Nashville Community Health Needs for Children and Youth, 0-24

1. Nashville Community Health Needs for Children and Youth, 0-24 GOAL 4Adolescents are Sexually Responsible

2. Adolescents are Sexually Responsible means… • All Nashville/Davidson County middle & high school students have information about healthy lifestyle practices. • All Nashville/Davidson County middle & high school students use that information to practice healthy lifestyle behavior as appropriate for their developmental levels. • All Nashville/Davidson County teens have an equal opportunity to experience optimal health and wellness and develop positive health behaviors.

3. There are many current issues that prevent adolescents from being sexually responsible. • Young people get too little sex education and guidance too late, and they get harmful misinformation. • When young people feel disconnected to home, family, and school, they may become involved in activities that put their health at risk. • Parents are most influential, yet many do not discuss the information about sex that young people need. • Schools have insufficient focus on programs in high-poverty schools that improve the acquisition of basic skills for all students. • Not enough youth are served through evidence-based programs that reduce the incidence of teenage pregnancy, encourage sexual health, and offer youth development opportunities. • Lack of preconception health education for all students.

4. Numbers help tell the story… • Over 60% of US teens report having had sexual intercourse by the time they graduate from high school.1 • Tennessee has the 9th highest teen birth rates in the US.2 • Sexually active teens living in Davidson County have:3 • More children born to teen mothers, more cases of Chlamydia, and other sexually transmitted diseases than teens living anywhere else in the state, except Memphis. • Systematic and cultural differences.4 • Latina girls are three times more likely and African American girls are twice as likely to experience pregnancy as their Caucasian peers. • Immigrant and refugee populations are at higher risk due to transitions and assimilation into the dominant culture. • Regardless of where you live, gross annual income or where your child goes to school, Tennessee tax payers pay for teen childbearing. • Financial costs - $181 million (2004) • Social costs - Negative outcomes for the children of teen mothers.

5. Concentrated Areas of teen births, age 15 – 19, 37206, 37207, 37115, 37013, 37214

6. Currently, a number of programs in the community address these issues. • Lifetime Wellness - Standard health class • Metro Nashville Public School. • Engages 100% of public middle and high schools. • CHOICES - Preconception health program • Metro Public Health Department. • Engages approximately 5% of high school population. • Oasis Center - Teen Outreach Program (TOP) • Combines voluntary community service with structured weekly group discussions about decision-making and coping with challenges. • Serves 356 students annually through TOP with targeted outreach to immigrant and refugees and low wealth schools. • 2% Caucasian. • 17% African American. • 81% Immigrants & Refugees. NOTE: This slide provides only a few examples of programs; it is not intended to be a comprehensive list.

7. There are many gaps in today’s programs and services. • Programs are not yet coordinated to serve as a pipeline of support and engagement for children across their developmental transitions. • Programs are not to scale across the city. • Opportunity for culturally/racially sensitive programs. • Outreach to parents and parent engagement is lacking. • Head in the sand mentality – we cannot continue to do business as usual.

8. In the next 2-5 years a number of changes are expected. • Increase in immigrant and refugees, with Nashville’s growth exceeding the trend nationwide. • Metro Public Schools serve 7,270 ELL students – most in the state. • Expected cuts in federal family planning funds. • A growing shift from programs to evidenced-based programs within schools and communities. • Racial disparity on a number of indexes (health, poverty, education, juvenile justice involvement). • MNPS- paradigm shift to small learning communities (i.e. Learning Academies) • United Way and Alignment Nashville bring providers together to increase the collective impact on youth sexual health. • The new Nashville Youth Opportunities Center is forming as a deliberate effort locally to focus on youth health and well being.

9. References • Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance Survey. 2003. • Annie E. Casey Foundation. 2006. • Metro Public Health Department. Family Planning and STD. 2002–2004. • Tennessee Department of Health. Crude Birth Rates. 2002–2004.