Pregnancy Outcomes in US Prisons, 2016-2017.

OBJECTIVES: To collect national data on pregnancy frequencies and outcomes among women in US state and federal prisons. METHODS: From 2016 to 2017, we prospectively collected 12 months of pregnancy statistics from a geographically diverse sample of 22 state prison systems and the Federal Bureau of Prisons. Prisons reported numbers of pregnant women, births, miscarriages, abortions, and other outcomes. RESULTS: Overall, 1396 pregnant women were admitted to prisons; 3.8% of newly admitted women and 0.6% of all women were pregnant in December 2016. There were 753 live births (92% of outcomes), 46 miscarriages (6%), 11 abortions (1%), 4 stillbirths (0.5%), 3 newborn deaths, and no maternal deaths. Six percent of live births were preterm and 30% were cesarean deliveries. Distributions of outcomes varied by state. CONCLUSIONS: Our study showed that the majority of prison pregnancies ended in live births or miscarriages. Our findings can enable policymakers, researchers, and public health practitioners to optimize health outcomes for incarcerated pregnant women and their newborns, whose health has broad sociopolitical implications.

Trends and determinants of IUD use in the USA, 2002-2012.

STUDY QUESTION: What factors and subgroups have propelled the recent increase in intrauterine device (IUD) use in the USA? SUMMARY ANSWER: The increase in IUD use, from 1.8 to 9.5% in the USA between 2002 and 2012, was driven primarily by a marked uptake among parous women who intended to have more children. WHAT IS KNOWN ALREADY: Recent data suggest an unprecedented increase in IUD use among women in the USA, yet less is known about how this increase has affected the overall proportion of women, at risk of unintended pregnancy, who are using contraception and which social and economic groups are involved. STUDY DESIGN, SIZE, DURATION: Data are drawn from the 2002 and 2011-2013 National Surveys of Family Growth. The surveys were based on cross-sectional, national samples of women of 15-44 years of age in the USA. Women responded to in-person interviews, which lasted an average of 80 min. The response rate was 80% in 2002 and 73% in 2011-2013. The sample included 7643 completed interviews in 2002 and 5601 interviews in 2011-2013. PARTICIPANTS/MATERIALS, SETTING, METHODS: This study was limited to women at risk of unintended pregnancy, i.e. women who were sexually active in the previous 3 months (using contraception or not); it excludes women who were sterile, currently pregnant or trying to conceive. Altogether, 5181 women were at risk in the 2002 sample and 3681 were at risk in the 2012 sample. We used descriptive statistics to investigate trends in contraceptive use patterns by women's sociodemographic characteristics between 2002 and 2012 and used logistic regression to identify current predictors of IUD use in 2012. MAIN RESULTS AND THE ROLE OF CHANCE: IUD use increased from 1.8% in 2002 to 9.5% in 2012 (P < 0.001). The surge was especially marked among parous women who intended to have more children (4.2% in 2002 to 19.3% in 2012; P < 0.001); it occurred to a lesser extent among parous women who did not intend to have more children (2.0-9.7% P < 0.001), suggesting that IUDs are more often used for spacing than for ending childbearing in the USA. The most important predictors of IUD use in 2012 were age, parity and intent to have children. Dissatisfaction with a previous method was also associated with IUD use (adjusted odds ratio = 1.89, P < 0.001). LIMITATIONS, REASONS FOR CAUTION: As with all cross-sectional studies, causal inference is limited. Data are self-reported, but the survey had a high response rate and rigorous quality controls. WIDER IMPLICATION OF THE FINDINGS: This study shows promising trends in the use of highly effective contraceptive methods in the USA, which may help to explain recently reported declines in unintended pregnancy in the USA. STUDY FUNDING/COMPETING INTERESTS: Caroline Moreau was supported by the William Robertson endowment funds. The work of Hannah Lantos and William Mosher on this analysis was supported by the Department of Population Family and Reproductive Health, The Johns Hopkins Bloomberg School of Public Health. The authors declare that no conflict of interest exists.

Responsive Design, Weighting, andVariance Estimation in the 2006-2010 National Survey of Family Growth.

