Globally, one of the major contributors of maternal and child mortality is teen pregnancy and childbirth. This is largely caused by socio economic factors that affect the teens before and after getting pregnant. According to the National Statistics Office, the highest teen birth rates in Western Europe are found in the UK (FPA, 2016). Some of these pregnancies are either unwanted or unplanned and the teens that are more likely to get pregnant are marginalized in terms of education, health, economic, and social amenities. Despite being the highest contraceptives user, Britain has the highest number of teenage pregnancies. Girls aged between 15 and 19 years are at a bigger risk of pregnancies especially in Romania, Bulgaria and Slovaki (Kelly, 2007). It is difficult to tackle the problem of teenage pregnancy due to poverty and poor health conditions. The lowest teen birth rates are in Denmark. According to the UK health department, teenage pregnancies are getting lower in the past 40 years. It is quite evident that these pregnancies are associated with the youth that are socially excluded and deprived therefore the local authorities must make progress in order to curb the problem (Bearing, Sieving, Ferguson & sharma, 2007). According to the British advisory, teenage pregnancies can be reduced through access to better health coupled sex education and availability of contraceptives.
Health Psychology and the Social Context
Brannon, Feist, and Updegraff (2013) define health psychology as a discipline that applies psychological tenets to the empirical study of individuals’ health, illness, and health-related behaviour. This scientific approach aims at increasing the understanding concerning health, injury, illness, recovery, and the effects of each of these variables on human life. Advances in this specialty have revealed the social psychological and cultural influences of ailing and injured people on their diagnosis, management, and rehabilitation. Further, health psychology investigates how illnesses and injuries can be prevented as well the formulation of effective, efficient, and appropriate health policies. According to Moritsugu, Vera, Wong, and Duffy (2015), while individuals have responsibilities concerning their personal health, communities and governments at large bear social responsibilities. Consequently, behaviour modification is considered as an apt way of improving health by curtailing some problem behaviours, such as drug and substance abuse, lack of exercise, and overeating. Health psychology acknowledges the close relationship between health, emotions, cognition, cultural beliefs, and social factors, such as poverty and socioeconomic status.
Engel’s biopsychosocial model of health integrates biological, psychological, and social dynamics in the diagnosis, management, and treatment of diseases. By emphasizing the existence of a continuum between health and illness, the model asserts that psychology plays a significant role in the onset of diseases, seeking help, illness adaptation and progression, as well as health outcomes (Brannon, 2017). The biopsychosocial model can be used to explain the trends seen with regard to teenage pregnancy in the United Kingdom in the recent past. According to the Office for National Statistics, the UK has managed to reduce the conception rate of teenagers under the age of 18 by over 50% (McLaren, 2014). Nevertheless, the UK still has some of the highest rates of teenage pregnancies among other Western European nations. This decline has been attributed to an ambitious, long-term approach implemented in 1999 (Hill, 2016). At the core of the strategy was the focus on sex and relationship education, seeking health services, and sociable, nonjudgmental personnel to help teenagers abstain from sex.
There are several risk factors for teenage pregnancy. According to Arai (2009), this condition is heavily influenced by culture. In societies where early marriages are the norm, for instance, adolescents are persuaded to bear children at a tender age, although this practice is arguable non-existent in the UK. Moritsugu, Vera, Wong, and Duffy (2015) note that other cultural factors, such as the misconceptions concerning the attitudes of adolescents on sex education, stigma, and the lack of adequate sex education, are some of the risk factors for teen conception in the UK (FPA, 2016). Societal norms have also been found to be a primary factor, where some people may consider getting pregnant as a status symbol, although this belief is quickly being eliminated (Hill, 2016).
Moreover, Daflapurkar (2014) argues that most males in the UK and other developing nations tend to engage in sexual intercourse sooner than those in developing and culturally-conservative nations. This trend causes peer pressure on teenagers, who may feel compelled to have sex earlier than they may want to. Additionally, the predilection of many parents in the UK to lead busy lives takes them away from their teenage daughters, thereby preventing them from providing the much needed guidance and support, and making them susceptible to misinformation. Other factors that may contribute to incidences of teenage pregnancy include the media, lack of contraceptives, teenage drinking, and sexual abuse (Arai, 2009). According to the FPA (2016), teenage pregnancy is a social issue that occurs primarily with increased rates of poverty. In the UK, over 50% of all incidences of teen pregnancies have been found to occur in 30% of the poorest communities while only 14% occur among the 30% economically well-off population.
