Deprivation-based inequalities in under-18 conception rates and the proportion of under-18 conceptions leading to abortion in England, 1998-2010

J Public Health (Oxf). 2012 Dec;34(4):609-14. doi: 10.1093/pubmed/fds031. Epub 2012 May 21.

Abstract

Background: In 1999, the UK Government launched a strategy to reduce teenage pregnancy and geographical inequalities in teenage conception rates. This study investigates how associations between deprivation and under-18 conceptions, along with subsequent abortions, since changed as teenage pregnancy rates fell.

Methods: A data set was constructed from local authority Indices of Multiple Deprivation (IMD) scores and routine data on under-18 conception rates and the proportion of under-18 conceptions leading to abortion from 1998 to 2010. Correlation analysis (Pearson's r) was used to measure the association between each period of conception and abortion data and the relevant version of the IMD. Changes in these correlations over the period were tested for statistical significance.

Results: There remained a strong association between IMD and under-18 conception rates from 1998 (r = 0.782, P< 0.0001) to 2010 (r = 0.817, P< 0.0001) with no statistically significant change. A statistically significant decrease occurred in the inverse association between IMD and the proportion of under-18 conceptions leading to abortion from 1998 (r = -0.501, P< 0.0001) to 2010 (r = -0.332, P< 0.0001)

Conclusions: While under-18 conceptions fell from 1998 to 2010, inequalities in rates between the most and least deprived local authorities remained undiminished. At the same time, abortion became an increasingly common outcome of under-18 conceptions.

MeSH terms

  • Abortion, Induced / economics
  • Abortion, Induced / statistics & numerical data*
  • Adolescent
  • Attitude to Health
  • England / epidemiology
  • Female
  • Health Services Accessibility / economics
  • Health Services Accessibility / trends
  • Humans
  • Poverty Areas*
  • Pregnancy
  • Pregnancy in Adolescence / prevention & control
  • Pregnancy in Adolescence / statistics & numerical data*
  • Reproductive Health Services / economics
  • Reproductive Health Services / supply & distribution
  • Reproductive Health Services / trends*