Objective-The National Survey of Family Growth (NSFG) collects data on pregnancy, childbearing, men's and women's health, and parenting from a national sample of men and women aged 15-44 in the United States. The 2006-2010 NSFG design was a significant departure from the previous periodic design, used in 1973-2002. This report shows fieldwork results and weighting, imputation, and variance estimation procedures. The report should be useful to users of the 2006-2010 public-use data file and to survey methodologists wishing to learn how the NSFG was conducted. Methods-NSFG's new design is based on an independent national probability sample of men and women aged 15-44. The University of Michigan's Institute for Social Research conducted fieldwork under a contract with the National Center for Health Statistics. Professional female interviewers conducted in-person, face-to-face interviews using laptop computers. A responsive design approach was used in planning and managing the fieldwork for NSFG to control costs and reduce nonresponse bias. Results-The 2006-2010 NSFG is based on 22,682 completed interviews-10,403 interviews with men and 12,279 with women. Interviews with men lasted an average of 52 minutes, and for women, 71 minutes. Weighted response rates were 75% among men, 78% among women, and 77% overall. Analysis of NSFG data requires the use of sampling weights and estimation of sampling errors that account for the complex sample design and estimation features of the survey. Sampling weights are provided on the data files. The rate of missing data in the survey is generally low.

Abortion Access for Incarcerated People: Incidence of Abortion and Policies at U.S. Prisons and Jails.

OBJECTIVE: To understand abortion incidence among incarcerated people and the relation to prison and jail pregnancy policies. METHODS: We collected abortion numbers and policy data from convenience sample of 22 state prison systems, all Federal Bureau of Prisons sites, and six county jails that voluntarily reported monthly, aggregate pregnancy outcomes for 12 months in 2016-2017. Sites also completed a baseline survey of institution characteristics and pregnancy policies, including abortion. We reported facility policies and abortion incidence according to state-level abortion characteristics. RESULTS: Only half of state prisons in the study allowed abortion in both the first and second trimesters, and 14% did not allow abortion at all. Of the 19 state prisons permitting abortion, two thirds required the incarcerated woman to pay. Four jails of the six study jails (67%) allowed abortions in the first and second trimesters, and 25% of those required the incarcerated woman to pay for the procedure. The three prisons and two jails that did not allow abortions were in states considered hostile to abortion access. In the state and federal prisons studied, 11 of the 816 pregnancies (1.3%) that ended during the study time period were abortions. Of the 224 pregnancies that ended at study jails, 33 were abortions (15%), with more than half of those (55%) occurring in the first trimester. The abortion ratio (proportion of pregnancies ending in abortion) was 1.4% for prisons and 18% for jails. CONCLUSION: Although some incarcerated individuals have abortions, many prisons and jails have restrictive policies surrounding abortion, either through self-payment requirements or explicit prohibition. Findings from this study should prompt further inquiry into abortion incidence in these settings and address interventions to ensure incarcerated people, in accordance with legal requirements and health equity, have access to abortion.

The 2006-2010 National Survey of Family Growth: sample design and analysis of a continuous survey.

OBJECTIVE: The National Survey of Family Growth (NSFG) collects data on pregnancy, childbearing, men's and women's health, and parenting from a national sample of women and men 15-44 years of age in the United States. This report describes the sample design for the NSFG's new continuous design and the effects of that design on weighting and variance estimation procedures. A working knowledge of this information is important for researchers who wish to use the data. Two data files are being released--the first covering 2.5 years (30 months) of data collection and the second after all data have been collected. This report is being released with the first data file. A later report in this Series will include specific results of the weighting, imputation, and variance estimation. METHODS: The NSFG's new design is based on an independent, national probability sample of women and men 15-44 years of age. Fieldwork was carried out by the University of Michigan's Institute for Social Research (ISR) under a contract with the National Center for Health Statistics (NCHS). In-person, face-to-face interviews were conducted by professional female interviewers using laptop computers. RESULTS: Analysis of NSFG data requires the use of sampling weights and estimation of sampling errors that account for the complex sample design and estimation features of the survey. Sampling weights are provided on the data files. The rate of missing data in the survey is generally low. However, missing data were imputed for about 600 key variables (called "recodes") that are used for most analyses of the survey. Imputation was accomplished using a multiple regression procedure with software called IVEware, available from the University of Michigan website.

