Teen Pregnancy Prevention 101: Setting the StageSetting the Stage

National Conference of State Legislatures

Ron Haskins

September 8, 2011

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T P O iTeen Pregnancy: Overview

• The Problem: Trends and Comparisons• The Problem: Trends and Comparisons• Impacts of Teen Pregnancy:

On po ert– On poverty– On mothers– On children– On public spending

• Successful Programs• Federal Support for State and Local Programs• State Action Options

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i h i h i dTeen Birth Rate in the United States, 1985-2009

70

50

60

40

50

Per 1

,000

Wom

en

20

30

Birt

h R

ate

P

0

10

1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 20091985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009Year

Source: Stephanie Ventura and Brady Hamilton, "US Teenage Birth Rate Resumes Decline," NCHS Data Brief no. 58 (February 2011). Available at http://www.cdc.gov/nchs/data/databriefs/db58.htm.

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Birth Rates for Unmarried Women byBirth Rates for Unmarried Women by Age of Mother, 1980-2008

90

70

80

Ages 15–17

Ages 18–19

50

60

r 1,0

00 W

omen Ages 20–24

20

30

40

Birt

hs P

e

0

10

20

Source: Forum on Child and Family Statistics, “Table FAM2.A: Births to Unmarried Women: Birth Rates for Unmarried Women by Age of Mother, Selected Years 1980-2009,” America’s Children: Key National Indicators of Well-Being, 2011, http://www.childstats.gov/americaschildren/tables.asp.Note: 2005 data not included.

019801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008

Year

5

Teen Birth Rates for Selected Countries,Teen Birth Rates for Selected Countries,2004-2008

42 5United States

14 115.9

17.126.7

31.742.5

CPortugalAustralia

United KingdomNetherlands

United States

9.810.2

12.013.614.1

GermanyFranceGreece

SpainCanada

5 96.06.8

8.69.39.8

S dDenmark

ItalyFinlandNorway

y

4.35.15.9

0 10 20 30 40 50

SwitzerlandJapan

Sweden

Teen Birth Rates Per 1,000 WomenSource: United Nations Statistics Division, “Table 10: Live Births by Age of Mother and Sex of Child, General and Age-Specific Fertility Rates: Latest Available Year, 1999-2008,” Demographic Yearbook 2008 (Latest Available as of 8/30/2011).Note: For all countries other than United States, rates are for mothers 15-19. US figure is for all women under age 19.

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T Bi h R b E h i i 1980 2009*Teen Birth Rates by Ethnicity, 1980-2009*120

100.8

97.8

82.290

omen

70.1

59.0

55 5

60

e Pe

r 1,0

00 W

o

HispanicBlack 55.5

39.9

26.7

30Birt

h R

ate Black

American IndianNon-Hispanic White

0

Year*Data for 2009 are preliminary.Sources: Ventura, S.J., Mathews, T.J, & Hamilton, B.E. (2001). Births to Teenagers in the United States: 1940-2000. National Vital Statistics Reports, 49(10); Martin, J.A., Hamilton, B.E., Ventura, S.J., Menacker, F., Park, M.M., & Sutton, P.D. (2002). Final Data for 2001. National Vital Statistics Reports, 51(2);Martin, J.A., Hamilton, B.E., Sutton, P.D., Ventura, S.J., Menacker, F., & Kirmeyer S., (2006). Final Data for 2004. National Vital Statistics Reports, 55(1);Hamilton, B.E., Martin, J.A., & Ventura, S.J. (2010). Preliminary Data for 2009. National Vital Statistics Reports, 59(3).

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Percent of All Births to Unmarried Women,Percent of All Births to Unmarried Women, 1940-2009

4541.0

35

40

45

20

25

30

nt o

f Birt

hs

10

15

20

Perc

en

3.8

0

5

40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86 88 90 92 94 96 98 00 02 04 06 08

194

194

194

194

194

19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 20 20 20 20 20

Year

Source: CDC, National Vital Health Statistics.

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Impacts: On PovertyImpacts: On Poverty

9

Percent of Children Living inPercent of Children Living in Single-Parent Families, 1970 - 2010

3026.6

25

30

en

11 9

15

20

nt o

f Chi

ldre

11.9

5

10

Perc

en

0

Source: U.S. Census Bureau, Families and Living Arrangements, Table CH-1, "Living Arrangements of Children Under 18 Years Old: 1960 to Present," (available at: http://www.census.gov/population/www/socdemo/hh-fam.html).Note: Beginning in 2007, the CPS introduced new parent pointer variables which likely explains the disruption to the trend.

Year

10

Poverty Rates for Children in Female-HeadedPoverty Rates for Children in Female Headed and Married-Couple Families, 1975 - 200940

32.529.9

30

35

erty

15

20

25

nt in

Pov

e

Married-Couple Families Female Headed Families

6.15

10

15

Perc

en Female-Headed Families

5.8

0

5

Year

Source: U.S. Census Bureau, Income, Poverty, and Health Insurance Coverage in the United States: 2009 (U.S. Department of Commerce, 2010 ), Table B-3.

