We are pretty sure of our stereotypes in this country, and we hold them close.
One of them is that teen pregnancy is an inner-city problem, a poor problem, a black problem.
Another is that "rural" equals "farm," and life there is wholesome and God-fearing.
Like so many of the things we believe to be true, these aren't. Not exactly.
New research from the National Campaign to Prevent Teen and Unplanned Pregnancy reveals that the teen birth rate is a third higher in rural counties than in other areas of the country, regardless of age, race or ethnicity. Rural counties account for 1 in 5 teen births, even though they make up only 16 percent of the overall teen population.
"The prevailing stereotype of the young mother continues to be a young, urban person," said Bill Albert, chief program officer for the campaign. "What the data suggests is something quite different.
"As it turns out, teen pregnancy is more rural than concrete jungle."
For a while now, organizations like the campaign have been asked what was going on outside the city limits, and they had to say, frankly, they didn't know. There was just no data.
New statistics from the Centers for Disease Control and Prevention from 2010, sifted by the National Campaign's research staff, show that the number of teen pregnancies remains highest in the areas of highest population.
"But look at rates, as opposed to numbers, and you have a very different picture," Mr. Albert said.
The first task here might be to define "rural." We are not just talking the family farm. Rural counties are defined by their proximity to population centers, but the economic activity can cover quite a range.
So, Mr. Albert said, the stereotype that farm kids get each other pregnant because there is nothing better to do is equally uninformed.
Then why are the numbers higher?
"It is unlikely that any single reason explains the difference in teen birth rates," said Albert. It is probably a combination of factors, including poverty, education levels and access to clinical care, access to insurance.
"And," he said. "It may be simply that teens are unlikely to ask for condoms at a store where everybody working there knows you and your parents."
It is also possible that these pregnancies are not all unintended. That women in rural areas are more likely than their suburban peers to be actively seeking to start a family. The difference in teen birth rates between rural counties and other counties is particular pronounced among teens 18 and 19 years old.
The fact is, the news about teen pregnancy in this country continues to be good — rates are still dropping in cities and in rural areas — just not as fast in rural areas. It might be the biggest public health success story of the last 20 years, considering the lifelong detriment suffered by children born to children.
The reason for this success appears to be that teens overall are having less sex and using more contraception. "In the rural counties," Mr. Albert said, "it appears to be more sex and less contraception."
This research is step one, he said. "It may be that this is not news to anybody living in a rural area. It may only be news to those of us who pontificate from urban areas.
"But no one will work on a problem they don't know exists. You have to convince parents and policymakers that the problem is there."
From here, the action plan is familiar: Convince parents that we still have great influence with our teens and, attitudes and ear buds aside, the kids want to know what we think, what we believe.
That if we tell them that they are too young for sex and it can break their hearts, they will hear us. If we help them with access to contraception — while telling that it is protection, not permission — they will understand this message.
That if we tell them that their futures (and the futures of the children they may ever have) depend on delaying pregnancy until their education is complete, they will give our ideas thought.
And if we tell them that marriage is not some old-fashioned notion, but a framework for making the best life for them and their children, that they will believe us.
Susan Reimer's columns appear on Mondays and Thursdays. She can be reached at email@example.com and @SusanReimer on Twitter.com