Projected Economic Costs Due to Health Consequences of Teenagers’ Loss of Confidentiality in Obtaining Reproductive Health Care Services in Texas

Franzini, Luisa; Marks, Elena; Cromwell, Polly F.; Risser, Jan M. H.; McGill, Laurie; Markham, Christine; Selwyn, Beatrice J.; Shapiro, Carrie

doi:10.1001/archpedi.158.12.1140

Cited by 30 publications

(13 citation statements)

References 35 publications

(51 reference statements)

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“…18 As well as the costs to the individual, there are economic costs associated with loss of confidentiality and compulsory notification, which in one US state are estimated to be 43.6 million dollars. 19 The results of this study have highlighted the importance of confidentiality to young people and the risk that if it is lost there may be decreased utilization of services, with a detriment to their individual and the public health, with increased STI transmission and increased teenage pregnancy rates. It should inform sexual health care providers, child protection services and government bodies on the high regard that young people place on confidentiality and the potential serious risks to young people's health if it is lost.…”

Section: Discussionmentioning

confidence: 85%

Confidentiality is essential if young people are to access sexual health services

2006

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A survey was undertaken to determine the importance of confidentiality of sexual health clinics to young people, and their preferences for service provision. A questionnaire was given to school attenders in year 9 (age 13-14 years) at four comprehensive schools. Class leaders assisted students with literacy or language difficulties. Two hundred and ninety five questionnaires were distributed and all were returned (male 143 (48.5%), female 152 (51.5%). In all 199 (67.5%) had never used sexual health services. The importance of confidentiality (asked in two differently worded questions) was rated as 8.84 and 8.59 (mean) on a scale of 1 (not important) to 10 (very important), 166 (56.3%) rated confidentiality as most important feature of service and 254 (86.1%) were more likely to use a service if it was confidential; 161 (54.6%) would not use service if it were not confidential. Two hundred and sixty-six (90.2%) would give honest answers in a confidential service; 186 (63.1%) would not attend if they thought that child protection services would be informed; 136 (46.1%) would not want general practitioner informed of attendance; 209 (70.8%) would like regular sexual health check ups; 150 (50.8%) would prefer a young people clinic, but only 105 (35.6%) prefer a 'one-stop shop'. This study shows that confidentiality is extremely important to young people considering using a sexual health service. It is the first UK study to show that if confidentiality is lost, young people may not attend, or may not be honest when they utilize a sexual health service. This is particularly relevant at the moment in light of the threat to confidentiality for young people attending sexual health services.

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Section: Discussionmentioning

confidence: 85%

Confidentiality is essential if young people are to access sexual health services

2006

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“…The reporting requirements apply not only to sexual abuse and sexual exploitation, but also to several categories of consensual sexual contact (36). A recent analysis offers a sobering price tag for the anticipated pregnancies, abortions, births, and STDs that are likely to occur if adolescents would not seek care, but would continue to engage in sexual activity.…”

Section: Access To Reproductive Health and Contraceptivesmentioning

confidence: 99%

“…A recent analysis offers a sobering price tag for the anticipated pregnancies, abortions, births, and STDs that are likely to occur if adolescents would not seek care, but would continue to engage in sexual activity. As a result of the policy changes, an estimated additional 8265 pregnancies, 5372 births, and 1654 abortions will occur; the potential costs are anticipated to be $43.6 million (ranging from $11.8 million to $56.6 million) for girls younger than 18 years currently using publicly funded services (36). These totals are likely to be an underestimate as the analyses do not include the likely costs resulting from the greater incidence of low birth weight among pregnant adolescents or from the public assistance, education, and special services that are often required because of the increased likelihood of adverse economic development and education outcomes for the adolescent mother and child (15).…”

Section: Access To Reproductive Health and Contraceptivesmentioning

confidence: 99%

A PUBLIC HEALTH SUCCESS: Understanding Policy Changes Related to Teen Sexual Activity and Pregnancy

