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Teen Pregnancy Prevention

Teen Pregnancy Prevention

7/11/2014

Introduction

Since the 1990s, teen pregnancy in the United States has declined 51 percent. The teen birth rate is down 57 percent. Both have reached historic lows. Downward trends span all 50 states and all racial and ethnic groups. Yet teen pregnancy, abortion and birth rates in the United States for teens age 15 to 19 remain among the highest in the industrialized world. Three in 10 girls will be pregnant at least once before their 20th birthday. One in five teen moms will have a second child during her teen years. Significant disparities also persist across racial and ethnic lines, geographic regions, rural and urban areas and among age groups.

Adolescent pregnancy and parenthood are closely associated with a host of social and economic issues that affect teen parents, their children and society. Teenage mothers are less likely to finish high school and are more likely to live in poverty, depend on public assistance, and be in poor health than slightly older mothers. Their children are more likely to suffer health and cognitive disadvantages, come in contact with the child welfare and correctional systems, live in poverty, drop out of high school and become teen parents themselves. According to a recently updated analysis by the National Campaign to Prevent Teen and Unplanned Pregnancy, the annual public cost of teen childbearing—due to the cost of public health care, foster care, incarceration and lost tax revenue—is nearly $9.4 billion.

 

Teen Birth Rate Among Girls Aged 15-19, 2012

Birth rate per 1,000 teen girls, aged 15 -19
Less than 21 21 - 30 31 - 40 41 - 50 51
 

 Teen Pregnancy Affects Educational Achievement

High School Completion
Teen pregnancy and parenting are significant contributors to high school drop-out rates among teen girls. Thirty percent of teenage girls who drop out of high school cite pregnancy or parenthood as a primary reason. This rate is even higher for Hispanic and African American teens, 36 and 38 percent, respectively. Overall, only 40 percent of teen moms finish high school and less than two percent—of those who have a baby before age 18—finish college by age 30.

Intergenerational Impact: Children of Teen Parents
The mother’s education is not the only victim of teen childbearing; children born to teen moms often do not perform as well as children of older mothers on early childhood development indicators and school readiness measures, such as communication, cognition and social skills. Research shows that children of teen mothers not only start school at a disadvantage, they also fare worse than those born to older parents later on. For example, children born to teens have lower educational performance, score lower on standardized tests, and are twice as likely to repeat a grade. Additionally, only around two-thirds of children born to teen mothers earn a high school diploma, compared to 81 percent of children born to adults.

Older Teens & Community College
The pregnancy rate for women aged 18 to 19 is three times higher than that of younger teens and the birth rate for older adolescents is more than three and a half times that of their younger peers. Older teens account for nearly 500,000 pregnancies and 234,000 births each year. Nearly 25 percent of births to women in this age group are teens who have previously given birth, greatly increasing the challenges for these mothers and their children. With almost 70 percent of 18- and 19-year-olds attending either high school or college, unplanned pregnancies can disrupt or derail educational achievement. Sixty-one percent of women who have children after enrolling in college fail to complete their degree, a rate which is 65 percent higher than that for students who did not have children. In addition, surveys indicate that close to half of all community college students have been pregnant or gotten someone pregnant at some point. 

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Economic Wellbeing and the Cycle of Poverty

Poverty is both a cause and a consequence of teen pregnancy and childbearing. Two-thirds of young unmarried mothers are poor and around 25 percent go on welfare within three years of a child’s birth. Low educational attainment among teen mothers affects their economic opportunities and earnings in later years. Teen mothers are less likely to complete high school or college, and are therefore less likely to find well-paying jobs. This reality is evident in the fact that over the past 20 years, the median income for college graduates has increased 19 percent, while income among high school drop-outs has decreased 28 percent.The economic consequences of dropping out of school often contribute to the perpetual cycle of economic hardship and poverty that spans generations.

Only around 20 percent of fathers of children born to teen mothers marry the mothers. Therefore, child support generally represents a vital income source for these single parent families, accounting for 23 percent of family income among families that receive it. However, teen fathers may pay less than $800 a year in child support, compounding financial difficulties for the parent responsible for day to day care. Teen fathers are often poor themselves; research indicates that they are also less educated and experience earning losses of 10-15 percent annually.

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Teen Pregnancy Among Youth in Foster Care

Teen pregnancy rates are much higher among teens in foster care than among the general population. By age 19, pregnancy rates for girls in foster care are 2.5 times greater than that of their peers who are not in the system. Nearly half of girls in foster care become pregnant at least once by their 19th birthday and around 75 percent report being pregnant by age 21, compared to only one-third of their peers. In addition, by age 21, nearly two-thirds of teens in foster care have been pregnant more than once. Young men in foster care also report having gotten someone pregnant at higher rates than young men not in the system: 50 percent of men aging out of foster care at age 21 say that they have gotten someone pregnant, compared to 19 percent of young men not in foster care. 

Pregnancy among adolescents in foster care creates challenges and costs for the system, such as providing health care and housing for teen mothers and their children. Currently, states may provide Medicaid—public health insurance jointly funded by states and the federal government—to finance prenatal care, delivery costs, and other health care services for foster children up to age 21. By 2014, however, the Affordable Care Act will extend Medicaid coverage to all young people in foster care, up to age 26. 

Many teens “age out” of the system when they reach age 18 or 21, depending on the state. Teen parents transitioning out of foster care face significant challenges: caring for their children, completing education and finding employment. And the cycle often continues. The children of teen mothers are twice as likely to be placed in foster care as their peers born to older parents.