Evidently, the issues that have been proven to increase the occurrence of teenage pregnancy are tied to personal and societal beliefs, attitudes, and behaviour, thereby proving the veracity of the biopsychosocial model. The model’s inclination towards the incorporation of multiple factors in the analysis, diagnosis, and treatment of diseases, and injuries impacts positively on patients’ recovery. More specifically, patients need support from their friends and families to enhance their outcomes. In addition, the environment and culture within which people are brought up and in which they reside has an effect on their health behaviours, emotional states, and impetus to recover (Brannon, 2017). The use of the biopsychosocial model has facilitated the determination of additional causes of teenage pregnancy in the UK, over and above the physiological and biological perspectives, and has helped the government to structure policies that incorporate all these aspects.
Social Determinants of Health and Health Inequalities
Health inequalities are caused by inequalities that exist within communities. Economic and social conditions in which people live in affect their lives and can lead to risks of illnesses and can be prevented when illnesses occur. Health inequalities that affect teen mothers in UK include infant mortality which is the dying of babies that are below one year of age and maternal deaths that occur shortly after pregnancy or during child birth. According to Rootman (2001) the poorest of the poor in the world are known to have worse health conditions. Generally, people living under lower socio economic conditions are known to have poor health. For example Mail Online, n.d. notes that in the UK, the poor countries experience higher maternal and infant mortality for the teen compared to the richer ones. Health inequalities are caused by domestic policies and international relations which organize communities in terms of income, ethnicity/race, occupation, income, and gender (Who.int, n.d).
According to the World Health Organization (WHO), the conditions in which people work, live, learn and plays have a great impact on their health outcomes and risks (Who.int, n.d). These conditions are referred to as social determinants of health (SDH). These factors include, the physical environment, level of education, socio economic status, employment status, access to health care and social support facilities. The social determinants contribute to health inequalities in different countries and if these inequalities are reduced, teenage pregnancies can be resolved in a healthy manner. According to (Who.int, n.d.) unequal distribution of socio economic determinant of heath that include employment, income, housing, environment and lead to inequalities in health. These determinants therefore can lead to social disadvantages to the marginalized communities.
Social determinants of health are complex and overlapping social and economic systems that are linked to lack of resources and opportunities that are important in improvement, protection and maintaining of health (Cdc.gov, n.d.). These factors operate beyond family or individual level and are the root cause of health outcomes experienced by individuals and communities. Social health determinants are linked to teenage pregnancies especially due to the impact of socio economic factors. For instance living in socially disadvantaged communities is a factor that is associated with teen pregnancies. Education is also an important health determinant that is a major contribution factor to the rate of teenage pregnancies. Teenagers, with higher education level are more likely to make better life choices compared to the uneducated. First, the level of education has a high relationship with the income level and living conditions (Cdc.gov, n.d.). Looking at it this way, it is quite evident that educated people are likely to move up the economic and social ladder that enables them access vital resources. Education provides youths with an opportunity to access training and counselling services. The youths are therefore able to understand the world better and can influence society factors that enable them to shape their behaviour. Lastly, education enables the teens as well as their parents to increase their literacy and understand how they can promote their sexual heath through their actions.
Teens live in poor physical environment that is characterised by poor housing; low income, food insecurity and discrimination in terms of race, gender, disability and race are more likely to suffer from psychological stress. They lack support which leads to social isolation and in the end they suffer from stress (Cdc.gov, n.d.). Prolonged stress can lead to the need to fight it and in an environment where they lack opportunities for recovery they may end up engaging in risky sexual behaviour. The stress from poor living conditions provokes emotions of shame, unworthiness and insecurity. According to the teens, everyday life becomes unpredictable, meaningless and uncontrollable which makes them feel difficult to cope with such conditions and in the end they look for a shoulder to lean on which may lead to early pregnancies (Hadley, Ingham and Chandra-Mouli, 2001). Other behaviour associated with stressful conditions is alcohol and drug use which leads to making of unhealthy choices.
