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Teenage birth, pregnancy rates hold steady in Northland

According to a report from the University of Minnesota, 2020 Northland birth and pregnancy rates stayed largely similar to 2019, but are low compared to years past. In most Northland counties, fewer teenage pregnancies and births were recorded in 2020 than in 2019.

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DULUTH — Fewer pregnancies and births among teens age 15-19 occurred in the Northland in 2020 than in 2019, according to a new report from the University of Minnesota Healthy Youth Development–Prevention Research Center that included teenage pregnancy, birth and sexually transmitted infection data from 2020.

In Minnesota's seven Northland counties, 431 pregnancies were recorded in 2018-2020, compared to 491 recorded in 2017-2019. The number of pregnancies and births in all Northland counties except Cook County decreased or stayed the same from 2017-2019 to 2018-2020.

Total teen pregnancies in 2018-2020

  • Aitkin: 14 — decrease of 3.
  • Carlton: 57 — no change.
  • Cook: 3 — increase of 3.
  • Itasca: 70 — decrease of 8.
  • Koochiching: 10 — decrease of 8.
  • Lake: 9 — decrease of 3.
  • St. Louis: 268 — decrease of 41.

St. Louis County's birth rate of 10.1 births per 1,000 did not change from 2019 to 2020, but decreased from 2015, when the birth rate was 13.1 per 1,000.
Dr. Jill Farris, director of Adolescent Sexual Health Training and Education for the HYD-PRC at the University of Minnesota Medical School, said rates have been trending downward in Minnesota since the 1990s, and this year's report found the pregnancy rate among teens ages 15-19 decreased by 6% from 2019 to 2020, while the birth rate decreased by nearly 10%.

“While we obviously have a few more years of data that we need to be able to tell whether or not this is a trend or not, it seems that in terms of sexual health outcomes, there were at least some things about the pandemic that appeared to be protective for some people,” Farris said.

St. Louis County's teen pregnancy rate increased slightly from 13.4 in 2019 to 14.5 in 2020, but is down from the 2015 rate of 17.8 per 1,000.

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In the Northland's other Minnesota counties, Itasca and Koochiching saw decreases in birth and pregnancy rates from 2019 to 2020. Aitkin, Carlton and Lake counties saw increases in adolescent birth and pregnancy rates. Cook County's rates were not recorded due to low volume. In Lake County, all teenage pregnancies and births were among women age 18 and 19, and despite rates increasing the most of any Northland county, fewer actual births and pregnancies occurred.

Northland birth rates from 2019-2020

  • Aitkin: 14.2 per 1,000 — increased 2.4 per 1,000.
  • Carlton: 13.6 per 1,000 — increased 3.9 per 1,000.
  • Cook: No data.
  • Itasca: 12.6 per 1,000 — decreased 4.1 per 1,000.
  • Koochiching: 3 per 1,000 — decreased 5.2 per 1,000.
  • Lake: 17.2 per 1,000 — increased 12.9 per 1,000.
  • St. Louis: 10.1 per 1,000 — no change.

Northand pregnancy rates from 2019-2020

  • Aitkin: 17 per 1,000 — increase of 5.2 per 1,000.
  • Carlton: 23.2 per 1,000 — increase of 12.5 per 1,000.
  • Cook: No data.
  • Itasca: 15.8 per 1,000 — decrease of 1.7 per 1,000.
  • Koochiching: 9 per 1,000 — decrease of 4.7 per 1,000.
  • Lake: 17.2 per 1,000 — increase of 13.1 per 1,000.
  • St. Louis: 14.5 — increase of 1.1 per 1,000.

Farris noted that changes in rates from year to year can be greatly impacted by only a small change in actual numbers because of population density. Overall, Minnesota's pregnancy and birth rates have decreased by 77% and 75%, respectively, since 1990.

Farris said statewide, sexually transmitted infections of chlamydia and gonorrhea were trending upward in previous years, but decreased this year.

“One area of caution is that even though we’re happy that these rates went down for one year from 2020 to 2021, rates are still quite high compared to where they were 10 and 15 years ago," Farris said.

Chlamydia rates have increased 54% since 2004, she said, while gonorrhea rates have gone up 82%. Carlton County was among the top 10 counties in Minnesota with the highest rates of youth chlamydia cases in 2021. According to the University of Minnesota's report, which used data from the Minnesota Department of Health's STD and HIV/AIDS Surveillance Statistics, Minnesota teens age 15-19 accounted for 24% of chlamydia and 14% of gonorrhea cases in 2021, despite making up only 6.5% of the state's population.

Disparities and education

According to the report, there are persistent sexual health disparities among youth who are LGBTQ, gender diverse, Black, Indigenous, people of color, from rural areas, homeless or runaways, in foster care, in juvenile justice systems and/or come from adolescent parents.

"In rural areas, access to confidential, affordable, youth-friendly health care may be limited," the report read. "There are large geographic disparities in sexual health clinic hours of availability and distance to service. For example, there are 29 sexual health clinics in Hennepin and Ramsey counties with services available five days per week. In contrast, 47% of rural counties in Minnesota have no sexual health clinic location in the county itself."

Statewide, birth rates are especially high among youth who are not white. American Indian adolescent birth rates are almost seven times higher than those of white youth, while rates were five times higher for Hispanic youth and three and a half times higher for Black youth. American Indian and Asian/Pacific Islander youth birth rates in Minnesota were also recorded to be much higher than national averages. However, birth rates among all racial and ethnic groups decreased in Minnesota from 2019 to 2020.

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University of Minnesota Healthy Youth Development–Prevention Research Center conducted a survey about parental support for comprehensive sexuality education. Among the more than 700 people surveyed across the state, 90% support public schools teaching abstinence and science-based, comprehensive sexuality education, including pregnancy prevention and STIs. Six percent supported abstinence-only education, and 4% did not support sexuality education in schools at all.

District 8, which includes the Northland, had support from 88% of parents surveyed about the comprehensive education.

The survey also found that 95% or more of the parents support education about puberty; reproductive anatomy; sexual abuse/assault; STIs; reasons for not having sex; responsibilities of parenting; healthy relationships; pregnancy prevention; and pregnancy and birth.

“I think that’s important because sometimes people are trying to advocate for an issue and they don’t know, ‘Am I the only one who wants this or who thinks this way?’" Farris said. "It’s important to point out that there are high, high levels of support for this among adults in every part of our state — liberal, conservative and everywhere in between.”

Minnesota does not have any statewide health instruction standards or health course graduation requirements. According to the university's survey, 79% of parents want the Minnesota Legislature to adopt basic standards for sexuality education. There is not any dedicated state funding for health instruction or teacher training about health topics.

“It’s oftentimes surprising to parents that we don’t have any sort of statewide standard or policy to teach sexual health education," Farris said. "When we talk about advocating for these things to happen, especially at a statewide level, we wouldn't be advocating for one approach and every school doing the same thing. It would really be up to individual districts and communities to figure out how best to do this in a way that works for their young people, but that there would be standards and a dedicated funding source and things like that to really help support teachers and schools to be able to deliver this in whatever way they felt was best.”

The complete report for 2022 and years past can be accessed at prc.umn.edu/trainings/minnesota-adolescent-sexual-health-report.

Laura Butterbrodt covers health for the Duluth News Tribune. She has a bachelor of arts in journalism from South Dakota State University and has been working as a reporter in Minnesota and South Dakota since 2014.
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