month ago, the federal government sent a “Dear John” letter to the Children’s Hospital Los Angeles.
“Due to changes in program priorities,” the letter began, “it has been determined that it is in the best interest of the Federal government to no longer continue funding” the grant for one of our hospital’s teen pregnancy prevention programs. This one-page form letter, sent from the Department of Health and Human Services, arrived almost a year to the day that HHS initially approved our five-year project with glowing reviews about how the Children’s Hospital Los Angeles is “recognized for innovative service and training models, leadership in community collaboration, and research regarding adolescent issues” and has “over 50 years of experience in implementing programs in safe and supportive environments for youth and their families.”
This teen pregnancy prevention program, which we oversee, wasn’t the only one to be abruptly dumped. The Trump administration withdrew nearly $214 million from 80 HHS-funded teen pregnancy prevention programs across the country. The HHS didn’t give us a reason for the decision.
So far, the only explanation we’ve been able to glean is an HHS statement to the Associated Press reportedly saying that only four of 37 programs they evaluated had shown evidence of lasting positive impacts, while the other 33 programs had no effect or were harmful.
To this day, we don’t know, nor do our colleagues in the teen pregnancy prevention community, exactly why these cuts were made. Not even our U.S. senators seem to know.
As an organization that has been involved in developing, implementing, and evaluating teen pregnancy prevention programming for more than 30 years, Children’s Hospital Los Angeles is deeply concerned about the long-term effects these cuts will have on teen birth rates and on the lives and health of young people around the country.
Before we go on, let us be clear: Teen pregnancy is still a problem in the United States. Our country has the highest teen birth rate — 57 per 1,000 females ages 15 to 19 — among 20 countries with complete birth statistics. In 2015, 230,000 babies were born to women ages 15 to 19. And less than 5 percent of sexually active teens use the most effective forms of birth control.
That said, the teen birth rate in the U.S. has been dropping, and hit an all-time low in June 2017. The Centers for Disease Control and Prevention and the American Congress of Obstetricians and Gynecologists credit evidence-based teen pregnancy prevention programs with this dramatic decline.
So we’re confused by claims that these programs aren’t working. And we don’t understand why the administration is choosing to bulldoze them just as we are getting a handle on the issue.
It’s possible that our country’s successes in curbing teen pregnancy have led some to believe that such cuts will allow us to save money on a problem that has already been solved. That couldn’t be further from the truth.
The funding that Children’s Hospital Los Angeles lost would have helped us train and work with other HHS grantees to ensure that their teen pregnancy prevention programs continue to adapt and respond to new challenges, like reaching populations often neglected in the past like LGBT youth; being more responsive to the needs of youth who have experienced past trauma; and promoting more authentic youth-adult partnerships where young people are actively involved and not just passive consumers of information.
Unlike the sex education programs that many of us endured between the 1950s and the 1990s, those funded by HHS in the last decade have been more targeted and more accountable than ever. They focus on delivering medically accurate and comprehensive sex education, and require that grantees use interventions and methods proven to be effective. Today’s programs include multiple sessions; interactive and engaging curricula; and focus on life skills like decision-making, communication, and goal-setting.
The HHS decision to de-fund these programs:
- takes a big step away from evidence-based interventions
- will slow or stop the momentum needed to reduce early and unplanned teen pregnancies
- represents a significant disinvestment in the lives and health of adolescents nationally, particularly those living in poverty and in under-resourced communities.
For young women and young men, early childbearing is significantly linked with dropping out of school. That means teen pregnancy prevention programs do more than just prevent youths from becoming parents. These programs prevent poverty and teach youth the core skills needed to make healthy choices. In essence, they help create successful adults.
Preventing teen pregnancy is a long-term investment in our future. That’s why we ask HHS to revisit their “changes in program priorities” and we urge Congress to help restore and ensure continued funding of teen pregnancy prevention grants.
If we aren’t investing in our young people, who are we investing in?
Marvin E. Belzer, M.D., is director of the Division of Adolescent and Young Adult Medicine at Children’s Hospital Los Angeles and a professor of clinical pediatrics and medicine at the Keck School of Medicine of USC. Arlene Schneir is the administrator of the Division of Adolescent and Young Adult Medicine at Children’s Hospital Los Angeles.