Why is the teen birth rate so much higher in rural areas?

Fewer teens are giving birth nationwide, but new government data reveals that teen births are much higher in rural areas than urban ones.

In urban counties with large populations, 18.9 teens per 1,000 females age 15 to 19 gave birth in 2015, far lower than in rural counties with populations of fewer than 50,000 people that reported a significantly higher 30.9 teen birth rate, according to a new report from the National Center for Health Statistics.

Nationwide, the teen birth rate is 22.3, the Centers for Disease Control and Prevention reported earlier this year.

This latest report marked the first time the government looked for patterns (and differences) in teen birth rates in rural communities versus urban ones, said Brady Hamilton, a statistician and demographer with the Centers for Disease Control and Prevention and the study’s lead author.

The results surprised him, he said.

“This is more of a broad perspective that still shows this striking difference in teen birth rates,” Hamilton said.

For more than 70 years, researchers such as Hamilton explored data from birth certificates, which include information about a mother’s hometown and racial or ethnic background. That way, researchers can better track trends and understand fluctuations in county, state and national birth rates across the United States.

And those disparities have endured over time. Since 2007, the teen birth rate dropped by about half nationwide and in urban counties. But in rural counties, the rate of teen moms fell by a little more a third.

The numbers point to problems with access to health care services and contraception, said Ginny Ehrlich, chief officer for the National Campaign to Prevent Teen and Unplanned Pregnancy.

“Women may have health coverage by virtue of ACA, but that doesn’t mean they have access to health services,” Ehrlich said.

About nine out of 10 Americans say birth control is “morally acceptable,” according to a Gallup poll in June. That overwhelming support emerged in a new poll released today by Ehrlich’s organization. She said sharing that message with youth in tight-knit communities could remove stigma from asking about contraception and help narrow the gap between rural and urban teen birth rates.

Why is it important? Economic opportunity, poverty and teen birth “seem to be a chicken-and-egg question,” Ehrich said.