Exploring longitudinal associations between social determinants of health during adolescence and self-reported contraceptive use in young adulthood in the United States.

OBJECTIVE

Childhood environment and socioeconomic status influence adult health. Past research links early social and economic disadvantages to later-life diseases and substance abuse, but their effects on contraceptive use remain unexplored. This longitudinal study utilizes the Social Determinants of Health (SDH) framework to explore the associations between social domains in adolescence and contraceptive use in young adulthood.

STUDY DESIGN

Fourteen measures of the SDH domains were extracted from the National Longitudinal Study of Adolescent and Adult Health Wave I data (1994-95) to explore associations with reported ever-use and consistent use of contraception among young adults in the U.S (18-26 years) at Wave III (2001) using multilevel logistic regression.

RESULTS

Among 11,172 participants, 87.60 % reported past-year ever-use of contraception, while 47.30 % were consistent contraceptive users. Measures significantly associated with the past year's ever-use of contraceptives in young adulthood included parents' high school graduation status (positive/+), volunteering experience (+), history of foster care (negative/-), and parental reporting a trash problem in the neighborhood (-) during adolescence. For consistent use of contraception in young adulthood, parent high school education (+), volunteering experience (+), higher social cohesion scores (+), access to health care (+), receiving family planning counseling (-), parental receipt of public assistance (-), non-English language spoken at home (-) and the number of neighborhood crimes (-) during adolescence were found to be significant.

CONCLUSIONS

A favorable environment during adolescence provides a foundation for positive health behaviors. Interventions aimed at improving contraceptive use in young adulthood should consider creating supportive environments for adolescents.