A public health success: understanding policy changes related to teen sexual activity and pregnancy.

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.