Certain health issues are linked to others in a never-ending circle of choice and consequence.

Dr. Albert Woolbright, who works in the Center for Health Statistics within the Alabama Department of Public Health, said poverty is a factor in teen pregnancy, which is in turn a factor in low birthweight and infant mortality.

According to the ADPH, in Pike County, 9.2 percent per 1,000 babies were born with a low birthweight and infant mortality rates were at 12 percent in 2001.

The solutions to these health problems start when children are still young.

As Sheppard said, a many of the numbers are a result of poor education.

Teaching children proper nutrition and the consequences of their decisions will help start a downward trend in teen pregnancies and other related issues.

What does Woolbright suggest?

"Increasing their self-esteem and giving them a future and a reason to not get pregnant," he said.

"Also, keep them in school and convince parents to be involved."

He said there is some truth to the commercials on television that encourage parents to ask questions and know where their children are and what they are doing.

"Parents who show an interest seems to be a deterrent," he said.

"Developing a rapport is important."

Woolbright said the health department also has a program called Plan First, which targets low-income mothers to prevent unintended pregnancies.

"We provide contraceptives and we have social workers to council (the women) about the advantages of delaying pregnancies."

Sheppard said the efforts of the AIM Project, which encourages abstinence before marriage, has been well received in Pike County.

"We teach 7th, 8th, 9th and 10th graders in five counties about making healthy choices to have brighter futures," she said.

Educators at AIM work to teach adolescents about the physical and emotional consequences of pre-marital sex.

"The reaction is very, very positive," she said.

"They are listening and understanding that the only safe sex is no sex."

She said even if a condom prevents pregnancy, it won't always prevent a sexually transmitted disease.

Both Woolbright and Sheppard said there is a long way to go before the numbers see drastic improvement.

"It's a tough battle," Sheppard said.

"Everybody pushes sex so much on television, in movies and in music.

It's a struggle to reach the youth."