Employment is an important social health determinant that enables people to shape their day to day lives (Cdc.gov, n.d.). On the other hand, unemployment leads psychological stress, social deprivation and life threatening coping mechanisms. Teens living with unemployed parents are highly likely to suffer from mental and physical health conditions due to lack good living conditions. Unemployment is associated poor health due to material deprivation and limited access to health facilities. Unemployment also affects parenting effectiveness and the behaviour of children (Hadley, Ingham and Chandra-Mouli, 2001). Poverty associated with unemployment can lead the young girls to engage in risky behaviour that may lead to early pregnancies.
UK Policies on Teen Pregnancies
The main goal for public health professionals is health improvement and in order to achieve it, there has to be efforts in evaluating the impact of public health activities (Rootman, 2001). Public health goals have expanded beyond prevention of communicable and non-communicable diseases to include social contexts that that influence inequalities in health. Due to the high rates in teenage pregnancy in England, UK the government launched a teenage pregnancy strategy in 1999. Current data Rootman (2001) shows that the rate of conception for girls under 18 years has dropped by 13% and the rate of teenage births has dropped by 25% since the formulation of the strategy. According to Arai (2009) the policy requires dedication by all, including youth services, teenage pregnancy coordinators, sexual health hospitals and strategic leaders. The reason why the UK government is working towards reduction of teenage pregnancy is due to the fact that it causes maternal health problems, emotional health issues, and teenage mothers living in poverty which in the end leads to health inequalities. The policies are geared towards providing support, advice and information in order to improve their social relationships. Through implementation of Teenage Pregnancy Strategy in England, the government has been able to reduce teen pregnancy by 51% according to 2014 studies (Gordon, 2004). The 10 year strategy was formulated in a period of 18 months through collaboration between professional organizations, Young people, national stakeholders and NGO’s.
The strategy is implemented by the local government and other stakeholders who publish diverse guidance on education on sex and relationships in schools, offering youth friendly services on reproductive and sexual health, improving sexual heath to the minorities, setting up of schools sexual health services and involving the youth formulation of sexual health strategies (Morris, 2006). According to the Teenage Pregnancy Strategy, most of these pregnancies are unwanted and unplanned therefore; most of them end up in abortions. In most cases, teenagers who give birth find it difficult to support themselves and their children and may result to poor health for both the infant and the mother. The strategy also aims at providing advice, information and support to the young people in regards to fertility, sex and myths that revolve around sexuality (Morris, 2006). The work force dealing with children is not well equipped with information on sex education and parents lack knowledge and confidence to talk to their children. The strategy therefore aims at enabling the young the young people to better understand sexual relationships and resist pressure when making decisions regarding healthy living.
While most of the young people are currently using contraceptives, there is still a number of them that so not while there are those that do not use them effectively. UK policy on teenage pregnancy ensures that the youth have adequate information regarding fertility and the available contraceptive methods. The strategy emphasizes that Sexual and Reproductive Health services should be accessible at all times and they should also offer youth friendly services. Parents are also encouraged to advice the youth that asking for the right contraceptive methods is a responsible move that can reduce teen pregnancies. According to Morris (2006) evidence shows that equipping young people with knowledge about relationships and sex education enables them to develop skills that are crucial in managing their relationships effectively. It is also clear that Sex and Relationship Programs enable them to delay first sex and use contraceptives when they get sexually active. Covington (2008) adds that UK policies also develop programs that are organized for young people living under vulnerable conditions and they have an impact on reducing conception in teenagers.
Teenage pregnancy in the UK has
largely been attributed to multiple socioeconomic factors, including culture,
beliefs, societal norms, and the lack of contraceptives, poverty, sexual abuse,
and the media. These aspects have been identified by using the biopsychosocial
model that investigates diseases, injuries, and other public health matters
from multiple perspectives. The differences in the prevalence of teenage
pregnancy have been attributed to health inequalities within the community. As
such, communities in poor regions of the UK have been found to have higher
rates of teen pregnancies. Further, the social determinants of health,
including employment status, socioeconomic status, physical environment, and
access to social support and health care facilities, also have an effect on the
occurrence of this issue. To combat the menace, the UK government has
instituted several policies, such as the teenage pregnancy strategy of 1999,
which has managed to lower the occurrence of the condition by over 50%. The policy
requires cooperation from all concerned parties, sex education in schools, the
provision of adequate support, youth-friendly services, and the provision of
contraceptives. Evidently, the government’s approach targets different facets
of the society that may reduce the occurrence of teenage pregnancies.
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