Examining pathways by which socioeconomic instability in adolescence influence sexual health during emerging adulthood in an agricultural setting in California

Abstract

This study investigates the longitudinal impact of socioeconomic instability on teen pregnancy and sexually transmitted infection (STI) diagnosis among adolescents and young adults (AYA) living in an agricultural region and examines pathways including supportive family and social structures, decision making autonomy in romantic relationships, health access, mental health and coping behaviors, and perceptions of future opportunities. Data were drawn from A Crecer, an 8-year cohort study in Salinas, California (2015-2023). Outcomes of teen pregnancy (<20 years) and STIs were measured using self-report and biological testing. Socioeconomic instability was defined as experiencing severe crowding, food insecurity, or housing instability at baseline. Log-binomial regression models estimated associations, and causal mediation analyses explored mediation pathways. Among 373 participants (median age 13.7; 96% Latine), socioeconomic instability was associated with teen pregnancy (RR 2.28, 95% CI 1.38-3.75) and STIs (RR 3.25, 95% CI 1.77-5.99). Housing instability, in particular, had strong associations with both pregnancy (RR 2.07; 95% CI 1.23, 3.48) and STIs (RR 2.38; 95% CI 1.33, 4.29). No statistically significant mediators were identified. Findings highlight the need for early economic and housing policy interventions to support AYA and their families early in adolescence to promote sexual health during the transition to adulthood.