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Chances of Growing Up in PovertyChances of Growing Up in Poverty Associated with Circumstances of Teen Births

6470 64

50

60

Perc

ent)

27

42

30

40

50

Pove

rty

(P

7

27

10

20

30

ance

s of

P

7

0

10

None If One If Two If Three

Cha

If Teen Birth, Unmarried, No High School Degree

Source: National Campaign to Prevent Teen and Unplanned Pregnancy.

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Impacts: On MothersImpacts: On Mothers

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I M h ’ Ed iImpacts: Mothers’ Education

• Only 40% graduate from high school• Only 40% graduate from high school• Less than 2% have a college degree by age 30

T hi h h l d t lik l t• Teen high school dropouts are more likely to become pregnant61% f i ll d h h• 61% of community college students who have children after enrolling don’t finish their d ti (65% hi h th th h d ’teducation (65% higher than those who don’t

have children)

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I F CImpacts: Foster Care

• Half of girls in foster care become pregnant by• Half of girls in foster care become pregnant by age 19

• Compared to mothers age 20 21 young teen• Compared to mothers age 20-21, young teen mothers 2.2 times more likely to have a child placed in foster care by age 5placed in foster care by age 5

• Delaying birth from age 17 or earlier to age 20-21 would reduce foster care placement rate by21 would reduce foster care placement rate by 8%

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Impacts: On ChildrenImpacts: On Children

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Development of ChildrenDevelopment of Children from Nonmarital Births

M f I t N b f St di N ti Eff t f Si lMeasure of Impact Number of Studies Negative Effects of Single Parenting or Instability

Cognitive Development 3 2 of 3Behavior Problem 7 6 of 7Health (obesity, asthma, low birth rate, overall health rating)

6 6 of 6

rating)Child Abuse 2 2 of 2

Source: Waldfogel, Craigie, and Brooks-Gunn, 2010, p. 96.Note: These results are taken from 14 studies of child outcomes using data from the Fragile Families and Child Wellbeing Study (Sara McLanahan and others, eds., “Fragile Families,” The Future of Children 20, no. 2 (Fall 2010).

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Children of Teen MothersChildren of Teen Mothers Have A Wide Range of Problems

As compared with children born to older mothers childrenAs compared with children born to older mothers, children born to teen mothers:• More likely to be to have low birth weight and a host of

associated conditions (blindness, deafness, cerebral palsy, hyperactivity)Higher rates of abuse and neglect• Higher rates of abuse and neglect

• Sons more likely to end up in prison• Daughters more likely to become teen mothers• Daughters more likely to become teen mothers

themselves• Do worse in school• Be impulsive, suffer from anxiety, have low self-esteem

Source: National Campaign to Prevent Teen and Unplanned Pregnancy.

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Public CostsPublic Costs

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N i l C f T Bi hNational Costs of Teen Births

• Public health care: $2 3 billion• Public health care: $2.3 billion • Child Welfare: $2.8 billion

I ti $2 3 billi• Incarceration: $2.3 billion• Lost tax revenue: $3.2 billion

Total $10.9 billion

Source: National Campaign to Prevent Teen and Unplanned Pregnancy.Note: The sum of individual costs does not add to total because total includes costs attributable to mothers.

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Effective Teen Pregnancy Prevention Programs

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Ch i i f Eff i PCharacteristics of Effective Programs

• A focus on both abstinence and birth control• A focus on both abstinence and birth control• Knowledge and beliefs about sex and the

norms surrounding sexual activitynorms surrounding sexual activity• Knowledge about contraception

Skill i idi l d b• Skills in avoiding sexual advances by partners• Mentoring by adults• Participation in community activities, especially

during after-school hours

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Federal Support for State and Local Programs

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Overview of Federal ProgramsOverview of Federal Programs to Reduce Teen Pregnancy

Program Brief Description Funding Administering AgencyAgency

Teen Pregnancy Prevention (Evidence-based)

Competitive grants; mostly approved model programs; 2 tiers offunding; 94 grants

$105 million(2011)

Office of Adolescent Health

Community-wide 9 cooperative agreements for $10 million Centers for DiseaseCommunity wide 9 cooperative agreements for community-wide programs; 5 support grants

$10 million Centers for Disease Control

Personal ResponsibilityEducation Program

•Formula grants for states to implement evidence-based

$55 million(5 years)

Administration for Children and Families

(PREP) programs (44 states)

•Competitive grants to public and private entities to test innovative strategies (13 grants)

$10 million(5 years)

$•Funds for Indian tribes $3.5 million(5 years)

Title V Abstinence Education

Formula grants to states for abstinence education programs

$50 million Administration for Children and Families

$Adolescent Family Life Grants to public or private entities to provide comprehensive health education and social services to adolescents; focused on abstinence

$12 million Office of Adolescent Pregnancy

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State PolicyState Policy

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B ildi C h i SBuilding a Comprehensive Strategy

• Parents• Parents• Teachers

S h l d C it C ll• Schools and Community Colleges• Children, Teens, Young Adults• Hospitals, Clinics, Physicians• Media

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Programs:Programs:• Medicaid• Title X (4 500 clinics; $317 million)Title X (4,500 clinics; $317 million)• Teen Pregnancy Prevention• Community WideCommunity Wide• PREP• Abstinence Education• Adolescent Family Life• Other Programsg