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Federal Funding

Personal Responsibility Education Program
Administered by the Administration on Children, Youth, and Families, the Personal Responsibility Education Program (PREP) provides $75 million annually for FY 2010–2014 to fund evidence-based programs that emphasize both abstinence and contraception and educate adolescents on how to prevent pregnancy and sexually transmitted infections. All states and territories are eligible to apply for a minimum of $250,000 per year. Programs are required to educate youth ages 10-19 about responsible sexual behavior and must also address at least three of the following topics: healthy relationships, adolescent development, financial literacy, parent-child communication skills, education and employment preparation skills, and healthy life skills. Curricula must be medically accurate and age appropriate and programs must target young people who are at a higher risk for teen pregnancy.

  • In 2010, 2011 and 2012, 45 states, the District of Columbia, Puerto Rico, the Virgin Islands and the Federated States of Micronesia accepted PREP funds. For the five states and three territories that chose not to apply for funding in the first two years, funding was made available on a competitive basis to other organizations in each state or territory. Grantee lists are available for 2010 and 2011, and 2012.
  • In 2012, Competitive PREP Grants were awarded to organizations in Florida, Indiana, North Dakota, Texas, Virginia, American Samoa, Guam, and the Northern Mariana Islands—the states and territories that chose not to pursue state PREP funds. A list of competitive PREP recipients is availablehere
  • PREP also provides $10 million annually for competitive Personal Responsibility Innovative Strategies (PREIS) grants to public and private entities to develop, replicate, refine and test innovative strategies to reduce teen and repeat pregnancies. A list of 2011 grantees is available here.
  • In addition, PREP provides $3.5 million for Tribal PREP Grants, on a competitive basis, to Indian tribes or tribal organizations. Sixteen tribes and organizations received funding to develop teen pregnancy prevention programs over a four-year period. A list of 2011 grantees is available here

Title V State Abstinence Education Grant Program
The Abstinence Education Program has existed in its current form since 1996, although program funding lapsed briefly in 2009. The Affordable Care Act renewed funding through FY 2014. A 43 percent state match is required. States may use funds for abstinence education, mentoring, counseling or adult supervised activities. While states are encouraged to use evidence-based programs and are required to address each point in the eight-point definition of abstinence education, individual states may determine how much emphasis to place on each point. Programs must be medically accurate and focus on youth at high risk of teen pregnancy, including homeless teens, those in or aging out of foster care, or who live in geographic areas with high teen birth rates.  A list of Title V program awards is available here.

  • In FY 2010, 29 states and Puerto Rico accepted nearly $33.5 million in grants for abstinence education.
  • In FY 2011, 34 states, Guam, Puerto Rico and the Federated States of Micronesia accepted about $37.5 million.
  • In FY 2012, 36 states, Guam, Puerto Rico and the Federated States of Micronesia accepted nearly $40 million.
In FY 2012, $5 million was added for a Competitive Abstinence Education Grant Program. This funding uses the eight-point definition described above and requires programs to be medically accurate, but does not have requirements related to evidence. The nine programs that received funding focus on abstinence education, and where appropriate, mentoring, counseling and adult supervision. A list of grantees is available here. 

Teen Pregnancy Prevention Program

Administered by the Office of Adolescent Health, the Teen Pregnancy Prevention Program provides competitive grants to a wide range of agencies and organizations for both evidence-based programs and research and demonstration programs that develop, implement or refine innovative strategies for preventing teen pregnancy. Grants run for five years, subject to federal appropriations, and were initially funded at $110 million in FY 2010. In FY 2011, funding was cut to $105 million. The program includes two “tiers.”

  • Tier 1 grants replicate teen pregnancy prevention programs that have proven effective through rigorous evaluation. Funded entities choose a program model based on community needs. Every program undergoes independent, systemic review to develop addition information on the model. In 2011, $75 million was available for tier 1 grants. A list of OAH evidence-based programs is available here.
  • Tier 2 grants develop, replicate, and refine new and innovative models to reduce teen pregnancy. $25 million was available for tier 2 grants in 2011.
  • The final $5 million goes to program support, evaluation, training and technical assistance to grantees. Additional information on the OAH Teen Pregnancy Prevention Program is available here

Community-Wide Initiatives to Reduce Teen Pregnancy, Centers for Disease Control and Prevention
Funded with $10 million from the Teen Pregnancy Prevention “Tier 2” grants described above, the Office of Adolescent Health and the Centers for Disease Control and Prevention awarded competitive grants to eight state and local organizations, and five national organizations. These entities will work together to support community-wide strategies that reduce teen pregnancy by promoting the use of evidence-based programs, educating community leaders, and connecting youth to clinical services. More
 
Pregnancy Assistance Fund
In July 2013, the Department of Health and Human Services awarded competitive Pregnancy Assistance Fund grants, totaling $21.6 million, to 17 states and tribes to support pregnant and parenting teens and women continuing their education. The Pregnancy Assistance Fund offers pregnant and parenting teens and women a continuous network of support services to assist them in completing educational degrees, whether high school or postsecondary, and to obtain and retain access to health care, family housing and other essential supports. Funds may also be used to combat violence against pregnant women. Through the Pregnancy Assistance Fund, states work with a broad range of stakeholders—such as high schools, institutions of higher education and community organizations—to provide these key services to pregnant teens and women who carry their pregnancies to term, and to parenting mothers. In 2010, 17 states were awarded $24 million in Pregnancy Assistance Funds. More

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