The ages of fathers in California adolescent births, 1993.

Officals, media coverage and prevention programs have assumed that fathers of infants born to US school-age (10-18 years old) mothers are school-age peers. This study analyzes fathers' ages in 46 500 California births to school-age mothers in 1993, for which 85% of the fathers' ages were stated and whose distribution is similar to that of less complete national samples. Adult, postschool men father two thirds of the infants born to school-age mothers and average 4.2 years older than the senior-high mothers and 6.7 years older than the junior-high mothers. The extensive involvement of adult males in both school-age motherhood and its precursors represents a significant, undiscussed factor deserving greater attention.

Adult involvement in teenage childbearing and STD.

PIP: Many of the proposed counter measures to US teenage pregnancy, childbearing, and sexually transmitted diseases center on sex and abstinence education. A tabulation by the California Center for Health Statistics of 46,511 marital and unwed births among school-age girls in 1993 showed that only 29% were fathered by school-age peers 10-18 years old; 71%, or over 33,000, were fathered by adult post high-school men whose mean age was 22.6 years. Even among junior high school mothers 15 and younger, most births are fathered by adult men 6-7 years their senior. Studies of 535 pregnant and parenting teenagers (mostly Whites) by researchers in Washington state and of 445 teenage mothers (most nonWhites) in Chicago found that large majorities had histories of rapes and sexual abuse before age 12, inflicted mainly by adults who were at least 5-10 years older than their early adolescent girlfriends. 40% of US girls live near or below poverty income levels, and this low-income population accounts for 6 out of 7 teenage births. US teenage pregnancy rates are 3-10 times higher than those found among industrial nations of western Europe, but poverty rates among US youth are also higher by a similar magnitude. The sexual abuse and rape of young girls, pregnancy during adolescent years, and abandonment of women to raise or support children are, overwhelmingly, adult male behavior problems exacerbated by poverty. The claim that superficial pregnancy prevention programs emphasizing abstinence and contraceptive techniques can persuade young teenagers to enforce abstinence or contraception on their older adult partners is dubious. US prevention campaigns are likely to succeed only when they limit the emphasis on youth-targeted campaigns, condescending attitudes, and punitive approaches, and forcefully confront the excessive economic attrition inflicted on US youth, and the thoroughly integrated nature of sexual behaviors among adolescents and adults.^ieng

California's suicide decline, 1970-1990.

From 1970 to 1990 California experienced a 32% decline in suicide, which was particularly pronounced among women, non-whites, the young, and urban dwellers. Suicide declines of over 50% were recorded in San Francisco and Los Angeles, and large decreases occurred in other coastal counties. Additionally, California was the only one of 51 states to show a consistent decline in teenage and young-adult suicide (accompanied by an 88% decrease in teenage drug and other poisoning deaths). Initial investigation of death certification, accident and homicide trends, economic measures, and prevention efforts did not produce an explanation for a suicide decrease of California's magnitude. However, the state does display anomalous trends in certain social measures (reduced divorce, rising non-White population, and rising homicide) that point to multifactorial hypotheses including demographic changes and changed attitudes toward violence. Review of the accuracy of past suicide certification procedures nationally is also indicated.

School-age pregnancy: why hasn't prevention worked?

