Highlights from the most recent edition of the Cascadia Scorecard.

Average family size (lifetime births per woman or, more precisely, the “total fertility rate”) is an excellent gauge of women’s—and families’—well-being. In nations where women have more opportunities and greater equality with men, women tend to have smaller families, later in life; in particular, they have fewer teen births and markedly lower rates of unplanned pregnancies.

Regional birth rates

• Family size varies widely around the region (see map). Idaho has the region’s largest families, with 2.3 children per woman on average, while British Columbia has the smallest, with 1.4 children. The rates for Washington and Oregon are more stable and considerably higher, but still below the US average.
• Decreasing births among young women contributed to the region’s overall 2004 stability in family size. For the second year running, Cascadia’s teen birthrate was at a record low, with just under 27 births per 1,000 teenage girls in the region.
• Births among women in their early 20s also declined. In British Columbia, births to thirtysomethings overtook births to twentysomethings in 2004—an unprecedented pattern in Cascadia.

Household composition

• Progress toward smaller, later families is shaping the composition of households. The share of Cascadian households with no children is expanding and reached 68 percent in 2000.
  
• Single-person households also roughly doubled in the region in the last half century, to more than 26 percent in Oregon and Washington and 22 percent in Idaho. 
  
• Aging baby boomers promise to expand the number of childless households. The over-65 age group currently represents 12 percent of the regional population and will rise to 20 percent by 2030.
  
• The share of the population under age 15 has also shrunk from 28 percent in 1971 to 19 percent in 2004. These trends in household composition bode well for the healthful, compact communities described in the special section on sprawl and health in the Cascadia Scorecard.
• Teen births have declined to what are all-time lows in every state and province of the Northwest. Teen birthrates in British Columbia are the lowest in the region by far, at 13 births per 1,000 teenage women.

Contraceptive access

• Insurance coverage for prescription contraceptives has improved markedly over the past decade. From 1993 to 2002, the percentage of US employer-paid health plans with prescription drug benefits that pay for all prescription contraceptives soared from 28 percent to 86 percent. In California and Washington, state law dictates that all such plans must do so.
• Enacting similar rules in other Cascadian states would prevent thousands of unplanned pregnancies each year. Insurance coverage for prescription contraceptives increases the share of couples who use the most effective forms of contraception.
• Access to emergency contraceptive pills gained significant ground in the region, with emergency contraceptive pills now available from pharmacies without a doctor’s prescription in Alaska, California, British Columbia, and Washington. 
• To expand these gains, the US Food and Drug Administration (FDA) can, like its Canadian and British counterparts, approve emergency contraceptives as nonprescription medicine.
  
• Although contraceptive access has improved, nearly 40 percent of births in the Northwest states still result from mistimed and unwanted pregnancies. Read about the range of powerful, compounding benefits that come from ensuring every child born is wanted.