Department of Mathematics & Statistics, University of West Florida, and the Department of Obstetrics and Gynecology, University of Florida-Pensacola, Pensacola, and the University of Florida-Gainesville, Gainesville, Florida.
Obstet Gynecol. 2017 Jun;129(6):1068-1077. doi: 10.1097/AOG.0000000000001897.
To investigate the geographic variation in the average teenage birth rates by county in the contiguous United States.
Data from the National Center for Health Statistics were used in this retrospective cohort to count the total number of live births to females aged 15-19 years by county between 2006 and 2012. Software for disease surveillance and spatial cluster analysis was used to identify clusters of high or low teenage births in counties or areas of greater than 100,000 teenage females. The analysis was then adjusted for percentage of poverty and high school diploma achievement.
The unadjusted analysis identified the top 10 clusters of teenage births. The cluster with the highest rate was a city and the surrounding 40 counties, demonstrating an average teen birth rate of 67 per 1,000 females in the age range, 87% higher than the rate in the contiguous United States. Adjustments for poverty rates and high school diploma achievement shifted the top clusters to other areas.
Despite an overall national decline in the teenage birth rate, clusters of elevated teenage birth rates remain. These clusters are not random and remain higher than expected when adjusted for poverty and education. This data set provides a framework to focus targeted interventions to reduce teenage birth rates in this high-risk population.
调查美国相邻各州按县划分的青少年平均出生率的地域差异。
本回顾性队列研究使用了国家卫生统计中心的数据，统计了 2006 年至 2012 年期间，年龄在 15-19 岁的女性的活产总数。利用疾病监测和空间聚类分析软件，确定了青少年出生率较高或较低的县或超过 10 万青少年女性的地区集群。然后，对贫困率和高中文凭完成率进行了调整。
未调整分析确定了青少年出生率最高的前 10 个集群。出生率最高的集群是一个城市及其周边的 40 个县，该年龄段的平均青少年出生率为每 1000 名女性 67 例，比美国相邻各州的出生率高 87%。调整贫困率和高中文凭完成率后，前几个集群转移到了其他地区。
尽管全国青少年出生率总体呈下降趋势，但青少年出生率高的集群仍然存在。这些集群并非随机分布，而且在调整贫困和教育因素后，其出生率仍高于预期。该数据集为集中干预措施提供了框架，以降低这一高危人群的青少年出生率。
