If you could grab a thread that runs all through Kentucky's knot of social and economic ills, you'd give it a yank and see what unravels, right?
One of those threads is teen pregnancy.
Kentucky has one of the highest rates of teen births in the United States, which has the dubious distinction of leading the industrialized world in babies being born to mothers who are barely more than children themselves.
Kentucky ranks seventh among the states, according to data released last week by the National Center for Health Statistics.
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In 2010, there were 6,689 births to Kentuckians aged 15 to 19 for a rate of 46.2 per 1,000 of population.
That's 12 percent lower than in 2007 but still much higher than the national average of 34.3 births to this age group. Also, the decline in teen pregnancy from 2007 to 2012 was sharper in the rest of the nation than in Kentucky.
Experts can argue whether teen motherhood is a cause or an effect of poverty. What's indisputable is that teen mothers are significantly more likely to be poor and remain under-educated. Only about 50 percent of teen mothers receive a high school diploma by age 22, versus about 90 percent of their counterparts who make it through adolescence without giving birth.
The children of teen moms face an uphill battle. They are more likely to struggle in school and drop out, have more health problems, be incarcerated at some time during adolescence, give birth as a teenager and be unemployed as a young adult.
Taking care of teen mothers and their children costs Kentucky an estimated $132 million a year. That estimate, which covers the first year after birth, does not begin to fully calculate the economic impact on Kentucky of perpetuating the cycle of poverty.
Every relevant statistic tells us that teen pregnancy is something to be prevented. Yet, Kentucky is failing to educate youngsters in personal responsibility and sexuality.
A survey of Kentucky middle and high schools by the state Department of Public Health found that only a third were providing comprehensive sexuality education.
In focus group interviews, Kentucky teens were asked about preventing teen pregnancy. They called for sexuality education every year or every other year to reinforce their knowledge.
They also said they need parents who are better able to communicate with them, more positive activities and community involvement to fill their time and more one-on-one time with adults and mentoring.
Information from the surveys was used to create a teen pregnancy prevention strategy with the goal of reducing teen births in Kentucky by 20 percent by the year 2020.
The Kentucky Teen Pregnancy Coalition will be holding a summit April 26-27 in Louisville. The target audience is educators and school nurses, health department staff and health care providers, youth ministers and other agencies that work with youngsters.
If we're serious about freeing Kentucky from the knot of poverty and all its costs, business and political leaders will also get behind the goal of empowering young Kentuckians to wait until they're ready for parenthood.