Are our data on teenage pregnancy across ethnic groups in England fit for the purpose of policy formulation, implementation, and monitoring?

Abstract

The Teenage Pregnancy Strategy for England has a Public Service Agreement target to substantially reduce the level of teenage pregnancies by 2010. It argues that all the main risk factors need to be incorporated into risk assessments undertaken by agencies and professionals. These include deprivation, poor educational attainment and disengagement from school, and ethnicity, the last's association with high teenage pregnancy rates being independent of deprivation. The strategy adds, too, that local areas should target delivery of their local strategy more intensively on these groups most at risk. An attempt is made to systematically review the evidence on the availability and quality of ethnicity data on maternities and abortions, based on extensive structured searches of a wide range of abstracted and full-text literature and statistical sources published 1997–2008. This reveals that, in practice, local teenage pregnancy strategies have little, if any, ethnically coded data to draw upon and it is not surprising that they have had difficulties in targeting these groups. The experience of other countries demonstrates that data of quality can be collected on teenage pregnancy if this is prioritised. The Race Relations (Amendment) Act 2000 should be used to catalyse statutory agencies to set up the necessary systems to ensure that collection of teenage pregnancy data by ethnic group is routine and robust.

Keywords:

• teenage pregnancy
• live births
• abortions
• fetal loss
• ethnicity

Notes

Notes

1. See: About the Teenage Pregnancy Strategy. Online source (website) available from: http://www.everychildmatters.gov.uk/health/teenagepregnancy/about/ [Accessed 17 November 2008].

2. The medical definition of miscarriage is a pregnancy that ended by spontaneous loss before 24 weeks’ gestation (although the number of weeks varies in definitions). For operational reasons, they usually include only those records with diagnoses of ICD-9 634, 636 or 637 that required inpatient care. A stillbirth is a baby showing no sign of life after 24 or more weeks’ completed gestation.

3. Statutory Instrument 2002 No. 887. The Abortion (Amendment) (England) Regulations 2002. Online source (website) available from: http://www.opsi.gov.uk/si/si2002/20020887.htm [Accessed 17 November 2008]. See also: Welsh Statutory Instrument 2002 No. 2879. The Abortion (Amendment) (Wales) Regulations 2002: http://www.opsi.gov.uk/legislation/wales/wsi2002/20022879e.htm.

4. NHS Connecting for Health. Birth Notification Data Set. Version 4.0. 10.08.2001 (the latest version). Online source (website) available from: http://www.connectingforhealth.nhs.uk/systemsandservices/nhsnumber/nn4b [Accessed 17 November 2008].

5. Online source (website) available from: http://www.natcen.ac.uk/natsal/reference_tables.doc [Accessed 17 November 2008]. Ethnicity is suppressed for confidentiality reasons.

6. Department of Health. Hospital Episode Statistics. Detailed NHS Trust Data Quality Indicator (DQI) Report, 2004–5. Online source (website) available from: http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=452 [Accessed 17 November 2008].

7. For the purposes of calculating an abortion ratio and abortion rate by race and ethnicity, data for women of unknown race/ethnicity were distributed according to the known race/ethnicity distribution for particular states.

8. Statistics Canada. Therapeutic Abortion Survey: Online source (website) available from: http://www.statcan.ca/cgi-bin/imdb/p2SV.pl?Function=getSurvey&SDDS=3209&lang=en&db=IMDB&dbg=f&adm=8&dis=2 [Accessed 17 November 2008].