Use of contraception in the United States: 1982-2008.

OBJECTIVE: This report presents national estimates of contraceptive use and method choice based on the 1982, 1995, 2002, and 2006-2008 National Surveys of Family Growth (NSFG). METHODS: Data for 2006-2008 were collected through in-person interviews with 13,495 men and women 15-44 years of age in the household population of the United States. This report is based on the sample of 7,356 women interviewed in 2006-2008. The response rate for women in the 2006-2008 survey was about 76%. RESULTS: More than 99% of women 15-44 years of age who have ever had sexual intercourse with a male (referred to as "sexually experienced women") have used at least one contraceptive method. The percentage of women who have ever used emergency contraception, the contraceptive patch, and the contraceptive ring increased between 2002 and 2006-2008. Looking at contraceptive use in the month of interview, or current use, the leading method of contraception in the United States during 2006-2008 was the oral contraceptive pill, used by 10.7 million women; the second leading method was female sterilization, used by 10.3 million women. While contraceptive use is virtually universal in the United States, women with different characteristics make different choices of methods--for example, college educated women are much more likely to use the pill and less likely to use female sterilization than less educated women. Age, parity, marital status, and income are also closely related to the choice of method. These method choices are related to the risk of unintended pregnancy in these groups.

Marriage and cohabitation in the United States: A statistical portrait based on cycle 6 (2002) of the National Survey of Family Growth.

OBJECTIVE: This report provides an overview of marital and cohabiting relationships in the United States among men and women aged 15-44 in 2002, by a variety of characteristics. National estimates are provided that highlight formal and informal marital status, previous experience with marriage and cohabitation, the sequencing of marriage and cohabitation, and the stability of cohabitations and marriages. METHODS: The analyses presented in this report are based on a nationally representative sample of 12,571 men and women aged 15-44 living in households in the United States in 2002, based on the National Survey of Family Growth, Cycle 6. RESULTS: Over 40% of men and women aged 15-44 were currently married at the date of interview, compared with about 9% who were currently cohabiting. Men and women were, however, likely to cohabit prior to becoming married. Marriages were longer lasting than cohabiting unions; about 78% of marriages lasted 5 years or more, compared with less than 30% of cohabitations. Cohabitations were shorter-lived than marriages in part because about half of cohabitations transitioned to marriage within 3 years. Variations--often large variations-in marital and cohabiting relationships and durations were found by race and Hispanic origin, education, family background, and other factors.

Pregnancy Prevalence and Outcomes in U.S. Jails.

OBJECTIVE: To describe the number of admissions of pregnant people to U.S. jails and the outcomes of pregnancies that end in custody. METHODS: We prospectively collected pregnancy data from six U.S. jails, including the five largest jails, on a monthly basis for 12 months. Jails reported de-identified, aggregate numbers of pregnant people admitted, births, preterm births, cesarean deliveries, miscarriages, induced abortions, ectopic pregnancies, and maternal and newborn deaths. RESULTS: There were 1,622 admissions of pregnant people in 12 months in the selected jails. The highest 1-day count of pregnant people at a single jail was 65. The majority of these admissions involved the release of a pregnant person. Of the 224 pregnancies that ended in jail, 144 (64%) were live births, 41 (18%) were miscarriages, 33 (15%) were induced abortions, and four were ectopic (1.8%). One third of the births were cesarean deliveries and 8% were preterm. There were two stillbirths, one newborn death, and no maternal deaths. CONCLUSION: About 3% of admissions of females to U.S. jails are of pregnant people; extrapolating study results to national female jail admission rates suggests nearly 55,000 pregnancy admissions in 1 year. It is feasible to track pregnancy statistics about this overlooked group.

Obesity and contraceptive use among women 20-44years of age in the United States: results from the 2011-15 National Survey of Family Growth (NSFG).

