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Many adolescents need basic health care and other services that address risky behaviors such as sexual activity, violence, alcohol and drug abuse, and the consequences of these behaviors. This publication summarizes laws and resolutions on adolescent health issues passed in 1997 state and territory legislative sessions. No 1997 legislative session was held in Kentucky; therefore, adolescent health legislation from this state is not included. Nor was any legislation related to adolescent health passed in 1997 in American Samoa, the District of Columbia, Guam, New Mexico, the Northern Mariana Islands, Puerto Rico, the U.S. Virgin Islands, and Wyoming. Brief descriptions of laws are provided pertaining to the following topics: (1) abortions; (2) abstinence, sexuality education, and pregnancy prevention; (3) adolescent general health; (4) community health, including immunizations; (5) HIV/AIDS; (6) insurance; (7) Medicaid; (8) mental health; (9) pregnancy, parenting, contraception, and family planning; (10) school health and school-based health services; (11) sexual conduct; (12) sexually transmitted diseases; (13) substance abuse, including date rape drugs, drinking and driving, penalties, and prevention; (14) tattooing and body piercing; (15) tobacco; and (16) violence prevention. The summary indicates that during the 1997 legislative session teen pregnancy, school health programs, substance abuse, and tobacco were the top adolescent health issues addressed by state legislatures. The summary's appendices include a state-by-state summary of 1992-1996 health legislation, resource directory, and a list of state adolescent health coordinators/directors. (KB)

Recent research has identified several long-term negative life outcomes associated with teenage childbearing for parents and their children. To better understand teen births, data from the National Education Longitudinal Study of 1988 were used to examine factors associated with a second teen birth or a closely spaced second teen birth within 24 months. Results of this study are reported here. Out of a sample of 589 teen mothers, 34.5% had a second birth at any point in their teens, and among a sub-sample of young teen mothers (n=475, under age 18 at first birth), 27.6% had a closely spaced second teen birth. Factors associated with postponing a second teen birth included characteristics measured prior to the first birth (race/ethnicity and school type), at the time of the first birth (age at first birth, dropout status and marital status), and after the first birth (living situation, child care support, and educational and employment status). Among the full sample, younger teens were more likely to have a second birth at any point. Teen mothers who were involved in educational activities or (among older mothers) employment activities, even part-time, were more likely to postpone a second teen birth. (RJM)

Many adolescents need basic health care and other services that address risky behaviors such as sexual activity, violence, alcohol and other drug abuse, and the consequences of those behaviors. This publication summarizes approximately 200 child health-related laws and resolutions passed in the 50 states, Puerto Rico, American Samoa, and the U.S. Virgin Islands. This publication, third in a series of adolescent health summaries, includes a new section on violence prevention in schools. The state legislation reflects health problems that largely involve preventable behavior. Brief descriptions of laws are provided pertaining to the following topics: (1) abortion; (2) abstinence/sexuality education; (3) adolescent general health; (4) community health services; (5) HIV/AIDS and sexually transmitted diseases; (6) insurance and Medicaid; (7) mental health; (8) pregnancy/parenting and contraception/family planning; (9) school health/school-based health services; (10) substance abuse; (11) tobacco; and (12) violence prevention. Appendices include a state-by-state summary of 1992-1996 legislation, resource directory, and a list of state adolescent health coordinators/directors. (KB)

Findings in this report summarize the first phase of a larger, multi-year study that is combining qualitative and quantitative methods to outline a conceptual framework to guide future demographic/fertility research, pregnancy prevention programs and policies. Twelve focus groups--involving a multiculturally representative group of male and female adolescents (N=106)--were held in two cities so as to learn about teens' views on adolescent childbearing and to develop possible pregnancy prevention programs and policies. Participants were encouraged to discuss openly their opinions about three topics: teen sexual activity, pregnancy, and contraceptive behavior. Topics discussed are: (1) teen culture regarding sex; (2) reasons teens have sex; (3) reasons teens do not have sex; (4) the influence of relationships on sexual behavior; (5) decision-making concerning sex; (6) the consequences of sex; (7) acceptance of teen pregnancy; (8) sexual partners' communication about pregnancy; (9) contraceptive methods; (10) reasons teens choose to use or not to use contraceptives; (11) private versus public school context; (12) adolescents' suggestions about how to motivate teens to prevent pregnancy and delay first sexual intercourse; and (13) social policies for preventing teen pregnancy. (EMK)

