School of Nursing, Saint Louis University, St. Louis, MO, USA.
Public Health Nurs. 2012 Sep-Oct;29(5):444-54. doi: 10.1111/j.1525-1446.2012.01017.x. Epub 2012 Mar 9.
The teen birth rate in the United States is one of the highest in the post-industrialized world. International comparisons suggest that U.S. rates reflect high levels of social disadvantage and misguided policies that frame teen parenting as costly for mothers, children, and taxpayers. Studies that control for background factors that predispose teens to become parents highlight the social inequities that contribute to early childbearing and unfavorable maternal-child outcomes, regardless of maternal age. After reviewing these studies, federal policies that target and scrutinize teenage and single mothers are described and critiqued for the ways they disregard the social determinants of early childbearing and further the marginalization and social exclusion of low-income families. This review calls for public health nurses to challenge the ideological assumptions driving downstream policies and to advocate for comprehensive reforms that reduce the wide and growing inequities in education, income, and health among U.S. citizens. Building the public support and political will to move upstream will remain daunting in light of the pervasive stereotypes of teen parents and the ideological assumptions that early childbearing and poor maternal-child outcomes stem more from individual choices and lifestyles than from social inequities.
美国青少年的生育率是后工业化世界中最高的之一。国际比较表明，美国的比率反映了社会劣势的高水平和误导性政策，这些政策将青少年生育视为对母亲、孩子和纳税人的代价高昂。控制青少年成为父母的背景因素的研究强调了导致早育和不利母婴结果的社会不平等，而不论母亲年龄如何。在审查了这些研究之后，描述并批评了针对青少年和单身母亲的联邦政策，这些政策忽视了早育的社会决定因素，并进一步使低收入家庭边缘化和被社会排斥。这一审查呼吁公共卫生护士挑战推动下游政策的意识形态假设，并倡导进行全面改革，以减少美国公民在教育、收入和健康方面的广泛和日益扩大的不平等。鉴于青少年父母的普遍刻板印象以及早育和不良母婴结果更多地源于个人选择和生活方式而不是社会不平等的意识形态假设，要获得推动这一改革所需的公众支持和政治意愿仍然是一项艰巨的任务。
