The challenge for tomorrow's health care is to address factors such as income, education, occupation, environment, and access to services--all of which impact African-Americans' health status. It will be our purpose here to look at just one aspect of the overall plight facing African-Americans: adolescent pregnancy. We will explore the social and medical consequences of adolescent pregnancy in the African-American community. Policy questions will be addressed, as well as their implications for health care and societal reform.
Adolescent pregnancy is considered to be an epidemic in the United States. For African-Americans, the problem of teenage pregnancy is particularly devastating because of the sociomedical consequences experienced by this group. National data, as well as data from Washington, D.C., are used to highlight the problem. An exploration of the consequences is necessary because they are so varied, and because the teen parent's adjustment is dependent on supportive family services and policies.
Urban areas such as the District of Columbia, Chicago, Los Angeles, and New York experience especially high rates of teenage pregnancy. The following statistics are given to show the incidence of teenage pregnancy in Washington, D.C., an area having a large percentage of African-American citizens:
In the District of Columbia, two in ten teenagers become pregnant each year. In 1986, 4,180 District of Columbia teenagers had pregnancies that terminated in birth, abortions, or miscarriages. Also in Washington, D.C., the rate of teenage pregnancies for girls twelve to fifteen years of age increased between 1984 and 1986, while the rate for teens fifteen to nineteen ears of age remained stable. An even more dramatic statistic from 1986 is the observation that 309 adolescents in the District of Columbia gave birth to a second child, while 49 gave birth to a third child.
The high teenage pregnancy rates in the District...