A Key Step Forward in Overhauling U.S. Teen Pregnancy Prevention Efforts

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On September 30, the Obama administration awarded $155 million in federal grants to state governments, nonprofit organizations, school districts and universities to support evidence-based teen pregnancy prevention efforts. Programs funded through these grants are required either to replicate already proven programs or to support innovative, promising approaches to reducing teen pregnancy. Programs are further required to be medically accurate and age appropriate.

The grant announcement marks a key milestone in the administration’s ongoing overhaul of U.S. teen pregnancy prevention efforts, under which significant funding has been shifted away from rigid and ineffective abstinence-only programs and toward more comprehensive and evidence-based approaches. It also marks a major victory for evidence-based policymaking, after a decade in which the federal government spent well over $1.5 billion promoting abstinence-only-until-marriage programs that were prohibited by law from discussing the benefits of contraception.

However, the good news is tempered by the survival of the highly controversial and largely discredited Title V abstinence-only program, which will continue to make available $50 million annually for states to promote abstinence-only education. The program expired in June 2009, only to be quietly resuscitated for another five years as part of health care reform in March 2010. The Obama administration, which had been on the record opposing the program, has issued guidelines to somewhat soften the program’s potential harm, for instance by requiring curricula to be medically accurate and by making clear that a state may not present information as factual when it reflects only a value or opinion. Still, even these guidelines may not prevent a state from implementing rigid abstinence-only programs.

Perhaps the best illustration that sound policies can have a significant impact in reducing teen pregnancy comes from California. The state’s teen pregnancy rate declined by 52% between 1992 and 2005, the steepest drop registered by any state over that period—and far larger than the national decline of 37%. Public health experts credit this record decline to California’s aggressive and evidence-based policies dating back to the 1990s, including comprehensive sexuality education, contraceptive services that are particularly well suited to address the needs of adolescents, private-sector involvement, and bipartisan support for evidence-based policies. Notably, California is also the only state that never accepted federal abstinence-only dollars under the rigid Title V abstinence-only program.

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The overhaul of U.S. teen pregnancy prevention efforts

The Title V abstinence-only program

California’s concerted effort to reduce teen pregnancy