OBJECTIVE: Obesity has increased dramatically in the United States in recent decades. Our objective was to explore associations of contraceptive choices of US women, aged 20-44years, with body mass index (BMI) and relevant covariates. STUDY DESIGN: Data are based on interviews with a national sample of 11,300 women in the 2011-2015 National Survey of Family Growth. We analyzed women ages 20-44 at risk of unintended pregnancy. The primary dependent variable was BMI category. Covariates analyzed included age, parity, race/ethnicity, marital status, self-reported health and education. Data were analyzed via cross-tabulation and logistic regression. We determined unadjusted and adjusted odds ratios for three categories of contraceptive method: female sterilization, intrauterine device (IUD) and hormonal contraception. RESULTS: Obese women have higher odds of female sterilization (BMI 30.0-34.9 kg/m2: adjusted odds ratio (aOR)=1.96, 95% confidence interval (CI) 1.45-2.66; BMI 35.0 kg/m2 and higher: aOR=1.56, 95% CI 1.13-2.14) compared to women with normal BMI. Odds of IUD use are significantly higher among women with BMI >35 kg/m2 (aOR=1.64, 95% CI 1.20-2.25). Odds of hormonal contraceptive use are correspondingly reduced (aOR=0.78, 95% CI 0.62-0.98) for women in the highest BMI category. CONCLUSIONS: Contraceptive use varies by BMI category even after adjusting for usual correlates of use. Differences in contraceptive use by BMI category have implications for contraceptive counseling and provision. IMPLICATIONS: Findings that obese women are more likely to rely on female sterilization raise questions about how weight concerns and obesity affect contraceptive decision making. Future research could explore associations between obesity and contraceptive use in adolescent women.

Measuring HIV risk in the U.S. population aged 15-44: results from Cycle 6 of the National Survey of Family Growth.

OBJECTIVE: This report presents national estimates of the percentage and number of persons in the U.S. population aged 15-44 who report behaviors that place them at increased risk for acquiring or transmitting human immunodeficiency virus, or HIV. The report also contains data on condom use and HIV testing by persons who report risk behaviors. In addition, estimates of self-reported risk for HIV from the Cycle 6 National Survey of Family Growth (NSFG) are compared with data from other recent national surveys. METHODS: Data from the NSFG Cycle 6, conducted by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS), are based on interviews with a national sample of the household population of the United States. In-person, face-to-face interviews were conducted in the homes of 12,571 males and females 15-44 years of age in 2002. Most of the data were collected by Computer-Assisted Personal Interviewing (CAPI), in which a laptop computer is used to select and present the questions, which an interviewer reads to the respondent. The more sensitive data, including the risk behavior items on which this report is based, were collected by Audio Computer-Assisted Self-Interviewing (ACASI), in which the respondent listens to a recording of each question and enters his or her own answers into the computer without involving an interviewer. RESULTS: Overall, 8.9 percent of persons 15-44 years of age had engaged in sexual behaviors in the past year that put them at increased risk of HIV, and 1.5 percent had engaged in drug use behaviors that put them at risk. In all, an estimated 9.9 percent engaged in either drug use or sexual behavior that placed them at increased risk for HIV. Including those who were treated for a sexually transmitted disease (STD) in the past year, 11.9 percent of persons 15-44 years of age--13.0 percent males and 10.8 percent of females+-were at risk of HIV in 2002. The 11.9 percent at risk is equivalent to an estimated 14.4 million persons aged 15-44 at higher risk of HIV through drug use, sexual behavior, or having been treated for an STD in the past year. Persons who were at increased risk reported greater condom use and higher rates of HIV testing, but among those at risk, 33.6 percent had never been tested for HIV and 60.4 percent did not use condoms at last sex.

National Survey of Family Growth, Cycle 6: sample design, weighting, imputation, and variance estimation.

OBJECTIVES: Cycle 6 of the National Survey of Family Growth (NSFG) was conducted by the National Center for Health Statistics in 2002 and early 2003. This report describes how the sample was designed, shows response rates for various subgroups of men and women, describes how the sample weights were computed to make national estimates possible, shows how missing data were imputed for a limited set of key variables, and describes the proper ways to estimate sampling errors from the NSFG. The report includes both nontechnical summaries for readers who need only general information and more technical detail for readers who need an in-depth understanding of these topics. METHODS: The NSFG Cycle 6 was based on an independent, national probability sample of men and women 15-44 years of age. It was the first NSFG ever to include a national sample of men 15-44 as well as a sample of women. Fieldwork was carried out by the University of Michigan's Institute for Social Research (ISR) under a contract with NCHS. In-person, face-to-face interviews were conducted by professional female interviewers using laptop computers. In all, 12,571 women and men-7,643 females and 4,928 males-were interviewed, the largest NSFG ever done. RESULTS: Analysis of NSFG Cycle 6 data requires the use of sampling weights and estimation of sampling errors that accounts for the complex sample design and estimation features of the survey. Examples of how to use several available software packages that incorporate complex design features in estimation, such as SAS, SUDAAN, and STATA, are presented.