Brindis

2006

Annu. Rev. Public Health

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Key Words teenage pregnancy prevention, policy strategies, adolescent reproductive health ■ Abstract Teenage pregnancy prevention has long been on the American public health agenda. Over the past decade, a number of concurrent federal, state, and local policies have responded to the myriad and diverse needs of adolescents, from supporting adolescents who have not initiated sexual intercourse to strategies aimed at avoiding a repeat pregnancy among teenage parents. Key policies, including comprehensive family life education, access to contraceptive care, and youth development, have resulted in delays in sexual debut, improved contraceptive use, and have achieved reductions in pregnancies, abortions, and births. Although improvements are documented across all ethnic and racial subgroups, substantial health disparities continue to exist. Synergistic policy approaches represent a substantial change from the past when narrow, single-issue strategies were adopted and were limited in their effectiveness. Renewed efforts to implement narrow policy approaches (e.g., abstinence-until-marriage or restrictions to contraceptive access) need to be considered in light of existing research findings. INTRODUCTIONAfter steadily rising in the late 1980s and peaking in 1991, childbearing rates among teenagers fell steadily throughout the 1990s and early twenty-first century. By 2002, the overall teenage pregnancy rate declined from 111 in 1980 to 83.6 per 1000 women aged 15-19, while the birthrate declined from 53.2 in 1980 to a record low of 41.7 per 1000 women aged 15-19 in 2003 (38, 43, 57) (Figure 1). Thus, there is now some hope that this seemingly intractable problem is beginning to change. In spite of decreases across all ethnic and racial groups, epidemiological data continue to document significant disparities within subgroups of adolescents (20,38,43,57).Young women from all economic and ethnic backgrounds face unintended pregnancies, but poor youth and youth of color are more likely to become 0163- 278BRINDIS adolescent parents (1). For example, 8% of non-Hispanic white teens had a first birth by age 20, compared to 20% of non-Hispanic black teens and 24% of Hispanics ( Figure 2) (1). Overall, there is strong agreement that teen pregnancy and birthrates in the U.S. are still too high and that reducing the number of births to teens remains an important policy goal (28,31,56,62,63). Furthermore, a growing and more ethnically and racially diverse adolescent population, coupled with the current budget crisis, and increasingly narrow policies at the federal and state levels threaten to affect these important declines (14,24). This is especially worrisome as the deleterious effects of early parenthood, especially in poor communities, have been amply documented: poorer health status for mother and her baby, worse educational outcomes, limited future employment opportunities, and greater incidence of poverty (62,63). Early parenthood is also clearly linked to an array of other critical social concerns, including welfare depen...

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“…Within the public health sector, barriers to treatment and preventative measures have been shown to greatly increase overall costs. For example, Franzini et.al., estimated a likely additional cost of $43.6 million in a one year period in Texas, if adolescents were required to notify parents when they received reproductive health care [16]. This suggests that allowing access to security patches, even in the case of illegal copies, would be effective in lowering system-wide costs, though offering those patches may not be profit maximizing for a given firm [22].…”

Section: Discussionmentioning

confidence: 99%

Online Promiscuity: Prophylactic Patching and the Spread of Computer Transmitted Infections

Kelley

Camp

2013

The Economics of Information Security and Privacy

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There is a long history of studying the epidemiology of computer malware. Much of this work has focused on the behaviors of specific viruses, worms, or botnets. In contrast, we seek to utilize an extension of the simple SIS model to examine the efficacy of various aggregate patching and recovery behaviors. We use the SIS model because we are interested in global prevalence of malware, rather than the dynamics, such as recovery, covered in previous work. We consider four populations: vigilant and non-vigilant with infected or not for both sets. We show, using our model and a real world data set, that small increases in patch rates and recovery speed are the most effective approaches to reduce system wide vulnerabilities due to unprotected computers. Our results illustrate that a public health approach may be feasible, as what is required is that a subpopulation adopt prophylactic actions rather than near-universal immunization.

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Projected Economic Costs Due to Health Consequences of Teenagers’ Loss of Confidentiality in Obtaining Reproductive Health Care Services in Texas

Cited by 30 publications

References 35 publications

Confidentiality is essential if young people are to access sexual health services

Confidentiality is essential if young people are to access sexual health services

A PUBLIC HEALTH SUCCESS: Understanding Policy Changes Related to Teen Sexual Activity and Pregnancy

Online Promiscuity: Prophylactic Patching and the Spread of Computer Transmitted Infections

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