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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2004.059816v1 96/9/1588    most recent Submit a response View responses View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Ricketts, S. A. Articles by Guernsey, B. P. Search for Related Content PubMed PubMed Citation Articles by Ricketts, S. A. Articles by Guernsey, B. P. Related Collections Other Birth Control Access to Care Adolescent Health Birth Outcomes Public Health Practice African Americans/Blacks

Sue A. Ricketts, MA, PhD and Bruce P. Guernsey, MSW

The authors are with the Prevention Services Division of the Colorado Department of Public Health and Environment, Denver, Colo.

Correspondence: Requests for reprints should be sent to Bruce Guernsey, PSD-AD-4, Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive South, Denver, CO 80246 (e-mail: bruce.guernsey{at}state.co.us).

Objectives. We examined the changes in Black adolescent fertility rates in high-school areas with school-based health centers and compared them over time with changes in rates in high-school areas without school-based health centers.

Methods. Fertility rates were estimated for high-school areas with and without school-based health centers with geocoded birth certificate and school enrollment data.

Results. A high adolescent fertility rate (165 births/1000) in 1992 among Black students in Denver high-school areas with school-based health centers declined to a low rate (38/1000) in 1997 that matched the rate of school areas that did not have school-based health centers. Rates declined for both types of areas over the study period, but the rate of decline in the areas with school-based health centers was significantly greater (77% vs 56%).

Conclusions. The rapid and significant decline in Black adolescent fertility in school areas with school-based health centers strongly suggests that attending to the health needs of students at risk of pregnancy resulted in a radically lowered risk of fertility. The decline is likely the result of strategies to identify, intervene, and follow-up on students engaging in behaviors that place them at risk for unintended pregnancy.

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