Fertility, contraception, and fatherhood: data on men and women from cycle 6 (2002) of the 2002 National Survey of Family Growth.

OBJECTIVE: This report presents national estimates of fertility, family formation, contraceptive use, and father involvement indicators among males 15-44 years of age in the United States in 2002 from Cycle 6 of the National Survey of Family Growth (NSFG). Data are also shown for women for purposes of comparison. METHODS: Descriptive tables of numbers and percentages are presented. Data were collected through in-person interviews of the household population 15-44 years of age in the United States between March 2002 and March 2003. The sample included 7,643 females and 4,928 males. This report focuses primarily on data from the male sample, but compares findings with the female data whenever appropriate. The overall response rate for Cycle 6 of the NSFG was 79 percent, and the response rate for men was 78 percent. RESULTS: This report covers a wide range of topics including first sexual intercourse and its timing in relation to marriage; contraceptive use; wantedness of births in the past 5 years; marital and cohabiting status at first birth; living arrangement of fathers with their children; father's activities with children they live with and those they do not live with; HIV-risk related behaviors; and infertility services. CONCLUSION: The reproductive experiences of men and women 15-44 years of age in the United States vary significantly, and often sharply, by demographic characteristics such as education, income, and Hispanic origin and race.

HIV testing in the United States, 2002.

OBJECTIVE: This report presents national estimates of testing for Human immunodeficiency virus, or HIV, the virus that causes acquired immunodeficiency syndrome (AIDS). The objectives are to present nationally representative estimates of the degree of self-reported lifetime and recent HIV testing among persons 15-44 years of age in the United States. The report also contains data on sources of testing, reasons for tests, and whether HIV counseling was obtained. METHODS: Data from the 2002 NSFG, conducted by the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), are based on interviews with a national sample of the household population of the United States. In-person, face-to-face interviews were conducted in the homes of 12,571 males and females 15-44 years of age in 2002. Most of the data used for this report were collected by an interviewer who asked the questions and entered the answers into a laptop computer. RESULTS: One-half of men and women 15-44 years of age in 2002 reported that they had been tested at least once (other than through blood donation), and 15.1 percent had been tested in the past 12 months, which is equivalent to 17-20 million tests per year among 15-44 year olds. Testing is more common in some population subgroups than others, for example, among African Americans and persons with increased risk for HIV. Private physicians and HMOs were the largest provider of tests, accounting for 45 percent of recent tests. Public sources accounted for 22 percent of tests. A minority of recently tested respondents (29 percent) reported talking with a health professional about the HIV test after being tested. Among women who had recently been pregnant, 69 percent reported being tested for HIV during prenatal care. Persons 15-44 years of age with increased risk for HIV, defined by drug-related or sex-related behavior, had higher reported testing during their lifetime and in the past 12 months than those not at higher risk. However, one-third of this higher risk group reported that they had never had an HIV test, equivalent to 4.1-5.5 million untested, at-risk persons aged 15-44 years, and a majority of higher risk persons had not been tested in the past year.

Sexual behavior and selected health measures: men and women 15-44 years of age, United States, 2002.