Recent efforts targeting teenage pregnancy in the United States have marked a renewed conviction to reduce the level of childbearing among adolescents. Some of the behavioral, psychosocial, and ethnographic studies that explore the underlying motivation to delay sex and to effectively use contraception are the focus of this literature review. Eschewing the more traditional, demographic or descriptive approach to teenage pregnancy, the goal of this study is to understand adolescents' motivation to prevent pregnancy; subsequently, it focuses on research that addresses the transition to first sex, sexual activity, and the use of contraception. A select number of studies on pregnancy resolution are also included as they are helpful for understanding the broader context of factors that may encourage/discourage adolescent sex and contraceptive behavior. The studies under review address individual-level factors, the influence of partners, peers, siblings and family processes, community and policy influences. Key findings are summarized, areas in need of further exploration are discussed, and a preliminary framework for a model integrating current knowledge is presented. Two sections, "Literature Cited" and "Literature Reviewed," contain approximately 267 references. An appendix describes and compares 19 models for understanding adolescent pregnancy. (EMK)

Population growth around the world affects Americans through its impact on economy, environment, safety, and health, and the condition of the world children will inherit. The cumulative evidence is strong that current rates of population growth pose significant and interacting risks to human well-being and are a legitimate concern for Americans. The demographic case is presented for U.S. assistance to programs that help slow population growth in developing countries. Furthermore lower rates of population growth would contribute significantly to improving people's lives. The population, which numbers about 5.8 billion people, grows by nearly 90 million people each year, and it is not physically possible for population growth to continue long at today's levels. Sixteen key reasons for slowing population growth are described under the general headings of economic development, the environment, and safety and health. "Education" is key reason number 5 (pages 23-24) under the heading of Economic Development. The U.S. government currently provides its population assistance through bilateral, nongovernmental, and multilateral channels, but growth in U.S. funding for family planning and other reproductive health services has not kept pace with demand. The 30-year U.S. effort to make contraception and related health services available worldwide is threatened by misunderstandings and misinformation. An attachment explains how to write effective letters to legislators in support of population programs. (Contains 17 graphs, 2 tables, 2 figures, and 15 references.) (SLD)

The rapid and still-accelerating increase in the world's population, especially in developing nations, will have a number of serious economic, social, and ecological consequences for the whole world. Germany is attempting to help solve these problems by providing family planning and poverty alleviation assistance to developing nations. German assistance in these areas is being directed against the following problems: maternal mortality and the status of children, children who have children, acquired immune deficiency syndrome, and unplanned pregnancies. Germany is also assisting with rural development efforts in the following ways: agricultural development programs to produce sufficient food, economic development and urbanization programs to improve chances of survival, rural development programs to raise standards of living, and self-help programs for small farmers and women to ensure regional food security and improve family health. Population policy/family planning has become a priority in the German government's development policy, and Germany is working with a number of partners to pursue a double strategy of family planning and development that is aimed directly at improving individual life and self-realization. (Lists of 14 organizations and 18 publications concerned with family planning and population control are included.) (MN)

