Reflections
Kimberlydawn Wisdom
Surgeon General, State of Michigan
Vice President, Community Health, Education, and Wellness, Henry Ford Health System
It is our own personal choices and commitments that will make the difference in our health and the health of our communities. Unless we all take greater responsibility for ourselves, our families and our communities, our collective health will not improve. Each person must be encouraged to see that preventing unintended pregnancies is within his/her control.
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In the state of Michigan and across the nation we have had much to celebrate over the last few decades with the steady decline of teen pregnancy rates. Supportive public policies, advances in contraceptive technology, enhanced access to care, increases in public education (particularly in response to the HIV epidemic) — have all contributed significantly to the declining rates of teen pregnancy. Yet, the time for celebrating may be over; in Michigan, as well as nationally, there have been recent increased in teen pregnancy and birth rates. This disheartening news calls all of us to reflect on this issue in different ways; clearly, education and access to resources and services are not always enough to ensure that a person or couple does not experience an unintended pregnancy. It is time to include in the dialogue not only public policy but a deeper examination of personal responsibility.
With supportive public policies, we can give individuals the external supports they may need to avoid teen and unintended pregnancies, but it is up to them to access those resources. Ultimately, the only people who can prevent a pregnancy are the individuals involved in the sexual act; they are the ones who are responsible. From the large body of research on health behavior and on adolescent asset development, however, we know that there is a complex web of factors that infl uence personal health behavior and support the ability of individuals to recognize, understand and respond appropriately to the consequences of one’s behavior — to act “responsibly.” All the best services and information may be rendered useless if given to a young person with a hopeless world view and low self-esteem, who cannot see a bright future and who feels incapable of altering it. At the same time that we emphasize individual responsibility, we need to emphasize our collective responsibility; each of us has a role to play in reducing adolescent and unintended pregnancies by helping young people take charge of their sexual health.
At home, in schools, in faith communities, in clinics, and in the media and entertainment industries all across our communities, we each have the responsibility to promote basic core values and positively address the factors that infl uence personal health behaviors. We need to support clear, positive messages about personal responsibility.
Taking care of and understanding that your health is important is also key. Adults themselves have the responsibility to learn about and respond to personal health issues, including sexual health, and assist youth in accessing age-appropriate, accurate, comprehensive information. Thinking about and addressing needs for family planning is a priority health issue for all people who are sexually active or considering becoming so, males and females alike.
Love your neighbor as yourself. Young people need strong self-esteem and self-effi cacy to carry out healthy choices and behave responsibly; they need to love themselves and know that what happens to them matters. They also must view mutual respect as the required basis for all healthy relationships. As a society, we have the responsibility to respect and protect all members of our community from sexual abuse and exploitation.
With freedom, comes responsibility. We all have, to some extent, the freedom to choose our path and impact our destiny. At the same time, if we have the freedom to make choices about our behaviors, those choices come with consequences: a pregnancy creates consequences not only for the mother, but also for the father, the extended family, and, most of all, for the child. We need to emphasize that the consequences of unintended pregnancies are to be borne by both the mother and the father.
We can teach basic personal decision-making from an early age, in our homes, schools, and faith communities. Young people need to learn the appropriate processes and resources for gathering information, weighing the benefi ts and consequences of a variety of actions, and making a decision. Parents and other leaders need to be role models for informed decision-making and for taking responsibility for the consequences of their choices. And parents and caregivers need to understand the importance of talking early and often to their teenagers.
With responsibilities, come rights. Individuals have the right to clear, complete, accurate, and age appropriate information about pregnancy, pregnancy prevention, and parenting. Individuals have the right to safe, healthy, and respectful relationships. Individuals have the right to respectful, compassionate, and informed health care providers and services.
It is our own personal choices and commitments that will make the difference in our health and the health of our communities. Unless we all take greater responsibility for ourselves, our families and our communities, our collective health will not improve. Each person must be encouraged to see that preventing unintended pregnancies is within his/her control.
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About the Author
Dr. Kimberlydawn Wisdom is the Surgeon General of Michigan. She practiced medicine for 20 years at the Henry Ford Health System in Detroit, MI. She also founded and directed both the Institute of Multicultural Health at Henry Ford Health System and a National Minority Quality Forum award-winning community-based health screening initiative entitled AIMHI (African-American Initiative for Male Health Improvement) focused on improving the health of those disproportionately affected by poor health outcomes — African-American men. She is an Assistant Professor of Medical Education at the University of Michigan Medical Center and serves as adjunct Assistant Professor in the Department of Health Behavior and Health Education at the University of Michigan School of Public Health.
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