Local trends in teen conceptions reveal some surprises
Teenage pregnancy rates in the UK are high compared with many other countries but there is marked variation across local areas, including those with high deprivation.
Tim Blackman discusses his research in this area published in Social Policy and Society:
It has been a challenge for the UK to reduce its health inequalities. I carried out a study with colleagues at Durham University into why some areas have done better than others. We published findings on circulatory disease and cancers, which revealed some surprises, and recently I used updated teenage pregnancy data to conduct a similar analysis. This also revealed some unexpected findings.
Research Findings –
The bureaucracy obstacle
As with the cancer findings, those areas that were assessed as having a good or exemplary standard of commissioning services to tackle the issue actually saw no narrowing of their gap in rates compared to the national average. Areas that assessed this standard as less than good saw their gap narrow. A possible explanation came from talking with practitioners on the ground who revealed that commissioning generated a lot of bureaucracy and process that, while being possible to achieve to a high standard, had little to do with working with young people at the grassroots. In fact, it could actually distract from the work that mattered, which is what the findings suggest.
Educational aspirations and infection awareness
Another surprise was that areas with a high proportion of black and minority ethnic residents in the population saw their teen conception gap narrow while this was not the case in other areas. The result was not due to a pre-existing high rate, and BME effects have not especially featured in policy or practice debate on teen conceptions in the UK. It is a finding that is difficult to explain but may be to do with a growing awareness of the risk of infection and rising educational aspirations among young BME populations.
Areas with a narrowing gap in their conception rates had a higher proportion of under 18s in the population. A possible explanation, although very speculative, is that these areas are more likely to have a high level of services overall to help young people in many aspects of their lives, steering them away from vulnerability to early pregnancy.
Narrowing gaps were also found in areas where fewer people were being treated for drug addiction: low numbers of people being treated for drugs may indicate a lower prevalence of risky behaviours generally in those areas.
The research used Charles Ragin’s method of Qualitative Comparative Analysis, which is not based on looking for associations between variables but on looking for groups of actual cases (local areas in this study) that share the same conditions, whether ways of working or features such as demography. This enables the important effect of combinations of conditions to be taken into account, which in QCA is known as complex causation.
In the article I explain how the above findings need to be considered as part of ‘sufficient’ combinations with a certain outcome, although the combination is not ‘necessary’ for the outcome if the outcome appears in other combinations. The aim of QCA is to map all the relevant combinations, and in doing so to show how outcomes of interest arise from complex causation.
Blog post written by Tim Blackman, Faculty of Social Sciences, The Open University