Recent declines in funding for contraceptive services have led to questions regarding the role of contraceptive services and social policy in shaping adolescent reproductive behavior. This 2-year study examined the impact of state-level policies on adolescent pregnancy and fertility. Data were obtained from a variety of sources, including the Guttmacher Institute and the Department of Health and Human Services. Among the findings are the following: (1) greater state public funding for contraceptive services predicts lower adolescent fertility and lower non-marital fertility;(2) state public abortion funding is associated with lower childbearing rates, particularly for African-American teens, and with higher abortion rates; (3) state laws restricting minors' abortion availability are unrelated to teen birth rates, abortion rates, or teen pregnancy resolution; (4) coordinated state-level pregnancy prevention programs in 1985 predicted lower 1988 pregnancy rates; (5) states with higher teen poverty had higher non-marital teen childbearing rates; (6) AFDC benefits were weakly associated with higher White unmarried teen childbearing but not African-American teen childbearing; (7) the proportion of the White population that is Hispanic is associated with higher nonmarital birth rates among White teens 15-17; however, the proportion of the state population that is African-American does not influence the rates of teen fertility among Blacks; (8) the proportion of Blacks who are college-educated significantly influenced childbearing rates and non-marital childbearing among Black teens; (9) social disorganization was correlated with teen childbearing, pregnancy, and abortion; (10) the proportion of fundamentalists contributed to fewer non-marital births and fewer abortions among White teens; (11) women's labor force participation was related to higher teen childbearing; and (12) prior fertility was the strongest predictor of later teen fertility. (Thirty-five tables detail results. Contains 56 references.) (Author/KB)

This report details family planning service delivery at the state level and presents state administrators' views about service delivery and policy options for the 1990s. Data for the report were obtained from telephone surveys of 109 State Administrators from the Title X, Maternal and Child Health Block Grant, Social Services Block Grant, and State and Medicaid programs. Following the introduction, the report is comprised of nine sections: (1) a description of study methodology and the respondents; (2) an overview of family planning service delivery at the state level, including funding streams, how states allocate family planning revenues, reporting requirements, and state regulations on family planning service provision; (3) a review of family planning services paid for by Title X, Maternal and Child Health, Title XX, and State monies in 1991, highlighting special family planning initiatives and special populations targeted by Title X Grantees; (4) an overview of reversible contraceptive care covered by managed care programs under Medicaid; (5) a review of changes in funding and demand for Title X services during the 1980s, including how Title X Administrators responded to shifts in funding and client demand; (6) a discussion of the difficulties Title X Administrators encountered in delivering family planning services since 1990; (7) a presentation of perspectives of state program administrators regarding ways to improve services to low-income women; (8) a description of Title X administrators' reactions to five policy scenarios for future family planning service delivery; and (9) a review of implications of findings for family planning policy and health care reform. Contains 11 references. (KB)

The Program for Pregnant and Parenting Services (PPPF) assists children in the New York City public school system who also happen to be parents. In 1993 the program received a federal child care and development block grant which was used to augment the child development, child care, and case management services provided to their student clientele. This report summarizes the steps taken by the program to enhance its services to students. After outlining the basic services offered to the students, the researchers describe some of the program's augmented services, such as day care so that new mothers can continue to attend classes. Recognizing the politically volatile issues of adolescent sexual behavior and contraception, while also acknowledging the desirability of reducing the rate of unintended pregnancy among adolescents, the program analysts recommend that PPPF increase efforts in two areas: (1) include the partners of its pregnant and parenting students in all program activities; and (2) develop a curriculum that encourages adolescents to delay childbearing until both the father and the mother are willing and able to make a life-long financial and emotional commitment to the child. Included with the findings are six tables which describe the students and services in this program. (RJM)

The State Legalization Impact Assistance Grant (SLIAG) Program, administered by the Administration for Children and Families within the Department of Health and Human Services, provides grants to states to help them pay the costs of providing services to certain aliens legalized under the Immigration Reform and Control Act of 1986 (IRCA). An executive summary introduces the report and includes information on such aspects of the program as management and specific services funded. An overview of the SLIAG program, a profile of legalized aliens, and information on state and local costs by program area (education, public assistance, and health assistance) are provided. The report includes an extensive list of exhibits. In conclusion, the evidence indicates that, except in the area of adult education, SLIAG costs do not represent new service demands on state and local programs. SLIAG dollars provide states and localities with a temporary source of funds to cover costs they would have been incurring, regardless of IRCA. (KM)