OBJECTIVE: This report presents national estimates of several measures of sexual behavior among males and females 15-44 years of age in the United States in 2002, as collected in the 2002 National Survey of Family Growth (NSFG). These data are relevant to demographic and public health concerns, including fertility and sexually transmitted diseases among teenagers and adults. Data from the 2002 NSFG are compared with previous national surveys. METHODS: The 2002 NSFG was conducted by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS) and is based on in-person, face-to-face interviews with a national sample of 12,571 males and females in the household population of the United States. The measures of sexual behavior presented in this report were collected using Audio Computer-Assisted Self-Interviewing (ACASI), in which the respondent enters his or her own answers into a laptop computer without telling them to an interviewer. RESULTS: Among adults 25-44 years of age, 97 percent of men and 98 percent of women have had vaginal intercourse; 90 percent of men and 88 percent of women have had oral sex with an opposite-sex partner; and 40 percent of men and 35 percent of women have had anal sex with an opposite-sex partner. About 6.5 percent of men 25-44 years of age have had oral or anal sex with another man. Based on a differently worded question, 11 percent of women 25-44 years of age reported having had a sexual experience with another woman. The public health significance of the findings is described.

Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth.

OBJECTIVE: This report presents national estimates of fertility, family planning, and reproductive health indicators among females 15-44 years of age in the United States in 2002 from Cycle 6 of the National Survey of Family Growth (NSFG). For selected indicators, data are also compared with earlier cycles of the NSFG. METHODS: Descriptive tables of numbers and percentages are presented and interpreted. Data were collected through in-person interviews of the household population 15-44 years of age in the United States between March 2002 and March 2003. The sample included 7,643 females and 4,928 males, and this report focuses on data from the female sample. The overall response rate for the Cycle 6 NSFG was 79 percent, and the response rate for women was 80 percent. RESULTS: Given the range of topics covered in the report, only selected findings are listed here. About 14 percent of recent births to women 15-44 years of age in 2002 were unwanted at time of conception, an increase from the 9 percent seen for recent births in 1995. Among recent births, 64 percent occurred within marriage, 14 percent within cohabiting unions, and 21 percent to women who were neither married nor cohabiting. The overall rate of breastfeeding initiation among recent births increased from 55 to 67 percent between 1995 and 2002. About 50 percent of women 15-44 had ever cohabited compared with 41 percent of women in the 1995 survey; the percentage of women currently cohabiting also increased, from 7 to 9 percent between 1995 and 2002.

Use of contraception and use of family planning services in the United States: 1982-2002.

OBJECTIVE: This report presents national estimates of contraceptive use and method choice based on the 1982, 1995, and 2002 National Surveys of Family Growth (NSFG). It also presents data on where women obtained family planning and medical services, and some of the services that they received. METHODS: Data were collected through in-person interviews with 12,571 men and women 15-44 years of age in the civilian noninstitutional population of the United States in 2002. This report is based on the sample of 7,643 women interviewed in 2002. The response rate for women in the study was about 80 percent. RESULTS: The leading method of contraception in the United States in 2002 was the oral contraceptive pill, used by 11.6 million women; the second leading method was female sterilization, used by 10.3 million women. The condom was the third-leading method, used by about 9 million women and their partners. The condom is the leading method at first intercourse; the pill is the leading method among women under 30; and female sterilization is the leading method among women 35 and older. More than 98 percent of women 15-44 years of age who have ever had sexual intercourse with a male (referred to as "sexually experienced women") have used at least one contraceptive method. Over the 20 years from 1982 to 2002, the percent who had ever had a partner who used the male condom increased from 52 to 90 percent. The proportion who had ever had a partner who used withdrawal increased from 25 percent in 1982 to 56 percent in 2002. Another important measure of contraceptive use is use at the first premarital intercourse: before 1980, only 43 percent of women (or their partner) used a method of birth control at their first premarital intercourse. By 1999-2002, the proportion using a method at first premarital intercourse had risen to 79 percent.

Cohabitation, marriage, divorce, and remarriage in the United States.

OBJECTIVES: This report presents national estimates of the probabilities of marital and cohabitation outcomes for women 15-44 years of age in 1995, by a wide variety of individual- and community-level characteristics. The life-table analysis in this report takes a life cycle approach to estimate the probabilities that: a woman will marry for the first time, an intact first cohabitation will make the transition to marriage, a first cohabitation will end in separation, a first marriage will end in separation or divorce, a disrupted first marriage will be followed by a new cohabitation, a separation from first marriage will result in divorce, a divorce from first marriage will be followed by remarriage, and a second marriage will end in separation or divorce. METHODS: The life-table estimates presented here are based on a nationally representative sample of women 15-44 years of age in the United States in 1995 from the National Survey of Family Growth, Cycle 5. RESULTS: The analyses show that various individual and community-level characteristics are related to the marital and cohabitational outcomes examined in this report. The results consistently demonstrate that the cohabitations and marriages of non-Hispanic black women are less stable than those of non-Hispanic white women. An analysis of trends over time suggests that differences by race/ethnicity are becoming more pronounced in recent years. Racial differences observed are associated with individual characteristics and with the characteristics of the communities in which the women live.

