title: School-based health centers and the decline in black teen fertility during the 1990s in Denver, Colorado.
abstract: OBJECTIVE
  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.
authors.affiliation: Prevention Services Division of the Colorado Department of Public Health and Environment, Denver, Colo 80246, USA.
authors.forename: Sue A
authors.initials: SA
authors.lastname: Ricketts
authors.forename: Bruce P
authors.initials: BP
authors.lastname: Guernsey
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001741:Black or African American; D003120:Colorado; D005260:Female; D005298:Fertility; D006801:Humans; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D012189:Retrospective Studies; D012572:School Health Services / Q000706:statistics & numerical data*