New research released today at the American Public Health Association's 140th Annual Meeting in San Francisco builds on previous knowledge about the link between teen pregnancy and social inequities internationally and suggests that, independent of other factors, low literacy in pre-teen girls strongly predicts childbearing among US teens.

This is the first study of its kind to examine the prospective link between literacy among US pre-teens and subsequent teen child bearing. Researchers at the Perelman School of Medicine at the University of Pennsylvania and the University of Pennsylvania School of Nursing linked seventh-grade reading among 12,339 girls (average age 11.9 years) enrolled in Philadelphia Public Schools to subsequent live birth records between 1996-2002. Findings reveal that girls with a less-than-average reading skill were 2.5 times more likely to have a child in their teen years compared with those with average reading skill. Twenty-one percent and three percent of girls with below-average reading skill had either one or two (or more) live births respectively during the six-year assessment period. Meanwhile, 12 percent and 1 percent of girls with average reading skill and 5 percent and 0.4 percent with above average reading skill had such births.

The study also assessed racial disparities in literacy as a contributor to teen child bearing. Hispanic and African American girls were overrepresented in the below-average reading skill group. In addition, the effect of low literacy on risk of teenage parenting was stronger in Hispanic and African American girls than those who self identified as White. The researchers point out that poor reading skills in early grades are difficult to overcome and predictive of subsequent decisions to drop out of formal education.

"It is quite possible that adolescent girls who experience a daily sense of rejection in the classroom might feel as though they have little chance of achievement later on in life," said Rosemary Frasso, PhD, researcher at the University of Pennsylvania School of Nursing. "Our findings underscore the role of literacy as its own social risk factor throughout the life-course."

Researchers conclude that health care providers working with pre-teen girls should consider literacy when delivering contraceptive and other reproductive health services to this population. The study is scheduled to be published in the February 2013 issue of Contraception.

APHA's 140th Annual Meeting is themed "Prevention and Wellness Across the Lifespan" and will focus on the importance of environmental, social and behavioral issues that impact health at all stages of life.