Community environment and women's health outcomes: contextual data.

OBJECTIVES: This report presents some illustrative data and analyses from the Contextual Data File for the 1995 National Survey of Family Growth (NSFG). Data are shown by the woman's race and Hispanic origin, and selected characteristics of the community in which she lived. METHODS: Cycle 5 of the NSFG was based on in-person interviews with a national sample of 10,847 women 15-44 years of age in the United States in 1995. The interview included questions on the woman's births, marriages, contraceptive use, and characteristics such as her race and education. Measures of the characteristics of the woman's neighborhood were added to the interview data. RESULTS: This report shows that several simple measures of the social and economic status (SES) and resources of the woman's community of residence are closely associated with outcomes such as delayed childbearing, unwanted births, current marital status, the use of male or female contraceptive sterilization, breast-feeding, vaginal douching, and cigarette smoking. CONCLUSIONS: It is well-documented that the outcomes studied in this report are closely associated with individual characteristics such as age, race, education, and household income. But this report shows that these outcomes are also related to characteristics of the communities in which the individuals live. Researchers are encouraged to use the NSFG Contextual Data File to study these relationships further.

Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002.

OBJECTIVE: This report presents national estimates of sexual activity, contraceptive use, and births among males and females 15-19 years of age in the United States in 2002 from the National Survey of Family Growth (NSFG). Data are also presented from the 1988 and 1995 NSFGs, and from the 1988 and 1995 National Survey of Adolescent Males (NSAM). METHODS: Descriptive tables of numbers and percents are presented and interpreted. Data were collected through in-person interviews of the civilian noninstitutionalized population in the United States. Interviews were conducted with 7,643 females, 1,150 of whom were teenagers, and 4,928 males, 1,121 of whom were teenagers. RESULTS: In 2002, about 47 percent of female teenagers (4.6 million), and about 46 percent of male teenagers (4.7 million) had had sexual intercourse at least once. For never-married males, there was a significant decline from 55 percent in 1995 to 46 percent in 2002. Among never-married females, for those aged 15-17 there was a significant decline in the percent sexually experienced, and for those aged 18-19 there was no significant change. Teenagers showed increases in the use of contraceptives. About 3 out of 4 teens used a method of contraception at their first intercourse. About 91 percent of males and 83 percent of females used a method at their last (most recent) sex. Hispanic teens are most likely to have a birth before age 20 and non-Hispanic whites are least likely, with non-Hispanic black teens in the middle. CONCLUSION: This report documents findings that may be helpful in understanding trends in teen birth and pregnancy, and STD rates.

Fathers' involvement with their children: United States, 2006-2010.

OBJECTIVE: This report measures fathers' involvement with their children. Father involvement is measured by how often a man participated in a set of activities in the last 4 weeks with children who were living with him and with children who were living apart from him. Involvement is measured separately for children aged 0-4 years and children aged 5-18 years. Increased involvement of fathers in their children's lives has been associated with a range of positive outcomes for the children. METHODS: The analyses presented in this report are based on a nationally representative sample of 10,403 men aged 15-44 years in the household population of the United States. The father-involvement measures are based on 2,200 fathers of children under age 5-1,790 who live with their children and 410 who live apart from their children, and on 3,166 fathers of children aged 5-18-2,091 who live with their children and 1,075 who live apart from their children. RESULTS: Statistics are presented on the frequency with which fathers took part in a set of age-specific activities in their children's lives. Differences in percent distributions are found by whether the father lives with or apart from his children, and by his demographic characteristics. In general, fathers living with their children participated in their children's lives to a greater degree than fathers who live apart from their children. Differences in fathers' involvement with their children were also found by the father's age, marital or cohabiting status, education, and Hispanic origin and race.