-5.2) compared to Whites. Filipinos (OR=1.9, 95% CI=1.5-2.3), Other Pacific Islanders (OR=3.9, 95% CI=3.2-4.8), Blacks (OR=2.2, 95% CI=1.6-3.0), and Samoans (OR=3.9, 95% CI=2.9-5.3) also had higher odds of teen births compared to Whites. While Native Hawaiians and Other Pacific Islanders together make up 26% of Hawaii’s overall population, Native Hawaiians made up 50% of all teen births in 2015 and Other Pacific Islanders made up an additional 13%. There has been an 82% increase in the percentage of teen births that are to Other Pacific Islanders since 2006. Adjusting for maternal race, odds of teen births in Maui County (OR=1.3, 95% CI=1.1-1.5) and Hawaii County (OR=1.3, 95% CI=1.2-1.5) were higher compared to Honolulu County.
CONCLUSIONS: We can reduce unplanned teen births with the increased availability and affordability of contraception. The differences in teen births by race and county suggest focus areas for family planning and reproductive health services. By identifying high risk groups, we can inspire more community discussions and target education and access to care efforts. Collaboration with various community partners may help develop culturally sensitive strategies to reduce unplanned teen births.