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When it comes to teen birth rates, where you live matters.

A November report from the Centers for Disease Control and Prevention shows U.S. teen births nationwide dropped 9 percent between 2007 and 2015 to their lowest point in history — 22.3 births per 1,000 females — from 41.5, but there are large disparities when it comes to geographic regions.

Teens in rural counties also are  seeing an overall decrease in birth rates, but it’s at a much slower pace than counties in more urban areas. From 2007 to 2015, teen birth rates fell 50 percent in large urban counties, regardless of race or ethnicity, to 20.9 from 39.9. Teen birth rates also were  lowest in those counties.

Medium and small counties, such as York, saw decreases of 44 percent on average, 24.3 birth per 1,000 from 43.1.

However in the same time period, rates in rural counties fell just 37 percent, from 30.9 births per 1,000 females from 49.1, leaving rural counties with overall rates greater than the national rate.

Rates in Pennsylvania, Maryland, Montana, North Dakota saw the smallest decreases at less than 30 percent.

The downward trend is good, according to the CDC, because higher teen birth rates are associated with high unemployment and low educational achievement. According to the nonprofit National Campaign to Prevent Teen and Unplanned Pregnancy, just 38 percent of teen girls who have a child before 18 go on to earn a high school diploma.

Local outcomes: Teen birth rates in rural Pennsylvania dropped just 24.8 percent compared to 44.7 percent in more urban parts of the state. York County falls somewhere in the middle at 32.9 births per 1,000 females, higher than the state and neighboring Lancaster County, which is at 26.3 births per 1,000 females.

“We are gaining a better understanding of the nuances that impact rates of teen pregnancy, along with many other health indicators, and those are largely linked to social determinants of health,” said Family First Health CEO Jenny Englerth.

Whether parents finished high school or gave births as teens themselves all factors in to their child's future.

Englerth said residents of communities that struggle with basic needs, such as housing and jobs, often develop a decreased sense of empowerment that leaves them vulnerable to  risky behaviors that could lead to an unplanned pregnancy. Interventions such as engaging teens in planning their futures and helping them to envision their goals could help, as could education.

“Comprehensive health education is critical,” Englerth said. “The number of young people that we encounter who do not understand how their bodies work is staggering. Young people must be given the information they need to make good decisions about their bodies.”

In York, about 6 percent of county births were to those ages 15-19 in 2014, according to the Pennsylvania Department of Health.

Department of Health spokeswoman April Hutcheson said that  falls in the hands of multiple state departments, as well as community organizations, schools and families.

“There are a lot of efforts that are geared toward helping teens make choices,” Hutcheson said. “Whether that’s teen pregnancy or life choices we want to help them make the best decisions possible.”

She pointed to the Teen Game Plan, a tool developed by the Department of Health, Family Health Council of Central Pennsylvania, Center for Schools and Communities and the Department of Education, which helps teens plan their futures while testing their knowledge regarding risky behavior.

“We need to support our teens to make as many good life decisions as we possibly can,” she said.

Read the report here.

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