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The state of Massachusetts has one of the lowest teen pregnancy and birth rates in the country, but the city of Holyoke has rates that compare to the states that have the highest. For many years, the city of Holyoke has ranked number one in the state of Massachusetts with the highest teen pregnancy and birth rates. The disparity between the state and city rates was shocking and spearheaded the creation of the Holyoke Adolescent Sexual Health and Pregnancy Prevention Task Force.