Dataset Information

Impact of social service and public health spending on teenage birth rates across the USA: an ecological study.

ABSTRACT:

Objective

To examine whether greater state-level spending on social and public health services such as income, education and public safety is associated with lower rates of teenage births in USA.

Design

Ecological study.

Setting

USA.

Participants

50 states.

Primary outcome measure

Our primary outcome measure was teenage birth rates. For analyses, we constructed marginal models using repeated measures to test the effect of social spending on teenage birth rates, accounting for several potential confounders.

Results

The unadjusted and adjusted models across all years demonstrated significant effects of spending and suggested that higher spending rates were associated with lower rates of teenage birth, with effects slightly diminishing with each increase in spending (linear effect: B=-0.20; 95% CI -0.31 to 0.08; p<0.001?and quadratic effect: B=0.003; 95% CI 0.002 to 0.005; p<0.001).

Conclusion

Higher state spending on social and public health services is associated with lower rates of teenage births. As states seek ways to limit healthcare costs associated with teenage birth rates, our findings suggest that protecting existing social service investments will be critical.

SUBMITTER: Sipsma HL

PROVIDER: S-EPMC5541339 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Impact of social service and public health spending on teenage birth rates across the USA: an ecological study.

Sipsma Heather L HL Canavan Maureen M Gilliam Melissa M Bradley Elizabeth E

BMJ open 20170613 5

<h4>Objective</h4>To examine whether greater state-level spending on social and public health services such as income, education and public safety is associated with lower rates of teenage births in USA.<h4>Design</h4>Ecological study.<h4>Setting</h4>USA.<h4>Participants</h4>50 states.<h4>Primary outcome measure</h4>Our primary outcome measure was teenage birth rates. For analyses, we constructed marginal models using repeated measures to test the effect of social spending on teenage birth rates ...[more]

PMID: 28611088

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Project description:ObjectivesChanges in public sector service spending may influence food consumption. We make use of changing local authority (LA) expenditure in England to assess impacts on food purchasing. We examine total LA service spending and explore two potential pathways: highways and transport spending which may affect access to food; and housing service expenditure which may affect household resources available to purchase foods.DesignLongitudinal panel survey at the LA level (2008-2015) using fixed effects linear regression.Setting324 LAs in England.Main exposureExpenditure per capita on total LA services, highways and transport services, and housing services.Main outcome measuresLA area estimates of purchasing of fresh fruits and vegetables, high in fat, sugar and salt (HFSS) foods, and takeaways at home, expressed as a percentage of total food and drink expenditure.ResultsTotal LA service spending decreased by 17% on average between 2008 and 2015. A 10% decrease in total LA spending was associated with a 0.071 percentage point decrease in HFSS (95% CI -0.093 to -0.050) and a 0.015 percentage point increase in takeaways (95% CI 0.006 to 0.024). A 10% decrease in highways and transport expenditure was associated with a 0.006 percentage point decrease in fruit and vegetable purchasing (95% CI -0.009 to -0.002) and a 0.006 percentage point increase in takeaway purchasing (95% CI 0.001 to 0.010). These associations were seen in urban areas only when analyses were stratified by rural/urban area status. A 0.006 percentage point decrease in HFSS purchasing was also seen with a 10% decrease in housing expenditure (95% CI -0.010 to -0.002).ConclusionChanges in LA spending may have impacts on food purchasing which are evident at the area level. This suggests that in addition to more prominent impacts such as foodbank use, austerity measures may have mixed impacts on food purchasing behaviours among the wider population. Individual-level research is needed to further elucidate these relationships.

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Dataset Information

Impact of social service and public health spending on teenage birth rates across the USA: an ecological study.

Objective

Design

Setting

Participants

Primary outcome measure

Results

Conclusion

Publications

Impact of social service and public health spending on teenage birth rates across the USA: an ecological study.

Similar Datasets

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