This document is a compendium of approximately 170 national health promotion and disease prevention objectives affecting mothers, infants, children, adolescents, and youth. It offers a vision characterized by reductions of preventable death and disability, enhanced quality of life, and reduced disparities in the health status of the populations in our society. The introduction to the document reviews the health status of Americans according to age group. Subsequent text discusses health objectives relating to: (1) physical activity and fitness; (2) nutrition; (3) tobacco, alcohol, and other drugs; (4) family planning; (5) mental health; (6) violent and abusive behavior; (7) educational and community-based programs; (8) unintentional injuries; (9) environmental health; (10) oral health; (11) maternal and infant health; (12) cancer; (13) diabetes and chronic disabling conditions; (14) HIV infection; (15) sexually transmitted diseases; (16) immunization and infectious diseases; and (17) clinical preventive services. Chapters typically describe objectives relating to health status, risk reduction, and services and protection. Chapters also outline research needs and list references. (BC)

Facts on teenage pregnancy, particularly with reference to Minnesota, are discussed. Contents discuss the following topics: Teenage pregnancy is a significant problem in the United States; adolescents' stage of development influences their views on sexuality; many sexually active adolescents do not use contraceptives; adolescent males have special family planning needs; and, family planning programs for teens are necessary and cost-effective. Concluding remarks suggest action policy-makers can take regarding the promotion of legislation and establishment of incentives for program development. (RH)

This survey analyzed the nature and level of services in adolescent pregnancy prevention in the developing countries of Latin America, Africa, and Asia. While focusing on programs to prevent adolescent pregnancy, many of the groups surveyed were also responding to the Acquired Immune Deficiency Syndrome (AIDS) epidemic in their work with youth. The majority of the organizations also provided services to youth beyond reproductive health, such as tutoring and scholarships, income generation and vocational education, and general adolescent health services and community development. An analysis of the 103 programs that responded to the survey found that the majority of the organizations were nongovernmental organizations which relied heavily on overseas assistance. A variety of professionals worked in the programs, but health professionals and educators were the personnel most commonly found. The most frequently reached clientele were in-school youth, although many programs also served school drop-outs. The sex education offered by most of these programs focused on the biological aspects of reproduction, but more than one-half of the programs also included additional information. Peer education as a method of sex education continued to be an important component of many adolescent pregnancy prevention programs. The vast majority said they offered contraceptive services, with condoms being the most frequently cited method, followed by oral contraceptives. Printed educational materials for youth continued to be an important aspect of sex education. The report also provides a directory of programs by region and country that includes program name and address, type of organization, age range of clientele, and program focus. (LLL)

An evaluation of the reproductive health programs of six diverse school-based clinics measured the impact of the clinics on sexual behavior and contraceptive use. All six clinics served low-income populations; at five of them, the great majority of the students were black. An analysis of student visits by type of care given found that these clinics were not primarily family planning facilities; rather, they provided reproductive health care as one component of a comprehensive health program. Student survey data was collected in four schools with clinics and four nearby comparison schools with similar social and demographic characteristics but without clinics. Because the other two schools included in the evaluation had not yet opened their clinics, preclinic baseline data and 2-year postclinic data were collected for them. Findings indicated that the clinics neither hastened the onset of sexual activity nor increased its frequency. The clinics had varying effects on contraceptive use. Providing contraceptives on site was not enough to significantly increase their use; in only one of the three sites that did so were students in the clinic school significantly more likely than students in the comparison school to have used birth control during last intercourse. Although the data suggest that the clinics probably prevented small numbers of pregnancies at some schools, none of the clinics had a statistically significant effect on school-wide pregnancy rates. (ABL)

