Date of Award

2025

Type

Thesis

Major

Liberal Arts - Humanities and Social Science Track

Degree Type

Master of Public Health

Department

Kinesiology and Health Sciences

First Advisor

Patricia Anafi, PhD

Second Advisor

Rebecca Toland, PhD

Abstract

Teen pregnancy remains a persistent public health concern in the United States, with rural regions experiencing disproportionately higher rates compared to urban areas. This study examines adolescent pregnancy in six rural Georgia counties between 20125 and 2024 using the framework of social reproduction to understand how structural, socioeconomic, and cultural forces shape reproductive outcomes. Despite national declines in teen birth rates, rural regions of Georgia continue to exhibit elevated rates due to entrenched inequalities, limited access to comprehensive reproductive health services, and inconsistent sed education policies. Social reproduction theory provides a lens to understand how intergeneration disadvantages such as poverty, low educational attainment, and limited access to healthcare contributes to sustained cycles of adolescent pregnancy in rural communities. Using county-level data from the Georgia Department of Public Health’s OASIS database, this study assesses adolescent birth rates, low birth weight prevalence, prenatal care adequacy using the Kotelchuck Iindex, socioeconomic vulnerability, and insurance patterns. Additional contextual data on sex education curriculum and reproductive health service availability were collected from schoolboards, public records, and facility directories. A stratified sampling method selected six rural counties across four quartiles of adolescent birth rates to ensure both representation and depth of comparison. Findings demonstrate that counties with the highest socioeconomic vulnerability exhibited the highest adolescent birth rates and the greatest proportions of inadequate prenatal care. Despite geographic proximity to healthcare facilities in most counties, barriers such as stigma, poverty, and limited contraceptive education significantly influenced utilization. Counties offering comprehensive sex education showed slightly more favorable reproductive health indicators, 4 nonetheless, curriculum alone did not full mitigate structural determinants. Racial disparities were also evident with Black and multiracial adolescents experiencing higher birth rates and poorer prenatal care adequacy. Overall, results highlight that rural adolescent pregnancy is shaped by a complex interplay of structural disadvantage educational policy gaps, and cultural norms. Effective intervention requires comprehensive sex education, expanded adolescent-friendly healthcare access, and targeted policies addressing socioeconomic vulnerability. These findings underscore the need for cross sector public health strategies that disrupt intergenerational cycles of adolescent pregnancy in rural Georgia.

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