The study did find, however, that across all of the focus countries, young people growing up in disadvantaged economic, familial and social circumstances are more likely than their better-off peers to engage in risky behavior and have a child during adolescence. It is true, therefore, that pregnancy and birth are more common among U.S. teens in part because the United States has a greater proportion of disadvantaged families. (While the United States has the highest per capita income of the study countries, it also has the highest percentage of its population who are poor.) However, at all socioeconomic levels, American teenagers are less likely than their peers in the other study countries to use contraceptives and more likely to have a child. For example, U.S. teenagers in the highest income subgroup have birthrates that are 14% higher than similar teenagers in Great Britain and rates that are higher than the overall teen birthrates in Sweden and France.
* Research is the basis for public policies to reduce unintended pregnancy, abortion, and sexually transmitted infections, including HIV. Political and religious interest groups have little influence on public health policy.
* A national desire to reduce the number of abortions and to prevent sexually transmitted infections, including HIV, provides the major impetus in each country for unimpeded access to contraception, including condoms, consistent sexuality education, and widespread public education campaigns.
* Governments support massive, consistent, long-term public education campaigns utilizing the Internet, television, films, radio, billboards, discos, pharmacies, and health care providers. Media is a partner, not a problem, in these campaigns. Campaigns are far more direct and humorous than in the U.S. and focus on safety and pleasure.
* Youth have convenient access to free or low-cost contraception through national health insurance.
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