Reducing Teenage Pregnancy in Sheffield Sam Martin Joint Commissioning and Health Strategy Manager Sheffield City Council It’s not just about the numbers but…in 2008 • Number of under 18 conceptions • Number of births • Number of abortions 449 245 200 Why reducing teenage pregnancy matters Impact on mother Increased risk at age 30 of: • Living in poverty • Unemployment • Single parent • No qualifications 3 x increased risk post natal depression Higher risk of poor mental health up to 3 years after birth Why reducing teenage pregnancy matters Impact on child 60% higher infant mortality rate Mother 3 x more likely to smoke during pregnancy,more likely to have low weight birth, and 50% less likely to breastfeed, all with negative health consequences for the child 63% increased risk of being born into poverty Increased risk of: • mortality under 8 years old • accidents • behavioural problems • (for girls) becoming a teenage mother Risk Factors • • • • • • • • • • • • • • Early sexual activity Poor contraceptive use Poor mental health/conduct disorder/involvement in crime Alcohol and substance misuse Teenage motherhood Repeat abortions Low educational attainment Disengagement from school Leaving school at 16 with no qualifications Living in care Being a daughter of a teenage parent Some ethnic minority groups. Parental aspirations Low socioeconomic background National Reducing Teenage Pregnancy Strategy • Target: Reduce the rate of conception for 15-17 year olds by 50% by 2010, from the baseline rate in 1998. So How Are We Doing So Far….. Sheffield Quarterly rate Sheffield Rolling average Sheffield Annual Rate Other Sheffield targets Yorkshire & Humber Quarterly Average England Quarterly Average Quarter & Year Sheffield LAA targets Sept March 2010 Sept March 2009 Sept March 2008 Sept March 2007 Sept March 2006 Sept March 2005 Sept March 2004 Sept March 2003 Sept March 2002 Sept March 2001 Sept March 2000 Sept March 1999 Sept March 1998 Rate per 1,000 females aged 15-17 years 65 60 55 50 45 40 35 30 Trends in under 18 conception rates. Statistical Neighbours Under 18 conception rate (Q1 2009 calendar year) 60 Statistical Neighbours Statistical Neighbour average 58 56 54 52 50 48 46 47 44 42 Dudley Sheffield Plymouth Portsmouth Leeds Telford and Wrekin Southampton Derby Rotherham Peterborough Tameside The change in the rate of under-18 conceptions per 1,000 girls (Q1 2009 calendar year) as compared with the 1998 baseline rate, shown as a percentage of the 1998 calendar year rate 0.078358209 10.0% 5.0% 0.001984127 -0.134646962 -0.163009404 -20.0% -0.200934579 -25.0% -0.223034735 -0.156140351 -0.041594454 Tameside -0.049469965 Leeds Rotherham Sheffield Plymouth -0.12797075 -0.069306931 Peterborough -15.0% Southampton Derby Portsmouth -10.0% Telford and Wrekin -5.0% Dudley 0.0% Under 18 Years Conceptions and Abortions 2006-2008 (based on year of outcome event) 90.0 80 80.0 70 70.0 60 60.0 50 50.0 40 40.0 % Abortions rate per 1,000 girls aged 15-17 yrs Neighbourhood Deprivation Quintiles* 30 30.0 20 20.0 10.0 10 0.0 0 Most Deprived Above Average Average Below average Least Deprived 2008 Deprivation Quintile (% households receiving income support/council tax beneft) Conception Rate Source: Inpatient data sets, Population Health Register Abortion Rate % Abortions Public Health Analysis Team (AR), NHS Sheffield Teenage Pregnancy National Support Team Visit 2007 • • • • It’s a ‘health’ issue It’s all about sex Not targeted enough Not systematic in efforts What have we got to do ?– evidence from successful partnerships • senior local sponsorship and engagement of all key partners – inc communications and workforce training • Make good use of data • Good quality young people’s contraceptive and sexual health services • Strong delivery of PSHE and SRE in schools and in the youth services • Target interventions in the right place with the right people at the right time • Work with parents • RAISING ASPIRATION What are we doing now? • Targeted Programmes • Expanding access to contraception including LARC • Workforce training • Better intelligence • Integration with other strategies i.e. targeted youth, sexual health, etc. What difference can YOU make? • Don’t be afraid to tackle the sex and contraception issue! • Don’t assume that for some young people early parenthood is inevitable • Know where the support services are and how to access them for young people What does the future hold? • National Strategy ends 2010 • Financial uncertainty – Comprehensive Spending Review • New focus of Coalition Government