Journal
Summary
July/August 2001
The
Association of Sexual Behaviors with Socioeconomic Status, Family Structure,
and Race/Ethnicity Among U.S. Adolescents
Original
article authored by:
John S. Santelli,
MD, MPH, Richard Lowry, MD, Nancy D. Brener, Ph.D., and
Leah Robin, Ph.D.
This
summary includes the following sections:
The authors
of this article note that previous research has shown that poverty and
ethnic minority status have been associated with increased adolescent
pregnancy and sexually transmitted infection (STI) rates. Lower socioeconomic
status (SES) may negatively influence adolescents' health by limiting
their social and educational opportunities and access to health care.
While
lower SES may be a risk factor for adolescent pregnancy and STI infection
rates, the impact of SES and race/ethnicity on sexual behaviors is unclear.
In this study, the authors attempt to shed some light on this issue by
addressing two questions:
- What
is the relationship between adolescent sexual behaviors and SES, family
structure, and race ethnicity?
- Does
the relationship between race/ethnicity and sexual behavior change when
the effects of SES and family structure are taken into account?
The authors
of this article used data from two different surveys to find a link between
household demographics and adolescent sexual behaviors. The authors selected
13,789 adolescents from the list of households that completed the 1992
National Health Interview Survey (NHIS). This survey measures family income,
adult educational attainment, adolescent marital status, race/ethnicity,
and family structure.
The authors
then administered the 1992 Youth Risk Behavior Survey (YRBS) which
measures adolescent sexual behaviors to this group of adolescents.
The final analytic sample was composed of 3,904 adolescents between the
ages of 14 and 17.
The influence
of SES was examined for the following behaviors:
- ever
having had sexual intercourse,
- recent
sexual activity,
- recent
multiple partners, and
- condom
or oral contraceptive use at last intercourse.
Four demographic
measures of SES were collapsed into four categories each:
- Family
income: less than $20,000 per year, $20,000-$34,999, $35,000-$49
999, or more than $50,000
- Parent
educational level: less than high school, high school graduate,
some college, or college graduate
- Family
structure: living with both parents, with mother only, with father
only, or with neither parent, and
- Race/ethnicity:
White, Black, Hispanic, or Other.
top
Demographics:
- Approximately
74% of adolescents were living with both parents, 21% with their mother
only, and the remaining 5% with either their father only or neither
parent.
- The sample
was approximately 66% White, 15.5% Black, 12.5% Hispanic and 6% "Other.
- Parental
educational attainment, family income, and adolescent age varied widely
and were approximately evenly split between the four categories.
General
& Specific Patterns:
- The relationship
between race/ethnicity and sexual behavior was only slightly affected
by adjustment for socioeconomic factors such as parental education,
family income, and family structure. In other words, within racial/ethnic
groups, SES was not a significant factor either as a risk or a protection
against pregnancy or STIs.
- Family
income did not show a significant relation to any sexual behavior.
- Regardless
of race/ethnicity, there was a relationship between the educational
level of parents and teens' sexual behavior. Female adolescents whose
parents were college graduates were less likely to report recent sexual
activity than females whose parents did not complete high school. Also,
adolescents (male and female) whose parents were college graduates were
less likely to have had sexual intercourse than their counterparts whose
parents did not complete high school.
- Family
structure was a factor in teen sexual behavior. Adolescents who lived
with both parents were less likely to have had sexual intercourse than
were adolescents who lived with only one or neither parent.
top
The overall
findings suggest that differences in sexual behavior by race/ethnicity
cannot be attributed to the effect of a family's socioeconomic status.
Sexual behavior differences by SES and race/ethnicity were not large enough
to account for differences by race/ethnicity in national STI and birth
rates. This finding suggests that larger societal influences not measured
here such as media portrayal of sexuality, HIV education programs,
and access to health care may have a significant impact on adolescent
sexual behaviors.
The authors
acknowledge several limitations of this study. First, cross-sectional
surveys can determine whether a correlation between two variables exists,
but not whether a difference in one causes a difference in another. Second,
the data used in this study were self-reported and may have been either
intentionally or unintentionally misreported.
Third, the
study did not gather information about other factors affecting adolescent
decision-making skills, such as parenting practices, peer influences,
and self-efficacy. Finally, factors such as family income, parental education,
and family structure provide only a partial explanation of the complex
relationships between adolescents, their parents, and their communities.
top
- Adolescents
from all economic strata are susceptible to STIs and pregnancy; thus
prevention efforts for these health concerns should be universal.
- Access
to health care is an important factor in the prevention and control
of STIs. Screening and treatment services need to be expanded with special
attention given to communities that are traditionally medically underserved
and where a high prevalence of STIs exists.
- Adolescent
connectedness to school and parental expectations of the adolescents
success in school may be important factors in delaying the onset of
intercourse and protecting against other risky sexual behaviors.
- Adolescents
with high aspirations and life opportunities are more likely to delay
sexual activity. Therefore, efforts to reduce adolescent STI infection
and pregnancy rates should move beyond the health care system and include
parents, schools, and communities.
|
Santelli,
J.S., Lowry, R., Brener, N.D., and Robin, L. The Association of
Sexual Behaviors with Socioeconomic Status, Family Structure, and
Race/Ethnicity among US Adolescents. American Journal of Public
Health. Vol. 90, No. 10, 1582-1587, 2000.
|
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