This report summarizes the evidence that family planning can reduce deaths of children under 5 years of age at a reasonable cost. The report also: (1) identifies the major reproductive factors associated with child mortality; (2) estimates the approximate reduction in child mortality that could be achieved through improved childbearing patterns; and (3) assesses the likely costs of preventing child death through family planning. A number of studies that analyzed the data of the World Fertility Survey, carried out in 41 countries, found 3 factors related to the risk of death in childhood. These factors are births spaced less than 2 years apart, births to mothers under 20, and first births. Possible biological causes of these three factors are examined. A number of studies have provided estimates of reductions in child mortality through alteration of childbearing patterns, such as increasing birth spacing and reducing births to women under 20 and over 34. Child mortality can be reduced through the use of contraceptives, the increased use of breastfeeding, oral rehydration therapy, distribution of vaccines for preventable diseases, and changes in family relationships through increased family planning. Costs of implementing family planning programs are estimated, and recommendations for family planning policy are offered. Ten references are cited. (BC)

Locating the issue of abortion in a global public policy context, with the array of public health, human rights, and social questions that are implicated, is the aim of this paper. Abortion laws around the world have been liberalized since the 1950s, with a resultant decrease in abortion-related mortality among women. The proportion of the world's population, governed by laws that permit abortion on medical or broader social and economic grounds, is 75 percent (nearly 4 billion people). In addition to women living in those countries that have resisted liberalization of their abortion laws, many women have restricted access to abortion, even those in countries in which abortion is technically legal. There are a number of reasons for this, including a lack of government or public commitment to provide or fund services, lack of trained specialists, administrative roadblocks, a woman's ability to pay, and a lack of truthful information about legal rights and services. Abortion rates from countries around the world are examined and discussed in terms of the varying demographic and social realities. The large number of maternal deaths due to abortion that still occur is not due to a deficiency in technology, but a deficiency in the value placed on women's lives. The numerous roadblocks to safe abortion services drive women to seek illegal or clandestine abortions that greatly endanger their lives. The debate surrounding abortion has been too often portrayed as a conflict between black and white hues. The debate needs to take place in a larger context, complete with public health, family planning, and human rights concerns. Equality of political rights for women, and likely the lives of many, hinges on political decisions regarding abortion. (DB)

An overview of The Body Shop wellness program at Eastern Washington University provides information on enrollment figures, demographic data, physiological improvements, and the results of a survey of participants' attitudes toward and perceptions of the program. The Body Shop serves the university as a fitness center and also as a wellness resource center and community outreach program. Following the overview is a proposal to the administration of the University for the establishment of the Northwest Wellness Institute. The administrative model is outlined and a mission statement describes the six dimensions of wellness upon which the program is based: (1) intellectual; (2) physical; (3) emotional; (4) social; (5) occupational; and (6) spiritual. Appendices provide further information on selected features and benefits of the program. A bibliography is included. (JD)

The most devastating effects of teenage pregnancy are felt among African Americans because of the disproportionate number of adolescent unmarried females in this community who get pregnant and give birth each year. Aspects of this problem are discussed as they relate to the African-American community. Historical antecedents of the problem are traced, including the trend towards reduced services for teen parents. Studies have suggested that parental involvement in the lives of their teenagers is the most critical factor in the prevention of teen pregnancy. Little attention was originally given to the behavior of young males, but a growing body of literature shows that most men who father the children of adolescent mothers are not themselves teenagers. In addition, fathering without marriage is not associated with socially deviant behavior among African-American males, which suggests that fathering without marriage may become a normative behavior. African-American attitudes toward family planning are also a factor in teenage pregnancy. In the 1960s, black activists were openly hostile to family planning and argued that the use of birth control was genocidal. Although this attitude did not represent black views generally, its resonance is still heard when discussing the use of birth control, particularly by unmarried adolescents. Recommendations are made for addressing the teen-pregnancy problem. Footnotes contain 10 references. (SLD)