To the Editor.
—Ms Spitz and colleagues1 document persistently high rates of adolescent pregnancy in the United States, and Dr Litt2 mentions many of the factors responsible, including poverty and limited access to contraceptives. However, neither article adequately describes the scope and magnitude of these and other factors involved.Forty percent of US girls live near or below poverty income levels, and these individuals account for 6 of 7 births to teenagers.3 Adolescent pregnancy rates in the United States are 3 to 10 times higher than those found among industrialized nations of Western Europe, and poverty rates among US youths are higher by a similar magnitude. In areas of the United States with adolescent poverty rates as low as those in Western Europe, adolescent pregnancy rates are similarly low.3Access to contraceptives remains limited. While more than 50% of high school-aged adolescents are sexually active, only
Donohoe MT. Adolescent Pregnancy. JAMA. 1996;276(4):282. doi:10.1001/jama.1996.03540040026021