FAYETTEVILLE — A new report from West Virginia Kids Count has revealed that Fayette County ranks 51st out of 55 counties in West Virginia for its rate of teen pregnancy. In 2011, 68 out of 1,000 females age 15-19 gave birth in the county, compared to a statewide rate of 46.

Stakeholders say no single factor is to blame, and strong coordination and collaboration are key to addressing the problem.

Carri Strunk, who delivers sex education in Fayette County’s schools, says she is not surprised by the ranking.

“I’m in the schools. I see it,” she says. “I do think it’s surprising for people who are not in the schools.”

The West Virginia Department of Education expects that every school in the state presents statewide content standards around sex education, set forth in policy 25-10.

But how to implement the content is up to local school systems, and each does so a little differently, according to spokesperson Liza Cordeiro.

Mary Weikle is the coordinator for health and physical education at the Office of Healthy Schools in the state Department of Education. She says counties fit their instruction to the needs of local students.

The content is primarily delivered by health teachers, and counties are free to use professionals, nurses, physician’s assistants or pregnancy prevention specialists.

Rainelle Medical Center has been delivering the majority of Fayette County’s sex ed program since January 2012, meaning the latest numbers do not reflect their efforts.

Four educators go into health classes, typically during sophomore year, and teach a 16-lesson, evidence-based program funded through a federal grant program.

The educators are currently working in four of five high schools — Valley being the exception — and the county’s middle schools. Strunk says that schools have been “very inviting,” and if more funding were available, they’d be in Valley as well.

“Some kids come in with a lot of misinformation. I think they’re really confused because of all the different forces our kids are exposed to every day. They are getting mixed messages or no messages,” says Strunk.

The high school sex education curriculum is “comprehensive,” meaning it covers a broad range of issues relating to physical and biological aspects of sexuality, as well as the social and emotional aspects. Topics covered include abstinence, refusal skills, delay tactics, birth control methods, STDs, how to contact health providers and outcomes.

Middle schools use the abstinence-based “Promoting Health Among Teens” curriculum, which is targeted at African-American adolescents from low-income urban communities.

Rainelle sources much of its pregnancy prevention curricula — including programs like “Reducing the Risk” and “Draw the Line” — from a company called ETR Associates.

Condoms and other family planning services are not available in Fayette County schools. Weikle is not aware of any school districts that provide access to contraceptives.

“It’s a medical decision and it’s not the role of the school. ... In many counties I don’t think that would go over well,” she says.

In Fayette County, teens can get free family planning services at New River Health clinics, the Fayette County Health Department, Montgomery General Hospital, and just over the county line at Rainelle Medical Center, according to Strunk.

Professionals who deal with the issue generally agree that there is no single source of blame.

To a large degree, the county’s high rate of teen pregnancy is a reflection of the county’s socioeconomic status — Fayette ranks 47 out of 55 counties in its per capita income. Teen pregnancy rates are high among youth of all races and ethnicities who are socioeconomically disadvantaged.

“Our Children, Our Future” — a new campaign to end child poverty spearheaded by the WV Healthy Kids and Families Coalition — included teen pregnancy in its 2013 platform. They want to see funding for community health centers to provide more hours convenient for students, among several other initiatives.

“A lot of times kids in poverty aren’t taught that there’s more out there. They don’t realize there’s a future outside of Fayette County,” says Strunk.

“Or even of my little road I live on,” adds her supervisor Darla Thomas, who coordinates the sex ed program at Rainelle Medical Center. “Kids need to realize they have something to look forward to outside their little worlds, that they don’t have to have a baby at 16 because they have other things to look forward to in life.”

Strunk says a lack of transportation can also play a role. She says people in certain areas in the county with the highest poverty levels don’t have vehicles to get to the doctor to access resources that might prevent pregnancy.

“The services are out there if we can just get the people to the services,” she says.

The culture of the county as a whole also makes a difference, says Weikle. Ideological hurdles, taboos and social mores all contribute to the numbers in some way.

“There really is a culture of no discussion happening, and it’s really problematic,” says Lauren Weatherford, an Extension agent in Fayette County.

“Sometimes talking about sex with adults is much harder than with teens. ... Let’s talk about it and address the issue, because we do have a problem,” says Thomas.

Dr. Donald Newell, the Fayette County Health Department’s physician director, says his department takes a “lead role” in addressing the issue.

“In addition to the Family Planning Program Clinic, offering free contraception and women’s health services, registered nurses conduct off-site countywide outreach for pregnancy prevention, including attending schools and health fairs and presenting to students in the classroom,” he said.

The Fayette County Health Department offers family planning services every other Friday by appointment.

Condoms and emergency contraception and counseling are available for free at any time, anonymously, without an appointment, according to Newell.

Fayette County Commission President Matthew Wender says the health department has a key role to play and that he’d like to see them making a more “aggressive and cooperative” effort with other health initiatives who deliver similar services.

Others agree that collaboration is key — solutions start in the homes, continue in the schools and are bolstered by outside entities.

“I’d like to see everybody in agreement that this is an issue that we all need to take on, and if we pull together, we can make a difference,” said Strunk. “It’s a societal problem and it will take everybody’s help to see change.”

Weikle says coordinating efforts among all stakeholders, building communitywide support for effective sex education and supporting teachers’ efforts through professional development and removing barriers to teaching the sensitive topic will all help.

Darla Thomas says the costs to society are real and should not be diminished.

“Teen pregnancy costs everyone,” she said. “Society pays a price in dollar amounts. Children born to teens are at greater risk for abuse and neglect, for living in poverty, for not graduating from high school. You may think, ‘It doesn’t affect me,’ but it affects everyone.”

For more information on teen pregnancy from the Centers for Disease Control and Prevention, visit http://www.cdc.gov/teenpregnancy/.

To view the Kids Count data, visit http://www. wvkidscountfund.org/.

— E-mail: cmoore@register-herald.com