PIP: Adolescent pregnancy or sexually transmitted disease (STD) reduction has not occurred, despite sexuality education and abstinence programs, and intensive publicity and community initiatives. An obstacle to adolescent pregnancy, STD, and childbearing prevention is the assumption that adolescent sexuality is a closed system of activity among peers. When a nation is consumed with the preoccupation of condoms versus chastity debates, and is ignoring high poverty levels and abuse of the young, adolescent girls will seek escape from harsh childhoods in early family formation with young adult men. There is a high correlation between poverty rates and teenage birth, AIDS, and STD rates. Schools are not able to produce magical solutions to teenage pregnancy when adult lawmakers abnegate their responsibility to provide for youth well-being. Adolescent pregnancy will occur regardless of the expansion of curative programs such as school-based clinics; fundamental changes in assumptions, attitudes, and policies are needed. Beneficial aspects of programming appear to be fact-based sexuality and contraceptive education, counseling and referrals for youths with histories of child abuse, and child care classes and flexible school schedules for parenting students. A statistical profile in California indicates that 85% of all fathers of babies born to girls between ages of 11 and 18 years were adults. More than 50% of mothers aged 11-15 years were impregnated by adult men. Fathers' average age for births among junior high school mothers was 15-26 years, when the youngest and the oldest 2.5% of fathers are eliminated. There is a greater likelihood that a man older than 23 years will impregnate a junior high girl than will a junior high boy. The partner age gap is greatest among the very young girls. The California profile of father's age is similar to birth patterns in other states and similar to the national average. An examination of STDs shows a higher rate of STDs among females younger than 20. AIDS cases and HIV infections also appear higher among girls ages 13-19 years. The patterns indicate that teenage female STDs are likely to have been acquired by contact with older men by rape or voluntary intercourse. Fathering in abortion cases is not well documented. The predominate neglect of the role of adult-teen intercourse is a major omission. Teenage sex behavior for births, abortion, and STDs is often controlled by the behavior of adult partners.^ieng

The 1990 Montana initiative to increase cigarette taxes: lessons for other states and localities.

In November 1990, voters in Montana defeated an initiative that would have increased the state's excise tax on a pack of cigarettes by 25 cents. The increased revenues were intended for tobacco education and research. Opponents of the measure, primarily tobacco companies, outspent proponents by more than 35 to 1. Their primary themes were opposition to new taxes and to a larger state bureaucracy. Based on the results of initiative campaigns in Montana and California, taxation initiatives are more likely to succeed if guidance is sought from leaders of similar campaigns in other states, tobacco control coalitions are built and funding secured early, and polling conducted before initiative measures are finalized. Other requirements for success include careful wording of the initiative, strong leadership, consideration of a paid petition drive, effective use of the news media, anticipating opposition arguments, and emphasizing the benefits of the tax increase in the campaign.

Use of a school referendum to deter teen-age tobacco use.

Montana's 1991 school "tobacco referendum," authorized by the state legislature and approved by about 60% of approximately 50,000 students voting in grades 7-12, represents an innovative attempt to include youth in decisions regarding tobacco and health and to decisively demonstrate peer disapproval of tobacco use. The referendum asked students whether tobacco sellers should voluntarily refuse to sell cigarettes and tobacco to persons younger than age 18. Montana is one of five states which allow tobacco sales to minors but has one of the nation's lowest youth smoking rates. The statewide referendum follows the successful example of the Bozeman, Montana, school district's 1990 tobacco referendum, in which 80% of the 2,200 grade 7-12 students and staff voted to make their schools "tobacco-free."

The Code Blue report: call to action, or unwarranted "dirism"?

The Code Blue report, recently issued by a distinguished panel formed by national medical and educational associations, paints a dire picture of the state of adolescent health and recommends far-reaching measures to reverse "dangerous trends." However, analysis of the report's findings reveals serious flaws in its presentation of nearly every youth problem cited, and its recommendations are much less original and workable than portrayed. A more moderate and positive approach toward youth problems is suggested.

Teen suicide and changing cause-of-death certification, 1953-1987.

This study examines whether the purported tripling in teenage suicides since the 1950s represents a real increase or is simply an artifact of the increased skill of medical examiners in distinguishing youth suicides from fatal accidents. This study examines firearms and poisoning deaths, which together account for 75% of all certified youth suicides, from 1953 through 1987, and concludes: (a) a past undercount of youth suicides is likely, (b) the increase in youth suicide that has occurred is less dramatic than reported and resembles increases in adult suicide, and (c) the suicide increase indicated among youths and adults occurred from 1964 to 1971 and has since stabilized.